WorldWideScience

Sample records for designing post-marketing ecrfs

  1. Design and analysis of post-marketing research.

    Science.gov (United States)

    Zhou, Xiao-Hua Andrew; Yang, Wei

    2013-07-01

    A post-marketing study is an integral part of research that helps to ensure a favorable risk-benefit profile for approved drugs used in the market. Because most of post-marketing studies use observational designs, which are liable to confounding, estimation of the causal effect of a drug versus a comparative one is very challenging. This article focuses on methodological issues of importance in designing and analyzing studies to evaluate the safety of marketed drugs, especially marketed traditional Chinese medicine (TCM) products. Advantages and limitations of the current designs and analytic methods for postmarketing studies are discussed, and recommendations are given for improving the validity of postmarketing studies in TCM products.

  2. MATURING ECRF TECHNOLOGY FOR PLASMA CONTROL

    International Nuclear Information System (INIS)

    CALLIS, R.W.; CARY, W.P.; CHU, S.; LOANE, J.L.; ELLIS, R.A.; FELCH, K.; GORELOV, Y.A.; GRUNLOH, H.J.; HOSEA, J.; KAJIWARA, K.; LOHR, J.; LUCE, T.C.; PEAVY, J.J.; PINSKER, R.I.; PONCE, D.; PRATER, R.; SHAPIRO, M.; TEMKIN, R.J.; TOOKER, J.F.

    2002-01-01

    OAK A271 MUTURING ECRF TECHNOLOGY FOR PLASMA CONTROL. Understanding of the physics of internal transport barriers (ITBs) is being furthered by analysis and comparisons of experimental data from many different tokamaks worldwide. An international database consisting of scalar and 2-D profile data for ITB plasmas is being developed to determine the requirements for the formation and sustainment of ITBs and to perform tests of theory-based transport models in an effort to improve the predictive capability of the models. Analysis using the database indicates that: (a) the power required to form ITBs decreases with increased negative magnetic shear of the target plasma, and: (b) the E x B flow shear rate is close to the linear growth rate of the ITG modes at the time of barrier formation when compared for several fusion devices. Tests of several transport models (JETTO, Weiland model) using the 2-D profile data indicate that there is only limited agreement between the model predictions and the experimental results for the range of plasma conditions examined for the different devices (DIII-D, JET, JT-60U). Gyrokinetic stability analysis (using the GKS code) of the ITB discharges from these devices indicates that the ITG/TEM growth rates decrease with increased negative magnetic shear and that the E x B shear rate is comparable to the linear growth rates at the location of the ITB

  3. Performance of the ITER ECRF launchers

    International Nuclear Information System (INIS)

    Lloyd, Brian; Warrick, Chris; O'Brien, Martin

    2003-01-01

    The Fokker-Planck code BANDIT-3D has been used to explore the heating and current drive capabilities of electron cyclotron waves in ITER. Calculations have been carried out for both the upper launcher and the mid-plane launcher designs. BANDIT-3D is a relativistic and self-consistent ray tracing and Fokker-Planck code incorporating 2D velocity space (generalized speed and pitch angle) and 1D real space effects. Electron radial diffusion, trapping, toroidal dc electric fields and realistic magnetic geometry (e.g. up-down asymmetric single null divertor configuration) can all be included and synergy with other schemes can be studied. It has been found that the effective poloidal steering range for the upper launcher is limited by loss of current localisation at large poloidal angle α (most severe for the upper rows of the launcher) and by electron trapping effects at low α where deposition is at large r/a. Electron trapping eventually leads to a reversal of the driven current at large minor radius due to the Ohkawa effect. The effectiveness of the upper launcher for NTM suppression will strongly depend on the rational surface location and local temperature. The extreme geometry and limited steering range mean that performance will be fairly intolerant to variations in magnetic configuration. Calculations for the mid-plane launcher show that absorption is restricted to r/a < 0.5 for the reference equilibrium employed and current drive efficiencies are comparable to those previously calculated for RTO/RCITER. (authors)

  4. Development of a linear motion antenna for the JT-60SA ECRF system

    International Nuclear Information System (INIS)

    Moriyama, Shinichi; Kobayashi, Takayuki; Isayama, Akihiko; Hoshino, Katsumichi; Suzuki, Sadaaki; Hiranai, Shinichi; Yokokura, Kenji; Sawahata, Masayuki; Terakado, Masayuki; Hinata, Jun; Wada, Kenji; Sato, Yoshikatsu

    2013-01-01

    Highlights: ► Development of an antenna featuring linear motion (LM) concept for long pulse electron cyclotron range of frequency (ECRF) heating and current drive in JT-60SA is in progress. ► A mock-up using a metallic sliding bearing with solid lubricant was fabricated. ► A vacuum pumping test with mass analyzer showed evidence of some hydrocarbons during shaft motion. ► Injection beam profile in toroidal beam scan was checked by low power measurement with mock-up. ► Current drive characteristics with the LM antenna for typical experimental scenarios of JT-60SA have been investigated by calculation. -- Abstract: Development of an antenna that features the linear motion (LM) concept for long-pulse electron-cyclotron range of frequency heating and current drive for the JT-60SA is in progress. Combining a linearly movable first mirror and a fixed curved second mirror allows the injection-beam angle to be controlled. Cooling water is fed through the drive shaft for the first mirror and through the fixed support for the second mirror. The shaft support structure uses a metallic sliding bearing with a solid lubricant. The sliding bearing supports combined linear and rotational motion, whereas a conventional ball bearing supports either linear or rotational motion. Therefore, the sliding bearing offers the advantage of reducing the support-structure volume, which is important in the design of the relatively narrow port duct of the JT-60SA. Recently, the sliding bearing has been installed into the mockup. Results of a vacuum test with a mass analyzer indicate the presence of hydrocarbons during shaft motion. The injection-beam profile obtained from a toroidal beam scan is checked against low-power measurements taken on the mockup. Finally, for typical JT-60SA experimental scenarios, heating- and current-drive characteristics of the LM antenna are investigated theoretically

  5. Case Study: Converting Paper-based Case Report Forms to an Electronic Format (e-CRF) with ACASI Self-Report Integration.

    Science.gov (United States)

    Mierzwa, Stan; Souidi, Samir; Akello, Carolyne; Etima, Juliane; Ssebagala, Richard; Nolan, Monica; Kabwigu, Samuel; Nakablito, Clemensia

    2017-01-01

    This paper will discuss the integration of electronic Case Report Forms (e-CRFs) into an already existing Android-based Audio Computer-Assisted Self-Interview (ACASI) software solution that was developed for a public health project in Kampala, Uganda, the technical outcome results, and lessons learned that may be useful to other projects requiring or considering such a technology solution. The developed product can function without a connection to the Internet and allows for synchronizing collected data once connectivity is possible. Previously, only paper-based CRFs were utilized at the Uganda project site. A subset or select group of CRFs were targeted for integration with ACASI in order to test feasibility and success. Survey volume, error rate, and acceptance of the system, as well as the operational and technical design of the solution, will be discussed.

  6. Type I error probability spending for post-market drug and vaccine safety surveillance with binomial data.

    Science.gov (United States)

    Silva, Ivair R

    2018-01-15

    Type I error probability spending functions are commonly used for designing sequential analysis of binomial data in clinical trials, but it is also quickly emerging for near-continuous sequential analysis of post-market drug and vaccine safety surveillance. It is well known that, for clinical trials, when the null hypothesis is not rejected, it is still important to minimize the sample size. Unlike in post-market drug and vaccine safety surveillance, that is not important. In post-market safety surveillance, specially when the surveillance involves identification of potential signals, the meaningful statistical performance measure to be minimized is the expected sample size when the null hypothesis is rejected. The present paper shows that, instead of the convex Type I error spending shape conventionally used in clinical trials, a concave shape is more indicated for post-market drug and vaccine safety surveillance. This is shown for both, continuous and group sequential analysis. Copyright © 2017 John Wiley & Sons, Ltd.

  7. [Sample size calculation in clinical post-marketing evaluation of traditional Chinese medicine].

    Science.gov (United States)

    Fu, Yingkun; Xie, Yanming

    2011-10-01

    In recent years, as the Chinese government and people pay more attention on the post-marketing research of Chinese Medicine, part of traditional Chinese medicine breed has or is about to begin after the listing of post-marketing evaluation study. In the post-marketing evaluation design, sample size calculation plays a decisive role. It not only ensures the accuracy and reliability of post-marketing evaluation. but also assures that the intended trials will have a desired power for correctly detecting a clinically meaningful difference of different medicine under study if such a difference truly exists. Up to now, there is no systemic method of sample size calculation in view of the traditional Chinese medicine. In this paper, according to the basic method of sample size calculation and the characteristic of the traditional Chinese medicine clinical evaluation, the sample size calculation methods of the Chinese medicine efficacy and safety are discussed respectively. We hope the paper would be beneficial to medical researchers, and pharmaceutical scientists who are engaged in the areas of Chinese medicine research.

  8. Support for ITER ECRF design. Substask 3. Design and optimzation of the window unit. Final Report

    International Nuclear Information System (INIS)

    Thumm, M.; Braz, O.; Iatrou, C.T.; Heidinger, S.; Henry, S.; Makowski, M.; Spoerl, R.; Szczesny, J.

    1999-02-01

    The proposed ITER ECH window unit employs a single, edge-cooled (water, e.g. 20 C) CVD-diamond disk in a corrugated HE 11 waveguide with 52 mm inner diameter, with an outer disk diameter of 77 mm and a thickness of 1.482 mm (4 λ/2). Thermal computations show that for larger outer disk diameters the peak temperature is unaffected. Thus due to the high thermal conductivity of the diamond, the exposed window edge area does not have to be large to obtain significant heat transfer. This implies that the window diameter can be minimized which has the added benefit of reducing the cost. For a power of 1 MW at 170 GHz, a loss tangent of 1.10 -5 , a thermal conductivity of 1800 W/mK (at room temperature) and a heat transfer coefficient of 12 kW/m 2 K (water flow: 13.5 1/min, water velocity: 2 m/s, room temperature) to the cooling water the central window temperature will not be higher than approx. 45 C and the edge temperature is about 30 C. The absorbed power is 176 W. Simulations also show that steady state conditions are generally achieved in under 3 s and that a 2 MW window should be feasible. Owing to the negligible temperature dependence of the CVD-diamond loss tangent, also the approximately 100 C hot torus cooling water could be used to cool the window. Simulations of an ''encased'' window, a window in which the edge of the disk has been covered with a 0.4 mm thick layer of electrodeposited copper (tritium barrier in case of broken window disk), show that this is feasible without a significant decrease in heat transfer rate. Neutron irradiation tests were extended to fluences of 10 21 n/m 2 (E > 0.1 MeV)

  9. The CXC chemokine receptor encoded by herpesvirus saimiri, ECRF3, shows ligand-regulated signaling through Gi, Gq, and G12/13 proteins but constitutive signaling only through Gi and G12/13 proteins

    DEFF Research Database (Denmark)

    Rosenkilde, Mette M; McLean, Katherine A; Holst, Peter J

    2004-01-01

    Open reading frame 74 (ORF74) of many gamma(2)-herpesviruses encodes a CXC chemokine receptor. The molecular pharmacological profile of ORF74 from herpesvirus saimiri, ECRF3, is characterized here and compared with that of the well known ORF74 from human herpesvirus 8 (HHV8). The ECRF3 receptor...... ligand selectivity of ECRF3 among ORF74 receptors could reflect differences in the cellular tropism of the gamma(2)-herpesviruses....

  10. How to establish precise proprietary Chinese medicine in post-marketing reappraisal?

    Directory of Open Access Journals (Sweden)

    Ran Tian

    2017-10-01

    Full Text Available The clinical efficacy and safety of proprietary Chinese medicine has become a more prevailing public health concern. The China Food and Drug Administration has pushed drug companies to conduct post-marketing reappraisal for proprietary Chinese medicine to provide additional evidence supporting the efficacy and safety of these medicine. In this paper, we propose a reappraisal protocol called “precise proprietary Chinese medicine” to precisely i define the therapeutic aim; ii design the protocol; iii control the quality of proprietary Chinese medicine; iv implement the protocol in the trial; v study the mechanism-of-action of the proprietary Chinese medicine and vi describe the indications of the proprietary Chinese medicine. We hope that these steps facilitate the post-marketing reappraisal of proprietary Chinese medicine.

  11. [Research about re-evaluation of screening of traditonal Chinese medicine symptoms item of post-marketing medicine Xuezhikang].

    Science.gov (United States)

    He, Wei; Xie, Yanming; Wang, Yongyan

    2011-10-01

    The purpose of post-marketing Chinese medicine re-evaluation is to identify Chinese medicine clinical indications, while designing scientific and rational of Chinese medicine symptoms items are important to the result of symptoms re-evaluation. This study give screening of traditional Chinese medicine(TCM) symptoms item of post-marketing medicine Xuezhikang re-evaluation as example that reference to principle dyslipidemia clinical research, academic dissertations, Xuezhikang directions, clinical expert practice experience etc. while standardization those symptom names and screening 41 dyslipidemia common symptoms. Furthermore, this paper discuss about the accoerdance and announcements when screening symptoms item, so as to providing a research thread to manufacture PRO chart for post-marketing medicine re-evaluation.

  12. [Post-marketing clinical study of traditional Chinese medicine--lessons learned from comprehensive evaluation of Fufang Zaoren capsule].

    Science.gov (United States)

    Qing, Shan; Gao, Lin; Zhang, Li; Jia, Jian-Ping; Liu, Xin-Min; Ji, Shao-Liang; Yang, Xiao-Hui

    2013-11-01

    By comprehensive review and analysis of post-marketing clinical research on the efficacy and safety,we concluded that Fufang Zaoren capsule has certain therapeutic effects for insomnia, although current clinical research design needs improving. The post-marketing clinical studies also showed that it causes several adverse reactions at the recommended doses, such as chills, fever, dizziness, nausea, shortness of breath, chest tightness and palpitations, whereas high doses of Fufang Zaoren capsule can cause delayed extrapyramidal symptoms. Health Canada government website also prompted the L-tetrahydropalmatine in Fufang Zaoren capsule caused liver damage in pregnant women. The authors summarized the risk points, factors and risk control in the clinical use of Fufang Zaoren capsule and also present their perspective on the research status, existing problems and corresponding countermeasures in the post-marketing clinical re-evaluation of traditional Chinese medicine.

  13. Progress on radio frequency auxiliary heating system designs in ITER

    International Nuclear Information System (INIS)

    Makowski, M.; Bosia, G.; Elio, F.

    1996-09-01

    ITER will require over 100 MW of auxiliary power for heating, on- and off-axis current drive, accessing the H-mode, and plasma shut-down. The Electron Cyclotron Range of Frequencies (ECRF) and Ion Cyclotron Range of Frequencies (ICRF) are two forms of Radio Frequency (RF) auxiliary power being developed for these applications. Design concepts for both the ECRF and ICRF systems are presented, key features and critical design issues are discussed, and projected performances outlined

  14. [Post-marketing reevaluation for potential quality risk and quality control in clinical application of traditional Chinese medicines].

    Science.gov (United States)

    Li, Hong-jiao; He, Li-yun; Liu, Bao-yan

    2015-06-01

    The effective quality control in clinical practices is an effective guarantee for the authenticity and scientificity of the findings. The post-marketing reevaluation for traditional Chinese medicines (TCM) focuses on the efficacy, adverse reaction, combined medication and effective dose of drugs in the market by expanded clinical trials, and requires a larger sample size and a wider range of patients. Therefore, this increases the difficulty of quality control in clinical practices. With the experience in quality control in clinical practices for the post-marketing reevaluation for Kangbingdu oral for cold, researchers in this study reviewed the study purpose, project, scheme design and clinical practice process from an overall point of view, analyzed the study characteristics of the post-marketing reevaluation for TCMs and the quality control risks, designed the quality control contents with quality impacting factors, defined key review contents and summarized the precautions in clinical practices, with the aim to improve the efficiency of quality control of clinical practices. This study can provide reference to clinical units and quality control-related personnel in the post-marketing reevaluation for TCMs.

  15. Sample size for post-marketing safety studies based on historical controls.

    Science.gov (United States)

    Wu, Yu-te; Makuch, Robert W

    2010-08-01

    As part of a drug's entire life cycle, post-marketing studies are an important part in the identification of rare, serious adverse events. Recently, the US Food and Drug Administration (FDA) has begun to implement new post-marketing safety mandates as a consequence of increased emphasis on safety. The purpose of this research is to provide exact sample size formula for the proposed hybrid design, based on a two-group cohort study with incorporation of historical external data. Exact sample size formula based on the Poisson distribution is developed, because the detection of rare events is our outcome of interest. Performance of exact method is compared to its approximate large-sample theory counterpart. The proposed hybrid design requires a smaller sample size compared to the standard, two-group prospective study design. In addition, the exact method reduces the number of subjects required in the treatment group by up to 30% compared to the approximate method for the study scenarios examined. The proposed hybrid design satisfies the advantages and rationale of the two-group design with smaller sample sizes generally required. 2010 John Wiley & Sons, Ltd.

  16. Social Media Listening for Routine Post-Marketing Safety Surveillance.

    Science.gov (United States)

    Powell, Gregory E; Seifert, Harry A; Reblin, Tjark; Burstein, Phil J; Blowers, James; Menius, J Alan; Painter, Jeffery L; Thomas, Michele; Pierce, Carrie E; Rodriguez, Harold W; Brownstein, John S; Freifeld, Clark C; Bell, Heidi G; Dasgupta, Nabarun

    2016-05-01

    Post-marketing safety surveillance primarily relies on data from spontaneous adverse event reports, medical literature, and observational databases. Limitations of these data sources include potential under-reporting, lack of geographic diversity, and time lag between event occurrence and discovery. There is growing interest in exploring the use of social media ('social listening') to supplement established approaches for pharmacovigilance. Although social listening is commonly used for commercial purposes, there are only anecdotal reports of its use in pharmacovigilance. Health information posted online by patients is often publicly available, representing an untapped source of post-marketing safety data that could supplement data from existing sources. The objective of this paper is to describe one methodology that could help unlock the potential of social media for safety surveillance. A third-party vendor acquired 24 months of publicly available Facebook and Twitter data, then processed the data by standardizing drug names and vernacular symptoms, removing duplicates and noise, masking personally identifiable information, and adding supplemental data to facilitate the review process. The resulting dataset was analyzed for safety and benefit information. In Twitter, a total of 6,441,679 Medical Dictionary for Regulatory Activities (MedDRA(®)) Preferred Terms (PTs) representing 702 individual PTs were discussed in the same post as a drug compared with 15,650,108 total PTs representing 946 individual PTs in Facebook. Further analysis revealed that 26 % of posts also contained benefit information. Social media listening is an important tool to augment post-marketing safety surveillance. Much work remains to determine best practices for using this rapidly evolving data source.

  17. [Application of nested case-control study on safe evaluation of post-marketing traditional Chinese medicine injection].

    Science.gov (United States)

    Xiao, Ying; Zhao, Yubin; Xie, Yanming

    2011-10-01

    The nested case-control study design (or the case-control in a cohort study) is described here as a new study design used in safe evaluation of post-marketing traditional Chinese medicine injection. In the nested case-control study, cases of a disease that occur in a defined cohort are identified and, for each, a specified number of matched controls is selected from among those in the cohort who have not developed the disease by the time of disease occurrence in the case. For many research questions, the nested case-control design potentially offers impressive reductions in costs and efforts of data collection and analysis compared with the full cohort approach, with relatively minor loss in statistical efficiency. The nested case-control design is particularly advantageous for studies in safe evaluation of post-marketing traditional Chinese medicine injection. Some examples of the application of nested case-control study were given.

  18. Contribution of industry funded post-marketing studies to drug safety: survey of notifications submitted to regulatory agencies

    Science.gov (United States)

    Prugger, Christof; Doshi, Peter; Ostrowski, Kerstin; Witte, Thomas; Hüsgen, Dieter; Keil, Ulrich

    2017-01-01

    Objectives To investigate the practice of post-marketing studies in Germany during a three year period and to evaluate whether these trials meet the aims specified in the German Medicinal Products Act. Design Survey of notifications submitted to German regulatory agencies before post-marketing studies were carried out, 2008-10. Setting Notifications obtained through freedom of information requests to the three authorities responsible for registering post-marketing studies in Germany. Main outcome measures Descriptive statistics of post-marketing studies, including the products under study, intended number of patients, intended number of participating physicians, proposed remunerations, study plan and protocol, and availability of associated scientific publications and reports on adverse drug reactions. Results Information was obtained from 558 studies, with a median of 600 (mean 2331, range 2-75 000) patients and 63 (270, 0-7000) participating physicians per study. The median remuneration to physicians per patient was €200 (€441, €0-€7280) (£170, £0-£6200; $215, $0-$7820), with a total remuneration cost of more than €217m for 558 studies registered over the three year period. The median remuneration per participating physician per study was €2000 (mean €19 424), ranging from €0 to €2 080 000. There was a broad range of drugs and non-drug products, of which only a third represented recently approved drugs. In many notifications, data, information, and results were, by contract, strictly confidential and the sole property of the respective sponsor. No single adverse drug reaction report could be identified from any of the 558 post-marketing studies. Less than 1% of studies could be verified as published in scientific journals. Conclusions Post-marketing studies are not improving drug safety surveillance. Sample sizes are generally too small to allow the detection of rare adverse drug reactions, and many participating physicians are

  19. Post-market clinical research conducted by medical device manufacturers: a cross-sectional survey.

    Science.gov (United States)

    Ross, Joseph S; Blount, Katrina L; Ritchie, Jessica D; Hodshon, Beth; Krumholz, Harlan M

    2015-01-01

    In the US, once a medical device is made available for use, several requirements have been established by the US Food and Drug Administration (FDA) to ensure ongoing post-market surveillance of device safety and effectiveness. Our objective was to determine how commonly medical device manufacturers initiate post-market clinical studies or augment FDA post-market surveillance requirements for higher-risk devices that are most often approved via the FDA's pre-market approval (PMA) pathway. We conducted a cross-sectional survey of 47 manufacturers with operations in California, Minnesota, and Massachusetts who market devices approved via the PMA pathway. Among 22 respondents (response rate =47%), nearly all self-reported conducting post-market clinical research studies, commonly between 1 and 5; only 1 respondent reported never conducting post-market clinical research studies. While manufacturers most often engaged in these studies to satisfy FDA requirements, other reasons were reported, including performance monitoring and surveillance and market acceptance initiatives. Risks of conducting and not conducting post-market clinical research studies were described through open-ended response to questions. Medical device manufacturers commonly initiate post-market clinical studies at the request of the FDA. Clinical data from these studies should be integrated into national post-market surveillance initiatives.

  20. Drug- and herb-induced liver injury: Progress, current challenges and emerging signals of post-marketing risk.

    Science.gov (United States)

    Raschi, Emanuel; De Ponti, Fabrizio

    2015-07-08

    Drug-induced liver injury (DILI) and herb-induced liver injury is a hot topic for clinicians, academia, drug companies and regulators, as shown by the steadily increasing number of publications in the past 15 years. This review will first provide clues for clinicians to suspect idiosyncratic (unpredictable) DILI and succeed in diagnosis. Causality assessment remains challenging and requires careful medical history as well as awareness of multifaceted aspects, especially for herbs. Drug discontinuation and therapy reconciliation remain the mainstay in patent's management to minimize occurrence of acute liver failure. The second section will address novel agents associated with liver injury in 2014 (referred to as "signals"), especially in terms of clinical, research and drug development implications. Insights will be provided into recent trends by highlighting the contribution of different post-marketing data, especially registries and spontaneous reporting systems. This literature scrutiny suggests: (1) the importance of post-marketing databases as tools of clinical evidence to detect signals of DILI risk; and (2) the need for joining efforts in improving predictivity of pre-clinical assays, continuing post-marketing surveillance and design ad hoc post-authorization safety studies. In this context, ongoing European/United States research consortia and novel pharmaco-epidemiological tools (e.g., specialist prescription event monitoring) will support innovation in this field. Direct oral anticoagulants and herbal/dietary supplements appear as key research priorities.

  1. [The importance of defining methodology for post-marketing observational studies on cardiovascular therapies].

    Science.gov (United States)

    Pelliccia, Francesco; Barillà, Francesco; Tanzilli, Gaetano; Viceconte, Nicola; Paravati, Vincenzo; Mangieri, Enrico; Gaudio, Carlo

    2017-01-01

    In recent years, a growing number of observational studies in cardiology have been carried out following the criticism that rigid design of randomized clinical trials produces information that is not applicable to the general patient. This approach is very common in several branches of medicine, first of all oncology, but has often been considered marginal in cardiology. The recent introduction of new oral anticoagulants (NOACs) on the market, however, has seen a proliferation of "real-life" studies, drawing the attention of cardiologists to the advantages and limitations of post-marketing studies. NOACs have been approved for use on the basis of large randomized clinical trials that have clearly documented their efficacy and safety. Since they have become available, the analysis of phase IV data has been considered crucial and therefore a great amount of information on the use of NOACs in daily practice has become available. It should be considered, however, that the possibility exists that results obtained from "real-world" studies, which do not apply rigid scientific criteria, may lead to incorrect conclusions. Accordingly, it is mandatory to fully define the operational standards of observational studies. All the protagonists of post-marketing analysis (physicians, epidemiologists, pharmacologists, statisticians) should handle the data strictly in order to ensure their reliability and comparability with other studies. To this end, it is crucial that researchers follow rigorous operational protocols for phase IV studies. Briefly, any "real-life" study should be prospective and adhere to what is prespecified by the research protocol - which must illustrate the background and rationale of the study, define its primary endpoint, and detail the methods, i.e. study design, population and variables.

  2. Risk management and post-marketing surveillance of CNS drugs.

    Science.gov (United States)

    Henningfield, Jack E; Schuster, Charles R

    2009-12-01

    Drugs affecting the central nervous system span a broad range of chemical entities, dosage forms, indications, and risks. Unintended consequences include potential abuse and overdose in non-patient drug abusers, deliberate tampering of drug dosage forms, and criminal behavior associated with diversion. Regulators must consider diverse factors to find the appropriate conditions of approval to minimize unintended consequences while enabling a level of access desired by health care providers and patients. This commentary appears as part of a special issue of Drug and Alcohol Dependence that focuses on risk management and post-marketing surveillance and addresses key issues that pose real-world challenges to pharmaceutical sponsors and regulators in particular. For example, in the U.S., Controlled Substances Act drug scheduling can be considered a risk management strategy but its legal authorities and administrative processes are independent from those of risk management (including Risk Evaluation and Mitigation Strategies or REMS); better harmonization of these approaches is vital from drug development and regulatory perspectives. Risk management would ideally be implemented on a strong science foundation demonstrating that the tools employed to mitigate risks and ensure safe use are effective. In reality, research and evaluation of tools in this area is in its infancy and will necessarily be an evolutionary process; furthermore, there is little precedent for linking interventions and program evolution to unintended consequences such as regional outbreaks of abuse and diversion. How such issues are resolved has the potential to stimulate or stifle innovations in drug development and advance or imperil health care.

