Effects of bite-jumping appliances on mandibular advancement in growing rats: A radiographic study

PubMed Central

Oksayan, Ridvan; Sokucu, Oral; Ucuncu, Neslihan

2014-01-01

Objective: The aim was to evaluate the effects of the use of mandibular advancement appliances on mandibular growth in growing rats. Materials and Methods: Twenty-four 8-week-old male Wistar albino rats were randomly divided into two experimental groups (12 rats each): Group I was a control group, and Group II was the mandibular advancement appliance group. A functional bite-jumping appliance was used in Group II to promote mandibular advancement. Anatomical changes in the condyle and mandible were evaluated by comparing radiographic results from before and after the study, with angular and linear measurements. Friedman and Mann-Whitney U-tests were used in statistical analysis. Results: According to the radiographic results, the growth of mandibles and condyles in Group II was significantly greater than with the length of the condylar process (A-B) and distance from condyle to menton (A-D) variables (P < 0.05). In addition, Group I showed greater mandibular base growth than did Group II (P < 0.05). Conclusions: We conclude that the use of an intraoral bite-jumping appliance can stimulate condylar growth and increase sagittal mandibular advancement in growing rats. PMID:25202205

Effect of KRAS codon13 mutations in patients with advanced colorectal cancer (advanced CRC) under oxaliplatin containing chemotherapy. Results from a translational study of the AIO colorectal study group

PubMed Central

2012-01-01

Background To evaluate the value of KRAS codon 13 mutations in patients with advanced colorectal cancer (advanced CRC) treated with oxaliplatin and fluoropyrimidines. Methods Tumor specimens from 201 patients with advanced CRC from a randomized, phase III trial comparing oxaliplatin/5-FU vs. oxaliplatin/capecitabine were retrospectively analyzed for KRAS mutations. Mutation data were correlated to response data (Overall response rate, ORR), progression-free survival (PFS) and overall survival (OS). Results 201 patients were analysed for KRAS mutation (61.2% males; mean age 64.2 ± 8.6 years). KRAS mutations were identified in 36.3% of tumors (28.8% in codon 12, 7.4% in codon 13). The ORR in codon 13 patients compared to codon 12 and wild type patients was significantly lower (p = 0.008). There was a tendency for a better overall survival in KRAS wild type patients compared to mutants (p = 0.085). PFS in all patients was not different in the three KRAS genetic groups (p = 0.72). However, we found a marked difference in PFS between patients with codon 12 and 13 mutant tumors treated with infusional 5-FU versus capecitabine based regimens. Conclusions Our data suggest that the type of KRAS mutation may be of clinical relevance under oxaliplatin combination chemotherapies without the addition of monoclonal antibodies in particular when overall response rates are important. Trial registration number 2002-04-017 PMID:22876876

40 CFR 35.4085 - Can my group get an “advance payment” to help us get started?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Can my group get an âadvance paymentâ to help us get started? 35.4085 Section 35.4085 Protection of Environment ENVIRONMENTAL PROTECTION... You Get the Money § 35.4085 Can my group get an “advance payment” to help us get started? Yes, a...

40 CFR 35.4085 - Can my group get an “advance payment” to help us get started?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Can my group get an âadvance paymentâ to help us get started? 35.4085 Section 35.4085 Protection of Environment ENVIRONMENTAL PROTECTION... You Get the Money § 35.4085 Can my group get an “advance payment” to help us get started? Yes, a...

40 CFR 35.4085 - Can my group get an “advance payment” to help us get started?

Code of Federal Regulations, 2012 CFR

2012-07-01

... You Get the Money § 35.4085 Can my group get an “advance payment” to help us get started? Yes, a... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Can my group get an âadvance paymentâ to help us get started? 35.4085 Section 35.4085 Protection of Environment ENVIRONMENTAL PROTECTION...

40 CFR 35.4085 - Can my group get an “advance payment” to help us get started?

Code of Federal Regulations, 2013 CFR

2013-07-01

... You Get the Money § 35.4085 Can my group get an “advance payment” to help us get started? Yes, a... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Can my group get an âadvance paymentâ to help us get started? 35.4085 Section 35.4085 Protection of Environment ENVIRONMENTAL PROTECTION...

40 CFR 35.4085 - Can my group get an “advance payment” to help us get started?

Code of Federal Regulations, 2014 CFR

2014-07-01

... You Get the Money § 35.4085 Can my group get an “advance payment” to help us get started? Yes, a... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Can my group get an âadvance paymentâ to help us get started? 35.4085 Section 35.4085 Protection of Environment ENVIRONMENTAL PROTECTION...

Advanced Ionospheric Sensing using GROUP-C and LITES aboard the ISS

NASA Astrophysics Data System (ADS)

Budzien, S. A.; Stephan, A. W.; Chakrabarti, S.; Finn, S. C.; Cook, T.; Powell, S. P.; O'Hanlon, B.; Bishop, R. L.

2015-12-01

The GPS Radio Occultation and Ultraviolet Photometer Co-located (GROUP-C) and Limb-imaging Ionospheric and Thermospheric Extreme-ultraviolet Spectrograph (LITES) experiments are manifested for flight aboard the International Space Station (ISS) in 2016 as part of the Space Test Program Houston #5 payload. The two experiments provide technical development and risk-reduction for future DoD space weather sensors suitable for ionospheric specification, space situational awareness, and data products for global ionosphere assimilative models. In addition, the combined instrument complement of these two experiments offers a unique opportunity to study structures of the nighttime ionosphere. GROUP-C includes an advanced GPS receiver providing ionospheric electron density profiles and scintillation measurements and a high-sensitivity far-ultraviolet photometer measuring horizontal ionospheric gradients. LITES is an imaging spectrograph that spans 60-140 nm and will obtain high-cadence limb profiles of the ionosphere and thermosphere from 150-350 km altitude. In the nighttime ionosphere, recombination of O+ and electrons produces optically thin emissions at 91.1 and 135.6 nm that can be used to tomographically reconstruct the two-dimensional plasma distribution in the orbital plane below ISS altitudes. Ionospheric irregularities, such as plasma bubbles and blobs, are transient features of the low and middle latitude ionosphere with important implications for operational systems. Irregularity structures have been studied primarily using ground-based systems, though some spaced-based remote and in-situ sensing has been performed. An ionospheric observatory aboard the ISS would provide new capability to study low- and mid-latitude ionospheric structures on a global scale. By combining for the first time high-sensitivity in-track photometry, vertical ionospheric airglow spectrographic imagery, and recent advancements in UV tomography, high-fidelity tomographic reconstruction of

Advance Approach to Concept and Design Studies for Space Missions

NASA Technical Reports Server (NTRS)

Deutsch, M.; Nichols, J.

1999-01-01

Recent automated and advanced techniques developed at JPL have created a streamlined and fast-track approach to initial mission conceptualization and system architecture design, answering the need for rapid turnaround of trade studies for potential proposers, as well as mission and instrument study groups.

40 CFR 35.4090 - If my group is eligible for an advance payment, how do we get our funds?

Code of Federal Regulations, 2010 CFR

2010-07-01

... approval of your request, EPA will advance cash (in the form of a check or electronic funds transfer) to... 40 Protection of Environment 1 2010-07-01 2010-07-01 false If my group is eligible for an advance... Assistance How You Get the Money § 35.4090 If my group is eligible for an advance payment, how do we get our...

Advanced planetary studies

NASA Technical Reports Server (NTRS)

1982-01-01

Results of planetary advanced studies and planning support provided by Science Applications, Inc. staff members to Earth and Planetary Exploration Division, OSSA/NASA, for the period 1 February 1981 to 30 April 1982 are summarized. The scope of analyses includes cost estimation, planetary missions performance, solar system exploration committee support, Mars program planning, Galilean satellite mission concepts, and advanced propulsion data base. The work covers 80 man-months of research. Study reports and related publications are included in a bibliography section.

Advanced turbocharger design study program

NASA Technical Reports Server (NTRS)

Culy, D. G.; Heldenbrand, R. W.; Richardson, N. R.

1984-01-01

The advanced Turbocharger Design Study consisted of: (1) the evaluation of three advanced engine designs to determine their turbocharging requirements, and of technologies applicable to advanced turbocharger designs; (2) trade-off studies to define a turbocharger conceptual design and select the engine with the most representative requirements for turbocharging; (3) the preparation of a turbocharger conceptual design for the Curtiss Wright RC2-32 engine selected in the trade-off studies; and (4) the assessment of market impact and the preparation of a technology demonstration plan for the advanced turbocharger.

Advanced Virus Detection Technologies Interest Group (AVDTIG): Efforts on High Throughput Sequencing (HTS) for Virus Detection.

PubMed

Khan, Arifa S; Vacante, Dominick A; Cassart, Jean-Pol; Ng, Siemon H S; Lambert, Christophe; Charlebois, Robert L; King, Kathryn E

Several nucleic-acid based technologies have recently emerged with capabilities for broad virus detection. One of these, high throughput sequencing, has the potential for novel virus detection because this method does not depend upon prior viral sequence knowledge. However, the use of high throughput sequencing for testing biologicals poses greater challenges as compared to other newly introduced tests due to its technical complexities and big data bioinformatics. Thus, the Advanced Virus Detection Technologies Users Group was formed as a joint effort by regulatory and industry scientists to facilitate discussions and provide a forum for sharing data and experiences using advanced new virus detection technologies, with a focus on high throughput sequencing technologies. The group was initiated as a task force that was coordinated by the Parenteral Drug Association and subsequently became the Advanced Virus Detection Technologies Interest Group to continue efforts for using new technologies for detection of adventitious viruses with broader participation, including international government agencies, academia, and technology service providers. © PDA, Inc. 2016.

77 FR 39564 - Group Lotus Plc, Receipt of Petition for Temporary Exemption From an Advanced Air Bag Requirement...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-03

... went into effect, low volume manufacturers now have access to advanced air bag technology. Accordingly, NHTSA has concluded that the expense of advanced air bag technology is not now sufficient, in and of...-0086] Group Lotus Plc, Receipt of Petition for Temporary Exemption From an Advanced Air Bag Requirement...

Trastuzumab beyond progression in human epidermal growth factor receptor 2-positive advanced breast cancer: a german breast group 26/breast international group 03-05 study.

PubMed

von Minckwitz, Gunter; du Bois, Andreas; Schmidt, Marcus; Maass, Nicolai; Cufer, Tanja; de Jongh, Felix E; Maartense, Eduard; Zielinski, Christoph; Kaufmann, Manfred; Bauer, Wolfgang; Baumann, Klaus H; Clemens, Michael R; Duerr, Ralph; Uleer, Christoph; Andersson, Michael; Stein, Robert C; Nekljudova, Valentina; Loibl, Sibylle

2009-04-20

Trastuzumab shows clinical activity in human epidermal growth factor receptor 2 (HER-2)-positive early and advanced breast cancer. In the German Breast Group 26/Breast International Group 03-05 trial, we investigated if trastuzumab treatment should be continued beyond progression. Patients with HER-2-positive breast cancer that progresses during treatment with trastuzumab were randomly assigned to receive capecitabine (2,500 mg/m(2) body-surface area on days 1 through 14 [1,250 mg/m(2) semi-daily]) alone or with continuation of trastuzumab (6 mg/kg body weight) in 3-week cycles. The primary end point was time to progression. We randomly assigned 78 patients to capecitabine and 78 patients to capecitabine plus trastuzumab. Sixty-five events and 38 deaths in the capecitabine group and 62 events and 33 deaths in the capecitabine-plus-trastuzumab group occurred during 15.6 months of follow-up. Median times to progression were 5.6 months in the capecitabine group and 8.2 months in the capecitabine-plus-trastuzumab group with an unadjusted hazard ratio of 0.69 (95% CI, 0.48 to 0.97; two-sided log-rank P = .0338). Overall survival rates were 20.4 months (95% CI, 17.8 to 24.7) in the capecitabine group and 25.5 months (95% CI, 19.0 to 30.7) in the capecitabine-plus-trastuzumab group (P = .257). Overall response rates were 27.0% with capecitabine and 48.1% with capecitabine plus trastuzumab (odds ratio, 2.50; P = .0115). Continuation of trastuzumab beyond progression was not associated with increased toxicity. Continuation of trastuzumab plus capecitabine showed a significant improvement in overall response and time to progression compared with capecitabine alone in women with HER-2-positive breast cancer who experienced progression during trastuzumab treatment.

Advanced Chemical Propulsion Study

NASA Technical Reports Server (NTRS)

Woodcock, Gordon; Byers, Dave; Alexander, Leslie A.; Krebsbach, Al

2004-01-01

A study was performed of advanced chemical propulsion technology application to space science (Code S) missions. The purpose was to begin the process of selecting chemical propulsion technology advancement activities that would provide greatest benefits to Code S missions. Several missions were selected from Code S planning data, and a range of advanced chemical propulsion options was analyzed to assess capabilities and benefits re these missions. Selected beneficial applications were found for higher-performing bipropellants, gelled propellants, and cryogenic propellants. Technology advancement recommendations included cryocoolers and small turbopump engines for cryogenic propellants; space storable propellants such as LOX-hydrazine; and advanced monopropellants. It was noted that fluorine-bearing oxidizers offer performance gains over more benign oxidizers. Potential benefits were observed for gelled propellants that could be allowed to freeze, then thawed for use.

Prospective randomized phase II study of FOLFIRI versus FOLFOX7 in advanced gastric adenocarcinoma: a Chinese Western Cooperative Gastrointestinal Oncology Group Study

PubMed Central

Qiu, Meng; Liu, Jiyan; Chen, Jing; Yi, Cheng; Li, Zhiping; Luo, Deyun; Xu, Feng; Cai, Xiaohong; Bi, Feng

2017-01-01

Until now, no standard chemotherapy has been widely accepted for advanced gastric cancer (GC). The current research aimed to compare folinic acid, fluorouracil with irinotecan (mFOLFIRI) or with oxaliplatin (mFOLFOX7) as first-line treatments in patients with locally advanced GC in an open, randomized, phase II study. Previously untreated metastatic or recurrent GC patients with measurable disease received mFOLFIRI (arm A) or mFOLFOX7 (arm B) every 2 weeks. The defined second-line treatment was mFOLFOX7 for arm A and mFOLFIRI for arm B. Primary endpoint was progression-free survival (PFS), and secondary endpoints were overall survival (OS), disease control rate (DCR) and toxicity. The evaluable population consisted of 128 patients (54 in arm A; 74 in arm B). Median PFS of arm A was 2.9 months (m) (95% confidence interval, CI, 1.9 to 4.1 m) versus 4.1 m (95% CI, 3.2 to 4.8 m) for arm B (p = 0.109). Median OS was 9.9 months (95% CI, 6.0 to 13.5 m) for arm A versus 12.0 m for arm B (95% CI, 10.3 to 13.7m; p = 0.431). DCRs for arm A and arm B were 59.3% and 66.3%, respectively (p = 0.850). In subgroup analysis of the patients who completed both treatment lines per protocol, the median first-line PFS was 2.1 m for the mFOLFIRI/mFOLFOX7arm versus 8.0 m for the mFOLFOX7/mFOLFIRI arm (p = 0.053), and the median second-line PFS values were 1.2 m versus 5.1 m (p = 0.287). Total PFS and OS were 8.1m and 11.0 m for the mFOLFIRI/mFOLFOX7 group compared with 12.2m and 20.2 m for the mFOLFOX7/mFOLFIRI group (p = 0.008, p = 0.030). Both regimens were well-tolerated with acceptable and manageable toxicities. Hence, there was no significant difference in the PFS or DCR. However, mFOLFOX7 followed by mFOLFIRI might have a better OS. PMID:29228659

Prospective randomized phase II study of FOLFIRI versus FOLFOX7 in advanced gastric adenocarcinoma: a Chinese Western Cooperative Gastrointestinal Oncology Group Study.

PubMed

Li, Qiu; Wen, Feng; Zhou, Chengya; Qiu, Meng; Liu, Jiyan; Chen, Jing; Yi, Cheng; Li, Zhiping; Luo, Deyun; Xu, Feng; Cai, Xiaohong; Bi, Feng

2017-11-17

Until now, no standard chemotherapy has been widely accepted for advanced gastric cancer (GC). The current research aimed to compare folinic acid, fluorouracil with irinotecan (mFOLFIRI) or with oxaliplatin (mFOLFOX7) as first-line treatments in patients with locally advanced GC in an open, randomized, phase II study. Previously untreated metastatic or recurrent GC patients with measurable disease received mFOLFIRI (arm A) or mFOLFOX7 (arm B) every 2 weeks. The defined second-line treatment was mFOLFOX7 for arm A and mFOLFIRI for arm B. Primary endpoint was progression-free survival (PFS), and secondary endpoints were overall survival (OS), disease control rate (DCR) and toxicity. The evaluable population consisted of 128 patients (54 in arm A; 74 in arm B). Median PFS of arm A was 2.9 months (m) (95% confidence interval, CI , 1.9 to 4.1 m) versus 4.1 m (95% CI , 3.2 to 4.8 m) for arm B ( p = 0.109). Median OS was 9.9 months (95% CI , 6.0 to 13.5 m) for arm A versus 12.0 m for arm B (95% CI , 10.3 to 13.7m; p = 0.431). DCRs for arm A and arm B were 59.3% and 66.3%, respectively ( p = 0.850). In subgroup analysis of the patients who completed both treatment lines per protocol, the median first-line PFS was 2.1 m for the mFOLFIRI/mFOLFOX7arm versus 8.0 m for the mFOLFOX7/mFOLFIRI arm ( p = 0.053), and the median second-line PFS values were 1.2 m versus 5.1 m ( p = 0.287). Total PFS and OS were 8.1m and 11.0 m for the mFOLFIRI/mFOLFOX7 group compared with 12.2m and 20.2 m for the mFOLFOX7/mFOLFIRI group ( p = 0.008, p = 0.030). Both regimens were well-tolerated with acceptable and manageable toxicities. Hence, there was no significant difference in the PFS or DCR. However, mFOLFOX7 followed by mFOLFIRI might have a better OS.

Friends and Family: A Literature Review on How High School Social Groups Influence Advanced Math and Science Coursetaking

ERIC Educational Resources Information Center

Gottfried, Michael; Owens, Ann; Williams, Darryl; Kim, Hui Yon; Musto, Michela

2017-01-01

In this study, we synthesized the literature on how informal contexts, namely friends and family social groups, shape high school students' likelihood of pursuing advanced math and science coursework. Extending scholarly understandings of STEM education, we turned to the body of literature with three guiding questions: (1) What influence do…

Advances in technologies and study design

USDA-ARS?s Scientific Manuscript database

Completion of the initial draft sequence of the human genome was the proving ground for and has ushered in significant advancements in technology of increasing sophistication and ever increasing amounts of data. Often, this combination has a multiplicative effect of stimulating research groups to co...

[Isolation and identification methods of enterobacteria group and its technological advancement].

PubMed

Furuta, Itaru

2007-08-01

In the last half-century, isolation and identification methods of enterobacteria groups have markedly improved by technological advancement. Clinical microbiology tests have changed overtime from tube methods to commercial identification kits and automated identification. Tube methods are the original method for the identification of enterobacteria groups, that is, a basically essential method to recognize bacterial fermentation and biochemical principles. In this paper, traditional tube tests are discussed, such as the utilization of carbohydrates, indole, methyl red, and citrate and urease tests. Commercial identification kits and automated instruments by computer based analysis as current methods are also discussed, and those methods provide rapidity and accuracy. Nonculture techniques of nucleic acid typing methods using PCR analysis, and immunochemical methods using monoclonal antibodies can be further developed.

Observational study of sleep disturbances in advanced cancer.

PubMed

Davies, Andrew Neil; Patel, Shuchita D; Gregory, Amanda; Lee, Bernadette

2017-12-01

To determine the prevalence of nightmares, sleep terrors and vivid dreams in patients with advanced cancer (and the factors associated with them in this group of patients). The study was a multicentre, prospective observational study. Participants were patients with locally advanced/metastatic cancer, who were under the care of a specialist palliative care team. Data were collected on demographics, cancer diagnosis, cancer treatment, current medication, performance status, sleep quality (Pittsburgh Sleep Quality Index), dreams and nightmares, and physical and psychological symptoms (Memorial Symptom Assessment Scale-Short Form). 174 patients completed the study. Sleep quality was poor in 70.5% participants and was worse in younger patients and in inpatients (hospital, hospice). 18% of patients reported nightmares, 8% sleep terrors and 34% vivid dreams. Nightmares were associated with poor sleep quality and greater sleep disturbance; nightmares were also associated with greater physical and psychological burden. Nightmares (and vivid dreams) were not associated with the use of opioid analgesics. Nightmares do not seem to be especially common in patients with advanced cancer, and when they do occur, there is often an association with sleep disturbance, and/or physical and psychological burden. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Advanced Stage Mucinous Adenocarcinoma of the Ovary is both Rare and Highly Lethal: A Gynecologic Oncology Group Study

PubMed Central

Zaino, Richard J.; Brady, Mark F.; Lele, Subodh M.; Michael, Helen; Greer, Benjamin; Bookman, Michael A.

2010-01-01

Background Primary mucinous adenocarcinomas of the ovary are uncommon and their biologic behavior uncertain. Retrospective studies suggest that many mucinous carcinomas diagnosed as primary to the ovary were actually metastatic from another site. A prospective randomized trial provided an opportunity to estimate the frequency of mucinous tumors, diagnostic reproducibility, and clinical outcomes. Methods A phase III trial enrolled 4000 women with stage III or IV ovarian carcinoma, treated by surgical staging and debulking, with randomization to one of five chemotherapeutic arms. Slides and pathology reports classified as primary mucinous carcinoma were reviewed independently by three pathologists. Cases were re-classified as primary or metastatic to the ovary according to two methods. Overall survival (OS) of reclassified groups was compared with each other and with that of patients with serous carcinomas. Results Forty-four cases were classified as mucinous adenocarcinoma at review. Using either method, only about one third were interpreted by the three reviewers as primary mucinous carcinomas. Reproducibility of interpretations among the reviewers was high with unanimity of opinion in 30 of the 44 (68%) cases. The median survival (MS) did not differ significantly between the groups interpreted as primary or metastatic, but the OS was significantly less than that for women with serous carcinoma (14 vs 42 months, p<0.001). Conclusion Advanced stage mucinous carcinoma of the ovary is very rare and is associated with poor OS. Many mucinous adenocarcinomas that are diagnosed as primary ovarian neoplasms appear to be metastatic to the ovary. PMID:20862744

Advanced Nursing Education: Critical Factors That Influence Diploma and Associate Degree Nurses to Advance.

PubMed

McGhie-Anderson, Rose Lavine

The purpose of this study was to gain an understanding of the social processes associated with the decision of diploma and associate degree nurses to advance academically. Advanced nursing education needs to be pursued along the continuum of the nursing career path. This education process is indispensable to the role of nurses as educator, manager, nurse leader, and researcher who will effect policy changes, assume leadership roles as revolutionary thinkers, and implement paradigmatic shifts. Data were collected from two groups of participants using face-to-face, semistructured interviews. Group 1 consisted of diploma and associate degree nurses; Group 2 consisted of baccalaureate, masters, and doctoral degree nurses who have progressed academically. Emerging from the thick, rich data were core categories of rewarding, motivating, and supporting as critical factors that influence professional advancement. This qualitative study elucidated that professional advancement was the social process that grounds. The emergent theory was the theory of professional advancement.

Chemotherapy intensity and toxicity among black and white women with advanced and recurrent endometrial cancer: a Gynecologic Oncology Group Study.

PubMed

Farley, John H; Tian, Chunqiao; Rose, G Scott; Brown, Carol L; Birrer, Michael; Risinger, John I; Thigpen, J Tate; Fleming, Gini F; Gallion, Holly H; Maxwell, G Larry

2010-01-15

The purpose of this study was to confirm whether black and white women with endometrial cancer are equally tolerant of chemotherapy and identify factors that impact survival. A retrospective review of 169 black women and 982 white women with the International Federation of Gynecologists and Obstetricians stage III, stage IV, or recurrent endometrial carcinoma was performed. All patients received doxorubicin combined with cisplatin. Chemotherapy parameters that were reviewed included relative dose, relative time, and relative dose intensity. Treatment cycles > or =7 were defined as treatment completion. Although black patients were more likely to experience grades 3-4 anemia (20% vs 14%) and genitourinary (5% vs 1%) toxicity, and less likely to experience severe gastrointestinal toxicity (10% vs 17%), the overall incidence of grades 3-4 treatment-related chemotoxicity was the same between the 2 groups (82% vs 82%). There were no differences in the number of cycles received, relative dose (0.57 vs 0.58), relative time (0.77 vs 0.78), or relative dose intensity (0.76 vs 0.76) for black and white patients. Black patients with advanced stage or recurrent endometrial cancer, treated on 4 Gynecologic Oncology Group (GOG) protocols, had similar dose intensity and severe chemotherapy-related toxicity compared with white patients, suggesting that previously described racial disparities in survival among patients in GOG trials may have an novel etiology.

Prototype Tool and Focus Group Evaluation for an Advanced Trajectory-Based Operations Concept

NASA Technical Reports Server (NTRS)

Guerreiro, Nelson M.; Jones, Denise R.; Barmore, Bryan E.; Butler, Ricky W.; Hagen, George E.; Maddalon, Jeffrey M.; Ahmad, Nash'at N.

2017-01-01

Trajectory-based operations (TBO) is a key concept in the Next Generation Air Transportation System transformation of the National Airspace System (NAS) that will increase the predictability and stability of traffic flows, support a common operational picture through the use of digital data sharing, facilitate more effective collaborative decision making between airspace users and air navigation service providers, and enable increased levels of integrated automation across the NAS. NASA has been developing trajectory-based systems to improve the efficiency of the NAS during specific phases of flight and is now also exploring Advanced 4-Dimensional Trajectory (4DT) operational concepts that will integrate these technologies and incorporate new technology where needed to create both automation and procedures to support gate-to-gate TBO. A TBO Prototype simulation toolkit has been developed that demonstrates initial functionality of an Advanced 4DT TBO concept. Pilot and controller subject matter experts (SMEs) were brought to the Air Traffic Operations Laboratory at NASA Langley Research Center for discussions on an Advanced 4DT operational concept and were provided an interactive demonstration of the TBO Prototype using four example scenarios. The SMEs provided feedback on potential operational, technological, and procedural opportunities and concerns. This paper describes an Advanced 4DT operational concept, the TBO Prototype, the demonstration scenarios and methods used, and the feedback obtained from the pilot and controller SMEs in this focus group activity.

Advanced engine study program

NASA Technical Reports Server (NTRS)

Masters, A. I.; Galler, D. E.; Denman, T. F.; Shied, R. A.; Black, J. R.; Fierstein, A. R.; Clark, G. L.; Branstrom, B. R.

1993-01-01

A design and analysis study was conducted to provide advanced engine descriptions and parametric data for space transfer vehicles. The study was based on an advanced oxygen/hydrogen engine in the 7,500 to 50,000 lbf thrust range. Emphasis was placed on defining requirements for high-performance engines capable of achieving reliable and versatile operation in a space environment. Four variations on the expander cycle were compared, and the advantages and disadvantages of each were assessed. Parametric weight, envelope, and performance data were generated over a range of 7,500 to 50,000 lb thrust and a wide range of chamber pressure and nozzle expansion ratio.

Effects of metabolic syndrome on arterial function in different age groups: the Advanced Approach to Arterial Stiffness study.

PubMed

Topouchian, Jirar; Labat, Carlos; Gautier, Sylvie; Bäck, Magnus; Achimastos, Apostolos; Blacher, Jacques; Cwynar, Marcin; de la Sierra, Alejandro; Pall, Denes; Fantin, Francesco; Farkas, Katalin; Garcia-Ortiz, Luis; Hakobyan, Zoya; Jankowski, Piotr; Jelakovic, Ana; Kobalava, Zhanna; Konradi, Alexandra; Kotovskaya, Yulia; Kotsani, Marina; Lazareva, Irina; Litvin, Alexander; Milyagin, Viktor; Mintale, Iveta; Persson, Oscar; Ramos, Rafael; Rogoza, Anatoly; Ryliskyte, Ligita; Scuteri, Angelo; Sirenko, Yuriy; Soulis, Georges; Tasic, Nebojsa; Udovychenko, Maryna; Urazalina, Saule; Wohlfahrt, Peter; Zelveian, Parounak; Benetos, Athanase; Asmar, Roland

2018-04-01

The aim of the Advanced Approach to Arterial Stiffness study was to compare arterial stiffness measured simultaneously with two different methods in different age groups of middle-aged and older adults with or without metabolic syndrome (MetS). The specific effects of the different MetS components on arterial stiffness were also studied. This prospective, multicentre, international study included 2224 patients aged 40 years and older, 1664 with and 560 without MetS. Patients were enrolled in 32 centres from 18 European countries affiliated to the International Society of Vascular Health & Aging. Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI) and the carotid-femoral pulse wave velocity (CF-PWV) in four prespecified age groups: 40-49, 50-59, 60-74, 75-90 years. In this report, we present the baseline data of this study. Both CF-PWV and CAVI increased with age, with a higher correlation coefficient for CAVI (comparison of coefficients P < 0.001). Age-adjusted and sex-adjusted values of CF-PWV and CAVI were weakly intercorrelated (r = 0.06, P < 0.001). Age-adjusted and sex-adjusted values for CF-PWV but not CAVI were higher in presence of MetS (CF-PWV: 9.57 ± 0.06 vs. 8.65 ± 0.10, P < 0.001; CAVI: 8.34 ± 0.03 vs. 8.29 ± 0.04, P = 0.40; mean ± SEM; MetS vs. no MetS). The absence of an overall effect of MetS on CAVI was related to the heterogeneous effects of the components of MetS on this parameter: CAVI was positively associated with the high glycaemia and high blood pressure components, whereas lacked significant associations with the HDL and triglycerides components while exhibiting a negative association with the overweight component. In contrast, all five MetS components showed positive associations with CF-PWV. This large European multicentre study reveals a differential impact of MetS and age on CAVI and CF-PWV and suggests that age may have a more pronounced effect on CAVI, whereas Met

Deformation and Damage Studies for Advanced Structural Materials

NASA Technical Reports Server (NTRS)

2005-01-01

Advancements made in understanding deformation and damage of advanced structural materials have enabled the development of new technologies including the attainment of a nationally significant NASA Level 1 Milestone and the provision of expertise to the Shuttle Return to Flight effort. During this collaborative agreement multiple theoretical and experimental research programs, facilitating safe durable high temperature structures using advanced materials, have been conceived, planned, executed. Over 26 publications, independent assessments of structures and materials in hostile environments, were published within this agreement. This attainment has been recognized by 2002 Space Flight Awareness Team Award, 2004 NASA Group Achievement Award and 2003 and 2004 OAI Service Awards. Accomplishments in the individual research efforts are described as follows.

Advanced cogeneration research study: Executive summary

NASA Technical Reports Server (NTRS)

Bluhm, S. A.; Moore, N.; Rosenberg, L.; Slonski, M.

1983-01-01

This study provides a broad based overview of selected areas relevant to the development of a comprehensive Southern California Edison (SCE) advanced cogeneration project. The areas studied are: (1) Cogeneration potential in the SCE service territory; (2) Advanced cogeneration technologies; and (3) Existing cogeneration computer models. An estimated 3700 MW sub E could potentially be generated from existing industries in the Southern California Edison service territory using cogeneration technology. Of this total, current technology could provide 2600 MW sub E and advanced technology could provide 1100 MW sub E. The manufacturing sector (SIC Codes 20-39) was found to have the highest average potential for current cogeneration technology. The mining sector (SIC Codes 10-14) was found to have the highest potential for advanced technology.

Evaluation of an advanced physical diagnosis course using consumer preferences methods: the nominal group technique.

PubMed

Coker, Joshua; Castiglioni, Analia; Kraemer, Ryan R; Massie, F Stanford; Morris, Jason L; Rodriguez, Martin; Russell, Stephen W; Shaneyfelt, Terrance; Willett, Lisa L; Estrada, Carlos A

2014-03-01

Current evaluation tools of medical school courses are limited by the scope of questions asked and may not fully engage the student to think on areas to improve. The authors sought to explore whether a technique to study consumer preferences would elicit specific and prioritized information for course evaluation from medical students. Using the nominal group technique (4 sessions), 12 senior medical students prioritized and weighed expectations and topics learned in a 100-hour advanced physical diagnosis course (4-week course; February 2012). Students weighted their top 3 responses (top = 3, middle = 2 and bottom = 1). Before the course, 12 students identified 23 topics they expected to learn; the top 3 were review sensitivity/specificity and high-yield techniques (percentage of total weight, 18.5%), improving diagnosis (13.8%) and reinforce usual and less well-known techniques (13.8%). After the course, students generated 22 topics learned; the top 3 were practice and reinforce advanced maneuvers (25.4%), gaining confidence (22.5%) and learn the evidence (16.9%). The authors observed no differences in the priority of responses before and after the course (P = 0.07). In a physical diagnosis course, medical students elicited specific and prioritized information using the nominal group technique. The course met student expectations regarding education of the evidence-based physical examination, building skills and confidence on the proper techniques and maneuvers and experiential learning. The novel use for curriculum evaluation may be used to evaluate other courses-especially comprehensive and multicomponent courses.

Satisfaction with life during pregnancy and early motherhood in first-time mothers of advanced age: a population-based longitudinal study.

PubMed

Aasheim, Vigdis; Waldenström, Ulla; Rasmussen, Svein; Espehaug, Birgitte; Schytt, Erica

2014-02-25

The trend to delay motherhood to the age of 30 and beyond is established in most high-income countries but relatively little is known about potential effects on maternal emotional well-being. This study investigates satisfaction with life during pregnancy and the first three years of motherhood in women expecting their first baby at an advanced and very advanced age. The study was based on the National Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Data on 18 565 nulliparous women recruited in the second trimester 1999-2008 were used. Four questionnaires were completed: at around gestational weeks 17 and 30, and at six months and three years after the birth. Medical data were retrieved from the national Medical Birth Register. Advanced age was defined as 32-37 years, very advanced age as ≥38 years and the reference group as 25-31 years. The distribution of satisfaction with life from age 25 to ≥40 years was investigated, and the mean satisfaction with life at the four time points was estimated. Logistic regression analyses based on generalised estimation equations were used to investigate associations between advanced and very advanced age and satisfaction with life when controlling for socio-demographic factors. Satisfaction with life decreased from around age 28 to age 40 and beyond, when measured in gestational weeks 17 and 30, and at six months and three years after the birth. When comparing women of advanced and very advanced age with the reference group, satisfaction with life was slightly reduced in the two older age groups and most of all in women of very advanced age. Women of very advanced age had the lowest scores at all time points and this was most pronounced at three years after the birth. First-time mothers of advanced and very advanced age reported a slightly lower degree of satisfaction with life compared with the reference group of younger women, and the age-related effect was greatest

NASA Advanced Supercomputing (NAS) User Services Group

NASA Technical Reports Server (NTRS)

Pandori, John; Hamilton, Chris; Niggley, C. E.; Parks, John W. (Technical Monitor)

2002-01-01

This viewgraph presentation provides an overview of NAS (NASA Advanced Supercomputing), its goals, and its mainframe computer assets. Also covered are its functions, including systems monitoring and technical support.

A pilot study on understanding the journey of advanced prostate cancer patients.

PubMed

Wagholikar, Amol; Fung, Maggie; Nelson, Colleen

2011-01-01

To understand the journey of advanced prostate cancer patients for supporting development of an innovative patient journey browser. Prostate cancer is one of the common cancers in Australia. Due to the chronic nature of the disease, it is important to have effective disease management strategy and care model. Multi-disciplinary care is a well-proven approach for chronic disease management. The Multi-disciplinary team (MDT) can function more effectively if all the required information is available for the clinical decision support. The development of innovative technology relies on an accurate understanding of the advanced prostate cancer patient's journey over a prolonged period. This need arises from the fact that advanced prostate cancer patients may follow various treatment paths and change their care providers. As a result of this, it is difficult to understand the actual sources of patient's clinical records and their treatment patterns. The aim of the research is to understand variable sources of clinical records, treatment patterns, alternative therapies, over the counter (OTC) medications of advanced prostate cancer patients. This study provides better and holistic understanding of advanced prostate cancer journey. The study was conducted through an on-line survey developed to seek and analyse the responses from the participants. The on-line questionnaire was carefully developed through consultations with the clinical researchers at the Australian Prostate Cancer Research Centre-Queensland, prostate cancer support group representatives and health informaticians at the Australian E-Health Research Centre. The non-identifying questionnaire was distributed to the patients through prostate cancer support groups in Queensland, Australia. The pilot study was carried out between August 2010 and December 2010. The research made important observations about the advanced prostate cancer journey. It showed that General Practitioner (GP) was the common source of

A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla.

PubMed

Andersen, Kristian; Nørholt, Sven Erik; Küseler, Annelise; Jensen, John; Pedersen, Thomas Klit

2012-01-01

To compare cleft lip and palate patients' satisfaction with aesthetics and functional parameters after conventional advancement of the maxilla or by the use of distraction osteogenesis. Case series observational study. Group of distraction osteogenesis (DO) consisted of 15 patients treated with distraction osteogenesis while group conventional (CONV) included 10 patients treated with traditional advancement of the maxilla. Patients were asked to fill out a questionnaire about their subjective evaluation of satisfaction with facial aesthetics and functional parameters on a continuous visual analog-scale (VAS) when the treatment was finished. The total response rate was 76%. Preoperatively the two groups did not differ significantly according to group characteristics. At follow-up both groups were satisfied with aesthetics and functional parameters. The DO group was less satisfied with the duration of the treatment than the CONV group. There were no statistically significant differences among the groups regarding functional parameters or facial aesthetics. Cleft lip and palate patients experienced a high level of satisfaction with functional parameters and aesthetics as a result of surgical maxillary advancement. The patients treated with distraction osteogenesis were less satisfied with the duration of the treatment. Further studies are needed.

[Nurses' Attitudes toward the “Advanced Nursing Process” before and after an educational intervention – a quasi-experimental study].

PubMed

Leoni-Scheiber, Claudia; Gothe, Raffaella Matteucci; Müller-Staub, Maria

2016-02-01

The attitude of nurses influences their application of the Advanced Nursing Process. Studies reveal deficits in the application of the Advanced Nursing Process that is based on valid assessments and nursing classifications. These deficits affect decision-making and – as a result – nursing care quality. In German speaking countries nurses' attitudes towards nursing diagnoses as part of the Advanced Nursing Process were not yet measured. The aim of this study was to evaluate the effects of an educational intervention on nurses' attitude. A quasi-experimental intervention study was carried out in Austria and Germany. Before and after a standardised educational intervention 51 nurses estimated their attitude with the instrument Positions on Nursing Diagnosis (PND). Analyses were performed by Wilcoxon- and U-tests. Before the educational intervention the average attitude score of the Austrian nurses was more positive than in the German group. After the study intervention both groups regarded nursing diagnostics statistically significant more convincing and better understandable. However, both groups still described the application of the Advanced Nursing Process as difficult and demanding to perform. In the future, more attention should be given to the reflexion and development of nurses' attitude towards the Advanced Nursing Process because attitudes lead nurses' actions. In further studies influencing organizational and structural factors in diverse settings will be analysed.

Treatment-related mortality in patients with advanced-stage hodgkin lymphoma: an analysis of the german hodgkin study group.

PubMed

Wongso, Diana; Fuchs, Michael; Plütschow, Annette; Klimm, Beate; Sasse, Stephanie; Hertenstein, Bernd; Maschmeyer, Georg; Vieler, Tom; Dührsen, Ulrich; Lindemann, Walter; Aulitzky, Walter; Diehl, Volker; Borchmann, Peter; Engert, Andreas

2013-08-01

The introduction of BEACOPP(escalated) (escalated-dose bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) has significantly improved tumor control and overall survival in patients with advanced-stage Hodgkin lymphoma. However, this regimen has also been associated with higher treatment-related mortality (TRM). Thus, we analyzed clinical course and risk factors associated with TRM during treatment with BEACOPP(escalated). In this retrospective analysis, we investigated incidence, clinical features, and risk factors for BEACOPP(escalated)-associated TRM in the German Hodgkin Study Group trials HD9, HD12, and HD15. Among a total of 3,402 patients, TRM of 1.9% (64 of 3,402) was mainly related to neutropenic infections (n = 56; 87.5%). Twenty of 64 events occurred during the first course of BEACOPP(escalated) (31.3%). Higher risk of TRM was seen in patients age ≥ 40 years with poor performance status (PS) and in patients age ≥ 50 years. PS and age were then used to construct a new risk score; those with a score ≥ 2 had TRM of 7.1%, whereas patients who scored 0 or 1 had TRM of 0.9%. The individual risk of TRM associated with BEACOPP(escalated) can be predicted by a simple algorithm based on age and PS. High-risk patients should receive special clinical attention.

Health literacy: a study of internet-based information on advance directives.

PubMed

Stuart, Peter

2017-11-28

The aim of this study was to evaluate the quality and value of web-based information on advance directives. Internet-based information on advance directives was selected because, if it is inaccurate or difficult to understand, patients risk making decisions about their care that may not be followed in practice. Two validated health information evaluation tools, the Suitability Assessment of Materials and DISCERN, and a focus group were used to assess credibility, user orientation and effectiveness. Only one of the 34 internet-based information items on advance directives reviewed fulfilled the study criteria and 30% of the sites were classed as unreadable. In terms of learning and informing, 79% of the sites were considered unsuitable. Using health literacy tools to evaluate internet-based health information highlights that often it is not at a functional literacy level and neither informs nor empowers users to make independent and valid healthcare decisions. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Treatment of Advanced Glaucoma Study: a multicentre randomised controlled trial comparing primary medical treatment with primary trabeculectomy for people with newly diagnosed advanced glaucoma-study protocol.

PubMed

King, Anthony J; Fernie, Gordon; Azuara-Blanco, Augusto; Burr, Jennifer M; Garway-Heath, Ted; Sparrow, John M; Vale, Luke; Hudson, Jemma; MacLennan, Graeme; McDonald, Alison; Barton, Keith; Norrie, John

2017-10-26

Presentation with advanced glaucoma is the major risk factor for lifetime blindness. Effective intervention at diagnosis is expected to minimise risk of further visual loss in this group of patients. To compare clinical and cost-effectiveness of primary medical management compared with primary surgery for people presenting with advanced open-angle glaucoma (OAG). Design : A prospective, pragmatic multicentre randomised controlled trial (RCT). Twenty-seven UK hospital eye services. Four hundred and forty patients presenting with advanced OAG, according to the Hodapp-Parish-Anderson classification of visual field loss. Participants will be randomised to medical treatment or augmented trabeculectomy (1:1 allocation minimised by centre and presence of advanced disease in both eyes). The primary outcome is vision-related quality of life measured by the National Eye Institute-Visual Function Questionnaire-25 at 24 months. Secondary outcomes include generic EQ-5D-5L, Health Utility Index-3 and glaucoma-related health status (Glaucoma Utility Index), patient experience, visual field measured by mean deviation value, logarithm of the mean angle of resolution visual acuity, intraocular pressure, adverse events, standards for driving and eligibility for blind certification. Incremental cost per quality-adjusted life-year (QALY) based on EQ-5D-5L and glaucoma profile instrument will be estimated. The study will report the comparative effectiveness and cost-effectiveness of medical treatment against augmented trabeculectomy in patients presenting with advanced glaucoma in terms of patient-reported health and visual function, clinical outcomes and incremental cost per QALY at 2 years. Treatment of Advanced Glaucoma Study will be the first RCT reporting outcomes from the perspective of those with advanced glaucoma. ISRCTN56878850, Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial

78 FR 39062 - Group Lotus plc; Modification of a Temporary Exemption From an Advanced Air Bag Requirement of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

...-0086] Group Lotus plc; Modification of a Temporary Exemption From an Advanced Air Bag Requirement of... temporary exemption granted to Group Lotus plc (Lotus) on March 8, 2013. The agency granted Lotus an... Lotus Plc (Lotus) a temporary exemption from the higher maximum speed (56 km/h (35 mph)) belted test...

Advanced life support study

NASA Technical Reports Server (NTRS)

1991-01-01

Summary reports on each of the eight tasks undertaken by this contract are given. Discussed here is an evaluation of a Closed Ecological Life Support System (CELSS), including modeling and analysis of Physical/Chemical Closed Loop Life Support (P/C CLLS); the Environmental Control and Life Support Systems (ECLSS) evolution - Intermodule Ventilation study; advanced technologies interface requirements relative to ECLSS; an ECLSS resupply analysis; the ECLSS module addition relocation systems engineering analysis; an ECLSS cost/benefit analysis to identify rack-level interface requirements of the alternate technologies evaluated in the ventilation study, with a comparison of these with the rack level interface requirements for the baseline technologies; advanced instrumentation - technology database enhancement; and a clean room survey and assessment of various ECLSS evaluation options for different growth scenarios.

Advances in hypersonic vehicle synthesis with application to studies of advanced thermal protection system

NASA Technical Reports Server (NTRS)

Ardema, Mark D.

1995-01-01

This report summarizes the work entitled 'Advances in Hypersonic Vehicle Synthesis with Application to Studies of Advanced Thermal Protection Systems.' The effort was in two areas: (1) development of advanced methods of trajectory and propulsion system optimization; and (2) development of advanced methods of structural weight estimation. The majority of the effort was spent in the trajectory area.

Factors influencing advanced practitioners' ability to enact leadership: a case study within Irish healthcare.

PubMed

Higgins, Agnes; Begley, Cecily; Lalor, Joan; Coyne, Imelda; Murphy, Kathy; Elliott, Naomi

2014-10-01

To report the factors that influence clinical specialists' and advanced nurse practitioners' ability to enact their clinical and professional leadership roles; findings from the SCAPE study. The importance of leadership for specialist and advanced practitioners is highlighted in the international literature and is considered an important factor in the provision of improved patient outcomes. Despite many studies identifying the barriers in developing and integrating new specialist/advanced practice roles into health services, little is known about the factors that influence the leadership dimension of their role. A case study design involving 23 clinical specialist/advanced practitioners working in Ireland and multidisciplinary team members working with them, was used. Data were collected using interview, observation and documentary analysis. Four mediating factors influence the specialist/advanced practitioner's ability to perform a leadership role, namely the presence of a framework for the professional development of the role; opportunities to act as leaders; mechanisms for sustaining leadership; and personal attributes of practitioners. Nursing/midwifery leaders and managers at all levels have a key role in supporting leadership potential, through countering the negative impact of professional isolation, expanding opportunities for specialist/advanced practitioners to influence policy and network with wider professional groups. © 2013 John Wiley & Sons Ltd.

Reducing anxiety and enhancing physical performance by using an advanced version of EMDR: a pilot study

PubMed Central

Rathschlag, Marco; Memmert, Daniel

2014-01-01

Background The main aim of this pilot study was to investigate an advanced version of eye movement desensitization and reprocessing (EMDR) for reducing anxiety. Methods Fifty participants were asked at two times of measurement (T1 and T2 with a rest of 4 weeks) to generate anxiety via the recall of autobiographical memories according to their anxiety. Furthermore, the participants were randomly assigned to an experimental group and a control group, and the experimental group received an intervention of 1–2 h with the advanced version of EMDR in order to their anxiety 2 weeks after T1. At T1 as well as T2, we measured the intensity of participants' anxiety with a Likert scale (LS) and collected participants' state (temporary) and trait (chronic) anxiety with the State-Trait Anxiety Inventory (STAI). In addition, we measured participants' physical performance in a test for the finger musculature under the induction of their anxiety. Results The results showed that participant's ratings of their perceived intensity of anxiety (measured by a 9-point LS) and the state and trait anxiety decreased significantly in the experimental group but not in the control group from T1 to T2. Moreover, the physical performance under the induction of participants' anxiety increased significantly in the experimental group from T1 to T2 and there were no significant changes in the control group. Conclusions The study could show that the advanced version of EMDR is an appropriate method to reduce anxiety. PMID:24944864

Operation of the power information center: Performance of secretariat functions and information exchange activities in the advanced power field of the interagency advanced power group

NASA Technical Reports Server (NTRS)

1983-01-01

Highlights of activities conducted during the reporting period to facilitate the exchange of technical information among scientists and engineers both within the federal government and within industry are cited. Interagency Advanced Power Group meetings and special efforts, project briefs, and organization development are considered.

A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla

PubMed Central

Nørholt, Sven Erik; Küseler, Annelise; Jensen, John; Pedersen, Thomas Klit

2012-01-01

ABSTRACT Objectives To compare cleft lip and palate patients' satisfaction with aesthetics and functional parameters after conventional advancement of the maxilla or by the use of distraction osteogenesis. Material and methods Case series observational study. Group of distraction osteogenesis (DO) consisted of 15 patients treated with distraction osteogenesis while group conventional (CONV) included 10 patients treated with traditional advancement of the maxilla. Patients were asked to fill out a questionnaire about their subjective evaluation of satisfaction with facial aesthetics and functional parameters on a continuous visual analog-scale (VAS) when the treatment was finished. Results The total response rate was 76%. Preoperatively the two groups did not differ significantly according to group characteristics. At follow-up both groups were satisfied with aesthetics and functional parameters. The DO group was less satisfied with the duration of the treatment than the CONV group. There were no statistically significant differences among the groups regarding functional parameters or facial aesthetics. Conclusions Cleft lip and palate patients experienced a high level of satisfaction with functional parameters and aesthetics as a result of surgical maxillary advancement. The patients treated with distraction osteogenesis were less satisfied with the duration of the treatment. Further studies are needed. PMID:24422010

A phase II study of flavopiridol in patients with advanced renal cell carcinoma: results of Southwest Oncology Group Trial 0109.

PubMed

Van Veldhuizen, Peter J; Faulkner, James R; Lara, Primo N; Gumerlock, Paul H; Goodwin, J Wendall; Dakhil, Shaker R; Gross, Howard M; Flanigan, Robert C; Crawford, E David

2005-07-01

Flavopiridol is a cyclin-dependent kinase inhibitor that prevents cell cycle progression and tumor growth. In initial phase I studies, encouraging responses were seen in advanced renal cell cancer (RCC). In a phase II study of flavopiridol given as a 72-h continuous infusion every 2 weeks in RCC, a response rate of 6% was seen but with considerable grade 3 or 4 asthenia, diarrhea, and thrombosis. Subsequently, an alternative 1-h bolus schedule was reported to have enhanced tolerability in a phase I trial. We therefore conducted a phase II study of this bolus regimen. A total of 38 patients with advanced RCC were entered into this multi-institutional phase II study. Flavopiridol (50 mg/m(2) per day) was administered by bolus intravenous injection daily for three consecutive days, repeated every 3 weeks. Out of 34 eligible patients, one complete response and three partial responses were observed, for an overall response rate of 12% (95% CI 3-27%). Of the 34 patients, 14 (41%) had stable disease (SD). The probability of not failing treatment by 6 months was 21% (95% CI 9-35%). Median overall survival time was 9 months (95% CI 8-18 months). The most common grade 3 or 4 toxicities were diarrhea (35%) and tumor pain (12%) along with anemia, dyspnea, and fatigue (9% each). Flavopiridol at this dose and schedule is feasible with an acceptable toxicity profile. Flavopiridol has some modest biologic activity against advanced RCC, as evidenced by its single-agent objective response and SD rates.

The Science Advancement through Group Engagement Program: Leveling the Playing Field and Increasing Retention in Science

ERIC Educational Resources Information Center

Hall, Donna M.; Curtin-Soydan, Amanda J.; Canelas, Dorian A.

2014-01-01

How can colleges and universities keep an open gateway to the science disciplines for the least experienced first-year science students while also maintaining high standards that challenge the students with the strongest possible high school backgrounds? The Science Advancement through Group Engagement (SAGE) project targets cohorts of less…

Teaching Groups as Foci for Evaluating Performance in Cost-Effectiveness of GCE Advanced Level Provision: Some Practical Methodological Innovations.

ERIC Educational Resources Information Center

Fielding, Antony

2002-01-01

Analyzes subject teaching-group effectiveness in English and Welsh General Certification of Education (GCE) Advanced Level prior to a linking to resources; suggests cross-classified multilevel models with weighted random effects for disentangling student, group, and teacher effects; finds that teacher effects are considerable, but cannot find…

Phase II trial of cisplatin in advanced or recurrent cancer of the vagina: a Gynecologic Oncology Group Study.

PubMed

Thigpen, J T; Blessing, J A; Homesley, H D; Berek, J S; Creasman, W T

1986-01-01

Twenty-six patients with advanced or recurrent cancer of the vagina no longer amenable to control with surgery and/or radiotherapy were entered into a phase II study of cisplatin 50 mg/m2 intravenously every 3 weeks. Two were deemed ineligible because of a primary site of origin other than vagina. Two were deemed inevaluable, one because of the lack of measurable disease and the other because she never received drug. The remaining 22 included a variety of histologies (16 squamous cell carcinomas, 2 adenosquamous carcinomas, 1 clear cell carcinoma, 1 leiomyosarcoma, and 2 carcinomas not otherwise specified). One complete responder was observed among the 16 patients with squamous cell carcinoma. Adverse effects were tolerable and were essentially those reported in other series. These results suggest that cisplatin has insignificant activity in advanced or recurrent squamous cell carcinoma of the vagina at least at the dose and schedule tested. No comment can be made regarding the activity of cisplatin in other histologies.

Treatment of pancreatic insufficiency using pancreatic extract in patients with advanced pancreatic cancer: a pilot study (PICNIC).

PubMed

Zdenkowski, Nicholas; Radvan, George; Pugliese, Leanna; Charlton, Julie; Oldmeadow, Christopher; Fraser, Allison; Bonaventura, Antonino

2017-06-01

Survival with advanced pancreatic cancer is less than 12 months. Pancreatic exocrine insufficiency may contribute to pancreatic cancer-related cachexia, via nutrient malabsorption. We aimed to determine the feasibility of prescribing pancreatic extract (Creon®) for patients with advanced pancreatic cancer. Patients with advanced pancreatic cancer, without frank malabsorption, were randomised in this feasibility study to pancreatic extract 50,000 units with meals and 25,000 units with snacks, or placebo. Standardised dietary advice was given. Anti-cancer and supportive care treatments were permitted. Outcomes included weight, body mass index (BMI), quality of life (QLQC30, PAN26), survival and nutritional assessment (PG-SGA). Eighteen patients were randomised before study closure due to slow recruitment. Baseline characteristics were well matched. Weight loss prior to randomisation was numerically greater in the pancreatic extract group (mean 0.7 vs 2.2 kg). Weight loss was numerically greater in the placebo group, however not significantly. No differences in BMI or nutrition score were seen. Quality of life did not differ between study groups. Median overall survival was 17 (95% CI 8.1-48.7) weeks in the control group, and 67.6 (95% CI 14.1-98.4) weeks in the pancreatic extract group (p = 0.1063). Only 17% (18/106) of potentially eligible patients were recruited, related to patient/family reluctance, rapid clinical deterioration and patients already prescribed pancreatic extract. A moderate pill burden was noted. Despite intriguing survival results, this study was not sufficiently feasible to proceed to a fully powered comparative study. A multi-centre study would be required to exclude a significant difference in outcomes.

Progression-free survival of early interim PET-positive patients with advanced stage Hodgkin's lymphoma treated with BEACOPPescalated alone or in combination with rituximab (HD18): an open-label, international, randomised phase 3 study by the German Hodgkin Study Group.