  3. Post-market clinical research conducted by medical device manufacturers: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Ross JS

    2015-05-01

    Full Text Available Joseph S Ross, Katrina L Blount, Jessica D Ritchie, Beth Hodshon, Harlan M Krumholz Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA Background: In the US, once a medical device is made available for use, several requirements have been established by the US Food and Drug Administration (FDA to ensure ongoing post-market surveillance of device safety and effectiveness. Our objective was to determine how commonly medical device manufacturers initiate post-market clinical studies or augment FDA post-market surveillance requirements for higher-risk devices that are most often approved via the FDA's pre-market approval (PMA pathway. Methods and results: We conducted a cross-sectional survey of 47 manufacturers with operations in California, Minnesota, and Massachusetts who market devices approved via the PMA pathway. Among 22 respondents (response rate =47%, nearly all self-reported conducting post-market clinical research studies, commonly between 1 and 5; only 1 respondent reported never conducting post-market clinical research studies. While manufacturers most often engaged in these studies to satisfy FDA requirements, other reasons were reported, including performance monitoring and surveillance and market acceptance initiatives. Risks of conducting and not conducting post-market clinical research studies were described through open-ended response to questions. Conclusion: Medical device manufacturers commonly initiate post-market clinical studies at the request of the FDA. Clinical data from these studies should be integrated into national post-market surveillance initiatives. Keywords: FDA, PMA pathway, post-market surveillance

  4. [Application of Markov model in post-marketing pharmacoeconomic evaluation of traditional Chinese medicine].

    Science.gov (United States)

    Wang, Xin; Su, Xia; Sun, Wentao; Xie, Yanming; Wang, Yongyan

    2011-10-01

    In post-marketing study of traditional Chinese medicine (TCM), pharmacoeconomic evaluation has an important applied significance. However, the economic literatures of TCM have been unable to fully and accurately reflect the unique overall outcomes of treatment with TCM. For the special nature of TCM itself, we recommend that Markov model could be introduced into post-marketing pharmacoeconomic evaluation of TCM, and also explore the feasibility of model application. Markov model can extrapolate the study time horizon, suit with effectiveness indicators of TCM, and provide measurable comprehensive outcome. In addition, Markov model can promote the development of TCM quality of life scale and the methodology of post-marketing pharmacoeconomic evaluation.

  5. [Thought on several problems of clinical revaluation of post-marketing herb research].

    Science.gov (United States)

    He, Wei; Xie, Yanming; Wang, Yongyan

    2010-06-01

    The revaluation of post-marketing herb is a complex research work, which concerns widely content and difficult to put it into practice. The starting of our country's revaluation post-marketing herb was comparatively late. It should profect it both in laws and regulations mechanism as well as technological specification. This article is try to focus on some attention problems in revaluation of postmarketing herb process. Such as the laws and regulations demand, the basement and the subject of revaluation of post-marketing herb.

  6. Evaluation of Pre-marketing Factors to Predict Post-marketing Boxed Warnings and Safety Withdrawals.

    Science.gov (United States)

    Schick, Andreas; Miller, Kathleen L; Lanthier, Michael; Dal Pan, Gerald; Nardinelli, Clark

    2017-06-01

    An important goal in drug regulation is understanding serious safety issues with new drugs as soon as possible. Achieving this goal requires us to understand whether information provided during the Food and Drug Administration (FDA) drug review can predict serious safety issues that are usually identified after the product is approved. However, research on this topic remains understudied. In this paper, we examine whether any pre-marketing drug characteristics are associated with serious post-marketing safety actions. We study this question using an internal FDA database containing every new small molecule drug submitted to the FDA's Center for Drug Evaluation and Research (CDER) on or after November 21, 1997, and approved and commercially launched before December 31, 2009. Serious post-marketing safety actions include whether these drugs ever experienced either a post-marketing boxed warning or a withdrawal from the market due to safety concerns. A random effects logistic regression model was used to test whether any pre-marketing characteristics were associated with either post-marketing safety action. A total of 219 new molecular entities were analyzed. Among these drugs, 11 experienced a safety withdrawal and 30 received boxed warnings by July 31, 2016. Contrary to prevailing hypotheses, we find that neither clinical trial sample sizes nor review time windows are associated with the addition of a post-marketing boxed warning or safety withdrawal. However, we do find that new drugs approved with either a boxed warning or priority review are more likely to experience post-marketing boxed warnings. Furthermore, drugs approved with boxed warnings tend to receive post-marketing boxed warnings resulting from new safety information that are unrelated to the original warning. Drugs approved with a boxed warning are 3.88 times more likely to receive a post-marketing boxed warning, while drugs approved with a priority review are 3.51 times more likely to receive a post-marketing

  7. A data-capture system for post-marketing surveillance of drugs that integrates with hospital electronic health records

    Directory of Open Access Journals (Sweden)

    Yamamoto K

    2011-04-01

    Full Text Available Keiichi Yamamoto1, Shigemi Matsumoto2, Kazuhiro Yanagihara2, Satoshi Teramukai1, Masanori Fukushima1,2,31Department of Clinical Trial Design and Management, Translational Research Center, Kyoto University Hospital, Kyoto, Japan; 2Outpatient Oncology Unit, Kyoto University Hospital, Kyoto, Japan; 3Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, JapanPurpose: In conventional clinical studies, the cost of data management for the purposes of quality control tend to be high and collecting paper-based case report forms (CRFs can be burdensome, because paper-based CRFs must be developed and filled out for each clinical study protocol. Use of electronic health records (EHRs for this purpose could reduce costs and improve data quality in clinical studies. Kyoto University Hospital launched an EHR system in January 2005. At the same time, a replicate of that database was established for other purposes. At the Outpatient Oncology Unit of Kyoto University Hospital we developed a data-capture system that includes a cancer clinical database system and a data warehouse for outcomes studies. This system allows us to accumulate data at low cost and apply it to various uses in clinical or outcomes studies. Here we report on the application of this system to the post-marketing surveillance of drugs.Methods: We evaluated the availability of this system and identified problems for future development. With this system investigators can register cases for post-marketing surveillance, and the registered cases are listed on a screen. When CRFs for a particular case are required, data can be extracted from the list and CRFs are produced in PDF format.Results and conclusion: In this study we confirmed the applicability of our new system to post-marketing surveillance in providing prompt and efficient data exchange. We expect it to reduce the cost of data management and analysis and to improve the quality of data in post-marketing

  8. Post market surveillance in the german medical device sector - current state and future perspectives.

    Science.gov (United States)

    Zippel, Claus; Bohnet-Joschko, Sabine

    2017-08-01

    Medical devices play a central role in the diagnosis and treatment of diseases but also bring the potential for adverse events, hazards or malfunction with serious consequences for patients and users. Medical device manufacturers are therefore required by law to monitor the performance of medical devices that have been approved by the competent authorities (post market surveillance). Conducting a nationwide online-survey in the German medical device sector in Q2/2014 in order to explore the current status of the use of post market instruments we obtained a total of 118 complete data sets, for a return rate of 36%. The survey included manufacturers of different sizes, producing medical devices of all risk classes. The post market instruments most frequently reported covered the fields of production monitoring and quality management as well as literature observation, regulatory vigilance systems, customer knowledge management and market observation while Post Market Clinical Follow-up and health services research were being used less for product monitoring. We found significant differences between the different risk classes of medical devices produced and the intensity of use of post market instruments. Differences between company size and the intensity of instruments used were hardly detected. Results may well contribute to the development of device monitoring which is a crucial element of the policy and regulatory system to identify device-related safety issues. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. [Exploration of how to formulate guidelines on post-marketing traditional Chinese medicine surveillance].

    Science.gov (United States)

    Zhang, Wen; Xie, Yan-Ming; Yu, Wen-Ya

    2013-09-01

    Combining the world health organization's (WHO), the United States and the European union's relevant laws and guidelines on post-marketing drug surveillance to judge the status of post-marketing surveillance of traditional Chinese medicine(TCM) in China. We found that due to the late start of post-marketing surveillance of traditional Chinese medicine, the appropriate guidelines are yet to be developed. Hence, hospitals, enterprises and research institutions do not have a shared foundation from which to compare their research results. Therefore there is an urgent need to formulate such post-marketing surveillance guidelines. This paper has used as guidance various technical documents such as, "procedures to formulate national standards" and "testing methods of management in formulating traditional Chinese medicine standards" and has combined these to produce a version of post-marketing surveillance particular to Chinese medicine in China. How to formulate these guidelines is discussed and procedures and methods to formulate technical specifications are introduced. These provide a reference for future technical specifications and will assist in the development of TCM.

  10. [Clinical orientation and thought on several problems in post-marketed reassessment of traditional Chinese medicine].

    Science.gov (United States)

    Wang, Xin; Su, Xia; Yu, Jie; Xie, Yanming; Wang, Yongyan

    2011-10-01

    The post-marketed reassessment is an important link to ensure the safety and effectiveness of traditional chinese medicine. It is also the expansion and stretch of new drug evaluation. Through the systematic, standard, rigorous post-marketed reassessment, the enterprise can full access to drugs after listing the efficacy and safety information, evaluate the interests and risk of the drug and provide the scientific basis for the drug use. It can also provide timely, scientific technology basis for government health decisions, the enterprise marketing decision and public health security. This paper mainly discussed the thought on clinical orientation of traditional chinese medicine in the post-marketed reassessment and how to reach the goal through systematic consideration and overall plan.

  11. [Necessity of applying pharmacovigilance in post-marketing safety monitoring of traditional Chinese medicine injections].

    Science.gov (United States)

    Wang, Hai-Nan; Chen, Wen; Fu, Zheng; Du, Wen-min; He, Jia

    2008-03-01

    Traditional Chinese medicine (TCM) injection has become one of the hotspots in the new TCM research and development. The serious adverse drug reactions happened in clinical have arosed attention widely in the whole society. It's very urgent to monitor the post-marketing safety of TCM injections. This paper elucidated the pharmacovigilance's necessity in the post-marketing safety monitoring of TCM injections, basing on the reason of safety problem of TCM injections and the future developing trend of adverse drug reaction monitoring. Also, this paper introduced the rapid signal detection method of spontaneous reporting system database by data mining technology.

  12. Arthritis, Rheumatism and Aging Medical Information System Post-Marketing Surveillance Program.

    Science.gov (United States)

    Singh, G

    2001-05-01

    The Arthritis, Rheumatism, and Aging Post-Marketing Surveillance Program (ARAMIS-PMS) is a collection of multicenter, prospective, noninterventional, observational longitudinal studies of patients with rheumatic diseases. The ARAMIS-PMS program aims to study patients in normal clinical setting to evaluate the real-life effectiveness, toxicity, and cost effectiveness of various medications used to treat rheumatic diseases.

  13. [Post-marketing drug safety-risk management plan(RMP)].

    Science.gov (United States)

    Ezaki, Asami; Hori, Akiko

    2013-03-01

    The Guidance for Risk Management Plan(RMP)was released by the Ministry of Health, Labour and Welfare in April 2012. The RMP consists of safety specifications, pharmacovigilance plans and risk minimization action plans. In this paper, we outline post-marketing drug safety operations in PMDA and the RMP, with examples of some anticancer drugs.

  14. Fatal adverse drug reactions of anticancer drugs detected by all-case post-marketing surveillance in Japan.

    Science.gov (United States)

    Mori, Jinichi; Tanimoto, Tetsuya; Miura, Yuji; Kami, Masahiro

    2015-06-01

    All-case post-marketing surveillance of newly approved anticancer drugs is usually conducted on all patients in Japan. The present study investigates whether all-case post-marketing surveillance identifies fatal adverse drug reactions undetected before market entry. We examined fatal adverse drug reactions identified via all-case post-marketing surveillance by reviewing the disclosed post-marketing surveillance results, and determined the time points in which the fatal adverse drug reactions were initially reported by reviewing drug labels. We additionally scanned emergency alerts on the Japanese regulatory authority website to assess the relationship between all-case post-marketing surveillance and regulatory action. Twenty-five all-case post-marketing surveillances were performed between January 1999 and December 2009. Eight all-case post-marketing surveillances with final results included information on all fatal cases. Of these, the median number of patients was 1287 (range: 106-4998), the median number of fatal adverse drug reactions was 14.5 (range: 4-23). Of the 111 fatal adverse drug reactions detected in the eight post-marketing surveillances, only 28 (25.0%) and 22 (19.6%) were described on the initial global and the initial Japanese drug label, respectively, and 58 (52.3%) fatal adverse drug reactions were first described in the all-case post-marketing surveillance reports. Despite this, the regulatory authority issued only four warning letters, and two of these were prompted by case reports from the all-case post-marketing surveillance. All-case post-marketing surveillance of newly approved anticancer drugs in Japan was useful for the rigorous compilation of non-specific adverse drug reactions, but it rarely detected clinically significant fatal adverse drug reactions. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. The applicability of animal health surveillance systems for post-market monitoring of potential adverse effects of genetically modified (GM) feed.

    Science.gov (United States)

    Vince, L; Kleter, G A; Kostov, K; Pfeiffer, D U; Guitian, J

    2018-04-20

    A facultative post market monitoring of potential health impacts of genetically modified (GM) feedstuffs on livestock consuming these feeds after pre-market risk assessment is under ongoing consideration. Within the IPAFEED database, scientific studies on health effects beyond performance in livestock and the results of a systematic search for evidence of outcome effects due to GM feed are consolidated. These outcomes were reviewed and checked for consistency in order to identify plausible syndromes suitable for conducting surveillance. The 24 selected studies showed no consistent changes in any health parameter. There were no repeated studies in any species by GM crop type and animal species. As such, there is insufficient evidence to inform the design of surveillance systems for detecting known adverse effects. Animal health surveillance systems have been proposed for the post market monitoring of potential adverse effects in animals. Such systems were evaluated for their applicability to the detection of hypothetical adverse effects and their strengths and weaknesses to detect syndromes of concern are presented. For known adverse effects, applied controlled post-market studies may yield conclusive and high-quality evidence. For detecting unknown adverse effects, the use of existing surveillance systems may still be of interest. A simulation tool developed within the project can be adapted and applied to existing surveillance systems to explore their applicability to the detection of potential adverse effects of GM feed. Copyright © 2018. Published by Elsevier Ltd.

  16. [Opportunity and challenge of post-marketing evaluation of traditional Chinese medicine].

    Science.gov (United States)

    Du, Xiao-Xi; Song, Hai-Bo; Ren, Jing-Tian; Yang, Le; Guo, Xiao-Xin; Pang, Yu

    2014-09-01

    Post-marketing evaluation is a process which evaluate the risks and benefits of drug clinical application comprehensively and systematically, scientific and systematic results of post-marketing evaluation not only can provide data support for clinical application of traditional Chinese medicine, but also can be a reliable basis for the supervision department to develop risk control measures. With the increasing demands for treatment and prevention of disease, traditional Chinese medicine has been widely used, and security issues are also exposed. How to find risk signal of traditional Chinese medicine in the early stages, carry out targeted evaluation work and control risk timely have become challenges in the development of traditional Chinese medicine industry.

  17. [Process and key points of clinical literature evaluation of post-marketing traditional Chinese medicine].

    Science.gov (United States)

    Liu, Huan; Xie, Yanming

    2011-10-01

    The clinical literature evaluation of the post-marketing traditional Chinese medicine is a comprehensive evaluation by the comprehensive gain, analysis of the drug, literature of drug efficacy, safety, economy, based on the literature evidence and is part of the evaluation of evidence-based medicine. The literature evaluation in the post-marketing Chinese medicine clinical evaluation is in the foundation and the key position. Through the literature evaluation, it can fully grasp the information, grasp listed drug variety of traditional Chinese medicines second development orientation, make clear further clinical indications, perfect the medicines, etc. This paper discusses the main steps and emphasis of the clinical literature evaluation. Emphasizing security literature evaluation should attach importance to the security of a comprehensive collection drug information. Safety assessment should notice traditional Chinese medicine validity evaluation in improving syndrome, improveing the living quality of patients with special advantage. The economics literature evaluation should pay attention to reliability, sensitivity and practicability of the conclusion.

  18. [Strategy of constructing post-market integral evaluation system of traditional Chinese medicine injection].

    Science.gov (United States)

    Zhang, Xiao-Yu; Wang, Yan-Ping; Lin, Li-Kai; Shang, Hong-Cai; Wang, Yong-Yan

    2017-08-01

    As an important representative of modern Chinese medicine, traditional Chinese medicine (TCM) injzection has become an indispensable part of the Chinese medicine industry. However, its development is now restricted by the bottleneck of insufficient core competitiveness, low-level research and production, even injection quality and the safe use are not guaranteed. Thus, it is urgent to reevaluate post-marketing TCM injection generally and to make secondary development. Under current circumstances, taking major brands which have good clinical and market foundation, as well as research value, as the main subject of cultivation and evaluation is an important approach to innovative development of TCM injection industry. Unlike oral proprietary Chinese medicine, the cultivatation of major brands of TCM injection needs higher technical support, quality standards and more timely feedback. Therefore, a post-market integral evaluation system adaptive to TCM injection is required. This article discussed some key points on the construction of a post-market integral evaluation system of TCM injection in three levels: optimizing evaluation methods, building synergistic innovation platforms which combine the medical research institutions and pharmaceutical enterprises, and finally constructing the integral evaluation system. A "five to one" structure has been proposed to enhance TCM injection effectiveness, safety and adaptability on the whole, which are from the following aspects: mechanism research, clinical evidence validation, literature information mining, sustainable development of resources and industrialization operation. Copyright© by the Chinese Pharmaceutical Association.

  19. Estimating post-marketing exposure to pharmaceutical products using ex-factory distribution data.

    Science.gov (United States)

    Telfair, Tamara; Mohan, Aparna K; Shahani, Shalini; Klincewicz, Stephen; Atsma, Willem Jan; Thomas, Adrian; Fife, Daniel

    2006-10-01

    The pharmaceutical industry has an obligation to identify adverse reactions to drug products during all phases of drug development, including the post-marketing period. Estimates of population exposure to pharmaceutical products are important to the post-marketing surveillance of drugs, and provide a context for assessing the various risks and benefits, including drug safety, associated with drug treatment. This paper describes a systematic approach to estimating post-marketing drug exposure using ex-factory shipment data to estimate the quantity of medication available, and dosage information (stratified by indication or other factors as appropriate) to convert the quantity of medication to person time of exposure. Unlike the non-standardized methods often used to estimate exposure, this approach provides estimates whose calculations are explicit, documented, and consistent across products and over time. The methods can readily be carried out by an individual or small group specializing in this function, and lend themselves to automation. The present estimation approach is practical and relatively uncomplicated to implement. We believe it is a useful innovation. Copyright 2006 John Wiley & Sons, Ltd.

  20. [Systematic review on methodology of randomized controlled trials of post-marketing Chinese patent drugs for treatment of type 2 diabetes].

    Science.gov (United States)

    Ma, Li-xin; Wang, Yu-yi; Li, Xin-xue; Liu, Jian-ping

    2012-03-01

    concealment of random numbers, 5% used placebo, 10% reported outcome attrition bias and no study employed the analysis of intention-to-treat and 98% reported the diagnostic criteria for type 2 diabetes. The participants mainly consisted of outpatients without complications (76%). The minimum and maximum sample size was 40 and 300 (106 ± 60), respectively. The inclusion and exclusion criteria and outcome measures did not match the purposes and contents of post-marketing research in the included studies. They also failed to reflect the basic principles of traditional Chinese medicine in the process of diagnosis and treatment. The demographic characteristics of the patients, the indications for medicine and the syndrome differentiation process were not reported sufficiently and transparently. In order to improve the post-marketing research and promote the rational use of Chinese patent drugs, it is recommended that phase IV clinical trials should establish clear research purpose as well as hypothesis first, and choose scientific and evidence-based study design and outcome measures. In addition, guidelines for implementation of post-marketing research should be developed.

  1. [Expert consensus post-marketing evaluation scheme to detect immunotoxicity of Chinese medicine in clinical populations (draft version for comments)].

    Science.gov (United States)

    Xie, Yan-Ming; Zhao, Yu-Bin; Jiang, Jun-Jie; Chang, Yan-Peng; Zhang, Wen; Shen, Hao; Lu, Peng-Fei

    2013-09-01

    Through consensus, establish a post-marketing scheme and the technical processes to evaluate Chinese medicine's immunotoxicity on a population, as well as its beneficial influences on the immune system. Provide regulations on the collection, storage and transportation of serum samples. This article applies to the post-marketing scientific evaluation of the immunotoxicity of parenterally administered, and for other ways of taking Chinese medicine.

  2. Worldwide, 3-Year, Post-Marketing Surveillance Experience with Tofacitinib in Rheumatoid Arthritis.

    Science.gov (United States)

    Cohen, Stanley; Curtis, Jeffrey R; DeMasi, Ryan; Chen, Yan; Fan, Haiyun; Soonasra, Arif; Fleischmann, Roy

    2018-06-01

    Post-marketing surveillance (PMS) is an integral part of monitoring adverse events (AEs) following approval of new drugs. Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). An analysis of PMS reports was conducted to evaluate the safety of tofacitinib in a post-marketing setting. Worldwide tofacitinib PMS data received in the Pfizer safety database from November 6, 2012 (first marketing authorization of tofacitinib) to November 5, 2015 were analyzed. Serious AEs (SAEs) of interest were reviewed and reporting rates (RRs) were calculated by dividing the number of SAEs by the estimated 100 patient-years of exposure. Patient exposure was calculated based on estimated worldwide sales and an estimated daily regimen of tofacitinib 5 mg twice daily. During the 3-year reporting period, worldwide post-marketing exposure to tofacitinib since approval was estimated to be 34,223 patient-years. In total, 9291 case reports (82.9% non-serious) were received and 25,417 AEs, 102 fatal cases, and 4352 SAEs were reported. The RRs (per 100 patient-years) for SAEs of interest by Medical Dictionary for Regulatory Activities System Organ Class were 2.57 for infections, 0.91 for gastrointestinal disorders, 0.60 for respiratory disorders, 0.45 for neoplasms, 0.43 for cardiac disorders, and 0.12 for hepatobiliary disorders. Although there are limitations to these data, no new safety risks were revealed in this real-world setting compared with the safety profile identified in the tofacitinib RA clinical development program. Any risks identified through the tofacitinib development program and PMS will continue to be monitored through pharmacovigilance surveillance. Pfizer Inc.

  3. A distributed research network model for post-marketing safety studies: the Meningococcal Vaccine Study.

    Science.gov (United States)

    Velentgas, Priscilla; Bohn, Rhonda L; Brown, Jeffrey S; Chan, K Arnold; Gladowski, Patricia; Holick, Crystal N; Kramer, Judith M; Nakasato, Cynthia; Spettell, Claire M; Walker, Alexander M; Zhang, Fang; Platt, Richard

    2008-12-01

    We describe a multi-center post-marketing safety study that uses distributed data methods to minimize the need for covered entities to share protected health information (PHI). Implementation has addressed several issues relevant to creation of a large scale post-marketing drug safety surveillance system envisioned by the FDA's Sentinel Initiative. This retrospective cohort study of Guillain-Barré syndrome (GBS) following meningococcal conjugate vaccination incorporates the data and analytic expertise of five research organizations closely affiliated with US health insurers. The study uses administrative claims data, plus review of full text medical records to adjudicate the status of individuals with a diagnosis code for GBS (ICD9 357.0). A distributed network approach is used to create the analysis files and to perform most aspects of the analysis, allowing nearly all of the data to remain behind institutional firewalls. Pooled analysis files transferred to a central site will contain one record per person for approximately 0.2% of the study population, and contain PHI limited to the month and year of GBS onset for cases or the index date for matched controls. The first planned data extraction identified over 9 million eligible adolescents in the target age range of 11-21 years. They contributed an average of 14 months of eligible time on study over 27 months of calendar time. MCV4 vaccination coverage levels exceeded 20% among 17-18-year olds and 16% among 11-13 and 14-16-year-old age groups by the second quarter of 2007. This study demonstrates the feasibility of using a distributed data network approach to perform large scale post-marketing safety analyses and is scalable to include additional organizations and data sources. We believe these results can inform the development of a large national surveillance system. Copyright (c) 2008 John Wiley & Sons, Ltd.

  4. Reevaluation of the post-marketing safety of Shuxuening injection based on real-world and evidence-based evaluations

    Directory of Open Access Journals (Sweden)

    Wang C

    2018-04-01

    Full Text Available Can Wang,1,2 Qing-ping Shi,1,2 Feng Ding,2 Xiao-dong Jiang,1,2 Wei Tang,3 Mei-Ling Yu,1,2 Jian-Hua Zhu2 1Department of Pharmacy, The First Affiliated Hospital of Bengbu Medical College, Bengbu, People’s Republic of China; 2Faculty of Pharmacy, Bengbu Medical College, Bengbu, People’s Republic of China; 3Department of Pharmacy, Huaiyuan County Hospital of TCM in Anhui, Bengbu, People’s Republic of China Aim: To evaluate the factors influencing suspected hypersensitivity and adverse systemic reactions after Shuxuening injection and to provide innovative ideas and methods for the reevaluation of post-marketing safety of Shuxuening.Methods: This study used a prospective, nested case–control study design, combined with a prescription sequence analysis design method. It classified patients who exhibited trigger signals after administration of Shuxuening injection as suspected allergic patients and made comparisons with patients who did not report adverse effects to calculate the correlation between relevant risk factors and suspected allergic reactions. Randomized controlled studies and cohort studies of the adverse drug reaction (ADR of Shuxuening were performed using a computer database. Data retrieval was carried out by the foundation governing the individual database. Meta-analysis was performed by using R3.2.3 software to evaluate the ADRs of Shuxuening.Results: The results of real-world study showed that administration of Shuxuening in combination with potassium aspartate and magnesium, atorvastatin calcium, Shengmai injection, pantoprazole sodium, or high-dose medication was a risk factor for suspected allergic reactions. Meta-analysis showed that the incidence of adverse events was 5.84% (95% CI 0.0499; 0.0674, and serious adverse reaction rate was 4.36% (95% CI 0.0188; 0.0760 when Shuxuening was used in combination with these drugs. The incidence of allergic reaction was also influenced by the vehicle, duration of treatment, single

  5. [Comparative study on four kinds of assessment methods of post-marketing safety of Danhong injection].