PubMed

Borchmann, Peter; Haverkamp, Heinz; Lohri, Andreas; Mey, Ulrich; Kreissl, Stefanie; Greil, Richard; Markova, Jana; Feuring-Buske, Michaela; Meissner, Julia; Dührsen, Ulrich; Ostermann, Helmut; Keller, Ulrich; Maschmeyer, Georg; Kuhnert, Georg; Dietlein, Markus; Kobe, Carsten; Eich, Hans; Baues, Christian; Stein, Harald; Fuchs, Michael; Diehl, Volker; Engert, Andreas

2017-04-01

Advanced stage Hodgkin's lymphoma represents a heterogeneous group of patients with different risk profiles. Data suggests that interim PET assessment during chemotherapy is superior to baseline international prognostic scoring in terms of predicting long-term treatment outcome in patients with Hodgkin's lymphoma. We therefore hypothesised that early interim PET-imaging after two courses of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) might be suitable for guiding treatment in patients with advanced stage Hodgkin's lymphoma. We aimed to assess whether intensifying standard chemotherapy (BEACOPP escalated ) by adding rituximab would improve progression-free survival in patients with positive PET after two courses of chemotherapy. In this open-label, international, randomised, phase 3 study, we recruited patients aged 18-60 years with newly diagnosed, advanced stage Hodgkin's lymphoma from 160 hospitals and 77 private practices in Germany, Switzerland, Austria, the Netherlands, and the Czech Republic. Interim PET-imaging was done after two cycles of BEACOPP escalated and centrally assessed by an expert panel. Patients with a positive PET after 2 cycles of BEACOPP escalated chemotherapy (PET-2) were randomly assigned (1:1) to receive six additional courses of either BEACOPP escalated (BEACOPP escalated group) or BEACOPP escalated plus rituximab (R-BEACOPP escalated group). PET-2 was assessed using a 5-point scale with 18 FDG uptake higher than the mediastinal blood pool (corresponding to Deauville scale 3) defined as positive. BEACOPP escalated was given as previously described; rituximab was given intravenously at a dose of 375 mg/m 2 (maximum total dose 700 mg), the first administration starting 24 h before starting the fourth cycle of BEACOPP escalated (day 0 and day 3 in cycle 4, day 1 in cycles 5-8). Randomisation was done centrally and used the minimisation method including a random component

Advance care treatment plan (ACT-Plan) for African American family caregivers: a pilot study.

PubMed

Bonner, Gloria J; Wang, Edward; Wilkie, Diana J; Ferrans, Carol E; Dancy, Barbara; Watkins, Yashika

2014-01-01

Research is limited on end-of-life treatment decisions made by African American family caregivers. In a pilot study, we examined the feasibility of implementing an advance care treatment plan (ACT-Plan), a group-based education intervention, with African American dementia caregivers. Theoretically based, the ACT-Plan included strategies to enhance knowledge, self-efficacy, and behavioral skills to make end-of-life treatment plans in advance. Cardiopulmonary resuscitation, mechanical ventilation, and tube feeding were end-of-life treatments discussed in the ACT-Plan. In a four-week pre/posttest two-group design at urban adult day care centers, 68 caregivers were assigned to the ACT-Plan or attention-control health promotion conditions. Findings strongly suggest that the ACT-Plan intervention is feasible and appropriate for African American caregivers. Self-efficacy and knowledge about dementia, cardiopulmonary resuscitation, mechanical ventilation, and tube feeding increased for ACT-Plan participants but not for the attention-control. More ACT-Plan than attention-control participants developed advance care plans for demented relatives. Findings warrant a randomized efficacy trial.

An Advanced Trajectory-Based Operations Prototype Tool and Focus Group Evaluation

NASA Technical Reports Server (NTRS)

Guerreiro, Nelson M.; Jones, Denise R.; Barmore, Bryan E.; Butler, Ricky W.; Hagen, George E.; Maddalon, Jeffrey M.; Ahmad, Nash'at N.; Rogers, Laura J.; Underwood, Matthew C.; Johnson, Sally C.

2017-01-01

operational constraints demonstrated, in cooperation with the Air Traffic Control System Command Center, while air traffic control should be responsible for the implementation of those constraints. The SMEs also indicated that digital data communications would be very beneficial for TBO operations and would result in less workload due to reduced communications, would eliminate issues due to language barriers and frequency problems, and would make receiving, loading, accepting, and executing clearances easier, less ambiguous, and more expeditious. This paper describes an Advanced 4DT operational concept, the TBO Prototype, the demonstration scenarios and methods used, and the feedback obtained from the pilot and controller SMEs in this focus group evaluation.

Advanced Demonstration and Test Reactor Options Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Petti, David Andrew; Hill, R.; Gehin, J.

Global efforts to address climate change will require large-scale decarbonization of energy production in the United States and elsewhere. Nuclear power already provides 20% of electricity production in the United States (U.S.) and is increasing in countries undergoing rapid growth around the world. Because reliable, grid-stabilizing, low emission electricity generation, energy security, and energy resource diversity will be increasingly valued, nuclear power’s share of electricity production has a potential to grow. In addition, there are non electricity applications (e.g., process heat, desalination, hydrogen production) that could be better served by advanced nuclear systems. Thus, the timely development, demonstration, and commercializationmore » of advanced nuclear reactors could diversify the nuclear technologies available and offer attractive technology options to expand the impact of nuclear energy for electricity generation and non-electricity missions. The purpose of this planning study is to provide transparent and defensible technology options for a test and/or demonstration reactor(s) to be built to support public policy, innovation and long term commercialization within the context of the Department of Energy’s (DOE’s) broader commitment to pursuing an “all of the above” clean energy strategy and associated time lines. This planning study includes identification of the key features and timing needed for advanced test or demonstration reactors to support research, development, and technology demonstration leading to the commercialization of power plants built upon these advanced reactor platforms. This planning study is consistent with the Congressional language contained within the fiscal year 2015 appropriation that directed the DOE to conduct a planning study to evaluate “advanced reactor technology options, capabilities, and requirements within the context of national needs and public policy to support innovation in nuclear energy�

Prospective Validation of Objective Prognostic Score for Advanced Cancer Inpatients in South Korea: A Multicenter Study.

PubMed

Yoon, Seok Joon; Suh, Sang-Yeon; Lee, Yong Joo; Park, Jeanno; Hwang, Sunwook; Lee, Sanghee Shiny; Ahn, Hong Yup; Koh, Su-Jin; Park, Keon Uk

2017-01-01

Objective Prognostic Score (OPS) was developed as an easy and simple prognosticating tool in South Korea. It has been validated retrospectively in a single center in South Korea. We aimed to validate the OPS prospectively for advanced cancer inpatients in South Korea using a multicenter study. This was a prospective cohort study. We enrolled 243 advanced cancer patients admitted in five palliative care units in South Korea from May 2013 till March 2015. Seven members of the Korean Palliative Medicine Research Network who are experts of palliative care led the study. Clinical variables (dyspnea/anorexia/performance status) and laboratory variables (total leukocyte counts/serum total bilirubin/serum creatinine/lactate dehydrogenase) were collected at the enrollment. Survival time was calculated as days from enrollment to death during admission. A total of 217 patients were included in the final analysis (feasibility: 89.3%). Survival time of the higher OPS group (OPS ≥3) and the lower OPS group (OPS <3) was 10.0 (95% confidence interval (CI) 7.72-12.28) days and 32.0 (95% CI 25.44-38.56) days, respectively. There were significant differences between the 2 groups (p < 0.001). Overall accuracy of OPS ≥3 for predicting survival less than three weeks was 71.0%. OPS was successfully validated using a prospective multicenter study in South Korea. It is a useful method to predict three-week survival of Korean inpatients with advanced cancer.

High dose melphalan in the treatment of advanced neuroblastoma: results of a randomised trial (ENSG-1) by the European Neuroblastoma Study Group.

PubMed

Pritchard, Jon; Cotterill, Simon J; Germond, Shirley M; Imeson, John; de Kraker, Jan; Jones, David R

2005-04-01

High dose myeloablative chemotherapy ("megatherapy"), with haematopoietic stem cell support, is now widely used to consolidate response to induction chemotherapy in patients with advanced neuroblastoma. In this study (European Neuroblastoma Study Group, ENSG1), the value of melphalan myeloablative "megatherapy" was evaluated in a randomised, multi-centre trial. Between 1982 and 1985, 167 children with stages IV and III neuroblastoma (123 stage IV > 1 year old at diagnosis and 44 stage III and stage IV from 6 to 12 months old at diagnosis) were treated with oncovin, cisplatin, epipodophyllotoxin, and cyclophosphamide (OPEC) induction chemotherapy every 3 weeks. After surgical excision of primary tumour, the 90 patients (69% of the total) who achieved complete response (CR) or good partial response (GPR) were eligible for randomisation either to high dose melphalan (180 mg per square meter) with autologous bone marrow support or to no further treatment. Sixty-five (72%) of eligible children were actually randomised and 21 of these patients were surviving at time of this analysis, with median follow-up from randomisation of 14.3 years. Five year event-free survival (EFS) was 38% (95% confidence interval (CI) 21-54%) in the melphalan-treated group and 27% (95% CI 12-42%) in the "no-melphalan" group. This difference was not statistically significant (P = 0.08, log rank test) but for the 48 randomised stage IV patients aged >1 year at diagnosis outcome was significantly better in the melphalan-treated group-5 year EFS 33% versus 17% (P = 0.01, log rank test). In this trial, high dose melphalan improved the length of EFS and overall survival of children with stage IV neuroblastoma >1 year of age who achieved CR or GPR after OPEC induction therapy and surgery. Multi-agent myeloablative regimens are now widely used as consolidation therapy for children with stage IV disease and in those with other disease stages when the MYCN gene copy number in tumour cells is amplified

Docetaxel/S-1 Versus Docetaxel/Capecitabine as First-Line Treatment for Advanced Breast Cancer: A Retrospective Study.

PubMed

Li, Jinyu; You, Junhao; Si, Wen; Zhu, Yanyun; Chen, Yi; Yang, Bo; Han, Chun; Linghu, Ruixia; Zhang, Xingyang; Jiao, Shunchang; Yang, Junlan

2015-10-01

The treatment efficacy of advanced breast cancer is still not promising. This study aimed to compare the efficacy and safety of docetaxel/S-1 (DS1) versus docetaxel/capecitabine (DX) as the first-line treatment for advanced breast cancer.From June 2008 to June 2013, 22 patients with advanced breast cancer were treated with the DS1 regimen. Another 26 age- and disease status-matched patients treated with the DX regimen served as controls. The 2 groups were compared in terms of time to progression (TTP), objective response rate, disease control rate, clinical benefit rate, and safety profiles.Median TTP did not differ significantly between the DS1 group and the DX group (9.04 vs 10.94 months, P = 0.473). There were no significant differences in objective response rate, disease control rate, and clinical benefit rate between the 2 groups. Both the DS1 and the DX regimens showed good tolerability. The 2 regimens showed no significant difference in adverse events except degree III hand-foot syndrome (DS1 0 vs DX 23.1%, P = 0.025).For the first-line treatment of advanced breast cancer, the DS1 and the DX regimens showed similar efficacy and safety. The DS1 regimen had less severe hand-foot syndrome than the DX regimen.

Facilitating Group Analysis of Two Case Studies Utilising Peer Tutoring: Comparison of Tasks and Outcomes

ERIC Educational Resources Information Center

Fong, Lin Siew

2016-01-01

Peer-tutoring sessions of two groups of advanced diploma in financial accounting students with mixed proficiency were analysed thoroughly in this study. Numerous studies in peer tutoring have produced favourable results to both tutors and tutees due to the scaffolding process which promotes effective learning. However, there is a lack of studies…

Coping Well with Advanced Cancer: A Serial Qualitative Interview Study with Patients and Family Carers

PubMed Central

Roberts, Diane; Appleton, Lynda; Calman, Lynn; Large, Paul; Lloyd-Williams, Mari; Grande, Gunn

2017-01-01

Objectives To understand successful strategies used by people to cope well when living with advanced cancer; to explore how professionals can support effective coping strategies; to understand how to support development of effective coping strategies for patients and family carers. Design Qualitative serial (4–12 week intervals) interview study with people with advanced cancer and their informal carers followed by focus groups. The iterative design had a novel focus on positive coping strategies. Interview analysis focused on patients and carers as individuals and pairs, exploring multiple dimensions of their coping experiences. Focus group analysis explored strategies for intervention development. Participants 26 people with advanced (stage 3–4) breast, prostate, lung or colorectal cancer, or in receipt of palliative care, and 24 paired nominated informal/family carers. Setting Participants recruited through outpatient clinics at two tertiary cancer centres in Merseyside and Manchester, UK, between June 2012 and July 2013. Results 45 patient and 41 carer interviews were conducted plus 4 focus groups (16 participants). People with advanced cancer and their informal/family carers develop coping strategies which enable effective management of psychological wellbeing. People draw from pre-diagnosis coping strategies, but these develop through responding to the experience of living with advanced cancer. Strategies include being realistic, indulgence, support, and learning from others, which enabled participants to regain a sense of wellbeing after emotional challenge. Learning from peers emerged as particularly important in promoting psychological wellbeing through the development of effective ‘everyday’, non-clinical coping strategies. Conclusions Our findings challenge current models of providing psychological support for those with advanced cancer which focus on professional intervention. It is important to recognise, enable and support peoples’ own

Advance Care Planning Does Not Adversely Affect Hope or Anxiety Among Patients With Advanced Cancer.

PubMed

Green, Michael J; Schubart, Jane R; Whitehead, Megan M; Farace, Elana; Lehman, Erik; Levi, Benjamin H

2015-06-01

Many physicians avoid advance care planning (ACP) discussions because they worry such conversations will lead to psychological distress. To investigate whether engaging in ACP using online planning tools adversely affects hope, hopelessness, or anxiety among patients with advanced cancer. Patients with advanced cancer and an estimated survival of two years or less (Intervention group) and a Control group were recruited at a tertiary care academic medical center (2007-2012) to engage in ACP using an online decision aid ("Making Your Wishes Known"). Pre/post and between-group comparisons were made, including hope (Herth Hope Index), hopelessness (Beck Hopelessness Scale), and anxiety (State Trait Anxiety Inventory). Secondary outcomes included ACP knowledge, self-determination, and satisfaction. A total of 200 individuals completed the study. After engaging in ACP, there was no decline in hope or increase in hopelessness in either the Control or Intervention group. Anxiety was likewise unchanged in the Control group but decreased slightly in the Intervention group. Knowledge of ACP (% correct answers) increased in both the groups, but more so in the Intervention group (13% increase vs. 4%; P<0.01). Self-determination increased slightly in both groups, and satisfaction with the ACP process was greater (P<0.01) in the Intervention than Control group. Engaging in ACP with online planning tools increases knowledge without diminishing hope, increasing hopelessness, or inducing anxiety in patients with advanced cancer. Physicians need not avoid ACP out of concern for adversely affecting patients' psychological well-being. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Healthcare professionals' response to cachexia in advanced cancer: a qualitative study.

PubMed

Millar, Claire; Reid, Joanne; Porter, Sam

2013-11-01

To explore healthcare professionals' experience, understanding, and perception of the needs of patients with cachexia in advanced cancer. A qualitative approach based on symbolic interactionism. A regional cancer center in a large teaching hospital in the United Kingdom. 34 healthcare professionals who had experience providing care to patients with cachexia in advanced cancer. Data collection consisted of two phases: focus group and semistructured interviews. Interviews were digitally recorded and transcribed verbatim for analysis. This article reports on findings from the second phase of data collection. Analysis revealed that professional approaches to cachexia were influenced by three overarching and interthinking themes: knowledge, culture, and resources. Healthcare professionals commonly recognized the impact of the syndrome; however, for nonpalliative healthcare professionals, a culture of avoidance and an overreliance on the biomedical model of care had considerable influence on the management of cachexia in patients with advanced cancer. Cachexia management in patients with advanced cancer can be difficult and is directed by a variable combination of the influence of knowledge, culture of the clinical area, and available resources. Distinct differences exist in the management of cachexia among palliative and nonpalliative care professionals. This study presented a multiprofessional perspective on the management of cachexia in patients with advanced cancer and revealed that cachexia is a complex and challenging syndrome that needs to be addressed from a holistic model of care. Cachexia management in patients with advanced cancer is complex and challenging and is directed by a combination of variables. An overreliance on the biomedical model of health and illness occurs in the management of cachexia in patients with advanced cancer. Cachexia needs to be addressed from a holistic model of care to reflect the multidimensional needs of patients and their

Triptorelin for the relief of lower urinary tract symptoms in men with advanced prostate cancer: results of a prospective, observational, grouped-analysis study

PubMed Central

Gil, Thierry; Aoun, Fouad; Cabri, Patrick; Perrot, Valérie; van Velthoven, Roland

2017-01-01

Background: Lower urinary tract symptoms (LUTSs) may develop in men with prostate cancer (PCa) and can impact quality of life (QoL). Gonadotropin-releasing hormone (GnRH) agonists as androgen deprivation therapy are standard treatment for PCa, however, data are limited on their effects on LUTSs. A grouped analysis of national observational, non-interventional studies initiated in clinical practice was performed to assess the effectiveness of triptorelin in reducing moderate or severe LUTSs, measured using the International Prostate Symptom Score (IPSS) in men with advanced or metastatic PCa. Methods: Men with PCa and LUTSs scheduled to receive triptorelin (3-month or 1-month extended release formulation) were recruited into prospective, non-interventional studies at centres in Algeria, Australia, Belgium, China, Hungary, Romania and South Korea. The primary effectiveness endpoint was the proportion of patients with moderate or severe LUTSs, assessed by IPSS, after 48 weeks. Secondary endpoints included: total IPSS, QoL due to urinary symptoms (IPSS Question 8) and prostate-specific antigen (PSA) levels at 24 and 48 weeks. Results: A total of 2701 patients were recruited; 1851 patients with moderate or severe LUTSs at baseline (IPSS > 7), received triptorelin and had follow-up IPSS (efficacy population). The proportion of patients with moderate or severe LUTSs was reduced to 67.2% from baseline at week 48, following a reduction to 75.9% at week 24: the overall time effect was significant (p < 0.001). QoL due to urinary symptoms significantly improved from a mean score of 3.7 at baseline, to adjusted means of 2.5 and 2.1, at weeks 24 and 48, respectively (p < 0.001 versus baseline). Mean PSA levels were reduced from 158.8 ng/ml at baseline to 11.5 and 16.0 ng/ml at weeks 24 and 48, respectively. Conclusions: Within the limitations of these observational studies, improvements in LUTSs and QoL observed after 24 weeks and maintained at 48 weeks indicate that triptorelin

Evaluation of PET and laparoscopy in STagIng advanced gastric cancer: a multicenter prospective study (PLASTIC-study).

PubMed

Brenkman, H J F; Gertsen, E C; Vegt, E; van Hillegersberg, R; van Berge Henegouwen, M I; Gisbertz, S S; Luyer, M D P; Nieuwenhuijzen, G A P; van Lanschot, J J B; Lagarde, S M; de Steur, W O; Hartgrink, H H; Stoot, J H M B; Hulsewe, K W E; Spillenaar Bilgen, E J; van Det, M J; Kouwenhoven, E A; van der Peet, D L; Daams, F; van Sandick, J W; van Grieken, N C T; Heisterkamp, J; van Etten, B; Haveman, J W; Pierie, J P; Jonker, F; Thijssen, A Y; Belt, E J T; van Duijvendijk, P; Wassenaar, E; van Laarhoven, H W M; Wessels, F J; Haj Mohammad, N; van Stel, H F; Frederix, G W J; Siersema, P D; Ruurda, J P

2018-04-20

Initial staging of gastric cancer consists of computed tomography (CT) and gastroscopy. In locally advanced (cT3-4) gastric cancer, fluorodeoxyglucose positron emission tomography with CT (FDG-PET/CT or PET) and staging laparoscopy (SL) may have a role in staging, but evidence is scarce. The aim of this study is to evaluate the impact and cost-effectiveness of PET and SL in addition to initial staging in patients with locally advanced gastric cancer. This prospective observational cohort study will include all patients with a surgically resectable, advanced gastric adenocarcinoma (cT3-4b, N0-3, M0), that are scheduled for treatment with curative intent after initial staging with gastroscopy and CT. The modalities to be investigated in this study is the addition of PET and SL. The primary outcome of this study is the proportion of patients in whom the PET or SL lead to a change in treatment strategy. Secondary outcome parameters are: diagnostic performance, morbidity and mortality, quality of life, and cost-effectiveness of these additional diagnostic modalities. The study recently started in August 2017 with a duration of 36 months. At least 239 patients need to be included in this study to demonstrate that the diagnostic modalities are break-even. Based on the annual number of gastrectomies in the participating centers, it is estimated that approximately 543 patients are included in this study. In this study, it is hypothesized that performing PET and SL for locally advanced gastric adenocarcinomas results in a change of treatment strategy in 27% of patients and an annual cost-reduction in the Netherlands of €916.438 in this patient group by reducing futile treatment. The results of this study may be applicable to all countries with comparable treatment algorithms and health care systems. NCT03208621 . This trial was registered prospectively on June 30, 2017.

Advanced heat receiver conceptual design study

NASA Technical Reports Server (NTRS)

Kesseli, James; Saunders, Roger; Batchelder, Gary

1988-01-01

Solar Dynamic space power systems are candidate electrical power generating systems for future NASA missions. One of the key components of the solar dynamic power system is the solar receiver/thermal energy storage (TES) subsystem. Receiver development was conducted by NASA in the late 1960's and since then a very limited amount of work has been done in this area. Consequently the state of the art (SOA) receivers designed for the IOC space station are large and massive. The objective of the Advanced Heat Receiver Conceptual Design Study is to conceive and analyze advanced high temperature solar dynamic Brayton and Stirling receivers. The goal is to generate innovative receiver concepts that are half of the mass, smaller, and more efficient than the SOA. It is also necessary that these innovative receivers offer ease of manufacturing, less structural complexity and fewer thermal stress problems. Advanced Brayton and Stirling receiver storage units are proposed and analyzed in this study which can potentially meet these goals.

Advanced Platform Systems Technology study. Volume 3: Supporting data

NASA Technical Reports Server (NTRS)

1983-01-01

The overall study effort proceeded from the identification of 106 technology topics to the selection of 5 for detail trade studies. The technical issues and options were evaluated through the trade process. Finally, individual consideration was given to costs and benefits for the technologies identified for advancement. Eight priority technology items were identified for advancement. Supporting data generated during the trade selection and trade study process were presented. Space platform requirements, trade study and cost benefits analysis, and technology advancement planning are advanced. The structured approach used took advantage of a number of forms developed to ensure that a consistent approach was employed by each of the diverse specialists that participated. These forms were an intrinsic part of the study protocol.

CHEMOTHERAPY INTENSITY AND TOXICITY AMONG BLACK AND WHITE WOMEN WITH ADVANCED AND RECURRENT ENDOMETRIAL CANCER: A GYNECOLOGIC ONCOLOGY GROUP STUDY

PubMed Central

Farley, John H.; Tian, Chunqiao; Rose, G. Scott; Brown, Carol L.; Birrer, Michael; Risinger, John I; Thigpen, J. Tate; Fleming, Gini F.; Gallion, Holly H.; Maxwell, G. Larry

2009-01-01

OBJECTIVE: The purpose of this study was to confirm whether Black and White women with endometrial cancer are equally tolerant of chemotherapy and identify factors that impact survival. METHODS: A retrospective review of 169 Black women and 982 White women with FIGO Stage III/IV or recurrent endometrial carcinoma was performed. All patients received doxorubicin combined with cisplatin. Chemotherapy parameters that were reviewed included relative dose (RD), relative time (RT), and relative dose intensity (RDI). Treatment cycles ≥ 7 were defined as treatment completion. RESULTS: Although Black patients were more likely to experience grade 3-4 anemia (20% vs. 14%) and genitourinary (5% vs. 1%) toxicity, and less likely to experience severe GI toxicity (10% vs. 17%), the overall incidence of grade 3-4 treatment-related chemotoxicity was the same between the two groups (82% vs. 82%). There were no differences in the number of cycles received, RD (0.57 vs. 0.58), RT (0.77 vs. 0.78), or RDI (0.76 vs. 0.76) for Black and White patients. CONCLUSION: Black patients with advanced stage or recurrent endometrial cancer, treated on four GOG protocols, had similar dose intensity and severe chemotherapy-related toxicity compared to White patients, suggesting that previously described racial disparities in survival among patients in GOG trials may have an novel etiology. PMID:19924790

Benchmarking Investments in Advancement: Results of the Inaugural CASE Advancement Investment Metrics Study (AIMS). CASE White Paper

ERIC Educational Resources Information Center

Kroll, Juidith A.

2012-01-01

The inaugural Advancement Investment Metrics Study, or AIMS, benchmarked investments and staffing in each of the advancement disciplines (advancement services, alumni relations, communications and marketing, fundraising and advancement management) as well as the return on the investment in fundraising specifically. This white paper reports on the…

The Strategic Study Group on the Status of Women: Report to the President and the Commission for Women--Recommendation Package #2.

ERIC Educational Resources Information Center

Pennsylvania State Univ., University Park.

The document presents partial recommendations of a Pennsylvania State University Study Group on the Status of Women at the University. Recommendations concern family-responsive and flexible employee benefits, clerical advancement and development, retention and advancement of women faculty, and sexual harassment of students. Among specific…

Skills Required for Nursing Career Advancement: A Qualitative Study.

PubMed

Sheikhi, Mohammad Reza; Fallahi-Khoshnab, Masoud; Mohammadi, Farahnaz; Oskouie, Fatemeh

2016-06-01

Nurses require certain skills for progression in their field. Identifying these skills can provide the context for nursing career advancement. This study aimed to identify the skills needed for nurses' career advancement. A qualitative approach using content analysis was adopted to study a purposive sample of eighteen nurses working in teaching hospitals affiliated with the Qazvin, Shahid Beheshti, and Iran Universities of Medical Sciences. The data were collected through semi-structured interviews, and analyzed using conventional content analysis. The three themes extracted from the data included interpersonal capabilities, competency for career success, and personal capacities. The results showed that acquiring a variety of skills is essential for career advancement. The findings showed that personal, interpersonal, and functional skills can facilitate nurses' career advancement. The effects of these skills on career advancement depend on a variety of conditions that require further studies.

Advanced Cogeneration Technology Economic Optimization Study (ACTEOS)

NASA Technical Reports Server (NTRS)

Nanda, P.; Ansu, Y.; Manuel, E. H., Jr.; Price, W. G., Jr.

1980-01-01

The advanced cogeneration technology economic optimization study (ACTEOS) was undertaken to extend the results of the cogeneration technology alternatives study (CTAS). Cost comparisons were made between designs involving advanced cogeneration technologies and designs involving either conventional cogeneration technologies or not involving cogeneration. For the specific equipment cost and fuel price assumptions made, it was found that: (1) coal based cogeneration systems offered appreciable cost savings over the no cogeneration case, while systems using coal derived liquids offered no costs savings; and (2) the advanced cogeneration systems provided somewhat larger cost savings than the conventional systems. Among the issues considered in the study included: (1) temporal variations in steam and electric demands; (2) requirements for reliability/standby capacity; (3) availability of discrete equipment sizes; (4) regional variations in fuel and electricity prices; (5) off design system performance; and (6) separate demand and energy charges for purchased electricity.

Phase II study of erlotinib in patients with advanced biliary cancer.

PubMed

Philip, Philip A; Mahoney, Michelle R; Allmer, Cristine; Thomas, James; Pitot, Henry C; Kim, George; Donehower, Ross C; Fitch, Tom; Picus, Joel; Erlichman, Charles

2006-07-01

Epidermal growth factor receptor/human epidermal growth factor receptor 1 and ligand expression is common in biliary cancers (BILI) and may be associated with worse outcome. The primary objective of this study was to determine the proportion of patients with advanced BILI who were progression-free at 6 months. Patients with either unresectable or metastatic disease were studied. Only one prior systemic or locoregional therapy was allowed. Erlotinib was administered continuously at a dose of 150 mg per day orally. Forty-two patients with BILI were enrolled. The median age was 67 years (range, 33 to 82 years). Fifty-two percent of patients had Eastern Cooperative Oncology Group performance status of 1. Fifty-seven percent of patients had received prior chemotherapy for advanced BILI. HER1/EGFR expression by immunohistochemistry in tumor cells was detected in 29 (81%) of the 36 assessable patients. Seven of the patients (17%; 95% CI, 7% to 31%) were progression free at 6 months. Three patients had partial response by Response Evaluation Criteria in Solid Tumors Group classification of duration 4, 4, and 14 months, respectively. All responding patients had mild (grade 1/2) skin rash and two patients had positive tumoral HER1/EGFR expression. Three patients (7%) had toxicity-related dose reductions of erlotinib due to grade 2/3 skin rash. Results suggest a therapeutic benefit for EGFR blockade with erlotinib in patients with biliary cancer. Additional studies with erlotinib as a single agent and in combination with other targeted agents are warranted in this disease.

Study Groups: Conduit for Reform.

ERIC Educational Resources Information Center

Makibbin, Shirley S.; Sprague, Marsha M.

This conference presentation describes study groups as a mechanism for changing teacher behavior. The history of study groups is discussed, beginning with the first American study groups organized by Benjamin Franklin; the Chautauqua Literary and Scientific Circle; the waning of study groups in the early 20th century as college enrollment…

Skills Required for Nursing Career Advancement: A Qualitative Study

PubMed Central

Sheikhi, Mohammad Reza; Fallahi-Khoshnab, Masoud; Mohammadi, Farahnaz; Oskouie, Fatemeh

2016-01-01

Background Nurses require certain skills for progression in their field. Identifying these skills can provide the context for nursing career advancement. Objectives This study aimed to identify the skills needed for nurses’ career advancement. Materials and Methods A qualitative approach using content analysis was adopted to study a purposive sample of eighteen nurses working in teaching hospitals affiliated with the Qazvin, Shahid Beheshti, and Iran Universities of Medical Sciences. The data were collected through semi-structured interviews, and analyzed using conventional content analysis. Results The three themes extracted from the data included interpersonal capabilities, competency for career success, and personal capacities. The results showed that acquiring a variety of skills is essential for career advancement. Conclusions The findings showed that personal, interpersonal, and functional skills can facilitate nurses’ career advancement. The effects of these skills on career advancement depend on a variety of conditions that require further studies. PMID:27556054

Facilitated Psychiatric Advance Directives: A Randomized Trial of an Intervention to Foster Advance Treatment Planning Among Persons with Severe Mental Illness

PubMed Central

Swanson, Jeffrey W.; Swartz, Marvin S.; Elbogen, Eric B.; Van Dorn, Richard A.; Ferron, Joelle; Wagner, H. Ryan; McCauley, Barbara J.; Kim, Mimi

2013-01-01

Objective Studies show a high potential demand for psychiatric advance directives but low completion rates. The authors conducted a randomized study of a structured, manualized intervention to facilitate completion of psychiatric advance directives. Method A total of 469 patients with severe mental illness were randomly assigned to a facilitated psychiatric advance directive session or a control group that received written information about psychiatric advance directives and referral to resources in the public mental health system. Completion of an advance directive, its structure and content, and its short-term effects on working alliance and treatment satisfaction were recorded. Results Sixty-one percent of participants in the facilitated session completed an advance directive or authorized a proxy decision maker, compared with only 3% of control group participants. Psychiatrists rated the advance directives as highly consistent with standards of community practice. Most participants used the advance directive to refuse some medications and to express preferences for admission to specific hospitals and not others, although none used an advance directive to refuse all treatment. At 1-month follow-up, participants in the facilitated session had a greater working alliance with their clinicians and were more likely than those in the control group to report receiving the mental health services they believed they needed. Conclusions The facilitation session is an effective method of helping patients complete psychiatric advance directives and ensuring that the documents contain useful information about patients’ treatment preferences. Achieving the promise of psychiatric advance directives may require system-level policies to embed facilitation of these instruments in usual-care care settings. PMID:17074946

Characteristics of first-time fathers of advanced age: a Norwegian population-based study

PubMed Central

2013-01-01

Background The modern phenomenon of delayed parenthood applies not only to women but also to men, but less is known about what characterises men who are expecting their first child at an advanced age. This study investigates the sociodemographic characteristics, health behaviour, health problems, social relationships and timing of pregnancy in older first-time fathers. Methods A cross-sectional study was conducted of 14 832 men who were expecting their first child, based on data from the Norwegian Mother and Child Cohort Study (MoBa) carried out by the Norwegian Institute of Public Health. Data were collected in 2005–2008 by means of a questionnaire in gestational week 17–18 of their partner’s pregnancy, and from the Norwegian Medical Birth Register. The distribution of background variables was investigated across the age span of 25 years and above. Men of advanced age (35–39 years) and very advanced age (40 years or more) were compared with men aged 25–34 years by means of bivariate and multivariate logistic regression analyses. Results The following factors were found to be associated with having the first child at an advanced or very advanced age: being unmarried or non-cohabitant, negative health behaviour (overweight, obesity, smoking, frequent alcohol intake), physical and mental health problems (lower back pain, cardiovascular diseases, high blood pressure, sleeping problems, previous depressive symptoms), few social contacts and dissatisfaction with partner relationship. There were mixed associations for socioeconomic status: several proxy measures of high socioeconomic status (e.g. income >65 000 €, self-employment) were associated with having the first child at an advanced or very advanced age, as were several other proxy measures of low socioeconomic status (e.g. unemployment, low level of education, immigrant background).The odds of the child being conceived after in vitro fertilisation were threefold in men aged 34–39 and fourfold from 40

Facebook and Classroom Group Work: A Trial Study Involving University of Botswana Advanced Oral Presentation Students

ERIC Educational Resources Information Center

Magogwe, Joel M.; Ntereke, Beauty; Phetlhe, Keith R.

2015-01-01

In the 21st century, the use of information technology in the classroom is advancing rapidly, especially in higher education. The Internet, through social networking, has made it possible for students to learn and teachers to teach outside the classroom walls. Facebook in particular has made it possible for students to interact and communicate…

Advanced Platform Systems Technology study. Volume 4: Technology advancement program plan

NASA Technical Reports Server (NTRS)

1983-01-01

An overview study of the major technology definition tasks and subtasks along with their interfaces and interrelationships is presented. Although not specifically indicated in the diagram, iterations were required at many steps to finalize the results. The development of the integrated technology advancement plan was initiated by using the results of the previous two tasks, i.e., the trade studies and the preliminary cost and schedule estimates for the selected technologies. Descriptions for the development of each viable technology advancement was drawn from the trade studies. Additionally, a logic flow diagram depicting the steps in developing each technology element was developed along with descriptions for each of the major elements. Next, major elements of the logic flow diagrams were time phased, and that allowed the definition of a technology development schedule that was consistent with the space station program schedule when possible. Schedules show the major milestone including tests required as described in the logic flow diagrams.

Space transfer vehicle concepts and requirements study. Volume 2, book 4: Integrated advanced technology development

NASA Technical Reports Server (NTRS)

Weber, Gary A.

1991-01-01

The Space Transfer Vehicle (STV) program provides both an opportunity and a requirement to increase our upper stage capabilities with the development and applications of new technologies. Issues such as man rating, space basing, reusability, and long lunar surface storage times drive the need for new technology developments and applications. In addition, satisfaction of mission requirements such as lunar cargo delivery capability and lunar landing either require new technology development or can be achieved in a more cost-effective manner with judicious applications of advanced technology. During the STV study, advanced technology development requirements and plans have been addressed by the Technology/Advanced Development Working Group composed of NASA and contractor representatives. This report discusses the results to date of this working group. The first section gives an overview of the technologies that have potential or required applications for the STV and identifies those technologies baselined for the STV. Figures are provided that list the technology categories and show the priority placed on those technology categories for either the space-based or ground-based options. The second section covers the plans and schedules for incorporating the technologies into the STV program.

Japanese citizens' attitude toward end-of-life care and advance directives: A qualitative study for members of medical cooperatives.

PubMed

Hirayama, Yoko; Otani, Takashi; Matsushima, Masato

2017-12-01

Japanese citizens are interested in choosing their own end-of-life care, but few have created their own advance directive. This study examined changes among Japanese citizens' attitudes toward end-of-life care and advance directives and explored factors that affected these attitudes. We conducted five focus groups with 48 participants in 2009 and 2010. All participants were members of health cooperatives in Tokyo. We identified many barriers and reasons for creating and writing down advance directives. Experience caring for dying people and having a serious disease affected attitudes toward advance directives. Some participants changed their attitude toward end-of-life care by writing their own advance directive. When someone is writing advance directives, asking about his/her past experience of caring may be helpful. And learning about or filling out advance directives may help to break down resistance to using these documents.

Resection after neoadjuvant chemotherapy in advanced carcinoma of the gallbladder: a retrospective study.

PubMed

Selvakumar, Veda Padma Priya; Zaidi, Shuaib; Pande, Pankaj; Goel, Ashish; Kumar, Kapil

2015-03-01

Although rare over most of the world, Gallbladder cancer is very common in northern india. A delayed presentation, aggressive nature,lack of randomised trials and a poor prognosis have all contributed to the nihilistic halo encircling gallbladder cancer. None of the advances in oncology have been exploited enough to shatter the nihilistic halo. In this background we sought to analyze if the addition of neoadjuvant chemotherapy had any impact on the resectability, overall and disease free survival in patients with advanced carcinoma of the gallbladder. We reviewed the records of all patients who underwent surgery for carcinoma of the gall bladder from 2004 to 2010 at our institute retrospectively. Twenty-one patients received neoadjuvant chemotherapy and subsequently taken up for surgery. Outcome analysis of these 21 patients were done by Kaplan meier method and graphs plotted. Out of the 21 patients who were taken up for surgery after neoadjuvant chemotherapy, fourteen patients underwent R0 resection (Group 1). Seven patients had been rendered inoperable on exploration (Group 2). Thus about 66.67 % of patients deemed resectable after neoadjuvant chemotherapy on imaging underwent R0 resection. The mean overall survival of the group 1 was 42.8 months versus 6.6 months of group 2(Hazard Ratio: 3.42). Neoadjuvant chemotherapy improves resectability in some patients with unresectable gall bladder cancer. Resection after neoadjuvant chemotherapy is feasible and may improve survival in a select group of patients. However randomized studies are required to establish its definitive role.

Study protocol for 'we DECide': implementation of advance care planning for nursing home residents with dementia.

PubMed

Ampe, Sophie; Sevenants, Aline; Coppens, Evelien; Spruytte, Nele; Smets, Tinne; Declercq, Anja; van Audenhove, Chantal

2015-05-01

To evaluate the effects of 'we DECide', an educational intervention for nursing home staff on shared decision-making in the context of advance care planning for residents with dementia. Advance care planning (preparing care choices for when persons no longer have decision-making capacity) is of utmost importance for nursing home residents with dementia, but is mostly not realized for this group. Advance care planning consists of discussing care choices and making decisions and corresponds to shared decision-making (the involvement of persons and their families in care and treatment decisions). This quasi-experimental pre-test-post-test study is conducted in 19 nursing homes (Belgium). Participants are nursing home staff. 'We DECide' focuses on three crucial moments for discussing advance care planning: the time of admission, crisis situations and everyday conversations. The 'ACP-audit' assesses participants' views on the organization of advance care planning (organizational level), the 'OPTION scale' evaluates the degree of shared decision-making in individual conversations (clinical level) and the 'IFC-SDM Questionnaire' assesses participants' views on Importance, Frequency and Competence of realizing shared decision-making (clinical level). (Project funded: July 2010). The study hypothesis is that 'we DECide' results in a higher realization of shared decision-making in individual conversations on advance care planning. A better implementation of advance care planning will lead to a higher quality of end-of-life care and more person-centred care. We believe our study will be of interest to researchers and to professional nursing home caregivers and policy-makers. © 2014 John Wiley & Sons Ltd.

Needs of people with advanced dementia in their final phase of life: A multi-perspective qualitative study in nursing homes.

PubMed

Schmidt, Holger; Eisenmann, Yvonne; Golla, Heidrun; Voltz, Raymond; Perrar, Klaus Maria

2018-03-01

People with advanced dementia present an important target group for palliative care. They suffer a range of symptoms, and their verbal communication abilities are highly restricted. At present, little is known about their needs in the final phase of life. To identify the needs of people with advanced dementia in their final phase of life and to explore the aspects relevant to first recognize and then meet these needs. Multi-perspective qualitative study using grounded theory methodology conducting group discussions, individual interviews, and participant observation. The study encompassed nursing homes and involved health professionals, relatives, and residents with advanced dementia. Data were collected in six nursing homes. Nine group discussions and three individual interviews were conducted comprising 42 health professionals and 14 relatives. Participant observations aided in giving the perspective of 30 residents with advanced dementia. Data analysis generated a total of 25 physical, psychosocial, and spiritual needs divided into 10 categories. Physical needs were classified as follows: "food intake," "physical well-being," and "physical activity and recovery." Categories of psychosocial needs were classified as follows: "adaptation of stimuli," "communication," "personal attention," "participation," "familiarity and safety," as well as "self-determination." Spiritual needs addressed "religion." The results revealed a multitude of key aspects for recognizing and meeting these needs, stressing the importance of personhood. People with advanced dementia in their final phase of life have a multitude of individual and complex needs. This evidence contributes to narrowing the current research gap, offering an orientation framework for research and practice.

Simulated Group Counseling: An Experiential Training Model for Group Work.

ERIC Educational Resources Information Center

Romano, John L.

1998-01-01

Describes an experiential group training model designed for prepracticum-level counseling graduate students. Simulated Group Counseling (SCG) offers students an opportunity to experience being group members; facilitating a group; and processing the group with peers, an advanced graduate student observer, and the instructor. SGC reduces…

Group Theory with Applications in Chemical Physics

NASA Astrophysics Data System (ADS)

Jacobs, Patrick

2005-10-01

Group Theory is an indispensable mathematical tool in many branches of chemistry and physics. This book provides a self-contained and rigorous account on the fundamentals and applications of the subject to chemical physics, assuming no prior knowledge of group theory. The first half of the book focuses on elementary topics, such as molecular and crystal symmetry, whilst the latter half is more advanced in nature. Discussions on more complex material such as space groups, projective representations, magnetic crystals and spinor bases, often omitted from introductory texts, are expertly dealt with. With the inclusion of numerous exercises and worked examples, this book will appeal to advanced undergraduates and beginning graduate students studying physical sciences and is an ideal text for use on a two-semester course. An introductory and advanced text that comprehensively covers fundamentals and applications of group theory in detail Suitable for a two-semester course with numerous worked examples and problems Includes several topics often omitted from introductory texts, such as rotation group, space groups and spinor bases

Advanced protein crystal growth programmatic sensitivity study

NASA Technical Reports Server (NTRS)

1992-01-01

The purpose of this study is to define the costs of various APCG (Advanced Protein Crystal Growth) program options and to determine the parameters which, if changed, impact the costs and goals of the programs and to what extent. This was accomplished by developing and evaluating several alternate programmatic scenarios for the microgravity Advanced Protein Crystal Growth program transitioning from the present shuttle activity to the man tended Space Station to the permanently manned Space Station. These scenarios include selected variations in such sensitivity parameters as development and operational costs, schedules, technology issues, and crystal growth methods. This final report provides information that will aid in planning the Advanced Protein Crystal Growth Program.

Advanced Active Thermal Control Systems Architecture Study

NASA Technical Reports Server (NTRS)

Hanford, Anthony J.; Ewert, Michael K.

1996-01-01

The Johnson Space Center (JSC) initiated a dynamic study to determine possible improvements available through advanced technologies (not used on previous or current human vehicles), identify promising development initiatives for advanced active thermal control systems (ATCS's), and help prioritize funding and personnel distribution among many research projects by providing a common basis to compare several diverse technologies. Some technologies included were two-phase thermal control systems, light-weight radiators, phase-change thermal storage, rotary fluid coupler, and heat pumps. JSC designed the study to estimate potential benefits from these various proposed and under-development thermal control technologies for five possible human missions early in the next century. The study compared all the technologies to a baseline mission using mass as a basis. Each baseline mission assumed an internal thermal control system; an external thermal control system; and aluminum, flow-through radiators. Solar vapor compression heat pumps and light-weight radiators showed the greatest promise as general advanced thermal technologies which can be applied across a range of missions. This initial study identified several other promising ATCS technologies which offer mass savings and other savings compared to traditional thermal control systems. Because the study format compares various architectures with a commonly defined baseline, it is versatile and expandable, and is expected to be updated as needed.

Metabolomics and Epidemiology Working Group

Cancer.gov

The Metabolomics and Epidemiology (MetEpi) Working Group promotes metabolomics analyses in population-based studies, as well as advancement in the field of metabolomics for broader biomedical and public health research.

Factors associated with prolonged time to treatment failure with fulvestrant 500 mg in patients with post-menopausal estrogen receptor-positive advanced breast cancer: a sub-group analysis of the JBCRG-C06 Safari study.

PubMed

Kawaguchi, Hidetoshi; Masuda, Norikazu; Nakayama, Takahiro; Aogi, Kenjiro; Anan, Keisei; Ito, Yoshinori; Ohtani, Shoichiro; Sato, Nobuaki; Saji, Shigehira; Takano, Toshimi; Tokunaga, Eriko; Nakamura, Seigo; Hasegawa, Yoshie; Hattori, Masaya; Fujisawa, Tomomi; Morita, Satoshi; Yamaguchi, Miki; Yamashita, Hiroko; Yamashita, Toshinari; Yamamoto, Yutaka; Yotsumoto, Daisuke; Toi, Masakazu; Ohno, Shinji

2018-01-01

The JBCRG-C06 Safari study showed that earlier fulvestrant 500 mg (F500) use, a longer time from diagnosis to F500 use, and no prior palliative chemotherapy were associated with significantly longer time to treatment failure (TTF) among Japanese patients with estrogen receptor-positive (ER+) advanced breast cancer (ABC). The objective of this sub-group analysis was to further examine data from the Safari study, focusing on ER + and human epidermal growth factor receptor-negative (HER2-) cases. The Safari study (UMIN000015168) was a retrospective, multi-center cohort study, conducted in 1,072 patients in Japan taking F500 for ER + ABC. The sub-analysis included only patients administered F500 as second-line or later therapy (n = 960). Of these, 828 patients were HER2-. Results Multivariate analysis showed that advanced age (≥65 years; p = .035), longer time (≥3 years) from ABC diagnosis to F500 use (p < .001), no prior chemotherapy (p < .001), and F500 treatment line (p < .001) were correlated with prolonged TTF (median = 5.39 months). In ER+/HER2- patients receiving F500 as a second-line or later therapy, treatment line, advanced age, no prior palliative chemotherapy use, and a longer period from ABC diagnosis to F500 use were associated with longer TTF.

A preliminary randomised controlled study of short-term Antrodia cinnamomea treatment combined with chemotherapy for patients with advanced cancer.

PubMed

Tsai, Ming-Yen; Hung, Yu-Chiang; Chen, Yen-Hao; Chen, Yung-Hsiang; Huang, Yu-Chuen; Kao, Chao-Wei; Su, Yu-Li; Chiu, Hsien-Hsueh Elley; Rau, Kun-Ming

2016-08-26

Antrodia cinnamomea (AC) is a popular medicinal mushroom in Taiwan that has been widely used for treatment of various cancers. Few clinical studies have reported its application and efficiency in therapeutic chemotherapy strategies. We performed a double-blind, randomized clinical study to investigate whether AC given for 30 days had acceptable safety and efficacy in advanced cancer patients receiving chemotherapy. Patients with advanced and/or metastatic adenocarcinoma, performance status (PS) 0-2, and adequate organ function who had previously been treated with standard chemotherapy were randomly assigned to receive routine chemotherapy regimens with AC (20 ml twice daily) orally for 30 days or placebo. The primary endpoint was 6-month overall survival (OS); the secondary endpoints were disease control rate (DCR), quality of life (QoL), adverse event (AE), and biochemical features within 30 days of treatment. From August 2010 to July 2012, 37 subjects with gastric, lung, liver, breast, and colorectal cancer (17 in the AC group, 20 in the placebo group) were enrolled in the study. Disease progression was the primary cause of death in 4 (33.3 %) AC and 8 (66.7 %) placebo recipients. Mean OSs were 5.4 months for the AC group and 5.0 months for the placebo group (p = 0.340), and the DCRs were 41.2 and 55 %, respectively (p = 0.33). Most hematologic, liver, or kidney functions did not differ significantly between the two groups, but platelet counts were lower in the AC group than in the placebo group (p = 0.02). QoL assessments were similar in the two groups, except that the AC group showed significant improvements in quality of sleep (p = 0.04). Although we found a lower mortality rate and longer mean OS in the AC group than in the control group, A. cinnamomea combined with chemotherapy was not shown to improve the outcome of advanced cancer patients, possibly due to the small sample size. In fact, the combination may present a potential risk

Methodological Challenges in Studies Comparing Prehospital Advanced Life Support with Basic Life Support.

PubMed

Li, Timmy; Jones, Courtney M C; Shah, Manish N; Cushman, Jeremy T; Jusko, Todd A

2017-08-01

Determining the most appropriate level of care for patients in the prehospital setting during medical emergencies is essential. A large body of literature suggests that, compared with Basic Life Support (BLS) care, Advanced Life Support (ALS) care is not associated with increased patient survival or decreased mortality. The purpose of this special report is to synthesize the literature to identify common study design and analytic challenges in research studies that examine the effect of ALS, compared to BLS, on patient outcomes. The challenges discussed in this report include: (1) choice of outcome measure; (2) logistic regression modeling of common outcomes; (3) baseline differences between study groups (confounding); (4) inappropriate statistical adjustment; and (5) inclusion of patients who are no longer at risk for the outcome. These challenges may affect the results of studies, and thus, conclusions of studies regarding the effect of level of prehospital care on patient outcomes should require cautious interpretation. Specific alternatives for avoiding these challenges are presented. Li T , Jones CMC , Shah MN , Cushman JT , Jusko TA . Methodological challenges in studies comparing prehospital Advanced Life Support with Basic Life Support. Prehosp Disaster Med. 2017;32(4):444-450.

Dignity and deferral narratives as strategies in facilitated technology-based support groups for people with advanced cancer.

PubMed

Street, Annette F; Wakelin, Kate; Hordern, Amanda; Bruce, Nicola; Horey, Dell

2012-01-01

This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated.

Dignity and Deferral Narratives as Strategies in Facilitated Technology-Based Support Groups for People with Advanced Cancer

PubMed Central

Street, Annette F.; Wakelin, Kate; Hordern, Amanda; Bruce, Nicola; Horey, Dell

2012-01-01

This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated. PMID:22530115

[Career structure and advancement in cardiology in Italy. The Group for the Study of the Italian Status of Cardiologists].

PubMed

Modena, M G; Molinari, R; Lalla, M

1999-03-01

Women are less present on the labor market and many studies have demonstrated the existence of gender differences regarding the participation rate and career advancement of women. The processes through which job-, career- and research-related choices are structured within the realm of Italian cardiology is described in this study, emphasizing the effects of productivity, gender and family commitments. In June of 1996, a questionnaire was mailed to all members of the Italian societies of cardiology. It included mainly (pre-coded) set-choice questions concerning individual characteristics, career-related data and information pertaining to teaching, scientific and research activity. Returned questionnaires numbered 1715 (21.4% of the total mailed), with 83% completed by males and 17% by females. For both hospital and academic careers, advancement in rank was influenced by variables denoting productivity, family and individual characteristics. Promotion to the upper ranks of the hierarchy was highly dependent upon time (once the effects of the covariates were eliminated). This is a situation that is typical of the internal labor market or in other words, of an institution in which staff members are ranked on a hierarchical scale according to formal criteria that are "rigid" and institutionalized, partially or totally sheltered from competition. Therefore, once a member has gained access to the first level of the hierarchy, his/her professional career is pre-determined to a certain extent and seniority ends up taking on importance in promotion decisions to an appreciable extent; in this field, the weight of seniority on promotion ranges between 30 and 50%.

The Origin and Advancement of Cardiovascular Physiology in Brazil: The Contribution of Eduardo Krieger to Research Groups

PubMed Central

Vasquez, Elisardo C.

2016-01-01

Since 1996, symposia devoted to the discussion of advances in cardiovascular physiology have been alternately organized by Brazilian research groups, most of which were created or joined by Ph.D. trainees of Eduardo M Krieger. Therefore, as Frontiers in Physiology is publishing a topic devoted to the celebration of the 20th edition of the Brazilian Symposium of Cardiovascular Physiology, it is a great opportunity to talk about the contributions of Eduardo Krieger to the development of cardiovascular physiology. In this historical mini-review, first, the influence of the Argentinian group of Bernardo Houssay and Braun Menéndez on cardiovascular physiology in Brazil is discussed. Second, the contribution of Eduardo Krieger to the creation of several of those groups and to the development of science and technology is reviewed. Finally, the origin and consolidation of the group of Vitoria is highlighted as an example of a research group that was influenced by the University of Sao Paulo-Faculty of Medicine of Ribeirao Preto and has trained hundreds of Master and Ph.D. students in the area of cardiovascular research. PMID:27148073

The Origin and Advancement of Cardiovascular Physiology in Brazil: The Contribution of Eduardo Krieger to Research Groups.

PubMed

Vasquez, Elisardo C

2016-01-01

Since 1996, symposia devoted to the discussion of advances in cardiovascular physiology have been alternately organized by Brazilian research groups, most of which were created or joined by Ph.D. trainees of Eduardo M Krieger. Therefore, as Frontiers in Physiology is publishing a topic devoted to the celebration of the 20th edition of the Brazilian Symposium of Cardiovascular Physiology, it is a great opportunity to talk about the contributions of Eduardo Krieger to the development of cardiovascular physiology. In this historical mini-review, first, the influence of the Argentinian group of Bernardo Houssay and Braun Menéndez on cardiovascular physiology in Brazil is discussed. Second, the contribution of Eduardo Krieger to the creation of several of those groups and to the development of science and technology is reviewed. Finally, the origin and consolidation of the group of Vitoria is highlighted as an example of a research group that was influenced by the University of Sao Paulo-Faculty of Medicine of Ribeirao Preto and has trained hundreds of Master and Ph.D. students in the area of cardiovascular research.

Social Studies: Semester Electives for Grade 12. Advanced Economics--Advanced Government.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of General Education Curriculum Development.

Major concepts and generalizations related to economics and American government are presented. The syllabus is intended for 12th grade social studies teachers. Using the guide, teachers develop and implement strategies which will help students understand more advanced economic and political concepts. Introductory sections provide an overview of…

Advanced Subsonic Airplane Design and Economic Studies

NASA Technical Reports Server (NTRS)

Liebeck, Robert H.; Andrastek, Donald A.; Chau, Johnny; Girvin, Raquel; Lyon, Roger; Rawdon, Blaine K.; Scott, Paul W.; Wright, Robert A.

1995-01-01

A study was made to examine the effect of advanced technology engines on the performance of subsonic airplanes and provide a vision of the potential which these advanced engines offered. The year 2005 was selected as the entry-into-service (EIS) date for engine/airframe combination. A set of four airplane classes (passenger and design range combinations) that were envisioned to span the needs for the 2005 EIS period were defined. The airframes for all classes were designed and sized using 2005 EIS advanced technology. Two airplanes were designed and sized for each class: one using current technology (1995) engines to provide a baseline, and one using advanced technology (2005) engines. The resulting engine/airframe combinations were compared and evaluated on the basis on sensitivity to basic engine performance parameters (e.g. SFC and engine weight) as well as DOC+I. The advanced technology engines provided significant reductions in fuel burn, weight, and wing area. Average values were as follows: reduction in fuel burn = 18%, reduction in wing area = 7%, and reduction in TOGW = 9%. Average DOC+I reduction was 3.5% using the pricing model based on payload-range index and 5% using the pricing model based on airframe weight. Noise and emissions were not considered.

Managing uncertainty in advanced liver disease: a qualitative, multiperspective, serial interview study.