    Science.gov (United States)

    Li, Xuelin; Tang, Jinfa; Meng, Fei; Li, Chunxiao; Xie, Yanming

    2011-10-01

    To study the adverse reaction of Danhong injection with four kinds of methods, central monitoring method, chart review method, literature study method and spontaneous reporting method, and to compare the differences between them, explore an appropriate method to carry out post-marketing safety evaluation of traditional Chinese medicine injection. Set down the adverse reactions' questionnaire of four kinds of methods, central monitoring method, chart review method, literature study method and collect the information on adverse reactions in a certain period. Danhong injection adverse reaction information from Henan Province spontaneous reporting system was collected with spontaneous reporting method. Carry on data summary and descriptive analysis. Study the adverse reaction of Danhong injection with four methods of central monitoring method, chart review method, literature study method and spontaneous reporting method, the rates of adverse events were 0.993%, 0.336%, 0.515%, 0.067%, respectively. Cyanosis, arrhythmia, hypotension, sweating, erythema, hemorrhage dermatitis, rash, irritability, bleeding gums, toothache, tinnitus, asthma, elevated aminotransferases, constipation, pain are new discovered adverse reactions. The central monitoring method is the appropriate method to carry out post-marketing safety evaluation of traditional Chinese medicine injection, which could objectively reflect the real world of clinical usage.

  6. Review of Post-Marketing Safety Data on Tapentadol, a Centrally Acting Analgesic.

    Science.gov (United States)

    Stollenwerk, Ariane; Sohns, Melanie; Heisig, Fabian; Elling, Christian; von Zabern, Detlef

    2018-01-01

    Tapentadol is a centrally acting analgesic that has been available for the management of acute and chronic pain in routine clinical practice since 2009. This is the first integrated descriptive analysis of post-marketing safety data following the use of tapentadol in a broad range of pain conditions relating to the topics overall safety, dose administration above approved dosages, administration during pregnancy, serotonin syndrome, respiratory depression, and convulsion. The data analyzed pertain to spontaneous reports from healthcare and non-healthcare professionals and were put in the context of safety information known from interventional and non-interventional trials. The first years of routine clinical practice experience with tapentadol have confirmed the tolerability profile that emerged from the clinical trials. Moreover, the reporting of expected side effects such as respiratory depression and convulsion was low and no major risks were identified. The evaluation of available post-marketing data did not confirm the theoretical risk of serotonin syndrome nor did it reveal unexpected side effects with administration of higher than recommended doses. More than 8 years after its first introduction, the favorable overall safety profile of tapentadol in the treatment of various pain conditions is maintained in the general population. Grünenthal GmbH.

  7. Herpes zoster vaccine live: A 10 year review of post-marketing safety experience.

    Science.gov (United States)

    Willis, English D; Woodward, Meredith; Brown, Elizabeth; Popmihajlov, Zoran; Saddier, Patricia; Annunziato, Paula W; Halsey, Neal A; Gershon, Anne A

    2017-12-19

    Zoster vaccine is a single dose live, attenuated vaccine (ZVL) indicated for individuals ≥50 years-old for the prevention of herpes zoster (HZ). Safety data from clinical trials and post-licensure studies provided reassurance that ZVL is generally safe and well tolerated. The objective of this review was to provide worldwide post-marketing safety information following 10 years of use and >34 million doses distributed. All post-marketing adverse experience (AE) reports received worldwide between 02-May-2006 and 01-May-2016 from healthcare professionals following vaccination with ZVL and submitted to the MSD AE global safety database, were analyzed. A total of 23,556 AE reports, 93% non-serious, were reported. Local injection site reactions (ISRs), with a median time-to-onset of 2 days, were the most frequently reported AEs followed by HZ. The majority of HZ reports were reported within 2 weeks of vaccination and considered, based on time-to-onset, pathogenesis of HZ, and data from clinical trials, to be caused by wild-type varicella-zoster virus (VZV). HZ confirmed by PCR analysis to be VZV Oka/Merck vaccine-strain was identified in an immunocompetent individual 8 months postvaccination and in 4 immunocompromised individuals. Disseminated HZ was reported very rarely (marketing use, was favorable and consistent with that observed in clinical trials and post-licensure studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. [Establish research model of post-marketing clinical safety evaluation for Chinese patent medicine].

    Science.gov (United States)

    Zheng, Wen-ke; Liu, Zhi; Lei, Xiang; Tian, Ran; Zheng, Rui; Li, Nan; Ren, Jing-tian; Du, Xiao-xi; Shang, Hong-cai

    2015-09-01

    The safety of Chinese patent medicine has become a focus of social. It is necessary to carry out work on post-marketing clinical safety evaluation for Chinese patent medicine. However, there have no criterions to guide the related research, it is urgent to set up a model and method to guide the practice for related research. According to a series of clinical research, we put forward some views, which contained clear and definite the objective and content of clinical safety evaluation, the work flow should be determined, make a list of items for safety evaluation project, and put forward the three level classification of risk control. We set up a model of post-marketing clinical safety evaluation for Chinese patent medicine. Based this model, the list of items can be used for ranking medicine risks, and then take steps for different risks, aims to lower the app:ds:risksrisk level. At last, the medicine can be managed by five steps in sequence. The five steps are, collect risk signal, risk recognition, risk assessment, risk management, and aftereffect assessment. We hope to provide new ideas for the future research.

  9. Pediatric post-marketing safety systems in North America: assessment of the current status.

    Science.gov (United States)

    McMahon, Ann W; Wharton, Gerold T; Bonnel, Renan; DeCelle, Mary; Swank, Kimberley; Testoni, Daniela; Cope, Judith U; Smith, Phillip Brian; Wu, Eileen; Murphy, Mary Dianne

    2015-08-01

    It is critical to have pediatric post-marketing safety systems that contain enough clinical and epidemiological detail to draw regulatory, public health, and clinical conclusions. The pediatric safety surveillance workshop (PSSW), coordinated by the Food and Drug Administration (FDA), identified these pediatric systems as of 2010. This manuscript aims to update the information from the PSSW and look critically at the systems currently in use. We reviewed North American pediatric post-marketing safety systems such as databases, networks, and research consortiums found in peer-reviewed journals and other online sources. We detail clinical examples from three systems that FDA used to assess pediatric medical product safety. Of the 59 systems reviewed for pediatric content, only nine were pediatric-focused and met the inclusion criteria. Brief descriptions are provided for these nine. The strengths and weaknesses of three systems (two of the nine pediatric-focused and one including both children and adults) are illustrated with clinical examples. Systems reviewed in this manuscript have strengths such as clinical detail, a large enough sample size to capture rare adverse events, and/or a patient denominator internal to the database. Few systems include all of these attributes. Pediatric drug safety would be better informed by utilizing multiple systems to take advantage of their individual characteristics. Copyright © 2015 John Wiley & Sons, Ltd.

  10. [Establishment of model of traditional Chinese medicine injections post-marketing safety monitoring].

    Science.gov (United States)

    Guo, Xin-E; Zhao, Yu-Bin; Xie, Yan-Ming; Zhao, Li-Cai; Li, Yan-Feng; Hao, Zhe

    2013-09-01

    To establish a nurse based post-marketing safety surveillance model for traditional Chinese medicine injections (TCMIs). A TCMIs safety monitoring team and a research hospital team engaged in the research, monitoring processes, and quality control processes were established, in order to achieve comprehensive, timely, accurate and real-time access to research data, to eliminate errors in data collection. A triage system involving a study nurse, as the first point of contact, clinicians and clinical pharmacists was set up in a TCM hospital. Following the specified workflow involving labeling of TCM injections and using improved monitoring forms it was found that there were no missing reports at the ratio of error was zero. A research nurse as the first and main point of contact in post-marketing safety monitoring of TCM as part of a triage model, ensures that research data collected has the characteristics of authenticity, accuracy, timeliness, integrity, and eliminate errors during the process of data collection. Hospital based monitoring is a robust and operable process.

  11. Use of carabids for the post-market environmental monitoring of genetically modified crops

    Czech Academy of Sciences Publication Activity Database

    Skoková Habuštová, Oxana; Svobodová, Zdeňka; Cagáň, Ľ.; Sehnal, František

    2017-01-01

    Roč. 9, č. 4 (2017), č. článku 121. E-ISSN 2072-6651 R&D Projects: GA MŠk(CZ) 7AMB14SK096 Grant - others:projekt VEGA(SK) 1/0732/14; GA ČR(CZ) L200961652 Institutional support: RVO:60077344 Keywords : Carabidae * surrogate * post-market environmental monitoring Subject RIV: GF - Plant Pathology, Vermin, Weed, Plant Protection OBOR OECD: GM technology (crops and livestock), livestock cloning, marker assisted selection, diagnostics (DNA chips and biosensing devices for the early/accurate detection of diseases) biomass feedstock production technologies, biopharming Impact factor: 3.030, year: 2016 http://www.mdpi.com/2072-6651/9/4/121

  12. Decision support methods for the detection of adverse events in post-marketing data.

    Science.gov (United States)

    Hauben, M; Bate, A

    2009-04-01

    Spontaneous reporting is a crucial component of post-marketing drug safety surveillance despite its significant limitations. The size and complexity of some spontaneous reporting system databases represent a challenge for drug safety professionals who traditionally have relied heavily on the scientific and clinical acumen of the prepared mind. Computer algorithms that calculate statistical measures of reporting frequency for huge numbers of drug-event combinations are increasingly used to support pharamcovigilance analysts screening large spontaneous reporting system databases. After an overview of pharmacovigilance and spontaneous reporting systems, we discuss the theory and application of contemporary computer algorithms in regular use, those under development, and the practical considerations involved in the implementation of computer algorithms within a comprehensive and holistic drug safety signal detection program.

  13. Evaluation of Electronic Healthcare Databases for Post-Marketing Drug Safety Surveillance and Pharmacoepidemiology in China.

    Science.gov (United States)

    Yang, Yu; Zhou, Xiaofeng; Gao, Shuangqing; Lin, Hongbo; Xie, Yanming; Feng, Yuji; Huang, Kui; Zhan, Siyan

    2018-01-01

    Electronic healthcare databases (EHDs) are used increasingly for post-marketing drug safety surveillance and pharmacoepidemiology in Europe and North America. However, few studies have examined the potential of these data sources in China. Three major types of EHDs in China (i.e., a regional community-based database, a national claims database, and an electronic medical records [EMR] database) were selected for evaluation. Forty core variables were derived based on the US Mini-Sentinel (MS) Common Data Model (CDM) as well as the data features in China that would be desirable to support drug safety surveillance. An email survey of these core variables and eight general questions as well as follow-up inquiries on additional variables was conducted. These 40 core variables across the three EHDs and all variables in each EHD along with those in the US MS CDM and Observational Medical Outcomes Partnership (OMOP) CDM were compared for availability and labeled based on specific standards. All of the EHDs' custodians confirmed their willingness to share their databases with academic institutions after appropriate approval was obtained. The regional community-based database contained 1.19 million people in 2015 with 85% of core variables. Resampled annually nationwide, the national claims database included 5.4 million people in 2014 with 55% of core variables, and the EMR database included 3 million inpatients from 60 hospitals in 2015 with 80% of core variables. Compared with MS CDM or OMOP CDM, the proportion of variables across the three EHDs available or able to be transformed/derived from the original sources are 24-83% or 45-73%, respectively. These EHDs provide potential value to post-marketing drug safety surveillance and pharmacoepidemiology in China. Future research is warranted to assess the quality and completeness of these EHDs or additional data sources in China.

  14. National post-market surveillance assessment of veterinary medicines in Korea during the past decade.

    Science.gov (United States)

    Kang, JeongWoo; Park, Hae-Chul; Jang, Yang Ho; Hossain, Md Akil; Jeong, Kyunghun; Jeong, Mi Young; Yun, Seon-Jong; Park, Sung-Won; Kim, Dae Gyun; Lee, Kwang-Jick

    2017-05-22

    Veterinary medicines have been widely used for the prevention and treatment of diseases, growth promotion, and to promote feeding efficacy in livestock. As the veterinary medicine industry has steadily grown, it is crucial to set up a baseline for the quality of medicine as well as the insufficiency or excessiveness of the active ingredients in drug products to ensure the compliance, safety and efficacy of these medicines. Thus, the 10 years data of post-marketing quality control study was summarized to determine the rate and extent of non-compliance of these medicines and to establish baseline data for future quality control measures of veterinary medicine. In this study, 1650 drugs for veterinary use were collected per year from each city and province in Korea and analysed for the quantity of active ingredients according to the "national post-market surveillance (NPMS) system" over the past decade. The NPMS assessment was performed using liquid and gas chromatography, titration, UV/Vis spectrophotometry, and bioassays. A total of 358 cases were deemed noncompliant, with the average noncompliance rate for all medicine types being 2.0%. The average noncompliance rates for antibiotics, biologics and other chemical drugs except antibiotics (OCD) were 1.1%, 1.2%, and 3.0%, respectively. The first leading cause for noncompliant products was insufficient quantity of major ingredients (283 cases), and the second leading cause was the existence of excess amount of active ingredients (60 cases). Tylosin, spiramycin, ampicillin, tetracyclines and penicillins were most frequently found to be noncompliant among antibiotics. Among the OCD, the noncompliance was found commonly in vitamin A. The overall trend presented gradually decreasing violation rates, suggesting that the quality of veterinary medicines has improved. Consistent application of the NPMS assessment and the establishment of the Korea Veterinary Good Manufacturing Practice (KVGMP) will help to maintain the good

  15. Reevaluation of the post-marketing safety of Shuxuening injection based on real-world and evidence-based evaluations.

    Science.gov (United States)

    Wang, Can; Shi, Qing-Ping; Ding, Feng; Jiang, Xiao-Dong; Tang, Wei; Yu, Mei-Ling; Zhu, Jian-Hua

    2018-01-01

    To evaluate the factors influencing suspected hypersensitivity and adverse systemic reactions after Shuxuening injection and to provide innovative ideas and methods for the reevaluation of post-marketing safety of Shuxuening. This study used a prospective, nested case-control study design, combined with a prescription sequence analysis design method. It classified patients who exhibited trigger signals after administration of Shuxuening injection as suspected allergic patients and made comparisons with patients who did not report adverse effects to calculate the correlation between relevant risk factors and suspected allergic reactions. Randomized controlled studies and cohort studies of the adverse drug reaction (ADR) of Shuxuening were performed using a computer database. Data retrieval was carried out by the foundation governing the individual database. Meta-analysis was performed by using R3.2.3 software to evaluate the ADRs of Shuxuening. The results of real-world study showed that administration of Shuxuening in combination with potassium aspartate and magnesium, atorvastatin calcium, Shengmai injection, pantoprazole sodium, or high-dose medication was a risk factor for suspected allergic reactions. Meta-analysis showed that the incidence of adverse events was 5.84% (95% CI 0.0499; 0.0674), and serious adverse reaction rate was 4.36% (95% CI 0.0188; 0.0760) when Shuxuening was used in combination with these drugs. The incidence of allergic reaction was also influenced by the vehicle, duration of treatment, single dose, and indicated vs off-label use. Risk factors for adverse reaction following the use of Shuxuening injection in patients are associated with a single dose, vehicle, type of disease, and combination with potassium aspartate, atorvastatin calcium, Shengmai injection, injection with pantoprazole sodium, and other drugs. Physicians should be careful to follow guidelines when administering this drug. We further propose that the unique methodology

  16. Mining association patterns of drug-interactions using post marketing FDA's spontaneous reporting data.

    Science.gov (United States)

    Ibrahim, Heba; Saad, Amr; Abdo, Amany; Sharaf Eldin, A

    2016-04-01

    Pharmacovigilance (PhV) is an important clinical activity with strong implications for population health and clinical research. The main goal of PhV is the timely detection of adverse drug events (ADEs) that are novel in their clinical nature, severity and/or frequency. Drug interactions (DI) pose an important problem in the development of new drugs and post marketing PhV that contribute to 6-30% of all unexpected ADEs. Therefore, the early detection of DI is vital. Spontaneous reporting systems (SRS) have served as the core data collection system for post marketing PhV since the 1960s. The main objective of our study was to particularly identify signals of DI from SRS. In addition, we are presenting an optimized tailored mining algorithm called "hybrid Apriori". The proposed algorithm is based on an optimized and modified association rule mining (ARM) approach. A hybrid Apriori algorithm has been applied to the SRS of the United States Food and Drug Administration's (U.S. FDA) adverse events reporting system (FAERS) in order to extract significant association patterns of drug interaction-adverse event (DIAE). We have assessed the resulting DIAEs qualitatively and quantitatively using two different triage features: a three-element taxonomy and three performance metrics. These features were applied on two random samples of 100 interacting and 100 non-interacting DIAE patterns. Additionally, we have employed logistic regression (LR) statistic method to quantify the magnitude and direction of interactions in order to test for confounding by co-medication in unknown interacting DIAE patterns. Hybrid Apriori extracted 2933 interacting DIAE patterns (including 1256 serious ones) and 530 non-interacting DIAE patterns. Referring to the current knowledge using four different reliable resources of DI, the results showed that the proposed method can extract signals of serious interacting DIAEs. Various association patterns could be identified based on the relationships among

  17. Post-marketing surveillance of OraQuick whole blood and oral fluid rapid HIV testing.

    Science.gov (United States)

    Wesolowski, Laura G; MacKellar, Duncan A; Facente, Shelley N; Dowling, Teri; Ethridge, Steven F; Zhu, Julia H; Sullivan, Patrick S

    2006-08-01

    Post-marketing surveillance was conducted to monitor the performance of the OraQuick Advance rapid HIV-1/2 antibody test (OraQuick) on whole blood and oral fluid. Surveillance of routinely collected data on clients tested with OraQuick in 368 testing sites affiliated with 17 state and city health departments between 11 August 2004 and 30 June 2005. For whole blood and oral fluid, we report the median (range) health department OraQuick specificity and positive predictive value (PPV), and the number of clients with discordant results (e.g. who had a reactive rapid test not confirmed positive by Western blot or indirect immunofluorescence). At one site with lower than expected oral-fluid specificity, we evaluated whether device expiration, manufacturing lot, operator practices, or device-storage or testing-area temperatures were associated with false-positive tests. During the surveillance period, 135 724 whole blood and 26 066 oral fluid rapid tests were conducted. The median health department whole blood OraQuick specificity was 99.98% (range: 99.73-100%) and PPV was 99.24% (range: 66.67-100%); the median oral fluid specificity was 99.89% (range: 99.44-100%) and PPV was 90.00% (range: 50.00-100%). A total of 124 discordant results were reported from 68 (0.05%) whole blood and 56 (0.22%) oral fluid rapid tests. The oral fluid specificity at the site with excess oral fluid false-positive tests was 98.7% (95% confidence interval: 98.18-99.11%). The increase in false-positive tests at that site was not associated with any specific device characteristic, operator procedure or temperature condition. The specificity of OraQuick performed on whole blood and oral fluid during post-marketing surveillance was compatible with the manufacturer's claim within the package insert. However, one site experienced lower than expected oral fluid specificity. Sites that observe that the specificity of OraQuick is lower than the range indicated in the package insert should notify the

  18. Transitioning from first- to second-generation biosimilars: An appraisal of regulatory and post-marketing challenges.

    Science.gov (United States)

    Blandizzi, Corrado; Galeazzi, Mauro; Valesini, Guido

    2018-02-01

    Second-generation biosimilars (i.e. monoclonal antibodies or proteins generated by fusion of antibody and receptor moieties) differ in several respects as compared to first-generation ones (e.g. epoetins, bone marrow stimulating factors, somatotropins). In this respect, as second-generation biosimilars are endowed with much greater structural and molecular complexity, which might translate into a number of pharmacological and therapeutic issues, they raise new challenges for manufacturers and regulatory authorities as well as new concerns for clinicians. Based on these arguments, the present article was intended to review information on the main differences between first- and second-generation biosimilars for treatment of immune-mediated inflammatory diseases, as well as their impact on immunogenicity, the design of clinical trials and the critical issue of extrapolation of therapeutic indications. The positions taken by relevant medical associations and the crucial role of pharmacovigilance are also reviewed. According to current knowledge, the initial post-marketing clinical experience with second-generation biosimilars is providing encouraging results, though their long-term safety and efficacy as well as the scientific basis underlying the extrapolation of therapeutic indications are still matter of discussion. There is some consensus that marketing applications should rely on studies supporting the clinical use of biosimilars in their different target diseases and patient populations. In parallel, clinical safety must be ensured by a strict control of the manufacturing processes and a solid pharmacovigilance program. It remains then a responsibility of the physician to drive a proper use of second-generation biosimilars into clinical practice, in accordance with guidelines issued by scientific societies. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Clinical outcomes with daptomycin: a post-marketing, real-world evaluation.

    Science.gov (United States)

    Sakoulas, G

    2009-12-01

    The Cubicin Outcomes Registry and Experience (CORE) is an ongoing, retrospective, post-marketing database of daptomycin use in the USA. Although non-comparative, CORE offers insight into real-life clinical experience with daptomycin in various Gram-positive infections and specific patient types. Analyses of daptomycin treatment outcomes using the CORE database revealed that treatment with daptomycin has resulted in high rates of clinical success for a variety of Gram-positive infections, including indicated infections such as complicated skin and soft tissue infections, Staphylococcus aureus bacteraemia and right-sided infective endocarditis, and non-indicated infections such as osteomyelitis. Treatment outcomes did not differ significantly according to the causative pathogen for any of the analyses performed and were not influenced by the vancomycin MIC. Patients frequently received therapy with alternative antibiotics prior to treatment with daptomycin, particularly those patients with more serious infections. However, similar treatment outcomes were observed when daptomycin was used as first-line therapy or as salvage therapy, demonstrating the effectiveness of daptomycin in the treatment of these patients.

  20. A temporal interestingness measure for drug interaction signal detection in post-marketing surveillance.

    Science.gov (United States)

    Ji, Yanqing; Ying, Hao; Tran, John; Dews, Peter; Mansour, Ayman; Massanari, R Michael

    2014-01-01

    Drug-drug interactions (DDIs) can result in serious consequences, including death. Existing methods for identifying potential DDIs in post-marketing surveillance primarily rely on the FDA's (Food and Drug Administration) spontaneous reporting system. However, this system suffers from severe underreporting, which makes it difficult to timely collect enough valid cases for statistical analysis. In this paper, we study how to signal potential DDIs using patient electronic health data. Specifically, we focus on discovery of potential DDIs by analyzing the temporal relationships between the concurrent use of two drugs of interest and the occurrences of various symptoms using novel temporal association mining techniques we developed. A new interestingness measure called functional temporal interest was proposed to assess the degrees of temporal association between two drugs of interest and each symptom. The measure was employed to screen potential DDIs from 21,405 electronic patient cases retrieved from the Veterans Affairs Medical Center in Detroit, Michigan. The preliminary results indicate the usefulness of our method in finding potential DDIs for further analysis (e.g., epidemiology study) and investigation (e.g., case review) by drug safety professionals.

  1. Effectiveness and tolerability of parenteral testosterone undecanoate: a post-marketing surveillance study.

    Science.gov (United States)

    Wolf, Jan; Keipert, Dieter; Motazedi, Heiko; Ernst, Michael; Nettleship, Joanne; Gooren, Louis

    2017-12-01

    This observational post-marketing study of parenteral testosterone undecanoate (TU) in a non-selected population aimed to: examine the effectiveness of TU as treatment of hypogonadism; record adverse drug reactions (ADR) quantitatively particularly regarding polycythemia, prostate safety and cardiovascular-related metabolic risk factors; and verify whether recommended injection intervals apply to routine clinical practice. Eight hundred and seventy subjects from 259 outpatient units scheduled to visit the clinic six times were included. Effectiveness and tolerability of TU administration were assessed on a 4-point scale. Body weight, waist girth, blood pressure, hemoglobin levels, hematocrit, prostate-specific antigen (PSA), and digital rectal prostate examination were assessed. Over 90% of subjects completed the observational duration of 52.8 ± 9.7 weeks (mean ± SD) and 56% judged effectiveness as very good, 30.8% as good. 63.1% judged tolerability as very good, and 24.4% as good. No adverse effects on indicators of cardiovascular risk were observed. Polycythemia occurred in one subject and a supranormal hematocrit in one subject. Four subjects developed supranormal PSA levels. Prostate carcinoma was found in one subject, one subject had recurrence of a previously surgically treated prostate carcinoma, and the other two showed no indication of malignancy. Parenteral TU is safe, effective, and well-tolerated in clinical practice proving a good therapeutic option for hypogonadism.

  2. [Post-marketing surveillance on Guizhi Fuling Jiaonang based on literature review].

    Science.gov (United States)

    Wang, Gui-Qian; Gao, Yang; Liu, Fu-Mei; Wei, Rui-Li; Xie, Yan-Ming

    2018-02-01

    To systemically evaluate the post-marketing safety of Guizhi Fuling Jiaonang. Computer retrieval was conducted in Medline, EMbase, the Web of Science, Clinical Trials. Gov, the Cochrane Library, CNKI, VIP, WanFang Data and CBM to collect relevant information. The papers were then screened according to inclusion and exclusion criteria. A total of 234 papers were included in this study, including 164 randomized controlled trials, 7 quasi-randomized controlled trials, 8 non-randomized controls, 56 case series, and 1 cohort study. The patients were only treated with Guizhi Fuling Jiaonang in 56 studies, and Guizhi Fuling Jiaonang was combined with other drugs in 178 studies. The total ADRs/AEs incidence was 1.99% in single use of Guizhi Fuling Jiaonang, and 8.21% in combined use, but showing no severe adverse reactions. Gastrointestinal system damage was most common in mild ADRs. In this study, it was found that the overall safety of Guizhi Fuling Jiaonang was acceptable. The direct evidences of the drug's safety case reports were systematically analyzed in this study, but the mechanism study on the safety of the drug after marketing or the prospective long-term clinical observation study was not sufficient, so the further studies on the safety of drug use should be conducted in order to provide better guidance for clinical medication. Copyright© by the Chinese Pharmaceutical Association.

  3. [The role of drug registries in the post-marketing surveillance].