PubMed

Kimbell, Barbara; Boyd, Kirsty; Kendall, Marilyn; Iredale, John; Murray, Scott A

2015-11-19

To understand the experiences and support needs of people with advanced liver disease and those of their lay and professional carers to inform improvements in the supportive and palliative care of this rapidly growing but currently neglected patient group. Multiperspective, serial interviews. We conducted up to three qualitative in-depth interviews with each patient and lay carer over 12 months and single interviews with case-linked healthcare professionals. Data were analysed using grounded theory techniques. Patients with advanced liver disease of diverse aetiologies recruited from an inpatient hepatology ward, and their lay carers and case-linked healthcare professionals nominated by the patients. Primary and secondary care in South-East Scotland. 37 participants (15 patients, 11 lay and 11 professional carers) completed 51 individual and 13 joint patient-carer interviews. Nine patients died during the study. Uncertainty dominated experiences throughout the course of the illness, across patients' considerable physical, psychological, social and existential needs and affected patients, lay carers and professionals. This related to the nature of the condition, the unpredictability of physical deterioration and prognosis, poor communication and information-sharing, and complexities of care. The pervasive uncertainty also shaped patients' and lay carers' strategies for coping and impeded care planning. While patients' acute medical care was usually well coordinated, their ongoing care lacked structure and focus. Living, dying and caring in advanced liver disease is dominated by pervasive, enduring and universally shared uncertainty. In the face of high levels of multidimensional patient distress, professionals must acknowledge this uncertainty in constructive ways that value its contribution to the person's coping approach. Pervasive uncertainty makes anticipatory care planning in advanced liver disease challenging, but planning 'just in case' is vital to ensure

Risk of Advanced Neoplasia in First-Degree Relatives with Colorectal Cancer: A Large Multicenter Cross-Sectional Study

PubMed Central

Quintero, Enrique; Gargallo, Carla; Lanas, Angel; Bujanda, Luis; Gimeno-García, Antonio Z.; Hernández-Guerra, Manuel; Nicolás-Pérez, David; Alonso-Abreu, Inmaculada; Morillas, Juan Diego; Balaguer, Francesc; Muriel, Alfonso

2016-01-01

Background First-degree relatives (FDR) of patients with colorectal cancer have a higher risk of developing colorectal cancer than the general population. For this reason, screening guidelines recommend colonoscopy every 5 or 10 y, starting at the age of 40, depending on whether colorectal cancer in the index-case is diagnosed at <60 or ≥60 y, respectively. However, studies on the risk of neoplastic lesions are inconclusive. The aim of this study was to determine the risk of advanced neoplasia (three or more non-advanced adenomas, advanced adenoma, or invasive cancer) in FDR of patients with colorectal cancer compared to average-risk individuals (i.e., asymptomatic adults 50 to 69 y of age with no family history of colorectal cancer). Methods and Findings This cross-sectional analysis includes data from 8,498 individuals undergoing their first lifetime screening colonoscopy between 2006 and 2012 at six Spanish tertiary hospitals. Of these individuals, 3,015 were defined as asymptomatic FDR of patients with colorectal cancer (“familial-risk group”) and 3,038 as asymptomatic with average-risk for colorectal cancer (“average-risk group”). The familial-risk group was stratified as one FDR, with one family member diagnosed with colorectal cancer at ≥60 y (n = 1,884) or at <60 y (n = 831), and as two FDR, with two family members diagnosed with colorectal cancer at any age (n = 300). Multiple logistic regression analysis was used for between-group comparisons after adjusting for potential confounders (age, gender, and center). Compared with the average-risk group, advanced neoplasia was significantly more prevalent in individuals having two FDR with colorectal cancer (odds ratio [OR] 1.90; 95% confidence interval [CI] 1.36–2.66, p < 0.001), but not in those having one FDR with colorectal cancer diagnosed at ≥60 y (OR 1.03; 95% CI 0.83–1.27, p = 0.77) and <60 y (OR 1.19; 95% CI 0.90–1.58, p = 0.20). After the age of 50 y, men developed advanced

Advanced chronic kidney disease in non-valvular atrial fibrillation: extending the utility of R2CHADS2 to patients with advanced renal failure.

PubMed

Bautista, Josef; Bella, Archie; Chaudhari, Ashok; Pekler, Gerald; Sapra, Katherine J; Carbajal, Roger; Baumstein, Donald

2015-04-01

The R2CHADS2 is a new prediction rule for stroke risk in atrial fibrillation (AF) patients wherein R stands for renal risk. However, it was created from a cohort that excluded patients with advanced renal failure (defined as glomerular filtration rate of <30 mL/min). Our study extends the use of R2CHADS2 to patients with advanced renal failure and aims to compare its predictive power against the currently used CHADS and CHA2DS2VaSc. This retrospective cohort study analyzed the 1-year risk for stroke of the 524 patients with AF at Metropolitan Hospital Center. AUC and C statistics were calculated using three groups: (i) the entire cohort including patients with advanced renal failure, (ii) a cohort excluding patients with advanced renal failure and (iii) all patients with GFR < 30 mL/min only. R2CHADS2, as a predictor for stroke risk, consistently performs better than CHADS2 and CHA2DS2VsC in groups 1 and 2. The C-statistic was highest in R2CHADS compared with CHADS or CHADSVASC in group 1 (0.718 versus 0.605 versus 0.602) and in group 2 (0.724 versus 0.584 versus 0.579). However, there was no statistically significant difference in group 3 (0.631 versus 0.629 versus 0.623). Our study supports the utility of R2CHADS2 as a clinical prediction rule for stroke risk in patients with advanced renal failure.

An airline study of advanced technology requirements for advanced high speed commercial transport engines. 1: Engine design study assessment

NASA Technical Reports Server (NTRS)

Sallee, G. P.

1973-01-01

The advanced technology requirements for an advanced high speed commercial tranport engine are presented. The results of the phase 1 study effort cover the following areas: (1) statement of an airline's major objectives for future transport engines, (2) airline's method of evaluating engine proposals, (3) description of an optimum engine for a long range subsonic commercial transport including installation and critical design features, (4) discussion of engine performance problems and experience with performance degradation, (5) trends in engine and pod prices with increasing technology and objectives for the future, (6) discussion of the research objectives for composites, reversers, advanced components, engine control systems, and devices to reduce the impact of engine stall, and (7) discussion of the airline objectives for noise and pollution reduction.

Energy Efficient Engine program advanced turbofan nacelle definition study

NASA Technical Reports Server (NTRS)

Howe, David C.; Wynosky, T. A.

1985-01-01

Advanced, low drag, nacelle configurations were defined for some of the more promising propulsion systems identified in the earlier Benefit/Cost Study, to assess the benefits associated with these advanced technology nacelles and formulate programs for developing these nacelles and low volume thrust reversers/spoilers to a state of technology readiness in the early 1990's. The study results established the design feasibility of advanced technology, slim line nacelles applicable to advanced technology, high bypass ratio turbofan engines. Design feasibility was also established for two low volume thrust reverse/spoiler concepts that meet or exceed the required effectiveness for these engines. These nacelle and thrust reverse/spoiler designs were shown to be applicable in engines with takeoff thrust sizes ranging from 24,000 to 60,000 pounds. The reduced weight, drag, and cost of the advanced technology nacelle installations relative to current technology nacelles offer a mission fuel burn savings ranging from 3.0 to 4.5 percent and direct operating cost plus interest improvements from 1.6 to 2.2 percent.

Systems study of transport aircraft incorporating advanced aluminum alloys

NASA Technical Reports Server (NTRS)

Sakata, I. F.

1982-01-01

A study was performed to quantify the potential benefits of utilizing advanced aluminum alloys in commercial transport aircraft and to define the effort necessary to develop fully the alloys to a viable commercial production capability. The comprehensive investigation (1) established realistic advanced aluminum alloy property goals to maximize aircraft systems effectiveness (2) identified performance and economic benefits of incorporating the advanced alloy in future advanced technology commercial aircraft designs (3) provided a recommended plan for development and integration of the alloys into commercial aircraft production (4) provided an indication of the timing and investigation required by the metal producing industry to support the projected market and (5) evaluate application of advanced aluminum alloys to other aerospace and transit systems as a secondary objective. The results of the investigation provided a roadmap and identified key issues requiring attention in an advanced aluminum alloy and applications technology development program.

Advancing Diagnostics to Address Antibacterial Resistance: The Diagnostics and Devices Committee of the Antibacterial Resistance Leadership Group

PubMed Central

Tsalik, Ephraim L.; Petzold, Elizabeth; Kreiswirth, Barry N.; Bonomo, Robert A.; Banerjee, Ritu; Lautenbach, Ebbing; Evans, Scott R.; Hanson, Kimberly E.; Klausner, Jeffrey D.

2017-01-01

Abstract Diagnostics are a cornerstone of the practice of infectious diseases. However, various limitations frequently lead to unmet clinical needs. In most other domains, diagnostics focus on narrowly defined questions, provide readily interpretable answers, and use true gold standards for development. In contrast, infectious diseases diagnostics must contend with scores of potential pathogens, dozens of clinical syndromes, emerging pathogens, rapid evolution of existing pathogens and their associated resistance mechanisms, and the absence of gold standards in many situations. In spite of these challenges, the importance and value of diagnostics cannot be underestimated. Therefore, the Antibacterial Resistance Leadership Group has identified diagnostics as 1 of 4 major areas of emphasis. Herein, we provide an overview of that development, highlighting several examples where innovation in study design, content, and execution is advancing the field of infectious diseases diagnostics. PMID:28350903

The ADVANCE Code of Conduct for collaborative vaccine studies.

PubMed

Kurz, Xavier; Bauchau, Vincent; Mahy, Patrick; Glismann, Steffen; van der Aa, Lieke Maria; Simondon, François

2017-04-04

Lessons learnt from the 2009 (H1N1) flu pandemic highlighted factors limiting the capacity to collect European data on vaccine exposure, safety and effectiveness, including lack of rapid access to available data sources or expertise, difficulties to establish efficient interactions between multiple parties, lack of confidence between private and public sectors, concerns about possible or actual conflicts of interest (or perceptions thereof) and inadequate funding mechanisms. The Innovative Medicines Initiative's Accelerated Development of VAccine benefit-risk Collaboration in Europe (ADVANCE) consortium was established to create an efficient and sustainable infrastructure for rapid and integrated monitoring of post-approval benefit-risk of vaccines, including a code of conduct and governance principles for collaborative studies. The development of the code of conduct was guided by three core and common values (best science, strengthening public health, transparency) and a review of existing guidance and relevant published articles. The ADVANCE Code of Conduct includes 45 recommendations in 10 topics (Scientific integrity, Scientific independence, Transparency, Conflicts of interest, Study protocol, Study report, Publication, Subject privacy, Sharing of study data, Research contract). Each topic includes a definition, a set of recommendations and a list of additional reading. The concept of the study team is introduced as a key component of the ADVANCE Code of Conduct with a core set of roles and responsibilities. It is hoped that adoption of the ADVANCE Code of Conduct by all partners involved in a study will facilitate and speed-up its initiation, design, conduct and reporting. Adoption of the ADVANCE Code of Conduct should be stated in the study protocol, study report and publications and journal editors are encouraged to use it as an indication that good principles of public health, science and transparency were followed throughout the study. Copyright © 2017

Magnetic suspension and balance system advanced study, 1989 design

NASA Technical Reports Server (NTRS)

Boom, Roger W.; Eyssa, Y. M.; Abdelsalam, Moustafa K.; Mcintosh, Glen E.

1991-01-01

The objectives are to experimentally confirm several advanced design concepts on the Magnetic Suspension and Balance Systems (MSBS). The advanced design concepts were identified as potential improvements by Madison Magnetics, Inc. (MMI) during 1984 and 1985 studies of an MSBS utilizing 14 external superconductive coils and a superconductive solenoid in an airplane test model suspended in a wind tunnel. This study confirmed several advanced design concepts on magnetic suspension and balance systems. The 1989 MSBS redesign is based on the results of these experiments. Savings of up to 30 percent in supporting magnet ampere meters and 50 percent in energy stored over the 1985 design were achieved.

Study Groups: Collaboration and Conflagration.

ERIC Educational Resources Information Center

Jones, Barbara M.

In August 1995, the teachers at an elementary school in Houston (Texas) voted to adopt teacher-led study groups as their form of staff development for the 1995-96 school year. This study documents the progress of one of these groups, the Multiple Intelligences group, and examines the changes that occurred in roles and relationships as the teachers…

Is it feasible to discuss an advance directive with a Chinese patient with advanced malignancy? A prospective cohort study.

PubMed

Wong, S Y; Lo, S H; Chan, C H; Chui, H S; Sze, W K; Tung, Y

2012-06-01

Advance directives have been implemented for years in western countries, but the concept is new to Asian cultures. According to traditional Chinese culture, family members usually play a decisive role in a patient's treatment plan. Thus it may be hard to implement an advance directive despite its importance to the treatment of patients. The objectives of this study were to assess the feasibility of advance directive engagement and to explore significant contributing factors to achieving such a goal. Prospective cohort study. Palliative Care Unit of Clinical Oncology, Tuen Mun Hospital, Hong Kong. The subjects of the investigation were adult patients diagnosed to have advanced malignancy and newly referred to the hospice service from 24 April 2009 to 30 July 2009. Data were collected from nursing assessment forms, locally designed advance directive forms, a checklist completed by oncologists, and details available in the electronic hospital record. Of the 191 eligible patients, 120 (63%) had the advance directive, whereas 71 (37%) did not. In the Cox regression model, the patient having insight of a poor prognosis was the most significant factor facilitating advance directive engagement (P=0.001). Any family objection in the discussion of advance directives was also an important factor, though it did not reach statistical significance (P=0.082). Other factors like age, gender, education, religion, financial status, living environment, understanding the diagnosis, bereavement experience, type of cancer, nature of illness, courses of chemotherapy or radiotherapy received, main caregiver, in-house supporter, nurse-led clinic attendance, clinical psychologist consultation, and in-patient hospice nurse coordinator interview were all statistically insignificant. Our study demonstrated that it was feasible to discuss an advance directive with Chinese patients with advanced malignancy. When patients have insight about their poor prognosis and family members have no

Vascular endothelial growth factor (VEGF) expression in locally advanced prostate cancer: secondary analysis of radiation therapy oncology group (RTOG) 8610.

PubMed

Pan, Larry; Baek, Seunghee; Edmonds, Pamela R; Roach, Mack; Wolkov, Harvey; Shah, Satish; Pollack, Alan; Hammond, M Elizabeth; Dicker, Adam P

2013-04-25

Angiogenesis is a key element in solid-tumor growth, invasion, and metastasis. VEGF is among the most potent angiogenic factor thus far detected. The aim of the present study is to explore the potential of VEGF (also known as VEGF-A) as a prognostic and predictive biomarker among men with locally advanced prostate cancer. The analysis was performed using patients enrolled on RTOG 8610, a phase III randomized control trial of radiation therapy alone (Arm 1) versus short-term neoadjuvant and concurrent androgen deprivation and radiation therapy (Arm 2) in men with locally advanced prostate carcinoma. Tissue samples were obtained from the RTOG tissue repository. Hematoxylin and eosin slides were reviewed, and paraffin blocks were immunohistochemically stained for VEGF expression and graded by Intensity score (0-3). Cox or Fine and Gray's proportional hazards models were used. Sufficient pathologic material was available from 103 (23%) of the 456 analyzable patients enrolled in the RTOG 8610 study. There were no statistically significant differences in the pre-treatment characteristics between the patient groups with and without VEGF intensity data. Median follow-up for all surviving patients with VEGF intensity data is 12.2 years. Univariate and multivariate analyses demonstrated no statistically significant correlation between the intensity of VEGF expression and overall survival, distant metastasis, local progression, disease-free survival, or biochemical failure. VEGF expression was also not statistically significantly associated with any of the endpoints when analyzed by treatment arm. This study revealed no statistically significant prognostic or predictive value of VEGF expression for locally advanced prostate cancer. This analysis is among one of the largest sample bases with long-term follow-up in a well-characterized patient population. There is an urgent need to establish multidisciplinary initiatives for coordinating further research in the area of human

Adjuvant neutron therapy in complex treatment of patients with locally advanced breast cancer

NASA Astrophysics Data System (ADS)

Lisin, V. A.; Velikaya, V. V.; Startseva, Zh. A.; Popova, N. O.; Goldberg, V. E.

2017-09-01

The study included 128 patients with stage T2-4N0-3M0 locally advanced breast cancer. All patients were divided into two groups. Group I (study group) consisted of 68 patients, who received neutron therapy, and group II (control group) comprised 60 patients, who received electron beam therapy. Neutron therapy was well tolerated by the patients and 1-2 grade radiation skin reactions were the most common. Neutron therapy was shown to be effective in multimodality treatment of the patients with locally advanced breast cancer. The 8-year recurrence-free survival rate in the patients with locally advanced breast cancer was 94.5 ± 4.1% after neutron therapy and 81.4 ± 5.9% after electron beam therapy (p = 0.05).

[Mindfulness-based stimulation in advanced Alzheimer's disease: A comparative, non-inferiority, clinical pilot study].

PubMed

Quintana Hernández, Domingo Jesús; Miró Barrachina, María Teresa; Ibáñez Fernández, Ignacio; Santana del Pino, Angelo; Rojas Hernández, Jaime; Rodríguez García, Javier; Quintana Montesdeoca, María del Pino

2015-01-01

A longitudinal study was conducted in order to analyze the feasibility, safety, and effects of the practice of mindfulness, relaxation and cognitive stimulation on the evolution of Alzheimer's disease, with the aim of testing the equivalence of these interventions. There were a total of 168 participants with probable Alzheimer's disease (AD) treated with donepezil. In the present article, the 21 participants with advanced AD who completed a follow-up period of 24 months are presented. The participants were grouped into three experimental groups (mindfulness, relaxation, and cognitive stimulation) and one control group. Each group carried out three weekly sessions with bi-annual follow-up measurements (cognition: CAMCOG and MMSE; functionality: RDRS; psychopathology: NPI). Non-parametric analyses were performed. The cognitive function and functionality scores showed no significant differences between the groups. However, the scores in cognitive function of the mindfulness group and the cognitive stimulation group did not decrease in an intra-group analysis. In NPI, there were significant differences between the mindfulness group and the control group by the end of the study (P<.017). The data showed that the treatment with donepezil in combination with mindfulness or cognitive stimulation presented a better clinical evolution than the pharmacological treatment alone or combined with relaxation. These data suggest that these therapeutic alternatives should be investigated further, and that the non-pharmacological treatments should be recommended in clinical practice in order to control the evolution of AD in the long term. In order to confirm these findings, a larger study is necessary. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

Promoting advance directives among African Americans: a faith-based model.

PubMed

Bullock, Karen

2006-02-01

Studies show that African Americans are less likely than other ethnic groups to complete advance directives. However, what influences African Americans' decisions to complete or not complete advance directives is unclear. Using a faith-based promotion model, 102 African Americans aged 55 years or older were recruited from local churches and community-based agencies to participate in a pilot study to promote advance care planning. Focus groups were used to collect data on participants' preferences for care, desire to make personal choices, values and attitudes, beliefs about death and dying, and advance directives. A standardized interview was used in the focus groups, and the data were organized and analyzed using NUDIST 4 software (QRS Software, Victoria, Australia). Three fourths of the participants refused to complete advance directives. The following factors influenced the participants' decisions about end-of-life care and completion of an advance directive: spirituality; view of suffering, death, and dying; social support networks; barriers to utilization; and mistrust of the health care system. The dissemination of information apprises individuals of their right to self-determine about their care, but educational efforts may not produce a significant change in behavior toward completion of advance care planning. Thus, ongoing efforts are needed to improve the trust that African Americans have in medical and health care providers.

A study of the factors affecting advancement and graduation for engineering students

NASA Astrophysics Data System (ADS)

Fletcher, John Thomas

The purpose of this study was, first, to determine whether a set of predictor variables could be identified from pre-enrollment and post-enrollment data that would differentiate students who advance to a major in engineering from non-advancers and, further, to determine if the predictor variables would differentiate students who graduate from the College of Engineering from non-graduates and graduates of other colleges at Auburn University. A second purpose was to determine if the predictor variables would correctly identify male and female students with the same degree of accuracy. The third purpose was to determine if there were significant relationships between the predictor variables studied and grades earned in a set of 15 courses that have enrollments over 100 students and are part of the pre-engineering curriculum. The population for this study was the 868 students who entered the pre-engineering program at Auburn University as freshmen during the Summer and Fall Quarters of 1991. The variables selected to differentiate the different groups were ACT scores, high school grade indices, and first quarter college grade point average. Two sets of classification matrices were developed using analysis and holdout samples that were divided based on sex. With respect to the question about advancement to the professional engineering program, structure coefficients derived from discriminant analysis procedures performed on all the cases combined indicated that first quarter college grade point average, high school math index, ACT math score, and high school science grade index were important predictor variables in classifying students who advanced to the professional engineering program and those who did not. Further, important structure coefficients with respect to graduation with a degree from the College of Engineering were first quarter college grade point average, high school math index, ACT math score, and high school science grade index. The results of this

The Promoting Effective Advance Care for Elders (PEACE) randomized pilot study: theoretical framework and study design.

PubMed

Allen, Kyle R; Hazelett, Susan E; Radwany, Steven; Ertle, Denise; Fosnight, Susan M; Moore, Pamela S

2012-04-01

Practice guidelines are available for hospice and palliative medicine specialists and geriatricians. However, these guidelines do not adequately address the needs of patients who straddle the 2 specialties: homebound chronically ill patients. The purpose of this article is to describe the theoretical basis for the Promoting Effective Advance Care for Elders (PEACE) randomized pilot study. PEACE is an ongoing 2-group randomized pilot study (n=80) to test an in-home interdisciplinary care management intervention that combines palliative care approaches to symptom management, psychosocial and emotional support, and advance care planning with geriatric medicine approaches to optimizing function and addressing polypharmacy. The population comprises new enrollees into PASSPORT, Ohio's community-based, long-term care Medicaid waiver program. All PASSPORT enrollees have geriatric/palliative care crossover needs because they are nursing home eligible. The intervention is based on Wagner's Chronic Care Model and includes comprehensive interdisciplinary care management for these low-income frail elders with chronic illnesses, uses evidence-based protocols, emphasizes patient activation, and integrates with community-based long-term care and other community agencies. Our model, with its standardized, evidence-based medical and psychosocial intervention protocols, will transport easily to other sites that are interested in optimizing outcomes for community-based, chronically ill older adults. © Mary Ann Liebert, Inc.

Advanced stratified charge rotary aircraft engine design study

NASA Technical Reports Server (NTRS)

Badgley, P.; Berkowitz, M.; Jones, C.; Myers, D.; Norwood, E.; Pratt, W. B.; Ellis, D. R.; Huggins, G.; Mueller, A.; Hembrey, J. H.

1982-01-01

A technology base of new developments which offered potential benefits to a general aviation engine was compiled and ranked. Using design approaches selected from the ranked list, conceptual design studies were performed of an advanced and a highly advanced engine sized to provide 186/250 shaft Kw/HP under cruise conditions at 7620/25,000 m/ft altitude. These are turbocharged, direct-injected stratified charge engines intended for commercial introduction in the early 1990's. The engine descriptive data includes tables, curves, and drawings depicting configuration, performance, weights and sizes, heat rejection, ignition and fuel injection system descriptions, maintenance requirements, and scaling data for varying power. An engine-airframe integration study of the resulting engines in advanced airframes was performed on a comparative basis with current production type engines. The results show airplane performance, costs, noise & installation factors. The rotary-engined airplanes display substantial improvements over the baseline, including 30 to 35% lower fuel usage.

Middleman Minorities and Advanced Capitalism.

ERIC Educational Resources Information Center

Bonacich, Edna

1980-01-01

Argues against the notion that advanced capitalism is not conducive to the functioning of middleman entrepreneurial minorities. Holds that ethnic groups are sometimes able to use communal solidarity to keep their costs down, and that within advanced capitalism there is still a place for groups with petit bourgeois specialities. (Author/GC)

Diagnosing and managing anorexia nervosa in UK primary care: a focus group study.

PubMed

Hunt, D; Churchill, R

2013-08-01

Anorexia is a leading cause of adolescent hospital admission and death from psychiatric disorder. Despite the potential role of general practitioners in diagnosis, appropriate referral and coordinating treatment, few existing studies provide fine-grained accounts of GPs' beliefs about anorexia. To identify GPs' understandings and experiences of diagnosing and managing patients with anorexia in primary care. Case-based focus groups with co-working general practitioners in the East Midlands region of England were used to explore attitudes towards issues common to patients with eating disorders. Group discussions were transcribed and analysed using corpus linguistic and discourse analytic approaches. Participants' discussion focused on related issues of making hesitant diagnoses, the utility of the body mass index, making referrals and overcoming patient resistance. Therapeutic relationships with patients with anorexia are considered highly complex, with participants using diagnostic tests as rhetorical strategies to help manage communicative obstacles. Overcoming patient repudiation and securing referrals are particular challenges with this patient group. Successfully negotiating these problems appears to require advanced communication skills.

[Retrospective Study of Efficacy in BIM Gene Polymorphism on First-line EGFR-TKIs Treatment for Advanced Lung Adenocarcinoma].

PubMed

Qian, Kun; Zhang, Yi; Zhi, Xiuyi

2017-08-20

The aim of this study is to detect the BIM polymorphism in 85 formalin-fixed and parrffin-embedded (FFPE) and some blood samples of advanced lung adenocarcinoma patients and study the relativity betweenthe BIM polymorphism and tyrosine kinase inhibitor (TKI). The correlation between BIM detection of different types of specimens was discussed. There were 85 patients who were diagnosed as advanced lung adenocarcinoma with epidermal growth factor receptor (EGFR) 19 or 21 exon mutation in thoracic surgery of Xuanwu Hospital from February 2013 to November 2014, all of who were received EGFR-TKI as first-line treatment in the study. FFPE and some blood were used to detect the BIM polymorphism. The objective response rate (ORR) and progression-free survival (PFS) of two groups were compared. According to smoking, sex, EGFR mutation and other factors, the single factor analysis was performed, and the correlation between paraffin samples and blood test BIM was compared. The ORR in BIM polymorphism and non-polymorphism groups was no significant differences (P>0.05). The median PFS in BIM polymorphism and non-polymorphism group was 7.1 months and 12.8 months, respectively (P=0.013). Univariate analysis the median PFS, women were longer than men (12.1 months vs 10.7 months, P=0.835); Non-smokers were longer than smokers (12.1 months vs 9.7 months, P=0.974). Group in EGFR exon 21 is longer than group in EGFR exon 19 (12.2 months vs 8.7 months, P=0.303). Detection of BIM gene polymorphism in lung cancer patients with EGFR-TKIs treatment might be helpful for predicting prognosis. But a large sample study is needed.

Living with Symptoms: A Qualitative Study of Black Adults with Advanced Cancer Living in Poverty.

PubMed

Yeager, Katherine A; Quest, Tammie E; Vena, Catherine; Sterk, Claire E

2018-02-01

Cancer is associated with disease-related and treatment-related symptoms. Little is known about the symptom experience of black individuals with advanced cancer especially those with limited financial resources. Therefore, the purpose of this study was to explore the symptom experience of black adults with advanced cancer living in poverty. This qualitative descriptive study focused on the perspectives of the participants experiencing at least two symptoms related to cancer. A purposive sample of 27 individuals receiving care at a public hospital in a southeastern city participated in the study. Semi-structured audiotaped interviews were conducted by two research interviewers. Content analysis was used to develop themes to describe the symptom experience. Two main themes emerged in terms of the participants' symptom experiences: (1) "living in pain," which included the overwhelming experience of pain, both physical and emotional, and (2) "symptoms associated with functioning in everyday life." Participants frequently used the context of activities in their daily lives to explain symptoms, including the effect of symptoms on the activities of eating, moving and doing, and communicating. People with advanced cancer work to negotiate a high frequency of multiple distressful symptoms of severe-to-moderate severity. Information gained from this study can help guide research in symptom science and provide direction for clinicians working with this minority group. Copyright © 2017 American Society for Pain Management Nursing. All rights reserved.

Advanced X-ray Astrophysics Facility (AXAF): Science working group report. [space shuttle payload

NASA Technical Reports Server (NTRS)

1980-01-01

The Advanced X-Ray Astrophysics Facility (AXAF) mission concept is examined from a scientific viewpoint. A brief description of the development of X-ray astronomy and a summary description of AXAF, the scientific objectives of the facility, a description of representative scientific instruments, requirements for X-ray ground testing, and a summary of studies related to spacecraft and support subsystems, are included.

Bridging the Geoscientist Workforce Gap: Advanced High School Geoscience Programs

NASA Astrophysics Data System (ADS)

Schmidt, Richard William

The purpose of this participatory action research was to create a comprehensive evaluation of advanced geoscience education in Pennsylvania public high schools and to ascertain the possible impact of this trend on student perceptions and attitudes towards the geosciences as a legitimate academic subject and possible career option. The study builds on an earlier examination of student perceptions conducted at Northern Arizona University in 2008 and 2009 but shifts the focus to high school students, a demographic not explored before in this context. The study consisted of three phases each examining a different facet of the advanced geoscience education issue. Phase 1 examined 572 public high schools in 500 school districts across Pennsylvania and evaluated the health of the state's advanced geoscience education through the use of an online survey instrument where districts identified the nature of their geoscience programs (if any). Phase 2 targeted two groups of students at one suburban Philadelphia high school with an established advanced geoscience courses and compared the attitudes and perceptions of those who had been exposed to the curricula to a similar group of students who had not. Descriptive and statistically significant trends were then identified in order to assess the impact of an advanced geoscience education. Phase 3 of the study qualitatively explored the particular attitudes and perceptions of a random sampling of the advanced geoscience study group through the use of one-on-one interviews that looked for more in-depth patterns of priorities and values when students considered such topics as course enrollment, career selection and educational priorities. The results of the study revealed that advanced geoscience coursework was available to only 8% of the state's 548,000 students, a percentage significantly below that of the other typical K-12 science fields. It also exposed several statistically significant differences between the perceptions and

2001 Industry Studies: Advanced Manufacturing

DTIC Science & Technology

2001-05-28

oriented, 19 and manufacturers are employing the Internet and associated information technologies to better integrate supply chains and form extended...ways to compete in world markets . As part of this ongoing transformation, the broad implementation of advanced manufacturing technologies , processes...competitive advantages and better performance in world markets . Importantly, advanced manufacturing involves the innovative integration of new technology

Patient Reported Outcomes in a Practice Changing Randomized Trial of Bevacizumab in the Treatment of Advanced Cervical Cancer: An NRG Oncology/Gynecologic Oncology Group Study

PubMed Central

Penson, Richard T.; Huang, Helen Q.; Wenzel, Lari B.; Monk, Bradley J.; Stockman, Sharon; Long, Harry J.; Ramondetta, Lois M.; Landrum, Lisa M.; Oaknin, Ana; Reid, Thomas J.A.; Leitao, Mario M.; Method, Michael; Michael, Helen; Tewari, Krishnansu S.

2015-01-01

Background To analyze patient reported outcomes (PROs) in GOG 240, the practice-changing, randomized phase 3 trial that concluded that chemotherapy (cisplatin-paclitaxel or topotecan-paclitaxel) plus bevacizumab significantly improves overall survival (OS), progression-free survival (PFS), and response rates compared to chemotherapy alone in advanced cervical cancer. Trial registration number: NCT00803062. Methods Patients were assessed pre-cycle 1, 2, and 5 and at 6 and 9 months post-cycle 1 with the Functional Assessment of Cancer Therapy-Cervix Trial Outcome Index (FACT-Cx TOI), and items from the FACT/GOG-Neurotoxicity (Ntx) subscale, and a worst pain item from the Brief Pain Inventory (BPI). Differences in FACT-Cx TOI scores were assessed using a linear mixed model adjusting for baseline score and age. A mixed effects mixed distributions model was fitted to evaluate treatment differences of likelihood to report neurotoxicity and pain, and severity of these symptoms, once reported. The association between baseline health-related quality of life and survival was analyzed using Cox proportional hazards models. Findings Among 390 evaluable patients, PRO completion rates declined from 96% (baseline) to 63% (9 months post-cycle 1). Completion rates were not statistically different among treatment regimens (p=0.67). Patients receiving chemotherapy plus bevacizumab reported 1.2 points lower on average (98.75% CI: −4.1, 1.7; p=0.30) in the FACT-Cx TOI scores than those with chemotherapy alone. Patients treated with chemotherapy plus bevacizumab were less likely to report neurotoxicty (overall odds ratio: 0.58; 98.75% CI: 0.17, 0.98; p=0.01). Severity of neurotoxic symptoms did not differ between the two groups (p=0.69). Both groups had similar odds of complaining of pain (odds ratio=0.96; 95% CI: 0.39, 1.52; p=0.78) and reported similar severity of pain (p=0.1). For the entire population, the baseline FACT-Cx TOI score was significantly associated with OS (HR 0

Pain experiences of patients with advanced cancer: A qualitative descriptive study.

PubMed

Erol, Ozgul; Unsar, Serap; Yacan, Lale; Pelin, Meryem; Kurt, Seda; Erdogan, Bülent

2018-04-01

Uncontrolled pain, especially in patients with advanced cancer, affects quality of life negatively and causes negative physical and psychological conditions. The aim of this study was to explore the pain experiences of patients with advanced cancer and how they manage with pain, and to present a view of pain management approaches of nurses from the perspectives of the patients. This was a qualitative descriptive study of sixteen hospitalized patients with advanced cancer. Data were collected using semi-structured interviews with patients. Data were analysed by Colaizzi's phenomenological method. This study found that patients with advanced cancer who had pain experienced anxiety, helplessness, hopelessness and many restrictions in daily life as well as inability to manage with pain. Most of the patients with advanced cancer were not satisfied with their nursing care with regard to pain management. The themes that emerged were pain perception and experiences, effects of pain on daily life, pain management and management strategies and the patients' perspectives about nursing approaches to pain. This study demonstrated the difficulties of patients with advanced cancer who experienced pain in their daily lives, yet lack pain management strategies. Furthermore, nurses' caring approaches to patients with advanced cancer who experienced pain was found inadequate. Oncology nurses should provide educational interventions in order to enhance knowledge and skills about pain assessment and non-pharmacologic and pharmacologic strategies used in pain management. Copyright © 2018 Elsevier Ltd. All rights reserved.

Smooth Transition for Advancement to Graduate Education (STAGE) for Underrepresented Groups in the Mathematical Sciences Pilot Project: Broadening Participation through Mentoring

ERIC Educational Resources Information Center

Eubanks-Turner, Christina; Beaulieu, Patricia; Pal, Nabendu

2018-01-01

The Smooth Transition for Advancement to Graduate Education (STAGE) project was a three-year pilot project designed to mentor undergraduate students primarily from under-represented groups in the mathematical sciences. The STAGE pilot project focused on mentoring students as they transitioned from undergraduate education to either graduate school…

Follow-On Technology Requirement Study for Advanced Subsonic Transport

NASA Technical Reports Server (NTRS)

Wendus, Bruce E.; Stark, Donald F.; Holler, Richard P.; Funkhouser, Merle E.

2003-01-01

A study was conducted to define and assess the critical or enabling technologies required for a year 2005 entry into service (EIS) engine for subsonic commercial aircraft, with NASA Advanced Subsonic Transport goals used as benchmarks. The year 2005 EIS advanced technology engine is an Advanced Ducted Propulsor (ADP) engine. Performance analysis showed that the ADP design offered many advantages compared to a baseline turbofan engine. An airplane/ engine simulation study using a long range quad aircraft quantified the effects of the ADP engine on the economics of typical airline operation. Results of the economic analysis show the ADP propulsion system provides a 6% reduction in direct operating cost plus interest, with half the reduction resulting from reduced fuel consumption. Critical and enabling technologies for the year 2005 EIS ADP were identified and prioritized.

Advanced space program studies. Overall executive summary

NASA Technical Reports Server (NTRS)

Wolfe, M. G.

1977-01-01

NASA and DoD requirements and planning data were used in multidiscipline advanced planning investigations of space operations and associated elements (including man), identification of potential low cost approaches, vehicle design, cost synthesis techniques, technology forecasting and opportunities for DoD technology transfer, and the development near-, mid-, and far-term space initiatives and development plans with emphasis on domestic and military commonality. An overview of objectives and results are presented for the following studies: advanced space planning and conceptual analysis, shuttle users, technology assessment and new opportunities, standardization and program practice, integrated STS operations planning, solid spinning upper stage, and integrated planning support functions.

Advanced orbit transfer vehicle propulsion system study

NASA Technical Reports Server (NTRS)

Cathcart, J. A.; Cooper, T. W.; Corringrato, R. M.; Cronau, S. T.; Forgie, S. C.; Harder, M. J.; Mcallister, J. G.; Rudman, T. J.; Stoneback, V. W.

1985-01-01

A reuseable orbit transfer vehicle concept was defined and subsequent recommendations for the design criteria of an advanced LO2/LH2 engine were presented. The major characteristics of the vehicle preliminary design include a low lift to drag aerocapture capability, main propulsion system failure criteria of fail operational/fail safe, and either two main engines with an attitude control system for backup or three main engines to meet the failure criteria. A maintenance and servicing approach was also established for the advanced vehicle and engine concepts. Design tradeoff study conclusions were based on the consideration of reliability, performance, life cycle costs, and mission flexibility.

METHODS ADVANCEMENT FOR MILK ANALYSIS: THE MAMA STUDY

EPA Science Inventory

The Methods Advancement for Milk Analysis (MAMA) study was designed by US EPA and CDC investigators to provide data to support the technological and study design needs of the proposed National Children=s Study (NCS). The NCS is a multi-Agency-sponsored study, authorized under the...

Advancing Diagnostics to Address Antibacterial Resistance: The Diagnostics and Devices Committee of the Antibacterial Resistance Leadership Group.

PubMed

Tsalik, Ephraim L; Petzold, Elizabeth; Kreiswirth, Barry N; Bonomo, Robert A; Banerjee, Ritu; Lautenbach, Ebbing; Evans, Scott R; Hanson, Kimberly E; Klausner, Jeffrey D; Patel, Robin

2017-03-15

Diagnostics are a cornerstone of the practice of infectious diseases. However, various limitations frequently lead to unmet clinical needs. In most other domains, diagnostics focus on narrowly defined questions, provide readily interpretable answers, and use true gold standards for development. In contrast, infectious diseases diagnostics must contend with scores of potential pathogens, dozens of clinical syndromes, emerging pathogens, rapid evolution of existing pathogens and their associated resistance mechanisms, and the absence of gold standards in many situations. In spite of these challenges, the importance and value of diagnostics cannot be underestimated. Therefore, the Antibacterial Resistance Leadership Group has identified diagnostics as 1 of 4 major areas of emphasis. Herein, we provide an overview of that development, highlighting several examples where innovation in study design, content, and execution is advancing the field of infectious diseases diagnostics. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

[Are advance directives useful for doctors and what for?].

PubMed

Fournier, Véronique; Berthiau, Denis; Kempf, Emmanuelle; d'Haussy, Julie

2013-06-01

In France, the law has introduced the possibility to write advance directives since 2005. In this paper, we will present the results of a study designed for checking how much people over 75 years are interested by this new tool. The inquiry consisted in deep qualitative interviews (around 45') to further understand what people included in the study have to say about advance directives, but also about the conditions of ageing and dying. The study sample was composed of 8 over 75 years subgroups, chosen for being illustrative of different health status and/or disabling status. Finally, a last subgroup was also included, called "referent", because composed of people, all members of the "Association pour le droit à mourir dans la dignité" (ADMD), and as such supposed to be pro-advance directives. Interviews content was analysed through qualitative analysis referent methods ("Analyse qualitative en sciences humaines et sociales", Paillé et Muschielli, "Grounded Theory", Glaser). POPULATION OF THE STUDY: One hundred and eighty-six patients were included (106 female, 80 male, mean age 82.7 ans), 167 in the general group and 19 in the "ADMD" group. Ninety percent in the general group said that they never heard about advance directives before the inquiry. After having been informed by us about what advance directives were for, 83% remained not interested they said, some because they felt they were not personally concerned, others expressed that the tool appears to them inefficient - "things never happen the way you planned it", not useful - "doctors will act as they will decide whatever will be written", or even more potentially dangerous - "writing advance directives might lead doctors not to be as much therapeutically aggressive as for other people". Only 28 persons in the general group (17%), together with the 19 of the ADMD group, said they were interested by advance directives. They all were quite similar according to their personal character: they were quite strong

Advances in Behavioral Laboratory Methods that Inform Tobacco Regulatory Science: A TCORS Working Group Special Issue

PubMed Central

Wright, M. Jerry; Valentine, Gerald

2017-01-01

Objective The 2009 Family Smoking Prevention and Tobacco Control Act (TCA) created unprecented enabling conditions for establishing national regulatory policy that reduces the burden of public health and societal problems associated with tobacco product use. The Center for Tobacco Products (CTP), created by the FDA to implement the TCA, developed a first-of-its-kind FDA/National Institutes of Health (NIH) collaborative program to fund Tobacco Centers of Regulatory Science (TCORS). Methods To assist the TCORS with addressing research priorites, working groups (WGs) comprised of FDA-CTP liasions and TCORS investigators were formed. Under the direction of the Center for Evaluation and Coordination of Trainin and Research (CECTR), the TCORS WGs seek to develop tangible work products in their respective areas of focus. Results The focus of the behavioral pharmacology WG evolved from publishing a narrow paper on behavioral methods in electronic cigarette research to a collection of papers on advances in behavioral laboratory methods that may inform tobacco regulatory science. Conclusion This Special Issue contains articles that address all of the CTP research priorities and demonstrates how advances in behavioral laboratory methods made by TCORS investigators can inform FDA efforst to regulate tobacco products. PMID:29152546

Advanced Integrated Power and Attitude Control System (IPACS) study

NASA Technical Reports Server (NTRS)

Oglevie, R. E.; Eisenhaure, D. B.

1985-01-01

Integrated Power and Attitude Control System (IPACS) studies performed over a decade ago established the feasibility of simultaneously satisfying the demands of energy storage and attitude control through the use of rotating flywheels. It was demonstrated that, for a wide spectrum of applications, such a system possessed many advantages over contemporary energy storage and attitude control approaches. More recent technology advances in composite material rotors, magnetic suspension systems, and power control electronics have triggered new optimism regarding the applicability and merits of this concept. This study is undertaken to define an advanced IPACS and to evaluate its merits for a space station application. System and component designs are developed to establish the performance of this concept and system trade studies conducted to examine the viability of this approach relative to conventional candidate systems. It is clearly demonstrated that an advanced IPACS concept is not only feasible, but also offers substantial savings in mass and life-cycle cost for the space station mission.

Screening studies of advanced control concepts for airbreathing engines

NASA Technical Reports Server (NTRS)

Ouzts, Peter J.; Lorenzo, Carl F.; Merrill, Walter C.

1993-01-01

The application of advanced control concepts to airbreathing engines may yield significant improvements in aircraft/engine performance and operability. Accordingly, the NASA Lewis Research Center has conducted screening studies of advanced control concepts for airbreathing engines to determine their potential impact on turbine engine performance and operability. The purpose of the studies was to identify concepts which offered high potential yet may incur high research and development risk. A target suite of proposed concepts was formulated by NASA and industry. These concepts were evaluated in a two phase study to quantify each concept's impact on desired engine characteristics. To aid in the evaluation, three target aircraft/engine combinations were considered: a military high performance fighter mission, a high speed civil transport mission, and a civil tiltrotor mission. Each of the advanced control concepts considered in the study were defined and described. The concept's potential impact on engine performance was determined. Relevant figures of merit on which to evaluate the concepts were also determined. Finally, the concepts were ranked with respect to the target aircraft/engine missions.

Cardiac autonomic modulation impairments in advanced breast cancer patients.

PubMed

Arab, Claudia; Vanderlei, Luiz Carlos Marques; da Silva Paiva, Laércio; Fulghum, Kyle Levi; Fristachi, Carlos Elias; Nazario, Afonso Celso Pinto; Elias, Simone; Gebrim, Luiz Henrique; Ferreira Filho, Celso; Gidron, Yori; Ferreira, Celso

2018-05-02

To compare cardiac autonomic modulation in early- versus advanced-stage breast cancer patients before any type of cancer treatment and investigate associated factors. This cross-sectional study included women (30-69 years old) with primary diagnosis of breast cancer and women with benign breast tumors. We evaluated cardiac modulation by heart rate variability and assessed factors of anxiety, depression, physical activity, and other relevant medical variables. Patients were divided into three groups based on TNM staging of cancer severity: early-stage cancer (n = 42), advanced-stage cancer (n = 37), or benign breast tumors to serve as a control (n = 37). We analyzed heart rate variability in time and frequency domains. The advanced-stage cancer group had lower vagal modulation than early-stage and benign groups; also, the advance-stage group had lower overall heart rate variability when compared to benign conditions. Heart rate variability was influenced by age, menopausal status, and BMI. Heart rate variability seems to be a promising, non-invasive tool for early diagnosis of autonomic dysfunction in breast cancer and detection of cardiovascular impairments at cancer diagnosis. Cardiac autonomic modulation is inversely associated with breast cancer staging.

Application of advanced data collection and quality assurance methods in open prospective study - a case study of PONS project.

PubMed

Wawrzyniak, Zbigniew M; Paczesny, Daniel; Mańczuk, Marta; Zatoński, Witold A

2011-01-01

Large-scale epidemiologic studies can assess health indicators differentiating social groups and important health outcomes of the incidence and mortality of cancer, cardiovascular disease, and others, to establish a solid knowledgebase for the prevention management of premature morbidity and mortality causes. This study presents new advanced methods of data collection and data management systems with current data quality control and security to ensure high quality data assessment of health indicators in the large epidemiologic PONS study (The Polish-Norwegian Study). The material for experiment is the data management design of the large-scale population study in Poland (PONS) and the managed processes are applied into establishing a high quality and solid knowledge. The functional requirements of the PONS study data collection, supported by the advanced IT web-based methods, resulted in medical data of a high quality, data security, with quality data assessment, control process and evolution monitoring are fulfilled and shared by the IT system. Data from disparate and deployed sources of information are integrated into databases via software interfaces, and archived by a multi task secure server. The practical and implemented solution of modern advanced database technologies and remote software/hardware structure successfully supports the research of the big PONS study project. Development and implementation of follow-up control of the consistency and quality of data analysis and the processes of the PONS sub-databases have excellent measurement properties of data consistency of more than 99%. The project itself, by tailored hardware/software application, shows the positive impact of Quality Assurance (QA) on the quality of outcomes analysis results, effective data management within a shorter time. This efficiency ensures the quality of the epidemiological data and indicators of health by the elimination of common errors of research questionnaires and medical

Study of advanced fuel system concepts for commercial aircraft

NASA Technical Reports Server (NTRS)

Coffinberry, G. A.

1985-01-01

An analytical study was performed in order to assess relative performance and economic factors involved with alternative advanced fuel systems for future commercial aircraft operating with broadened property fuels. The DC-10-30 wide-body tri-jet aircraft and the CF6-8OX engine were used as a baseline design for the study. Three advanced systems were considered and were specifically aimed at addressing freezing point, thermal stability and lubricity fuel properties. Actual DC-10-30 routes and flight profiles were simulated by computer modeling and resulted in prediction of aircraft and engine fuel system temperatures during a nominal flight and during statistical one-day-per-year cold and hot flights. Emergency conditions were also evaluated. Fuel consumption and weight and power extraction results were obtained. An economic analysis was performed for new aircraft and systems. Advanced system means for fuel tank heating included fuel recirculation loops using engine lube heat and generator heat. Environmental control system bleed air heat was used for tank heating in a water recirculation loop. The results showed that fundamentally all of the three advanced systems are feasible but vary in their degree of compatibility with broadened-property fuel.

Advanced Instruction: Facilitation of Individual Learning Processes in Large Groups

ERIC Educational Resources Information Center

Putz, Claus; Intveen, Geesche

2009-01-01

By supplying various combinations of advanced instructions and different forms of exercises individual learning processes within the impartation of basic knowledge can be activated and supported at best. The fundamentals of our class "Introduction to spatial-geometric cognition using CAD" are constructional inputs, which systematically induce the…

Advancing Alternative Analysis: Integration of Decision Science.

PubMed

Malloy, Timothy F; Zaunbrecher, Virginia M; Batteate, Christina M; Blake, Ann; Carroll, William F; Corbett, Charles J; Hansen, Steffen Foss; Lempert, Robert J; Linkov, Igor; McFadden, Roger; Moran, Kelly D; Olivetti, Elsa; Ostrom, Nancy K; Romero, Michelle; Schoenung, Julie M; Seager, Thomas P; Sinsheimer, Peter; Thayer, Kristina A

2017-06-13

Decision analysis-a systematic approach to solving complex problems-offers tools and frameworks to support decision making that are increasingly being applied to environmental challenges. Alternatives analysis is a method used in regulation and product design to identify, compare, and evaluate the safety and viability of potential substitutes for hazardous chemicals. We assessed whether decision science may assist the alternatives analysis decision maker in comparing alternatives across a range of metrics. A workshop was convened that included representatives from government, academia, business, and civil society and included experts in toxicology, decision science, alternatives assessment, engineering, and law and policy. Participants were divided into two groups and were prompted with targeted questions. Throughout the workshop, the groups periodically came together in plenary sessions to reflect on other groups' findings. We concluded that the further incorporation of decision science into alternatives analysis would advance the ability of companies and regulators to select alternatives to harmful ingredients and would also advance the science of decision analysis. We advance four recommendations: a ) engaging the systematic development and evaluation of decision approaches and tools; b ) using case studies to advance the integration of decision analysis into alternatives analysis; c ) supporting transdisciplinary research; and d ) supporting education and outreach efforts. https://doi.org/10.1289/EHP483.

Advance care planning in a multi-cultural family-centric community: A qualitative study of healthcare professionals', patients' and caregivers' perspectives.

PubMed

Menon, Sumytra; Kars, Marijke; Malhotra, Chetna; Campbell, Alastair V; van Delden, J J M

2018-05-15

Advance care planning has been shown to improve end-of-life care but it was developed in the USA and most research has been conducted in western communities. We aimed to study the attitudes and perceptions of patients with life-limiting illnesses, informal caregivers, doctors, nurses and medical social workers regarding advance care planning in a multi-cultural family-centric community. We conducted an explorative qualitative study, using focus groups and individual in-depth interviews. We used purposive sampling techniques to recruit 61 adults (15 doctors, 13 nurses, 5 medical social workers, 15 patients and 13 caregivers) from multiple healthcare settings across the country. The participants are genuinely anxious about the implementation of advance care planning. They had positive and negative expectations of advance care planning. Many were confused about the legal framework for healthcare decision-making and expected advance care planning to be of limited value because family members, rather than the patient, were usually the key decision-makers. A nuanced approach to advance care planning which considers the family network is required in multi-cultural family centric communities. Policies should be reconciled to create a more consistent message that respects patients, the family, and is legally coherent. Further research could focus on adaptations of advance care planning to promote its acceptance in such communities. Copyright © 2018. Published by Elsevier Inc.

Advanced Collaborative Emissions Study (ACES)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Greenbaum, Daniel; Costantini, Maria; Van Erp, Annemoon

2013-12-31

The objective of the Advanced Collaborative Emissions Study (ACES) was to determine before widespread commercial deployment whether or not the new, energy-efficient, heavy duty diesel engines (2007 and 2010 EPA Emissions Standards Compliant) may generate anticipated toxic emissions that could adversely affect the environment and human health. ACES was planned to take place in three phases. In Phase 1, extensive emissions characterization of four production-intent prototype engine and control systems designed to meet 2007 standards for nitrogen oxides (NOx) and particulate matter (PM) was conducted at an existing emissions characterization facility: Southwest Research Institute (SwRI). One of the tested enginesmore » was selected (at random, after careful comparison of results) for health testing in Phase 3. In Phase 2, extensive emission characterization of three production-intent prototype engine and control systems meeting the 2010 standards (including more advanced NOx controls to meet the more stringent 2010 NOx standards) was conducted at the same test facility. In Phase 3, one engine/aftertreatment system selected from Phase 1 was further characterized during health effects studies (at an existing inhalation toxicology laboratory: Lovelace Respiratory Research Institute, [LRRI]) to form the basis of the ACES safety assessment. The Department of Energy (DOE) award provided funding for emissions characterization in Phases 1 and 2 as well as exposure characterization in Phase 3. The main health analyses in Phase 3 were funded separately and are not reported here.« less

Effects of Exercise on Functional Performance and Fall Rate in Subjects with Mild or Advanced Alzheimer's Disease: Secondary Analyses of a Randomized Controlled Study.

PubMed

Öhman, Hannareeta; Savikko, Niina; Strandberg, Timo; Kautiainen, Hannu; Raivio, Minna; Laakkonen, Marja-Liisa; Tilvis, Reijo; Pitkälä, Kaisu H

2016-01-01

Exercise improves functional performance in subjects with dementia. However, whether the benefits of exercise are evident in all stages of dementia remains uncertain. This study examines how people in different stages of Alzheimer's disease (AD) benefit from exercise intervention in their physical functioning and risk of falling. The present study is a subanalysis of a randomized controlled trial examining the effects of exercise intervention (twice a week for 12 months) in AD patients (n = 194). We studied the effects separately in participants with mild dementia and in participants with advanced dementia. In subjects with mild dementia, the deterioration in physical functioning was slower in the intervention group than in the controls. Changes in Functional Independence Measure at 12 months were -2.7 (95% CI -0.5 to -4.9) in the intervention group and -10.1 (95% CI -7.0 to -13.3) in the control group (p < 0.001). The exercise intervention proved effective in preventing falls among patients with advanced AD, with an incidence rate ratio of 0.47 (95% CI 0.37-0.60; p < 0.001). Regular exercise may slow the rate of functional deterioration in mild AD and reduce falls in patients suffering from advanced AD. © 2016 S. Karger AG, Basel.

Opinions about euthanasia and advanced dementia: a qualitative study among Dutch physicians and members of the general public.

PubMed

Kouwenhoven, Pauline S C; Raijmakers, Natasja J H; van Delden, Johannes J M; Rietjens, Judith A C; van Tol, Donald G; van de Vathorst, Suzanne; de Graeff, Nienke; Weyers, Heleen A M; van der Heide, Agnes; van Thiel, Ghislaine J M W

2015-01-28

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive (AED) when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia. In this qualitative study, 16 medical specialists, 19 general practitioners, 16 elderly physicians and 16 members of the general public were interviewed and asked for their opinions about a vignette on euthanasia based on an AED in a patient with advanced dementia. Members of the general public perceived advanced dementia as a debilitating and degrading disease. Physicians emphasized the need for direct communication with the patient when making decisions about euthanasia. Respondent from both groups acknowledged difficulties in the assessment of patients' autonomous wishes and the unbearableness of their suffering. Legally, an AED may replace direct communication with patients about their request for euthanasia. In practice, physicians are reluctant to forego adequate verbal communication with the patient because they wish to verify the voluntariness of patients' request and the unbearableness of suffering. For this reason, the applicability of AEDs in advanced dementia seems limited.

Significant renoprotective effect of telbivudine during preemptive antiviral therapy in advanced liver cancer patients receiving cisplatin-based chemotherapy: a case-control study.

PubMed

Lin, Chih-Lang; Chien, Rong-Nan; Yeh, Charisse; Hsu, Chao-Wei; Chang, Ming-Ling; Chen, Yi-Cheng; Yeh, Chau-Ting

2014-12-01

Cisplatin is a known nephrotoxic agent requiring vigorous hydration before use. However, aggressive hydration could be life-threatening. Therefore, in cirrhotic patients with advanced hepatocellular carcinoma (HCC) under cisplatin-based chemotherapy, the risk of nephrotoxicity increased. Because previous studies showed that long-term telbivudine treatment improved renal function in chronic hepatitis B virus (HBV) infected patients, we conducted a case-control study to evaluate the clinical outcome of telbivudine preemptive therapy in HBV-related advanced HCC patients treated by combination chemotherapy comprising 5-fluorouracil, mitoxantrone and cisplatin (FMP). From June 2007 to March 2012, 60 patients with HBV-related advanced HCC, all receiving the same FMP chemotherapy protocol, were enrolled. Of them, 20 did not receive any antiviral therapy, whereas the remaining 40 patients (sex and age matched) received telbivudine preemptive therapy. Progressive decrease of aminotransferase levels (p < 0.05) and progressive increase of viral clearance rates (p < 0.001) were found in telbivudine-treated group. No drug resistance developed during the course of treatment. When compared with non-antiviral-treated patients, a significantly higher post-therapeutic estimated glomerular filtration rate (eGFR) was found in the telbivudine-treated group (p < 0.001). In patients with initial eGFR >100 ml/min (n = 34), the median overall survival was significantly longer in the telbivudine-treated group (12.1 vs. 4.9 months; p = 0.042). Preemptive use of telbivudine significantly prevented eGFR deterioration caused by cisplatin-based chemotherapy in HBV-related advanced HCC. In patients with initially sufficient eGFR level, telbivudine treatment was associated with a longer overall survival.

Advanced Propulsion Study

DTIC Science & Technology

2004-02-01

outcome. The author wishes to apologize in advance to fellow NASA BPP researchers for not including their work in this report . However, Millis (2003a...San Rafael Ave. Las Vegas, NV 89120 September 2004 Special Report APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED...AIR FORCE RESEARCH LABORATORY AIR FORCE MATERIEL COMMAND EDWARDS AIR FORCE BASE CA 93524-7048 REPORT DOCUMENTATION PAGE Form Approved

Efficacy and safety of sorafenib versus apatinib in the treatment of intermediate and advanced hepatocellular carcinoma: a comparative retrospective study.

PubMed

Wang, Yizhuo; Gou, Qing; Xu, Rongde; Chen, Xiaoming; Zhou, Zejian

2018-01-01

To compare the efficacy and safety profiles of sorafenib and apatinib in patients with intermediate- and advanced-stage hepatocellular carcinoma (HCC). This was a single-center, retrospective study where we collected the clinical data of 72 patients, diagnosed with intermediate or advanced HCC from January 2014 to December 2016. Depending on the treatment received, 38 patients were categorized into group S (sorafenib group) and 34 into group A (apatinib group). The patients in group A received the initial recommended dose of 750 mg once daily (QD), which was reduced to 250 mg QD in the case of any class 3 or 4 adverse event (AE). Sorafenib was administered orally 400 mg twice daily (BID), and dose was modified to 400 mg or 200 mg QD in the case of grade 3 or 4 AEs. The median overall survival (OS), progression-free survival (PFS), and AEs reported in the two groups were analyzed and compared. Among the 38 patients treated with sorafenib, one patient had complete response (CR), 5 patients had partial response (PR), and 10 patients had stable disease (SD), and among the 34 patients treated with apatinib, 6 patients had PR and 7 patients had SD with no cases of CR. PFS in group S was significantly longer compared with that in group A (7.39 vs 4.79 months, respectively, P =0.031). Similar observations were made for median OS (10.4 months in group S vs 7.18 months in group A, P =0.011). However, there was no significant difference in the objective response rates (ORRs) among the study population (15.7 vs 17.6%, P =0.829). Common AEs in group S included hand and foot syndrome (HFS) and diarrhea, whereas common AEs in group A included hypertension, proteinuria, and increased transaminase. Our study showed promising clinical outcome with apatinib, but the sorafenib group exhibited better clinical efficacy with no significant difference in safety profile.

Overview of Thoracic Oncology Trials in Cooperative Groups Around the Globe

PubMed Central

Salahudeen, Ameen Abdulla; Patel, Manali I.; Baas, Paul; Curran, Walter J.; Bradley, Jeffrey D.; Gandara, David R.; Goss, Glenwood D.; Mok, Tony S.; Ramalingam, Suresh S.; Vokes, Everett E.; Malik, Shakun M.; Wakelee, Heather A.

2017-01-01

Survival rates of patients with either early and advanced stage non–small-cell lung cancer (NSCLC) have improved with newer systemic therapy and radiation techniques, including combination regimens, targeted therapies, and immunotherapies. The cancer cooperative groups have historically played a critical role in the advancement of NSCLC therapy. Annually, representatives from cooperative groups worldwide convene at the International Lung Cancer Congress (ILCC). In summer 2015, the ILCC reached its 16th anniversary. This article highlights the NSCLC studies presented by participating groups in 2015. PMID:27473736

Profile of advanced nursing practice in Spain: A cross-sectional study.

PubMed

Sevilla Guerra, Sonia; Miranda Salmerón, Josep; Zabalegui, Adelaida

2018-03-01

In this study, we described the profile of advanced nursing practice in Spain. A cross-sectional study design was used to explore the extent and patterns of advanced nursing practice activity within the domains of expert care planning, integrated care, interprofessional collaboration, education, research, evidence-based practice, and professional leadership. Data were collected in 2015/2016. Purposive sampling yielded a sample of 165 specialist and expert nurses employed by a dual tertiary and community hospital in an urban setting. The study included specialist and expert nurses who had a higher practice profile than registered general nurses. The performance of activities according to age, current position, years of experience, nursing grade, and education was compared. Practice domains were more strongly influenced by the predictors of nursing position and professional career ladder. Age and experience predictors were found to be weak predictors of advanced practice domains. This study offers essential information of the nursing workforce, and clarifies both the advanced nursing practice profile and nomenclature in the context of study. © 2017 John Wiley & Sons Australia, Ltd.

Canadian Nurses' Perspectives on Prostate Cancer Support Groups: A Survey Study.

PubMed

Yu Ko, Wellam F; Oliffe, John L; Han, Christina S; Garrett, Bernie; Henwood, Tim; Tuckett, Anthony G; Sohrevardi, Armin

2016-01-01

Prostate cancer support groups (PCSGs) are community-based organizations that offer information and psychosocial support to men who experience prostate cancer and their families. Nurses are well positioned to refer men to a range of psychosocial resources to help them adjust to prostate cancer; however, little is known about nurses' perspectives on PCSGs. The aim of this study was to describe nurses' views about PCSGs as a means to making recommendations for advancing the effectiveness of PCSGs. A convenience sample of 101 Canadian nurses completed a 43-item Likert-scale questionnaire with the additional option of providing comments in response to an open-ended question. Univariate descriptive statistics and content analysis were used to analyze the quantitative and qualitative data, respectively. Participants held positive views about the roles and potential impact of PCSGs. Participants strongly endorsed the benefits of support groups in disseminating information and providing support to help decrease patient anxiety. Online support groups were endorsed as a practical alternative for men who are reluctant to participate in face-to-face groups. Findings suggest that nurses support the value of Canadian face-to-face and online PCSGs. This is important, given that nurses can help connect individual patients to community-based sources providing psychosocial support. Many men benefit from participating in PCSGs. Aside from positively endorsing the work of PCSGs, nurses are important partners for raising awareness of these groups among potential attendees and can directly contribute to information sharing in face-to-face and online PCSGs.

Building successful coalitions for promoting advance care planning.

PubMed

Marchand, Lucille; Fowler, Kathryn J; Kokanovic, Obrad

2006-01-01

Advance care planning (ACP) has had few successful initiatives. This qualitative study explores the challenges and successes of an advance care planning coalition in Wisconsin called Life Planning 2000 using key informant interviews (n = 24) and grounded theory. Major themes included: commitment (the need for leadership, recruitment of key members, and funding); cohesiveness (disparate groups collaborating toward a common purpose), and outcomes (shift in paradigm from signing documents to process of advanced care planning, new-found collaborative relationships, and educational tool development). Coalitions need to define short-, intermediate-, and long-term goals that result in measurable outcomes and an evaluation process. Resources must be commensurate with goals. Strong leadership, paid staff adequate funding, and the collaboration of diverse groups working toward common goals are the basic requirements of a successful coalition.

TIMMS Advanced 2015 Assessment Frameworks

ERIC Educational Resources Information Center

Mullis, Ina V. S., Ed.; Martin, Michael O., Ed.

2014-01-01

It is critical for countries to ensure that capable secondary school students receive further preparation in advanced mathematics and science, so that they are ready to enter challenging university-level studies that prepare them for careers in science, technology, engineering, and mathematics (STEM) fields. This group of students will become the…

Psychosocial Accommodation to Group Confinement in the Advanced Base Habitat

DTIC Science & Technology

1988-06-01

16 Recommendations................................................ 22 Conflict Management ....................................... 22... Conflict Management . Even these brief tests revealed significant potential for interpersonal conflict. Further, crew members stated that the brevity of the...that specific attention be given to conflict management in the Advanced Base Habitat. This may take the form of selection of crew members who have highly

Advancing Survivors' Knowledge (ASK) about skin cancer study: study protocol for a randomized controlled trial.

PubMed

Daniel, Casey L; Armstrong, Gregory T; Keske, Robyn R; Davine, Jessica A; McDonald, Aaron J; Sprunck-Harrild, Kim M; Coleman, Catherine; Haneuse, Sebastien J; Mertens, Ann C; Emmons, Karen M; Marghoob, Ashfaq A; Elkin, Elena B; Dusza, Stephen W; Robison, Leslie L; Geller, Alan C

2015-03-24

Advances in treatment have increased childhood cancer 5-year survival rates to greater than 80%. However, children previously treated with radiation are at significantly increased risk of developing subsequent neoplasms, the most common of which are skin cancers. The National Cancer Institute and Children's Oncology Group have issued recommendations for survivors treated with radiation to perform monthly skin self-examinations and receive a physician skin examination at least annually, as early detection has demonstrated markedly improved outcomes in the diagnosis and treatment of skin cancers. The goal of the present study is to increase rates of skin self-examinations and clinical skin examinations among adult survivors of childhood cancer treated with radiation. This randomized controlled trial uses a 3-group comparative effectiveness design comparing: (1) Patient Activation and Education (PAE) including text messaging, print and web-based tutorials over 12 months; (2) PAE plus physician activation (PAE + MD) adding physician activation/educational materials about survivors' increased skin cancer risk and conducting full-body skin exams; and (3) PAE plus physician activation, plus teledermoscopy (PAE + MD + TD) adding participant receipt of a dermatoscope intended to empower them to photograph suspect moles or lesions for review by the study dermatologist. The current study addresses barriers to screening in this population by providing educational and motivational information for both survivors and physicians regarding the value of periodic skin examinations. It also utilizes innovative mobile health technology to encourage and motivate (that is activate) survivors to conduct skin self-examinations, request physician exams, and obtain treatment when worrisome lesions are found. Finally, as a comparative effectiveness trial, this study isolates the effects of adding specific components to the patient activation intervention to test the most effective

Advanced Motor Drives Studies

NASA Technical Reports Server (NTRS)

Ehsani, M.; Tchamdjou, A.

1997-01-01

This report presents an evaluation of advanced motor drive systems as a replacement for the hydrazine fueled APU units. The replacement technology must meet several requirements which are particular to the space applications and the Orbiter in general. Some of these requirements are high efficiency, small size, high power density. In the first part of the study several motors are compared, based on their characteristics and in light of the Orbiter requirements. The best candidate, the brushless DC is chosen because of its particularly good performance with regards to efficiency. Several power electronics drive technologies including the conventional three-phase hard switched and several soft-switched inverters are then presented. In the last part of the study, a soft-switched inverter is analyzed and compared to its conventional hard-switched counterpart. Optimal efficiency is a basic requirement for space applications and the soft-switched technology represents an unavoidable trend for the future.

Building Evidence: What Comes after an Efficacy Study? Technical Working Group Meeting. Meeting Summary (Washington, DC, October 14, 2016)

ERIC Educational Resources Information Center

Institute of Education Sciences, 2016

2016-01-01

On October 14, 2016, the National Center for Special Education Research (NCSER) and the National Center for Education Research (NCER) in the Institute of Education Sciences (IES) convened a group of experts to gain insights and advice on how best to support the advancement of evidence beyond an efficacy study. Discussion followed five topics of…

CCD detector development projects by the Beamline Technical Support Group at the Advanced Photon Source

NASA Astrophysics Data System (ADS)

Lee, John H.; Fernandez, Patricia; Madden, Tim; Molitsky, Michael; Weizeorick, John

2007-11-01

This paper will describe two ongoing detector projects being developed by the Beamline Technical Support Group at the Advanced Photon Source (APS) at Argonne National Laboratory (ANL). The first project is the design and construction of two detectors: a single-CCD system and a two-by-two Mosaic CCD camera for Small-Angle X-ray Scattering (SAXS). Both of these systems utilize the Kodak KAF-4320E CCD coupled to fiber optic tapers, custom mechanical hardware, electronics, and software developed at ANL. The second project is a Fast-CCD (FCCD) detector being developed in a collaboration between ANL and Lawrence Berkeley National Laboratory (LBNL). This detector will use ANL-designed readout electronics and a custom LBNL-designed CCD, with 480×480 pixels and 96 outputs, giving very fast readout.

Factors influencing the development and implementation of advanced radiographer practice in Australia – a qualitative study using an interpretative phenomenological approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Page, Barbara A, E-mail: barbpage09@gmail.com; Bernoth, Maree; Davidson, Rob

2014-09-15

The purpose of this study was to explore the factors influencing the implementation or the lack of implementation of advanced practitioner role in Australia. This study uses an interpretative phenomenological approach to explore the in-depth real life issues, which surround the advanced practitioner as a solution to radiologist workforce shortages in Australia. Research participants are radiographers, radiation therapists and health managers registered with the Australian Institute of Radiography (AIR) and holding senior professional and AIR Board positions with knowledge of current advanced practice. In total, seven interviews were conducted revealing education, governance, technical, people issues, change management, government, costs andmore » timing as critical factors influencing advanced practice in Australia. Seven participants in this study perceived an advanced practice role might have major benefits and a positive impact on the immediate and long-term management of patients. Another finding is the greater respect and appreciation of each other's roles and expertise within the multidisciplinary healthcare team. Engagement is required of the critical stakeholders that have been identified as ‘blockers’ (radiologists, health departments) as well as identified allies (e.g. emergency clinicians, supportive radiologists, patient advocacy groups). The research supports that the AIR has a role to play for the professional identity of radiographers and shaping the advanced practice role in Australia.« less

Impact of Group Work and Extended Essay Writing on Online Advanced Placement Program® Student Performance. Research Report. ETS RR-07-22

ERIC Educational Resources Information Center

Handwerk, Phil

2007-01-01

Online high schools are growing significantly in number, popularity, and function. However, little empirical data has been published about the effectiveness of these institutions. This research examined the frequency of group work and extended essay writing among online Advanced Placement Program® (AP®) students, and how these tasks may have…

Smoot Cosmology Group

Science.gov Websites

passes in advance and will email them to you. The Smoot Group is located in building 50, 5th floor, Room 5005 How to use Smoot Group Computers and Network http://www-astro.lbl.gov/wiki/index.php/Main_Page Procedures for New Students (and Visitors) working in the group Procedures for visiting scholars and

Group Performance in Information Systems Project Groups: An Empirical Study

ERIC Educational Resources Information Center

Bahli, Bouchaib; Buyukkurt, Meral Demirbag

2005-01-01

The importance of teamwork in Information Systems Development (ISD) practice and education has been acknowledged but not studied extensively to date. This paper tests a model of how groups participating in ISD projects perform and examines the relationships between some antecedents of this performance based on group research theory well…

International Study Tour Groups

ERIC Educational Resources Information Center

O'Reilly, Frances L.; Matt, John J.; McCaw, William P.; Kero, Patty; Stewart, Courtney; Haddouch, Reda

2014-01-01

Using the context of international study tour groups, this study examined the personal and professional transformation that occurred among host faculty and staff at The University of Montana-Missoula as a result of their interactions with traveling academics from other countries. Data were collected from participant responses (n = 27) using a…

Palbociclib and Letrozole in Advanced Breast Cancer.

PubMed

Finn, Richard S; Martin, Miguel; Rugo, Hope S; Jones, Stephen; Im, Seock-Ah; Gelmon, Karen; Harbeck, Nadia; Lipatov, Oleg N; Walshe, Janice M; Moulder, Stacy; Gauthier, Eric; Lu, Dongrui R; Randolph, Sophia; Diéras, Véronique; Slamon, Dennis J

2016-11-17

A phase 2 study showed that progression-free survival was longer with palbociclib plus letrozole than with letrozole alone in the initial treatment of postmenopausal women with estrogen-receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer. We performed a phase 3 study that was designed to confirm and expand the efficacy and safety data for palbociclib plus letrozole for this indication. In this double-blind study, we randomly assigned, in a 2:1 ratio, 666 postmenopausal women with ER-positive, HER2-negative breast cancer, who had not had prior treatment for advanced disease, to receive palbociclib plus letrozole or placebo plus letrozole. The primary end point was progression-free survival, as assessed by the investigators; secondary end points were overall survival, objective response, clinical benefit response, patient-reported outcomes, pharmacokinetic effects, and safety. The median progression-free survival was 24.8 months (95% confidence interval [CI], 22.1 to not estimable) in the palbociclib-letrozole group, as compared with 14.5 months (95% CI, 12.9 to 17.1) in the placebo-letrozole group (hazard ratio for disease progression or death, 0.58; 95% CI, 0.46 to 0.72; P<0.001). The most common grade 3 or 4 adverse events were neutropenia (occurring in 66.4% of the patients in the palbociclib-letrozole group vs. 1.4% in the placebo-letrozole group), leukopenia (24.8% vs. 0%), anemia (5.4% vs. 1.8%), and fatigue (1.8% vs. 0.5%). Febrile neutropenia was reported in 1.8% of patients in the palbociclib-letrozole group and in none of the patients in the placebo-letrozole group. Permanent discontinuation of any study treatment as a result of adverse events occurred in 43 patients (9.7%) in the palbociclib-letrozole group and in 13 patients (5.9%) in the placebo-letrozole group. Among patients with previously untreated ER-positive, HER2-negative advanced breast cancer, palbociclib combined with letrozole resulted in

Density matrix renormalization group study of Y-junction spin systems

NASA Astrophysics Data System (ADS)

Guo, Haihui

Junction systems are important to understand both from the fundamental and the practical point of view, as they are essential components in existing and future electronic and spintronic devices. With the continuous advance of technology, device size will eventual reach the atomic scale. Some of the most interesting and useful junction systems will be strongly correlated. We chose the Density Matrix Renormalization Group method to study two types of Y-junction systems, the Y and YDelta junctions, on strongly correlated spin chains. With new ideas coming from the quantum information field, we have made a very efficient. Y-junction DMRG algorithm, which improves the overall CUB cost from O(m6) to O(m4), where m is the number of states kept per block. We studied the ground state properties, the correlation length, and investigated the degeneracy problem on the Y and YDelta junctions. For the excited states, we researched the existence of magnon bound states for various conditions, and have shown that the bound state exists when the central coupling constant is small.

The Use of Visual Advance Organizers for Learning Earth Science Concepts.

ERIC Educational Resources Information Center

Weisberg, Joseph S.

This study was designed to determine whether advance organizers in the form of visual aids might serve the same function as Ausubel's verbal advance organizers. The basic design of the study consisted of a 4 X 3 X 2 ANOVA factorial design. Ninety-six eighth-grade students were involved in the study. One group was exposed to a physiographic diagram…

Sarcopenia is associated with an increased risk of advanced colorectal neoplasia.

PubMed

Park, Youn Su; Kim, Ji Won; Kim, Byeong Gwan; Lee, Kook Lae; Lee, Jae Kyung; Kim, Joo Sung; Koh, Seong-Joon

2017-04-01

Although sarcopenia is associated with an increased risk for mortality after the curative resection of colorectal cancer, its influence on the development of advanced colonic neoplasia remains unclear. This study included 1270 subjects aged 40 years or older evaluated with first-time screening colonoscopy at Seoul National University Boramae Health Care Center from January 2010 to February 2015. Skeletal muscle mass was measured with a body composition analyzer (direct segmental multifrequency bioelectrical impedance analysis method). Multiple logistic regression analysis was performed to determine whether sarcopenia is associated with advanced colorectal neoplasia. Of 1270 subjects, 139 (10.9%) were categorized into the sarcopenia group and 1131 (89.1%) into the non-sarcopenia group. In the non-sarcopenia group, 55 subjects (4.9%) had advanced colorectal neoplasia. However, in the sarcopenia group, 19 subjects (13.7%) had advanced colorectal neoplasia, including 1 subject with invasive colorectal cancer (0.7%). In addition, subjects with sarcopenia had a higher prevalence of advanced adenoma (P < 0.001) than those without sarcopenia. According to the multiple logistic regression analysis adjusted for variable confounders, age (odds ratio 1.062, 95% confidence interval 1.032-1.093; P < 0.001), male sex (odds ratio 1.749, 95% confidence interval 1.008-3.036; P = 0.047), and sarcopenia (odds ratio 2.347, 95% confidence interval 1.311-4.202; P = 0.004) were associated with an advanced colorectal neoplasia. Sarcopenia is associated with an increased risk of advanced colorectal neoplasia.

Advanced supersonic propulsion study. [with emphasis on noise level reduction

NASA Technical Reports Server (NTRS)

Sabatella, J. A. (Editor)

1974-01-01

A study was conducted to determine the promising propulsion systems for advanced supersonic transport application, and to identify the critical propulsion technology requirements. It is shown that noise constraints have a major effect on the selection of the various engine types and cycle parameters. Several promising advanced propulsion systems were identified which show the potential of achieving lower levels of sideline jet noise than the first generation supersonic transport systems. The non-afterburning turbojet engine, utilizing a very high level of jet suppression, shows the potential to achieve FAR 36 noise level. The duct-heating turbofan with a low level of jet suppression is the most attractive engine for noise levels from FAR 36 to FAR 36 minus 5 EPNdb, and some series/parallel variable cycle engines show the potential of achieving noise levels down to FAR 36 minus 10 EPNdb with moderate additional penalty. The study also shows that an advanced supersonic commercial transport would benefit appreciably from advanced propulsion technology. The critical propulsion technology needed for a viable supersonic propulsion system, and the required specific propulsion technology programs are outlined.

Conditional Inference and Advanced Mathematical Study: Further Evidence

ERIC Educational Resources Information Center

Inglis, Matthew; Simpson, Adrian

2009-01-01

In this paper, we examine the support given for the "theory of formal discipline" by Inglis and Simpson (Educational Studies Mathematics 67:187-204, "2008"). This theory, which is widely accepted by mathematicians and curriculum bodies, suggests that the study of advanced mathematics develops general thinking skills and, in particular, conditional…

Advanced turboprop testbed systems study

NASA Technical Reports Server (NTRS)

Goldsmith, I. M.

1982-01-01

The proof of concept, feasibility, and verification of the advanced prop fan and of the integrated advanced prop fan aircraft are established. The use of existing hardware is compatible with having a successfully expedited testbed ready for flight. A prop fan testbed aircraft is definitely feasible and necessary for verification of prop fan/prop fan aircraft integrity. The Allison T701 is most suitable as a propulsor and modification of existing engine and propeller controls are adequate for the testbed. The airframer is considered the logical overall systems integrator of the testbed program.

A retrospective cohort study on the association between periapical abscess, advanced periodontal disease, and the national oral health screening program among Korean adults.

PubMed

Ha, Jung-Eun; Jung, Se-Hwan; Jin, Bo-Hyoung; Lee, Byoung-Jin; Bae, Kwang-Hak

2013-09-01

The National Oral Health Screening Program (NOHSP) is a general population-based program in Korea. The objective of this study was to assess the association between participation in the NOHSP and dental visit for periapical abscess (PA) and advanced periodontal disease (APD) among Korean adults. Data were obtained for subjects from the National Health Insurance database. The authors conducted a retrospective cohort study of 9358 randomly selected subjects who were between 40 and 64 years old in 2002. The outcomes of dental visit for PA or APD from the years 2003 to 2007 were compared between the screening and nonscreening groups. The nonscreening group had 19% higher risk of PA and 15% higher risk of APD. This study suggests that the NOHSP may decrease the risk of dental visit because of PA and APD by preventing the progress of lesion to the advanced stage among Korean adults.

Advanced-technology space station study: Summary of systems and pacing technologies

NASA Technical Reports Server (NTRS)

Butterfield, A. J.; Garn, P. A.; King, C. B.; Queijo, M. J.

1990-01-01

The principal system features defined for the Advanced Technology Space Station are summarized and the 21 pacing technologies identified during the course of the study are described. The descriptions of system configurations were extracted from four previous study reports. The technological areas focus on those systems particular to all large spacecraft which generate artificial gravity by rotation. The summary includes a listing of the functions, crew requirements and electrical power demand that led to the studied configuration. The pacing technologies include the benefits of advanced materials, in-orbit assembly requirements, stationkeeping, evaluations of electrical power generation alternates, and life support systems. The descriptions of systems show the potential for synergies and identifies the beneficial interactions that can result from technological advances.

Differential effect of age on survival in advanced NSCLC in women versus men: Analysis of recent Eastern Cooperative Oncology Group (ECOG) studies, with and without bevacizumab

PubMed Central

Wakelee, H.A.; Dahlberg, S.E.; Brahmer, J.R.; Schiller, J.H.; Perry, M.C.; Langer, C.J.; Sandler, A.B.; Belani, C.P.; Johnson, D.H.

2012-01-01

Background The impact of age on prognosis in advanced stage non-small cell lung cancer (NSCLC) may differ by sex. Patients and methods Eligible patients (N = 1590) from E1594, a 4-arm platinum-based chemotherapy trial, and E4599 (carboplatin/paclitaxel ± bevacizumab) chemotherapy arm were divided into male and female cohorts and separated into age groups of <60 or ≥60 years old. Eligible E4599 patients (N = 850) were similarly separated by age and sex and by treatment (±bevacizumab). Survival was calculated separately for each cohort. Results The median survival time (MST) for women ≥60 years old treated with chemotherapy alone on E1594 and E4599 was 11.6 months versus 9.0 months for women <60 (p = 0.03). MST was 7.4 and 8.3 months for men ≥60 and <60 years old respectively (NS). In E4599 the age <60 by bevacizumab treatment interaction was statistically significant (p = 0.03) for women (younger had greater benefit), with no age effect in men. Conclusions In this unplanned, exploratory subgroup analysis of advanced stage NSCLC ECOG trials, women ≥60 years old treated with chemotherapy live longer than men and younger women. In contrast, bevacizumab survival benefit was more pronounced in men of any age and in younger women on E4599. PMID:22266041

Differential effect of age on survival in advanced NSCLC in women versus men: analysis of recent Eastern Cooperative Oncology Group (ECOG) studies, with and without bevacizumab.

PubMed

Wakelee, H A; Dahlberg, S E; Brahmer, J R; Schiller, J H; Perry, M C; Langer, C J; Sandler, A B; Belani, C P; Johnson, D H

2012-06-01

The impact of age on prognosis in advanced stage non-small cell lung cancer (NSCLC) may differ by sex. Eligible patients (N=1590) from E1594, a 4-arm platinum-based chemotherapy trial, and E4599 (carboplatin/paclitaxel ± bevacizumab) chemotherapy arm were divided into male and female cohorts and separated into age groups of <60 or ≥60 years old. Eligible E4599 patients (N=850) were similarly separated by age and sex and by treatment (± bevacizumab). Survival was calculated separately for each cohort. The median survival time (MST) for women ≥60 years old treated with chemotherapy alone on E1594 and E4599 was 11.6 months versus 9.0 months for women <60 (p=0.03). MST was 7.4 and 8.3 months for men ≥60 and <60 years old respectively (NS). In E4599 the age <60 by bevacizumab treatment interaction was statistically significant (p=0.03) for women (younger had greater benefit), with no age effect in men. In this unplanned, exploratory subgroup analysis of advanced stage NSCLC ECOG trials, women ≥60 years old treated with chemotherapy live longer than men and younger women. In contrast, bevacizumab survival benefit was more pronounced in men of any age and in younger women on E4599. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Comparative Analysis of Three-Dimensional Nasal Shape of Casts from Patients With Unilateral Cleft Lip and Palate Treated at Two Institutions Following Rotation Advancement Only (Iowa) or Nasoalveolar Molding and Rotation Advancement in Conjunction With Primary Rhinoplasty (New York).

PubMed

Hosseinian, Banafsheh; Rubin, Marcie S; Clouston, Sean A P; Almaidhan, Asma; Shetye, Pradip R; Cutting, Court B; Grayson, Barry H

2018-01-01

To compare 3-dimensional nasal symmetry in patients with UCLP who had either rotation advancement alone or nasoalveolar molding (NAM) followed by rotation advancement in conjunction with primary nasal repair. Pilot retrospective cohort study. Nasal casts of 23 patients with UCLP from 2 institutions were analyzed; 12 in the rotation advancement only group (Iowa) and 11 in the NAM, rotation advancement with primary nasal repair group (New York). Casts from patients aged 6 to 18 years were scanned using the 3Shape scanner and 3-dimensional analysis of nasal symmetry performed using 3dMD Vultus software, Version 2507, 3dMD, Atlanta, GA. Cleft and noncleft side columellar height, nasal dome height, alar base width, and nasal projection were linearly measured. Inter- and intragroup analyses were performed using t tests and paired t tests as appropriate. A statistically significant difference in mean-scaled 3-dimensional asymmetry index was found between groups with group 1 having a larger measure of asymmetry (4.69 cm 3 ) than group 2 (2.56 cm 3 ; P = .02). Intergroup analysis performed on the most sensitive linear measure, alar base width, revealed significantly less asymmetry on average in group 2 than in group 1 ( P = .013). This study suggests the NAM followed by rotation advancement in conjunction with primary nasal repair approach may result in less nasal asymmetry compared to rotation advancement alone.

Accelerating Mathematics Achievement Using Heterogeneous Grouping

ERIC Educational Resources Information Center

Burris, Carol Corbett; Heubert, Jay P.; Levin, Henry M.

2006-01-01

This longitudinal study examined the effects of providing an accelerated mathematics curriculum in heterogeneously grouped middle school classes in a diverse suburban school district. A quasi-experimental cohort design was used to evaluate subsequent completion of advanced high school math courses as well as academic achievement. Results showed…

Pressure Safety: Advanced Self-Study 30120

DOE Office of Scientific and Technical Information (OSTI.GOV)

Glass, George

2016-02-29

Pressure Safety Advance Self-Study (Course 30120) consists of an introduction, five modules, and a quiz. To receive credit in UTrain for completing this course, you must score 80% or better on the 15-question quiz (check UTrain). Directions for initiating the quiz are appended to the end of this training manual. This course contains several links to LANL websites. UTrain might not support active links, so please copy links into the address line in your browser.

Development of the Music Therapy Assessment Tool for Advanced Huntington's Disease: A Pilot Validation Study.

PubMed

O'Kelly, Julian; Bodak, Rebeka

2016-01-01

Case studies of people with Huntington's disease (HD) report that music therapy provides a range of benefits that may improve quality of life; however, no robust music therapy assessment tools exist for this population. Develop and conduct preliminary psychometric testing of a music therapy assessment tool for patients with advanced HD. First, we established content and face validity of the Music Therapy Assessment Tool for Advanced HD (MATA-HD) through focus groups and field testing. Second, we examined psychometric properties of the resulting MATA-HD in terms of its construct validity, internal consistency, and inter-rater and intra-rater reliability over 10 group music therapy sessions with 19 patients. The resulting MATA-HD included a total of 15 items across six subscales (Arousal/Attention, Physical Presentation, Communication, Musical, Cognition, and Psychological/Behavioral). We found good construct validity (r ≥ 0.7) for Mood, Communication Level, Communication Effectiveness, Choice, Social Behavior, Arousal, and Attention items. Cronbach's α of 0.825 indicated good internal consistency across 11 items with a common focus of engagement in therapy. The inter-rater reliability (IRR) Intra-Class Coefficient (ICC) scores averaged 0.65, and a mean intra-rater ICC reliability of 0.68 was obtained. Further training and retesting provided a mean of IRR ICC of 0.7. Preliminary data indicate that the MATA-HD is a promising tool for measuring patient responses to music therapy interventions across psychological, physical, social, and communication domains of functioning in patients with advanced HD. © the American Music Therapy Association 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Virtual worlds to support patient group communication? A questionnaire study investigating potential for virtual world focus group use by respiratory patients.

PubMed

Taylor, Michael J; Taylor, Dave; Vlaev, Ivo; Elkin, Sarah

2017-01-01

Recent advances in communication technologies enable potential provision of remote education for patients using computer-generated environments known as virtual worlds. Previous research has revealed highly variable levels of patient receptiveness to using information technologies for healthcare-related purposes. This preliminary study involved implementing a questionnaire investigating attitudes and access to computer technologies of respiratory outpatients, in order to assess potential for use of virtual worlds to facilitate health-related education for this sample. Ninety-four patients with a chronic respiratory condition completed surveys, which were distributed at a Chest Clinic. In accordance with our prediction, younger participants were more likely to be able to use, and have access to a computer and some patients were keen to explore use virtual worlds for healthcare-related purposes: Of those with access to computer facilities, 14.50% expressed a willingness to attend a virtual world focus group. Results indicate future virtual world health education facilities should be designed to cater for younger patients, because this group are most likely to accept and use such facilities. Within the study sample, this is likely to comprise of people diagnosed with asthma. Future work could investigate the potential of creating a virtual world asthma education facility.

Virtual worlds to support patient group communication? A questionnaire study investigating potential for virtual world focus group use by respiratory patients

PubMed Central

Taylor, Michael J.; Taylor, Dave; Vlaev, Ivo; Elkin, Sarah

2015-01-01

Recent advances in communication technologies enable potential provision of remote education for patients using computer-generated environments known as virtual worlds. Previous research has revealed highly variable levels of patient receptiveness to using information technologies for healthcare-related purposes. This preliminary study involved implementing a questionnaire investigating attitudes and access to computer technologies of respiratory outpatients, in order to assess potential for use of virtual worlds to facilitate health-related education for this sample. Ninety-four patients with a chronic respiratory condition completed surveys, which were distributed at a Chest Clinic. In accordance with our prediction, younger participants were more likely to be able to use, and have access to a computer and some patients were keen to explore use virtual worlds for healthcare-related purposes: Of those with access to computer facilities, 14.50% expressed a willingness to attend a virtual world focus group. Results indicate future virtual world health education facilities should be designed to cater for younger patients, because this group are most likely to accept and use such facilities. Within the study sample, this is likely to comprise of people diagnosed with asthma. Future work could investigate the potential of creating a virtual world asthma education facility. PMID:28239187

Yoga as palliation in women with advanced cancer: a pilot study.

PubMed

Carr, Tracey; Quinlan, Elizabeth; Robertson, Susan; Duggleby, Wendy; Thomas, Roanne; Holtslander, Lorraine

2016-03-01

The purpose of this pilot study was to investigate the palliative potential of home-based yoga sessions provided to women with advanced cancer. Personalised 45-minute yoga sessions were offered to three women with advanced cancer by an experienced yoga teacher. Each woman took part in a one-to-one interview after the completion of the yoga programme and was asked to describe her experiences of the programme's impact. The personalised nature of the yoga sessions resulted in similar positive physical and psychosocial effects comparable to those demonstrated in other studies with cancer patients. Participants described physical, mental, and emotional benefits as well as the alleviation of illness impacts. The enhancement of mind-body and body-spirit connections were also noted. Personalised home-based yoga programmes for people with advanced cancer may produce similar benefits, including palliation, as those institutionally-based programmes for people with non-advanced cancer.

Study of advanced rotary combustion engines for commuter aircraft

NASA Technical Reports Server (NTRS)

Berkowitz, M.; Jones, C.; Myers, D.

1983-01-01

Performance, weight, size, and maintenance data for advanced rotary aircraft engines suitable for comparative commuter aircraft system evaluation studies of alternate engine candidates are provided. These are turbocharged, turbocompounded, direct injected, stratified charge rotary engines. Hypothetical engines were defined (an RC4-74 at 895 kW and an RC6-87 at 1490 kW) based on the technologies and design approaches used in the highly advanced engine of a study of advanced general aviation rotary engines. The data covers the size range of shaft power from 597 kW (800 hp) to 1865 kW (2500 hp) and is in the form of drawings, tables, curves and written text. These include data on internal geometry and configuration, installation information, turbocharging and turbocompounding arrangements, design features and technologies, engine cooling, fuels, scaling for weight size BSFC and heat rejection for varying horsepower, engine operating and performance data, and TBO and maintenance requirements. The basic combustion system was developed and demonstrated; however the projected power densities and performance efficiencies require increases in engine internal pressures, thermal loading, and rotative speed.

Ford Partnership for Advanced Studies (Ford PAS)

ERIC Educational Resources Information Center

Carrier, Cheryl

2006-01-01

This article features the Ford Partnership for Advanced Studies (Ford PAS) program that helps students gain knowledge about real-life business issues. Ford PAS is an educational program that combines college-prep academics with the critical 21st century skills students will need to succeed in college and in the workplace. The Ford PAS program uses…

Study of the application of advanced technologies to long range transport aircraft. Volume 2: Advanced technology program recommendations

NASA Technical Reports Server (NTRS)

1972-01-01

The benefits of the application of advanced technology to future transport aircraft were investigated. The noise reduction goals established by the CARD (Civil Aviation Research and Development) study for the 1981-1985 time period can be satisfied. Reduced terminal area and airway congestion can result from use of advanced on-board systems and operating procedures. The use of advanced structural design concepts can result in greatly reduced gross weight and improved operating economics. The full potential of these benefits can be realized in a 1985 airplane by implementing a research and development program that is funded to an average level of approximately $55 million per year over a ten year period.

Advanced flight computer. Special study

NASA Technical Reports Server (NTRS)

Coo, Dennis

1995-01-01

This report documents a special study to define a 32-bit radiation hardened, SEU tolerant flight computer architecture, and to investigate current or near-term technologies and development efforts that contribute to the Advanced Flight Computer (AFC) design and development. An AFC processing node architecture is defined. Each node may consist of a multi-chip processor as needed. The modular, building block approach uses VLSI technology and packaging methods that demonstrate a feasible AFC module in 1998 that meets that AFC goals. The defined architecture and approach demonstrate a clear low-risk, low-cost path to the 1998 production goal, with intermediate prototypes in 1996.

[Prospective randomized study of HMVP, MVP, and HVP regimens in treatment of advanced non-small cell lung cancer].

PubMed

Gao, Jian-Fei; Li, Chang-Sheng; Zhang, Bi-Cheng; Du, Guang-Zu; Zhang, Xin-Hua; Wang, Jun; Zhu, Yu-Ze; Ou, Wu-Ling; Yang, Bo

2004-04-01

Non-small cell lung cancer (NSCLC) is hyposensitive to the normal first and second-line chemotherapy regimens. Camptothecin derivative is becoming a hot point in the treatment of advanced NSCLC. The objective of this article was to evaluate the response, toxicity, and survival time of HMVP, MVP, and HVP regimens (detail in below) in the treatment of advanced NSCLC. A total of 134 cases with advanced NSCLC was randomized into three groups: HMVP group [46 patients, hydroxycamptothecin (HCPT) 12 mg/m(2) from d1 to d5, mitomycin C (MMC) 6 mg/m(2) d1, vindesine (VDS) 2.5-3 mg/m(2) d1 and d8, cisplatin (DDP) 50 mg/m(2) d2 and d3], MVP group (44 patients, MMC, VDS and DDP were the same as HMVP group) and HVP group (44 patients, HCPT, VDS, DDP were the same as HMVP group). The response rates were 39.54% (17/43), 35.57% (15/42), and 26.19% (11/42) in HMVP, MVP, and HVP groups, respectively; no significant difference was detected among the three groups (P >0.05). No significant difference was detected in the median time of remission, median survival time, and 1-, 2-year survival rates among the three groups. Moreover, no significant difference was detected in grade III-IV leukopenia, grade III-IV thrombocytopenia, grade III-IV nausea and vomiting and grade III-IV constipation among the three groups. The response rate of MVP regimen is slightly lower than that of HMVP regimen, but HMVP regimen do not show obvious superiority. It may increase toxicities such as leukopenia, nausea/vomiting, and constipation. The response rate of HVP regimen is slightly lower than that of MVP regimen.

C-130 Advanced Technology Center wing box conceptual design/cost study

NASA Technical Reports Server (NTRS)

Whitehead, R. S.; Foreman, C. R.; Silva, K.

1992-01-01

A conceptual design was developed by Northrop/LTV for an advanced C-130 Center Wing Box (CWB) which could meet the severe mission requirements of the SOF C-130 aircraft. The goals for the advanced technology CWB relative to the current C-130H CWB were: (1) the same acquisition cost; (2) lower operating support costs; (3) equal or lower weight; (4) a 30,000 hour service life for the SOF mission; and (5) minimum impact on the current maintenance concept. Initially, the structural arrangement, weight, external and internal loads, fatigue spectrum, flutter envelope and design criteria for the SOF C-130 aircraft CWB were developed. An advanced materials assessment was then conducted to determine the suitability of advanced materials for a 1994 production availability and detailed trade studies were performed on candidate CWB conceptual designs. Finally, a life-cycle cost analysis was performed on the advanced CWB. The study results showed that a hybrid composite/metallic CWB could meet the severe SOF design requirements, reduce the CWB weight by 14 pct., and was cost effective relative to an all metal beefed up C-130H CWB.

Advanced general aviation engine/airframe integration study

NASA Technical Reports Server (NTRS)

Zmroczek, L. A.

1982-01-01

A comparison of the in-airframe performance and efficiency of the advanced engine concepts is presented. The results indicate that the proposed advanced engines can significantly improve the performance and economy of general aviation airplanes. The engine found to be most promising is the highly advanced version of a rotary combustion (Wankel) engine. The low weight and fuel consumption of this engine, as well as its small size, make it suited for aircraft use.

Grouping for Inequity

ERIC Educational Resources Information Center

Macqueen, Suzanne Elizabeth

2013-01-01

The inequity of streaming as a method of organising classes was established by research conducted in the 1960s and 1970s. While the practice produces small advantages for limited groups of students, it hinders the academic and social advancement of the majority. Although streaming has declined, new forms of achievement grouping have emerged, with…

Advanced Exploration Systems Water Architecture Study Interim Results

NASA Technical Reports Server (NTRS)

Sargusingh, Miriam J.

2013-01-01

The mission of the Advanced Exploration System (AES) Water Recovery Project (WRP) is to develop advanced water recovery systems that enable NASA human exploration missions beyond low Earth orbit (LEO). The primary objective of the AES WRP is to develop water recovery technologies critical to near-term missions beyond LEO. The secondary objective is to continue to advance mid-readiness-level technologies to support future NASA missions. An effort is being undertaken to establish the architecture for the AES Water Recovery System (WRS) that meets both near- and long-term objectives. The resultant architecture will be used to guide future technical planning, establish a baseline development roadmap for technology infusion, and establish baseline assumptions for integrated ground and on-orbit Environmental Control and Life Support Systems definition. This study is being performed in three phases. Phase I established the scope of the study through definition of the mission requirements and constraints, as well as identifying all possible WRS configurations that meet the mission requirements. Phase II focused on the near-term space exploration objectives by establishing an International Space Station-derived reference schematic for long-duration (>180 day) in-space habitation. Phase III will focus on the long-term space exploration objectives, trading the viable WRS configurations identified in Phase I to identify the ideal exploration WRS. The results of Phases I and II are discussed in this paper.

Advanced Orofacial Rhabdomyosarcoma: A Retrospective Study of 31 Cases.

PubMed

Otmani, Naima; Khattab, Mohamed

2016-07-01

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma encountered in childhood and adolescence. Early diagnosis of pediatric cases is critical to improving outcomes, especially when socioeconomic status and geographical access to specialist services can reduce opportunities for early cancer detection and treatment. The objective of this study is to determine factors that can delay referral and treatment in specialist pediatric oncology center upon our population specificities. This retrospective study involved 31 children between 2003 and 2013. Children affected by histologically confirmed RMS occurring as a primary lesion in the orofacial area were included. The median age was 8 ± 4.22 years (range: 3 months - 15 years). The male to female ratio was 1.8:1. Most of the patients had advanced stage disease at presentation (81.7% group had 3-4 pretreatment staging) with parameningeal involvement in 80.6% of the cases. The 2-year event-free survival rate was 17.7 ± 7.8% for all the patients. Delay of admission to our unit and abandonment of treatment seem to be important factors for the dismal prognosis. Patient's location, socioeconomic status and health care coverage have had an impact on longer delays in seeking care and on follow-up. More studies are needed for implementation of a better management practices and a better supportive care upon specificities of our population.

World Workshop on Oral Medicine VI: an international validation study of clinical competencies for advanced training in oral medicine.

PubMed

Steele, John C; Clark, Hadleigh J; Hong, Catherine H L; Jurge, Sabine; Muthukrishnan, Arvind; Kerr, A Ross; Wray, David; Prescott-Clements, Linda; Felix, David H; Sollecito, Thomas P

2015-08-01

To explore international consensus for the validation of clinical competencies for advanced training in Oral Medicine. An electronic survey of clinical competencies was designed. The survey was sent to and completed by identified international stakeholders during a 10-week period. To be validated, an individual competency had to achieve 90% or greater consensus to keep it in its current format. Stakeholders from 31 countries responded. High consensus agreement was achieved with 93 of 101 (92%) competencies exceeding the benchmark for agreement. Only 8 warranted further attention and were reviewed by a focus group. No additional competencies were suggested. This is the first international validated study of clinical competencies for advanced training in Oral Medicine. These validated clinical competencies could provide a model for countries developing an advanced training curriculum for Oral Medicine and also inform review of existing curricula. Copyright © 2015 Elsevier Inc. All rights reserved.

Nonsurgical treatment of moderate and advanced periimplantitis lesions: a controlled clinical study.

PubMed

Schwarz, Frank; Bieling, Katrin; Bonsmann, Martin; Latz, Thilo; Becker, Jürgen

2006-12-01

The aim of this controlled, parallel design clinical study was to evaluate the effectiveness of an Er:YAG (erbium-doped:yttrium, aluminum, and garnet) laser for nonsurgical treatment of periimplantitis lesions. Twenty patients, each of whom displayed at least one implant with (a) moderate and (b) advanced periimplantitis (n=40 implants; IMZ, ITI, Spline Twist, ZL-Duraplant, Camlog), were randomly instrumented nonsurgically using either (1) an Er:YAG laser (100 mJ/pulse, 10 Hz) device (LAS) or (2) mechanical debridement using plastic curettes and antiseptic therapy with chlorhexidine digluconate (0.2%) (C). The following clinical parameters were measured at baseline, 3, 6, and 12 months after treatment: plaque index, bleeding on probing (BOP), probing depth, gingival recession, and clinical attachment level (CAL). Mean BOP improved significantly in both groups at 3, 6, and 12 months (a- lesions: P<0.001 and b- lesions: P<0.01, respectively). After 3 and 6 months, the mean reduction of BOP was significantly higher in the LAS group when compared to the C group (a- and b- lesions: P<0.01 and P<0.05, respectively). At 3 and 6 months, both groups revealed significant CAL gains at a- and b- lesions (P<0.01, respectively). In both groups, however, the mean CAL at a- and b- lesions was not significantly different from the respective baseline values at 12 months (P>0.05, respectively). Although treatment of periimplantitis lesions with LAS resulted in a significantly higher BOP reduction than C, its effectiveness seemed to be limited to a period of 6 months, particularly at b- lesions.

Advanced Placement Academy: Case Study of a Program within a School

ERIC Educational Resources Information Center

Swanson, Julie Dingle; Nagy, Steven

2014-01-01

The focus of this study was the first year of implementation of the Advanced Placement Academy (APA), a program within a high school providing honors and Advanced Placement coursework for high-ability African American students with previously limited access to rigorous courses. The qualitative investigation explores practical solutions from…

The Clinical Research Associate Retention Study: A Report From the Children's Oncology Group.

PubMed

Owens Pickle, Emily E; Borgerson, Dawn; Espirito-Santo, Anelise; Wigginton, Sabrina; Devine, Susan; Stork, Sue

Pediatric medicine often struggles to receive adequate research funding for its small, yet vulnerable population of patients. Remarkable discovery in pediatric oncology is credited in large part to the collaborative structure of its research community. The Children's Oncology Group conducts studies supported by the National Cancer Institute. The clinical research associate (CRA) discipline comprises professionals who support administrative duties, regulatory duties, subject management, and data collection at individual research sites. The purpose of this study was to identify factors associated with CRA retention, as the group continues to have high turnover and position vacancy. A cross-sectional survey design was used to characterize the most frequently cited reasons CRAs gave when considering leaving or staying within their position. Results suggest that low salary, unmanageable workload, lack of career advancement and professional development, and lack of research commitment from the medical team were associated with intent to leave CRA positions. The most frequently cited reasons for staying at their job were the meaningfulness and interest in the work, a supportive principal investigator, and enjoyment working with colleagues. CRAs reported serious but eminently solvable issues that can be addressed using practical and low-cost solutions to improve job satisfaction and retention.

Impact of Advanced Grade 8 U.S. History on Participation and Performance in Advanced Placement Social Studies Courses in Grade 9

ERIC Educational Resources Information Center

Maina, Nyambura Susan

2015-01-01

At the request of the Office of Curriculum and Instructional Programs, the Office of Shared Accountability examined the impact of offering Advanced Grade 8 U.S. History on enrollment and performance in Advanced Placement (AP) social studies courses in Grade 9. The study compared Grade 9 enrollment and performance in AP U.S. History or AP U.S.…

Evaluation of support group interventions for children in troubled families: study protocol for a quasi-experimental control group study.

PubMed

Skerfving, Annemi; Johansson, Fredrik; Elgán, Tobias H

2014-01-24

Support groups for children in troubled families are available in a majority of Swedish municipalities. They are used as a preventive effort for children in families with different parental problems such as addiction to alcohol/other drugs, mental illness, domestic violence, divorce situations, or even imprisonment. Children from families with these problems are a well-known at-risk group for various mental health and social problems. Support groups aim at strengthening children's coping behaviour, to improve their mental health and to prevent a negative psycho-social development. To date, evaluations using a control-group study design are scarce. The aim of the current study is to evaluate the effects of support groups. This paper describes the design of an effectiveness study, initially intended as a randomized controlled trial, but instead is pursued as a quasi-experimental study using a non-randomized control group. The aim is to include 116 children, aged 7-13 years and one parent/another closely related adult, in the study. Participants are recruited via existing support groups in the Stockholm county district and are allocated either into an intervention group or a waiting list control group, representing care as usual. The assessment consists of questionnaires that are to be filled in at baseline and at four months following the baseline. Additionally, the intervention group completes a 12-month follow-up. The outcomes include the Strength and Difficulties Questionnaire (SDQ S11-16), the Kids Coping Scale, the "Ladder of life" which measures overall life satisfaction, and "Jag tycker jag är" (I think I am) which measures self-perception and self-esteem. The parents complete the SDQ P4-16 (parent-report version) and the Swedish scale "Familjeklimat" (Family Climate), which measures the emotional climate in the family. There is a need for evaluating the effects of support groups targeted to children from troubled families. This quasi-experimental study

Group heterogeneity increases the risks of large group size: a longitudinal study of productivity in research groups.

PubMed

Cummings, Jonathon N; Kiesler, Sara; Bosagh Zadeh, Reza; Balakrishnan, Aruna D

2013-06-01

Heterogeneous groups are valuable, but differences among members can weaken group identification. Weak group identification may be especially problematic in larger groups, which, in contrast with smaller groups, require more attention to motivating members and coordinating their tasks. We hypothesized that as groups increase in size, productivity would decrease with greater heterogeneity. We studied the longitudinal productivity of 549 research groups varying in disciplinary heterogeneity, institutional heterogeneity, and size. We examined their publication and citation productivity before their projects started and 5 to 9 years later. Larger groups were more productive than smaller groups, but their marginal productivity declined as their heterogeneity increased, either because their members belonged to more disciplines or to more institutions. These results provide evidence that group heterogeneity moderates the effects of group size, and they suggest that desirable diversity in groups may be better leveraged in smaller, more cohesive units.

A randomized, controlled trial of in situ pediatric advanced life support recertification ("pediatric advanced life support reconstructed") compared with standard pediatric advanced life support recertification for ICU frontline providers*.

PubMed

Kurosawa, Hiroshi; Ikeyama, Takanari; Achuff, Patricia; Perkel, Madeline; Watson, Christine; Monachino, Annemarie; Remy, Daphne; Deutsch, Ellen; Buchanan, Newton; Anderson, Jodee; Berg, Robert A; Nadkarni, Vinay M; Nishisaki, Akira

2014-03-01

Recent evidence shows poor retention of Pediatric Advanced Life Support provider skills. Frequent refresher training and in situ simulation are promising interventions. We developed a "Pediatric Advanced Life Support-reconstructed" recertification course by deconstructing the training into six 30-minute in situ simulation scenario sessions delivered over 6 months. We hypothesized that in situ Pediatric Advanced Life Support-reconstructed implementation is feasible and as effective as standard Pediatric Advanced Life Support recertification. A prospective randomized, single-blinded trial. Single-center, large, tertiary PICU in a university-affiliated children's hospital. Nurses and respiratory therapists in PICU. Simulation-based modular Pediatric Advanced Life Support recertification training. Simulation-based pre- and postassessment sessions were conducted to evaluate participants' performance. Video-recorded sessions were rated by trained raters blinded to allocation. The primary outcome was skill performance measured by a validated Clinical Performance Tool, and secondary outcome was behavioral performance measured by a Behavioral Assessment Tool. A mixed-effect model was used to account for baseline differences. Forty participants were prospectively randomized to Pediatric Advanced Life Support reconstructed versus standard Pediatric Advanced Life Support with no significant difference in demographics. Clinical Performance Tool score was similar at baseline in both groups and improved after Pediatric Advanced Life Support reconstructed (pre, 16.3 ± 4.1 vs post, 22.4 ± 3.9; p < 0.001), but not after standard Pediatric Advanced Life Support (pre, 14.3 ± 4.7 vs post, 14.9 ± 4.4; p =0.59). Improvement of Clinical Performance Tool was significantly higher in Pediatric Advanced Life Support reconstructed compared with standard Pediatric Advanced Life Support (p = 0.006). Behavioral Assessment Tool improved in both groups: Pediatric Advanced Life Support

Advanced composites: Design and application. Proceedings of the meeting of the Mechanical Failures Prevention Group

NASA Technical Reports Server (NTRS)

Shives, T. R.; Willard, W. A.

1979-01-01

The design and application of advanced composites is discussed with emphasis on aerospace, aircraft, automotive, marine, and industrial applications. Failure modes in advanced composites are also discussed.

[Efficacy and safety of Xiaoaiping combined with chemotherapy in the treatment of advanced esophageal cancer].

PubMed

Wang, F; Fan, Q X; Wang, H H; Han, D M; Song, N S; Lu, H

2017-06-23

Objective: To evaluate the efficacy and safety of Xiaoaiping combined with chemotherapy in the treatment of advanced esophageal cancer. Methods: This is a multi-center, randomized, open label and parallel controlled study. A total of 124 advanced esophageal cancer patients with Karnofsky Performance Status (KPS) score ≥60 and expected survival time≥3 months were enrolled. We adopted design and divided the patients into study and control group. The patients in study group received Xiaoaiping combined with S-1 and cisplatin. The control group received S-1 and cisplatin. Each group included 62 patients and 21 days as a treatment cycle. The efficacy and adverse events in patients of the two groups were observed and compared. Results: 57 patients in the study group and 55 in the control group were included in efficacy assessment. The response rate was 54.4% and 34.5% in the study group and control group, respectively( P <0.05). Disease control rates were 86.0% and 69.1%, respectively( P <0.05). The median progression-free survival (PFS) was 7.97 in the study group and 6.43 months in the control group( P <0.05). The median overall survival(OS) was 12.93 in the study group and 10.93 months in the control group( P <0.05). The most common adverse events in the two groups were nausea and vomiting, thrombocytopenia, anemia, neutropenia, liver damage, pigmentation, oral mucositis, renal impairment and diarrhea. The incidences of nausea, vomiting, thrombocytopenia, leukopenia, neutropenia and diarrhea in the study group were significantly higher than those in the control group( P <0.05). Conclusion: Xiaoaiping combined with S-1 and cisplatin significantly increased response rate, and prolongedpatients' survival in patients with advanced esophageal cancer.

Oncological safety of skin sparing mastectomy followed by immediate reconstruction for locally advanced breast cancer.

PubMed

Lim, Woosung; Ko, Beom-Seok; Kim, Hee-Jung; Lee, Jong Won; Eom, Jin Sup; Son, Byung Ho; Lee, Taik Jong; Ahn, Sei-Hyun

2010-07-01

Skin sparing mastectomy (SSM) has been demonstrated as an oncologically safe procedure for early breast cancer in several studies. But few studies concerned the safety of SSM for patients with locally advanced breast cancer; therefore, its safety for these patients is less clear. The purpose of this study is to examine the oncological safety of SSM followed by immediate reconstruction for locally advanced breast cancer. We retrospectively analyzed 897 breast cancer patients who underwent mastectomy for stage IIB (T3N0)-III between 1996 and 2005. Of 897, 87 underwent SSM (n = 73) or nipple sparing mastectomy (NSM, n = 14). We compared the local recurrence (LR) rate, disease-free survival (DFS) and overall survival (OS) for SSM group with conventional mastectomy group. The 5-year DFS and OS of SSM group were not worse than those of CM group for all stages. LR rate was 3.0% (2/67) for IIB, 2.8% (1/36) for IIIA, 4.5% (1/22) for IIIC, and 5.0% (1/20) for T3 in SSM group. There was no difference in LR rates between SSM group and CM group for all stages. Our study demonstrates that SSM followed by immediate reconstruction is oncologically safe for locally advanced breast cancer. (c) 2010 Wiley-Liss, Inc.

Advancing theory of family conflict at the end of life: a hospice case study.

PubMed

Boelk, Amy Z; Kramer, Betty J

2012-11-01

Although family conflict is a common occurrence for families involved in caregiving for a dying family member, it has not been examined in the hospice context. The purpose of this study was to advance theory of family conflict at the end of life through replication and expansion of a case study involving professional perspectives in the context of a managed care program for low-income elders with advanced chronic disease in their last six months of life, by exploring the perceptions of professionals and family caregivers experiencing conflict in the hospice context. Data were gathered through in-depth interviews with 15 hospice family caregivers experiencing substantial family conflict, and focus groups with 37 professionals employed in a large multicounty and nonprofit hospice in the Midwest U.S. Dimensional analysis, a method for the generation of grounded theory, was used to refine and expand an explanatory matrix of family conflict at the end of life. The initial matrix was expanded through the inclusion of eight new and two refined categories, strengthening our understanding of family conflict as a complex phenomenon influenced by salient contextual variables, conditions, and factors that may contribute to a number of negative outcomes for patients, family members, and professionals. The study findings are discussed in terms of implications for assessment and intervention. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

2010 Chemical Working Group Status

NASA Technical Reports Server (NTRS)

Reid, Concha M.