    Science.gov (United States)

    Traversa, Giuseppe; Sagliocca, Luciano; Magrini, Nicola; Venegoni, Mauro

    2013-06-01

    The aim of this article is to provide an introduction to issue of Recenti Progressi in Medicina, devoted to the role of drug registries in the post-marketing surveillance. We first motivate the need to implement registries as a tool in promoting the appropriateness of drug use and acquiring additional information on the risk-benefit profile of drugs. Then, the different role that can be played by registries in comparison with prescription monitoring systems and observational studies is clarified. The presentation of some of the most relevant registries established in Italy since the end of the '90s, with the analysis of their strengths and weaknesses, helps to understand some of the crucial issues that should be taken into account before a new registry is adopted. Specifically, we deal with the relationship between objectives - of appropriateness, effectiveness and safety - and methods; the overlapping between drug-based registries and disease-based ones; the duration and extension of data collection, which may be either exhaustive or based on a sampling frame; the importance of ensuring the quality of the data and to minimize the number of subjects who are lost to follow-up; the importance of infrastructures, and of ad hoc funding, for the functioning of a registry; the independence in data analysis and publication of findings.

  4. A post-marketing study of gadodiamide hydrate in patients with cerebral infarction

    International Nuclear Information System (INIS)

    Ono, Yuko; Aoki, Shigeki

    2003-01-01

    We evaluated the efficacy and safety of gadodiamide hydrate (GH: Omuniscan) in patients with cerebral infarction in a multicenter post-marketing study. A total of 122 patients enrolled in this study at 16 institutions in throughout Japan. We administrated GH to patients intravenously at 0.2 mL/kg, an approved usage and dosage for head MRI. Efficacy was evaluated by comparing contrast intensity and diagnostic improvement on T1WI before and after the administration of GH and diagnostic significance was investigated. Moreover, clinical data thus obtained were compared with those of phase III studies of GH and other contrast agents with respect to general evaluation of diagnostic improvement. The effects of contrast enhancement on the detection and extent of lesions as well as image quality were judged in terms of improving general evaluation and diagnosis, which was observed in 93.3% of the patients. No serious adverse event were associated with GH administration. The efficacy of GH in this clinical trial was higher, than historical data, with respect to general evaluation and diagnostic improvement. Contrast enhanced MRI with GH in cerebral infarction was confirmed to be of diagnostic value. (author)

  5. Use of Carabids for the Post-Market Environmental Monitoring of Genetically Modified Crops

    Directory of Open Access Journals (Sweden)

    Oxana Skoková Habuštová

    2017-03-01

    Full Text Available Post-market environmental monitoring (PMEM of genetically modified (GM crops is required by EU legislation and has been a subject of debate for many years; however, no consensus on the methodology to be used has been reached. We explored the suitability of carabid beetles as surrogates for the detection of unintended effects of GM crops in general PMEM surveillance. Our study combines data on carabid communities from five maize field trials in Central Europe. Altogether, 86 species and 58,304 individuals were collected. Modeling based on the gradual elimination of the least abundant species, or of the fewest categories of functional traits, showed that a trait-based analysis of the most common species may be suitable for PMEM. Species represented by fewer than 230 individuals (all localities combined should be excluded and species with an abundance higher than 600 should be preserved for statistical analyses. Sixteen species, representing 15 categories of functional traits fulfill these criteria, are typical dominant inhabitants of agroecocoenoses in Central Europe, are easy to determine, and their functional classification is well known. The effect of sampling year is negligible when at least four samples are collected during maize development beginning from 1 April. The recommended methodology fulfills PMEM requirements, including applicability to large-scale use. However, suggested thresholds of carabid comparability should be verified before definitive conclusions are drawn.

  6. Dabigatran Levels in Elderly Patients with Atrial Fibrillation: First Post-Marketing Experiences.

    Science.gov (United States)

    Bolek, Tomáš; Samoš, Matej; Škorňová, Ingrid; Stančiaková, Lucia; Staško, Ján; Galajda, Peter; Kubisz, Peter; Mokáň, Marián

    2018-05-08

    The number of elderly individuals with non-valvular atrial fibrillation (NV-AF) requiring long-term anticoagulation is rising. The pharmacokinetics of oral anticoagulants in elderly individuals may differ from that for younger patients. The aim of this study was to assess the dabigatran levels in elderly patients with NV-AF. A pilot prospective post-marketing study in patients with NV-AF on dabigatran therapy was performed; we enrolled 21 consecutive elderly patients (aged ≥ 75 years) on a reduced dabigatran regimen (110 mg twice daily) and compared them with 13 younger (≤ 70 years) individuals on reduced dabigatran therapy due to renal impairment and with 16 younger patients on standard dabigatran therapy (150 mg twice daily). Blood samples were taken for the assessment of dabigatran trough and peak levels. Dabigatran levels were measured with the Hemoclot ® Thrombin Inhibitor Assay. There were significant differences in dabigatran trough levels when comparing elderly patients on reduced dabigatran with non-elderly patients on reduced dabigatran (99.3 ± 73.6 vs 51.6 ± 25.6 ng/mL; p Similarly, the detected dabigatran peak levels were significantly higher in elderly patients on reduced dabigatran compared with non-elderly patients on reduced dabigatran (173.4 ± 116.2 vs 116.1 ± 19.1 ng/mL; p similar levels compared with younger individuals on standard dabigatran.

  7. The role of the pharmaceutical animal health industry in post-marketing surveillance of resistance.

    Science.gov (United States)

    Lens, S

    1993-06-01

    The pharmaceutical animal health industry must be committed to the total life cycle of products, i.e. during both the pre- and post-marketing period. Support of antibacterial agents during the postmarketing period is not restricted to maintaining a well-established distribution and promotion system. Care has to be taken continuously to maintain and/or improve the quality, safety (for user, target animal and environment) and clinical efficacy. The pharmaceutical industry contributes to this by: 1. Introducing antibacterials in different animal species for the most effective disease condition only and by ensuring the veterinary profession is informed about relevant findings on: a. the mechanism of action; b. pharmacodynamic properties; c. pharmacokinetic properties (plasma, target tissue); d. clinical efficacy data and in vitro sensitivity data; e. valid species-specific MIC breakpoints; f. precise dose and treatment regime. 2. Updating on a regular basis on: a. new findings on the mechanism of action (in vitro and in vivo); b. the optimal use program in the light of changes in animal husbandry, farm management and epidemiology on national and international level; c. adjustment of species-specific MIC breakpoints when necessary. 3. Providing continuous information in collaboration with animal health laboratories about: a. clinical field surveillance for efficacy (national, international); b. in vitro sensitivity/resistance surveillance (national, international); c. use of in vitro data to support prediction of in vivo efficacy. Surveillance of resistance, in vitro, is therefore part of a package of information needed on a routine basis by the pharmaceutical industry to allow the best possible use of antibacterials and to minimize induction of resistance.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Environmental change challenges decision-making during post-market environmental monitoring of transgenic crops.

    Science.gov (United States)

    Sanvido, Olivier; Romeis, Jörg; Bigler, Franz

    2011-12-01

    The ability to decide what kind of environmental changes observed during post-market environmental monitoring of genetically modified (GM) crops represent environmental harm is an essential part of most legal frameworks regulating the commercial release of GM crops into the environment. Among others, such decisions are necessary to initiate remedial measures or to sustain claims of redress linked to environmental liability. Given that consensus on criteria to evaluate 'environmental harm' has not yet been found, there are a number of challenges for risk managers when interpreting GM crop monitoring data for environmental decision-making. In the present paper, we argue that the challenges in decision-making have four main causes. The first three causes relate to scientific data collection and analysis, which have methodological limits. The forth cause concerns scientific data evaluation, which is controversial among the different stakeholders involved in the debate on potential impacts of GM crops on the environment. This results in controversy how the effects of GM crops should be valued and what constitutes environmental harm. This controversy may influence decision-making about triggering corrective actions by regulators. We analyse all four challenges and propose potential strategies for addressing them. We conclude that environmental monitoring has its limits in reducing uncertainties remaining from the environmental risk assessment prior to market approval. We argue that remaining uncertainties related to adverse environmental effects of GM crops would probably be assessed in a more efficient and rigorous way during pre-market risk assessment. Risk managers should acknowledge the limits of environmental monitoring programmes as a tool for decision-making.

  9. Serious adverse events after HPV vaccination: a critical review of randomized trials and post-marketing case series.

    Science.gov (United States)

    Martínez-Lavín, Manuel; Amezcua-Guerra, Luis

    2017-10-01

    This article critically reviews HPV vaccine serious adverse events described in pre-licensure randomized trials and in post-marketing case series. HPV vaccine randomized trials were identified in PubMed. Safety data were extracted. Post-marketing case series describing HPV immunization adverse events were reviewed. Most HPV vaccine randomized trials did not use inert placebo in the control group. Two of the largest randomized trials found significantly more severe adverse events in the tested HPV vaccine arm of the study. Compared to 2871 women receiving aluminum placebo, the group of 2881 women injected with the bivalent HPV vaccine had more deaths on follow-up (14 vs. 3, p = 0.012). Compared to 7078 girls injected with the 4-valent HPV vaccine, 7071 girls receiving the 9-valent dose had more serious systemic adverse events (3.3 vs. 2.6%, p = 0.01). For the 9-valent dose, our calculated number needed to seriously harm is 140 (95% CI, 79–653) [DOSAGE ERROR CORRECTED] . The number needed to vaccinate is 1757 (95% CI, 131 to infinity). Practically, none of the serious adverse events occurring in any arm of both studies were judged to be vaccine-related. Pre-clinical trials, post-marketing case series, and the global drug adverse reaction database (VigiBase) describe similar post-HPV immunization symptom clusters. Two of the largest randomized HPV vaccine trials unveiled more severe adverse events in the tested HPV vaccine arm of the study. Nine-valent HPV vaccine has a worrisome number needed to vaccinate/number needed to harm quotient. Pre-clinical trials and post-marketing case series describe similar post-HPV immunization symptoms.

  10. Safety and efficacy of gadoteric acid in pediatric magnetic resonance imaging: overview of clinical trials and post-marketing studies

    Energy Technology Data Exchange (ETDEWEB)

    Balassy, Csilla [Medical University of Vienna, Vienna General Hospital, Department of Radiology, Division of General and Pediatric Radiology, Vienna (Austria); Roberts, Donna [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Miller, Stephen F. [LeBonheur Children' s Hospital, Department of Radiology, Memphis, TN (United States)

    2015-11-15

    Gadoteric acid is a paramagnetic gadolinium macrocyclic contrast agent approved for use in MRI of cerebral and spinal lesions and for body imaging. To investigate the safety and efficacy of gadoteric acid in children by extensively reviewing clinical and post-marketing observational studies. Data were collected from 3,810 children (ages 3 days to 17 years) investigated in seven clinical trials of central nervous system (CNS) imaging (n = 141) and six post-marketing observational studies of CNS, musculoskeletal and whole-body MR imaging (n = 3,669). Of these, 3,569 children were 2-17 years of age and 241 were younger than 2 years. Gadoteric acid was generally administered at a dose of 0.1 mmol/kg. We evaluated image quality, lesion detection and border delineation, and the safety of gadoteric acid. We also reviewed post-marketing pharmacovigilance experience. Consistent with findings in adults, gadoteric acid was effective in children for improving image quality compared with T1-W unenhanced sequences, providing diagnostic improvement, and often influencing the therapeutic approach, resulting in treatment modifications. In studies assessing neurological tumors, gadoteric acid improved border delineation, internal morphology and contrast enhancement compared to unenhanced MR imaging. Gadoteric acid has a well-established safety profile. Among all studies, a total of 10 children experienced 20 adverse events, 7 of which were thought to be related to gadoteric acid. No serious adverse events were reported in any study. Post-marketing pharmacovigilance experience did not find any specific safety concern. Gadoteric acid was associated with improved lesion detection and delineation and is an effective and well-tolerated contrast agent for use in children. (orig.)

  11. Safety and efficacy of gadoteric acid in pediatric magnetic resonance imaging: overview of clinical trials and post-marketing studies.

    Science.gov (United States)

    Balassy, Csilla; Roberts, Donna; Miller, Stephen F

    2015-11-01

    Gadoteric acid is a paramagnetic gadolinium macrocyclic contrast agent approved for use in MRI of cerebral and spinal lesions and for body imaging. To investigate the safety and efficacy of gadoteric acid in children by extensively reviewing clinical and post-marketing observational studies. Data were collected from 3,810 children (ages 3 days to 17 years) investigated in seven clinical trials of central nervous system (CNS) imaging (n = 141) and six post-marketing observational studies of CNS, musculoskeletal and whole-body MR imaging (n = 3,669). Of these, 3,569 children were 2-17 years of age and 241 were younger than 2 years. Gadoteric acid was generally administered at a dose of 0.1 mmol/kg. We evaluated image quality, lesion detection and border delineation, and the safety of gadoteric acid. We also reviewed post-marketing pharmacovigilance experience. Consistent with findings in adults, gadoteric acid was effective in children for improving image quality compared with T1-W unenhanced sequences, providing diagnostic improvement, and often influencing the therapeutic approach, resulting in treatment modifications. In studies assessing neurological tumors, gadoteric acid improved border delineation, internal morphology and contrast enhancement compared to unenhanced MR imaging. Gadoteric acid has a well-established safety profile. Among all studies, a total of 10 children experienced 20 adverse events, 7 of which were thought to be related to gadoteric acid. No serious adverse events were reported in any study. Post-marketing pharmacovigilance experience did not find any specific safety concern. Gadoteric acid was associated with improved lesion detection and delineation and is an effective and well-tolerated contrast agent for use in children.

  12. Safety and efficacy of gadoteric acid in pediatric magnetic resonance imaging: overview of clinical trials and post-marketing studies

    International Nuclear Information System (INIS)

    Balassy, Csilla; Roberts, Donna; Miller, Stephen F.

    2015-01-01

    Gadoteric acid is a paramagnetic gadolinium macrocyclic contrast agent approved for use in MRI of cerebral and spinal lesions and for body imaging. To investigate the safety and efficacy of gadoteric acid in children by extensively reviewing clinical and post-marketing observational studies. Data were collected from 3,810 children (ages 3 days to 17 years) investigated in seven clinical trials of central nervous system (CNS) imaging (n = 141) and six post-marketing observational studies of CNS, musculoskeletal and whole-body MR imaging (n = 3,669). Of these, 3,569 children were 2-17 years of age and 241 were younger than 2 years. Gadoteric acid was generally administered at a dose of 0.1 mmol/kg. We evaluated image quality, lesion detection and border delineation, and the safety of gadoteric acid. We also reviewed post-marketing pharmacovigilance experience. Consistent with findings in adults, gadoteric acid was effective in children for improving image quality compared with T1-W unenhanced sequences, providing diagnostic improvement, and often influencing the therapeutic approach, resulting in treatment modifications. In studies assessing neurological tumors, gadoteric acid improved border delineation, internal morphology and contrast enhancement compared to unenhanced MR imaging. Gadoteric acid has a well-established safety profile. Among all studies, a total of 10 children experienced 20 adverse events, 7 of which were thought to be related to gadoteric acid. No serious adverse events were reported in any study. Post-marketing pharmacovigilance experience did not find any specific safety concern. Gadoteric acid was associated with improved lesion detection and delineation and is an effective and well-tolerated contrast agent for use in children. (orig.)

  13. A post-marketing safety and efficacy assessment of a monoclonal antibody purified high-purity factor VIII concentrate.

    Science.gov (United States)

    Hay, C R; Lee, C A; Savidge, G

    1996-01-01

    The identification of infrequent side-effects of clotting factor concentrates, undetected by clinical trials, is facilitated by post-marketing surveillance. We present a post-marketing surveillance study in which 97 patients with haemophilia A, attending three haemophilia centres, were treated over a median follow-up period of 284 days (range 1-1074), and a total follow-up period of 30,080 days, with a pasteurized immunoaffinity purified factor VIII concentrate (Monoclate-P, Armour, Collegeville, USA). 5216 infusions, using 10,527,000 units of Monoclate-P, were carried out, mostly for routine haemarthroses or prophylaxis. No new inhibitors were observed during the study. At the start of the study 60/97 were HIV seropositive, 67/97 HBs antibody positive, 12 HbsAb negative and the remainder HBsAb positive before the study period. 13/14 tested were HAV seropositive at the beginning of the study. One patient became HAV seropositive during the study period, an infection thought to be community acquired. No other seroconversions were observed. Only one mild transfusion reaction was observed. This study confirms the safety and efficacy of Monoclate-P. Post-marketing surveillance or nationally organized pharmaco-vigilance should be practiced more widely to enable identification of low-frequency side-effects of treatment.

  14. [Nationwide Survey on Informed Consent and Ethical Review at Hospitals Conducting Post-marketing Studies Sponsored by Pharmaceutical Companies].

    Science.gov (United States)

    Urushihara, Hisashi; Murakami, Yuka; Matsui, Kenji; Tashiro, Shimon

    2018-01-01

     Under the Japanese drug regulatory system, post-marketing studies (PMS) must be in compliance with Good Post-marketing Study Practice (GPSP). The GPSP Ordinance lacks standards for the ethical conduct of PMSs; although only post-marketing clinical trials are subject to Good Clinical Practice. We conducted a web-based questionnaire survey on the ethical conduct of PMSs in collaboration with the Japanese Society of Hospital Pharmacists and pharmacists belonging to the Society. 1819 hospitals around Japan answered the questionnaire, of which 503 hospitals had conducted company-sponsored PMSs in 2015. 40.2% of the hospitals had obtained informed consent from participating patients in at least one PMS conducted in 2015, the majority of which was in written form. The first and second most frequent reasons for seeking informed consent in PMSs were to meet protocol requirements, followed by the requirement to meet institutional standard operational procedures and the request of the ethical review board of the hospital. Ethical review of PMSs was conducted in 251 hospitals. Despite a lack of standards for informed consent and ethical review in PMSs, a considerable number of study sites employed informed consent and ethical review for PMSs. While company policies and protocols are likely to be major determinants of the ethical conduct of PMSs, the governmental regulatory agency should also play a significant role in implementing a standardized ethical code for the conduct of PMSs.

  15. Post-marketing research and its outcome for novel anticancer agents approved by both the FDA and EMA between 2005 and 2010: A cross-sectional study.

    Science.gov (United States)

    Zeitoun, Jean-David; Baron, Gabriel; Vivot, Alexandre; Atal, Ignacio; Downing, Nicholas S; Ross, Joseph S; Ravaud, Philippe

    2018-01-15

    Post-marketing research in oncology has rarely been described. We aimed to characterize post-marketing trials for a consistent set of anticancer agents over a long period. We performed a cross-sectional analysis of post-marketing trials registered at ClinicalTrials.gov through September 2014 for novel anticancer agents approved by both the US Food and Drug Administration and the European Medicines Agency between 2005 and 2010. All relevant post-marketing trials were classified according to indication, primary outcome, starting date, sponsors, and planned enrollment. Supplemental indications were retrieved from regulatory documents and publication rate was assessed by two different methods. Ten novel anticancer agents were eligible: five were indicated for hematologic malignancies and the remaining five for solid cancers (three for kidney cancer). We identified 2,345 post-marketing trials; 1,362 (58.1%) targeted an indication other than the originally approved one. We observed extreme variations among drugs in both number of post-marketing trials (range 8-530) and overall population to be enrolled per trial (1-8,381). Post-marketing trials assessed almost all types of cancers, the three most frequently studied cancers being leukemia, kidney cancer and myeloma. In all, 6.6% of post-marketing trials had a clinical endpoint as a primary outcome, and 35.9% and 54.1% had a safety or surrogate endpoint, respectively, as a primary outcome. Nine drugs obtained approval for supplemental indications. The publication rate at 10 years was 12.3 to 26.1% depending on the analysis method. In conclusion, we found that post-marketing research in oncology is highly heterogeneous and the publication rate of launched trials is low. © 2017 UICC.

  16. Valutazione della qualitá dei dati in uno studio post marketing

    Directory of Open Access Journals (Sweden)

    D. D’Alessandro

    2003-05-01

    Full Text Available

    Obiettivo: misurare l'affidabilita nella segnalazione
    di eventi avversi a vaccino nell'ambito di uno studio post-marketing sulla tollerabilita della vaccinazione antipneumococcica (AP in associazione con la vaccinazione antinfluenzale (AI nella popolazione anziana.


    Metodi: e stato predisposto un modello di regressione
    logistica per stimare gli OR tra la segnalazione di almeno un effetto collaterale locale (y ed alcune variabili individuali dei vaccinati (x1: eta .75 anni; x2: sesso; x3: allergie; x4: associazione AI+AP; x5: vivere solo; x6: patologie croniche. I medici aderenti al progetto (229 sono stati stratificati in cinque categorie in funzione dellfincidenza media di eventi avversi da loro registrata: 0% (29, 1-5%
    (68, 6-10% (50, 11-50% (72, .50% (10. Lo stesso modello di regressione e stato applicato ai quattro
    sotto-gruppi di vaccinati afferenti alle categorie di medici che hanno segnalato sintomi, per valutare la coerenza degli OR registrati nei gruppi.

    Risultati: tra i 29.086 vaccinati, l'f11,3% (3.278 ha segnalato almeno un evento avverso locale nelle
    72 ore successive alla vaccinazione: 9,9% tra i soggetti vaccinati con AI e 13,9% tra i vaccinati con
    AI+AP. I fattori significativamente associati all'faumento di rischio sono: AI+AP (OR 1,4; allergie (OR 1,3; patologie croniche (OR 1,3. L' applicazione del modello di regressione ai sotto-gruppi di vaccinati ha mostrato un trend negli OR per le categorie di medici che hanno segnalato dall'f1-5% fino all'f11- 50%, mostrando un'effettiva differenza di rischio dei pazienti.

    Tale coerenza non si e evinta nell'ultima categoria (.50%, dove tali fattori appaiono addiritura protettivi nei riguardi dei sintomi (AI+AP: OR 0,5; allergie: OR 0,7, o non associati
    (patologie croniche: OR 1,0.

    Conclusioni: il 4,3% dei medici arruolati nello studio (10 su 229 ha

  17. [Importance of Post-Marketing Studies in Gathering of Clinical Evidences for Proper Usage of Anti-Cancer Drugs, and the StudyRequirements for Their Credibility].

    Science.gov (United States)

    Inagaki, Osamu

    2016-04-01

    Pharmaceutical companies recognize the importance of post-marketing studies because they are crucial in the generation of clinical evidences for the usage of new medicines. To generate clinical evidences, quality of post-marketing studies should be well controlled from view point of "ethical conduction" and "reliability of results". In addition, control of conflict of interest (COI) between researchers and industries is also indispensable and is requested for the transparency of the studies. Japan Pharmaceutical Manufacturers Association(JPMA)stresses its commitment to the progressof transparency in post-marketing studies.

  18. Construction and analysis of a human hepatotoxicity database suitable for QSAR modeling using post-market safety data

    International Nuclear Information System (INIS)

    Zhu, Xiao; Kruhlak, Naomi L.

    2014-01-01

    Graphical abstract: - Abstract: Drug-induced liver injury (DILI) is one of the most common drug-induced adverse events (AEs) leading to life-threatening conditions such as acute liver failure. It has also been recognized as the single most common cause of safety-related post-market withdrawals or warnings. Efforts to develop new predictive methods to assess the likelihood of a drug being a hepatotoxicant have been challenging due to the complexity and idiosyncrasy of clinical manifestations of DILI. The FDA adverse event reporting system (AERS) contains post-market data that depict the morbidity of AEs. Here, we developed a scalable approach to construct a hepatotoxicity database using post-market data for the purpose of quantitative structure–activity relationship (QSAR) modeling. A set of 2029 unique and modelable drug entities with 13,555 drug-AE combinations was extracted from the AERS database using 37 hepatotoxicity-related query preferred terms (PTs). In order to determine the optimal classification scheme to partition positive from negative drugs, a manually-curated DILI calibration set composed of 105 negatives and 177 positives was developed based on the published literature. The final classification scheme combines hepatotoxicity-related PT data with supporting information that optimize the predictive performance across the calibration set. Data for other toxicological endpoints related to liver injury such as liver enzyme abnormalities, cholestasis, and bile duct disorders, were also extracted and classified. Collectively, these datasets can be used to generate a battery of QSAR models that assess a drug's potential to cause DILI

  19. Post-market drug evaluation research training capacity in Canada: an environmental scan of Canadian educational institutions.

    Science.gov (United States)

    Wiens, Matthew O; Soon, Judith A; MacLeod, Stuart M; Sharma, Sunaina; Patel, Anik

    2014-01-01

    Ongoing efforts by Health Canada intended to modernize the legislation and regulation of pharmaceuticals will help improve the safety and effectiveness of drug products. It will be imperative to ensure that comprehensive and specialized training sites are available to train researchers to support the regulation of therapeutic products. The objective of this educational institution inventory was to conduct an environmental scan of educational institutions in Canada able to train students in areas of post-market drug evaluation research. A systematic web-based environmental scan of Canadian institutions was conducted. The website of each university was examined for potential academic programs. Six core programmatic areas were determined a priori as necessary to train competent post-market drug evaluation researchers. These included biostatistics, epidemiology, pharmacoepidemiology, health economics or pharmacoeconomics, pharmacogenetics or pharmacogenomics and patient safety/pharmacovigilance. Twenty-three academic institutions were identified that had the potential to train students in post-market drug evaluation research. Overall, 23 institutions taught courses in epidemiology, 22 in biostatistics, 17 in health economics/pharmacoeconomics, 5 in pharmacoepidemiology, 5 in pharmacogenetics/pharmacogenomics, and 3 in patient safety/pharmacovigilance. Of the 23 institutions, only the University of Ottawa offered six core courses. Two institutions offered five, seven offered four and the remaining 14 offered three or fewer. It is clear that some institutions may offer programs not entirely reflected in the nomenclature used for this review. As Heath Canada moves towards a more progressive licensing framework, augmented training to increase research capacity and expertise in drug safety and effectiveness is timely and necessary.

  20. [Guidance of FDA risk evaluation and mitigation strategy and enlightenment to drug risk management of post-marketing Chinese medicine].

    Science.gov (United States)

    Li, Yuanyuan; Xie, Yanming

    2011-10-01

    The FDA risk evaluation and mitigation strategy (REMS) aims to drugs or biological products known or potential serious risk management. Analysis with the example of the content of the Onsolis REMS named FOCOS. Our country can be reference for the analysis of relevant experience and establish a scientific evaluation mechanism, strengthen the drug risk consciousness, promote the rational drug use, organic combined with the before-marketing and post-marketing evaluation of traditional Chinese medicine, and promote the evaluation of risk management of the drug development and improvement.

  1. [Taking evaluation of post-marketing as point of cut-in to promote systematic research of traditional Chinese medicine].