2010-01-01

The Steering Group for the Interagency Advanced Power Group (IAPG) held their business meeting on November 30-December 1st in McLean, Virginia. Status reports were presented from each of the IAPG's Working Groups. These charts contain a brief summary of the IAPG Chemical Working Group's activities during 2010 and its plans for 2011.

[Prevention of gastrointestinal bleeding in patients with advanced burns].

PubMed

Vagner, D O; Krylov, K M; Verbitsky, V G; Shlyk, I V

2018-01-01

To reduce the incidence of gastrointestinal bleeding in patients with advanced burns by developing a prophylactic algorithm. The study consisted of retrospective group of 488 patients with thermal burns grade II-III over 20% of body surface area and prospective group of 135 patients with a similar thermal trauma. Standard clinical and laboratory examination was applied. Instrumental survey included fibrogastroduodenoscopy, endoscopic pH-metry and invasive volumetric monitoring (PICCO plus). Statistical processing was carried out with Microsoft Office Excel 2007 and IBM SPSS 20.0. New algorithm significantly decreased incidence of gastrointestinal bleeding (p<0.001) and mortality rate (p=0.006) in patients with advanced burns.

Technological advances for studying human behavior

NASA Technical Reports Server (NTRS)

Roske-Hofstrand, Renate J.

1990-01-01

Technological advances for studying human behavior are noted in viewgraph form. It is asserted that performance-aiding systems are proliferating without a fundamental understanding of how they would interact with the humans who must control them. Two views of automation research, the hardware view and the human-centered view, are listed. Other viewgraphs give information on vital elements for human-centered research, a continuum of the research process, available technologies, new technologies for persistent problems, a sample research infrastructure, the need for metrics, and examples of data-link technology.

Focused development of advanced practice nurse roles for specific patient groups in a Swiss university hospital

PubMed

Spichiger, Elisabeth; Zumstein-Shaha, Maya; Schubert, Maria; Herrmann, Luzia

2018-02-01

Background: To cover future health care needs of the population, new care models are necessary. The development of advanced nursing practice (ANP) offers the opportunity to meet these challenges with novel services. At the Inselspital, Bern University Hospital, ANP services and corresponding advanced practice nurse (APN) roles have been developed since 2011. Purpose: The aim is to develop innovative and evidence based ANP services to supplement health care for specific patient groups and their family members with the goal to improve safety and achieve better outcomes. Methods: Project-based ANP services are developed in close collaboration of clinical departments and the Nursing Development Unit (NDU) of the Directorate of Nursing. Structure, process and outcome data are collected for evaluation. Findings: Currently, five ANP services are established and running, eight more are in the developmental phase. Most services address the long term care of patients with chronic illnesses and their family members. Ten APNs work between 10 % and 80 %, three are leading an ANP-team. APNs work over 50 % in direct clinical practice, primarily in counselling. An ANP network connects APNs and NDU, promoting synergy and exchange. Conclusions: The available resources often constitute a challenge for the development of ANP services. Vital for the long-term success are an adequate extent of the position, the support by department directorate, the conceptual framework that is implemented across the whole hospital, and the development within project structures.

Qualitative studies using in-depth interviews with older people from multiple language groups: methodological systematic review.

PubMed

Fryer, Caroline; Mackintosh, Shylie; Stanley, Mandy; Crichton, Jonathan

2012-01-01

This paper is a report of a methodological review of language appropriate practice in qualitative research, when language groups were not determined prior to participant recruitment. When older people from multiple language groups participate in research using in-depth interviews, additional challenges are posed for the trustworthiness of findings. This raises the question of how such challenges are addressed. The Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Web of Science, Ageline, PsycINFO, Sociological abstracts, Google Scholar and Allied and Complementary Medicine databases were systematically searched for the period 1840 to September 2009. The combined search terms of 'ethnic', 'cultural', 'aged', 'health' and 'qualitative' were used. In this methodological review, studies were independently appraised by two authors using a quality appraisal tool developed for the review, based on a protocol from the McMaster University Occupational Therapy Evidence-Based Practice Research Group. Nine studies were included. Consideration of language diversity within research process was poor for all studies. The role of language assistants was largely absent from study methods. Only one study reported using participants' preferred languages for informed consent. More examples are needed of how to conduct rigorous in-depth interviews with older people from multiple language groups, when languages are not determined before recruitment. This will require both researchers and funding bodies to recognize the importance to contemporary healthcare of including linguistically diverse people in participant samples. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Advanced Accelerators for Medical Applications

NASA Astrophysics Data System (ADS)

Uesaka, Mitsuru; Koyama, Kazuyoshi

We review advanced accelerators for medical applications with respect to the following key technologies: (i) higher RF electron linear accelerator (hereafter “linac”); (ii) optimization of alignment for the proton linac, cyclotron and synchrotron; (iii) superconducting magnet; (iv) laser technology. Advanced accelerators for medical applications are categorized into two groups. The first group consists of compact medical linacs with high RF, cyclotrons and synchrotrons downsized by optimization of alignment and superconducting magnets. The second group comprises laser-based acceleration systems aimed of medical applications in the future. Laser plasma electron/ion accelerating systems for cancer therapy and laser dielectric accelerating systems for radiation biology are mentioned. Since the second group has important potential for a compact system, the current status of the established energy and intensity and of the required stability are given.

Advanced Accelerators for Medical Applications

NASA Astrophysics Data System (ADS)

Uesaka, Mitsuru; Koyama, Kazuyoshi

We review advanced accelerators for medical applications with respect to the following key technologies: (i) higher RF electron linear accelerator (hereafter "linac"); (ii) optimization of alignment for the proton linac, cyclotron and synchrotron; (iii) superconducting magnet; (iv) laser technology. Advanced accelerators for medical applications are categorized into two groups. The first group consists of compact medical linacs with high RF, cyclotrons and synchrotrons downsized by optimization of alignment and superconducting magnets. The second group comprises laserbased acceleration systems aimed of medical applications in the future. Laser plasma electron/ion accelerating systems for cancer therapy and laser dielectric accelerating systems for radiation biology are mentioned. Since the second group has important potential for a compact system, the current status of the established energy and intensity and of the required stability are given.

Electrochemical carbon dioxide concentrator advanced technology tasks

NASA Technical Reports Server (NTRS)

Schneider, J. J.; Schubert, F. H.; Hallick, T. M.; Woods, R. R.

1975-01-01

Technology advancement studies are reported on the basic electrochemical CO2 removal process to provide a basis for the design of the next generation cell, module and subsystem hardware. An Advanced Electrochemical Depolarized Concentrator Module (AEDCM) is developed that has the characteristics of low weight, low volume, high CO2, removal, good electrical performance and low process air pressure drop. Component weight and noise reduction for the hardware of a six man capacity CO2 collection subsystem was developed for the air revitalization group of the Space Station Prototype (SSP).

Teaching Advance Care Planning to Medical Students with a Computer-Based Decision Aid

PubMed Central

Levi, Benjamin H.

2013-01-01

Discussing end-of-life decisions with cancer patients is a crucial skill for physicians. This article reports findings from a pilot study evaluating the effectiveness of a computer-based decision aid for teaching medical students about advance care planning. Second-year medical students at a single medical school were randomized to use a standard advance directive or a computer-based decision aid to help patients with advance care planning. Students' knowledge, skills, and satisfaction were measured by self-report; their performance was rated by patients. 121/133 (91%) of students participated. The Decision-Aid Group (n=60) outperformed the Standard Group (n=61) in terms of students´ knowledge (p<0.01), confidence in helping patients with advance care planning (p<0.01), knowledge of what matters to patients (p=0.05), and satisfaction with their learning experience (p<0.01). Likewise, patients in the Decision Aid Group were more satisfied with the advance care planning method (p<0.01) and with several aspects of student performance. Use of a computer-based decision aid may be an effective way to teach medical students how to discuss advance care planning with cancer patients. PMID:20632222

Advanced supersonic propulsion study, phase 3

NASA Technical Reports Server (NTRS)

Howlett, R. A.; Johnson, J.; Sabatella, J.; Sewall, T.

1976-01-01

The variable stream control engine is determined to be the most promising propulsion system concept for advanced supersonic cruise aircraft. This concept uses variable geometry components and a unique throttle schedule for independent control of two flow streams to provide low jet noise at takeoff and high performance at both subsonic and supersonic cruise. The advanced technology offers a 25% improvement in airplane range and an 8 decibel reduction in takeoff noise, relative to first generation supersonic turbojet engines.

Astrophysics at RIA (ARIA) Working Group

NASA Astrophysics Data System (ADS)

Smith, Michael S.; Schatz, Hendrik; Timmes, Frank X.; Wiescher, Michael; Greife, Uwe

2006-07-01

The Astrophysics at RIA (ARIA) Working Group has been established to develop and promote the nuclear astrophysics research anticipated at the Rare Isotope Accelerator (RIA). RIA is a proposed next-generation nuclear science facility in the U.S. that will enable significant progress in studies of core collapse supernovae, thermonuclear supernovae, X-ray bursts, novae, and other astrophysical sites. Many of the topics addressed by the Working Group are relevant for the RIKEN RI Beam Factory, the planned GSI-Fair facility, and other advanced radioactive beam facilities.

Advanced Waste Treatment. A Field Study Training Program.

ERIC Educational Resources Information Center

California State Univ., Sacramento. Dept. of Civil Engineering.

This operations manual represents a continuation of operator training manuals developed for the United States Environmental Protection Agency (USEPA) in response to the technological advancements of wastewater treatment and the changing needs of the operations profession. It is intended to be used as a home-study course manual (using the concepts…

Preliminary Study of Advanced Turboprops for Low Energy Consumption

NASA Technical Reports Server (NTRS)

Kraft, G. A.; Strack, W. C.

1975-01-01

The fuel savings potential of advanced turboprops (operational about 1985) was calculated and compared with that of an advanced turbofan for use in an advanced subsonic transport. At the design point, altitude 10.67 km and Mach 0.80, turbine-inlet temperature was fixed at 1590 K while overall pressure ratio was varied from 25 to 50. The regenerative turboprop had a pressure ratio of only 10 and an 85 percent effective rotary heat exchanger. Variable camber propellers were used with an efficiency of 85 percent. The study indicated a fuel savings of 33 percent, a takeoff gross weight reduction of 15 percent, and a direct operating cost reduction of 18 percent was possible when turboprops were used instead of the reference turbofan at a range of 10 200 km. These reductions were 28, 11, and 14 percent, respectively, at a range of 5500 km. Increasing overall pressure ratio from 25 to 50 saved little fuel and slightly increased takeoff gross weight.

Mapping extragalactic dark matter annihilation with galaxy surveys: A systematic study of stacked group searches

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lisanti, Mariangela; Mishra-Sharma, Siddharth; Rodd, Nicholas L.

Dark matter in the halos surrounding galaxy groups and clusters can annihilate to high-energy photons. Recent advancements in the construction of galaxy group catalogs provide many thousands of potential extragalactic targets for dark matter. In this paper, we outline a procedure to infer the dark matter signal associated with a given galaxy group. Applying this procedure to a catalog of sources, one can create a full-sky map of the brightest extragalactic dark matter targets in the nearby Universe (z≲0.03), supplementing sources of dark matter annihilation from within the local group. As with searches for dark matter in dwarf galaxies, thesemore » extragalactic targets can be stacked together to enhance the signals associated with dark matter. We validate this procedure on mock Fermi gamma-ray data sets using a galaxy catalog constructed from the DarkSky N-body cosmological simulation and demonstrate that the limits are robust, at O(1) levels, to systematic uncertainties on halo mass and concentration. We also quantify other sources of systematic uncertainty arising from the analysis and modeling assumptions. Lastly, our results suggest that a stacking analysis using galaxy group catalogs provides a powerful opportunity to discover extragalactic dark matter and complements existing studies of Milky Way dwarf galaxies.« less

Mapping extragalactic dark matter annihilation with galaxy surveys: A systematic study of stacked group searches

NASA Astrophysics Data System (ADS)

Lisanti, Mariangela; Mishra-Sharma, Siddharth; Rodd, Nicholas L.; Safdi, Benjamin R.; Wechsler, Risa H.

2018-03-01

Dark matter in the halos surrounding galaxy groups and clusters can annihilate to high-energy photons. Recent advancements in the construction of galaxy group catalogs provide many thousands of potential extragalactic targets for dark matter. In this paper, we outline a procedure to infer the dark matter signal associated with a given galaxy group. Applying this procedure to a catalog of sources, one can create a full-sky map of the brightest extragalactic dark matter targets in the nearby Universe (z ≲0.03 ), supplementing sources of dark matter annihilation from within the local group. As with searches for dark matter in dwarf galaxies, these extragalactic targets can be stacked together to enhance the signals associated with dark matter. We validate this procedure on mock Fermi gamma-ray data sets using a galaxy catalog constructed from the DarkSky N -body cosmological simulation and demonstrate that the limits are robust, at O (1 ) levels, to systematic uncertainties on halo mass and concentration. We also quantify other sources of systematic uncertainty arising from the analysis and modeling assumptions. Our results suggest that a stacking analysis using galaxy group catalogs provides a powerful opportunity to discover extragalactic dark matter and complements existing studies of Milky Way dwarf galaxies.

Mapping extragalactic dark matter annihilation with galaxy surveys: A systematic study of stacked group searches

DOE PAGES

Lisanti, Mariangela; Mishra-Sharma, Siddharth; Rodd, Nicholas L.; ...

2018-03-09

Dark matter in the halos surrounding galaxy groups and clusters can annihilate to high-energy photons. Recent advancements in the construction of galaxy group catalogs provide many thousands of potential extragalactic targets for dark matter. In this paper, we outline a procedure to infer the dark matter signal associated with a given galaxy group. Applying this procedure to a catalog of sources, one can create a full-sky map of the brightest extragalactic dark matter targets in the nearby Universe (z≲0.03), supplementing sources of dark matter annihilation from within the local group. As with searches for dark matter in dwarf galaxies, thesemore » extragalactic targets can be stacked together to enhance the signals associated with dark matter. We validate this procedure on mock Fermi gamma-ray data sets using a galaxy catalog constructed from the DarkSky N-body cosmological simulation and demonstrate that the limits are robust, at O(1) levels, to systematic uncertainties on halo mass and concentration. We also quantify other sources of systematic uncertainty arising from the analysis and modeling assumptions. Lastly, our results suggest that a stacking analysis using galaxy group catalogs provides a powerful opportunity to discover extragalactic dark matter and complements existing studies of Milky Way dwarf galaxies.« less

Fundamental Materials Studies for Advanced High Power Microwave and Terahertz Vacuum Electronic Radiation Sources

DTIC Science & Technology

2014-12-10

AFRL-OSR-VA-TR-2014-0359 Fundamental Materials Studies for Advanced High Power Microwave and Terahertz John Booske UNIVERSITY OF WISCONSIN SYSTEM...12-2014 Final Technical Performance Report October 1, 2011 - September 30, 2014 Fundamental Materials Studies for Advanced High Power Microwave and...emission-barrier scandate cathodes and identify related, alternative cathode materials systems for advanced vacuum electronic cathodes for high power THz

The Development of Nanotechnologies and Advanced Materials Industry in Science and Entrepreneurship: Socioeconomic and Technical Indicators. A Case Study of Latvia (Part One)

NASA Astrophysics Data System (ADS)

Geipele, I.; Geipele, S.; Staube, T.; Ciemleja, G.; Zeltins, N.

2016-08-01

The present scientific paper is the first part of two publications, where the authors obtain results from the scientific research presented in a series of works on the development of the nanotechnologies and advanced materials industry in science and entrepreneurship in Latvia. The study has a focus on finding proper socioeconomic and technical indicators. It provides resume on a scope of the study. The paper contains the developed structure of engineering economic indicator system, determined groups of indicators for assessment of the development of nanotechnologies and advanced materials industry in Latvia and results of the evaluation of the obtained statistics on the economic indicators.

Changing drivers' minds: the evaluation of an advanced driver coaching system.

PubMed

Stanton, N A; Walker, G H; Young, M S; Kazi, T; Salmon, P M

2007-08-01

This paper reports on the study of an advanced driver coaching system. The study distinguishes between different types of post-licensure programmes in order to explore a system based on a model of identifying and responding to hazards, called 'information, position, speed, gear and acceleration' (IPSGA). Previous literature has been sceptical about the benefits of advanced driver education; thus, the current study was designed to control for the effects of coaching drivers in the 'IPSGA' system (the treatment group) against the effects of being accompanied (control group 1), as well as the mere effects of time (control group 2). Measures were taken before the driver coaching began (as a baseline measure) and again after 8 weeks (to see if any changes had occurred). These measures included driver knowledge via a post-drive interview, observations of driving skill and driver attitude using a locus of control scale. The results suggest that advanced driver coaching using the IPSGA system had a beneficial effect on all of these measures. Drivers in the coaching condition improved their situation awareness, driving skills and reduced attributions of external locus of control. The study lends support to the case for one-to-one individualized driver coaching using a systematic model of driving.

Dinitrophenyl hapten with laser immunotherapy for advanced malignant melanoma: A clinical study

PubMed Central

Chen, Dian-Jun; Li, Xiao-Song; Zhao, Hui; Fu, Yan; Kang, Huan-Rong; Yao, Fang-Fang; Hu, Jia; Qi, Nan; Zhang, Huan-Huan; Du, Nan; Chen, Wei-R

2017-01-01

The present study aimed to evaluate the efficacy and safety of in situ immunotherapy with dinitrophenyl (DNP) hapten in combination with laser therapy for patients with malignant melanoma (MM). Between February 2008 and March 2012, 72 patients with stage III or IV MM were enrolled. Patients received in situ DNP alone (n=32) or in combination with laser therapy (n=32), and each group received dacarbazine chemotherapy. The levels of peripheral cluster of differentiation (CD)4+CD25+ regulatory T cells (Tregs), interleukin (IL)-10 and tumor growth factor (TGF)-β were detected by ELISA. The association between delayed-type hypersensitivity (DTH) and survival time was evaluated. Although peripheral Treg levels significantly decreased over time in the two groups (P<0.001), there was no significant difference between the treatment groups (P=0.098). Patients receiving the combination treatment exhibited significantly higher interferon-γ production by CD8+ and CD4+ T cells (both P<0.001), as well as significantly reduced levels of IL-10, TGF-β1 and TGF-β2. In addition, patients in the combination treatment group experienced significantly longer overall survival (OS; P=0.024) and disease-free survival (DFS; P=0.007) times; a DTH response of ≥15 mm was also associated with increased OS time and DFS time (P≤0.001). Finally, no severe adverse events were observed in either treatment group. Overall, in situ immunization with DNP in combination with laser immunotherapy may activate focal T cells, producing a regional antitumor immune response that increases cell-mediated immunity and improves survival in MM patients. Thus, this may represent a novel therapeutic strategy for patients with unresectable, advanced MM. PMID:28454272

Dinitrophenyl hapten with laser immunotherapy for advanced malignant melanoma: A clinical study.

PubMed

Chen, Dian-Jun; Li, Xiao-Song; Zhao, Hui; Fu, Yan; Kang, Huan-Rong; Yao, Fang-Fang; Hu, Jia; Qi, Nan; Zhang, Huan-Huan; Du, Nan; Chen, Wei-R

2017-03-01

The present study aimed to evaluate the efficacy and safety of in situ immunotherapy with dinitrophenyl (DNP) hapten in combination with laser therapy for patients with malignant melanoma (MM). Between February 2008 and March 2012, 72 patients with stage III or IV MM were enrolled. Patients received in situ DNP alone (n=32) or in combination with laser therapy (n=32), and each group received dacarbazine chemotherapy. The levels of peripheral cluster of differentiation (CD)4 + CD25 + regulatory T cells (Tregs), interleukin (IL)-10 and tumor growth factor (TGF)-β were detected by ELISA. The association between delayed-type hypersensitivity (DTH) and survival time was evaluated. Although peripheral Treg levels significantly decreased over time in the two groups (P<0.001), there was no significant difference between the treatment groups (P=0.098). Patients receiving the combination treatment exhibited significantly higher interferon-γ production by CD8 + and CD4 + T cells (both P<0.001), as well as significantly reduced levels of IL-10, TGF-β1 and TGF-β2. In addition, patients in the combination treatment group experienced significantly longer overall survival (OS; P=0.024) and disease-free survival (DFS; P=0.007) times; a DTH response of ≥15 mm was also associated with increased OS time and DFS time (P≤0.001). Finally, no severe adverse events were observed in either treatment group. Overall, in situ immunization with DNP in combination with laser immunotherapy may activate focal T cells, producing a regional antitumor immune response that increases cell-mediated immunity and improves survival in MM patients. Thus, this may represent a novel therapeutic strategy for patients with unresectable, advanced MM.

The Advanced Glaucoma Intervention Study (AGIS): 1. Study design and methods and baseline characteristics of study patients.

PubMed

Ederer, F; Gaasterland, D E; Sullivan, E K

1994-08-01

Medical therapy has been the standard initial treatment for open-angle glaucoma. When some visual field has been lost and maximum tolerated and effective medical therapy does not succeed in controlling the disease, the patient is considered to have advanced glaucoma, and the first of a potential sequence of surgical treatments is usually indicated. Little is known about the long-term course and prognosis of advanced glaucoma or about the long-term effectiveness of sequential surgical treatments in controlling the disease and preventing vision loss and blindness. The Advanced Glaucoma Intervention Study was designed to study, in advanced glaucoma, the long-term clinical course and prognosis, and, in a randomized trial, the comparative outcomes of two sequences of surgical treatments. Toward these goals, 789 eyes in 591 patients were enrolled at 11 clinical centers between 1988 and 1992. Follow-up will continue until 1996. Eyes were randomly assigned to one of two sequences of surgical treatments. One sequence begins with argon laser trabeculoplasty (ALT), is followed by trabeculectomy, an incisional surgical filtering procedure, should ALT fail to control the disease, and by a second trabeculectomy should the first trabeculectomy fail. The other sequence begins with trabeculectomy, is followed by ALT should the trabeculectomy fail, and by a second trabeculectomy should ALT fail. The main outcome of interest is visual function (visual field and visual acuity). Other important outcomes are intraocular pressure, complications of surgery, time to treatment failure, and extent of need for additional medical therapy. We present in this paper the rationale, objectives, design and methods of the study, and the baseline characteristics of study patients and eyes.

Extended lymphadenectomy for locally advanced and recurrent rectal cancer.

PubMed

Georgiou, Panagiotis A; Mohammed Ali, S; Brown, Gina; Rasheed, Shahnawaz; Tekkis, Paris P

2017-03-01

The purpose of this study is to assess the value of extended (lateral) lymphadenectomy (EL) in the operative management of locally advanced and recurrent rectal cancer. Patients that underwent exenterative surgery for locally advanced or recurrent rectal cancer between 2006 and 2009 were included in the study. A decision for EL was taken at the local multidisciplinary meeting based on the radiological findings. Perioperative and oncological outcomes were assessed and compared between the EL and non-EL group prospectively. Forty-one consecutive patients were included in the study (EL = 17). The median age was 57 (40-71) for EL and 66 (39-81) years for non-EL. Of patients, 27 (EL = 13) and 14 (EL = 4) underwent pelvic exenteration and abdominosacral resection, respectively. Twelve (EL = 7) patients were diagnosed with locally advanced primary rectal cancer. Thirty-one (EL = 12) patients received neoadjuvant radiotherapy. The median intraoperative time, blood loss and hospital stay were 9 h (3-13), 1.5 l (0.3-7) and 14 days (12-72), respectively, for the EL group, and 8 h (4-15), 1.6 l (0.25-17) and 14 days (10-86), respectively, for the non-EL (p ≥ 0.394). Morbidity was similar between the two groups (EL = 4, non-EL = 9; p = 0.344). Complete tumour resection (R0) was achieved in 30 (73.17%) patients, 12 (70.58%) in the EL group and 18 (75%) in the non-EL group (p = 0.649). There was no significant difference in 5-year survival (EL = 60.7%, non-EL = 75.2%; p = 0.447), local recurrence (EL = 53.6%, non-EL = 65.4%; p = 0.489) and disease-free survival (EL = 53.6%, non-EL = 51.4%; p = 0.814). The present study demonstrated that EL does not provide a statistically significant advantage in survival or recurrence rates, for patients with locally advanced primary or recurrent rectal cancer.

Theoretical Advanced Study Institute: 2014

DOE Office of Scientific and Technical Information (OSTI.GOV)

DeGrand, Thomas

The Theoretical Advanced Study Institute (TASI) was held at the University of Colorado, Boulder, during June 2-27, 2014. The topic was "Journeys through the Precision Frontier: Amplitudes for Colliders." The organizers were Professors Lance Dixon (SLAC) and Frank Petriello (Northwestern and Argonne). There were fifty-one students. Nineteen lecturers gave sixty seventy-five minute lectures. A Proceedings was published. This TASI was unique for its large emphasis on methods for calculating amplitudes. This was embedded in a program describing recent theoretical and phenomenological developments in particle physics. Topics included introductions to the Standard Model, to QCD (both in a collider context andmore » on the lattice), effective field theories, Higgs physics, neutrino interactions, an introduction to experimental techniques, and cosmology.« less

EGFR mutations in early-stage and advanced-stage lung adenocarcinoma: Analysis based on large-scale data from China.

PubMed

Pi, Can; Xu, Chong-Rui; Zhang, Ming-Feng; Peng, Xiao-Xiao; Wei, Xue-Wu; Gao, Xing; Yan, Hong-Hong; Zhou, Qing

2018-05-02

EGFR-tyrosine kinase inhibitors play an important role in the treatment of advanced non-small cell lung cancer (NSCLC). EGFR mutations in advanced NSCLC occur in approximately 35% of Asian patients and 60% of patients with adenocarcinoma. However, the frequency and type of EGFR mutations in early-stage lung adenocarcinoma remain unclear. We retrospectively collected data on patients diagnosed with lung adenocarcinoma tested for EGFR mutation. Early stage was defined as pathological stage IA-IIIA after radical lung cancer surgery, and advanced stage was defined as clinical stage IIIB without the opportunity for curative treatment or stage IV according to the American Joint Committee on Cancer Staging Manual, 7th edition. A total of 1699 patients were enrolled in this study from May 2014 to May 2016; 750 were assigned to the early-stage and 949 to the advanced-stage group. Baseline characteristics of the two groups were balanced, except that there were more smokers in the advanced-stage group (P < 0.001). The total EGFR mutation rate in the early-stage group was similar to that in the advanced-stage group (53.6% vs. 51.4%, respectively; P = 0.379). There was no significant difference in EGFR mutation type between the two groups. In subgroup analysis of smoking history, there was no difference in EGFR mutation frequency or type between the early-stage and advanced-stage groups. Early-stage and advanced-stage groups exhibited the same EGFR mutation frequencies and types. © 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

NSF/ESF Workshop on Smart Structures and Advanced Sensors, Santorini Island, Greece, June 26-28, 2005: Structural Actuation and Adaptation Working Group

NASA Technical Reports Server (NTRS)

Figueroa, Fernando; Tomizuka, Masayoshi; Bergman, Lawrence; Carpenter, Bernie; Salzano, Carmine; Bairrao, rogerio; Deraemaker, Arnaud; Magonette, Georges; Rodellar, Jose; Kadirkamanathan, Visaken

2005-01-01

This document is a result of discussions that took place during the workshop. It describes current state of research and development (R&D) in the areas of structural actuation and adaptation in the context of smart structures and advanced sensors (SS&AS), and provides an outlook to guide future R&D efforts to develop technologies needed to build SS&AS. The discussions took place among the members of the Structural Actuation and Adaptation Working Group, as well as in general sessions including all four working groups. Participants included members of academia, industry, and government from the US and Europe, and representatives from China, Japan, and Korea.

MSFC's Advanced Space Propulsion Formulation Task

NASA Technical Reports Server (NTRS)

Huebner, Lawrence D.; Gerrish, Harold P.; Robinson, Joel W.; Taylor, Terry L.

2012-01-01

In NASA s Fiscal Year 2012, a small project was undertaken to provide additional substance, depth, and activity knowledge to the technology areas identified in the In-Space Propulsion Systems Roadmap, Technology Area 02 (TA-02), as created under the auspices of the NASA Office of the Chief Technologist (OCT). This roadmap was divided into four basic groups: (1) Chemical Propulsion, (2) Non-chemical Propulsion, (3) Advanced (TRL<3) Propulsion Technologies, and (4) Supporting Technologies. The first two were grouped according to the governing physics. The third group captured technologies and physic concepts that are at a lower TRL level. The fourth group identified pertinent technical areas that are strongly coupled with these related areas which could allow significant improvements in performance. There were a total of 45 technologies identified in TA-02, and 25 of these were studied in this formulation task. The goal of this task was to provide OCT with a knowledge-base for decisionmaking on advanced space propulsion technologies and not waste money by unintentionally repeating past projects or funding the technologies with minor impacts. This formulation task developed the next level of detail for technologies described and provides context to OCT where investments should be made. The presentation will begin with the list of technologies from TA-02, how they were prioritized for this study, and details on what additional data was captured for the technologies studied. Following this, some samples of the documentation will be provided, followed by plans on how the data will be made accessible.

Life and living in advanced age: a cohort study in New Zealand--e Puāwaitanga o Nga Tapuwae Kia Ora Tonu, LiLACS NZ: study protocol.

PubMed

Hayman, Karen J; Kerse, Ngaire; Dyall, Lorna; Kepa, Mere; Teh, Ruth; Wham, Carol; Clair, Valerie Wright-St; Wiles, Janine; Keeling, Sally; Connolly, Martin J; Wilkinson, Tim J; Moyes, Simon; Broad, Joanna B; Jatrana, Santosh

2012-06-29

The number of people of advanced age (85 years and older) is increasing and health systems may be challenged by increasing health-related needs. Recent overseas evidence suggests relatively high levels of wellbeing in this group, however little is known about people of advanced age, particularly the indigenous Māori, in Aotearoa, New Zealand. This paper outlines the methods of the study Life and Living in Advanced Age: A Cohort Study in New Zealand. The study aimed to establish predictors of successful advanced ageing and understand the relative importance of health, frailty, cultural, social & economic factors to successful ageing for Māori and non-Māori in New Zealand. A total population cohort study of those of advanced age. Two cohorts of equal size, Māori aged 80-90 and non-Māori aged 85, oversampling to enable sufficient power, were enrolled. A defined geographic region, living in the Bay of Plenty and Lakes District Health Board areas of New Zealand, defined the sampling frame. Rūnanga (Māori tribal organisations) and Primary Health Organisations were subcontracted to recruit on behalf of the University. Measures--a comprehensive interview schedule was piloted and administered by a trained interviewer using standardised techniques. Socio-demographic and personal history included tribal affiliation for Māori and participation in cultural practices; physical and psychological health status used standardised validated research tools; health behaviours included smoking, alcohol use and nutrition risk; and environmental data included local amenities, type of housing and neighbourhood. Social network structures and social support exchanges are recorded. Measures of physical function; gait speed, leg strength and balance, were completed. Everyday interests and activities, views on ageing and financial interests complete the interview. A physical assessment by a trained nurse included electrocardiograph, blood pressure, hearing and vision, anthropometric

Life and Living in Advanced Age: A Cohort Study in New Zealand -Te Puāwaitanga o Nga Tapuwae Kia Ora Tonu, LiLACS NZ: Study protocol

PubMed Central

2012-01-01

Background The number of people of advanced age (85 years and older) is increasing and health systems may be challenged by increasing health-related needs. Recent overseas evidence suggests relatively high levels of wellbeing in this group, however little is known about people of advanced age, particularly the indigenous Māori, in Aotearoa, New Zealand. This paper outlines the methods of the study Life and Living in Advanced Age: A Cohort Study in New Zealand. The study aimed to establish predictors of successful advanced ageing and understand the relative importance of health, frailty, cultural, social & economic factors to successful ageing for Māori and non-Māori in New Zealand. Methods/design A total population cohort study of those of advanced age. Two cohorts of equal size, Māori aged 80–90 and non-Māori aged 85, oversampling to enable sufficient power, were enrolled. A defined geographic region, living in the Bay of Plenty and Lakes District Health Board areas of New Zealand, defined the sampling frame. Rūnanga (Māori tribal organisations) and Primary Health Organisations were subcontracted to recruit on behalf of the University. Measures - a comprehensive interview schedule was piloted and administered by a trained interviewer using standardised techniques. Socio-demographic and personal history included tribal affiliation for Māori and participation in cultural practices; physical and psychological health status used standardised validated research tools; health behaviours included smoking, alcohol use and nutrition risk; and environmental data included local amenities, type of housing and neighbourhood. Social network structures and social support exchanges are recorded. Measures of physical function; gait speed, leg strength and balance, were completed. Everyday interests and activities, views on ageing and financial interests complete the interview. A physical assessment by a trained nurse included electrocardiograph, blood pressure, hearing

Advanced Manned Launch System (AMLS) study

NASA Technical Reports Server (NTRS)

Ehrlich, Carl F., Jr.; Potts, Jack; Brown, Jerry; Schell, Ken; Manley, Mary; Chen, Irving; Earhart, Richard; Urrutia, Chuck; Randolph, Ray; Morris, Jim

1992-01-01

To assure national leadership in space operations and exploration in the future, NASA must be able to provide cost effective and operationally efficient space transportation. Several NASA studies and the joint NASA/DoD Space Transportation Architecture Studies (STAS) have shown the need for a multi-vehicle space transportation system with designs driven by enhanced operations and low costs. NASA is currently studying an advanced manned launch system (AMLS) approach to transport crew and cargo to the Space Station Freedom. Several single and multiple stage systems from air-breathing to all-rocket concepts are being examined in a series of studies potential replacements for the Space Shuttle launch system in the 2000-2010 time frame. Rockwell International Corporation, under contract to the NASA Langley Research Center, has analyzed a two-stage all-rocket concept to determine whether this class of vehicles is appropriate for the AMLS function. The results of the pre-phase A study are discussed.

Temsirolimus in women with platinum-refractory/resistant ovarian cancer or advanced/recurrent endometrial carcinoma. A phase II study of the AGO-study group (AGO-GYN8).

PubMed

Emons, Günter; Kurzeder, Christian; Schmalfeldt, Barbara; Neuser, Petra; de Gregorio, Nikolaus; Pfisterer, Jacobus; Park-Simon, Tjoung-Won; Mahner, Sven; Schröder, Willibald; Lück, Hans-Joachim; Heubner, Martin Leonhard; Hanker, Lars; Thiel, Falk; Hilpert, Felix

2016-03-01

To evaluate activity and toxicity of mTOR inhibitor temsirolimus in patients with platinum-refractory/resistant ovarian cancer (OC) or advanced/recurrent endometrial carcinoma (EC). Women with epithelial ovarian, fallopian tube or primary peritoneal cancer were eligible, when they had progression during treatment with a platinum based regimen or within 6 months after receiving a platinum based regimen and a previous taxane treatment. Women with advanced/recurrent EC, no longer amenable to curative surgery and/or radiotherapy were eligible when they had no previous or only adjuvant chemotherapy. Preceding endocrine therapy for metastatic/recurrent disease was allowed. Patients received weekly IV infusions of 25mg temsirolimus. Primary endpoint was progression free survival rate after 4 months (OC) or 6 months (EC). A two stage design was applied. Forty-four patients (OC: n=22; EC: n=22) were enrolled and received temsirolimus treatment. Median age was 56 years (OC) or 63 years (EC). After eight weeks of treatment, 10 of 21 evaluable patients in the OC cohort and 8 of 20 evaluable patients in the EC cohort had progressive disease. Thus efficacy did not meet the predefined levels during the first stage of recruitment and the trial was stopped. Some patients in both cohorts had long lasting PFS (>7 months). Toxicity of temsirolimus was mild. Temsirolimus treatment was well tolerated in our patients, but did not meet the predefined efficacy criteria. In our study as in other trials on rapalogs in OC or EC, a few patients had long lasting disease stabilisations. Copyright © 2015. Published by Elsevier Inc.

Advanced maternal age and risk perception: A qualitative study

PubMed Central

2012-01-01

Background Advanced maternal age (AMA) is associated with several adverse pregnancy outcomes, hence these pregnancies are considered to be “high risk.” A review of the empirical literature suggests that it is not clear how women of AMA evaluate their pregnancy risk. This study aimed to address this gap by exploring the risk perception of pregnant women of AMA. Methods A qualitative descriptive study was undertaken to obtain a rich and detailed source of explanatory data regarding perceived pregnancy risk of 15 women of AMA. The sample was recruited from a variety of settings in Winnipeg, Canada. In-depth interviews were conducted with nulliparous women aged 35 years or older, in their third trimester, and with singleton pregnancies. Interviews were recorded and transcribed verbatim, and content analysis was used to identify themes and categories. Results Four main themes emerged: definition of pregnancy risk, factors influencing risk perception, risk alleviation strategies, and risk communication with health professionals. Conclusions Several factors may influence women's perception of pregnancy risk including medical risk, psychological elements, characteristics of the risk, stage of pregnancy, and health care provider’s opinion. Understanding these influential factors may help health professionals who care for pregnant women of AMA to gain insight into their perspectives on pregnancy risk and improve the effectiveness of risk communication strategies with this group. PMID:22988825

Perception of Curability Among Advanced Cancer Patients: An International Collaborative Study.

PubMed

Yennurajalingam, Sriram; Rodrigues, Luis Fernando; Shamieh, Omar; Tricou, Colombe; Filbet, Marilène; Naing, Kyaw; Ramaswamy, Akhileshwaran; Perez-Cruz, Pedro Emilio; Bautista, Mary Jocelyn S; Bunge, Sofia; Muckaden, Mary Ann; Sewram, Vikash; Fakrooden, Sarah; Noguera-Tejedor, Antonio; Rao, Shobha S; Liu, Diane; Park, Minjeong; Williams, Janet L; Lu, Zhanni; Cantu, Hilda; Hui, David; Reddy, Suresh K; Bruera, Eduardo

2018-04-01

There are limited data on illness understanding and perception of cure among advanced cancer patients around the world. The aim of the study was to determine the frequency and factors associated with inaccurate perception of curability among advanced cancer patients receiving palliative care across the globe. Secondary analysis of a study to understand the core concepts in end-of-life care among advanced cancer patients receiving palliative care from 11 countries across the world. Advanced cancer patients were surveyed using a Patient Illness Understanding survey and Control Preference Scale. Descriptive statistics and multicovariate logistic regression analysis were performed. Fifty-five percent (763/1,390) of patients receiving palliative care inaccurately reported that their cancer is curable. The median age was 58, 55% were female, 59% were married or had a partner, 48% were Catholic, and 35% were college educated. Sixty-eight percent perceived that the goal of therapy was "to get rid of their cancer," and 47% perceived themselves as "seriously ill." Multicovariate logistic regression analysis shows that accurate perception of curability was associated with female gender (odds ratio [OR] 0.73, p  = .027), higher education (OR 0.37, p  < .0001), unemployment status (OR 0.69, p  = .02), and being from France (OR 0.26, p  < .0001) and South Africa (OR 0.52, p  = .034); inaccurate perception of curability was associated with better Karnofsky performance status (OR 1.02 per point, p  = .0005), and being from Philippines (OR 15.49, p  < .0001), Jordan (OR 8.43, p  < .0001), Brazil (OR 2.17, p  = .0037), and India (OR 2.47, p  = .039). Inaccurate perception of curability in advanced cancer patients is 55% and significantly differs by gender, education, performance status, employment status, and country of origin. Further studies are needed to develop strategies to reduce this misperception of curability in advanced cancer

[Application of clinical nursing path in standard management of advanced schistosomiasis patients with splenomegaly].

PubMed

Yang, Liu; Liu, Juan-Juan

2013-04-01

To study the feasibility and effect of clinical nursing path in the standard management of advanced schistosomiasis patients with splenomegaly. A total of 64 advanced schistosomiasis patients with splenomegaly were randomly divided into a routine nursing group (control group) and a clinical nursing pathway group (CNP group), and the postoperative situation, average hospitalization days, cost of hospitalization and the satisfaction of the patients of the 2 groups were compared. The complications, average hospitalization days, costs of hospitalization in the CNP group were significantly decreased compared with those in the control group, and satisfaction rate of the patients in the CNP group increased from 81.25% to 100%. The implementation of CNP effectively reduces the length of hospitalization, costs and complications, and improves the satisfaction of the patients.

Systematic review with meta-analysis: the incidence of advanced neoplasia after polypectomy in patients with and without low-risk adenomas.

PubMed

Hassan, C; Gimeno-García, A; Kalager, M; Spada, C; Zullo, A; Costamagna, G; Senore, C; Rex, D K; Quintero, E

2014-05-01

Patients with one to two tubular adenomas <1 cm in size without high-grade dysplasia (low-risk group) are considered at low risk for colorectal cancer. However, it is uncertain whether they have the same risk of subsequent advanced neoplasia as those with no neoplasia at baseline colonoscopy. To compare incidence of metachronous advanced neoplasia between patients in the low-risk adenoma group and those without neoplasia at index colonoscopy. Relevant publications were identified by MEDLINE/EMBASE and other databases for the period 1992-2013. Studies comparing the incidence of post-polypectomy advanced neoplasia (adenomas ≥10 mm/high-grade dysplasia/villous or cancer) between the low-risk group and patients without colorectal neoplasia at the first colonoscopy were included. Detection rates for advanced neoplasia at endoscopic surveillance were extracted. Study quality was ascertained according to Newcastle-Ottawa Scale. Forest plot was produced based on random-effect models. Inter-study heterogeneity was assessed using the I(2) statistic. Seven studies provided data on 11 387 patients. Mean surveillance periods ranged between 2 and 5 years. Altogether, 267 patients with post-polypectomy advanced neoplasia were detected in the two groups. The incidence of advanced neoplasia was 1.6% (119/7308) in those without neoplasia and 3.6% (148/4079) in those with low-risk adenoma, respectively, corresponding to a relative risk of 1.8 (95% CI: 1.3-2.6). Inter-study heterogeneity was only moderate (I(2) : 37%). No publication bias was present. Patients with low-risk adenomas at baseline had a higher risk of metachronous advanced neoplasia than the group with no adenomas at baseline, though the absolute risk was low in both groups. © 2014 John Wiley & Sons Ltd.

Long Term Stability and Relapse Following Mandibular Advancement and Mandibular Setback Surgeries: A Cephalometric Study

PubMed Central

Darshan, S Vinay; Ronad, Yusuf Ahammed; Kishore, M S V; Shetty, K Sadashiva; Rajesh, M; Suman, S D

2014-01-01

Background: The aim was to evaluate the long-term hard and soft tissue changes following mandibular advancement and setback surgeries. Materials and Methods: A total of 16 subjects each were selected who underwent bilateral sagittal split osteotomy mandibular advancement and mandibular setback groups. Pre-surgical (T1), immediate post-surgical (T2) and long-term post-surgical (T3) cephalograms were compared for hard and soft tissue changes. After cephalometric measurements, the quantity of changes between T1-T2 and T1-T3 were determined for each patient. The mean difference between T1-T2 and T1-T3 was compared with assess the long-term changes and stability. Results: In mandibular advancement the mean difference between immediate post-surgical and long term post-surgical is 7%, which accounts for a relapse of 7%. In mandibular setback, the mean difference between immediate post-surgical and long-term post-surgical is 29%, which accounts for a relapse of 29%. Conclusion: Mandibular advancement remained stable over the long period when compared to mandibular setback. PMID:25395792

Long term stability and relapse following mandibular advancement and mandibular setback surgeries: a cephalometric study.

PubMed

Darshan, S Vinay; Ronad, Yusuf Ahammed; Kishore, M S V; Shetty, K Sadashiva; Rajesh, M; Suman, S D

2014-09-01

The aim was to evaluate the long-term hard and soft tissue changes following mandibular advancement and setback surgeries. A total of 16 subjects each were selected who underwent bilateral sagittal split osteotomy mandibular advancement and mandibular setback groups. Pre-surgical (T1), immediate post-surgical (T2) and long-term post-surgical (T3) cephalograms were compared for hard and soft tissue changes. After cephalometric measurements, the quantity of changes between T1-T2 and T1-T3 were determined for each patient. The mean difference between T1-T2 and T1-T3 was compared with assess the long-term changes and stability. In mandibular advancement the mean difference between immediate post-surgical and long term post-surgical is 7%, which accounts for a relapse of 7%. In mandibular setback, the mean difference between immediate post-surgical and long-term post-surgical is 29%, which accounts for a relapse of 29%. Mandibular advancement remained stable over the long period when compared to mandibular setback.

A Study of Group Dynamics in Educational Leadership Cohort and Non-Cohort Groups

ERIC Educational Resources Information Center

Greenlee, Bobbie J.; Karanxha, Zorka

2010-01-01

The purpose of this study was to examine group dynamics of educational leadership students in cohorts and make comparisons with the group dynamics characteristics of non-cohort students. Cohorts have emerged as dynamic and adaptive entities with attendant group dynamic processes that shape collective learning and action. Cohort (n=42) and…

Advanced space program studies: Overall executive summary

NASA Technical Reports Server (NTRS)

Sitney, L. R.

1974-01-01

Studies were conducted to provide NASA with advanced planning analyses which relate integrated space program goals and options to credible technical capabilities, applications potential, and funding resources. The studies concentrated on the following subjects: (1) upper stage options for the space transportation system based on payload considerations, (2) space servicing and standardization of payloads, (3) payload operations, and (4) space transportation system economic analyses related to user charges and new space applications. A systems cost/performance model was developed to synthesize automated, unmanned spacecraft configurations based on the system requirements and a list of equipments at the assembly level.

Identification of resources and skills developed by partners of patients with advanced colon cancer: a qualitative study.

PubMed

Meunier-Beillard, N; Ponthier, N; Lepage, C; Gagnaire, A; Gheringuelli, F; Bengrine, L; Boudrant, A; Rambach, L; Quipourt, V; Devilliers, H; Lejeune, Catherine

2018-06-05

Family caregivers play an important role in caring for patients with advanced cancer. To become competent, individuals must draw on and mobilise an adequate combination of resources. Our goal was to identify the skills developed by caregivers of patients with advanced cancer and the associated resources mobilised. We chose to do it with partners of patients with colon cancer. The study used a cross-sectional qualitative design based on 20 individual interviews and a focus group. Partners were recruited from patients treated in three hospitals of France. Semi-structured interviews were conducted until data saturation was achieved. Each interview was transcribed verbatim, and thematic analyses were performed to extract significant themes and subthemes. Results from the individual and focus group interviews showed that the skills implemented by the partners (in domains of social relationships and health, domestic, organisational, emotional and well-being dimensions) were singular constructs, dependant on if resources (personal, external and schemes) may have been missing and insufficient. In addition, partners may have had these resources but not mobilised them. The identification of the skills and associated resources could allow healthcare professionals better identifying and understanding of the difficulties met by partners in taking care of patients. This could enable them to offer appropriate support to help the caregivers in their accompaniment.

Increase in counselling communication skills after basic and advanced microskills training.

PubMed

Kuntze, Jeroen; van der Molen, Henk T; Born, Marise P

2009-03-01

Mastering counselling communication skills is one of the requirements that lead to the diploma of a registered European psychologist. The microcounseling method proves to be effective in training these skills. Research into the effectiveness of the microcounseling method often reports overall effect sizes only. The aim of this study was to investigate the adequate use of separate counselling communication skills (seven basic skills: minimal encouragements; asking questions; paraphrasing; reflection of feeling; concreteness; summarizing; and situation clarification and five advanced skills: advanced accurate empathy; confrontation; positive relabelling; examples of one's own; and directness) after respectively a basic and an advanced training in these skills. Participants were 583 first year or second year bachelor students in psychology who took the counselling communication skills progress test (CSPT). The participants are divided in a group of freshmen, who had not received any training in counselling communication skills; first year students, who had received a training in basic skills; second year students who had followed a training in advanced skills and a control group. A between-subject design, a within-subject design and a pre-test-post-test-control group design were used to examine the scores on these skills. Seven basic skills and four advanced skills had large effect sizes. One advanced skill had a moderate effect size. The microcounseling method is very effective on the level of separate microskills. However, students perform better on the basic skills than on the advanced skills. More training seems to be needed in the latter to achieve the same level of mastery.

Advanced Concept

NASA Image and Video Library

1997-01-02

The Advanced Space Transportation Group takes the future of space travel far into the 21st Century. Pictured is an artist's concept of a third generation Reusable Launch Vehicle (RLV). Projected for the year 2025, this third generation RLV will introduce an era of space travel not unlike air travel today.

Relapse Analysis of Irradiated Patients Within the HD15 Trial of the German Hodgkin Study Group

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kriz, Jan; Reinartz, Gabriele; Dietlein, Markus

2015-05-01

Purpose: To determine, in the setting of advanced-stage of Hodgkin lymphoma (HL), whether relapses occur in the irradiated planning target volume and whether the definition of local radiation therapy (RT) used by the German Hodgkin Study Group (GHSG) is adequate, because there is no harmonization of field and volume definitions among the large cooperative groups in the treatment of advanced-stage HL. Methods and Materials: All patients with residual disease of ≥2.5 cm after multiagent chemotherapy (CTX) were evaluated using additional positron emission tomography (PET), and those with a PET-positive result were irradiated with 30 Gy to the site of residual disease. We re-evaluatedmore » all sites of disease before and after CTX, as well as the PET-positive residual tumor that was treated in all relapsed patients. Documentation of radiation therapy (RT), treatment planning procedures, and portal images were carefully analyzed and compared with the centrally recommended RT prescription. The irradiated sites were compared with sites of relapse using follow-up computed tomography scans. Results: A total of 2126 patients were enrolled, and 225 patients (11%) received RT. Radiation therapy documents of 152 irradiated patients (68%) were analyzed, with 28 irradiated patients (11%) relapsing subsequently. Eleven patients (39%) had an in-field relapse, 7 patients (25%) relapsed outside the irradiated volume, and an additional 10 patients (36%) showed mixed in- and out-field relapses. Of 123 patients, 20 (16%) with adequately performed RT relapsed, compared with 7 of 29 patients (24%) with inadequate RT. Conclusions: The frequency and pattern of relapses suggest that local RT to PET-positive residual disease is sufficient for patients in advanced-stage HL. Insufficient safety margins of local RT may contribute to in-field relapses.« less

Sub-classification of Advanced-Stage Hepatocellular Carcinoma: A Cohort Study Including 612 Patients Treated with Sorafenib.

PubMed

Yoo, Jeong-Ju; Chung, Goh Eun; Lee, Jeong-Hoon; Nam, Joon Yeul; Chang, Young; Lee, Jeong Min; Lee, Dong Ho; Kim, Hwi Young; Cho, Eun Ju; Yu, Su Jong; Kim, Yoon Jun; Yoon, Jung-Hwan

2018-04-01

Advanced hepatocellular carcinoma (HCC) is associated with various clinical conditions including major vessel invasion, metastasis, and poor performance status. The aim of this study was to establish a prognostic scoring system and to propose a sub-classification of the Barcelona-Clinic Liver Cancer (BCLC) stage C. This retrospective study included consecutive patientswho received sorafenib for BCLC stage C HCC at a single tertiary hospital in Korea. A Cox proportional hazard model was used to develop a scoring system, and internal validationwas performed by a 5-fold cross-validation. The performance of the model in predicting risk was assessed by the area under the curve and the Hosmer-Lemeshow test. A total of 612 BCLC stage C HCC patients were sub- classified into strata depending on their performance status. Five independent prognostic factors (Child-Pugh score, α-fetoprotein, tumor type, extrahepatic metastasis, and portal vein invasion) were identified and used in the prognostic scoring system. This scoring system showed good discrimination (area under the receiver operating characteristic curve, 0.734 to 0.818) and calibration functions (both p < 0.05 by the Hosmer-Lemeshow test at 1 month and 12 months, respectively). The differences in survival among the different risk groups classified by the total score were significant (p < 0.001 by the log-rank test in both the Eastern Cooperative Oncology Group 0 and 1 strata). The heterogeneity of patientswith BCLC stage C HCC requires sub-classification of advanced HCC. A prognostic scoring system with five independent factors is useful in predicting the survival of patients with BCLC stage C HCC.

Collaborative palliative care for advanced heart failure: outcomes and costs from the 'Better Together' pilot study.

PubMed

Pattenden, Jill F; Mason, Anne R; Lewin, R J P

2013-03-01

Patients with heart failure often receive little supportive or palliative care. 'Better Together' was a 2-year pilot study of a palliative care service for patients with advanced congestive heart failure (CHF). To determine if the intervention made it more likely that patients would be cared for and die in their place of choice, and to investigate its cost-effectiveness. This pragmatic non-randomised pilot evaluation was set in two English primary care trusts (Bradford and Poole). Prospective patient-level data on outcomes and costs were compared with data from a historical control group of clinically comparable patients. Outcomes included death in preferred place of care (available only for the intervention group) and 'hospital admissions averted'. Costs included medical procedures, inpatient care and the direct cost of providing the intervention. 99 patients were referred. Median survival from referral was 48 days in Bradford and 31 days in Poole. Most patients who died did so in their preferred place of death (Bradford 70%, Poole 77%). An estimated 14 and 18 hospital admissions for heart failure were averted in Bradford and Poole, respectively. The average cost-per-heart failure admission averted was £1529 in Bradford, but the intervention was cost saving in Poole. However, there was considerable uncertainty around these cost-effectiveness estimates. This pilot study provides tentative evidence that a collaborative home-based palliative care service for patients with advanced CHF may increase the likelihood of death in place of choice and reduce inpatient admissions. These findings require confirmation using a more robust methodological framework.

Development of a conceptual policy framework for advanced practice nursing: an ethnographic study.

PubMed

Schober, Madrean M; Gerrish, Kate; McDonnell, Ann

2016-06-01

To report on a study examining policy development for advanced practice nursing from intent of policy to realization in practice. Inclusion of advanced practice nursing roles in the healthcare workforce is a worldwide trend. Optimal advanced nursing practice requires supportive policies. Little is known about how policy is developed and implemented. Ethnography using an instrumental case study approach was selected to give an in-depth understanding of the experiences of one country (Singapore) to contribute to insight into development elsewhere. The four-phase study was conducted from 2008-2012 and included document analysis (n = 47), interviews with key policy decision makers (n = 12), interviews with nursing managers and medical directors (n = 11), interviews and participant observation with advanced practice nurses (n = 15). Key policymakers in positions of authority were able to promote policy development. However, this was characterized by lack of strategic planning for implementation. A vague understanding by nursing managers and medical directors of policies, the role and its position in the healthcare workforce led to indecision and uncertainty in execution. Advanced practice nurses developed their role based on theory acquired in their academic programme but were unsure what role to assume in practice. Lack of clear guidelines led to unanticipated difficulties for institutions and healthcare systems. Strategic planning could facilitate integration of advanced practice nurses into the healthcare workforce. A Conceptual Policy Framework is proposed as a guide for a coordinated approach to policy development and implementation for advanced practice nursing. © 2016 John Wiley & Sons Ltd.

Advanced small launch vehicle study

NASA Technical Reports Server (NTRS)

Reins, G. E.; Alvis, J. F.

1972-01-01

A conceptual design study was conducted to determine the most economical (lowest cost/launch) approach for the development of an advanced small launch vehicle (ASLV) for use over the next decade. The ASLV design objective was to place a 340 kg (750 lb) payload into a 556 km (300 n.mi.) circular orbit when launched due east from Wallops Island, Virginia. The investigation encompassed improvements to the current Scout launch vehicle; use of existing military and NASA launch vehicle stages; and new, optionally staged vehicles. Staging analyses included use of liquid, solid, and hybrid propellants. Improvements in guidance, controls, interstages, telemetry, and payload shroud were also considered. It was concluded that the most economical approach is to progressively improve the Scout launch vehicle in three phased steps which are discussed.

Advanced hybrid vehicle propulsion system study

NASA Technical Reports Server (NTRS)

Schwarz, R.

1982-01-01

Results are presented of a study of an advanced heat engine/electric automotive hybrid propulsion system. The system uses a rotary stratified charge engine and ac motor/controller in a parallel hybrid configuration. The three tasks of the study were (1) parametric studies involving five different vehicle types, (2) design trade-off studies to determine the influence of various vehicle and propulsion system paramaters on system performance fuel economy and cost, and (3) a conceptual design establishing feasibility at the selected approach. Energy consumption for the selected system was .034 1/km (61.3 mpg) for the heat engine and .221 kWh/km (.356 kWh/mi) for the electric power system over a modified J227 a schedule D driving cycle. Life cycle costs were 7.13 cents/km (11.5 cents/mi) at $2/gal gasoline and 7 cents/kWh electricity for 160,000 km (100,000 mi) life.

Consensus on the Definition of Advanced Parkinson's Disease: A Neurologists-Based Delphi Study (CEPA Study).

PubMed

Luquin, Maria-Rosario; Kulisevsky, Jaime; Martinez-Martin, Pablo; Mir, Pablo; Tolosa, Eduardo S

2017-01-01

To date, no consensus exists on the key factors for diagnosing advanced Parkinson disease (APD). To obtain consensus on the definition of APD, we performed a prospective, multicenter, Spanish nationwide, 3-round Delphi study (CEPA study). An ad hoc questionnaire was designed with 33 questions concerning the relevance of several clinical features for APD diagnosis. In the first-round, 240 neurologists of the Spanish Movement Disorders Group participated in the study. The results obtained were incorporated into the questionnaire and both, results and questionnaire, were sent out to and fulfilled by 26 experts in Movement Disorders. Review of results from the second-round led to a classification of symptoms as indicative of "definitive," "probable," and "possible" APD. This classification was confirmed by 149 previous participating neurologists in a third-round, where 92% completely or very much agreed with the classification. Definitive symptoms of APD included disability requiring help for the activities of daily living, presence of motor fluctuations with limitations to perform basic activities of daily living without help, severe dysphagia, recurrent falls, and dementia. These results will help neurologists to identify some key factors in APD diagnosis, thus allowing users to categorize the patients for a homogeneous recognition of this condition.

Incipient fault detection study for advanced spacecraft systems

NASA Technical Reports Server (NTRS)

Milner, G. Martin; Black, Michael C.; Hovenga, J. Mike; Mcclure, Paul F.

1986-01-01

A feasibility study to investigate the application of vibration monitoring to the rotating machinery of planned NASA advanced spacecraft components is described. Factors investigated include: (1) special problems associated with small, high RPM machines; (2) application across multiple component types; (3) microgravity; (4) multiple fault types; (5) eight different analysis techniques including signature analysis, high frequency demodulation, cepstrum, clustering, amplitude analysis, and pattern recognition are compared; and (6) small sample statistical analysis is used to compare performance by computation of probability of detection and false alarm for an ensemble of repeated baseline and faulted tests. Both detection and classification performance are quantified. Vibration monitoring is shown to be an effective means of detecting the most important problem types for small, high RPM fans and pumps typical of those planned for the advanced spacecraft. A preliminary monitoring system design and implementation plan is presented.

Advancing toward Shared Decision Making

ERIC Educational Resources Information Center

Muller, Lisa; Thorn, Judi

2007-01-01

In May 2004, a group of 25 teachers at Jenks High School in Oklahoma received an invitation to the Summer 2004 Advance. Although many organizations hold retreats for their employees, the administrators wanted to send a different message: we're not retreating; we're advancing! Like many states, Oklahoma suffered a school budget crisis during the…

Characteristics of personal health information management groups: findings from an online survey using Amazon's mTurk.

PubMed

Kim, Sujin; Huber, Jeffrey T

2017-10-01

The study characterized three groups with different levels of familiarity with personal health information management (PHIM) in terms of their demographics, health knowledge, technological competency, and information sources and barriers. In addition, the authors examined differences among PHIM groups in subjective self-ratings and objective test scores for health literacy. A total of 202 survey participants were recruited using Amazon's Mechanical Turk (mTurk) service, a crowdsourcing Internet service. Using K-means clustering, three groups with differing levels of familiarity with PHIM were formed: Advanced, Intermediate, and Basic. The Advanced group was the youngest, and the Basic group contained the highest proportion of males, whereas the Intermediate group was the oldest and contained the fewest males. The Advanced group was significantly more likely to engage in provider- or hospital-initiated PHIM activities such as emailing with providers, viewing test results online, and receiving summaries of hospital visits via email or websites than the other groups. The Basic group had significantly lower information management skills and Internet use than the other groups. Advanced and Basic groups reported significant differences in several information barriers. While the Advanced group self-reported the highest general literacy, they scored lowest on an objective health literacy test. For effective personal health records management, it is critical to understand individual differences in PHIM using a comprehensive measure designed to assess personal health records-specific activities. Because they are trained to perform an array of information management activities, medical librarians or patient educators are well positioned to promote the effective use of personal health records by health consumers.

Maternal obesity and physical activity and exercise levels as pregnancy advances: an observational study.

PubMed

Daly, N; Mitchell, C; Farren, M; Kennelly, M M; Hussey, J; Turner, M J

2016-05-01

Increases in clinical complications associated with maternal obesity have generated interest in increasing physical activity (PA) and exercise levels as an intervention to improve pregnancy outcomes. The objective of this study was to examine the relationship between BMI categorisation and PA and exercise levels as pregnancy advances. This was an observational study in a large university maternity hospital. Women were recruited at their convenience before they left hospital after delivering a baby weighing 500 g or more. They completed a detailed customised physical activity and exercise questionnaire. BMI categorisation was based on the measurement of weight and height in early pregnancy. Of the 155 women recruited, 42.5 % (n = 66) were primigravidas and 10.3 % (n = 16) were smokers. Mean Body Mass Index (BMI) was 24.6 kg/m(2) and 14.2 % (n = 22) were obese, based on a BMI >29.9 kg/m(2). Overall, women decreased their exercise from an average 194 min (range 0-650 min) per week pre-pregnancy to 98 min antenatally (range 0-420 min) (p < 0.0001). Obese women exercised least pre-pregnancy and antenatally at 187.5 and 75 min per week, respectively, compared with 193.2 and 95.5 min per week in the normal BMI group and 239.3 and 106.7 min per week in the overweight group. The mean gestation at which all women reduced their activity levels was 29 weeks. We found that women decreased their PA  and exercise levels significantly in the third trimester and, thus, in the absence of a medical contra-indication there is considerable scope for an exercise intervention to improve activity  and exercise levels as pregnancy advances. However, an increase in PA levels in obese women needs further studies to determine whether it will improve the clinical outcomes for the woman and her offspring.

A randomized study of rotigotine dose response on 'off' time in advanced Parkinson's disease.

PubMed

Nicholas, Anthony P; Borgohain, Rupam; Chaná, Pedro; Surmann, Erwin; Thompson, Emily L; Bauer, Lars; Whitesides, John; Elmer, Lawrence W

2014-01-01

Previous phase III studies in patients with advanced Parkinson's disease (PD) not adequately controlled on levodopa demonstrated significant reduction of 'off' time with rotigotine transdermal system up to 16 mg/24 h. However, the minimal effective dose has not been established. This international, randomized, double-blind, placebo-controlled study (SP921; NCT00522379) investigated rotigotine dose response up to 8 mg/24 h. Patients with advanced idiopathic PD (≥2.5 h of daily 'off' time on stable doses of levodopa) were randomized 1:1:1:1:1 to receive rotigotine 2, 4, 6, or 8 mg/24 h or placebo, titrated over 4 weeks and maintained for 12 weeks. The primary efficacy variable was change from baseline to end of maintenance in absolute time spent 'off'. 409/514 (80%) randomized patients completed maintenance. Mean (±SD) baseline daily 'off' times (h/day) were placebo: 6.4 (±2.5), rotigotine 2-8 mg/24 h: 6.4 (±2.6). Rotigotine 8 mg/24 h was the minimal dose to significantly reduce 'off' time versus placebo. LS mean (±SE) absolute change in daily 'off' time (h/day) from baseline was -2.4 (±0.28) with rotigotine 8 mg/24 h, and -1.5 (±0.26) with placebo; absolute change in 'off' time in the 8 mg/24 h group compared with placebo was -0.85 h/day (95% CI -1.59, -0.11; p = 0.024). There was an apparent dose-dependent trend. Adverse events (AEs) reported at a higher incidence in the rotigotine 8 mg/24 h group versus placebo included application site reactions, nausea, dry mouth, and dyskinesia; there was no worsening of insomnia, somnolence, orthostatic hypotension, confusional state or hallucinations, even in patients ≥75 years of age. The minimal statistically significant effective dose of rotigotine to reduce absolute 'off' time was 8 mg/24 h. The AE profile was similar to previous studies.

Advance care planning for haemodialysis patients.

PubMed

Lim, Chi Eung Danforn; Ng, Rachel W C; Cheng, Nga Chong Lisa; Cigolini, Maria; Kwok, Cannas; Brennan, Frank

2016-07-26

restriction. Data extraction was carried out independently by two authors using standard data extraction forms. Studies reported in non-English language journals were translated before assessment. Where more than one publication of one study exists, reports were grouped together and the publication with the most complete data was used in the analyses. Where relevant outcomes are only published in earlier versions these data were used. Any discrepancies between published versions were highlighted. Non-randomised controlled studies were excluded. We included two studies (three reports) that involved 337 participants which investigated advance care planning for people with ESKD. Neither of the included studies reported outcomes relevant to this review. Study quality was assessed as suboptimal. We found sparse data that were assessed at suboptimal quality and therefore we were unable to formulate conclusions about whether advance care planning can influence numbers of hospital admissions and treatment required by people with ESKD, or if patients' advance care directives were followed at end-of-life. Further well designed and adequately powered RCTs are needed to better inform patient and clinical decision-making about advance care planning and advance directives among people with ESKD who are undergoing dialysis.

Advancing Alternative Analysis: Integration of Decision Science

PubMed Central

Zaunbrecher, Virginia M.; Batteate, Christina M.; Blake, Ann; Carroll, William F.; Corbett, Charles J.; Hansen, Steffen Foss; Lempert, Robert J.; Linkov, Igor; McFadden, Roger; Moran, Kelly D.; Olivetti, Elsa; Ostrom, Nancy K.; Romero, Michelle; Schoenung, Julie M.; Seager, Thomas P.; Sinsheimer, Peter; Thayer, Kristina A.

2017-01-01

Background: Decision analysis—a systematic approach to solving complex problems—offers tools and frameworks to support decision making that are increasingly being applied to environmental challenges. Alternatives analysis is a method used in regulation and product design to identify, compare, and evaluate the safety and viability of potential substitutes for hazardous chemicals. Objectives: We assessed whether decision science may assist the alternatives analysis decision maker in comparing alternatives across a range of metrics. Methods: A workshop was convened that included representatives from government, academia, business, and civil society and included experts in toxicology, decision science, alternatives assessment, engineering, and law and policy. Participants were divided into two groups and were prompted with targeted questions. Throughout the workshop, the groups periodically came together in plenary sessions to reflect on other groups’ findings. Results: We concluded that the further incorporation of decision science into alternatives analysis would advance the ability of companies and regulators to select alternatives to harmful ingredients and would also advance the science of decision analysis. Conclusions: We advance four recommendations: a) engaging the systematic development and evaluation of decision approaches and tools; b) using case studies to advance the integration of decision analysis into alternatives analysis; c) supporting transdisciplinary research; and d) supporting education and outreach efforts. https://doi.org/10.1289/EHP483 PMID:28669940

Hydrotherapy in advanced heart failure: the cardio-HKT pilot study.

PubMed

Municinó, Annamaria; Nicolino, Annamaria; Milanese, Manlio; Gronda, Edoardo; Andreuzzi, Bruno; Oliva, Fabrizio; Chiarella, Francesco

2006-12-01

In-water exercise, hydrotherapy, may offer an attractive alternative to conventional training in markedly compromised patients with advanced HF. This Pilot Study evaluates the safety and efficacy of Cardio-Hydrokinesitherapy (Cardio-HKT) in patients with advanced HF on optimal medical therapy. Cardio-HKT is a novel rehabilitation program that includes training sessions in warm water (31 degrees C), integrated by educational and psycho-behavioural sessions to promote healthy life style modifications. We studied 18 adult patients with advanced HF, LVEF < 35%, NYHA functional class > II and peak oxygen uptake (peak VO2) < 18 ml/kg/min. Cardio-HKT consisted of a 3 weeks daily in-water training, combined to educational and psycho-behavioural sessions. Patients underwent a six-minute-walking-test (6mWT), a cardiopulmonary exercise test at baseline and after 3 weeks of Cardio-HKT. Quality of life was assessed with the Minnesota Living with Heart Failure Questionnaire (MLHF). All patients completed the Cardio-HKT rehabilitation program without complications. The 6mWT improved from 453 +/- 172 m to 571 +/- 120 m (p < 0.01), peak VO2 from 13.0 +/- 3.1 to 14.5 +/- 2.9 ml/kg/min (p = 0.03), whereas VE/ CO2 slope declined from 37 +/- 10 to 33 +/- 9 (p = 0.01). MLHF markedly improved from 56 (68-27) to 18 (40-7) (p < 0.01). Our results support the safety and efficacy of the innovative Cardio-HKT rehabilitation program in patients with advanced HF.

From "fixing women" to "institutional transformation": An ADVANCE case study

NASA Astrophysics Data System (ADS)

Yennello, Sherry; Kaunas, Christine

2015-12-01

The United States' position in the global economy requires an influx of women into science, technology, engineering, and mathematics (STEM) fields in order to remain competitive. Despite this, the representation of women in STEM continues to be low. The National Science Foundation's ADVANCE Program addresses this issue by funding projects that aim to increase the representation of women in academic STEM fields through transformation of institutional structures that impede women's progress in academic STEM fields. This paper includes a case study of the Texas A&M University ADVANCE Program.

The Effects of Virtual Communities on Group Identity in Classroom Management

ERIC Educational Resources Information Center

Ho, Tu-Kuang; Lin, Yu-Tzeng

2016-01-01

Group identity is a critical component in developing effective classroom management. While there have been numerous studies on group identity, they have primarily focused on its effects on the physical classroom entity. Advances in information technology, however, have enabled the creation of virtual communities, which have become a vital channel…

A score to estimate the likelihood of detecting advanced colorectal neoplasia at colonoscopy.

PubMed

Kaminski, Michal F; Polkowski, Marcin; Kraszewska, Ewa; Rupinski, Maciej; Butruk, Eugeniusz; Regula, Jaroslaw

2014-07-01

This study aimed to develop and validate a model to estimate the likelihood of detecting advanced colorectal neoplasia in Caucasian patients. We performed a cross-sectional analysis of database records for 40-year-old to 66-year-old patients who entered a national primary colonoscopy-based screening programme for colorectal cancer in 73 centres in Poland in the year 2007. We used multivariate logistic regression to investigate the associations between clinical variables and the presence of advanced neoplasia in a randomly selected test set, and confirmed the associations in a validation set. We used model coefficients to develop a risk score for detection of advanced colorectal neoplasia. Advanced colorectal neoplasia was detected in 2544 of the 35,918 included participants (7.1%). In the test set, a logistic-regression model showed that independent risk factors for advanced colorectal neoplasia were: age, sex, family history of colorectal cancer, cigarette smoking (p<0.001 for these four factors), and Body Mass Index (p=0.033). In the validation set, the model was well calibrated (ratio of expected to observed risk of advanced neoplasia: 1.00 (95% CI 0.95 to 1.06)) and had moderate discriminatory power (c-statistic 0.62). We developed a score that estimated the likelihood of detecting advanced neoplasia in the validation set, from 1.32% for patients scoring 0, to 19.12% for patients scoring 7-8. Developed and internally validated score consisting of simple clinical factors successfully estimates the likelihood of detecting advanced colorectal neoplasia in asymptomatic Caucasian patients. Once externally validated, it may be useful for counselling or designing primary prevention studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Risk contracting and operational capabilities in large medical groups during national healthcare reform.

PubMed

Mechanic, Robert E; Zinner, Darren

2016-06-01

Little is known about the scope of alternative payment models outside of Medicare. This study measures the full complement of public and private payment arrangements in large, multi-specialty group practices as a barometer of payment reform among advanced organizations. We collected information from 33 large, multi-specialty group practices about the proportion of their total revenue in 7 payment models, physician compensation strategies, and the implementation of selected performance management initiatives. We grouped respondents into 3 categories based on the proportion of their revenue in risk arrangements: risk-based (45%-100%), mixed (10%-35%), and fee-for-service (FFS) (0%-10%). We analyzed changes in contracting and operating characteristics between 2011 and 2013. In 2013, 68% of groups' total patient revenue was from FFS payments and 32% was from risk arrangements (unweighted average). Risk-based groups had 26% FFS revenue, whereas mixed-payment and FFS groups had 75% and 98%, respectively. Between 2011 and 2013, 9 groups increased risk contract revenue by about 15 percentage points and 22 reported few changes. Risk-based groups reported more advanced implementation of performance management strategies and were more likely to have physician financial incentives for quality and patient experience. The groups in this study are well positioned to manage risk-based contracts successfully, but less than one-third receive a majority of their revenue from risk arrangements. The experience of these relatively advanced groups suggests that expanding risk-based arrangements across the US health system will likely be slower and more challenging than many people assume.

[Study on qi deficiency syndrome distribution and quality of life in patients with advanced non-small cell lung cancer].

PubMed

Yuan, Lin; Zhang, Pei-tong; Yang, Zong-yan

2011-07-01

To study the qi deficiency syndrome distribution and quality of life (QOL) of patients with advanced non-small cell lung cancer (NSCLC). A questionnaire survey was conducted in 120 patients with advanced NSCLC using the QOL scale "Functional Assessment of Cancer Therapy" (FACT-L) (Version 4.0). Meanwhile, syndrome typing was performed. On the basis of results of syndrome typing, patients of different syndrome types were grouped and compared, thus studying the distribution of advanced NSCLC patients of qi deficiency syndrome and qi deficiency syndrome correlated QOL features. Qi deficiency, blood stasis, yin deficiency, phlegm and dampness dominated in syndrome types of the 120 patients with advanced NSCLC. Of syndrome types accounting for larger ratios in 112 patients, pure qi deficiency syndrome accounted for 30.36% (34 cases), qi deficiency and blood stasis syndrome for 18. 75% (21 cases), both qi and yin deficiency syndrome for 10. 71% (12 cases). There was no correlation between the appearance of qi deficiency syndrome and patients' age, sex, pathological typing (adenocarcinoma/squamous carcinoma), or the disease duration. NSCLC patients in phase IV were mostly complicated with qi deficiency syndrome (P<0.05). Scores of physical states, emotional states, functional states, and total scores in the FACT-L scale were lower in those complicated with qi deficiency syndrome (89 cases) than in those without complicated qi deficiency syndrome (31 cases), showing statistical difference (P<0.01, P<0.05). The scores of the lung cancer specific module (additional concerns) in the FACT-L scale showed statistical difference, sequenced as qi deficiency and blood stasis syndrome > pure qi deficiency syndrome > both qi and yin deficiency syndrome (P<0.05). Qi deficiency syndrome is the main syndrome of advanced NSCLC. The QOL of advanced NSCLC patients complicated with qi deficiency syndrome was poorer than those without complicated qi deficiency syndrome. Besides, along with

Mortality among men with locally advanced prostate cancer managed with noncurative intent: a nationwide study in PCBaSe Sweden.

PubMed

Akre, Olof; Garmo, Hans; Adolfsson, Jan; Lambe, Mats; Bratt, Ola; Stattin, Pär

2011-09-01

There are limited prognostic data for locally advanced prostate cancer PCa to guide in the choice of treatment. To assess mortality in different prognostic categories among men with locally advanced PCa managed with noncurative intent. We conducted a register-based nationwide cohort study within the Prostate Cancer DataBase Sweden. The entire cohort of locally advanced PCa included 14 908 men. After the exclusion of 2724 (18%) men treated with curative intent, 12 184 men with locally advanced PCa either with local clinical stage T3 or T4 or with T2 with serum levels of prostate-specific antigen (PSA) between 50 and 99 ng/ml and without signs of metastases remained for analysis. We followed up the patient cohort in the Cause of Death Register for ≤ 11 yr and assessed cumulative incidence of PCa -specific death stratified by age and clinical characteristics. The PCa -specific mortality at 8 yr of follow-up was 28% (95% confidence interval [CI], 25-32%) for Gleason score (GS) 2-6, 41% (95% CI, 38-44%) for GS 7, 52% (95% CI, 47-57%) for GS 8, and 64% (95% CI, 59-69%) for GS 9-10. Even for men aged >85 yr at diagnosis with GS 8-10, PCa was a major cause of death: 42% (95% CI, 37-47%). Men with locally advanced disease and a PSA<4 ng/ml at diagnosis were at particularly increased risk of dying from PCa. One important limitation is the lack of bone scans in 42% of the patient cohort, but results remained after exclusion of patients with unknown metastasis status. The PCa-specific mortality within 8 yr of diagnosis is high in locally advanced PCa, suggesting undertreatment, particularly among men in older age groups. Our results underscore the need for more studies of treatment with curative intent for locally advanced tumors. Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Advanced turbine study

NASA Technical Reports Server (NTRS)

Castro, J. H.

1985-01-01

The feasibility of an advanced convective cooling concept applied to rocket turbine airfoils which operate in a high pressure hydrogen and methane environment was investigated. The concept consists of a central structural member in which grooves are machined. The grooves are temporarily filled with a removable filler and the entire airfoil is covered with a layer of electroformed nickel, or nickel base alloy. After removal of the filler, the low thermal resistance of the nickel closure causes the wall temperature to be reduced by heat transfer to the coolant. The program is divided in the following tasks: (1) turbine performance appraisal; (2) coolant geometry evaluation; (3) test hardware design and analysis; and (4) test airfoil fabrication.

A feasibility study for advanced technology integration for general aviation

NASA Technical Reports Server (NTRS)

Kohlman, D. L.; Matsuyama, G. T.; Hawley, K. E.; Meredith, P. T.

1980-01-01

An investigation was conducted to identify candidate technologies and specific developments which offer greatest promise for improving safety, fuel efficiency, performance, and utility of general aviation airplanes. Interviews were conducted with general aviation airframe and systems manufacturers and NASA research centers. The following technologies were evaluated for use in airplane design tradeoff studies conducted during the study: avionics, aerodynamics, configurations, structures, flight controls, and propulsion. Based on industry interviews and design tradeoff studies, several recommendations were made for further high payoff research. The most attractive technologies for use by the general aviation industry appear to be advanced engines, composite materials, natural laminar flow airfoils, and advanced integrated avionics systems. The integration of these technologies in airplane design can yield significant increases in speeds, ranges, and payloads over present aircraft with 40 percent to 50 percent reductions in fuel used.

A Longitudinal Study on Learner Career Advancement in MOOCs

ERIC Educational Resources Information Center

Wang, Yuan; Paquette, Luc; Baker, Ryan

2014-01-01

In this paper, we present progress towards a longitudinal study of the post-course career advancement of MOOC learners. We present initial results and analysis plans for how to link this to in-course behaviour, towards better understanding the goals of all MOOC learners.

[Advance of heterologous expression study of eukaryote-origin laccases].

PubMed

Ning, Na; Tan, Huijun; Sun, Xinxin; Ni, Jinfeng

2017-04-25

Laccases are enzymes belonging to the group of multi-copper oxidases. These enzymes are widely distributed in insects, plants, fungi and bacteria. In general, laccases can oxidize an exceptionally high number of substrates, so they have broad applications in textile, pulp, food and the degradation of lignin. However, low yield, low activity and thermo-instability of laccase in nature limit the application of laccase. High efficient heterologous expression of the protein is an effective way for solving this problem. Here, we summarize the research advances of heterologous expression of eukaryote-origin laccases. We focus on the overexpression of eukaryote-origin laccases using different expression system and the method for improving the production yield and enzyme activity in yeast cells. Information provided in this review would be helpful for researchers in the field.

Content-Related Interactions in Self-initiated Study Groups

NASA Astrophysics Data System (ADS)

Christian, Karen; Talanquer, Vicente

2012-09-01

The central goal of the present exploratory study was to investigate the nature of the content-related interactions in study groups independently organized by college organic chemistry students. We were particularly interested in the identification of the different factors that affected the emergence of opportunities for students to co-construct understanding and engage in higher levels of cognitive processing. Our results are based on the analysis of in situ observations of 34 self-initiated study sessions involving over a 100 students in three academic semesters. The investigation revealed three major types of social regulation processes, teaching, tutoring, and co-construction in the observed study sessions. However, the extent to which students engaged in each of them varied widely from one session to another. This variability was mostly determined by the specific composition of the study groups and the nature of the study tasks in which they were engaged. Decisions about how to organize the study session, the relative content knowledge and conceptual understanding expressed by the participants, as well as the cognitive level of the problems that guided group work had a strong impact on the nature of student interactions. Nevertheless, group talk in the observed study groups was mostly focused on low-level cognitive processes. The results of our work provide insights on how to better support students' productive engagement in study groups.

Advanced colorectal neoplasia risk stratification by penalized logistic regression.

PubMed

Lin, Yunzhi; Yu, Menggang; Wang, Sijian; Chappell, Richard; Imperiale, Thomas F

2016-08-01

Colorectal cancer is the second leading cause of death from cancer in the United States. To facilitate the efficiency of colorectal cancer screening, there is a need to stratify risk for colorectal cancer among the 90% of US residents who are considered "average risk." In this article, we investigate such risk stratification rules for advanced colorectal neoplasia (colorectal cancer and advanced, precancerous polyps). We use a recently completed large cohort study of subjects who underwent a first screening colonoscopy. Logistic regression models have been used in the literature to estimate the risk of advanced colorectal neoplasia based on quantifiable risk factors. However, logistic regression may be prone to overfitting and instability in variable selection. Since most of the risk factors in our study have several categories, it was tempting to collapse these categories into fewer risk groups. We propose a penalized logistic regression method that automatically and simultaneously selects variables, groups categories, and estimates their coefficients by penalizing the [Formula: see text]-norm of both the coefficients and their differences. Hence, it encourages sparsity in the categories, i.e. grouping of the categories, and sparsity in the variables, i.e. variable selection. We apply the penalized logistic regression method to our data. The important variables are selected, with close categories simultaneously grouped, by penalized regression models with and without the interactions terms. The models are validated with 10-fold cross-validation. The receiver operating characteristic curves of the penalized regression models dominate the receiver operating characteristic curve of naive logistic regressions, indicating a superior discriminative performance. © The Author(s) 2013.

Advances in Field Deployable Instrumented Particles for the Study of Alluvial Transport Mechanisms

NASA Astrophysics Data System (ADS)

Dillon, B.; Strom, K.

2017-12-01

Advances in microelectromechanical systems (MEMs) in the past decade have lead to the development of various instrumented or "smart" particles for use in the study of alluvial transport. The goal of many of these devices is to collect data on the interaction between hydrodynamic turbulence and individual sediment particles. Studying this interaction provides a basis to better understand entrainment and deposition processes which leads to better predictive morphologic and transport models. In collecting data on these processes, researchers seek to capture the time history of the forces incident on the particle and the particle's reaction. Many methods have been employed to capture this data - miniaturized pressure traps, accelerometers, gyroscopes, MEMs pressure transducers, and cantilevered load cells. However no system to date has been able to capture the pressure forces incident on the particle and its reaction while remaining mobile and of a size and density comparable to most gravels. Advances in the development, deployment, and use of waterproofed laboratory instrumentation have led our research group to develop such a particle. This particle has been used in both laboratory settings and large-scale fluvial environments (coupled with a field-deployable PIV system) to capture data on turbulent erosion processes. This system advances the practice in several ways: 1) It is, at present, the smallest (⌀ 19mm) instrumented erodible particle reported in the literature. 2) It contains novel developments in pressure sensing technology which allow the inclusion of six pressure ports, a 3-axis accelerometer, and a 1-axis gyroscope - all of which can be recorded simultaneously. 3) It expands the researcher's abilities to gather data on phenomena that, previously, have mandated the use of a laboratory scale model. The use of this system has generated observations of the so-called very large scale motions (VLSMs) in a reach of the Virginia section of the New River. Their

Engagement in Multiple Steps of the Advance Care Planning Process: A Descriptive Study Among Diverse Older Adults

PubMed Central

Sudore, Rebecca L.; Schickedanz, Adam D.; Landefeld, C. Seth; Williams, Brie A.; Lindquist, Karla; Pantilat, Steven Z.; Schillinger, Dean

2017-01-01

Objectives Advance care planning (ACP) research and policy has focused on documentation, ignoring other ACP steps. We propose an ACP model based on the behavior change framework. We assess engagement in multiple steps of ACP six months after exposure to an advance directive. Design Descriptive study Setting County General Medicine clinic in San Francisco Participants 147 English/Spanish-speakers, aged ≥50 years (mean 61) given a standard (12th-grade reading level) and easy-to-read (5th grade) advance directive. Measurements Six months after exposure to advance directives, we measured self-reported ACP contemplation; discussions with family/friends and clinicians; and documentation. We examined associations between ACP steps and explored subject characteristics associated with ACP. Results Most participants (73%) were non-white and 31% had < high school education. Sixty one percent contemplated ACP, 56% discussed ACP with family/friends, 22% discussed with clinicians, and 13% documented ACP wishes. Compared to subjects who had not discussed ACP with family/friends, those who had were more likely to discuss ACP with their clinicians (36% vs. 2%, P<.001) and document ACP wishes (18% vs. 4%, P=.009). Latinos and subjects with < high school education more often discussed ACP with family/friends (P<.06) and clinicians (P<.03) than other ethnic groups and subjects with more education. Conclusion ACP involves distinct steps including contemplation, discussions, and documentation. The ACP paradigm should be broadened to include contemplation and discussions. Promoting discussions among family/friends may be one of the most important targets for ACP interventions, and literacy/language appropriate advance directives may help reverse patterns of socio-demographic disparities in ACP. PMID:18410324

Colonization with group B streptococci in pregnancy and adverse outcome. VIP Study Group.

PubMed

Regan, J A; Klebanoff, M A; Nugent, R P; Eschenbach, D A; Blackwelder, W C; Lou, Y; Gibbs, R S; Rettig, P J; Martin, D H; Edelman, R

1996-04-01

Our purpose was to study the association of cervicovaginal colonization with group B streptococci with pregnancy and neonatal outcome. A prospective study was conducted at seven medical centers between 1984 and 1989. Genital tract cultures were obtained at 23 to 26 weeks' gestation and at delivery. Prematurity and neonatal sepsis rates were compared between group B streptococci positive and negative women. Group B streptococci was recovered from 2877 (21%) of 13,646 women at enrollment. Heavy colonization was associated with a significant risk of delivering a preterm infant who had a low birth weight (odds ratio = 1.5, 95% confidence interval 1.1 to 1.9). Heavily colonized women given antibiotics effective against group B streptococci had little increased risk of a preterm, low-birth-weight birth. Women with light colonization were at the same risk of adverse outcome as the uncolonized women. Neonatal group B streptococci sepsis occurred in 2.6 of 1000 live births in women with and 1.6 of 1000 live births in women without group B streptococci at 23 to 26 weeks' gestation (p = 0.11). However, sepsis occurred in 16 of 1000 live births to women with and 0.4 of 1000 live births to women without group B streptococci at delivery (p < 0.001). Heavy group B streptococci colonization of 23 to 26 weeks' gestation was associated with an increased risk of delivering a preterm, low-birth-weight infant. Cervicovaginal colonization with group B streptococci at 23 to 26 weeks' gestation was not a reliable predictor of neonatal group B streptococci sepsis. Colonization at delivery was associated with sepsis.

Literature Study Groups: Literacy Learning "with Legs"

ERIC Educational Resources Information Center

Parsons, Sue Christian; Mokhtari, Kouider; Yellin, David; Orwig, Ryan

2011-01-01

Literature study groups help promote critical thinking and improve reading skills. These groups, in general, are characterized by: (1) a flexible grouping--usually determined by a reader's choice of a given book at a given time; (2) participant-centered dialogue, where the teacher takes on the role of facilitator and expert participant rather than…

A focus group study of the use of video-recorded simulated objective structured clinical examinations in nurse practitioner education.

PubMed

Barratt, Julian

2010-05-01

The objective structured clinical examination (OSCE) is a common method of clinical skills assessment used for advanced nurse practitioner students across the United Kingdom. The purpose of an advanced nursing OSCE is to assess a nurse practitioner student's competence and safety in the performance of commonly used advanced clinical practice skills. Students often feel nervous when preparing for and participating in an OSCE. Consideration of these identified anxieties led to the development of an alternative method of meeting students' OSCE learning and preparation needs; namely video-recorded simulated OSCEs. Video-recording was appealing for the following reasons: it provides a flexible usage of staff resources and time; OSCE performance mistakes can be rectified; it is possible to use the same video-recordings with multiple cohorts of students, and the recordings can be made conveniently available for students with video streaming on internet-based video-sharing sites or virtual learning environments. The aim of the study was to explore the value of using such recordings amongst nurse practitioner students, via online and face-to-face focus groups, to see if they are a suitable OSCE educational preparation technique. The study findings indicate that simulated OSCE video-recordings are an effective method for supporting nurse practitioner educational development. Copyright 2009 Elsevier Ltd. All rights reserved.

Head and neck cancer: proteomic advances and biomarker achievements.

PubMed

Rezende, Taia Maria Berto; de Souza Freire, Mirna; Franco, Octávio Luiz

2010-11-01

Tumors of the head and neck comprise an important neoplasia group, the incidence of which is increasing in many parts of the world. Recent advances in diagnostic and therapeutic techniques for these lesions have yielded novel molecular targets, uncovered signal pathway dominance, and advanced early cancer detection. Proteomics is a powerful tool for investigating the distribution of proteins and small molecules within biological systems through the analysis of different types of samples. The proteomic profiles of different types of cancer have been studied, and this has provided remarkable advances in cancer understanding. This review covers recent advances for head and neck cancer; it encompasses the risk factors, pathogenesis, proteomic tools that can help in understanding cancer, and new proteomic findings in this type of cancer. Copyright © 2010 American Cancer Society.

Vegetarianism as a protective factor for colorectal adenoma and advanced adenoma in Asians.

PubMed

Lee, Chang Geun; Hahn, Suk Jae; Song, Min Keun; Lee, Jun Kyu; Kim, Jae Hak; Lim, Yun Jeong; Koh, Moon-Soo; Lee, Jin Ho; Kang, Hyoun Woo

2014-05-01

Although epidemiologic and animal studies suggest a vegetarian diet protects against the development of colorectal cancer, the relationship between vegetarian diet and incidence of colorectal adenoma is not yet conclusive, especially for Asians. The purpose of this study was to examine the protective effect of a vegetarian diet against colorectal adenoma and advanced adenoma. This cross-sectional study compared the prevalence of colorectal adenoma among Buddhist priests, who are obligatory vegetarians, with that among age and sex-matched controls. All the subjects underwent health checkups in a health-promotion center in Korea. Colorectal adenoma and advanced adenoma were both more prevalent in the general population group than in the Buddhist priest group (25.2 vs. 17.9 %, 6.7 vs. 2.0 %). However, the prevalence of metabolic syndrome, high body mass index, and waist circumference were higher in the Buddhist priest group. According to univariate analysis, non-vegetarian diet (general population) significantly increased the prevalence of colorectal adenoma and advanced adenoma compared with a vegetarian diet (Buddhist priests) (OR 1.54, 95 % CI 1.08-2.21, P = 0.018; OR 3.60, 95 % CI 1.53-8.48, P = 0.003). In a conditional regression analysis model, non-vegetarian diet was also a significant risk factor for colorectal adenoma and advanced adenoma (OR 1.52, 95 % CI 0.75-2.07, P = 0.043; OR 2.94, CI 0.97-7.18, P = 0.036). Vegetarianism may be effective in preventing both colorectal adenoma and advanced adenoma in Asians.

Oxygen therapy in advanced COPD: in whom does it work?

PubMed

Make, Barry; Krachman, Samuel; Panos, Ralph J; Doherty, Dennis E; Stoller, James K

2010-06-01

Supplemental oxygen therapy is commonly used in patients with advanced chronic obstructive pulmonary disease (COPD) and severe hypoxemia at rest. Use of oxygen in these patients is justified by studies showing a mortality benefit. However, the use of oxygen in other patients with advanced COPD has not clearly been established. Long-term studies assessing not only mortality but also other outcomes that are important to patients and physicians such as dyspnea, health status, and exercise capacity are lacking. This article reviews the available studies of the use of supplemental oxygen in patients with less severe hypoxemia at rest during the day, hypoxemia occurring only at night, and hypoxemia occurring only with exercise. With the knowledge that studies in patients with advanced COPD and less severe hypoxemia are limited, recommendations are provided on oxygen use in these groups of patients.

Cost-effectiveness analysis of gemcitabine, S-1 and gemcitabine plus S-1 for treatment of advanced pancreatic cancer based on GEST study.

PubMed

Zhou, Jing; Zhao, Rongce; Wen, Feng; Zhang, Pengfei; Tang, Ruilei; Du, Zedong; He, Xiaofeng; Zhang, Jian; Li, Qiu

2015-04-01

Gemcitabine (GEM) alone, S-1 alone and gemcitabine plus S-1 (GS) have shown a marginal clinical benefit for the treatment of advanced pancreatic cancer. However, there is no clearly defined optimal cost-effectiveness treatment. The objective of this study was to assess the cost-effectiveness of GEM alone, S-1 alone and GS for the treatment of advanced pancreatic cancer based on GEST study for public payers. A decision model compared GEM alone, S-1 alone and GS. Primary base case data were identified using the GEST study and the literatures. Costs were estimated from West China Hospital, Sichuan University, China, and incremental cost-effectiveness ratios (ICERs) were calculated. Survival benefits were reported in quality-adjusted life-months (QALMs). Sensitive analyses were performed by varying potentially modifiable parameters of the model. The base case analysis showed that the GEM cost $21,912 and yielded survival of 6.93 QALMs, S-1 cost $19,371 and yielded survival of 7.90 QALMs and GS cost $22,943 and yielded survival of 7.46 QALMs in the entire treatment. The one-way sensitivity analyses showed that the ICER of S-1 was driven mostly by the S-1 group utility score of stable state compared with GEM, and the GEM group utility score of progressed state played a key role on the ICER of GS compared with GEM. S-1 represents an attractive cost-effective treatment for advanced pancreatic cancer, given the favorable cost per QALM and improvement in clinical efficacy, especially the limited available treatment options.

Using Online Study Groups to Prepare Police Promotional Candidates

ERIC Educational Resources Information Center

Kirkpatrick, Bonnie L.

2013-01-01

Quality policing requires selecting and retaining the best and the brightest officers and supporting their advancement into the leadership ranks of police organizations. This study investigates two aspects of police promotional testing: identifying and understanding the barriers to participation in the promotional process and the use of online…

Statistical study of some Lee galaxy groups

NASA Astrophysics Data System (ADS)

Mohamed, Sabry A.; Fouad, Ahmed M.

2017-12-01

Compact groups of galaxies are systems of small number of galaxies close to each other. They are a good laboratory to study galaxy properties, such as structure, morphology and evolution which are affected by the environment and galaxy interactions. We applied the tree clustering technique (the Euclidean separation distance coefficients) to test the physical reality of groups and used certain criteria (Sabry et al., 2009) depending on the physical attributes of the galaxies. The sample of the data is the quintets groups of Lee compact groups of galaxies (Lee et al., 2004). It is based on a modified version of Hickson's criteria (Hickson, 1982). The results reveal the membership of each galaxy and how it is related to its group. The tables of groups and their members are included. Our results indicates that 12 Groups are real groups with real members while 18 Groups have one galaxy that has attribute discordant and should be discarded from its group.

Advances for Studying Clonal Evolution in Cancer

PubMed Central

Raphael, Benjamin J.; Chen, Feng; Wendl, Michael C.

2013-01-01

The “clonal evolution” model of cancer emerged and “evolved” amid ongoing advances in technology, especially in recent years during which next generation sequencing instruments have provided ever higher resolution pictures of the genetic changes in cancer cells and heterogeneity in tumors. It has become increasingly clear that clonal evolution is not a single sequential process, but instead frequently involves simultaneous evolution of multiple subclones that co-exist because they are of similar fitness or are spatially separated. Co-evolution of subclones also occurs when they complement each other’s survival advantages. Recent studies have also shown that clonal evolution is highly heterogeneous: different individual tumors of the same type may undergo very different paths of clonal evolution. New methodological advancements, including deep digital sequencing of a mixed tumor population, single cell sequencing, and the development of more sophisticated computational tools, will continue to shape and reshape the models of clonal evolution. In turn, these will provide both an improved framework for the understanding of cancer progression and a guide for treatment strategies aimed at the elimination of all, rather than just some, of the cancer cells within a patient. PMID:23353056

Advances for studying clonal evolution in cancer.

PubMed

Ding, Li; Raphael, Benjamin J; Chen, Feng; Wendl, Michael C

2013-11-01

The "clonal evolution" model of cancer emerged and "evolved" amid ongoing advances in technology, especially in recent years during which next generation sequencing instruments have provided ever higher resolution pictures of the genetic changes in cancer cells and heterogeneity in tumors. It has become increasingly clear that clonal evolution is not a single sequential process, but instead frequently involves simultaneous evolution of multiple subclones that co-exist because they are of similar fitness or are spatially separated. Co-evolution of subclones also occurs when they complement each other's survival advantages. Recent studies have also shown that clonal evolution is highly heterogeneous: different individual tumors of the same type may undergo very different paths of clonal evolution. New methodological advancements, including deep digital sequencing of a mixed tumor population, single cell sequencing, and the development of more sophisticated computational tools, will continue to shape and reshape the models of clonal evolution. In turn, these will provide both an improved framework for the understanding of cancer progression and a guide for treatment strategies aimed at the elimination of all, rather than just some, of the cancer cells within a patient. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Geostationary platform study: Advanced ESGP/evolutionary SSF accommodation study

NASA Technical Reports Server (NTRS)

1990-01-01

The implications on the evolutionary space station of accommodating geosynchronous Earth Orbit (GEO) facilities including unmanned satellites and platforms, manned elements, and transportation and servicing vehicles/elements. The latest existing definitions of typical unmanned GEO facilities and transportation and servicing vehicles/elements are utilized. The physical design, functional design, and operations implications at the space station are determined. Various concepts of the space station from past studies are utilized ranging from the IOC Multifunction Space Station to a branched transportation node space station, and the implications of the accommodation the GEO infrastructure of each type are assessed. Where possible, parametric data are provided to show the implications of variations in sizes and quantities of elements, launch rates, crew sizes, etc. The use of advanced automation, robotics equipment, and an efficient mix of manned/automated support for accomplishing necessary activities at the space station are identified and assessed. The products of this study are configuration sketches, resource requirements, trade studies, and parametric data.

Recursive partitioning analysis of 1999 Radiation Therapy Oncology Group (RTOG) patients with locally-advanced non-small-cell lung cancer (LA-NSCLC): identification of five groups with different survival.

PubMed

Werner-Wasik, M; Scott, C; Cox, J D; Sause, W T; Byhardt, R W; Asbell, S; Russell, A; Komaki, R; Lee, J S

2000-12-01

Survival of patients with locally-advanced non-small-cell lung cancer (LA-NSCLC) is predicted by the stage of the disease and other characteristics. This analysis was undertaken to identify these characteristics in a large cooperative group patient population, as well as to define subgroups of the population with differing outcomes. Analysis included 1,999 patients treated in 9 RTOG trials between 1983 and 1994 with thoracic irradiation (RT) with (n = 355) or without chemotherapy (CT). In univariate analysis, the following characteristics were significantly associated with an improved survival: use of CT, CT delivered without major deviation, abnormal pulmonary function tests, normal hemoglobin, protein, LDH and BUN, presence of dyspnea, hemoptysis, cough or hoarseness, uninvolved lymph nodes, T1 or T2 stage, no malignant pleural effusion (PE), weight loss of < 8%, Karnofsky performance status (KPS) of at least 90, adenocarcinoma histology, female gender, and age less than 70 years. Recursive partitioning analysis (RPA) was subsequently applied to identify 5 patient subgroups with significantly different median survival times (MST): Group I, KPS of > or = 90, who received chemotherapy (MST 16.2 months); Group II, KPS of > or = 90, who received no CT, but had no PE (MST 11.9 months); Group III, KPS < 90, younger than 70 years, with non-large cell histology (MST 9.6 months); Group IV, KPS > or = 90, but with PE, or KPS < 90, younger than 70 years, and with large cell histology, or older than 70 years, but without PE (MST 5.6-6.4 months); Group V, older than 70, with PE (MST 2.9 months). Cisplatinum-based CT improves survival, for excellent prognosis of LA-NSCLC patients, over RT alone. The presence of a malignant pleural effusion is a major negative prognostic factor for survival. The identification of RPA prognostic groups among patients with LA-NSCLC provides prognostic information and may serve as a basis of stratification in future trials.

End-of-Life Treatment Preferences: A Key to Reducing Ethnic/Racial Disparities in Advance Care Planning?

PubMed Central

Garrido, Melissa M.; Harrington, Shannon T.; Prigerson, Holly G.

2014-01-01

Background This study sought to identify targets for interventions to reduce end-of-life care disparities among patients with advanced cancer. To do this, we evaluated the degree to which end-of-life care values and preferences are associated with advance care planning within racial/ethnic minority groups. Methods The Coping with Cancer study recruited patients with advanced cancer from outpatient clinics in five states from 2002-2008. We examined rates of one type of advance care planning, do not resuscitate [DNR] orders, reported at baseline interviews by 606 patients. Bivariate tests determined associations among DNR order completion, religious values, and treatment preferences within racial/ethnic groups. Results Non-Latino White patients were significantly more likely to have a DNR order (45%) than Black (25%) and Latino (20%) patients (p <.001). Preferences against specific life-prolonging treatments (e.g. chemotherapy, ventilation) were the only factor significantly associated with higher DNR order likelihood in each group, with non-Latino White patients more likely than Latino or Black patients to express preferences against life-prolonging care (e.g. 26% of non-Latino White, 46% of Black, and 41% of Latino patients wanted a feeding tube if it would extend life for one more day, p<.001). Conclusions Preferences against life-prolonging care differ dramatically by race/ethnicity, but they are uniformly significantly associated with DNR order completion rates across racial/ethnic groups of patients with advanced cancer. Advance care planning interventions that target preferences associated with DNR orders across racial/ethnic groups may reach a broad patient population and reduce end-of-life care disparities. PMID:25145489

Phase 2 study of bevacizumab plus erlotinib in patients with advanced hepatocellular cancer.

PubMed

Philip, Philip A; Mahoney, Michelle R; Holen, Kyle D; Northfelt, Donald W; Pitot, Henry C; Picus, Joel; Flynn, Patrick J; Erlichman, Charles

2012-05-01

Epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) are rational targets for therapy in hepatocellular cancer (HCC). Patients with histologically proven HCC and not amenable to curative or liver directed therapy were included in this 2-stage phase 2 trial. Eligibility included an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1 and Child's Pugh score of A or B, and 1 prior systemic therapy. Patients received erlotinib 150 mg daily and bevacizumab 10 mg/kg on days 1 and 15 every 28 days. Objective tumor response was the primary end point. Twenty-seven patients with advanced HCC (median age, 60 years) were enrolled in this multi-institutional study. The proportion of patients with Child's A classification was 74%. One patient had a confirmed partial response and 11 (48%) achieved stable disease. Median time to disease progression was 3.0 months (95% confidence interval [CI], 1.8-7.1). Median survival time was 9.5 months (95% CI, 7.1-17.1). Grade 3 toxicities included rash, hypertension, fatigue, and diarrhea. In this trial, erlotinib combined with bevacizumab had minimal activity in patients with advanced HCC based on objective response and progression-free survival. The role of targeting EGFR and VEGF in HCC needs further evaluation in molecularly selected patients. Copyright © 2011 American Cancer Society.

Phase 2 Study of Bevacizumab Plus Erlotinib in Patients With Advanced Hepatocellular Cancer

PubMed Central

Philip, Philip A.; Mahoney, Michelle R.; Holen, Kyle D.; Northfelt, Donald W.; Pitot, Henry C.; Picus, Joel; Flynn, Patrick J.; Erlichman, Charles

2013-01-01

BACKGROUND Epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) are rational targets for therapy in hepatocellular cancer (HCC). METHODS Patients with histologically proven HCC and not amenable to curative or liver directed therapy were included in this 2-stage phase 2 trial. Eligibility included an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1 and Child’s Pugh score of A or B, and 1 prior systemic therapy. Patients received erlotinib 150 mg daily and bevacizumab 10 mg/kg on days 1 and 15 every 28 days. Objective tumor response was the primary end point. RESULTS Twenty-seven patients with advanced HCC (median age, 60 years) were enrolled in this multi-institutional study. The proportion of patients with Child’s A classification was 74%. One patient had a confirmed partial response and 11 (48%) achieved stable disease. Median time to disease progression was 3.0 months (95% confidence interval [CI], 1.8-7.1). Median survival time was 9.5 months (95% CI, 7.1-17.1). Grade 3 toxicities included rash, hypertension, fatigue, and diarrhea. CONCLUSIONS In this trial, erlotinib combined with bevacizumab had minimal activity in patients with advanced HCC based on objective response and progression-free survival. The role of targeting EGFR and VEGF in HCC needs further evaluation in molecularly selected patients. PMID:21953248

Recent technological advances in using mouse models to study ovarian cancer.

PubMed

House, Carrie Danielle; Hernandez, Lidia; Annunziata, Christina Messineo

2014-01-01

Serous epithelial ovarian cancer (SEOC) is the most lethal gynecological cancer in the United States with disease recurrence being the major cause of morbidity and mortality. Despite recent advances in our understanding of the molecular mechanisms responsible for the development of SEOC, the survival rate for women with this disease has remained relatively unchanged in the last two decades. Preclinical mouse models of ovarian cancer, including xenograft, syngeneic, and genetically engineered mice, have been developed to provide a mechanism for studying the development and progression of SEOC. Such models strive to increase our understanding of the etiology and dissemination of ovarian cancer in order to overcome barriers to early detection and resistance to standard chemotherapy. Although there is not a single model that is most suitable for studying ovarian cancer, improvements have led to current models that more closely mimic human disease in their genotype and phenotype. Other advances in the field, such as live animal imaging techniques, allow effective monitoring of the microenvironment and therapeutic efficacy. New and improved preclinical mouse models, combined with technological advances to study such models, will undoubtedly render success of future human clinical trials for patients with SEOC.

Recent Technological Advances in Using Mouse Models to Study Ovarian Cancer

PubMed Central

House, Carrie Danielle; Hernandez, Lidia; Annunziata, Christina Messineo

2014-01-01

Serous epithelial ovarian cancer (SEOC) is the most lethal gynecological cancer in the United States with disease recurrence being the major cause of morbidity and mortality. Despite recent advances in our understanding of the molecular mechanisms responsible for the development of SEOC, the survival rate for women with this disease has remained relatively unchanged in the last two decades. Preclinical mouse models of ovarian cancer, including xenograft, syngeneic, and genetically engineered mice, have been developed to provide a mechanism for studying the development and progression of SEOC. Such models strive to increase our understanding of the etiology and dissemination of ovarian cancer in order to overcome barriers to early detection and resistance to standard chemotherapy. Although there is not a single model that is most suitable for studying ovarian cancer, improvements have led to current models that more closely mimic human disease in their genotype and phenotype. Other advances in the field, such as live animal imaging techniques, allow effective monitoring of the microenvironment and therapeutic efficacy. New and improved preclinical mouse models, combined with technological advances to study such models, will undoubtedly render success of future human clinical trials for patients with SEOC. PMID:24592355

Watching MOOCs Together: Investigating Co-Located MOOC Study Groups

ERIC Educational Resources Information Center

Li, Nan; Verma, Himanshu; Skevi, Afroditi; Zufferey, Guillaume; Blom, Jan; Dillenbourg, Pierre

2014-01-01

Research suggests that massive open online course (MOOC) students prefer to study in groups, and that social facilitation within the study groups may render the learning of difficult concepts a pleasing experience. We report on a longitudinal study that investigates how co-located study groups watch and study MOOC videos together. The study was…

[Study on the occupational stress norm and it's application for the marketing group, public service/safety group and production laborer group].

PubMed

Yang, Xin-Wei; Wang, Zhi-Ming; Jin, Tai-Yi; Lan, Ya-Jia

2006-09-01

A study of the occupational stress norm and it's application for the marketing group, public service/safety group and production laborer group. In this study, cross-sectional study method is used, and a synthetic way of sorting and randomized sampling is adopted to deal with research targets (36 marketing group, 331 public service/safety group, 903 production laborer group). Descriptive statistics for OSI-R scale scores for the marketing group, public service/safety group and production laborer group were modulated. Scale raw score to T-score conversion tables derived from the OSI-R normative sample for marketing group public service/safety group and production laborer group were established. OSI-R profile from for marketing group, public service/safety group and production laborer group were established. For the ORQ and PSQ scales, scores at or above 70 indicate a strong levels of maladaptive stress and strain. Score in the range of 60 to 69 suggest middle levels of maladaptive stress and strain. Score in the range of 40 to 59 indicate normal levels of stress and strain. Score below 40 indicate a relative absence of occupational stress and strain. For the PRQ scales, score below 30 indicate a significant lack of coping resources. Score in the range of 30 to 39 suggest middle deficits in coping resources. Score in the range of 40 to 59 indicate average coping resources. Scores at or above 60 indicate a strong levels of coping resources. The authors combined subjective and objective environment match model of occupational stress. Different intervention measure should be take to reduce the occupational stress so as to improve the work ability.

How are patient populations characterized in studies investigating depression in advanced cancer? Results from a systematic literature review.

PubMed

Janberidze, Elene; Hjermstad, Marianne Jensen; Haugen, Dagny Faksvåg; Sigurdardottir, Katrin Ruth; Løhre, Erik Torbjørn; Lie, Hanne Cathrine; Loge, Jon Håvard; Kaasa, Stein; Knudsen, Anne Kari

2014-10-01

Prevalence rates of depression in patients with advanced cancer vary considerably. This may be because of heterogeneous samples and use of different assessment methods. Adequate sample descriptions and consistent use of measures are needed to be able to generalize research findings and apply them to clinical practice. Our objective was twofold: First, to investigate which clinically important variables were used to describe the samples in studies of depression in patients with advanced cancer; and second, to examine the methods used for assessing and classifying depression in these studies. PubMed, PsycINFO, Embase, and CINAHL were searched combining search term groups representing "depression," "palliative care," and "advanced cancer" covering 2007-2011. Titles and abstracts were screened, and relevant full-text articles were evaluated independently by two authors. Information on 32 predefined variables on cancer disease, treatment, sociodemographics, depression-related factors, and assessment methods was extracted from the articles. After removing duplicates, 916 citations were screened of which 59 articles were retained. Age, gender, and stage of the cancer disease were the most frequently reported variables. Depression-related variables were rarely reported, for example, antidepressant use (17%) and previous depressive episodes (12%). Only 25% of the studies assessed and classified depression according to a validated diagnostic system. Current practice for describing sample characteristics and assessing depression varies greatly between studies. A more standardized practice is recommended to enhance the generalizability and utility of findings. Stakeholders are encouraged to work toward a common standard for sample descriptions. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Phase 2 study of ABT-510 in patients with previously untreated advanced renal cell carcinoma.

PubMed

Ebbinghaus, Scot; Hussain, Maha; Tannir, Nizar; Gordon, Michael; Desai, Apurva A; Knight, Raymond A; Humerickhouse, Rod A; Qian, Jiang; Gordon, Gary B; Figlin, Robert

2007-11-15

Angiogenesis is a characteristic of renal cell carcinoma. ABT-510 is an angiogenesis inhibitor that mimics the antiangiogenic properties of thrombospondin-1. This study was designed to assess the safety and efficacy of ABT-510 in patients with advanced renal cell carcinoma. Patients with previously untreated metastatic or unresectable renal cell carcinoma were randomized to treatment with one of two doses of ABT-510, self-administered s.c. twice daily in 28-day treatment periods without intervening rest periods. End points were progression-free survival (PFS), objective response rate, overall survival, and toxicity. The objective response rate was 4% in the 10 mg twice daily group, and there were two unconfirmed PRs in the 100 mg twice daily group. Respective median PFS was 4.2 and 3.3 months, with a 6-month PFS of 39% and 32%. Median overall survival was 27.8 months (10 mg twice daily) and 26.1 months (100 mg twice daily). The most frequent adverse events were injection site reactions (84%), fatigue (50%), headache (20%), and nausea (19%). The incidence of treatment-related, grade 3/4 adverse events was low and included three bleeding episodes (gastrointestinal hemorrhage, intracranial hemorrhage, and hemoptysis) and one thrombotic event (deep vein thrombosis). No deaths were attributed to ABT-510. There was little evidence of clinical activity for ABT-510, and further evaluation as a single agent for treating advanced renal cell carcinoma is not warranted. The evidence of a favorable safety profile may justify further evaluation in combination therapy.