    Science.gov (United States)

    Wang, Yong-yan; Wang, Zhi-fei; Xie, Yan-ming

    2014-09-01

    Research on post-marketing Chinese medicine should be the systematic study from application to mechanism. Clinical evaluation is the basis of mechanism study, we can find the clue from clinical evaluation, then make a mechanism study to find the reason, then apply the results to clinic. So it is a virtuous circle. In order to achieve it, we cannot be limited to traditional Chinese medicine, we should form multi-disciplinary team under the direction of grand science thinking, try hard to put industry-university-research institute collaboration association to use, and if necessary, explore the new model of the whole nation system. An appropriate operation mechanism is very important.

  2. Utility of registries for post-marketing evaluation of medicines. A survey of Swedish health care quality registries from a regulatory perspective.

    Science.gov (United States)

    Feltelius, Nils; Gedeborg, Rolf; Holm, Lennart; Zethelius, Björn

    2017-06-01

    The aim of this study was to describe content and procedures in some selected Swedish health care quality registries (QRs) of relevance to regulatory decision-making. A workshop was organized with participation of seven Swedish QRs which subsequently answered a questionnaire regarding registry content on drug treatments and outcomes. Patient populations, coverage, data handling and quality control, as well as legal and ethical aspects are presented. Scientific publications from the QRs are used as a complementary measure of quality and scientific relevance. The registries under study collect clinical data of high relevance to regulatory and health technology agencies. Five out of seven registries provide information on the drug of interest. When applying external quality criteria, we found a high degree of fulfillment, although information on medication was not sufficient to answer all questions of regulatory interest. A notable strength is the option for linkage to the Prescribed Drug Registry and to information on education and socioeconomic status. Data on drugs used during hospitalization were also collected to some extent. Outcome measures collected resemble those used in relevant clinical trials. All registries collected patient-reported outcome measures. The number of publications from the registries was substantial, with studies of appropriate design, including randomized registry trials. Quality registries may provide a valuable source of post-marketing data on drug effectiveness, safety, and cost-effectiveness. Closer collaboration between registries and regulators to improve quality and usefulness of registry data could benefit both regulatory utility and value for health care providers.

  3. [Investigation of the factors that contribute to the onset of insomnia in hypertensive patients by using a post-marketing surveillance database].

    Science.gov (United States)

    Tanabe, Naoto; Fujita, Toshiharu; Fujii, Yosuke; Orii, Takao

    2011-01-01

    Many factors contribute to the onset of insomnia. However, few studies have identified the factors related to the onset of insomnia in hypertensive patients. We conducted a pharmacoepidemiologic study to examine the incidence of insomnia in hypertensive patients by using a post-marketing surveillance database. The insomnia onset was defined as the time of first prescription of hypnotics. The insomnia incidence rate in hypertensive patients under antihypertensive therapy was 0.77/100 person-years. The median insomnia onset date was 5 weeks. The insomnia type in 50.2% of the patients was difficulty in initiating sleep. We assessed the factors contributing to insomnia by using a nested case-control design. We selected 10 time-matched controls for every case. The hypotensive effect induced by antihypertensive therapy on the case group was lesser than that on the control group (pchannel blockers (OR, 0.62; 95% CI, 0.43-0.90) compared with angiotensin-converting enzyme inhibitors; female sex (OR, 1.76; 95% CI, 1.27-2.44); complication of gastric/duodenal disorders (OR, 2.35; 95% CI, 1.14-4.86) or musculoskeletal system/connective tissue disorders (OR, 2.43; 95% CI, 1.23-4.79); and concomitant antihypertensive therapy (OR, 0.44; 95% CI, 0.31-0.63). This study identified the potential factors that may help to predict insomnia onset in hypertensive patients under antihypertensive therapy.

  4. An Ethical Justification for Expanding the Notion of Effectiveness in Vaccine Post-Market Monitoring: Insights from the HPV Vaccine in Canada.

    Science.gov (United States)

    Komparic, Ana; Smith, Maxwell J; Thompson, Alison

    2016-04-01

    Health regulators must carefully monitor the real-world safety and effectiveness of marketed vaccines through post-market monitoring in order to protect the public's health and promote those vaccines that best achieve public health goals. Yet, despite the fact that vaccines used in collective immunization programmes should be assessed in the context of a public health response, post-market effectiveness monitoring is often limited to assessing immunogenicity or limited programmatic features, rather than assessing effectiveness across populations. We argue that post-market monitoring ought to be expanded in two ways to reflect a 'public health notion of post-market effectiveness', which incorporates normative public health considerations: (i) effectiveness monitoring should yield higher quality data and grant special attention to underrepresented and vulnerable populations; and (ii) the scope of effectiveness should be expanded to include a consideration of the various social factors that maximize (and minimize) a vaccine's effectiveness at the population level, paying particular attention to how immunization programmes impact related health gradients. We use the case of the human papillomavirus vaccine in Canada to elucidate how expanding post-market effectiveness monitoring is necessary to close the gap between clinical practice and public health, and to ensure that vaccines are effective in a morally relevant sense.

  5. Clinical Safety and Tolerability of Vildagliptin - Insights from Randomised Trials, Observational Studies and Post-marketing Surveillance.

    Science.gov (United States)

    Mathieu, Chantal; Kozlovski, Plamen; Paldánius, Päivi M; Foley, James E; Modgill, Vikas; Evans, Marc; Serban, Carmen

    2017-08-01

    Vildagliptin is one of the most extensively studied dipeptidyl peptidase-4 (DPP-4) inhibitors in terms of its clinical utility. Over the last decade, a vast panorama of evidence on the benefit-risk profile of vildagliptin has been generated in patients with type 2 diabetes mellitus (T2DM). In this article, we review the cumulative evidence on the safety of vildagliptin from the clinical development programme, as well as reports of rare adverse drug reactions detected during the post-marketing surveillance of the drug. Across clinical studies, the overall safety and tolerability profile of vildagliptin was similar to placebo, and it was supported by real-world data in a broad population of patients with T2DM, making DPP-4 inhibitors, like vildagliptin, a safe option for managing patients with T2DM.

  6. Results of a customer-based, post-market surveillance survey of the HeRO access device.

    Science.gov (United States)

    Fusselman, Maureen

    2010-08-01

    In order to supplement post-market surveillance data on the HeRO vascular access device, a non-scientific customer survey was conducted to obtain quantitative data from dialysis providers caring for patients implanted with the device. Dialysis nurses involved in the care of HeRO patients were contacted in order to obtain post-implant device performance information for 10% of patients implanted with the device at the time of the survey. Thirty-eight dialysis units with a total of 65 HeRO patients participated in the survey. The total duration of HeRO device use was 348.4 months with an average use of 5.4 months. Thirty-eight of the 65 HeRO patients (58.5%) were reported to not have experienced any performance issues. There were 28 device performance incidents reported for the remaining 27 patients included in the survey. Occlusion was the single most commonly reported device-related performance issue with 18 patients (27.7%) experiencing 25 occlusive episodes. The majority of the patients who had an occlusion (66.7%) only experienced one occlusive event. Infections occurred in 4 patients (6.2%) with an overall infection rate of 0.38 per 1,000 patient days. Post-market clinical experience during the first 18 months of commercialization of the HeRO device were in line with expectations based on the results from initial clinical studies with the device. Device occlusion remains the most commonly reported performance issue with the reported rate in this survey less than that which was reported in earlier published studies with the device.

  7. The Barrel vascular reconstruction device for endovascular coiling of wide-necked intracranial aneurysms: a multicenter, prospective, post-marketing study.

    Science.gov (United States)

    Gory, Benjamin; Blanc, Raphaël; Turjman, Francis; Berge, Jérôme; Piotin, Michel

    2018-02-02

    The Barrel vascular reconstruction device (Barrel VRD) is a novel stent with design features that allow endovascular coiling of wide-necked bifurcation aneurysms while preserving adjacent branches, without necessitating dual stent implantation. This study aimed to assess the safety and effectiveness of the Barrel VRD at 12-month follow-up. The Barrel VRD trial is a prospective, multicenter, observational post-marketing registry evaluating the use of the Barrel VRD for treatment of wide-necked bifurcation aneurysms. The primary effectiveness endpoint was successful aneurysm treatment measured by digital subtraction angiography with a Raymond-Roy occlusion grade of 1 or 2 in the absence of retreatment, parent artery stenosis (>50%), or target aneurysm rupture at 12 months. The primary safety endpoint was the absence of neurological death or major stroke at 12 months. Twenty patients were enrolled from December 2013 to December 2014. The device was implanted in 19 patients with 19 aneurysms (8 middle cerebral artery, 4 anterior communicating artery, 1 internal carotid artery terminus, 4 basilar artery aneurysms; mean dome height 5.7±1.91 mm; mean neck length 4.8±1.35 mm, mean dome-to-neck ratio 1.6±2.0). Coiling was performed in all cases. The primary effectiveness endpoint was achieved in 78.9% of subjects (15/19; 12 complete occlusions, 3 neck remnants), and the primary safety endpoint was 5.3% (1/19). This prospective study demonstrates that the Barrel VRD device resulted in ~80% occlusion rates and ~5% rates of neurological complications at 1 year after endovascular treatment of wide-necked bifurcation intracranial aneurysms. REGISTERED CLINICAL TRIAL: NCT02125097;Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Post-marketing surveillance of levofloxacin 0.5% ophthalmic solution for external ocular infections.

    Science.gov (United States)

    Kanda, Yoshiko; Kayama, Tomoko; Okamoto, Shinji; Hashimoto, Masako; Ishida, Chiemi; Yanai, Tomoko; Fukumoto, Mitsuru; Kunihiro, Eiichi

    2012-12-01

    Levofloxacin 0.5% ophthalmic solution is an antibacterial formulation, which was approved and marketed for the treatment of ocular infections in Japan in 2000. This study was designed to investigate the safety and efficacy of levofloxacin 0.5% ophthalmic solution in patients who received treatment for external ocular bacterial infections in regular clinical practice. Patients were recruited from more than 800 medical facilities in Japan, in accordance with Japanese Ministry of Health, Labour and Welfare ordinance guidelines. They were followed during three distinct time periods: April 2000 to December 2001, January 2002 to June 2003, and July 2003 to December 2004. Information from 6760 patients receiving levofloxacin for the treatment of a variety of ocular infections was collected. Levofloxacin was well tolerated: adverse drug reactions (ADRs) were reported in 42 of 6686 patients (0.63%), with no serious ADRs reported. The most commonly reported ADRs were ocular disorders such as blepharitis, eye irritation, and punctate keratitis. The incidence of ADRs did not differ significantly with age, but it was significantly higher in females (0.82%) than in males (0.36%; p = 0.028). A clinical response was observed in 95.5% of patients receiving levofloxacin, with no difference in response between the three time periods. The rate of response to levofloxacin by bacterial disease ranged from 97.4% in keratitis to 88.3% in dacryocystitis. The rate was lower in patients with dacryocystitis, elderly patients, patients with a long duration of illness, and relapsing cases (all p marketing surveillance of levofloxacin, conducted over 4 years, confirms the safety and efficacy of levofloxacin in regular clinical use and highlights that levofloxacin is a promising treatment for a variety of external ocular bacterial infections.

  9. Comparing Safety and Efficacy of "Third-Generation" Antiepileptic Drugs: Long-Term Extension and Post-marketing Treatment.

    Science.gov (United States)

    Kwok, Charlotte S; Johnson, Emily L; Krauss, Gregory L

    2017-11-01

    Four "third-generation" antiepileptic drugs (AEDs) were approved for adjunctive treatment of refractory focal onset seizures during the past 10 years. Long-term efficacy and safety of the drugs were demonstrated in large extension studies and in reports of subgroups of patients not studied in pivotal trials. Reviewing extension study and post-marketing outcome series for the four newer AEDs-lacosamide, perampanel, eslicarbazepine acetate and brivaracetam-can guide clinicians in treating and monitoring patients. AED extension studies evaluate treatment retention, drug tolerability, and drug safety during individualized treatment with flexible dosing and thus provide information not available in rigid pivotal trials. Patient retention in the studies ranged from 75 to 80% at 1 year and from 36 to 68% at 2-year treatment intervals. Safety findings were generally similar to those of pivotal trials, with no major safety risks identified and with several specific adverse drug effects, such as hyponatremia, reported. The third-generation AEDs, some through new mechanisms and others with improved tolerability compared to related AEDs, provide new options in efficacy and tolerability.

  10. Clinical safety and efficacy of "filgrastim biosimilar 2" in Japanese patients in a post-marketing surveillance study.

    Science.gov (United States)

    Tamura, Kazuo; Hashimoto, Kazue; Nishikawa, Kiyohiro

    2018-05-01

    We conducted a post-marketing surveillance to evaluate the safety and efficacy of TKN732, approved as "filgrastim biosimilar 2", in Japanese patients who developed neutropenia in the course of cancer chemotherapy or hematopoietic stem cell transplantation. A total of 653 patients were registered during the 2-year enrollment period starting from May 2013, and 627 and 614 patients were eligible for safety and efficacy analyses of the G-CSF biosimilar, respectively. Forty-three adverse drug reactions were reported in 33 patients (5.26%). Back pain was most frequently observed and reported in 20 patients (3.19%), followed by pyrexia (1.28%) and bone pain (0.96%). Risk factors for adverse reactions identified by logistic regression analyses were younger age, presence of past medical history, and lower total dose at the onset of adverse reactions. Among the 576 cancer patients who developed Grade 2-4 neutropenia after chemotherapy, recovery to Grade 1/0 was reported in 553 patients (96%) following filgrastim biosimilar 2 treatment. The median duration of neutrophil counts below 1500/μL was 5 days. In addition, all 11 patients who underwent hematopoietic stem cell transplantation had good responses to filgrastim biosimilar 2. In conclusion, this study showed that filgrastim biosimilar 2 has a similar safety profile and comparable effects to the original G-CSF product in the real world clinical setting. Copyright © 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  11. Risk Management Post-Marketing Surveillance for the Abuse of Medications Acting on the Central Nervous System: Expert Panel Report

    Science.gov (United States)

    Johanson, Chris-Ellyn; Balster, Robert L.; Henningfield, Jack E.; Schuster, Charles R.; Anthony, James C.; Barthwell, Andrea G.; Coleman, John J.; Dart, Richard C.; Gorodetzky, Charles W.; O’Keeffe, Charles; Sellers, Edward M.; Vocci, Frank; Walsh, Sharon L.

    2010-01-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October, 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and eleven recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized. PMID:19783383

  12. [Safety and efficacy of docetaxel in prostate cancer patients: based on the post-marketing surveillance in Japan].

    Science.gov (United States)

    Mera, Takeshi; Saijo, Nagahiro; Akaza, Hideyuki

    2012-04-01

    The safety and efficacy of docetaxel in prostate cancer were evaluated based on the results of post-marketing surveillance. 149 patients were enrolled between September 2008 and May 2010. The starting dose of docetaxel was 75 mg/m² in 53 patients(36%), 70 mg/m² in 55 (37%), and ≤ 60 mg/m² in 41(28%). The median number of treatment cycles was 8 (range, 1 to 10). There was no age difference observed in the starting doses and the treatment cycles. The most common ≥ grade 3 adverse drug reactions (ADRs) were neutropenia (71%)and leukocytopenia (51%), and they occurred more frequently in patients receiving ≥ 70 mg/m². However, the multi-variate analyses revealed that ≥ grade 3 ADRs did not correlate with the starting doses. Infection-related events (≥ grade 3) and interstitial pneumonia were observed in 15% and 1% of patients, respectively. Prostate-specific-antigen (PSA) flare appeared in 19% of 95 evaluable patients at median period of 26 days from treatment initiation. It continued with median duration of 39. 5 days. PSA response rate as defined ≥ 50% level decline was 37%(95%confidence interval: 27-47) in evaluable patients. It was low in patients receiving ≤ 60 mg/m² (18%). There was no notable difference between patients with initial dose of 75 and 70 mg/m². Further investigation for the longer term is warranted.

  13. Post-marketing surveillance of the safety and effectiveness of tacrolimus in 3,267 Japanese patients with rheumatoid arthritis.

    Science.gov (United States)

    Takeuchi, Tsutomu; Kawai, Shinichi; Yamamoto, Kazuhiko; Harigai, Masayoshi; Ishida, Kota; Miyasaka, Nobuyuki

    2014-01-01

    A post-marketing surveillance (PMS) program was implemented to assess the safety and effectiveness of tacrolimus (TAC) in Japanese rheumatoid arthritis (RA) patients and to identify risk factors related to adverse drug reactions (ADRs). Patients were registered centrally and monitored for all adverse events (AEs) for 24 weeks. Effectiveness was evaluated using the Disease Activity Score 28-CRP (DAS28-CRP). Data from 3,172 patients (mean age 62.2 years) were evaluated in the safety analysis. Of the safety population, 78.5 %were female and 25.9 % were in Steinbrocker's functional class 3 or 4. TAC was prescribed as monotherapy in 52.5 % and the most common concomitant disease modifying antirheumatic drug (DMARD) was methotrexate, used in 28.9 % of the patients. The incidence of AEs, serious AEs (SAEs), ADRs and serious ADRs were 41.2, 6.4, 36.0, and 4.9 %, respectively. The most frequent serious ADR category was infections and infestations. Age ≥ 65 years, concurrent renal dysfunction, and concurrent diabetes mellitus were identified as significant risk factors for ADR. Based on EULAR response criteria, 65.4 % of the patients showed moderate or good response. The results demonstrate that TAC is well tolerated by Japanese patients with active RA, including those receiving concomitant methotrexate, in the real world.

  14. Safety and effectiveness of certolizumab pegol in patients with rheumatoid arthritis: Interim analysis of post-marketing surveillance.

    Science.gov (United States)

    Kameda, Hideto; Nishida, Keiichiro; Nannki, Toshihiro; Watanabe, Akira; Oshima, Yukiya; Momohara, Shigaki

    2017-01-01

    Objective: To evaluate the safety and effectiveness of certolizumab pegol (CZP) in a real-world setting among Japanese patients with rheumatoid arthritis. Post-marketing surveillance data from 2,579 patients treated with CZP were analyzed. Adverse events (AEs) observed during the 24-week CZP treatment period were recorded. Disease activity was evaluated using DAS28-ESR and DAS28-CRP at baseline, Week 12, Week 24, or at withdrawal. The total period of exposure to CZP was 1313.8 patient-years (PY). AEs were reported in 658 (25.5%) patients, at an event rate (ER) of 73.68/100 PY. The most frequent serious AEs were pneumonia, herpes zoster, and interstitial lung disease, at ER per 100 PY of 2.06, 1.29, and 1.22, respectively. Mean disease activity scores at baseline, as measured by DAS28-ESR and DAS28-CRP, were 4.77 ± 1.34 and 4.21 ± 1.27, respectively. Mean changes from baseline at the last observation were -1.29 ± 1.46 and -1.30 ± 1.42, respectively. EULAR good or moderate responses were achieved in 65% of patients. Longer disease duration, prior biologics use, and treatment without MTX co-therapy were associated with EULAR no response. In this interim analysis, no new safety signals were observed. Clinical response to CZP was observed in approximately two thirds of patients.

  15. Safety and efficacy of adapalene gel 0.1% in acne vulgaris: Results of a post-marketing surveillance study

    Directory of Open Access Journals (Sweden)

    Percy S

    2003-07-01

    Full Text Available Introduction: Adapalene is a novel retinoid indicated for the topical treatment of acne vulgaris. The drug was introduced in India in 2001. Aims: A post-marketing surveillance study was conducted to assess the safety and efficacy of adapalene gel 0.1% when used as monotherapy or in combination with other anti-acne agents in Indian patients of acne vulgaris. Material and Methods: A 12-week, multicentre, open-label, non-comparative study involving 571 patients from 21 centers across India was conducted between January and September of 2002. Concomitant prescription of other anti-acne drugs was permitted, if needed. Results: Of the 571 patients, 441 completed the treatment as per protocol. At the end of therapy, 96.3% of patients showed an improvement in their acne from baseline, with greater than 75% improvement seen in two-thirds of patients. Adverse events were reported in 24% of the patients, none of which were serious. The tolerability of therapy was rated as excellent/good in 81% of patients by physicians and in 78% by the patients. Conclusion: Adapalene gel 0.1% is a safe and effective topical agent in the treatment of mild to moderate acne vulgaris in Indian patients. It may be safely combined with other topical and oral anti-acne agents.

  16. Suspected adverse reactions to contrast media in Campania Region (Italy): results from 14 years of post-marketing surveillance.

    Science.gov (United States)

    Sessa, Maurizio; Rossi, Claudia; Mascolo, Annamaria; Grassi, Enrico; Fiorentino, Sonia; Scavone, Cristina; Reginelli, Alfonso; Rotondo, Antonio; Sportiello, Liberata

    2015-01-01

    During the last years in Italy, contrast media (CM) use increased. An increase of monitoring activities on CM-induced adverse drug reaction (ADR) is necessary, also in our regional territory. The main aim of this study was to give a preliminary evaluation of all Spontaneous Reports of ADRs (SRA) attributed to CM sent to Campania Pharmacovigilance Regional Center (CRFVC) from 01 January 2001 to 31 October 2014. For each SRA we evaluated: frequency and source, ADRs onset (time to event, seriousness and outcome), socio-demographic characteristics and risk factors of cases, the most reported CM (checking for pharmacodynamic and pharmacokinetic interactions). A total of 111 SRA were sent to CRFVC; specialist in radiology was the main source of reports. Ninety-seven SRA (87.3%) were referable to hypersensitivity reactions. Thirty-four SRA (30.6%) reported serious ADRs. The most reported CM were iopamidol, gadobenic acid and gadoteric acid. We identified two SRA induced by pharmacokinetic and/or pharmacodynamic interactions. During 14 years of post-marketing surveillance, only few SRA concerning CM-induced ADRs were sent to CRFVC probably due to underreporting. We aim to improve monitoring activity on CM-induced ADRs especially in hospitals. Most reported ADR and CM were in line with current body of literature.

  17. The clinical efficacy of a clarithromycin-based regimen for Mycobacterium avium complex disease: A nationwide post-marketing study.

    Science.gov (United States)

    Kadota, Jun-Ichi; Kurashima, Atsuyuki; Suzuki, Katsuhiro

    2017-05-01

    The revised 2007 American Thoracic Society/Infectious Diseases Society of America statement recommend clarithromycin-based combination therapy for treatment of Mycobacterium avium complex lung disease and stipulates approximately 1 year of continuous treatment after bacilli negative conversion. However, supporting data are insufficient. Our objective was to obtain data on the clinical outcome of clarithromycin-based daily regimens by conducting a nationwide retrospective post-marketing study of M. avium complex lung disease. In accordance with the Japanese guidelines, patients were enrolled in this survey according to their chest radiographic findings and microbiologic test results. They were treated with a multidrug regimen including clarithromycin, rifampicin, and ethambutol (clarithromycin-based regimen) until bacilli negative conversion, and the treatment was continued for approximately 1 year after the initial conversion. Data were collected before administration, at the time of bacilli negative conversion, at the end of treatment, and at 6 months after the end of treatment. Of the 466 subjects enrolled in the study, 271 patients who received clarithromycin at 800 mg/day underwent evaluation for M. avium complex disease. The final bacilli negative conversion rate in those patients was 94.7%. The bacteriological relapse rate was 5.0% (5/100 patients). Bacteriological relapse was noted in patients treated for less than 15 months after conversion. No life-threatening or serious adverse drug reactions were observed. This study demonstrated that a clarithromycin-based daily regimen can yield a high bacteriological conversion rate in M. avium complex disease. After conversion, treatment for less than 15 months might be insufficient to prevent bacteriological relapse. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  18. Drug-induced lung injury associated with sorafenib: analysis of all-patient post-marketing surveillance in Japan.

    Science.gov (United States)

    Horiuchi-Yamamoto, Yuka; Gemma, Akihiko; Taniguchi, Hiroyuki; Inoue, Yoshikazu; Sakai, Fumikazu; Johkoh, Takeshi; Fujimoto, Kiminori; Kudoh, Shoji

    2013-08-01

    Sorafenib is a multi-kinase inhibitor currently approved in Japan for unresectable and/or metastatic renal cell carcinoma and unresectable hepatocellular carcinoma. Although drug-induced lung injury has recently been the focus of interest in Japanese patients treated with molecular targeting agents, the clinical features of patients receiving sorafenib remain to be completely investigated. All-patient post-marketing surveillance data was obtained within the frame of Special Drug Use Investigation; between April 2008 and March 2011, we summarized the clinical information of 62 cases with drug-induced lung injury among approximately 13,600 sorafenib-treated patients in Japan. In addition, we summarized the results of evaluation by a safety board of Japanese experts in 34 patients in whom pulmonary images were available. For the calculation of reporting frequency, interim results of Special Drug Use Investigation were used. In the sets of completed reports (2,407 in renal cell carcinoma and 647 in hepatocellular carcinoma), the reporting frequency was 0.33 % (8 patients; fatal, 4/8) and 0.62 % (4 patients; fatal, 2/4), respectively. Major clinical symptoms included dyspnea, cough, and fever. Evaluation of the images showed that 18 cases out of 34 patients had a pattern of diffuse alveolar damage. The patients with hepatocellular carcinoma showed a greater incidence and earlier onset of lung injury than those with renal cell carcinoma. Although the overall reporting frequency of sorafenib-induced lung injury is not considered high, the radiological diffuse alveolar damage pattern led to a fatal outcome. Therefore, early recognition of sorafenib-induced lung injury is crucial for physicians and patients.

  19. Clinical significance and epidemiologic analyses of Mycobacterium avium and Mycobacterium intracellulare lung disease from post-marketing surveillance.

    Science.gov (United States)

    Suzuki, Katsuhiro; Kurashima, Atsuyuki; Tatsuno, Kinji; Kadota, Jun-Ichi

    2018-01-01

    In Japan, nontuberculous mycobacterial lung disease is mostly attributable to Mycobacterium avium complex (MAC), i.e., M. avium or M. intracellulare. However, clinical features of the disease caused by these two pathogens have not been studied sufficiently yet. A post-marketing survey of clarithromycin was performed at 130 facilities across Japan. The data on patients with M. avium infection and patients with M. intracellulare infection were selected from this survey for comparison of background variables and clinical features of the two pathogens. Among the patients analyzed (n = 368), 67.4% had M. avium infection and 32.6% had M. intracellulare infection. Stratified analysis revealed no significant differences between the ratio of the two pathogens based on gender, disease type, complication, past medical history, or smoking history. However, the percentage of patients with M. intracellulare infection was significantly higher among those with underlying lung disease than among those without lung disease (p = 0.0217). The percentage of patients with M. intracellulare infection rose significantly with age (p = 0.0296). This age-related change was more significant in women (p = 0.0018). When district-wise analysis was performed for Japan, the percentage of M. intracellulare infection was higher in the Chugoku/Shikoku and Kyushu districts whereas the percentage of M. avium infection was higher in the other districts. This survey revealed some differences in the clinical and epidemiologic features of M. avium and M. intracellulare infection. The significant predominance of M. avium infection among relatively young women is suggestive of an increase in the M. avium/M. intracellulare infection ratio among women in the future. Copyright © 2017 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  20. Safety and Effectiveness of Natalizumab: First Report of Interim Results of Post-Marketing Surveillance in Japan.