[Study on factors influencing survival in patients with advanced gastric carcinoma after resection by Cox's proportional hazard model].

PubMed

Wang, S; Sun, Z; Wang, S

1996-11-01

A prospective follow-up study of 539 advanced gastric carcinoma patients after resection was undertaken between 1 January 1980 and 31 December 1989, with a follow-up rate of 95.36%. A multivariate analysis of possible factors influencing survival of these patients was performed, and their predicting models of survival rates was established by Cox proportional hazard model. The results showed that the major significant prognostic factors influencing survival of these patients were rate and station of lymph node metastases, type of operation, hepatic metastases, size of tumor, age and location of tumor. The most important factor was the rate of lymph node metastases. According to their regression coefficients, the predicting value (PV) of each patient was calculated, then all patients were divided into five risk groups according to PV, their predicting models of survival rates after resection were established in groups. The goodness-fit of estimated predicting models of survival rates were checked by fitting curve and residual plot, and the estimated models tallied with the actual situation. The results suggest that the patients with advanced gastric cancer after resection without lymph node metastases and hepatic metastases had a better prognosis, and their survival probability may be predicted according to the predicting model of survival rates.

Checkpoint inhibitors and radiation treatment in Hodgkin's lymphoma : New study concepts of the German Hodgkin Study Group.

PubMed

Baues, C; Semrau, R; Gaipl, U S; Bröckelmann, P J; Rosenbrock, J; Engert, A; Marnitz, S

2017-02-01

Patients with classical Hodgkin's lymphoma (cHL) have a good prognosis even in advanced stages. However, combined chemo- and radiotherapy, as the standard of care, is also associated with treatment-related toxicities such as organ damage, secondary neoplasias, infertility, or fatigue and long-term fatigue. Many patients suffer from this burden although their cHL was cured. Therefore, the efficacy of immune checkpoint inhibitors like anti-PD1/PD-L1 antibodies in the treatment of solid cancers and also in HL offers new options. A remarkable and durable response rate with a favorable toxicity profile was observed in heavily pretreated cHL patients. Planning to perform prospective randomized clinical trials in the content of radio-immune treatment in patients with Hodgkin's lymphoma (HL), we transferred the results of preliminary clinical studies and basic research in clinical relevant study concepts. Based on these promising early phase trial data, the German Hodgkin Study Group (GHSG) will investigate innovative treatment regimens in upcoming phase II trials. The therapeutic efficacy and potential synergies of anti-PD1 antibodies in combination with chemo- or radiotherapy will be investigated in various settings of HL.

Prospective study of bacteremia rate after elective band ligation and sclerotherapy with cyanoacrylate for esophageal varices in patients with advanced liver disease.

PubMed

Bonilha, Danielle Queiroz; Correia, Lucianna Motta; Monaghan, Marie; Lenz, Luciano; Santos, Marcus; Libera, Ermelindo Della

2011-01-01

Band ligation (BL) is the most appropriate endoscopic treatment for acute bleeding or prophylaxis of esophageal variceal bleeding. Sclerotherapy with N-butyl-2-cyanoacrylate (CY) can be an alternative for patients with advanced liver disease. Bacteremia is an infrequent complication after BL while the bacteremia rate following treatment with CY for esophageal varices remains unknown. To evaluate and compare the incidence of transient bacteremia between cirrhotic patients submitted to diagnostic endoscopy, CY and BL for treatment of esophageal varices. A prospective study comprising the period from 2004 to 2007 was conducted at Hospital of Universidade Federal de São Paulo, UNIFESP, SP, Brazil. Cirrhotic patients with advanced liver disease (Child-Pugh B or C) were enrolled. The patients were divided into two groups according treatment: BL Group (patients undergoing band ligation, n = 20) and CY Group (patients receiving cyanoacrylate injection for esophageal variceal, n = 18). Cirrhotic patients with no esophageal varices or without indication for endoscopic treatment were recruited as control (diagnostic group n = 20). Bacteremia was evaluated by blood culture at baseline and 30 minutes after the procedure. After 137 scheduled endoscopic procedures, none of the 58 patients had fever or any sign suggestive of infection. All baseline cultures were negative. No positive cultures were observed after CY or in the control group - diagnostic endoscopy. Three (4.6 %) positive cultures were found out of the 65 sessions of band ligation (P = 0.187). Two of these samples were positive for coagulase-negative staphylococcus, which could be regarded as a contaminant. The isolated microorganism in the other case was Klebsiella oxytoca. The patient in this case presented no evidence of immunodeficiency except liver disease. There was no significant difference in bacteremia rate between these three groups. BL or CY injection for non-bleeding esophageal varices may be considered

Conceptual design study of advanced acoustic-composite nacelles

NASA Technical Reports Server (NTRS)

Nordstrom, K. E.; Marsh, A. H.; Sargisson, D. F.

1975-01-01

Conceptual studies were conducted to assess the impact of incorporating advanced technologies in the nacelles of a current wide-bodied transport and an advanced technology transport. The improvement possible in the areas of fuel consumption, flyover noise levels, airplane weight, manufacturing costs, and airplane operating cost were evaluated for short and long-duct nacelles. Use of composite structures for acoustic duct linings in the fan inlet and exhaust ducts was considered as well as for other nacelle components. For the wide-bodied transport, the use of a long-duct nacelle with an internal mixer nozzle in the primary exhaust showed significant improvement in installed specific fuel consumption and airplane direct operating costs compared to the current short-duct nacelle. The long-duct mixed-flow nacelle is expected to achieve significant reductions in jet noise during takeoff and in turbo-machinery noise during landing approach. Recommendations were made of the technology development needed to achieve the potential fuel conservation and noise reduction benefits.

Reaction mechanisms of DNT with hydroxyl radicals for advanced oxidation processes-a DFT study.

PubMed

Zhou, Yang; Yang, Zhilin; Yang, Hong; Zhang, Chaoyang; Liu, Xiaoqiang

2017-04-01

In advanced oxidation processes (AOPs), the detailed degradation mechanisms of a typical explosive of 2,4-dinitrotoluene (DNT) can be investigated by the density function theory (DFT) method at the SMD/M062X/6-311+G(d) level. Several possible degradation routes for DNT were explored in the current study. The results show that, for oxidation of the methyl group, the dominant degradation mechanism of DNT by hydroxyl radicals (•OH) is a series of sequential H-abstraction reactions, and the intermediates obtained are in good agreement with experimental findings. The highest activation energy barrier is less than 20 kcal mol -1 . Other routes are dominated by an addition-elimination mechanism, which is also found in 2,4,6-trinitrotoluene, although the experiment did not find the corresponding products. In addition, we also eliminate several impossible mechanisms, such as dehydration, HNO 3 elimination, the simultaneous addition of two •OH radials, and so on. The information gained about these degradation pathways is helpful in elucidating the detailed reaction mechanism between nitroaromatic explosives and hydroxyl radicals for AOPs. Graphical Abstract The degradation mechanism of an important explosive, 2,6-dinitrotoluene (DNT), by the hydroxyl radical for advanced oxidation progresses.

The impact of meticillin-resistant Staphylococcus aureus on patients with advanced cancer and their family members: A qualitative study.

PubMed

Gleeson, Aoife; Larkin, Philip; O'Sullivan, Niamh

2016-04-01

Little is known about the impact of meticillin-resistant Staphylococcus aureus on patients with advanced cancer, such as its impact on the quality of life of this vulnerable group. To date, research on meticillin-resistant Staphylococcus aureus in the palliative care setting has had a quantitative focus. The purpose of this study was to explore the impact of a meticillin-resistant Staphylococcus aureus diagnosis on patients and their carers. This article reports upon a qualitative interview study of nine patients with advanced cancer and meticillin-resistant Staphylococcus aureus and nine family members (n = 18). Framework analysis was used to analyse the data. Patients and family members of patients with advanced cancer either admitted to the specialist palliative care unit or receiving palliative care in the hospital setting, who had a laboratory confirmed diagnosis of meticillin-resistant Staphylococcus aureus colonisation, were considered for inclusion in the study. Four themes were identified using framework analysis: reactions to receiving a meticillin-resistant Staphylococcus aureus diagnosis, the need for effective communication of the meticillin-resistant Staphylococcus aureus diagnosis, the enigmatic nature of meticillin-resistant Staphylococcus aureus, and lessons to guide the future care of meticillin-resistant Staphylococcus aureus patients. This article indicates that meticillin-resistant Staphylococcus aureus can have a significant impact on advanced cancer patients and their families. This impact may be underestimated, but early and careful face-to-face explanation about meticillin-resistant Staphylococcus aureus and its implications can help patients and their families to cope better with it. These findings should be considered when developing policy relating to meticillin-resistant Staphylococcus aureus management and infection control in specialist palliative care settings. © The Author(s) 2015.

Advanced extravehicular activity systems requirements definition study

NASA Technical Reports Server (NTRS)

1988-01-01

A study to define the requirements for advanced extravehicular activities (AEVA) was conducted. The purpose of the study was to develop an understanding of the EVA technology requirements and to map a pathway from existing or developing technologies to an AEVA system capable of supporting long-duration missions on the lunar surface. The parameters of an AEVA system which must sustain the crewmembers and permit productive work for long periods in the lunar environment were examined. A design reference mission (DRM) was formulated and used as a tool to develop and analyze the EVA systems technology aspects. Many operational and infrastructure design issues which have a significant influence on the EVA system are identified.

Physiotherapy programme reduces fatigue in patients with advanced cancer receiving palliative care: randomized controlled trial.

PubMed

Pyszora, Anna; Budzyński, Jacek; Wójcik, Agnieszka; Prokop, Anna; Krajnik, Małgorzata

2017-09-01

Cancer-related fatigue (CRF) is a common and relevant symptom in patients with advanced cancer that significantly decreases their quality of life. The aim of this study was to evaluate the effect of a physiotherapy programme on CRF and other symptoms in patients diagnosed with advanced cancer. The study was designed as a randomized controlled trial. Sixty patients diagnosed with advanced cancer receiving palliative care were randomized into two groups: the treatment group (n = 30) and the control group (n = 30). The therapy took place three times a week for 2 weeks. The 30-min physiotherapy session included active exercises, myofascial release and proprioceptive neuromuscular facilitation (PNF) techniques. The control group did not exercise. The outcomes included Brief Fatigue Inventory (BFI), Edmonton Symptom Assessment Scale (ESAS) and satisfaction scores. The exercise programme caused a significant reduction in fatigue scores (BFI) in terms of severity of fatigue and its impact on daily functioning. In the control group, no significant changes in the BFI were observed. Moreover, the physiotherapy programme improved patients' general well-being and reduced the intensity of coexisting symptoms such as pain, drowsiness, lack of appetite and depression. The analysis of satisfaction scores showed that it was also positively evaluated by patients. The physiotherapy programme, which included active exercises, myofascial release and PNF techniques, had beneficial effects on CRF and other symptoms in patients with advanced cancer who received palliative care. The results of the study suggest that physiotherapy is a safe and effective method of CRF management.

Feasibility and acceptability of advance care planning in elderly Italian and Greek speaking patients as compared to English-speaking patients: an Australian cross-sectional study.

PubMed

Detering, Karen; Sutton, Elizabeth; Fraser, Scott; Wallis, Kasey; Silvester, William; Mawren, Daveena; Whiteside, Kathryn

2015-08-28

To assess the feasibility and acceptability of facilitated advance care planning (ACP) discussions in elderly Italian and Greek-speaking inpatients compared to English-speaking inpatients. This cross-sectional study with convenience sampling was conducted in Melbourne, Australia, and recruited hospital inpatients with medical decision-making capacity, aged 65 years or above, who spoke Greek (25 patients), Italian (24 patients) or English (63 patients). Facilitated ACP was offered, aiming to assists patients to consider and discuss their goals, values, beliefs and future treatment wishes with their family and doctor; to help them consider how they would like healthcare decisions made in the future if they become unable to do this for themselves; and to complete advance care directives. The completion of ACP discussions, their duration, advance care directive completion and utilisation of interpreters. Of 112 patients, 109 (97%) had at least one discussion, 63 (54%) completed advance care directives, either nominating a substitute decision-maker, documenting their wishes or both, and 76 (68%) included family in discussions. The median duration of discussions for all patients was slightly more than 1 h, over two visits. There were no differences between the Greek-speaking and the Italian-speaking patients, or between the Non-English speaking and the English-speaking patients in any of these measures. Only 14 non-English speaking patients, (30%) utilised interpreters, but when utilised, patients were much more likely (p<0.005) to complete advance care directives. Facilitated ACP in elderly Italian and Greek-speaking patients is feasible, acceptable and is similar to that for English-speaking patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A PHASE II STUDY OF GEMCITABINE AND CAPECITABINE IN PATIENTS WITH ADVANCED RENAL CELL CANCER (RCC): SOUTHWEST ONCOLOGY GROUP STUDY S0312

PubMed Central

Van Veldhuizen, Peter J.; Hussey, Michael; Lara, Primo N.; Mack, Philip C.; Gandour-Edwards, Regina; Clark, Joseph I.; Lange, Marianne K.; Crawford, E. David

2010-01-01

Background Gemcitabine plus capecitabine has modest efficacy in patients with advanced RCC but has considerable toxicity. We evaluated the efficacy and toxicity of a modified dose-schedule of this doublet in patients with advanced unresectable or metastatic RCC. Methods Chemotherapy-naïve patients were treated with gemcitabine at 900mg/m2 on days 1,8,15 and capecitabine at 625mg/m2 twice daily on days 1 through 21, every 28 days. Eligible patients must have adequate performance status and end-organ function. The primary endpoint was tumor response rate (RR). No further evaluation of this regimen would be pursued if the RR was ≤ 5%. In an exploratory manner using archival specimens, we also evaluated potential markers of prognosis and treatment response including thymidylate synthase (TS) gene polymorphisms and tumor expression of p53, PTEN, pAKT, pmTOR, and ERCC1. Results Of 43 patients registered, 1 was ineligible and 2 were not analyzable. There was 1 confirmed complete response (CR) and three unconfirmed partial responses (PR), for an overall response rate of 10% (95% CI: 3, 24). Nineteen patients (48%) had stable disease (SD). The six-month freedom-from-treatment-failure and overall survival rates were 20% (95% CI: 8, 32) and 75% (95% CI: 62, 88), respectively. Median survival time was 23 months (95% CI: 10, 37). One patient each experienced Grade 4 neutropenia, fatigue, thrombocytopenia and hemolysis with renal failure. The most common Grade 3 toxicities were neutropenia (12 patients), fatigue (5), and leucopenia (4). Patients with a best response of stable disease or better were more likely to have a decrease in expression of PTEN and an increased expression of pmTOR. Conclusions Gemcitabine plus capecitabine at this reduced dose-schedule benefits a small percentage of patients with RCC with an acceptable toxicity profile. The combination of gemcitabine and capecitabine may serve as a base regimen for combination therapy with targeted agents in select RCC

Cost/benefit studies of advanced materials technologies for future aircraft turbine engines: Materials for advanced turbine engines

NASA Technical Reports Server (NTRS)

Stearns, M.; Wilbers, L.

1982-01-01

Cost benefit studies were conducted on six advanced materials and processes technologies applicable to commercial engines planned for production in the 1985 to 1990 time frame. These technologies consisted of thermal barrier coatings for combustor and high pressure turbine airfoils, directionally solidified eutectic high pressure turbine blades, (both cast and fabricated), and mixers, tail cones, and piping made of titanium-aluminum alloys. A fabricated titanium fan blisk, an advanced turbine disk alloy with improved low cycle fatigue life, and a long-life high pressure turbine blade abrasive tip and ceramic shroud system were also analyzed. Technologies showing considerable promise as to benefits, low development costs, and high probability of success were thermal barrier coating, directionally solidified eutectic turbine blades, and abrasive-tip blades/ceramic-shroud turbine systems.

Randomized, Controlled Trial of an Advance Care Planning Video Decision Support Tool for Patients With Advanced Heart Failure.

PubMed

El-Jawahri, Areej; Paasche-Orlow, Michael K; Matlock, Dan; Stevenson, Lynne Warner; Lewis, Eldrin F; Stewart, Garrick; Semigran, Marc; Chang, Yuchiao; Parks, Kimberly; Walker-Corkery, Elizabeth S; Temel, Jennifer S; Bohossian, Hacho; Ooi, Henry; Mann, Eileen; Volandes, Angelo E

2016-07-05

Conversations about goals of care and cardiopulmonary resuscitation (CPR)/intubation for patients with advanced heart failure can be difficult. This study examined the impact of a video decision support tool and patient checklist on advance care planning for patients with heart failure. This was a multisite, randomized, controlled trial of a video-assisted intervention and advance care planning checklist versus a verbal description in 246 patients ≥64 years of age with heart failure and an estimated likelihood of death of >50% within 2 years. Intervention participants received a verbal description for goals of care (life-prolonging care, limited care, and comfort care) and CPR/intubation plus a 6-minute video depicting the 3 levels of care, CPR/intubation, and an advance care planning checklist. Control subjects received only the verbal description. The primary analysis compared the proportion of patients preferring comfort care between study arms immediately after the intervention. Secondary outcomes were CPR/intubation preferences and knowledge (6-item test; range, 0-6) after intervention. In the intervention group, 27 (22%) chose life-prolonging care, 31 (25%) chose limited care, 63 (51%) selected comfort care, and 2 (2%) were uncertain. In the control group, 50 (41%) chose life-prolonging care, 27 (22%) selected limited care, 37 (30%) chose comfort care, and 8 (7%) were uncertain (P<0.001). Intervention participants (compared with control subjects) were more likely to forgo CPR (68% versus 35%; P<0.001) and intubation (77% versus 48%; P<0.001) and had higher mean knowledge scores (4.1 versus 3.0; P<0.001). Patients with heart failure who viewed a video were more informed, more likely to select a focus on comfort, and less likely to desire CPR/intubation compared with patients receiving verbal information only. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01589120. © 2016 American Heart Association, Inc.

Advancement Staff and Alumni Advocates: Cultivating LGBTQ Alumni by Promoting Individual and Community Uplift

ERIC Educational Resources Information Center

Garvey, Jason C.; Drezner, Noah D.

2013-01-01

Using a constructivist case-study analysis, we explore philanthropy toward higher education among lesbian, gay, bisexual, transgender, and queer (LGBTQ) alumni, examining the role of advancement staff and alumni advocates in engaging LGBTQ alumni to promote individual and community uplift. Data come from focus groups with 37 advancement staff and…

An advanced concept secondary power systems study for an advanced transport technology aircraft

NASA Technical Reports Server (NTRS)

1972-01-01

The application of advanced technology to the design of an integrated secondary power system for future near-sonic long-range transports was investigated. The study showed that the highest payoff is achieved by utilizing secondary power equipment that contributes to minimum cruise drag. This is best accomplished by the use of the dedicated auxiliary power unit concept (inflight APU) as the prime power source for an airplane with a body-mounted engine or by the use of the internal engine generator concept (electrical power extraction from the propulsion engine) for an airplane with a wing-pod-mounted engine.

Is uniportal thoracoscopic surgery a feasible approach for advanced stages of non-small cell lung cancer?

PubMed Central

Fieira, Eva; Delgado, Maria; Mendez, Lucía; Fernandez, Ricardo; de la Torre, Mercedes

2014-01-01

Objectives Conventional video-assisted thoracoscopic (VATS) lobectomy for advanced lung cancer is a feasible and safe surgery in experienced centers. The aim of this study is to assess the feasibility of uniportal VATS approach in the treatment of advanced non-small cell lung cancer (NSCLC) and compare the perioperative outcomes and survival with those in early-stage tumors operated through the uniportal approach. Methods From June 2010 to December 2012, we performed 163 uniportal VATS major pulmonary resections. Only NSCLC cases were included in this study (130 cases). Patients were divided into two groups: (A) early stage and (B) advanced cases (>5 cm, T3 or T4, or tumors requiring neoadjuvant treatment). A descriptive and retrospective study was performed, comparing perioperative outcomes and survival obtained in both groups. A survival analysis was performed with Kaplan-Meier curves and the log-rank test was used to compare survival between patients with early and advanced stages. Results A total of 130 cases were included in the study: 87 (A) vs. 43 (B) patients (conversion rate 1.1 vs. 6.5%, P=0.119). Mean global age was 64.9 years and 73.8% were men. The patient demographic data was similar in both groups. Upper lobectomies (A, 52 vs. B, 21 patients) and anatomic segmentectomies (A, 4 vs. B, 0) were more frequent in group A while pneumonectomy was more frequent in B (A, 1 vs. B, 6 patients). Surgical time was longer (144.9±41.3 vs. 183.2±48.9, P<0.001), and median number of lymph nodes (14 vs. 16, P=0.004) were statistically higher in advanced cases. Median number of nodal stations (5 vs. 5, P=0.165), days of chest tube (2 vs. 2, P=0.098), HOS (3 vs. 3, P=0.072), and rate of complications (17.2% vs. 14%, P=0.075) were similar in both groups. One patient died on the 58th postoperative day. The 30-month survival rate was 90% for the early stage group and 74% for advanced cases Conclusions Uniportal VATS lobectomy for advanced cases of NSCLC is a safe and

Advanced Technology Spark-Ignition Aircraft Piston Engine Design Study

NASA Technical Reports Server (NTRS)

Stuckas, K. J.

1980-01-01

The advanced technology, spark ignition, aircraft piston engine design study was conducted to determine the improvements that could be made by taking advantage of technology that could reasonably be expected to be made available for an engine intended for production by January 1, 1990. Two engines were proposed to account for levels of technology considered to be moderate risk and high risk. The moderate risk technology engine is a homogeneous charge engine operating on avgas and offers a 40% improvement in transportation efficiency over present designs. The high risk technology engine, with a stratified charge combustion system using kerosene-based jet fuel, projects a 65% improvement in transportation efficiency. Technology enablement program plans are proposed herein to set a timetable for the successful integration of each item of required advanced technology into the engine design.

Environmentally Responsible Aviation N plus 2 Advanced Vehicle Study

NASA Technical Reports Server (NTRS)

Drake, Aaron; Harris, Christopher A.; Komadina, Steven C.; Wang, Donny P.; Bender, Anne M.

2013-01-01

This is the Northrop Grumman final report for the Environmentally Responsible Aviation (ERA) N+2 Advanced Vehicle Study performed for the National Aeronautics and Space Administration (NASA). Northrop Grumman developed advanced vehicle concepts and associated enabling technologies with a high potential for simultaneously achieving significant reductions in emissions, airport area noise, and fuel consumption for transport aircraft entering service in 2025. A Preferred System Concept (PSC) conceptual design has been completed showing a 42% reduction in fuel burn compared to 1998 technology, and noise 75dB below Stage 4 for a 224- passenger, 8,000 nm cruise transport aircraft. Roadmaps have been developed for the necessary technology maturation to support the PSC. A conceptual design for a 55%-scale demonstrator aircraft to reduce development risk for the PSC has been completed.

Women's groups and individual entrepreneurs: a Ugandan case study.

PubMed

Pickering, H; Kajura, E; Katongole, G; Whitworth, J

1996-10-01

This study is based on interviews conducted among 8 women's income-generating groups and 12 individual women entrepreneurs in 15 villages in Masaka district, Uganda. The Baganda are the main tribe in the study villages. The study evaluates the economic achievement, objectives, and social characteristics of the groups. Groups ranged in size from 9-20 members. All had functioned for 3-5 years. A regular membership fee was paid through the sale of agricultural produce. Groups met at least every 2 weeks. This study revealed that the individual goals were to increase individual wealth, while the stated group goals were to invest in the community. Members considered the groups as useful in providing an easy way to raise capital. Most members considered financial status as a criterion for group membership. Elderly women tended to join social and handicraft groups. The women's group members tended to be friends before the establishment of the group and tended to be currently married to men residing in the area. Of the 12 women entrepreneurs, only 5 were currently married. All 12 women entrepreneurs had considerable initiative. The 12 women and the women's group members derived income from two or more sources: agricultural projects, animal husbandry, craft production, alcohol production and sale, or other activities. Study findings indicate that decisions were often delayed or avoided in order to preserve social cohesion. In a market-oriented enterprise, quick response time is needed and the bureaucratic dynamics would hinder some agricultural ventures. The poorest women experienced barriers to group membership. Women entrepreneurs were more successful than group women.

Phase II study of the PI3K inhibitor BKM120 in patients with advanced or recurrent endometrial carcinoma: a stratified type I–type II study from the GINECO group

PubMed Central

Heudel, P-E; Fabbro, M; Roemer-Becuwe, C; Kaminsky, M C; Arnaud, A; Joly, F; Roche-Forestier, S; Meunier, J; Foa, C; You, B; Priou, F; Tazi, Y; Floquet, A; Selle, F; Berton-Rigaud, D; Lesoin, A; Kalbacher, E; Lortholary, A; Favier, L; Treilleux, I; Ray-Coquard, I

2017-01-01

Backround: Patients with metastatic endometrial carcinoma have a poor prognosis and PIK3CA mutations and amplifications are common in these cancers. This study evaluated the efficacy and safety of the pure PI3K inhibitor BKM120 in advanced or recurrent endometrial carcinoma. Methods: This phase II, multicentre, single-arm, double strata (histological low grade (LG) or high grade (HG)) open-label study enrolled patients with histologically confirmed advanced or recurrent endometrial carcinoma who had received not more than one prior chemotherapy regimen. Patients received initially BKM120 100 mg tablets once daily. Primary end points were proportion of patients free of progression at 2 months (HG strata) or at 3 months (LG strata), objective response rate (ORR), and safety. Results: A total of 40 patients were enrolled, of whom 16 patients had received BKM120 at 100 mg. Because of high toxicities (cutaneous rash (54%), depressive events (47%), and anxiety (40%), the IDMC has proposed to stop recruitment at 100 mg and to continue the clinical trial with a lower dose of 60 mg per day. In addition, 24 patients (median age 67 years old) were newly enrolled (14 in the LG strata and 10 in the HG strata). Rate of nonprogression at 2 months in the HG strata was 70% and at 3 months was 60% in the LG strata. Median progression-free survival (PFS) for all patients is 4.5 months (CI 95% 2.8–6.1), and the median PFS for LG strata is 8.3 months compared with 3.8 months for the HG strata. No response was reported. At 60 mg per day, the most commonly reported treatment-related adverse events (AEs) were hyperglycaemia (58%), cognitive (31%), digestive (28%), hepatic liver functions (26%), and rash (23%). The most commonly reported treatment-related grade ⩾3 AEs were HTA (17%), hyperglycaemia (17%), and increased alanine aminotransferase (24%). Five patients (21%) stopped BKM120 for toxicity. Conclusions: The BKM120 was associated with an unfavourable safety profile and

Phase I dose-finding study of sorafenib with FOLFOX4 as first-line treatment in patients with unresectable locally advanced or metastatic gastric cancer.

PubMed

Chi, Yihebali; Yang, Jianliang; Yang, Sheng; Sun, Yongkun; Jia, Bo; Shi, Yuankai

2015-06-01

To determine the maximum tolerated dose (MTD), dose-limiting toxicity (DLT) and efficacy of sorafenib in combination with FOLFOX4 (oxaliplatin/leucovorin (LV)/5-fluorouracil) as first-line treatment for advanced gastric cancer, we performed a phase I dose-finding study in nine evaluable patients with unresectable locally advanced or metastatic gastric cancer or gastroesophageal junction adenocarcinoma. According to modified Fibonacci method, the design of this study was to guide elevation of the sorafenib dosage to the next level (from 200 mg twice daily to 400 mg twice daily and then, if tolerated, 600 mg twice daily). If the patient achieved complete response (CR), partial response (PR) or stable disease (SD) after eight cycles of treatment, combination chemotherapy was scheduled to be discontinued and sorafenib monotherapy continued at the original dose until either disease progression or unacceptable toxicity. In sorafenib 200 mg twice daily group, DLT was observed in 1 of 6 patients, and in 400 mg twice daily group, it was observed in 2 of 3 patients. Seven of 9 (77.8%) evaluable patients achieved PR, with a median overall survival (OS) of 11.8 [95% confidence interval (CI): 8.9-14.7] months. Common adverse effects include hand-foot syndrome, leukopenia, neutropenia, anorexia, and nausea. Twice-daily dosing of sorafenib 200 mg in combination with FOLFOX4 was proven effective and safe for the treatment of advanced gastric cancer, and could be an appropriate dosage for subsequent phase II clinical studies.

Scanning for satisfaction or digging for dismay? Comparing findings from a postal survey with those from a focus group-study.

PubMed

Carlsen, Benedicte; Glenton, Claire

2012-09-03

Despite growing support for mixed methods approaches we still have little systematic knowledge about the consequences of combining surveys and focus groups. While the methodological aspects of questionnaire surveys have been researched extensively, the characteristics of focus group methodology are understudied. We suggest and discuss whether the focus group setting, as compared to questionnaire surveys, encourages participants to exaggerate views in a negative direction. Based on an example from our own research, where we conducted a survey as a follow up of a focus group study, and with reference to theoretical approaches and empirical evidence from the literature concerning survey respondent behaviour and small group dynamics, we discuss the possibility that a discrepancy in findings between the focus groups and the questionnaire reflects characteristics of the two different research methods. In contrast to the survey, the focus group study indicated that doctors were generally negative to clinical guidelines. We were not convinced that this difference in results was due to methodological flaws in either of the studies, and discuss instead how this difference may have been the result of a general methodological phenomenon. Based on studies of how survey questionnaires influence responses, it appears reasonable to claim that surveys are more likely to find exaggerated positive views. Conversely, there are some indications in the literature that focus groups may result in complaints and overly negative attitudes, but this is still an open question. We suggest that while problematic issues tend to be under-communicated in questionnaire surveys, they may be overstated in focus groups.We argue for the importance of increasing our understanding of focus group methodology, for example by reporting interesting discrepancies in mixed methods studies. In addition, more experimental research on focus groups should be conducted to advance the methodology and to test our

Scanning for satisfaction or digging for dismay? Comparing findings from a postal survey with those from a focus group-study

PubMed Central

2012-01-01

Background Despite growing support for mixed methods approaches we still have little systematic knowledge about the consequences of combining surveys and focus groups. While the methodological aspects of questionnaire surveys have been researched extensively, the characteristics of focus group methodology are understudied. We suggest and discuss whether the focus group setting, as compared to questionnaire surveys, encourages participants to exaggerate views in a negative direction. Discussion Based on an example from our own research, where we conducted a survey as a follow up of a focus group study, and with reference to theoretical approaches and empirical evidence from the literature concerning survey respondent behaviour and small group dynamics, we discuss the possibility that a discrepancy in findings between the focus groups and the questionnaire reflects characteristics of the two different research methods. In contrast to the survey, the focus group study indicated that doctors were generally negative to clinical guidelines. We were not convinced that this difference in results was due to methodological flaws in either of the studies, and discuss instead how this difference may have been the result of a general methodological phenomenon. Summary Based on studies of how survey questionnaires influence responses, it appears reasonable to claim that surveys are more likely to find exaggerated positive views. Conversely, there are some indications in the literature that focus groups may result in complaints and overly negative attitudes, but this is still an open question. We suggest that while problematic issues tend to be under-communicated in questionnaire surveys, they may be overstated in focus groups. We argue for the importance of increasing our understanding of focus group methodology, for example by reporting interesting discrepancies in mixed methods studies. In addition, more experimental research on focus groups should be conducted to advance the

Attachment to place in advanced age: A study of the LiLACS NZ cohort.

PubMed

Wiles, Janine L; Rolleston, Anna; Pillai, Avinesh; Broad, Joanna; Teh, Ruth; Gott, Merryn; Kerse, Ngaire

2017-07-01

An extensive body of research theorises that attachment to place is positively associated with health, particularly for older people. Building on this, we measure how indicators of attachment to place are associated with health for in people of advanced age in New Zealand. We use data from a cohort study (LiLACS NZ), which includes an indigenous Māori cohort aged 80-90 years and a non-Māori cohort aged 85 years from a mixed urban/rural region in New Zealand. Each cohort undertook a comprehensive interview and health assessment (n = 267 Māori and n = 404 non-Māori). Using multivariate regression analyses, we explore participants' feelings for and connectedness with their home, community and neighbourhood; nature and the outdoors; expectations about and enthusiasm for residential mobility; and how all these are associated with measures of health (e.g., SF-12 physical and mental health related quality of life) and functional status (e.g., NEADL). We demonstrate that people in advanced age hold strong feelings of attachment to place. We also establish some positive associations between attachment to place and health in advanced age, and show how these differ for the indigenous and non-indigenous cohorts. For older Māori there were strong associations between various health measures and the importance of nature and the outdoors, and connectedness to neighbourhood and community. For older non-Māori, there were strong associations between health and liking home and neighbourhood, and feeling connected to their community and neighbourhood. Place attachment, and particularly its relationship to health, operates in different ways for different groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

Parent-Child Communication and Adjustment Among Children With Advanced and Non-Advanced Cancer in the First Year Following Diagnosis or Relapse.

PubMed

Keim, Madelaine C; Lehmann, Vicky; Shultz, Emily L; Winning, Adrien M; Rausch, Joseph R; Barrera, Maru; Gilmer, Mary Jo; Murphy, Lexa K; Vannatta, Kathryn A; Compas, Bruce E; Gerhardt, Cynthia A

2017-09-01

To examine parent-child communication (i.e., openness, problems) and child adjustment among youth with advanced or non-advanced cancer and comparison children. Families (n = 125) were recruited after a child's diagnosis/relapse and stratified by advanced (n = 55) or non-advanced (n = 70) disease. Comparison children (n = 60) were recruited from local schools. Children (ages 10-17) reported on communication (Parent-Adolescent Communication Scale) with both parents, while mothers reported on child adjustment (Child Behavior Checklist) at enrollment (T1) and one year (T2). Openness/problems in communication did not differ across groups at T1, but problems with fathers were higher among children with non-advanced cancer versus comparisons at T2. Openness declined for all fathers, while changes in problems varied by group for both parents. T1 communication predicted later adjustment only for children with advanced cancer. Communication plays an important role, particularly for children with advanced cancer. Additional research with families affected by life-limiting conditions is needed. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Endoscopic traversability in patients with locally advanced esophageal squamous cell carcinoma: Is it a significant prognostic factor?

PubMed

Shin, Hae Jin; Moon, Hee Seok; Kang, Sun Hyung; Sung, Jae Kyu; Jeong, Hyun Yong; Kim, Seok Hyun; Lee, Byung Seok; Kim, Ju Seok; Yun, Gee Young

2017-12-01

The purpose of this study was to evaluate the prognostic impact of endoscopic traversability in patients with locally advanced esophageal squamous cell carcinoma.This retrospective study was based on medical records from a single tertiary medical center. The records of 317 patients with esophageal squamous cell carcinoma treated with surgery or definitive chemoradiotherapy (CRT) between January 2009 and March 2016 were reviewed. Finally, we retrieved the data on 168 consecutive patients. These 168 patients were divided into 2 groups based on their endoscopic traversability findings: Group A (the endoscope traversable group), and Group B (the endoscope non-traversable group). We then retrospectively compared the clinical characteristics of these 2 groups.The endoscope non-traversable group (Group B) revealed an advanced clinical stage, a poor Eastern Cooperative Oncology Group (ECOG) score, a lower serum albumin level, a higher rate of requirement for esophageal stent insertion and definitive CRT as initial treatment than the endoscope traversable group (Group A). Patients with endoscope traversable cancer showed a significantly higher 3-year overall survival and 3-year relapse-free survival than patients who were endoscope non-traversable (53.8% vs 17.3%, P < .001 and 71.1% vs 45.3%, P = .003, respectively). Upon multivariate analysis of patients with locally advanced esophageal squamous cell carcinoma treated with definitive CRT, the serum albumin level <3.5 g/dL and endoscopic non-traversability were significant negative factors of survival.Endoscopic traversability in patients with locally advanced esophageal squamous cell carcinoma treated with definitive CRT is a significant prognostic factor. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Survey of cogeneration: Advanced cogeneration research study

NASA Technical Reports Server (NTRS)

Slonski, M. L.

1983-01-01

The consumption of electricity, natural gas, or fuel oil was surveyed. The potential electricity that could be generated in the SCE service territory using cogeneration technology was estimated. It was found that an estimated 3700 MWe could potentially be generated in Southern California using cogenerated technology. It is suggested that current technology could provide 2600 MWe and advanced technology could provide 1100 MWe. Approximately 1600 MWt is considered not feasible to produce electricity with either current or advanced cogeneration technology.

Cost benefit study of advanced materials technology for aircraft turbine engines

NASA Technical Reports Server (NTRS)

Hillery, R. V.; Johnston, R. P.

1977-01-01

The cost/benefits of eight advanced materials technologies were evaluated for two aircraft missions. The overall study was based on a time frame of commercial engine use of the advanced material technologies by 1985. The material technologies evaluated were eutectic turbine blades, titanium aluminide components, ceramic vanes, shrouds and combustor liners, tungsten composite FeCrAly blades, gamma prime oxide dispersion strengthened (ODS) alloy blades, and no coat ODS alloy combustor liners. They were evaluated in two conventional takeoff and landing missions, one transcontinental and one intercontinental.

Delineating advanced practice nursing in New Zealand: a national survey.

PubMed

Carryer, J; Wilkinson, J; Towers, A; Gardner, G

2018-03-01

A variety of advanced practice nursing roles and titles have proliferated in response to the changing demands of a population characterized by increasing age and chronic illness. Whilst similarly identified as advanced practice roles, they do not share a common practice profile, educational requirements or legislative direction. The lack of clarity limits comparative research that can inform policy and health service planning. To identify advanced practice roles within nursing titles employed in New Zealand and practice differences between advanced practice and other roles. Replicating recent Australian research, 3255 registered nurses/nurse practitioners in New Zealand completed the amended Advanced Practice Delineation survey tool. The mean domain scores of the predominant advanced practice position were compared with those of other positions. Differences between groups were explored using one-way ANOVA and post hoc between group comparisons. Four nursing position bands were identified: nurse practitioner, clinical nurse specialist, domain-specific and registered nurse. Significant differences between the bands were found on many domain scores. The nurse practitioner and clinical nurse specialist bands had the most similar practice profiles, nurse practitioners being more involved in direct care and professional leadership. Similar to the position of clinical nurse consultant in Australia, those practicing as clinical nurse specialists were deemed to reflect the threshold for advanced practice nursing. The results identified different practice patterns for the identified bands and distinguish the advanced practice nursing roles. By replicating the Australian study of Gardener et al. (2016), this NZ paper extends the international data available to support more evidence-based nursing workforce planning and policy development. © 2017 International Council of Nurses.

A cluster randomized controlled trial on the effects and costs of advance care planning in elderly care: study protocol.

PubMed

Korfage, Ida J; Rietjens, Judith A C; Overbeek, Anouk; Jabbarian, Lea J; Billekens, Pascalle; Hammes, Bernard J; Hansen-van der Meer, Ellen; Polinder, Suzanne; Severijnen, Johan; Swart, Siebe J; Witkamp, Frederika E; van der Heide, Agnes

2015-07-22

Currently, health care and medical decision-making at the end of life for older people are often insufficiently patient-centred. In this trial we study the effects of Advance Care Planning (ACP), a formalised process of timely communication about care preferences at the end of life, for frail older people. We will conduct a cluster randomised controlled trial among older people residing in care homes or receiving home care in the Netherlands. The intervention group will receive the ACP program Respecting Choices® in addition to usual care. The control group will receive usual care only. Participants in both groups will fill out questionnaires at baseline and after 12 months. We hypothesize that ACP will lead to better patient activation in medical decision making and quality of life, while reducing the number of medical interventions and thus health care costs. Multivariate analysis will be used to compare differences between the intervention group and the control group at baseline and to compare differences in changes after 12 months following the inclusion. Our study can contribute to more understanding of the effects of ACP on patient activation and quality of life in frail older people. Further, we will gain insight in the costs and cost-effectiveness of ACP. This study will facilitate ACP policy for older people in the Netherlands. Nederlands Trial Register: NTR4454.

How can we help family carers manage pain medicines for patients with advanced cancer? A systematic review of intervention studies.

PubMed

Latter, Sue; Hopkinson, Jane B; Richardson, Alison; Hughes, Jane A; Lowson, Elizabeth; Edwards, Deborah

2016-09-01

Family carers play a significant role in managing pain and associated medicines for people with advanced cancer. Research indicates that carers often feel inadequately prepared for the tasks involved, which may impact on carers' and patients' emotional state as well as the achievement of optimal pain control. However, little is known about effective methods of supporting family carers with cancer pain medicines. To systematically identify and review studies of interventions to help carers manage medicines for pain in advanced cancer. To identify implications for practice and research. A systematic literature search of databases (MEDLINE, CINAHL, PsycINFO and AMED) was carried out to identify studies of pain medication management interventions that involved family carers of patients with advanced cancer, and reported specific outcomes for family carers. Patient pain outcomes were also sought. Studies were quality appraised; key aspects of study design, interventions and outcomes were compared and a narrative synthesis of findings developed. 8 studies were included; all had significant methodological limitations. The majority reported improvements in family carer knowledge and/or self-efficacy for managing pain medicines; no effect on patient pain outcomes; and no adverse effects. It was not possible to discern any association between particular intervention characteristics and family carer outcomes. Current evidence is limited, but overall suggests face-to-face educational interventions supported by written and/or other resources have potential to improve carers' knowledge and self-efficacy for pain management. Further research is needed to identify how best to help family carers manage pain medicines for patients with advanced cancer. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

From challenges to advanced practice registered nursing role development: Qualitative interview study.

PubMed

Jokiniemi, Krista; Haatainen, Kaisa; Pietilä, Anna-Maija

2015-12-01

The aim of this study is to describe the factors hindering and facilitating the implementation of the advanced practice registered nurses role at Finnish university hospitals, and to examine the implications for its future development. A descriptive qualitative approach, using thematic individual interviews, was conducted in 2011 with a sample of 11 advanced practice registered nurses. The data were analysed using qualitative content analysis. The advanced practice registered nurses role barriers had an impact on the role development needs. In turn, the facilitating factors helped encounter the challenges of the role, therefore having an impact on both the current role achievement, as well as contributing to the future role development. The factors hindering and facilitating the advanced practice registered nurses role need to be acknowledged to support the role implementation and planning of the future of the role. © 2014 Wiley Publishing Asia Pty Ltd.

Increased risk of alteration of nutritional status in hospitalized elderly patients with advanced cancer.

PubMed

Paillaud, E; Caillet, P; Campillo, B; Bories, P N

2006-01-01

Malnutrition is common in patients with advanced cancer and is associated with worse prognosis. The aim of this study was to follow-up the nutritional status of elderly patients with advanced cancer in comparison with that of younger ones, in the course of hospitalization. Eighty-eight (44 males and 44 females) patients with advanced cancer entered the study. Two groups were defined according to age : superior 70 y (n = 45) and < 70 y (n = 43). Nutritional status by means of anthropometric variables and daily intake were assessed on Day 0, Day 30 and Day 60. A blood sample was collected on Day 0 for determination of serum proteins. The two groups of patients did not differ in terms of anthropometry and biological variables on admission to our department ; only bicipital skinfold thickness and energy intake were lower in the elderly patients. After one month hospitalization, tricipital skinfold thickness and fat mass decreased in these patients. After two months, mid-arm circumference also decreased. Unlike the older group, the younger patients increased their daily energy and protein intakes. During hospitalization, older persons with advanced cancer cannot improve their energy intake and therefore, are at particular risk of aggravating their nutritional status.

Engine Concept Study for an Advanced Single-Aisle Transport

NASA Technical Reports Server (NTRS)

Guynn, Mark D.; Berton, Jeffrey J.; Fisher, Kenneth L.; Haller, William J.; Tong, Michael; Thurman, Douglas R.

2009-01-01

The desire for higher engine efficiency has resulted in the evolution of aircraft gas turbine engines from turbojets, to low bypass ratio, first generation turbofans, to today's high bypass ratio turbofans. Although increased bypass ratio has clear benefits in terms of propulsion system metrics such as specific fuel consumption, these benefits may not translate into aircraft system level benefits due to integration penalties. In this study, the design trade space for advanced turbofan engines applied to a single aisle transport (737/A320 class aircraft) is explored. The benefits of increased bypass ratio and associated enabling technologies such as geared fan drive are found to depend on the primary metrics of interest. For example, bypass ratios at which mission fuel consumption is minimized may not require geared fan technology. However, geared fan drive does enable higher bypass ratio designs which result in lower noise. The results of this study indicate the potential for the advanced aircraft to realize substantial improvements in fuel efficiency, emissions, and noise compared to the current vehicles in this size class.

An airline study of advanced technology requirements for advanced high speed commercial transport engines. 2: Engine preliminary design assessment

NASA Technical Reports Server (NTRS)

Sallee, G. P.

1973-01-01

The advanced technology requirements for an advanced high speed commercial transport engine are presented. The results of the phase 2 study effort cover the following areas: (1) general review of preliminary engine designs suggested for a future aircraft, (2) presentation of a long range view of airline propulsion system objectives and the research programs in noise, pollution, and design which must be undertaken to achieve the goals presented, (3) review of the impact of propulsion system unreliability and unscheduled maintenance on cost of operation, (4) discussion of the reliability and maintainability requirements and guarantees for future engines.

Phase II study of Erlotinib (OSI-774) in patients with advanced hepatocellular cancer.

PubMed

Philip, Philip A; Mahoney, Michelle R; Allmer, Cristine; Thomas, James; Pitot, Henry C; Kim, George; Donehower, Ross C; Fitch, Tom; Picus, Joel; Erlichman, Charles

2005-09-20

Epidermal growth factor receptor/human epidermal growth factor receptor 1 (EGFR/HER1) and ligand expression is frequently seen in hepatocellular cancers (HCCs). Erlotinib (Tarceva, OSI-774; OSI Pharmaceuticals, Melville, NY) is a receptor tyrosine kinase inhibitor with specificity for the EGFR/HER1. The primary objective of this study was to determine the proportion of patients with advanced HCC who were progression-free at 6 months. Patients with either unresectable or metastatic disease were studied. Only one prior systemic or locoregional therapy was allowed. Erlotinib was given continuously at a dose of 150 mg per day orally. Thirty-eight patients with HCC were enrolled. Median age of the patients was 69 years (range, 27 to 83 years). A majority of patients (63%) had an Eastern Cooperative Oncology Group performance status of 1. Forty-seven percent of patients had received prior chemotherapy for advanced HCC. EGFR/HER1 expression was detected in 88% of the patients. Median number of cycles per patient was two (range, 1 to 26). Twelve (32%; CI 95%, 18 to 49) of the 38 patients with HCC were progression-free at 6 months. Three patients had partial radiologic responses of duration of 2, 10, and 11 months, respectively. Disease control was seen in 59% of the patients. Median overall survival time was 13 months. Ten patients (26%) had toxicity-related dose reductions of erlotinib. Grade 3/4 skin toxicity or diarrhea was encountered in five and three patients, respectively. Results of this trial suggest a benefit for EGFR/HER1 blockade with erlotinib in patients with HCC manifested by disease control. Additional studies with erlotinib as a single agent or in combination with other agents are warranted.

Long-term quality of life after treatment of laryngeal cancer. The Veterans Affairs Laryngeal Cancer Study Group.

PubMed

Terrell, J E; Fisher, S G; Wolf, G T

1998-09-01

To assess long-term quality of life in surviving patients with advanced laryngeal cancer. A follow-up long-term quality-of-life survey of patients randomized to the Veterans Affairs Laryngeal Cancer Study No. 268 on induction chemotherapy and radiation (CT + RT) vs surgery and RT. Forty-six (71%) of the 65 surviving patients with prior stage III or IV laryngeal cancer who could be contacted completed the survey: 25 from the surgery and RT group and 21 from the CT + RT group. Baseline demographic and clinical characteristics among survey respondents were similar, except that those in the CT + RT group were significantly older (mean, 61.2 years) than those in the surgery and RT group (mean, 55.7 years; P<.05). Patients completed the University of Michigan Head and Neck Quality of Life (HNQOL) instrument, the Medical Outcomes Studies Short-Form 36 (SF-36) general health survey, the Beck Depression Inventory as well as smoking and alcohol consumption surveys. Patients randomized to the CT + RT group had significantly better (P<.05) quality-of-life scores on the SF-36 mental health domain (76.0) than the surgery and RT group (63.0), and also had better HNQOL pain scores (81.3 vs 64.3). Compared with patients who underwent laryngectomy, patients with intact larynges (CT + RT with larynx) had significantly less bodily pain (88.5 vs 56.5), better scores on the SF-36 mental health (79.8 vs 64.7), and better HNQOL emotion (89.7 vs 79.4) scores. More patients in the surgery and RT group (28%) were depressed than in the CT + RT group (15%). Better quality-of-life scores in the CT + RT groups appear to be related to more freedom from pain, better emotional well-being, and lower levels of depression than to preservation of speech function.

Advanced automotive diesel engine system study

NASA Technical Reports Server (NTRS)

1983-01-01

A conceptual study of an advanced automotive diesel engine is discussed. The engine concept selected for vehicle installation was a supercharged 1.4 liter, 4 cylinder spark assisted diesel of 14:1 compression ratio. A compounding unit consisting of a Lysholm compressor and expander is connected to the engine crankshaft by a belt drive. The inlet air charge is heated by the expander exhaust gas via a heat exchanger. Four levels of technology achievement on the selected engine concept were evaluated, from state-of-the-art to the ideal case. This resulted in the fuel economy increasing from 53.2 mpg to 81.7 mpg, and the 0-60 mph time decreasing from 17.6 seconds to 10.9 seconds.

The history of the Gynecologic Cancer Study Group (GCSG) of the Japan Clinical Oncology Group (JCOG).

PubMed

Onda, Takashi; Konishi, Ikuo; Yoshikawa, Hiroyuki; Kamura, Toshiharu

2011-10-01

The Gynecologic Cancer Study Group (GCSG) of the Japan Clinical Oncology Group (JCOG) was organized in 1994. The GCSG has developed under the leadership of three successive group representatives, five principal study investigators, the cooperation of group members and the support of several public research funds. At present, 38 institutions are participating as active members of the GCSG of the JCOG. In addition to gynecologic oncologists, medical oncologists, pathologists and radiotherapists are participating in our group. Our group manages female genital malignancies including uterine cervical, endometrial, ovarian, tubal and vulvar cancers. Because the incidences of uterine cervical (in younger women), endometrial and ovarian cancer have increased in Japan in recent years, we are developing new standard treatments especially for these malignancies. As of 31 May 2011, our group has conducted six JCOG clinical trials (three completed and three ongoing) and completed one JCOG accompanying study, which is now in preparation for publication. Our group has also conducted several retrospective studies, and Phase I and II trials independent of the JCOG Data Center. Our aim is to conduct unique and high-quality clinical trials which we can appeal to the world. In this review, we present the organization and achievements of our group, along with a list of participating institutions, as the history of the GCSG of the JCOG.

Radiation therapy oncology group gynecologic oncology working group: comprehensive results.

PubMed

Gaffney, David K; Jhingran, Anuja; Portelance, Lorraine; Viswanathan, Akila; Schefter, Tracey; Weidhaas, Joanne; Small, William

2014-06-01

The purpose of this report was to comprehensively describe the activities of the Gynecologic Oncology Working Group within the Radiation Therapy Oncology Group (RTOG). Clinical trials will be reviewed as well as translational science and ancillary activities. During the past 40 years, a myriad of clinical trials have been performed within the RTOG with the aim of improving overall survival (OS) and decreasing morbidity in women with cervical or endometrial cancer. Major study questions have included hyperbaric oxygen, neutron radiotherapy, altered fractionation, hypoxic cell sensitization, chemosensitization, and volume-directed radiotherapy.RTOG 7920 demonstrated improvement in OS in patients with stages IB through IIB cervical carcinoma receiving prophylactic para-aortic irradiation compared to pelvic radiation alone. RTOG 9001 demonstrated that cisplatin and 5-FU chemoradiotherapy to the pelvis for advanced cervix cancer markedly improved OS compared to extended field radiotherapy alone. More recent trials have used radioprotectors, molecular-targeted therapy, and intensity-modulated radiation therapy. Ancillary studies have developed clinical target volume atlases for research protocols and routine clinical use. Worldwide practice patterns have been investigated in cervix, endometrial, and vulvar cancer through the Gynecologic Cancer Intergroup. Translational studies have focused on immunohistochemical markers, changes in gene expression, and miRNA patterns impacting prognosis.The RTOG gynecologic working group has performed clinical trials that have defined the standard of care, improved survival, and added to our understanding of the biology of cervical and endometrial cancers.

ERCC1 protein as a guide for individualized therapy of late-stage advanced non-small cell lung cancer.

PubMed

Gao, Zhiqiang; Han, Baohui; Shen, Jie; Gu, Aiqin; Qi, Dajiang; Huang, Jinsu; Shi, Chunlei; Xiong, Liwen; Zhao, Yizhuo; Jiang, Liyan; Wang, Huimin; Chen, Yurong

2011-09-01

Excision repair cross-complementation group 1 (ERCC1) protein has been associated with cisplatin resistance. The objective of this study was to investigate the correlation between ERCC1 protein levels and the therapeutic effect of individualized therapy in advanced non-small cell lung cancer (NSCLC). A total of 190 advanced NSCLC patients were included in this study. Patients were randomized into either the individualized therapy group or the standard therapy group at a ratio of 2:1. Patients in the standard therapy group were treated with either gemcitabine plus cisplatin or vinorelbine plus cisplatin. The expression of ERCC1 protein in lung cancer tissues of patients from the individualized therapy group was detected with immunohistochemistry. Patients with low ERCC1 levels received either gemcitabine plus cisplatin or vinorelbine plus cisplatin, and patients with high levels received gemcitabine plus vinorelbine. The main outcome assessments were response rate (RR), overall survival (OS) and time to progression (TTP). Follow-up data were recorded until September 30, 2010. RR, 1-year survival rate and TTP were not statistically significant. The median survival time was 10.10 months in the standard therapy group (95% CI 8.48-11.92) and 13.59 months in the individualized therapy group (95% CI 11.86-14.74). The difference in median survival time was significantly different between these groups (P=0.036). The median survival time was longer in the individualized group compared to the standard therapy group. ERCC1 protein expression in advanced NSCLC patients, however, was not significantly correlated with RR, OS and TTP in the individualized therapy group. Therefore, this study suggests that ERCC1 protein levels should be assessed in combination with additional biomarkers to determine an optimal index for individualized therapy in advanced NSCLC patients.

Who Studies Religion at Advanced Level: Why and to What Effect?

ERIC Educational Resources Information Center

Francis, Leslie J.; Astley, Jeff; Parker, Stephen G.

2016-01-01

This study was established to profile students currently studying religion at Advanced level (A level) in terms of their demography, motivation, experience and attitudes. Eight specific areas were identified for examination: their personal motivation to study religion at A level, the personal challenges posed by the subject, their personal…

Advanced Extravehicular Protective System (AEPS) study

NASA Technical Reports Server (NTRS)

Williams, J. L.; Webbon, B. W.; Copeland, R. J.

1972-01-01

A summary is presented of Advanced Extravehicular Protective Systems (AEPS) for the future missions beyond Skylab in earth orbit, on the lunar surface, and on the Martian surface. The study concentrated on the origination of regenerable life support concepts for use in portable extravehicular protective systems, and included evaluation and comparison with expendable systems, and selection of life support subsystems. The study was conducted in two phases. In the first phase, subsystem concepts for performing life support functions in AEPS which are regenerable or partially regenerable were originated, and in addition, expendable subsystems were considered. Parametric data for each subsystem concept were evolved including subsystem weight and volume, power requirement, thermal control requirement; base regeneration equipment weight and volume, requirement. The second phase involved an evaluation of the impact of safety considerations involving redundant and/or backup systems on the selection of the regenerable life support subsystems. In addition, the impact of the space shuttle program on regenerable life support subsystem development was investigated.