    Science.gov (United States)

    Saida, Takahiko; Yokoyama, Kazumasa; Sato, Ryusuke; Makioka, Haruki; Iizuka, Yukihiko; Hase, Masakazu; Ling, Yan; Torii, Shinichi

    2017-12-01

    Natalizumab, a humanized anti-α4 integrin monoclonal antibody, received marketing approval in Japan in 2014 for the treatment of multiple sclerosis (MS). Because the previous large-scale clinical trials of natalizumab were mainly conducted in Europe and North American countries, and data in patients with MS from Japan were limited, we conducted an all-case post-marketing surveillance of natalizumab-treated MS patients from Japan to investigate the safety and effectiveness of natalizumab in a real-world clinical setting in Japan. Here, we report the results of an interim analysis. During the observation period of 2 years, all patients who were treated with natalizumab subsequent to its approval in Japan were followed. The effectiveness of natalizumab was assessed by examining the changes in expanded disability status scale (EDSS) score and annualized relapse rate (ARR) from baseline. Safety was assessed by analyzing the incidence of adverse drug reactions (ADRs). The safety analysis included 106 patients (mean age 39.3 years; women 62.3%) whose data were collected until the data lock point (February 7, 2016). The effectiveness analysis included 75 patients. The majority of patients had relapsing-remitting MS (93/106 patients; 87.7%). The mean length of treatment exposure in the present study was 6.6 months. During the 2-year observation period, no significant change in the EDSS was observed, while the ARR decreased significantly from baseline (72.9% reduction, p = 0.001). ADRs and serious ADRs were observed in 11.3% and 3.8% of patients, respectively; however, no new safety concerns were detected. No patient had progressive multifocal leukoencephalopathy (PML) during the present study period. The safety and effectiveness of natalizumab were confirmed in Japanese patients with MS in clinical practice. Nevertheless, potential risks including PML require continuous, careful observation. Biogen Japan Ltd (Tokyo, Japan).

  1. Safety and effectiveness of tadalafil in patients with pulmonary arterial hypertension: Japanese post-marketing surveillance data.

    Science.gov (United States)

    Yamazaki, Hiroyoshi; Kobayashi, Noriko; Taketsuna, Masanori; Tajima, Koyuki; Murakami, Masahiro

    2017-05-01

    To evaluate the long-term safety and effectiveness of tadalafil in patients with pulmonary arterial hypertension (PAH) in real-world clinical practice. This prospective, multicenter, noninterventional, post-marketing surveillance included patients with PAH who were observed for up to 2 years after initiation of tadalafil. Safety was assessed by analyzing the frequency of adverse drug reactions (ADRs), discontinuations due to adverse events (AEs), and serious adverse drug reactions (SADRs). Effectiveness measurements included the assessment of the change in World Health Organization (WHO) functional classification of PAH, 6-minute walk test, cardiac catheterization, and echocardiography. Among 1676 patients analyzed for safety, the overall incidence of ADRs was 31.2%. The common ADRs (≥1.0%) were headache (7.0%), diarrhea (1.9%), platelet count decreased (1.8%), anemia, epistaxis, and nausea (1.6% each), flushing (1.3%), hepatic function abnormal (1.1%), hot flush, and myalgia (1.0% each). The common SADRs (≥0.3%) were cardiac failure (0.7%), interstitial lung disease, worsening of PAH, and platelet count decreased (0.3% each). Among 1556 patients analyzed for effectiveness, the percentages of patients with improvement of WHO functional class at 3 months, 1 year, and 2 years after the initiation of tadalafil, and last observation were 17.1%, 24.8%, 28.9%, and 22.5%, respectively. At all observation points (except pulmonary regurgitation pressure gradient at end diastole at 3 months), the mean 6-minute walk distance, cardiac catheterization, and echocardiogram measurements showed statistically significant improvement. This surveillance demonstrated that tadalafil has favorable safety and effectiveness profiles for long-term use in patients with PAH in Japan.

  2. Itopride in the treatment of functional dyspepsia in Chinese patients: a prospective, multicentre, post-marketing observational study.

    Science.gov (United States)

    Sun, Jing; Yuan, Yao-Zong; Holtmann, Gerald

    2011-12-01

    Prokinetic agents are commonly used in the symptomatic treatment of functional dyspepsia (FD). Safety or efficacy issues associated with the use of available prokinetics, such as metoclopramide, domperidone, cisapride and mosapride, mean there is a need for an effective and well tolerated prokinetic agent. Itopride is a novel prokinetic agent with a dual mode of action, good safety profile and documented efficacy in placebo-controlled trials. The objective of this study was to assess the effectiveness and safety of itopride in the management of FD. This was a prospective, multicentre, post-marketing observational study carried out in private outpatient clinics throughout China. The study included patients with symptomatic FD aged ≥18 years. Patients were prescribed itopride 50 mg three times daily before meals for 4 weeks, after which there was a 2-week follow-up period during which they did not take itopride. Effectiveness and tolerability data obtained from patients who completed 4 weeks of therapy were analysed. The treatment response rate after 4 weeks was measured by patient global assessment; scores at the end of treatment were compared with baseline scores. Response rate based on symptom scoring was also measured after 4 weeks, with an effective treatment being defined as a symptom improvement of ≥50%. In total, 587 patients with FD were enrolled. The mean ± SD difference in the total symptom score before and after the 4-week treatment period was -5.62 ± 3.27, corresponding to a 69.23 ± 26.53% reduction from baseline (p Itopride was an effective and well tolerated drug in the management of FD in this patient population.

  3. Post-marketing access to orphan drugs: a critical analysis of health technology assessment and reimbursement decision-making considerations

    Directory of Open Access Journals (Sweden)

    Iskrov G

    2014-01-01

    Full Text Available Georgi Iskrov, Rumen Stefanov Department of Social Medicine and Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria Abstract: This study aims to explore the current rationale of post-marketing access to orphan drugs. As access to orphan medicinal products depends on assessment and appraisal by health authorities, this article is focused on health technology assessment (HTA and reimbursement decision-making considerations for orphan drugs. A critical analysis may identify important factors that could predetermine the combined outcomes of these two processes. Following this objective, an analytical framework was developed, comprising three overlaying issues: to outline what is currently done and what needs to be done in the field of HTA of orphan drugs, to synthesize important variables relevant to the reimbursement decision-making about orphan drugs, and to unveil relationships between theory and practice. Methods for economic evaluation, cost-effectiveness threshold, budget impact, uncertainty of evidence, criteria in reimbursement decision-making, and HTA research agenda are all explored and discussed from an orphan drug perspective. Reimbursement decision-making for orphan drugs is a debate of policy priorities, health system specifics, and societal attitudes. Health authorities need to pursue a multidisciplinary analysis on a range of criteria, ensuring an explicit understanding of the trade-offs for decisions related to eligibility for reimbursement. The only reasonable way to accept a higher valuation of orphan drug benefits is if these are demonstrated empirically. Rarity means that the quality of orphan drug evidence is not the same as for conventional therapies. Closing this gap is another crucial point for the timely access to these products. The generation of evidence goes far beyond pre-market authorization trials and requires transnational cooperation and coordination. Early constructive dialogue among orphan drug

  4. Post-marketing surveillance in the published medical and grey literature for percutaneous transluminal coronary angioplasty catheters: a systematic review.

    Science.gov (United States)

    Polisena, Julie; Forster, Alan J; Cimon, Karen; Rabb, Danielle

    2013-10-10

    Post-marketing surveillance (PMS) may identify rare serious incidents or adverse events due to the long-term use of a medical device, which was not captured in the pre-market process. Percutaneous transluminal coronary angioplasty (PTCA) is a non-surgical procedure that uses a balloon-tipped catheter to enlarge a narrowed artery. In 2011, 1,942 adverse event reports related to the use of PTCA catheters were submitted to the FDA by the manufacturers, an increase from the 883 reported in 2008. The primary research objective is to conduct a systematic review of the published and grey literature published between 2007 and 2012 for the frequency of incidents, adverse events and malfunctions associated with the use of PTCA catheters in patients with coronary artery disease (CAD). Grey literature has not been commercially published. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and PubMed for medical literature on PMS for PTCA catheters in patients with CAD published between January 2007 and July 2012. We also searched the grey literature. This review included 11 studies. The in-hospital adverse events reported were individual cases of myocardial infarction and hematoma. In studies of patients with coronary perforation, more patients with balloon angioplasty were identified compared with patients who required stenting. Our systematic review illustrates that the volume and quality of PMS studies associated with the use of PTCA catheters in patients with CAD are low in the published and grey literature, and may not be useful sources of information for decisions on safety. In most studies, the objectives were not to monitor the long-term safety of the use of PTCA catheters in clinical practice. Future studies can explore the strengths and limitations of PMS databases administered by regulatory authorities.

  5. Maturing ECRF technology for plasma control

    International Nuclear Information System (INIS)

    Callis, R.W.; .; Cary, W.P.; Chu, S.

    2003-01-01

    The availability of high power, (∼1 MW) long pulse length (effectively cw), high frequency, (>100 GHz) gyrotrons has opened the opportunity for enhanced scientific results on magnetic confinement devices for fusion research worldwide. This has led to successful experiments on electron cyclotron heating, electron cyclotron current drive, non-inductive tokamak operation, tokamak energy transport, suppression of instabilities and advanced profile control leading to enhanced performance. The key development in the gyrotron community that has led to the realization of high power long pulse gyrotrons is the availability of edge cooled synthetic diamond gyrotron output windows, which have low loss and excellent thermal and mechanical properties. In addition to the emergence of reliable high power gyrotrons, ancillary equipment for efficient microwave transmission over distances of hundreds of meters, polarization control, diagnostics, and flexible launch geometry have all been developed and proven in regular service. (author)

  6. [Study on building index system of risk assessment of post-marketing Chinese patent medicine based on AHP-fuzzy neural network].

    Science.gov (United States)

    Li, Yuanyuan; Xie, Yanming; Fu, Yingkun

    2011-10-01

    Currently massive researches have been launched about the safety, efficiency and economy of post-marketing Chinese patent medicine (CPM) proprietary Chinese medicine, but it was lack of a comprehensive interpretation. Establishing the risk evaluation index system and risk assessment model of CPM is the key to solve drug safety problems and protect people's health. The clinical risk factors of CPM exist similarities with the Western medicine, can draw lessons from foreign experience, but also have itself multi-factor multivariate multi-level complex features. Drug safety risk assessment for the uncertainty and complexity, using analytic hierarchy process (AHP) to empower the index weights, AHP-based fuzzy neural network to build post-marketing CPM risk evaluation index system and risk assessment model and constantly improving the application of traditional Chinese medicine characteristic is accord with the road and feasible beneficial exploration.

  7. Systematic review of reporting rates of adverse events following immunization: an international comparison of post-marketing surveillance programs with reference to China.

    Science.gov (United States)

    Guo, Biao; Page, Andrew; Wang, Huaqing; Taylor, Richard; McIntyre, Peter

    2013-01-11

    China is the most populous country in the world, with an annual birth cohort of approximately 16 million, requiring an average of 500 million vaccine doses administered annually. In China, over 30 domestic and less than 10 overseas vaccine manufacturers supply over 60 licensed vaccine products, representing a growing vaccine market mainly due to recent additions to the national immunization schedule, but data on post-marketing surveillance for adverse events following immunization (AEFI) are sparse. To compare reporting rates for various categories of AEFI from China with other routine post-marketing surveillance programs internationally. Systematic review of published studies reporting rates of AEFI by vaccine, category of reaction and age from post-marketing surveillance systems in English and Chinese languages. Overall AEFI reporting rates (all vaccines, all ages) in Chinese studies were consistent with those from similar international studies elsewhere, but there was substantial heterogeneity in regional reporting rates in China (range 2.3-37.8/100,000 doses). The highest AEFI reporting rates were for diphtheria-tetanus-pertussis whole-cell (DTwP) and acellular (DTaP) vaccines (range 3.3-181.1/100,000 doses for DTwP; range 3.5-92.6/100,000 doses for DTaP), with higher median rates for DTwP than DTaP, and higher than expected rates for DTaP vaccine. Similar higher rates for DTwP and DTaP containing vaccines, and relatively lower rates for vaccines against hepatitis B virus, poliovirus, and Japanese encephalitis virus were found in China and elsewhere in the world. Overall AEFI reporting rates in China were consistent with similar post-marketing surveillance systems in other countries. Sources of regional heterogeneity in AEFI reporting rates, and their relationships to differing vaccine manufacturers versus differing surveillance practices, require further exploration. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Prospective Observational Post-Marketing Study of Tafluprost for Glaucoma and Ocular Hypertension: Effectiveness and Treatment Persistence.

    Science.gov (United States)

    Kuwayama, Yasuaki; Hashimoto, Masako; Kakegawa, Reiko; Nomura, Akio; Shimada, Fumiki

    2017-06-01

    The aim of this study was to investigate the long-term intraocular pressure (IOP)-lowering effect and safety of tafluprost, a prostaglandin analogue, in actual clinical practice and to determine persistency of tafluprost as an indicator of its benefit-risk balance. This was a large-scale, post-marketing, multicenter, non-interventional, open-label, long-term study. Patients with glaucoma or ocular hypertension who initiated tafluprost treatment were registered and prospectively observed over a 2-year period in the real-world setting in Japan. Long-term IOP and safety data were collected. Of the 4502 patients registered from 553 medical institutions, 4265 patients were analyzed. The majority of patients had normal-tension glaucoma (44.4%) and primary open-angle glaucoma (37.8%), and patients with ocular hypertension constituted 7.0%. Treatment patterns with tafluprost during the study period were as follows: naïve monotherapy (48.1%), switching monotherapy (18.4%), and concomitant therapy (33.5%). In all patients analyzed, mean IOP was significantly reduced from 18.6 ± 5.9 mmHg (month 0) to 15 mmHg or below throughout the 2-year observation period after initiation of tafluprost. Significant IOP-lowering effects were shown in various treatment patterns and disease types. Adverse reactions were observed in 795 patients (18.64%). Major adverse reactions included eyelid pigmentation, ocular hyperemia, eyelash changes, eyelid hypertrichosis, and iris hyperpigmentation. Kaplan-Meier curves showed that 84.6% and 76.1% of patients were persistent on tafluprost for 1 and 2 years, respectively, when discontinuation due to insufficient efficacy or adverse events was defined as a treatment failure event. Furthermore, among treatment-naïve patients (n = 2304), the persistency rates on tafluprost monotherapy were 77.0% for 1 year and 67.0% for 2 years. Tafluprost showed significant long-term IOP-lowering effects regardless of treatment patterns or diagnosis, with

  9. A Post-marketing Surveillance Study of Chronic Wounds Treated With a Native Collagen Calcium Alginate Dressing.

    Science.gov (United States)

    Sabo, Matthew; Le, Lam; Yaakov, Raphael A; Carter, Marissa; Serena, Thomas E

    2018-04-01

    Chronic wounds (ie, wounds that fail to progress through a normal, orderly, timely sequence of repair) continue to pose significant clinical and economic burdens. A prospective, descriptive, 3-week post-marketing surveillance study was conducted across 3 wound care centers in the United States to evaluate the effectiveness of a collagen calcium alginate dressing on chronic wounds in conjunction with standard care (SC) practices (eg, offloading, debridement, compression) to support healing. Eligible participants had to be >18 years of age, have at least 1 chronic wound, and no known sensitivity to collagen. Demographic characteristics were recorded at the screening visit on case report forms. At each visit, wound-related pain was assessed using the Visual Analog Scale along with wound characteristics including size (using digital planimetry), wound exudate (minimal, moderate, heavy), and odor (none, mild). Participants were monitored for adverse events as well as infection based on signs and symptoms in and around the local wound bed, the deeper structures, and the surrounding skin. An intention-to-treat approach was used for all analyses. If an observation was missing, the last observation carried forward principle was used. For wounds that healed, pain and exudate were set to 0 (no pain/exudate) at visit 4. Descriptive, paired t tests and the Wilcoxon signed rank test were used to analyze the data. Of the 31 participants (15 men, 16 women, mean age 66.6 years), most (13, 42%) had a diabetic foot ulcer or venous leg ulcer (10, 32%); median duration of all wounds was 148 days. Thirty (30) patients completed the study. The mean number of comorbidities was 10.6 ± 6.3, and patients used a mean of 9.3 ± 5.64 prescription or over-the-counter medications. For all wounds combined, mean wound area was 4.8 ± 8.38 cm2 at baseline. At week 3, a decrease in wound area of 38.1% was noted (median: 45% ± 42.54; P = .006); 3 wounds healed completely. The change in wound exudate

  10. Durapain in symptomatic treatment of severe acute pain: a post-marketing, prospective, multicenter, observational study – PRIME study

    Directory of Open Access Journals (Sweden)

    Shah K

    2017-05-01

    Full Text Available Kshitij Shah,1 Omvijay B Chaudhari,2 Palash Gupta,3 R Hom Chaudhuri,4 Ranjan Kamilya,5 Shreedhar S Kulkarni,6 S Subbaiah,7 Zubair H Sorathia,8 Gauri Billa9 1MS Orthopedic, Prime Hospital, Andheri (West, 2Vatsalya Nursing Home, Kalyan (West, Mumbai, 3Dr. Palash Gupta Clinic, Rohini, New Delhi, 4Homchaudhuri’s Clinic, 5Apollo Gleneagles Hospital, Kolkata, West Bengal, 6Amrit Clinic, Matunga, Mumbai, 7Subbaiah’s Clinic, West Mambalam, Chennai, 8Medicare Hospital, Marol, Andheri East, 9Medical Services, Abbott Healthcare Pvt. Ltd, Mulund (West, Mumbai, Maharashtra, India Objective: To assess the effectiveness, overall tolerability, and gastrointestinal (GI tolerability of Durapain (fixed dose combination of tramadol hydrochloride immediate release [50 mg] and diclofenac sodium sustained release [75 mg] in symptomatic treatment of severe acute pain in physician’s routine clinical practice. Materials and methods: In this prospective, multicenter, observational, post-marketing study, adult patients (aged 18–60 years with severe acute pain were treated with tramadol hydrochloride/diclofenac sodium as per approved prescribing information. Evaluation was done at baseline, day 2, and day 5. Primary end point was pain intensity difference from baseline to day 5. Results: A total of 351 patients (mean age 44.2 years; male 43%; female 57% were included. The mean pain score was reduced from 9.2±1.09 at baseline to 2.8±1.73 at day 5 (p<0.0001. The number of patients with severe intensity of pain reduced from 100% at baseline to 18.3% at day 2 and 6.96% at day 5. According to the patient assessment, 68.36% of patients reported tolerability as “very good to good”, whereas according to physician’s assessment, “very good to good” tolerability was reported in 68.27% of patients. Five (1.43 % patients discontinued the study because of adverse drug reaction. Five patients developed nine GI-related events of moderate intensity. Two patients

  11. [Post-marketing surveillance of antibacterial activities of cefozopran against various clinical isolates--I. Gram-positive bacteria].

    Science.gov (United States)

    Igari, Jun; Oguri, Toyoko; Hiramatsu, Nobuyoshi; Akiyama, Kazumitsu; Koyama, Tsuneo

    2003-10-01

    As a post-marketing surveillance, the in vitro antibacterial activities of cefozopran (CZOP), an agent of cephems, against various clinical isolates were yearly evaluated and compared with those of other cephems, oxacephems, penicillins, and carbapenems. Changes in the bacterial susceptibility for CZOP were also evaluated with the resistance ratio calculated with breakpoint MIC. Sixteen species (2,363 strains) of Gram-positive bacteria were isolated from the clinical materials annually collected from 1996 to 2001, and consisted of methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant Staphylococcus aureus (MRSA), methicillin-susceptible Staphylococcus epidermidis (MSSE), methicillin-resistant Staphylococcus epidermidis (MRSE), Staphylococcus haemolyticus, Staphylococcus saprophyticus, Enterococcus faecalis, Enterococcus faecium, Enterococcus avium, Streptococcus pyogenes, Streptococcus agalactiae, penicillin-susceptible Streptococcus pneumoniae (PSSP), penicillin-intermediate resistant S. pneumoniae (PISP), penicillin-resistant S. pneumoniae (PRSP), Streptococcus milleri group and Peptostreptococcus spp. The antibacterial activity of CZOP either against MSSA or MSSE was preferable (MIC90: 2 or 0.5 micrograms/mL) and comparable to those of other cephems. CZOP was also effective on MRSE (MIC90: 16 micrograms/mL) but not on MRSA. CZOP and other cephems had low antibacterial activity against S. haemolyticus (MIC90: 64 micrograms/mL). The antibacterial activity of CZOP against S. saprophyticus was comparable to or higher than those of other cephems, but the MIC90 of CZOP in 2001 was higher than those in 1996-2000 (32 vs 1-2 micrograms/mL). The antibacterial activity of CZOP against E. faecalis was comparable to that of cefpirome (CPR; MIC90: 16 micrograms/mL) and higher than those of other cephems. No antibacterial activity of CZOP against E. faecium and E. avium was observed, like other drugs. The antibacterial activity of CZOP against S. pyogenes

  12. [Post-marketing surveillance of antibacterial activities of cefozopran against various clinical isolates--II. Gram-negative bacteria].

    Science.gov (United States)

    Igari, Jun; Oguri, Toyoko; Hiramatsu, Nobuyoshi; Akiyama, Kazumitsu; Koyama, Tsuneo

    2003-10-01

    As a post-marketing surveillance, the in vitro antibacterial activities of cefozopran (CZOP), an agent of cephems, against various clinical isolates were yearly evaluated and compared with those of other cephems, oxacephems, carbapenems, monobactams, and penicillins. Changes in CZOP susceptibility among bacteria were also evaluated with the bacterial resistance ratio calculated from the breakpoint MIC. Twenty-five species (4,154 strains) of Gram-negative bacteria were isolated from the clinical materials annually collected from 1996 to 2001, and consisted of Moraxella (Branhamella) catarrhalis, Haemophilus influenzae, Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, Enterobacter aerogenes, Serratia marcescens, Serratia liquefaciens, Citrobacter freundii, Citrobacter koseri, Proteus mirabilis, Proteus vulgaris, Morganella morganii, Providencia spp., Pseudomonas aeruginosa, Pseudomonas fluorescens, Pseudomonas putida, Acinetobacter baumannii, Acinetobacter Iwoffii, Burkholderia cepacia, Stenotrophomonas maltophilia, Bacteroides fragilis group, and Prevotella/Porphyromonas. CZOP preserved its antibacterial activity against M. (B.) catarrhalis (MIC90: 4 micrograms/mL) and showed comparable activity to carbapenems against H. influenzae (MIC90: 1 microgram/mL). The antibacterial activity of CZOP against E. coli was preferable (MIC90: 0.125 microgram/mL) and comparable to those of cefpirome (CPR), cefepime (CFPM), and imipenem (IPM). The MIC90 of CZOP against K. pneumoniae and K. oxytoca was 1 and 0.25 microgram/mL, respectively. The MIC90 of CZOP against E. cloacae increased during 6 years (32 to 128 micrograms/mL). The antibacterial activity of CZOP against E. aerogenes was preferable (MIC90: 1 microgram/mL). The antibacterial activities of CZOP against S. marcescens and S. liquefaciens were relatively potent (MIC90: 0.5 and 0.25 microgram/mL) and comparable to those of CPR, CFPM, and carumonam. CZOP preserved comparable antibacterial

  13. Safety and Effectiveness of Mirabegron in Patients with Overactive Bladder Aged ≥75 Years: Analysis of a Japanese Post-Marketing Study.

    Science.gov (United States)

    Yoshida, Masaki; Nozawa, Yumiko; Kato, Daisuke; Tabuchi, Hiromi; Kuroishi, Kentarou

    2017-09-12

    A 12-week post-marketing study was conducted to provide real-world data on Japanese patients with overactive bladder (OAB) initiating treatment with mirabegron. This post-hoc analysis focused on safety and effectiveness of mirabegron in patients aged ≥75 versus Similar changes were observed for I-PSS QoL in both groups. In a real-world clinical setting, mirabegron was well-tolerated and effective in patients aged ≥75 and <75 years. © 2017 John Wiley & Sons Australia, Ltd.

  14. Conceptual design study of fusion experimental reactor (FY86 FER)

    International Nuclear Information System (INIS)

    Nakashima, Kunihiko; Okano, Kunihiko; Miyamoto, Kazuhiro.

    1987-09-01

    This report describes the results of a conceptual study on the RF system in the typical candidates for the Fusion Experimental Reactor (FER), which were picked out through the '86FER scoping studies. According to the FER operation scenario, three RF systems, that is, ICRF (heating), LHRF (current drive and heating), ECRF (auxiliary heating) were studied. Main concern in these RF systems is the launcher, which may be so designed that required power match the geometrical constraints of the reactor. Then studies were concentrated on the launcher configuration. A prug-in concept of the launcher was adopted in each system and vacancies except transmission space were filled with water. The ICRF launcher had the 2 x 2 loop arrays antenna and the faraday shield area of 1.5 m x 1 m to provide a power of 20 MW. The LHRF launcher had the grillantenna with 28 x 8 open waveguides, and included multi junction-type power splitters which were connected to 56 transmission wave guides. The grild was designed to have two functions of current drive and heating, and provide a power of 20 MW each. The ECRF launcher had a boundle of open wave guides which a reflection mirror each, and three plain mirrors. Assuming a oscillator unit size of 200 kW, it had 40 oversized wave guides to provide a power of 3 MW. (author)

  15. Diffuse large B-cell lymphoma associated with the use of biologic and other investigational agents: the importance of long-term post-marketing safety surveillance.

    Science.gov (United States)

    Goddard, Allison; Borovicka, Judy H; West, Dennis P; Evens, Andrew M; Laumann, Anne

    2011-01-01

    This case report describes a patient who developed diffuse large B-cell lymphoma (DLBCL) after receiving courses of two investigational biologic agents and cyclosporine followed by more than four years of subcutaneous efalizumab for the treatment of extensive chronic plaque psoriasis. Three years later, the patient remains free of lymphoma and his psoriasis is well controlled with thrice-weekly narrow-band ultraviolet phototherapy. This case emphasizes the importance of continued long-term post-marketing safety surveillance and the early reporting of all possible serious side effects, including cancers, related to the use of any newly available product. In particular, surveillance should focus on the immunomodulating biologic agents in order to identify possible dangerous sequelae.

  16. A Pharmacovigilance Approach for Post-Marketing in Japan Using the Japanese Adverse Drug Event Report (JADER Database and Association Analysis.

    Directory of Open Access Journals (Sweden)

    Masakazu Fujiwara

    Full Text Available Rapid dissemination of information regarding adverse drug reactions is a key aspect for improving pharmacovigilance. There is a possibility that unknown adverse drug reactions will become apparent through post-marketing administration. Currently, although there have been studies evaluating the relationships between a drug and adverse drug reactions using the JADER database which collects reported spontaneous adverse drug reactions, an efficient approach to assess the association between adverse drug reactions of drugs with the same indications as well as the influence of demographics (e.g. gender has not been proposed.We utilized the REAC and DEMO tables from the May 2015 version of JADER for patients taking antidepressant drugs (SSRI, SNRI, and NaSSA. We evaluated the associations using association analyses with an apriori algorithm. Support, confidence, lift, and conviction were used as indicators for associations. The highest score in adverse drug reactions for SSRI was obtained for "aspartate aminotransferase increased", "alanine aminotransferase increased", with values of 0.0059, 0.93, 135.5, and 13.9 for support, confidence, lift and conviction, respectively. For SNRI, "international normalized ratio increased", "drug interaction" were observed with 0.0064, 1.00, 71.9, and NA. For NaSSA, "anxiety", "irritability" were observed with 0.0058, 0.80, 49.9, and 4.9. For female taking SSRI, the highest support scores were observed in "twenties", "suicide attempt", whereas "thirties", "neuroleptic malignant syndrome" were observed for male. Second, for SNRI, "eighties", "inappropriate antidiuretic hormone secretion" were observed for female, whereas "interstitial lung disease" and "hepatitis fulminant" were for male. Finally, for NaSSA, "suicidal ideation" was for female, and "rhabdomyolysis" was for male.Different combinations of adverse drug reactions were noted between the antidepressants. In addition, the reported adverse drug reactions

  17. Safety and effectiveness of tofogliflozin in elderly Japanese patients with type 2 diabetes mellitus: A post-marketing study (J-STEP/EL Study).

    Science.gov (United States)

    Utsunomiya, Kazunori; Shimmoto, Naoki; Senda, Masayuki; Kurihara, Yuji; Gunji, Ryoji; Fujii, Shoko; Kakiuchi, Seigo; Fujiwara, Hisataka; Kameda, Hiroyuki; Tamura, Masahiro; Kaku, Kohei

    2017-11-01

    Although sodium-glucose cotransporter 2 inhibitors are a promising treatment for type 2 diabetes mellitus, they are associated with concerns about specific adverse drug reactions. We carried out a 1-year post-marketing study of tofogliflozin, a novel agent in this class, in Japanese elderly patients with type 2 diabetes mellitus. This was a prospective, observational and multicenter post-marketing study carried out in the context of routine clinical practice. The study included all type 2 diabetes patients aged ≥65 years who started treatment with tofogliflozin during the first 3 months after its launch on 23 May 2014. Of 1,535 patients registered, 1,507 patients whose electronic case report forms were collected and who had at least one follow-up visit were included in the safety analysis. A total of 270 of 1,507 patients (17.92%) had at least one adverse drug reaction to tofogliflozin. The incidences of adverse drug reactions of special interest, namely, polyuria/pollakiuria, volume depletion-related events, urinary tract infection, genital infection, hypoglycemia and skin disorders were 2.92, 3.85, 2.06, 1.33, 1.06 and 2.39%, respectively. Among those patients evaluable for clinical effectiveness, the mean change in glycated hemoglobin and bodyweight from baseline to last visit was -0.46% (P < 0.0001) and -2.71 kg (P < 0.0001), respectively. The present study showed that the incidence of adverse drug reactions to tofogliflozin in this study of elderly patients aged ≥65 years differed little from the incidence in the preapproval clinical trials. It was shown that tofogliflozin significantly decreased glycated hemoglobin levels. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  18. Safety and effectiveness of gemcitabine in 260 patients with biliary tract cancer in a Japanese clinical practice based on post-marketing surveillance in Japan.

    Science.gov (United States)

    Okubo, Sumiko; Nishiuma, Shinichi; Kobayashi, Noriko; Taketsuna, Masanori; Taniai, Hisashi

    2012-11-01

    Gemcitabine was approved for the treatment of biliary tract cancer in 2006 in Japan. While biliary tract cancer is usually associated with patients 70 years of age or older and/or those who tend to have underlying liver dysfunction, data on this population were limited in the Japanese Phase II study of gemcitabine. Thus, further evaluation of safety and effectiveness in this population was planned. This special post-marketing surveillance was conducted as an observational study on the use of gemcitabine in a clinical practice setting. Gemcitabine-naïve patients with biliary tract cancer were enrolled from 2006 to 2008 and observed over 12 months; one or more doses of gemcitabine were administered during the period. Data such as patient background, treatment details, adverse events occurring during the observational period, laboratory values of liver enzyme and survival status were collected 3 and 12 months after the start of therapy. Of the 285 patients registered for the study, 260 were included in the analysis. The mean age was 66.9 years. There were 120 patients (46.2%) classified as elderly (70 years or older). Haematotoxicities were the most common adverse drug reactions. In the elderly and the non-elderly, adverse drug reactions (serious) occurred in 48.3% (20.8%) and 50.7% (12.9%), respectively. The overall estimated 1-year survival rate was 52.5% (95% confidence interval, 45.9-58.7%). In line with previous clinical and post-marketing studies conducted in Japan, the results of this study suggest that gemcitabine could be used safely and effectively for biliary tract cancer patients including the elderly.

  19. Multicenter, noninterventional, post-marketing surveillance study to evaluate dosing of recombinant human follicle-stimulating hormone using the redesigned follitropin alfa pen in women undergoing ovulation induction

    Science.gov (United States)

    Nawroth, Frank; Tandler-Schneider, Andreas; Bilger, Wilma

    2015-01-01

    This prospective, noninterventional, post-marketing surveillance study evaluated doses of recombinant human follicle-stimulating hormone (r-hFSH) using the redesigned follitropin alfa pen in women who were anovulatory or oligomenorrheic and undergoing ovulation induction (OI) alone or OI with intrauterine insemination. The primary endpoint was the proportion of patients who achieved monofollicular or bifollicular development (defined as one or two follicles ≥15 mm). Secondary endpoints included characteristics of ovulation stimulation treatment, such as mean total and mean daily r-hFSH doses. Data were analyzed for 3,193 patients from 30 German fertility centers. The proportion of patients with monofollicular or bifollicular development was 71.1% (n=2,270 of a total of 3,193 patients; intent-to-treat population). The mean±standard deviation total and daily doses of r-hFSH were 696.9±542.5 IU and 61.7±29.4 IU, respectively. The three doses prescribed most frequently were: 37.5 IU (n=703 from N=3,189; 22.0%), 50.0 IU (n=1,056 from N=3,189; 33.1%), and 75.0 IU (n=738 from N=3,189; 23.1%) on the first day of stimulation; and 37.5 IU (n=465 from N=3,189; 14.6%), 50.0 IU (n=922 from N=3,189; 28.9%), and 75.0 IU (n=895 from N=3,189; 28.1%) on the last day of stimulation. This noninterventional, post-marketing surveillance study found that monofollicular or bifollicular development was achieved in 71% of patients studied and the small dose increment (12.5 IU) of the redesigned follitropin alfa pen allowed individualized treatment of women undergoing OI. PMID:25926755

  20. The POST trial: initial post-market experience of the Penumbra system: revascularization of large vessel occlusion in acute ischemic stroke in the United States and Europe.

    Science.gov (United States)

    Tarr, Robert; Hsu, Dan; Kulcsar, Zsolt; Bonvin, Christophe; Rufenacht, Daniel; Alfke, Karsten; Stingele, Robert; Jansen, Olav; Frei, Donald; Bellon, Richard; Madison, Michael; Struffert, Tobias; Dorfler, Arnd; Grunwald, Iris Q; Reith, Wolfgang; Haass, Anton

    2010-12-01

    The purpose of this study was to assess the initial post-market experience of the device and how it is compared with the Penumbra Pivotal trial used to support the 510k application. A retrospective case review of 157 consecutive patients treated with the Penumbra system at seven international centers was performed. Primary endpoints were revascularization of the target vessel (TIMI score of 2 or 3), good functional outcome as defined by a modified Rankin scale (mRS) score of ≤2 and incidence of procedural serious adverse events. Results were compared with those of the Penumbra pivotal trial. A total of 157 vessels were treated. Mean baseline values at enrollment were: age 65 years, NIHSS score 16. After use of the Penumbra system, 87% of the treated vessels were revascularized to TIMI 2 (54%) or 3 (33%) as compared with 82% reported in the Pivotal trial. Nine procedural serious adverse events were reported in 157 patients (5.7%). All-cause mortality was 20% (32/157), and 41% had a mRS of ≤2 at 90-day follow-up as compared with only 25% in the Pivotal trial. Patients who were successfully revascularized by the Penumbra system had significantly better outcomes than those who were not. Initial post-market experience of the Penumbra system revealed that the revascularization rate and safety profile of the device are comparable to those reported in the Pivotal trial. However, the proportion of patients who had good functional outcome was higher than expected.

  1. Zilver PTX Post-Market Surveillance Study of Paclitaxel-Eluting Stents for Treating Femoropopliteal Artery Disease in Japan: 12-Month Results.

    Science.gov (United States)

    Yokoi, Hiroyoshi; Ohki, Takao; Kichikawa, Kimihiko; Nakamura, Masato; Komori, Kimihiro; Nanto, Shinsuke; O'Leary, Erin E; Lottes, Aaron E; Snyder, Scott A; Dake, Michael D

    2016-02-08

    This multicenter, prospective, post-market surveillance study in Japan evaluates the paclitaxel-coated Zilver PTX stent in real-world patients with complex lesions. The Zilver PTX stent is the first drug-eluting stent (DES) approved for the superficial femoral artery. Previously, results from a large randomized study and a complementary, large single-arm study supported the safety and effectiveness of the DES. There were no exclusion criteria, and consecutive patients with symptomatic peripheral artery disease (PAD) treated with the DES were enrolled in the study. Clinically driven target lesion revascularization (TLR) was defined as reintervention performed for ≥50% diameter stenosis after recurrent clinical symptoms of PAD. Clinical benefit was defined as freedom from persistent or worsening symptoms of ischemia. Patency was evaluated by duplex ultrasound where physicians considered this standard of care. In this study, 907 patients were enrolled at 95 institutions in Japan. There were numerous comorbidities including high incidences of diabetes (58.8%), chronic kidney disease (43.8%), and critical limb ischemia (21.5%). Lesions were also complex, with an average length of 14.7 cm, 41.6% total occlusions, and 18.6% in-stent restenosis. In total, 1,861 DES were placed in 1,075 lesions. Twelve-month follow-up was obtained for >95% of eligible patients. Freedom from TLR was 91.0%, and clinical benefit was 87.7% through 12 months. The 12-month primary patency rate was 86.4%. Despite more challenging lesions, results from the current study are similar to outcomes from the previous Zilver PTX studies, confirming the benefit of the Zilver PTX DES in a real-world patient population. (Zilver PTX Post-Market Study in Japan; NCT02254837). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  2. Optimal implantation depth and adherence to guidelines on permanent pacing to improve the results of transcatheter aortic valve replacement with the medtronic corevalve system: The CoreValve prospective, international, post-market ADVANCE-II study

    NARCIS (Netherlands)

    A.S. Petronio (Anna); J.-M. Sinning (Jan-Malte); N.M. van Mieghem (Nicolas); G. Zucchelli (Giulio); G. Nickenig (Georg); R. Bekeredjian (Raffi); J. Bosmans (Johan); F. Bedogni (Francesco); M. Branny (Marian); K. Stangl (Karl); J. Kovac (Jan); M. Schiltgen (Molly); S. Kraus (Stacia); P.P.T. de Jaegere (Peter)

    2015-01-01

    textabstractObjectives The aim of the CoreValve prospective, international, post-market ADVANCE-II study was to define the rates of conduction disturbances and permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement with the Medtronic CoreValve System (Minneapolis,

  3. Multicenter, noninterventional, post-marketing surveillance study to evaluate dosing of recombinant human follicle-stimulating hormone using the redesigned follitropin alfa pen in women undergoing ovulation induction

    Directory of Open Access Journals (Sweden)

    Nawroth F

    2015-04-01

    Full Text Available Frank Nawroth,1 Andreas Tandler-Schneider,2 Wilma Bilger3 1Centre for Reproductive and Prenatal Medicine, Endocrinology and Osteology, Hamburg, Germany; 2Center for Reproductive Medicine, Fertility Center Berlin, Berlin, Germany; 3Medical Affairs, Fertility, Endocrinology and General Medicine, Merck Serono GmbH, Darmstadt, Germany (an affiliate of Merck KGaA, Darmstadt, Germany Abstract: This prospective, noninterventional, post-marketing surveillance study evaluated doses of recombinant human follicle-stimulating hormone (r-hFSH using the redesigned follitropin alfa pen in women who were anovulatory or oligomenorrheic and undergoing ovulation induction (OI alone or OI with intrauterine insemination. The primary endpoint was the proportion of patients who achieved monofollicular or bifollicular development (defined as one or two follicles 15 mm. Secondary endpoints included characteristics of ovulation stimulation treatment, such as mean total and mean daily r-hFSH doses. Data were analyzed for 3,193 patients from 30 German fertility centers. The proportion of patients with monofollicular or bifollicular development was 71.1% (n=2,270 of a total of 3,193 patients; intent-to-treat population. The mean±standard deviation total and daily doses of r-hFSH were 696.9±542.5 IU and 61.7±29.4 IU, respectively. The three doses prescribed most frequently were: 37.5 IU (n=703 from N=3,189; 22.0%, 50.0 IU (n=1,056 from N=3,189; 33.1%, and 75.0 IU (n=738 from N=3,189; 23.1% on the first day of stimulation; and 37.5 IU (n=465 from N=3,189; 14.6%, 50.0 IU (n=922 from N=3,189; 28.9%, and 75.0 IU (n=895 from N=3,189; 28.1% on the last day of stimulation. This noninterventional, post-marketing surveillance study found that monofollicular or bifollicular development was achieved in 71% of patients studied and the small dose increment (12.5 IU of the redesigned follitropin alfa pen allowed individualized treatment of women undergoing OI. Keywords: ovulation

  4. ["Re-evaluation upon suspected event" is an approach for post-marketing clinical study: lessons from adverse drug events related to Bupleuri Radix preparations].

    Science.gov (United States)

    Wu, Shu-Xin; Sun, Hong-Feng; Yang, Xiao-Hui; Long, Hong-Zhu; Ye, Zu-Guang; Ji, Shao-Liang; Zhang, Li

    2014-08-01

    We revisited the "Xiao Chaihu Decoction event (XCHDE)" occurred in late 1980s in Japan and the Bupleuri Radix related adverse drug reaction (ADR) reports in China After careful review, comparison, analysis and evaluation, we think the interstitial pneumonitis, drug induced Liver injury (DILI) and other severe adverse drug envents (ADEs) including death happened in Japan is probably results from multiple factors, including combinatory use of XCHDE with interferon, Kampo usage under modern medicine theory guidance, and use of XCHD on the basis of disease diagnosis instead of traditional Chinese syndrome complex differentiation. There are less ADE case reports related to XCHD preparation in China compared to Japan, mostly manifest with hypersensitivity responses of skin and perfuse perspiration. The symptoms of Radix Bupleuri injection related ADEs mainly manifest hypersensitivity-like response, 2 cases of intravenous infusion instead of intramuscular injection developed hypokalemia and renal failure. One case died from severe hypersensitivity shock. In Chinese literatures, there is no report of the interstitial pneumonitis and DILI associated with XCHDG in Japan. So far, there is no voluntary monitoring data and large sample clinical research data available. The author elaborated the classification of "reevaluation" and clarified "re-evaluation upon events" included the reaction to the suspected safety and efficacy events. Based on the current status of the clinical research on the Radix Bupleuri preparations, the author points out that post-marketing "re-evaluation upon suspected event" is not only a necessity of continuous evaluation of the safety, efficacy of drugs, it is also a necessity for providing objective clinical research data to share with the international and domestic drug administrations in the risk-benefit evaluation. It is also the unavoidable pathway to culture and push the excellent species and famous brands of TCM to the international market, in

  5. Optical Coherence Tomography Substudy of A Prospective Multicenter Randomized Post-Market Trial to Assess the Safety and Effectiveness of the Firehawk™ Rapamycin Target Eluting Cobalt Chromium Coronary Stent System for the Treatment of Atherosclerotic Lesions: TARGET All Comers.

    Science.gov (United States)

    Baumbach, Andreas; Lansky, Alexandra J; Onuma, Yoshi; Asano, Taku; Johnson, Thomas; Anderson, Richard; Kiemeneij, Ferdinand; Zheng, Ming; Van Royen, Niels; Slagboom, Ton; Vlachojannis, Georg; Xu, Bo; Serruys, Patrick; Wijns, William

    2018-06-12

    Durable polymer drug-eluting stents (DP DES) may contribute to persistent inflammation, delayed endothelial healing and subsequent late DES thrombosis. The aim of this Optical Coherence Tomography (OCT) sub-study was to compare healing and neointimal coverage of a novel bioabsorbable polymer sirolimus-eluting stent (FIREHAWK®) (BP DES) versus the DP DES (XIENCE) at 90 days in an all comers patient population. The TARGET All Comers study is a prospective multicenter randomised post-market trial of 1656 patients randomised 1:1 to FIREHAWK or XIENCE at 21 centers in 10 European countries. The TARGET OCT sub-study enrolled 36 consecutive patients with 52 lesions at 6 centers proficient in OCT. Follow-up OCT was performed at 3 months or prior to revascularisation when occurring before the 3-month window. The substudy was designed for non-inferiority of the primary endpoint of neointimal thickness. At follow-up, the mean neointimal thickness by OCT (52 lesions, Firehawk, n=24; Xience, n=28), was not significantly different between groups (Firehawk 75.5μm vs Xience V 82.3 μm) meeting the primary endpoint of non-inferiority (Pnoninferiority<0.001). The percentage of stent strut coverage was high in both groups (strut level: 99.9% ± 0.3 vs 100% ± 0.1, p=0.26), and the proportion of malapposed struts (1.0±1.6% vs. 1.2±2.0%, p=0.51) was low in both groups. Based on OCT, the FIREHAWK BP DES has a similar healing response 3 months after implantation compared to the DP DES, with near complete strut coverage, moderate neointima formation and minimal strut malapposition.

  6. [Response of Pharmaceutical Companies to the Crisis of Post-Marketing Clinical Trials of Anti-Cancer Agents -- Results of Questionnaires to Pharmaceutical Companies].

    Science.gov (United States)

    Nakajima, Toshifusa

    2016-04-01

    Investigator-oriented post-marketing clinical trials of anti-cancer agents are faced to financial crisis due to drastic decrease in research-funds from pharmaceutical companies caused by a scandal in 2013. In order to assess the balance of research funds between 2012 and 2014, we made queries to 26 companies manufacturing anti-cancer agents, and only 10 of 26 responded to our queries. Decrease in the fund was observed in 5 of 10, no change in 1, increase in 3 and no answer in 1. Companies showed passive attitude to carry out doctor-oriented clinical trials of off-patent drugs or unapproved drugs according to advanced medical care B program, though some companies answered to proceed approved routines of these drugs if clinical trials showed good results. Most companies declined to make comments on the activity of Japan Agency for Medical Research and Development (AMED), but some insisted to produce good corroboration between AMED and pharmaceutical companies in order to improve the quality of trials. Further corroboration must be necessary for this purpose among researchers, governmental administrative organs, pharmaceutical companies, patients' groups, and mass-media.

  7. Risk management and post-marketing surveillance for the abuse of medications acting on the central nervous system: expert panel report.

    Science.gov (United States)

    Johanson, Chris-Ellyn; Balster, Robert L; Henningfield, Jack E; Schuster, Charles R; Anthony, James C; Barthwell, Andrea G; Coleman, John J; Dart, Richard C; Gorodetzky, Charles W; O'Keeffe, Charles; Sellers, Edward M; Vocci, Frank; Walsh, Sharon L

    2009-12-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and 11 recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized.

  8. Gadobutrol for contrast-enhanced magnetic resonance imaging in elderly patients: review of the safety profile from clinical trial, post-marketing surveillance, and pharmacovigilance data.

    Science.gov (United States)

    Endrikat, J; Schwenke, C; Prince, M R

    2015-07-01

    To assess the safety of gadobutrol administration in elderly patients (≥65 years) by comparing the incidence of adverse drug reactions (ADRs) following gadobutrol-enhanced magnetic resonance imaging (MRI) procedures in elderly patients with that in adults aged 18-64 years. Safety data on gadobutrol administration from clinical trials, post-marketing surveillance (PMS) studies, and pharmacovigilance reports were collected in three databases. In each dataset, absolute and relative frequencies of ADRs between age groups were analysed, along with odds ratios and 95% confidence intervals. Logistic regression was used to identify significant influencing factors on ADRs in the PMS and pharmacovigilance data. Rates of reported ADRs were lower in elderly patients versus adults aged statistically significant for the clinical trials and pharmacovigilance populations, with a trend in the PMS database. Serious ADRs occurred infrequently in the clinical trials and PMS populations (too low for statistical comparison), and pharmacovigilance data demonstrated a low incidence (<0.005%) in both age groups. This evaluation involving three large databases demonstrated no greater incidence of ADRs following gadobutrol-enhanced MRI in elderly patients (≥65 years) compared with younger adults, with gadobutrol having a favourable safety profile in both age groups. Copyright © 2015 The Royal College of Radiologists. All rights reserved.

  9. Long-term post-marketing surveillance of mizoribine for the treatment of lupus nephritis: Safety and efficacy during a 3-year follow-up

    Directory of Open Access Journals (Sweden)

    Nobuyuki Yagi

    2014-05-01

    Full Text Available Objective: To determine the safety and efficacy of long-term use of mizoribine by undertaking a 3-year post-marketing surveillance study. Methods: Subjects were all lupus nephritis patients newly treated with mizoribine between 1 October 2003 and 30 September 2005 at contracted study sites. Results: Mizoribine was administered to 881 lupus nephritis patients in the safety analysis set consisting of 946 patients recruited from 281 contracted study sites after satisfying the eligibility criteria. There were 301 events of adverse drug reactions that were observed in 196 (20.7% of the 946 subjects. There were 34 events of serious adverse drug reactions in 31 patients (3.2%. No deterioration in hematological and biochemical test values was observed, but immunological testing showed significant improvements in C3, CH50, and anti-DNA antibody titers. The negative rate of proteinuria also increased over time. The median steroid dosage was 15 mg/day at the commencement of treatment, but was reduced to 10 mg/day at 12 months and 8 mg/day at 36 months. Conclusion: The findings of the 3-year long-term drug use surveillance study indicated that mizoribine can be used over the long term with relatively few adverse drug reactions, suggesting its suitability for use in maintenance drug therapy.

  10. Post-marketing observational program of the effectiveness of fluvoxamine for the treatment of depression in patients with neurological disorders: the FRIENDS study.

    Science.gov (United States)

    Yahno, Nikolay N; Fedotova, Anastasia V

    2017-01-01

    In a prospective, non-blinded, uncontrolled, multicenter, post-marketing, observational study (FRIENDS; NCT02043197), fluvoxamine (50-300 mg/day for 90 days) was effective for the treatment of depression in 299 adult patients (age ≥18 years) with neurological disorders at baseline. The therapeutic effect of fluvoxamine was measured by means of changes in the Hospital Anxiety and Depression Scale depression and anxiety scores (HADS-D and HADS-A, respectively), global severity of illness, and clinical condition (measured using the Clinical Global Improvement [CGI] scale). The mean HADS-D subscale score at baseline in the per-protocol cohort (n=296) was 11.7±3.1 points and the corresponding mean HADS-A score was 12.6±3.2. Significant ( P 85%) recorded reductions versus baseline in both indices. In the CGI-based assessment, most evaluated patients (>200) experienced moderate to very substantial clinical improvement, with no or limited side effects. Significant improvements were also recorded in the exploratory outcomes of sleep quality, assessed using the Insomnia Severity Index, and cognitive function, assessed using the Montreal Cognitive Assessment ( P effective and well tolerated for the treatment of depression in the context of neurological disorders. The effects on the exploratory endpoints of this research merit evaluation in controlled trials.

  11. Evaluation of the Relative Abuse of an OROS® Extended-release Hydromorphone HCI Product: Results from three Post-market Surveillance Studies.

    Science.gov (United States)

    Butler, Stephen F; McNaughton, Emily C; Black, Ryan A; Cassidy, Theresa A

    2018-01-02

    Formulating prescription opioids to limit abuse remains a priority. OROS® extended-release (ER) hydromorphone HCl (EXALGO®) may have low abuse potential. Three post-marketing studies of the relative abuse liability of OROS hydromorphone ER were conducted. Estimates of abuse, unadjusted and adjusted for prescription volume, were generated for OROS hydromorphone ER and comparators from Q2 2010 through Q2 2014 for a high-risk, substance abuse treatment population and the general population using poison control center data. Comparators were selected for compound, market penetration, and route of administration (ROA) profile. ROA comparisons were made among the substance abuse treatment population. Internet discussion was examined to determine abusers' interest in and desire for the OROS formulation. Examination of abuse prevalence among adults within substance abuse treatment, intentional poison exposures and Internet discussion levels generally support the hypothesis that OROS hydromorphone ER may have lower abuse potential than many other opioid products. OROS hydromorphone ER also appears to be abused less often by alternate ROAs (e.g., snorting and injection). Lower levels of online discussion were observed along with relatively low endorsement for abuse. Abuse of OROS hydromorphone ER was observed in high-risk substance abuse and general population samples but at a very low relative prevalence. Evidence suggests it may be less often abused by alternate ROAs than some comparators. Online data did not find evidence of high levels of desire for OROS hydromorphone ER by recreational abusers. Continued monitoring of this product's abuse liability is warranted.

  12. Efficacy and tolerability of rasagiline in daily clinical use--a post-marketing observational study in patients with Parkinson's disease.