Safety assessment of nanomaterials using an advanced decision-making framework, the DF4nanoGrouping

NASA Astrophysics Data System (ADS)

Landsiedel, Robert; Ma-Hock, Lan; Wiench, Karin; Wohlleben, Wendel; Sauer, Ursula G.

2017-05-01

As presented at the 2016 TechConnect World Innovation Conference on 22-25 May 2016 in Washington DC, USA, the European Centre for Ecotoxicology and Toxicology of Chemicals (ECETOC) `Nano Task Force' proposes a Decision-making framework for the grouping and testing of nanomaterials (DF4nanoGrouping) consisting of three tiers to assign nanomaterials to four main groups with possible further subgrouping to refine specific information needs. The DF4nanoGrouping covers all relevant aspects of a nanomaterial's life cycle and biological pathways: intrinsic material properties and system-dependent properties (that depend upon the nanomaterial's respective surroundings), biopersistence, uptake and biodistribution, and cellular and apical toxic effects. Use, release, and exposure route may be applied as `qualifiers' to determine if, e.g., nanomaterials cannot be released from products, which may justify waiving of testing. The four main groups encompass (1) soluble, (2) biopersistent high aspect ratio, (3) passive, and (4) active nanomaterials. The DF4nanoGrouping foresees a stepwise evaluation of nanomaterial properties and effects with increasing biological complexity. In case studies covering carbonaceous nanomaterials, metal oxide, and metal sulfate nanomaterials, amorphous silica and organic pigments (all nanomaterials having primary particle sizes below 100 nm), the usefulness of the DF4nanoGrouping for nanomaterial hazard assessment was confirmed. The DF4nanoGrouping facilitates grouping and targeted testing of nanomaterials. It ensures that sufficient data for the risk assessment of a nanomaterial are available, and it fosters the use of non-animal methods. No studies are performed that do not provide crucial data. Thereby, the DF4nanoGrouping serves to save both animals and resources.

Implementing an Advance Care Planning Intervention in Community Settings with Older Latinos: A Feasibility Study.

PubMed

Nedjat-Haiem, Frances R; Carrion, Iraida V; Gonzalez, Krystyna; Quintana, Alejandra; Ell, Kathleen; O'Connell, Mary; Thompson, Beti; Mishra, Shiraz I

2017-09-01

Older Latinos with serious medical conditions such as cancer and other chronic diseases lack information about advance care planning (ACP). ACP Intervention (ACP-I Plan) was designed for informational and communication needs of older Latinos to improve communication and advance directives (ADs). To determine the feasibility of implementing ACP-I Plan among seriously ill, older Latinos (≥50 years) in Southern New Mexico with one or more chronic diseases (e.g., cancer, heart disease, renal/liver failure, stroke, hypertension, diabetes, chronic obstructive pulmonary disease, and HIV/AIDS). We conducted a prospective, pretest/post-test, two-group, randomized, community-based pilot trial by using mixed data collection methods. Older Latino/Hispanic participants were recruited from community-based settings in Southern New Mexico. All participants received ACP education, whereas the intervention group added: (1) emotional support addressing psychological distress; and (2) systems navigation for resource access, all of which included interactive ACP treatment decisional support and involved motivational interview (MI) methods. Purposive sampling was guided by a sociocultural framework to recruit Latino participants from community-based settings in Southern New Mexico. Feasibility of sample recruitment, implementation, and retention was assessed by examining the following: recruitment strategies, trial enrollment, retention rates, duration of MI counseling, type of visit (home vs. telephone), and satisfaction with the program. We contacted 104 patients, enrolled 74 randomized to usual care 39 (UC) and treatment 35 (TX) groups. Six dropped out before the post-test survey, three from TX before the post-test survey because of sickness (n = 1) or could not be located (n = 2), and the same happened for UC. Completion rates were 91.4% UC and 92.3% TX groups. All participants were Latino/Hispanic, born in the United States (48%) or Mexico (51.4%) on average in the United

Real world study of regimen containing bevacizumab as first-line therapy in Chinese patients with advanced non-small cell lung cancer.

PubMed

Xing, Puyuan; Mu, Yuxin; Wang, Yan; Hao, Xuezhi; Zhu, Yixiang; Hu, Xingsheng; Wang, Hongyu; Liu, Peng; Lin, Lin; Wang, Zhijie; Li, Junling

2018-05-16

Large scale randomized controlled trials have demonstrated that the use of bevacizumab in addition to chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) conveys significant survival benefits. We explored the clinical impact of a first-line regimen containing bevacizumab (B+) versus a non-bevacizumab regimen (non-B) in advanced non-squamous NSCLC (NS-NSCLC) patients in a real world setting. The medical records of patients with advanced NS-NSCLC who received first-line therapy with or without bevacizumab were retrospectively collected. The primary outcome was progression-free survival (PFS), with secondary objectives of objective response rate (ORR), disease control rate (DCR), and safety. Exploratory analysis of EGFR and ALK status was conducted in subgroup. One hundred and forty-nine patients met the selection criteria: 62 in the B+ and 87 in the non-B group. The baseline characteristics were well balanced. In the overall population, the median PFS was significantly longer in the B+ than in the non-B group (9.7 vs. 7.0 months, hazard ratio [HR] 0.52, 95% confidence interval [CI] 0.30-0.91; P = 0.0184). Improved trends in both ORR and DCR were observed in the B+ group. In wild-type patients, the median PFS of the B+ was 11.3 compared to 5.5 months in the non-B group (HR 0.43, 95% CI 0.20-0.91; P = 0.0234). In wild type and unknown populations, the median PFS was 11.3 (B+) compared to 6.0 months (non-B) (HR 0.53; 95% CI 0.28-1.02; P = 0.0520). The safety profile was acceptable in both groups and no unexpected findings were observed. Our analysis confirmed that a first-line regimen containing bevacizumab showed superior clinical benefits over a non-bevacizumab regimen in Chinese patients with advanced NS-NSCLC in a real world setting. © 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

Introduction to Group Relations and Organizational Diagnosis.

DTIC Science & Technology

The perspective of Group Relations and Organizational Diagnosis did not emerge from a vacuum. It is rooted in a clinical perspective on the study of... diagnosis became a specialty in its own right. Earlier treatments of organizational diagnosis , like the initial studies of organizational behavior...to the potential advances suggested by an intergroup perspective. The earlier works also varied in the degree to which they contributed to the entry, data collection, or feedback phases of organizational diagnosis .

Six key topics informal carers of patients with breathlessness in advanced disease want to learn about and why: MRC phase I study to inform an educational intervention.

PubMed

Farquhar, Morag; Penfold, Clarissa; Benson, John; Lovick, Roberta; Mahadeva, Ravi; Howson, Sophie; Burkin, Julie; Booth, Sara; Gilligan, David; Todd, Christopher; Ewing, Gail

2017-01-01

Breathlessness is a common symptom of advanced disease placing a huge burden on patients, health systems and informal carers (families and friends providing daily help and support). It causes distress and isolation. Carers provide complex personal, practical and emotional support yet often feel ill-prepared to care. They lack knowledge and confidence in their caring role. The need to educate carers and families about breathlessness is established, yet we lack robustly developed carer-targeted educational interventions to meet their needs. We conducted a qualitative interview study with twenty five purposively-sampled patient-carer dyads living with breathlessness in advanced disease (half living with advanced cancer and half with advanced chronic obstructive pulmonary disease (COPD). We sought to identify carers' educational needs (including what they wanted to learn about) and explore differences by diagnostic group in order to inform an educational intervention for carers of patients with breathlessness in advanced disease. There was a strong desire among carers for an educational intervention on breathlessness. Six key topics emerged as salient for them: 1) understanding breathlessness, 2) managing anxiety, panic and breathlessness, 3) managing infections, 4) keeping active, 5) living positively and 6) knowing what to expect in the future. A cross-cutting theme was relationship management: there were tensions within dyads resulting from mismatched expectations related to most topics. Carers felt that knowledge-gains would not only help them to support the patient better, but also help them to manage their own frustrations, anxieties, and quality of life. Different drivers for education need were identified by diagnostic group, possibly related to differences in caring role duration and resulting impacts. Meeting the educational needs of carers requires robustly developed and evaluated interventions. This study provides the evidence-base for the content of an

Efficacy of exercise interventions in patients with advanced cancer: A systematic review.

PubMed

Heywood, Reginald; McCarthy, Alexandra L; Skinner, Tina L

2018-05-05

To critically analyse the literature surrounding the efficacy of exercise interventions in patients with advanced cancer. A literature search was undertaken of health and medical electronic databases (PubMED, Medline, CINAHL, Embase, PEDRO, Web of Science and Scopus) until 1 st March 2017. Studies were included if they were published in the English language and met the following criteria: structured exercise as the primary intervention, ≥80% study participants diagnosed with advanced cancer that is unlikely to be cured; reported outcomes concerning physical function, quality of life, fatigue, body composition, psychosocial function, sleep quality pain and/or survival. Following title and abstract screening, 68 articles were eligible for full-text review, with a total of 25 studies (n=1188; 16 controlled trials, 9 non-controlled trials) included in the quantitative synthesis. Two reviewers assessed methodological quality using the Cochrane Risk of Bias Tool for controlled trials and a modified Newcastle-Ottawa Scale for non-controlled trials. Aerobic exercise was utilised in six studies, resistance training in three studies and combination training (aerobic and resistance) in 15 studies. Significant between- and within-group improvements were reported with exercise in ≥50% of studies assessing physical function (83%), quality of life (55%), fatigue (50%), body composition (56%), psychosocial function (56%), and sleep quality (100%). Improvement within or between groups in pain following exercise was only observed in two studies (25%), while survival was unaffected in any study. Most studies reported significant between- and/or within-group improvements in physical function, quality of life, fatigue, body composition, psychosocial function and sleep quality in patients with advanced cancer, although the effects on pain and survival rates are unclear. Exercise appears to be an effective adjunct therapy in the advanced cancer context, although targeted studies are

Effectiveness of combined therapy with pirfenidone and inhaled N-acetylcysteine for advanced idiopathic pulmonary fibrosis: a case-control study.

PubMed

Sakamoto, Susumu; Muramatsu, Yoko; Satoh, Keita; Ishida, Fumiaki; Kikuchi, Naoshi; Sano, Go; Sugino, Keishi; Isobe, Kazutoshi; Takai, Yujiro; Homma, Sakae

2015-04-01

Treatment with pirfenidone may slow the decline in vital capacity and increase progression-free survival (PFS) in idiopathic pulmonary fibrosis (IPF). The effects of combination therapy with inhaled N-acetylcysteine (NAC) and pirfenidone are unclear. We assessed the effects of this combination therapy in patients with advanced IPF. Patients with a diagnosis of advanced IPF (Japanese Respiratory Society stage III/IV IPF) and a relative decline in forced vital capacity (FVC) of ≥ 10% within the previous 6 (± 2) months were enrolled. Outcomes were evaluated in a 12-month follow-up pulmonary function test. Treatment was considered ineffective if the decline in FVC was ≥ 10% and effective if the decline was <10%. We compared clinical characteristics, effectiveness and PFS between patients receiving inhaled NAC plus pirfenidone (n = 24) and those receiving pirfenidone alone (control; n = 10). Data from 34 IPF patients (age range, 59-82 years) were analysed. At the 12-month follow-up examination, treatment was deemed effective in 8 of 17 (47%) patients receiving NAC plus pirfenidone and in 2 of 10 (20%) receiving pirfenidone alone. The annual rate of change in FVC was -610 mL in the NAC plus pirfenidone group and -1320 mL in the pirfenidone group (P < 0.01). PFS was longer (304 days) in the NAC plus pirfenidone group than in the pirfenidone group (168 days; P = 0.016). Combination treatment with inhaled NAC and oral pirfenidone reduced the rate of annual FVC decline and improved PFS in patients with advanced IPF. © 2015 Asian Pacific Society of Respirology.

Mortality Measurement at Advanced Ages: A Study of the Social Security Administration Death Master File

PubMed Central

Gavrilov, Leonid A.; Gavrilova, Natalia S.

2011-01-01

Accurate estimates of mortality at advanced ages are essential to improving forecasts of mortality and the population size of the oldest old age group. However, estimation of hazard rates at extremely old ages poses serious challenges to researchers: (1) The observed mortality deceleration may be at least partially an artifact of mixing different birth cohorts with different mortality (heterogeneity effect); (2) standard assumptions of hazard rate estimates may be invalid when risk of death is extremely high at old ages and (3) ages of very old people may be exaggerated. One way of obtaining estimates of mortality at extreme ages is to pool together international records of persons surviving to extreme ages with subsequent efforts of strict age validation. This approach helps researchers to resolve the third of the above-mentioned problems but does not resolve the first two problems because of inevitable data heterogeneity when data for people belonging to different birth cohorts and countries are pooled together. In this paper we propose an alternative approach, which gives an opportunity to resolve the first two problems by compiling data for more homogeneous single-year birth cohorts with hazard rates measured at narrow (monthly) age intervals. Possible ways of resolving the third problem of hazard rate estimation are elaborated. This approach is based on data from the Social Security Administration Death Master File (DMF). Some birth cohorts covered by DMF could be studied by the method of extinct generations. Availability of month of birth and month of death information provides a unique opportunity to obtain hazard rate estimates for every month of age. Study of several single-year extinct birth cohorts shows that mortality trajectory at advanced ages follows the Gompertz law up to the ages 102–105 years without a noticeable deceleration. Earlier reports of mortality deceleration (deviation of mortality from the Gompertz law) at ages below 100 appear to be

Randomized controlled study of extracorporeal albumin dialysis for hepatic encephalopathy in advanced cirrhosis.

PubMed

Hassanein, Tarek I; Tofteng, Flemming; Brown, Robert S; McGuire, Brendan; Lynch, Patrick; Mehta, Ravindra; Larsen, Fin S; Gornbein, Jeff; Stange, Jan; Blei, Andres T

2007-12-01

Extracorporeal albumin dialysis (ECAD) may improve severe hepatic encephalopathy (HE) in patients with advanced cirrhosis via the removal of protein or non-protein-bound toxins. A prospective, randomized, controlled, multicenter trial of the efficacy, safety, and tolerability of ECAD using molecular adsorbent recirculating system (MARS) was conducted in such patients. Patients were randomized to ECAD and standard medical therapy (SMT) or SMT alone. ECAD was provided daily for 6 hours for 5 days or until the patient had a 2-grade improvement in HE. HE grades (West Haven criteria) were evaluated every 12 hours using a scoring algorithm. The primary endpoint was the difference in improvement proportion of HE between the 2 groups. A total of 70 subjects [median age, 53; 56% male; 56% HE grade 3; 44% HE grade 4; median model for end-stage liver disease (MELD) 32 (11-50) and CPT 13 (10-15)] were enrolled in 8 tertiary centers. Patients were randomized to ECAD + SMT (n = 39) or SMT alone (n = 31). Groups were matched in demographics and clinical variables. The improvement proportion of HE was higher in ECAD (mean, 34%; median, 30%) versus the SMT group (mean, 18.9%; median, 0%) (P = 0.044) and was reached faster and more frequently than in the SMT group (P = 0.045). Subjects receiving ECAD tolerated treatment well with no unexpected adverse events. The use of ECAD may be associated with an earlier and more frequent improvement of HE (grade 3/4). Because this 5-day study was not designed to examine the impact of MARS on survival, a full assessment of the role of albumin dialysis awaits the results of additional controlled trials.

A Randomized, Double-Blind, Single-Dose, Placebo-Controlled, Multicenter, Polysomnographic Study of Gabapentin in Transient Insomnia Induced by Sleep Phase Advance

PubMed Central

Rosenberg, Russell P.; Hull, Steven G.; Lankford, D. Alan; Mayleben, David W.; Seiden, David J.; Furey, Sandy A.; Jayawardena, Shyamalie; Roth, Thomas

2014-01-01

Study Objectives: To evaluate the effects of single doses of gabapentin 250 and 500 mg on polysomnographic (PSG) and participant-reported sleep measures in a 5-h phase advance insomnia model. Methods: Adults reporting occasional disturbed sleep received gabapentin 500 mg (n = 125), 250 mg (n = 125), or placebo (n = 127) 30 min prior to bedtime and were in bed from 17:00 to 01:00, ∼5 h before their habitual bedtime. Sleep was assessed by PSG, post-sleep questionnaire, and the Karolinska Sleep Diary (KSD). Next-day residual effects (Digit Symbol Substitution Test [DSST] and Stanford Sleepiness Scale [SSS]) and tolerability were assessed. Results: Demographics were comparable among groups. Among PSG endpoints, wake after sleep onset (primary endpoint) (135.7 [placebo], 100.7 [250 mg], and 73.2 [500 mg] min) was significantly lower and total sleep time (TST) (311.4, 356.5, and 378.7 min) significantly greater in both gabapentin groups versus placebo. Latency to persistent sleep was not significantly different among groups. Percent slow wave sleep (12.6%, 15.4%, and 17.0%, respectively) was significantly greater and percent stage 1 (15.1%, 11.8%, and 10.8%, respectively) significantly lower relative to placebo. Gabapentin was associated with significantly higher values of KSD Sleep Quality Index and reported TST versus placebo; no other reported outcomes were significant. Neither gabapentin dose produced evidence of next-day residual effects as measured by DSST and SSS. Adverse events were infrequent (< 5%). Conclusion: Participants with occasional disturbed sleep treated with gabapentin showed significantly longer sleep duration and greater depth (versus placebo) in response to a phase advance manipulation known to disrupt sleep maintenance. Citation: Rosenberg RP, Hull SG, Lankford DA, Mayleben DW, Seiden DJ, Furey SA, Jayawardena S, Roth T. A randomized, double-blind, single-dose, placebo-controlled, multicenter, polysomnographic study of gabapentin in transient

Group-based variant calling leveraging next-generation supercomputing for large-scale whole-genome sequencing studies.

PubMed

Standish, Kristopher A; Carland, Tristan M; Lockwood, Glenn K; Pfeiffer, Wayne; Tatineni, Mahidhar; Huang, C Chris; Lamberth, Sarah; Cherkas, Yauheniya; Brodmerkel, Carrie; Jaeger, Ed; Smith, Lance; Rajagopal, Gunaretnam; Curran, Mark E; Schork, Nicholas J

2015-09-22

Next-generation sequencing (NGS) technologies have become much more efficient, allowing whole human genomes to be sequenced faster and cheaper than ever before. However, processing the raw sequence reads associated with NGS technologies requires care and sophistication in order to draw compelling inferences about phenotypic consequences of variation in human genomes. It has been shown that different approaches to variant calling from NGS data can lead to different conclusions. Ensuring appropriate accuracy and quality in variant calling can come at a computational cost. We describe our experience implementing and evaluating a group-based approach to calling variants on large numbers of whole human genomes. We explore the influence of many factors that may impact the accuracy and efficiency of group-based variant calling, including group size, the biogeographical backgrounds of the individuals who have been sequenced, and the computing environment used. We make efficient use of the Gordon supercomputer cluster at the San Diego Supercomputer Center by incorporating job-packing and parallelization considerations into our workflow while calling variants on 437 whole human genomes generated as part of large association study. We ultimately find that our workflow resulted in high-quality variant calls in a computationally efficient manner. We argue that studies like ours should motivate further investigations combining hardware-oriented advances in computing systems with algorithmic developments to tackle emerging 'big data' problems in biomedical research brought on by the expansion of NGS technologies.

[Advances in plant ecophysiological studies on re-vegetation of degraded ecosystem].

PubMed

Zhao, Ping

2003-11-01

Natural force and human intervention lead to many local, regional, and sometimes global changes in plant community patterns. Regardless of the cause and intensity of these changes, ecosystem can recover most of their attributes through natural succession, or can be repaired by human assistance. The essentiality of restoration of degraded ecosystem is community succession, a process during which an ecosystem evolves from primary stage to advanced stage, and its structure and function change from simple to complex plant. Ecophysiological study could explain some macroscopical phenomena of the ecology of re-vegetation of degraded ecosystem, and provide a scientific base for assembling pioneering plant community. The advances in plant ecophysiological study on re-vegetation of degraded ecosystems were reviewed in this paper.

Middle-Aged Independent-Living African Americans' Selections for Advance Directives: A Case Study

ERIC Educational Resources Information Center

McDaniel, Brenda J.

2013-01-01

The purpose of this collective embedded qualitative case study was to examine the perspectives of three middle-aged independent-living African Americans who had participated in the process of advance care planning (ACP) and completed at least two advance directives (ADs), a Durable Power of Attorney for Health Care (DPAHC) and a Living Will (LW).…

Assessing the feasibility, acceptability and potential effectiveness of Dignity Therapy for people with advanced cancer referred to a hospital-based palliative care team: Study protocol

PubMed Central

Hall, Sue; Edmonds, Polly; Harding, Richard; Chochinov, Harvey; Higginson, Irene J

2009-01-01

Background Loss of dignity for people with advanced cancer is associated with high levels of psychological and spiritual distress and the loss of the will to live. Dignity Therapy is a brief psychotherapy, which has been developed to help promote dignity and reduce distress. It comprises a recorded interview, which is transcribed, edited then returned to the patient, who can bequeath it to people of their choosing. Piloting in Canada, Australia and the USA, has suggested that Dignity Therapy is beneficial to people with advanced cancer and their families. The aims of this study are to assess the feasibility, acceptability and potential effectiveness of Dignity Therapy to reduce psychological and spiritual distress in people with advanced cancer who have been referred to hospital-based palliative care teams in the UK, and to pilot the methods for a Phase III RCT. Design A randomised controlled open-label trial. Forty patients with advanced cancer are randomly allocated to one of two groups: (i) Intervention (Dignity Therapy offered in addition to any standard care), and (ii) Control group (standard care). Recipients of the 'generativity' documents are asked their views on taking part in the study and the therapy. Both quantitative and qualitative outcomes are assessed in face-to-face interviews at baseline and at approximately one and four weeks after the intervention (equivalent in the control group). The primary outcome is patients' sense of dignity (potential effectiveness) assessed by the Patient Dignity Inventory. Secondary outcomes for patients include distress, hopefulness and quality of life. In view of the relatively small sample size, quantitative analyses are mainly descriptive. The qualitative analysis uses the Framework method. Discussion Dignity Therapy is brief, can be delivered at the bedside and may help both patients and their families. This detailed exploratory research shows if it is feasible to offer Dignity Therapy to patients with advanced

IGFBP-1 and IGF-I as markers for advanced fibrosis in NAFLD - a pilot study.

PubMed

Hagström, Hannes; Stål, Per; Hultcrantz, Rolf; Brismar, Kerstin; Ansurudeen, Ishrath

2017-12-01

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease globally. Advanced fibrosis (stage 3-4) is the most robust marker for future mortality, but diagnosis requires liver biopsy. Current non-invasive scoring systems aimed to identify advanced fibrosis are imperfect. Insulin-like growth factor I (IGF-I) and its binding protein IGFBP-1 are liver derived proteins, that are involved in various liver disorders. The aim of this study was to examine the possible association between advanced fibrosis and IGF-I and IGFBP-1 in NAFLD. Fasting blood samples were obtained from 52 patients diagnosed with NAFLD by liver biopsy. Total IGF-I and IGFBP-1 concentrations were determined in serum by in-house radio-immuno-assays. IGF-I levels were age-standardized (IGF-SD). A logistic regression model was used to investigate the association of IGF-SD and IGFBP-1 with advanced fibrosis (stage 3-4). Patients with advanced fibrosis (stage 3-4 vs. 0-2) had lower IGF-SD (-1.17 vs. 0.11, p = .01) and higher mean levels of IGFBP-1 (29.9 vs. 18.8 µg/l, p = .02). IGFBP-1 was associated with presence of advanced fibrosis (OR 1.04 per unit increase, 95%CI 1.0-1.07, p = .05), while IGF-1 was negatively associated with advanced fibrosis (OR 0.63 per standard deviation, 95%CI 0.44-0.92, p = .02). This pilot study suggests an association between serum IGFBP-1 and IGF-I levels with advanced fibrosis in NAFLD patients. IGFBP1 and IGF-1 could be of interest as future biomarkers. Similar studies in larger cohorts are needed.

Social Norms about a Health Issue in Work Group Networks

PubMed Central

Frank, Lauren B.

2015-01-01

The purpose of this study is to advance theorizing about how small groups understand health issues through the use of social network analysis. To achieve this goal, an adapted cognitive social structure examines group social norms around a specific health issue, H1N1 flu prevention. As predicted, individual’s attitudes, self-efficacy, and perceived social norms were each positively associated with behavioral intentions for at least one of the H1N1 health behaviors studied. Moreover, collective norms of the whole group were also associated with behavioral intentions, even after controlling for how individual group members perceive those norms. For members of work groups in which pairs were perceived to agree in their support for H1N1 vaccination, the effect of individually perceived group norms on behavioral intentions was stronger than for groups with less agreement. PMID:26389934

Control definition study for advanced vehicles

NASA Technical Reports Server (NTRS)

Lapins, M.; Martorella, R. P.; Klein, R. W.; Meyer, R. C.; Sturm, M. J.

1983-01-01

The low speed, high angle of attack flight mechanics of an advanced, canard-configured, supersonic tactical aircraft designed with moderate longitudinal relaxed static stability (Static Margin, SM = 16% C sub W at M = 0.4) was investigated. Control laws were developed for the longitudinal axis (""G'' or maneuver and angle of attack command systems) and for the lateral/directional axes. The performance of these control laws was examined in engineering simulation. A canard deflection/rate requirement study was performed as part of the ""G'' command law evaluation at low angles of attack. Simulated coupled maneuvers revealed the need for command limiters in all three aircraft axes to prevent departure from controlled flight. When modified with command/maneuver limiters, the control laws were shown to be adequate to prevent aircraft departure during aggressive air combat maneuvering.

Proceedings of the 2009 annual meeting of the Fetal Alcohol Spectrum Disorders Study Group

PubMed Central

Zhou, Feng C.; Kane, Cynthia J.M.; Smith, Susan M.

2013-01-01

The annual meeting of the Fetal Alcohol Spectrum Disorders Study Group (FASDSG) was held on June 20, 2009 in San Diego, CA, as a satellite of the Research Society on Alcoholism Meeting. The FASDSG membership includes clinical, basic, and social scientists who meet to discuss recent advances and issues in Fetal Alcohol Spectrum Disorders research. The main theme of the meeting was “Epigenetics and Development.” Two keynote speakers, Dr. Randy Jirtle and Dr. Michael Skinner, addressed the role of epigenetics and environmental inputs, including alcohol, during critical stages of development and their potential critical and long-lasting effects. Members of the FASDSG provided new findings through brief “FASt” data reports, and national agency representatives provided updates on activities and funding priorities. Scientific presentations were made by recipients of the Student Research Merit Award and Rosett Award. PMID:21621368

Advanced composites wing study program, volume 2

NASA Technical Reports Server (NTRS)

Harvey, S. T.; Michaelson, G. L.

1978-01-01

The study on utilization of advanced composites in commercial aircraft wing structures was conducted as a part of the NASA Aircraft Energy Efficiency Program to establish, by the mid-1980s, the technology for the design of a subsonic commercial transport aircraft leading to a 40% fuel savings. The study objective was to develop a plan to define the effort needed to support a production commitment for the extensive use of composite materials in wings of new generation aircraft that will enter service in the 1985-1990 time period. Identification and analysis of what was needed to meet the above plan requirements resulted in a program plan consisting of three key development areas: (1) technology development; (2) production capability development; and (3) integration and validation by designing, building, and testing major development hardware.

[Rehabilitation in undergraduate education and advanced professional training of the participating professional groups].

PubMed

Mau, Wilfried; Bengel, Jürgen; Pfeifer, Klaus

2017-04-01

In the German health care system, multiprofessional and coordinated rehabilitation care provides support for successful disease management. Against a background of the conditions and strong dynamics of the provision, this article gives an overview of some of the pertinent developments in rehabilitation-related undergraduate education and advanced professional training of physicians, psychologists, and exercise therapy professions in Germany. Frequently, there are few provisions and great variation between different locations. New conditions, such as the National Competence-Based Learning Objectives for Undergraduate Medical Education, the National Guidelines for Graduate Medical Education, and the ongoing reform of the psychotherapists' law emphasizing training in psychotherapy at university, allow the expectation of a positive effect on the competence of rehabilitation professionals. Education in physiotherapy is developing according to international standards aimed at improved evidence-based care. For the widely evidence-based undergraduate education and advanced professional training in sports and exercise therapy better profiling and professionalization should be sought.

Advancing implementation science through measure development and evaluation: a study protocol.

PubMed

Lewis, Cara C; Weiner, Bryan J; Stanick, Cameo; Fischer, Sarah M

2015-07-22

Significant gaps related to measurement issues are among the most critical barriers to advancing implementation science. Three issues motivated the study aims: (a) the lack of stakeholder involvement in defining pragmatic measure qualities; (b) the dearth of measures, particularly for implementation outcomes; and (c) unknown psychometric and pragmatic strength of existing measures. Aim 1: Establish a stakeholder-driven operationalization of pragmatic measures and develop reliable, valid rating criteria for assessing the construct. Aim 2: Develop reliable, valid, and pragmatic measures of three critical implementation outcomes, acceptability, appropriateness, and feasibility. Aim 3: Identify Consolidated Framework for Implementation Research and Implementation Outcome Framework-linked measures that demonstrate both psychometric and pragmatic strength. For Aim 1, we will conduct (a) interviews with stakeholder panelists (N = 7) and complete a literature review to populate pragmatic measure construct criteria, (b) Q-sort activities (N = 20) to clarify the internal structure of the definition, (c) Delphi activities (N = 20) to achieve consensus on the dimension priorities, (d) test-retest and inter-rater reliability assessments of the emergent rating system, and (e) known-groups validity testing of the top three prioritized pragmatic criteria. For Aim 2, our systematic development process involves domain delineation, item generation, substantive validity assessment, structural validity assessment, reliability assessment, and predictive validity assessment. We will also assess discriminant validity, known-groups validity, structural invariance, sensitivity to change, and other pragmatic features. For Aim 3, we will refine our established evidence-based assessment (EBA) criteria, extract the relevant data from the literature, rate each measure using the EBA criteria, and summarize the data. The study outputs of each aim are expected to have a positive impact

Neutron and X-Ray Diffraction Studies of Advanced Materials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barabash, Rozaliya; Tiley, Jaimie; Wang, Yandong

2010-01-01

The selection of articles in the special topic 'Neutron and X-Ray Studies of Advanced Materials' is based on the materials presented during the TMS 2009 annual meeting in San Francisco, CA, February 15-19, 2009. The development of ultrabrilliant third-generation synchrotron X-ray sources, together with advances in X-ray optics, has created intense X-ray microbeams, which provide the best opportunities for in-depth understanding of mechanical behavior in a broad spectrum of materials. Important applications include ultrasensitive elemental detection by X-ray fluorescence/absorption and microdiffraction to identify phase and strain with submicrometer spatial resolution. X-ray microdiffraction is a particularly exciting application compared with alternativemore » probes of crystalline structure, orientation, and strain. X-ray microdiffraction is nondestructive with good strain resolution, competitive or superior spatial resolution in thick samples, and with the ability to probe below the sample surface. Moreover, the high-energy X-ray diffraction technique provides an effective tool for characterizing the mechanical and functional behavior in various environments (temperature, stress, and magnetic field). At the same time, some neutron diffraction instruments constructed mainly for the purpose of engineering applications can be found at nearly all neutron facilities. The first generation-dedicated instruments designed for studying in-situ mechanical behavior have been commissioned and used, and industrial standards for reliable and repeatable measurements have been developed. Furthermore, higher penetration of neutron beams into most engineering materials provides direct measurements on the distribution of various stresses (i.e., types I, II, and III) beneath the surface up to several millimeters, even tens of millimeters for important industrial components. With X-ray and neutron measurements, it is possible to characterize material behavior at different length

Effects of advanced aging on the neural correlates of successful recognition memory

PubMed Central

Wang, Tracy H.; Kruggel, Frithjof; Rugg, Michael D.

2009-01-01

Functional neuroimaging studies have reported that the neural correlates of retrieval success (old>new effects) are larger and more widespread in older than in young adults. In the present study we investigated whether this pattern of age-related ‘over-recruitment’ continues into advanced age. Using functional magnetic resonance imaging (fMRI), retrieval-related activity from two groups (N = 18 per group) of older adults aged 84–96 yrs (‘old-old’) and 64–77 yrs (‘young-old’) was contrasted. Subjects studied a series of pictures, half of which were presented once, and half twice. At test, subjects indicated whether each presented picture was old or new. Recognition performance of the old-old subjects for twice-studied items was equivalent to that of the young-old subjects for once-studied items. Old>new effects common to the two groups were identified in several cortical regions, including medial and lateral parietal and prefrontal cortex. There were no regions where these effects were of greater magnitude in the old-old group, and thus no evidence of over-recruitment in this group relative to the young-old individuals. In one region of medial parietal cortex, effects were greater (and only significant) in the young-old group. The failure to find evidence of over-recruitment in the old-old subjects relative to the young-old group, despite their markedly poorer cognitive performance, suggests that age-related over-recruitment effects plateau in advanced age. The findings for the medial parietal cortex underscore the sensitivity of this cortical region to increasing age. PMID:19428399

A multimedia intervention on cardiopulmonary resuscitation and advance directives.

PubMed

Yamada, R; Galecki, A T; Goold, S D; Hogikyan, R V

1999-09-01

To assess the effects of a multimedia educational intervention about advance directives (ADs) and cardiopulmonary resuscitation (CPR) on the knowledge, attitude and activity toward ADs and life-sustaining treatments of elderly veterans. Prospective randomized controlled, single blind study of educational interventions. General medicine clinic of a university-affiliated Veterans Affairs Medical Center (VAMC). One hundred seventeen Veterans, 70 years of age or older, deemed able to make medical care decisions. The control group (n = 55) received a handout about ADs in use at the VAMC. The experimental group (n = 62) received the same handout, with an additional handout describing procedural aspects and outcomes of CPR, and they watched a videotape about ADs. Patients' attitudes and actions toward ADs, CPR and life-sustaining treatments were recorded before the intervention, after it, and 2 to 4 weeks after the intervention through self-administered questionnaires. Only 27.8% of subjects stated that they knew what an AD is in the preintervention questionnaire. This proportion improved in both the experimental and control (87.2% experimental, 52.5% control) subject groups, but stated knowledge of what an AD is was higher in the experimental group (odds ratio = 6.18, p <.001) and this effect, although diminished, persisted in the follow-up questionnaire (OR = 3.92, p =. 003). Prior to any intervention, 15% of subjects correctly estimated the likelihood of survival after CPR. This improved after the intervention in the experimental group (OR = 4.27, p =.004), but did not persist at follow-up. In the postintervention questionnaire, few subjects in either group stated that they discussed CPR or ADs with their physician on that day (OR = 0.97, p = NS). We developed a convenient means of educating elderly male patients regarding CPR and advance directives that improved short-term knowledge but did not stimulate advance care planning.

Initial Efficacy Testing of an Autobiographical Memory Intervention on Advance Care Planning for Patients With Terminal Cancer.

PubMed

Brohard, Cheryl

2017-11-01

To test the efficacy of a novel intervention to facilitate advance care planning.
. Exploratory, quasiexperimental pilot study with two independent groups.
. A large hospice located in the southwestern United States. 
. A convenience sample of 50 participants with terminal cancer enrolled in hospice.
. An autobiographical memory (ABM) intervention used the participants' experiences with cancer and end of life for the purpose of directing advance care planning.
. Two domains of advance care planning, decision making and communication, were measured in relation to 11 variables. The ABM intervention was nonthreatening, short in duration, and easily completed with participants as they recalled, without hesitation, specific personal memories of family and friends who had died and their advance care plans. The Mann-Whitney nonparametric test revealed that participants in the experimental group had a higher average rank than those in the control group for communicating the decision about antibiotics, as well as exhibited a trend toward significance for five other advance care planning variables.
. Findings showed that directive ABMs may be effective in influencing the decision making and communication of advance care planning for terminally ill patients with cancer.
. The current level of understanding about using the ABM intervention suggests that nurses can initiate an advance care planning conversation using this approach.

A Psychodynamic Approach on Group Career Counseling: A Brazilian Experience of 40 Years

ERIC Educational Resources Information Center

Lehman, Yvette Piha; Ribeiro, Marcelo Afonso; da Conceição Coropos Uvaldo, Maria; da Silva, Fabiano Fonseca

2015-01-01

Career guidance and career counselling have traditionally been conducted in an individualized fashion focusing on the counsellor-client relationship. Specialized literature, however, points to the potential use of group strategies. This article seeks to contribute to the advancement of studies in group career counselling practices, by introducing…

47 CFR 51.232 - Binder group management.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 3 2012-10-01 2012-10-01 false Binder group management. 51.232 Section 51.232... Obligations of All Local Exchange Carriers § 51.232 Binder group management. (a) With the exception of loops..., segregating or reserving particular loops or binder groups for use solely by any particular advanced services...

47 CFR 51.232 - Binder group management.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 3 2013-10-01 2013-10-01 false Binder group management. 51.232 Section 51.232... Obligations of All Local Exchange Carriers § 51.232 Binder group management. (a) With the exception of loops..., segregating or reserving particular loops or binder groups for use solely by any particular advanced services...

47 CFR 51.232 - Binder group management.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Binder group management. 51.232 Section 51.232... Obligations of All Local Exchange Carriers § 51.232 Binder group management. (a) With the exception of loops..., segregating or reserving particular loops or binder groups for use solely by any particular advanced services...

Center For Advanced Energy Studies Overview

ScienceCinema

Blackman, Harold; Curnutt, Byron; Harker, Caitlin; Hamilton, Melinda; Butt, Darryl; Imel, George; Tokuhiro, Akira; Harris, Jason; Hill, David

2017-12-09

A collaboration between Idaho National Laboratory, Boise State University, Idaho State University and the University of Idaho. Conducts research in nuclear energy, advanced materials, carbon management, bioenergy, energy policy, modeling and simulation, and energy efficiency. Educates next generation of energy workforce.

Technology and Group Leadership Training: Teaching Group Counseling in an Online Environment

ERIC Educational Resources Information Center

Krieger, Kenin M.; Stockton, Rex

2004-01-01

As online learning and pedagogy advances, more collegiate-level courses are being held in online environments. This article includes an illustration of such a course for school counselors, administrators, and mental health counselors who currently design and conduct counseling groups for school-aged children as well as suggestions for…

Measuring the quality of end of life management in patients with advanced kidney disease: results from the pan-Thames renal audit group.

PubMed

McAdoo, Stephen P; Brown, Edwina A; Chesser, Alistair M; Farrington, Ken; Salisbury, Emma M

2012-04-01

Despite a recent increased awareness of the need for quality End of Life (EOL) care for patients with advanced kidney disease, there is no established method for measuring or auditing outcomes relating to EOL care in this population. We designed a one-page proforma, which was used to collect data on various aspects of EOL care relating to all deaths of patients on dialysis and patients dying on specialist renal wards, over a predefined 8-week period in 10 hospitals in London and South-East England. One hundred and thirty-eight deaths were recorded over the 8-week study period. The majority of patients (83%) were receiving maintenance haemodialysis prior to their terminal presentation. About 69% of deaths occurred during an in-patient hospital admission-of these, 36% were considered 'unexpected' and most quality markers of good EOL management were significantly less likely to be achieved in these patients, including use of palliative care strategies, good symptom control and overall quality of death. Thirty-six per cent of patients were from various ethnic minorities, and in this group, there was a trend towards lower use of palliative care pathways and lower rates of withdrawal from dialysis. This study confirms that it is possible to measure many important outcomes relating to quality of EOL care using a proforma completed at the time of death. Our findings suggest that many aspects of good EOL care are under-achieved in our region. This, in part, is due to a failure to recognize the worsening trajectory of the deteriorating patient, resulting in missed opportunities for EOL care planning and appropriate symptom control. Our observations suggest that there is a need for improved education and training in this area, particularly in detection of the dying patient, the value of advance care planning and the utility of tools such as the Liverpool Care Pathway.

Forest fire advanced system technology (FFAST) conceptual design study

NASA Technical Reports Server (NTRS)

Nichols, J. David; Warren, John R.

1987-01-01

The National Aeronautics and Space Administration's Jet Propulsion Laboratory (JPL) and the U.S. Department of Agriculture (USDA) Forest Service completed a conceptual design study that defined an integrated forest fire detection and mapping system that will be based upon technology available in the 1990s. Potential system configuration options in emerging and advanced technologies related to the conceptual design were identified and recommended for inclusion as preferred system components. System component technologies identified for an end-to-end system include airborne mounted, thermal infrared (IR) linear array detectors, automatic onboard georeferencing and signal processing, geosynchronous satellite communications links, and advanced data integration and display. Potential system configuration options were developed and examined for possible inclusion in the preferred system configuration. The preferred system configuration will provide increased performance and be cost effective over the system currently in use. Forest fire management user requirements and the system component emerging technologies were the basis for the system configuration design. The conceptual design study defined the preferred system configuration that warrants continued refinement and development, examined economic aspects of the current and preferred system, and provided preliminary cost estimates for follow-on system prototype development.

Early Puberty, Friendship Group Characteristics, and Dating Abuse in US Girls.

PubMed

Chen, Frances R; Rothman, Emily F; Jaffee, Sara R

2017-06-01

The current study aimed to investigate the relationship between advanced pubertal development and adolescent dating abuse (ADA) and to test if this relationship is moderated by friendship group characteristics in a nationally representative sample of US girls. Data were drawn from wave 1 and 2 (1995-1996) of the National Longitudinal Study of Adolescent to Adult Health. The sample included 3870 girls aged 13 to 17 years, all of whom were in romantic and/or nonromantic sexual relationships. Relative pubertal development was measured as perceived physical development as compared with peers of the same age and race and age at menarche at wave 1. Participants reported at wave 2 whether they had experienced any verbal or physical abuse in their relationships. Friendship group characteristics included the percentage of boy friends, older friends, and friends' risk behavior level. Negative binomial regression analyses revealed an interaction between advanced pubertal development and percentage of boy friends on ADA victimization, adjusted for age, race, parents' marital status, household income, number of relationships, self-esteem, self-control, and antisocial behavior history. Advanced pubertal development was associated with more ADA victimization when girls' friendship groups comprised a higher percentage of boys. Findings highlight the importance of pubertal timing and friendship group characteristics to ADA victimization. Early pubertal development is a risk marker for ADA victimization, particularly when a higher percentage of girls' friends are boys. Pediatricians and adolescent health specialists should be sensitive to the elevated risk for ADA victimization in early-maturing girls. Copyright © 2017 by the American Academy of Pediatrics.

Cost-effectiveness of subthalmic nucleus deep brain stimulation for the treatment of advanced Parkinson disease in Hong Kong: a prospective study.

PubMed

Zhu, X L; Chan, Danny T M; Lau, Claire K Y; Poon, Wai S; Mok, Vincent C T; Chan, Anne Y Y; Wong, Lawrence K S; Yeung, Jonas H M; Leung, Michael C M; Tang, Venus Y H; Wong, Rosanna K M; Yeung, Carol

2014-12-01

Deep brain stimulation (DBS) is an effective but costly treatment for patients with advanced Parkinson disease (PD). This study examined the cost-effectiveness of DBS in relation to its improved effectiveness to help funding decision makers decide whether the treatment should be adopted. The incremental cost-effective ratio (ICER) per quality-adjusted life year has been benchmarked as being between US$50,000 and US$100,000 by US agencies, whereas it is less than €30,000 per quality-adjusted life year in Europe. To provide cost-effectiveness information of subthalamic nucleus DBS for patients with advanced PD. Direct medical expenses during the year before the DBS treatment were used to measure the baseline cost. Cost-effectiveness was measured by the ICER for the Unified Parkinson's Disease Rating Scale Part III and the ICER for the EuroQol Group's Health-Related Quality of Life measurement. Thirteen patients with advanced PD were recruited between January 2009 and January 2011. A 1-point improvement in the Unified Parkinson's Disease Rating Scale Part III score was associated with an ICER of US$926 in the first year and US$421 in the second year. A 1-point improvement on the EuroQol Group's Health-Related Quality of Life measurement was associated with an ICER of US$123,110 in the first year and US$62,846 in the second year. Cost-effectiveness of subthalamic nucleus DBS for treatment of advanced PD is greater during a 2-year period than 1 year only. These results can be used as a reference for the use of DBS for PD in a region with public health financing. Copyright © 2014 Elsevier Inc. All rights reserved.

Advancing Career Counseling and Employment Support for Survivors: An Intervention Evaluation

ERIC Educational Resources Information Center

Davidson, M. Meghan; Nitzel, Camie; Duke, Alysondra; Baker, Cynthia M.; Bovaird, James A.

2012-01-01

The purpose of this research was to conduct a replication-based and extension study examining the effectiveness of a 5-week career group counseling intervention, Advancing Career Counseling and Employment Support for Survivors (ACCESS; Chronister, 2008). The present study was conducted in a markedly different geographic region within a larger…

Advanced flight control system study

NASA Technical Reports Server (NTRS)

Mcgough, J.; Moses, K.; Klafin, J. F.

1982-01-01

The architecture, requirements, and system elements of an ultrareliable, advanced flight control system are described. The basic criteria are functional reliability of 10 to the minus 10 power/hour of flight and only 6 month scheduled maintenance. A distributed system architecture is described, including a multiplexed communication system, reliable bus controller, the use of skewed sensor arrays, and actuator interfaces. Test bed and flight evaluation program are proposed.

Effect of a life review program for Chinese patients with advanced cancer: a randomized controlled trial.

PubMed

Xiao, Huimin; Kwong, Enid; Pang, Samantha; Mok, Esther

2013-01-01

Empirical data suggest that life review is an effective psychospiritual intervention. However, it has not been applied to Chinese patients with advanced cancer, and its effects on this population remain unknown. The aim of the study was to determine the effect of a life review program on quality of life among Chinese patients with advanced cancer. In this prospective randomized controlled trial, a total of 80 patients were randomly assigned to the life review program group and the control group. The 3-weekly life review program included reviewing a life and formulating a life review booklet. Outcome data were assessed by a collector who was blinded to group assignment before and immediately after the program and at a 3-week follow-up. Significantly better scores in overall quality of life, support, negative emotions, sense of alienation, existential distress, and value of life were found in the life review group immediately after the program and at the 3-week follow-up. This study provides additional data on the potential role of a life review in improving quality of life, particularly psychospiritual well being; it also indicates that the life review program could enable Chinese patients with advanced cancer to express their views on life and death. The life review program offers advanced cancer patients an opportunity to integrate their whole life experiences and discuss end-of-life issues, which lays the ground for further active intervention in their psychospiritual distress. The program could be integrated into daily home care to enhance the psychospiritual well-being of Chinese patients with advanced cancer.

[A Critical Condition of Clinical Studies in Japan -- A Battle of Clinical Study Groups].

PubMed

Furukawa, Hiroshi

2016-04-01

The post-marketing clinical study groups have been losing their activity due to stop of financial support. As the result, clinical study groups cannot achieve any EBM for treatment guidelines. Financial supports should be restarted immediately not to extinguish the post-marketing clinical studies and study groups.

Validation of oppressed group behaviors in nursing.

PubMed

Matheson, Linda Kay; Bobay, Kathleen

2007-01-01

The possibility that nurses exhibit oppressed group behaviors was first broached by Roberts [Roberts, S. J. (1983). Oppressed group behavior: Implications for nursing. Advances in Nursing Science, 21-30] when Freire's model [Freire, P. (1970). Pedagogy of the oppressed. New York: Herder and Herder] was applied to nursing. Since then, scholarly discussion has focused on aspects of oppression in nursing, but little research toward validation of Freire's model has occurred. An extensive literature search in CINAHL was completed seeking exploration and validation of the oppressed group behavior model and its dimensions. The Educational Testing Services, PsychInfo, Health and Psychosocial Instruments, and Sociological Abstracts databases were searched for measurement tools created within the last 10 years. This literature review identified that a model of oppressed group behavior has not been developed and validated, and that oppressed group behaviors have been studied independent of each other; however, oppressed group behaviors may have implications for the current nursing shortage.

The Advanced Gamma-ray Imaging System (AGIS): Simulation Studies

NASA Astrophysics Data System (ADS)

Fegan, Stephen; Buckley, J. H.; Bugaev, S.; Funk, S.; Konopelko, A.; Maier, G.; Vassiliev, V. V.; Simulation Studies Working Group; AGIS Collaboration

2008-03-01

The Advanced Gamma-ray Imaging System (AGIS) is a concept for the next generation instrument in ground-based very high energy gamma-ray astronomy. It has the goal of achieving significant improvement in sensitivity over current experiments. We present the results of simulation studies of various possible designs for AGIS. The primary characteristics of the array performance, collecting area, angular resolution, background rejection, and sensitivity are discussed.

Study Abroad: The Reality of Building Dynamic Group Learning.

ERIC Educational Resources Information Center

Ransbury, Molly K.; Harris, Sandra A.

1994-01-01

The collaborative effort of a professor of human development with expertise in group process and a general education professor with expertise in Greek mythology and culture uses a case study format to apply theoretical models of group dynamics to the travel and learning experience of study abroad. Implications for course design and group process…

ABO blood groups and psychiatric disorders: a Croatian study.

PubMed

Pisk, Sandra Vuk; Vuk, Tomislav; Ivezić, Ena; Jukić, Irena; Bingulac-Popović, Jasna; Filipčić, Igor

2018-02-15

The prevalence of ABO alleles is different in different populations, and many studies have shown a correlation between the occurrences of some diseases and different genotypes of ABO blood groups. The aim of this study was to determine whether there is a significant association between psychiatric syndromes and ABO blood groups. This case-control study involved 156 psychiatric patients and 303 healthy, unrelated, voluntary blood donors. Genomic DNA was isolated from blood on a QIAcube device using a QIAamp DNA Blood mini QIAcube kit. ABO genotyping on five basic ABO alleles was performed using allele-specific polymerase chain reaction analysis. Compared with healthy subjects, a significantly higher proportion of psychiatric patients had AB blood group (χ 2 =9.359, df=3, p=0.025) and, accordingly, a significantly higher incidence of A1B genotype (χ 2 =8.226, df=3, p=0.042). The odds ratio showed that psychiatric disorders occur almost three times more frequently in carriers of AB group compared to other blood groups. However, no statistically significant difference was found in the distribution of ABO blood groups among patients with different psychiatric diagnoses. Likewise, no correlations were found between ABO blood groups and other characteristics of the psychiatric patients (sex, psychiatric heredity, somatic comorbidity, suicidality). The results of this study support the hypothesis of an association between psychiatric disorders and ABO blood groups. The probability is that psychiatric disorders will occur almost three times more frequently in carriers of AB group compared to other ABO blood groups in the Croatian population.

Significant activity of paclitaxel in advanced transitional-cell carcinoma of the urothelium: a phase II trial of the Eastern Cooperative Oncology Group.

PubMed

Roth, B J; Dreicer, R; Einhorn, L H; Neuberg, D; Johnson, D H; Smith, J L; Hudes, G R; Schultz, S M; Loehrer, P J

1994-11-01

To assess the efficacy and toxicity of single-agent paclitaxel as first-line chemotherapy in patients with locally advanced or metastatic transitional-cell carcinoma of the urothelium. Twenty-six eligible patients were enrolled onto this cooperative group study and treated with paclitaxel at a dosage of 250 mg/m2 by 24-hour continuous infusion every 21 days until progression or patient intolerance. All patients received recombinant human granulocyte colony-stimulating factor (rhG-CSF) at 5 micrograms/kg/d for at least 10 days during each cycle. Eleven of 26 patients (42%; 95% confidence interval [CI], 23% to 63%) demonstrated an objective response, with seven achieving a complete clinical response (CR) (27%; 95% CI, 12% to 48%) and four (15%) a partial response (PR). The median duration of response in the 11 responders is 7+ months (range, 4 to 17), with five responders (four CRs, one PR) remaining progression-free at 5, 6, 10, 12, and 16 months from the start of therapy. The estimated median survival duration for all patients is 8.4 months. Hematologic toxicity consisted of anemia (12% grade 3) and granulocytopenia (4% grade 3, 19% grade 4), with two patients developing granulocytopenic fevers. Nonhematologic toxicity included grade 3 mucositis in 11%, grade 3 neuropathy in 11%, and grade 4 diarrhea in 4%. Single-agent paclitaxel at this dosage and schedule is one of the most active single agents in previously untreated patients with advanced urothelial carcinoma, and is well tolerated by this patient population when given with hematopoetic growth factor support.

Allogeneic stem cell transplantation for advanced cutaneous T-cell lymphomas: a study from the French Society of Bone Marrow Transplantation and French Study Group on Cutaneous Lymphomas

PubMed Central

de Masson, Adèle; Beylot-Barry, Marie; Bouaziz, Jean-David; de Latour, Régis Peffault; Aubin, François; Garciaz, Sylvain; d’Incan, Michel; Dereure, Olivier; Dalle, Stéphane; Dompmartin, Anne; Suarez, Felipe; Battistella, Maxime; Vignon-Pennamen, Marie-Dominique; Rivet, Jacqueline; Adamski, Henri; Brice, Pauline; François, Sylvie; Lissandre, Séverine; Turlure, Pascal; Wierzbicka-Hainaut, Ewa; Brissot, Eolia; Dulery, Rémy; Servais, Sophie; Ravinet, Aurélie; Tabrizi, Reza; Ingen-Housz-Oro, Saskia; Joly, Pascal; Socié, Gérard; Bagot, Martine

2014-01-01

The treatment of advanced stage primary cutaneous T-cell lymphomas remains challenging. In particular, large-cell transformation of mycosis fungoides is associated with a median overall survival of two years for all stages taken together. Little is known regarding allogeneic hematopoietic stem cell transplantation in this context. We performed a multicenter retrospective analysis of 37 cases of advanced stage primary cutaneous T-cell lymphomas treated with allogeneic stem cell transplantation, including 20 (54%) transformed mycosis fungoides. Twenty-four patients (65%) had stage IV disease (for mycosis fungoides and Sézary syndrome) or disseminated nodal or visceral involvement (for non-epidermotropic primary cutaneous T-cell lymphomas). After a median follow up of 29 months, 19 patients experienced a relapse, leading to a 2-year cumulative incidence of relapse of 56% (95%CI: 0.38–0.74). Estimated 2-year overall survival was 57% (95%CI: 0.41–0.77) and progression-free survival 31% (95%CI: 0.19–0.53). Six of 19 patients with a post-transplant relapse achieved a subsequent complete remission after salvage therapy, with a median duration of 41 months. A weak residual tumor burden before transplantation was associated with increased progression-free survival (HR=0.3, 95%CI: 0.1–0.8; P=0.01). The use of antithymocyte globulin significantly reduced progression-free survival (HR=2.9, 95%CI: 1.3–6.2; P=0.01) but also transplant-related mortality (HR=10−7, 95%CI: 4.10−8–2.10−7; P<0.001) in univariate analysis. In multivariate analysis, the use of antithymocyte globulin was the only factor significantly associated with decreased progression-free survival (P=0.04). Allogeneic stem cell transplantation should be considered in advanced stage primary cutaneous T-cell lymphomas, including transformed mycosis fungoides. PMID:24213148

Advance provision of emergency contraception to young men: An exploratory study in a clinic setting.

PubMed

Garbers, Samantha; Bell, D L; Ogaye, K; Marcell, A V; Westhoff, C L; Rosenthal, S L

2018-04-17

To explore the acceptability of advance provision of emergency contraceptive pills (ECPs) to young men seeking health care. For this exploratory study in a clinic setting, we approached young men aged 16-35 to participate in a survey eliciting socio-demographics, sexual and contraceptive history, and knowledge about ECPs. We offered young men advance provision of ECPs and compared characteristics of 126 young men who did and did not accept the ECPs. Most (76%) of the participants accepted advance provision and left with an ECP pack, with even higher proportions among males whose sexual histories were suggestive of increased risk of involvement in an unintended pregnancy. This study holds promise to inform scale up of advance provision of ECPs among young men. Copyright © 2018 Elsevier Inc. All rights reserved.

A Dose Escalation Study in Adult Patients With Advanced Solid Malignancies

ClinicalTrials.gov

2018-06-05

Advanced Solid Tumors With Alterations of FGFR1, 2 and or 3; Squamous Lung Cancer With FGFR1 Amplification; Bladder Cancer With FGFR3 Mutation or Fusion; Advanced Solid Tumors With FGFR1 Amplication; Advanced Solid Tumors With FGFR2 Amplication; Advanced Solid Tumors With FGFR3 Mutation

What about N? A methodological study of sample-size reporting in focus group studies.