    Science.gov (United States)

    Reichmann, H; Jost, W H

    2010-09-01

    The MAO-B inhibitor rasagiline is indicated for the treatment of idiopathic Parkinson's disease (PD), and its use is supported by evidence from large-scale, controlled clinical studies. The post-marketing observational study presented here investigated the efficacy and tolerability of rasagiline treatment (monotherapy or combination therapy) in daily clinical practice. The study included patients with idiopathic PD who received rasagiline (recommended dose 1 mg, once daily) as monotherapy or combination therapy. The treatment and observation period was approximately 4 months. Outcome measures included the change from baseline in the Columbia University Rating Scale (CURS), the Unified PD Rating Scale fluctuation subscale, daily OFF time (patient home diaries) and the PD Questionnaire-39. Adverse drug reactions/adverse events (ADRs/AEs) and the physician's global judgement of tolerability and efficacy were also examined. Overall, 754 patients received rasagiline during the study. Patients treated with rasagiline (monotherapy or combination therapy) showed significant improvements from baseline in symptom severity (including classical motor and non-classical motor/non-motor symptoms) and quality of life (QoL). Patients receiving combination therapy also experienced significant reductions in daily OFF time. Tolerability was rated as good/very good in over 90% of patients. In daily clinical practice, monotherapy or combination therapy with rasagiline is able to improve PD symptoms, reduce OFF time, and improve QoL, whilst demonstrating favourable tolerability. In addition, rasagiline has a simple dosing schedule of one tablet, once daily, with no titration. These results are consistent with the pivotal rasagiline clinical studies (TEMPO, LARGO and PRESTO).

  13. Safety and efficacy of canagliflozin in elderly patients with type 2 diabetes mellitus: a 1-year post-marketing surveillance in Japan.

    Science.gov (United States)

    Goda, Maki; Yamakura, Tomoko; Sasaki, Kazuyo; Tajima, Takumi; Ueno, Makoto

    2018-02-01

    To evaluate the safety and efficacy of canagliflozin in elderly patients with type 2 diabetes mellitus (T2DM) in clinical settings. The authors conducted a 1-year post-marketing surveillance (PMS) of canagliflozin in almost all the elderly patients (≥65 years old) with T2DM who began taking canagliflozin during the first 3 months after its launch in Japan. The main outcomes included the incidences of adverse drug reactions (ADRs), serious ADRs, and the changes of laboratory tests as well as efficacy variables. An ADR was reported in 9.09% (125 of 1375 patients) in the safety analysis set. The main ADRs were dehydration, constipation, thirst, pollakiuria, dizziness, cystitis, eczema, pruritus, and rash. The incidence of serious ADRs was 1.02% (14 patients), which included urinary tract infection, dehydration, hypoglycemia, and cerebral infarction (two patients each). ADRs of special interest that had been reported in clinical trials of SGLT2 inhibitors, such as hypoglycemia, volume depletion-related events, genital/urinary tract infection, polyuria/pollakiuria, and ketone body increased were also observed in this PMS. The safety profiles were similar to the results of a previous clinical study of canagliflozin, and new safety concerns were not identified in this survey. The mean change in HbA1c was -0.77% after 12 months of treatment in the efficacy analysis set. In this PMS, the safety and efficacy profiles of canagliflozin in elderly patients with T2DM were obtained in the clinical settings in Japan and the drug was well tolerated and effective in improving glycemic control.

  14. Post-marketing observational program of the effectiveness of fluvoxamine for the treatment of depression in patients with neurological disorders: the FRIENDS study

    Directory of Open Access Journals (Sweden)

    Yahno NN

    2017-11-01

    Full Text Available Nikolay N Yahno,1 Anastasia V Fedotova2 1Neurology Department, I.M. Sechenov First Moscow State Medical University, 2Neurology Department, Additional Professional Education Faculty, Pirogov Russian National Research Medical University, Moscow, Russian Federation Abstract: In a prospective, non-blinded, uncontrolled, multicenter, post-marketing, observational study (FRIENDS; NCT02043197, fluvoxamine (50–300 mg/day for 90 days was effective for the treatment of depression in 299 adult patients (age ≥18 years with neurological disorders at baseline. The therapeutic effect of fluvoxamine was measured by means of changes in the Hospital Anxiety and Depression Scale depression and anxiety scores (HADS-D and HADS-A, respectively, global severity of illness, and clinical condition (measured using the Clinical Global Improvement [CGI] scale. The mean HADS-D subscale score at baseline in the per-protocol cohort (n=296 was 11.7±3.1 points and the corresponding mean HADS-A score was 12.6±3.2. Significant (P<0.0001 improvements in both scores were recorded during fluvoxamine treatment and later follow-up. Most patients (>85% recorded reductions versus baseline in both indices. In the CGI-based assessment, most evaluated patients (>200 experienced moderate to very substantial clinical improvement, with no or limited side effects. Significant improvements were also recorded in the exploratory outcomes of sleep quality, assessed using the Insomnia Severity Index, and cognitive function, assessed using the Montreal Cognitive Assessment (P<0.0001 vs baseline for both. No death or serious adverse drug reactions were reported during the study. The results of this observational study affirm that fluvoxamine is effective and well tolerated for the treatment of depression in the context of neurological disorders. The effects on the exploratory endpoints of this research merit evaluation in controlled trials. Keywords: depression, anxiety, fluvoxamine

  15. Assessment of safety and efficacy of lamotrigine over the course of 1-year observation in Japanese patients with bipolar disorder: post-marketing surveillance study report

    Science.gov (United States)

    Terao, Takeshi; Ishida, Atsuko; Kimura, Toshifumi; Yoshida, Mitsuhiro; Hara, Terufumi

    2017-01-01

    Background A post-marketing surveillance (PMS) study was conducted with a 1-year observation period to assess the safety and efficacy of lamotrigine in routine clinical practice in patients with bipolar disorder (BD). Patients and methods Central enrollment method was used to recruit patients diagnosed with BD who were being treated for the first time with lamotrigine to prevent the recurrence/relapse of BD mood episodes. Adverse drug reactions (ADRs) and recurrence/relapse were assessed. Improvement of mania and depression was also assessed using the Hamilton’s Rating Scale for Depression (HAM-D) and the Young Mania Rating Scale (YMRS) at treatment initiation, 4–6 months post treatment initiation, and 10–12 months post treatment initiation. Results A total of 237/989 patients (24.0%) reported ADRs, most commonly rash (9.1%), and the incidence of serious ADRs was 3.3% (33/989 patients). Skin disorders occurred in 130 patients (13.1%), mostly within 8 weeks post treatment. A total of 237/703 patients (33.7%) experienced recurrence/relapse of mood episodes. The 25th percentile of the time to recurrence/relapse of mood episodes was 105 days. Remission of depression symptoms (HAM-D ≤7) occurred in 147/697 patients (21.1%) at treatment initiation, rising to 361 patients (67.4%) at 10–12 months post treatment. Remission of manic symptoms (YMRS ≤13) occurred in 615/676 patients (91.0%) at treatment initiation, rising to 500 patients (97.3%) at 10–12 months post treatment. Conclusion The results of this PMS study suggest that lamotrigine is a well-tolerated and effective drug for preventing recurrence/relapse of BD in clinical practice. PMID:28652744

  16. Repeat confirmatory testing for persons with discordant whole blood and oral fluid rapid HIV test results: findings from post marketing surveillance.

    Science.gov (United States)

    Wesolowski, Laura G; Mackellar, Duncan A; Ethridge, Steven F; Zhu, Julia H; Owen, S Michele; Sullivan, Patrick S

    2008-02-06

    Reactive oral fluid and whole blood rapid HIV tests must be followed with a confirmatory test (Western blot (WB), immunofluorescent assay (IFA) or approved nucleic acid amplification test (NAAT)). When the confirmatory result is negative or indeterminate (i.e. discordant with rapid result), repeat confirmatory testing should be conducted using a follow-up specimen. Previous reports have not described whether repeat testing adequately resolves the HIV-infection status of persons with discordant results. Post-marketing surveillance was conducted in 368 testing sites affiliated with 14 state and 2 city health departments from August 11, 2004 to June 30, 2005 and one health department through December 31, 2005. For persons with discordant results, data were collected on demographics, risk behaviors, HIV test results and specimen types. Persons with repeat confirmatory results were classified as HIV-infected or uninfected. Regression models were created to assess risk factors for not having repeat testing. Of 167,371 rapid tests conducted, 2589 (1.6%) were reactive: of these, 2417 (93%) had positive WB/IFA, 172 (7%) had negative or indeterminate WB/IFA. Of 89/172 (52%) persons with a repeat confirmatory test: 17 (19%) were HIV-infected, including 3 with indeterminate WB and positive NAAT; 72 (81%) were uninfected, including 12 with repeat indeterminate WB. Factors associated with HIV-infection included having an initial indeterminate WB/IFA (vs. negative) (ptest [adjusted OR 2.6, 95% CI (1.3, 4.9)]. Though only half of persons with discordant results had repeat confirmatory testing, of those who did, nearly one in five were HIV-infected. These findings underscore the need for rapid HIV testing programs to increase repeat confirmatory testing for persons with discordant results. Because of the lower sensitivity of oral fluid WBs, confirmatory testing following a reactive rapid test should be conducted using serum or plasma, when possible.

  17. The safety and effectiveness profile of eldecalcitol in a prospective, post-marketing observational study in Japanese patients with osteoporosis: interim report.

    Science.gov (United States)

    Saito, Hitoshi; Kakihata, Hiroyuki; Nishida, Yosuke; Yatomi, Sawako; Nihojima, Shigeru; Kobayashi, Yumiko; Tabata, Hidehiro; Nomura, Makoto

    2017-07-01

    This large-scale post-marketing surveillance study was conducted to assess the safety and effectiveness of eldecalcitol treatment in patients with osteoporosis in a Japanese clinical setting. A total of 3567 patients with osteoporosis were enrolled and received eldecalcitol 0.75 μg/day for 12 months. For this interim report, 3285 patients were eligible for analysis. Mean age was 74.9 ± 8.7 years; 86.8 % (2854/3285) were women. There were 142 reported adverse drug reactions (ADRs) in 129 patients (3.92 % of the total 3285 patients): the most common were hypercalcemia and increased blood calcium (0.88 %), renal impairment (0.27 %), abdominal discomfort (0.24 %), constipation (0.24 %), and pruritus (0.24 %). The incidence of ADRs was 5.10 % in men and 3.74 % in women. Although 10 serious ADRs were reported in 9 patients (0.27 %), no clinically significant safety issues were identified. Incidence of hypercalcemia or increased blood calcium was 8.47 % in patients with renal impairment and only 0.74 % in patients without renal impairment. At last observation, the incidence of new vertebral and nonvertebral fractures was 2.44 % and 1.70 %, respectively. There was a significant increase in bone mineral density at the lumbar spine and distal radius. The bone turnover markers BAP, serum NTX, urinary NTX, and TRACP-5b were suppressed by eldecalcitol treatment in both sexes. In conclusion, consistent with the findings of the phase III pivotal clinical trial, eldecalcitol was shown to have a favorable safety profile and effectiveness in Japanese patients with osteoporosis. However, periodic measurements of serum calcium were required to prevent occurrence of hypercalcemia during eldecalcitol treatment, especially in patients with renal impairment.

  18. [Safety and effectiveness of pemetrexed in patients with non-small cell lung cancer in Japan - analysis of post-marketing surveillance].

    Science.gov (United States)

    Okubo, Sumiko; Kobayashi, Noriko; Taketsuna, Masanori; Kaneko, Naoya; Enatsu, Sotaro; Nishiuma, Shinichi

    2014-04-01

    The safety and effectiveness of pemetrexed(PEM)in patients with non-small cell lung cancer(NSCLC)were reviewed using data from post-marketing surveillance. Among 699 patients registered from June 2009 to May 2010, 683 patients were analyzed(343, first-line therapy: 340, second-line therapy or beyond). Patient backgrounds were as follows: median age=65 years(16.1%B75 years old); 64.7% male; 91.9% performance status 0-1; 83.2% Stage IV; 99.0% non-squamous cell cancer. Also, 86% of the first-line and 20% of the second-line cohort were receiving a concomitant anti-cancer drug(mostly platinum agents). The incidence rate of adverse drug reactions(ADR)was 76.7%, including serious cases(18.0%). The most common ADRs were decreased white blood cell count(26.8%), decreased neutrophil count(25.3%), anemia(19.2%), decreased platelet count(17.0%), and nausea(23.0%). The incidence of interstitial lung disease, which is a concern during chemotherapy, was 2.6%. Peripheral neuropathy and alopecia, events influencing a patient's quality of life, were less than 1%. The estimated median survival time was 23.2 months[95%CI: 19.8 months-not calculable]in the first-line cohort, and 11.8 months[95% CI: 10.5-13.7 months]in the B second-line cohort. The surveillance results showed no apparent difference in total ADRs in this current study compared to the safety profile established in clinical trials previously conducted in Japan and overseas. These results demonstrate the safety and effectiveness of PEM treatment for NSCLC patients in daily clinical settings.

  19. The safety and effectiveness profile of eldecalcitol in a prospective, post-marketing observational study in Japanese male patients with osteoporosis.

    Science.gov (United States)

    Kondo, Satoshi; Kakihata, Hiroyuki; Nishida, Yosuke; Furuno, Yuko; Kobayashi, Yumiko; Tabata, Hidehiro; Nomura, Makoto

    2018-03-12

    We conducted a post-marketing observational study to investigate the safety and effectiveness of eldecalcitol for the treatment of osteoporosis in a Japanese clinical setting. The observation period was 12 months for women and 36 months for men. The final results for the female patients have already been published. In this article, the final results for the male patients are reported. A total of 470 male osteoporosis patients were enrolled. The safety analysis set included 431 patients (mean age, 76.8 years; mean ± SD follow-up period, 631.0 ± 450.3 days), and 175 patients continued treatment throughout the 3-year observational period. Adverse drug reactions (ADRs) were reported in 28 patients (6.49%); the most common ADRs were hypercalcemia (1.16%) and renal impairment (1.16%). Serious ADRs were reported in 5 patients (1.16%). Mean serum calcium was within the normal range throughout the observation period. The cumulative incidence of new vertebral and nonvertebral fractures at 36 months, estimated by Kaplan-Meier analysis, was 10.23 and 4.06%, respectively. At the last observation, mean lumbar spine bone mineral density was 3.49% higher (P effectiveness of eldecalcitol for the treatment of Japanese male osteoporosis patients was confirmed in clinical practice. Careful monitoring of serum calcium and estimated glomerular filtration rate, both before and during treatment, is necessary to minimize the risk of hypercalcemia and renal impairment while maximizing the effectiveness of eldecalcitol.

  20. Effectiveness and safety of tolvaptan in liver cirrhosis patients with edema: Interim results of post-marketing surveillance of tolvaptan in liver cirrhosis (START study).

    Science.gov (United States)

    Sakaida, Isao; Terai, Shuji; Kurosaki, Masayuki; Yasuda, Moriyoshi; Okada, Mitsuru; Bando, Kosuke; Fukuta, Yasuhiko

    2017-10-01

    Loop diuretics and spironolactone are used in patients with hepatic edema, but they are sometimes associated with insufficient responses as well as adverse events. Tolvaptan, a vasopressin type 2 receptor antagonist, was approved for hepatic edema in 2013. A large-scale post-marketing surveillance study has been carried out to evaluate the effectiveness and safety of tolvaptan in real-world clinical settings. Patients with hepatic cirrhosis with insufficient response to conventional diuretics were enrolled. The observational period was up to 6 months. Changes in body weight and clinical symptoms were measured to evaluate effectiveness. The incidence of adverse drug reactions was summarized as a safety measure. Of 970 patients enrolled, 463 were included in the safety analysis. Of this group, 340 were included in the effectiveness analysis. Decreases in body weight from baseline were -2.38 kg on day 7 and -3.52 kg on day 14. Ascites and bloated feeling was significantly improved within 14 days. The mean change in body weight depended on estimated glomerular filtration rate levels. The most frequently reported adverse drug reaction was thirst (6.9% of patients). Serum sodium level of ≥146 mEq/L was observed in 12 patients (2.7%). In the real-world clinical setting, tolvaptan showed aquaretic effectiveness in patients with cirrhosis. The mean change in body weight depended on renal function. We recommend tolvaptan use for hepatic cirrhosis at a stage in which the renal function is maintained. © 2016 The Japan Society of Hepatology.

  1. Post-marketing safety surveillance conducted in Korea (2008-2013) following the introduction of the rotavirus vaccine, RIX4414 (Rotarix™).

    Science.gov (United States)

    Shin, Son Moon; Kim, Chun Soo; Karkada, Naveen; Liu, Aixue; Jayadeva, Girish; Han, Htay Htay

    2016-10-02

    According to regulations from the Ministry of Food and Drug Safety in Korea, additional safety information on the use of Rotarix™ vaccine (RIX4414; GSK, Belgium) in ≥3000 evaluable Korean infants was required following vaccine registration. In order to comply with these regulations, we conducted a 6-year open, non-comparative, multicenter post-marketing surveillance (NCT00750893). During this time, the original lyophilized vaccine formulation of RIX4414 was replaced by a liquid formulation. Healthy infants aged ≥6 weeks were enrolled and given 2 doses of the RIX4414 vaccine, separated by an interval of ≥4 weeks. The overall incidence of adverse events (AEs) (expected and unexpected) was then assessed for up to 30 days along with the incidence of serious adverse events (SAEs). Adverse drug reactions (ADRs: any AE whose causality to the drug could not be ruled out) were identified. A total of 3040 children (mean age: 9.55 weeks) were analyzed. One or more expected AE was experienced by 30.5% infants and 8.6% had an ADR. The most commonly seen expected AE was irritability (14.0%). One or more unexpected AE was seen in 32.5% infants and 3.1% experienced an ADR. The most commonly seen unexpected AE was upper respiratory tract infection (8.7%). Of 34 SAEs recorded in 24 subjects, none were related to vaccination. We conclude that this 6-year surveillance showed both formulations of RIX4414 to have acceptable safety profiles when administered to Korean infants according to local prescribing recommendations and current clinical practice.

  2. Is patient-reported outcome improved by nalfurafine hydrochloride in patients with primary biliary cholangitis and refractory pruritus? A post-marketing, single-arm, prospective study.

    Science.gov (United States)

    Yagi, Minami; Tanaka, Atsushi; Namisaki, Tadashi; Takahashi, Atsushi; Abe, Masanori; Honda, Akira; Matsuzaki, Yasushi; Ohira, Hiromasa; Yoshiji, Hitoshi; Takikawa, Hajime

    2018-04-16

    Patients with primary biliary cholangitis (PBC) frequently suffer from pruritus, which can severely impair their health-related quality of life (HRQOL). Nalfurafine hydrochloride, a selective κ-opioid receptor agonist, was recently approved in Japan for refractory pruritus in patients with chronic liver diseases, but it still remains unclear whether this treatment improves the patient-reported outcome (PRO) in PBC patients with refractory pruritus. Herein, we conducted a multicenter, post-marketing, single-arm prospective study to investigate the efficacy of nalfurafine in terms of PRO, and the associations of the efficacy with any clinical characteristics. After screening for pruritus in 496 patients with PBC using PBC-40 and the visual analog scale (VAS), we identified 141 patients with moderate to severe pruritus; these were invited to participate in the study. The participants received 2.5 μg nalfurafine once daily for 12 weeks, and pruritus and HRQOL were assessed in week 12 of this treatment. Generic HRQOL, short form 36, blood chemistries, and serum autotaxin levels were also measured at baseline and at week 12. Forty-four patients participated in this study. The mean PBC-40 itch domain scores and VAS declined during the study period, from 8.56 to 7.63 (P = 0.041) and from 42.9 to 29.3 (P = 0.001) at baseline and at week 12, respectively, indicating a significant effect of nalfurafine. The other domains of PBC-40 and all domains of SF-36 were not significantly altered by this treatment. We failed to find any association between the change in VAS and PBC-40 itch scores and any clinical variable. Serum autotaxin levels were significantly increased during the study period. This study demonstrated that nalfurafine improved pruritus in patients with PBC, independent of their clinical characteristics, but had a limited effect on the PRO.

  3. A multicenter post-marketing evaluation of the Elixir DESolve® Novolimus-eluting bioresorbable coronary scaffold system: First results from the DESolve PMCF study.

    Science.gov (United States)

    Nef, Holger; Wiebe, Jens; Boeder, Niklas; Dörr, Oliver; Bauer, Timm; Hauptmann, Karl-Eugen; Latib, Azeem; Colombo, Antonio; Fischer, Dieter; Rudolph, Tanja; Foin, Nicolas; Richardt, Gert; Hamm, Christian

    2018-03-06

    To date, experience with bioresorbable scaffolds (BRS) that elute agents other than everolimus is limited. Thus, a post-marketing clinical follow-up study was conducted to evaluate the continued safety and effectiveness of the DESolve® NOVOLIMUS™ Eluting BRS as treatment for patients with stable coronary artery disease. The DESolve BRS combines a poly-l-lactide-based backbone with a biodegradable polylactide-based polymer and Novolimus, a macrocyclic lactone mTOR inhibitor. One hundred and two patients (mean age 62 years, 77.5% male) were enrolled at 10 European sites. Comparison of baseline and post-procedural angiographic assessment was performed, and a device-oriented composite endpoint (comprising cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization) and rate of scaffold thrombosis at 12 months were examined. The device was successfully delivered and deployed in 98.2% (107/109) of the lesions, with two failures to cross the lesion. A total of 100 patients (109 lesions) were treated with a DESolve BRS. Post-procedural angiographic assessment indicated an in-scaffold acute gain of 1.54 ± 0.44 mm, with a reduction in % diameter stenosis from 61.00 ± 11.29 to 12.69 ± 0.44. At 12 months, the device-oriented composite endpoint had occurred in 3.0% (3/100) of patients, with 1.0% (1/100) experiencing scaffold thrombosis and myocardial infarction and 3.0% (3/100) undergoing target lesion revascularization. There were no cardiac deaths. Results through 12 months indicate that the DESolve BRS is a safe and effective treatment for coronary lesions, though larger, long-term prospective studies are needed. © 2018 Wiley Periodicals, Inc.

  4. Psychosocial functioning in patients with schizophrenia treated with aripiprazole - an office-based real-world setting. Results from the German post-marketing surveillance study.

    Science.gov (United States)

    Bergmann, F; Zacher, A; Nass, A; Urban, R; Werner, C; Spevakné-Göröcs, T; Kungel, M; Ebrecht, M; Modell, S

    2009-05-01

    Aripiprazole (ABILIFY) is an effective antipsychotic used in a dose range from 10 to 30 mg, administered once daily. Soon after its approval in Germany for treatment of schizophrenia, a 12-month post-marketing surveillance study was initiated that included 1 096 patients cared for by 408 office-based psychiatrists and/or neurologists in private practice. The aim was to gain further insights into safety and efficacy of aripiprazole in an outpatient real-life setting focusing on general health, well-being and psychosocial functioning. Efficacy was rated by using standard CGI, SF-12 and SIWM-PsySo instruments for severity of disease, physical and mental health outcomes and psychosocial state, respectively. Safety was evaluated according to the reports of adverse events. Mean total daily dose of aripiprazole increased from 15.4 mg at the visit after 1 month to 17.6 mg at the visits after 6 to 12 months, the most frequently administered maintenance dose being 15 mg. Within the observation period significant improvements of CGI, SF-12 and SIWM-PsySo scores over time versus baseline values were observed (pmuch" or "very much" improved. Aripiprazole was overall well tolerated; 19.9% of patients discontinued treatment after 12 months. Adverse effects in general were moderate to mild and corresponded to the known tolerability profile of aripiprazole. Psychotic side effects reported were probably due to a recurrence of the underlying schizophrenic disorder. The results indicate that aripiprazole may be an efficacious and safe treatment option for pre-treated patients with schizophrenia also in a naturalistic psychiatrist/neurologist practice setting with effects on health and psychosocial functioning and a comparably low dropout rate.

  5. Gadobutrol for contrast-enhanced magnetic resonance imaging in elderly patients: review of the safety profile from clinical trial, post-marketing surveillance, and pharmacovigilance data

    International Nuclear Information System (INIS)

    Endrikat, J.; Schwenke, C.; Prince, M.R.

    2015-01-01

    Aim: To assess the safety of gadobutrol administration in elderly patients (≥65 years) by comparing the incidence of adverse drug reactions (ADRs) following gadobutrol-enhanced magnetic resonance imaging (MRI) procedures in elderly patients with that in adults aged 18–64 years. Materials and methods: Safety data on gadobutrol administration from clinical trials, post-marketing surveillance (PMS) studies, and pharmacovigilance reports were collected in three databases. In each dataset, absolute and relative frequencies of ADRs between age groups were analysed, along with odds ratios and 95% confidence intervals. Logistic regression was used to identify significant influencing factors on ADRs in the PMS and pharmacovigilance data. Results: Rates of reported ADRs were lower in elderly patients versus adults aged <65 years due to a reduced incidence of non-serious ADRs; this was statistically significant for the clinical trials and pharmacovigilance populations, with a trend in the PMS database. Serious ADRs occurred infrequently in the clinical trials and PMS populations (too low for statistical comparison), and pharmacovigilance data demonstrated a low incidence (<0.005%) in both age groups. Conclusions: This evaluation involving three large databases demonstrated no greater incidence of ADRs following gadobutrol-enhanced MRI in elderly patients (≥65 years) compared with younger adults, with gadobutrol having a favourable safety profile in both age groups. -- Highlights: •First dedicated safety study of an extracellular contrast agent in the elderly. •Elderly patients experience fewer non-serious ADRs than younger adults. •Gadobutrol has a favourable safety profile in both age groups

  6. Safety Profile of Eslicarbazepine Acetate as Add-On Therapy in Adults with Refractory Focal-Onset Seizures: From Clinical Studies to 6 Years of Post-Marketing Experience.

    Science.gov (United States)

    Gama, Helena; Vieira, Mariana; Costa, Raquel; Graça, Joana; Magalhães, Luís M; Soares-da-Silva, Patrício

    2017-12-01

    Eslicarbazepine acetate was first approved in the European Union in 2009 as adjunctive therapy in adults with partial-onset seizures with or without secondary generalization. The objective of this study was to review the safety profile of eslicarbazepine acetate analyzing the data from several clinical studies to 6 years of post-marketing surveillance. We used a post-hoc pooled safety analysis of four phase III, double-blind, randomized, placebo-controlled studies (BIA-2093-301, -302, -303, -304) of eslicarbazepine acetate as add-on therapy in adults. Safety data of eslicarbazepine acetate in special populations of patients aged ≥65 years with partial-onset seizures (BIA-2093-401) and subjects with moderate hepatic impairment (BIA-2093-111) and renal impairment (BIA-2093-112) are also considered. The incidences of treatment-emergent adverse events, treatment-emergent adverse events leading to discontinuation, and serious adverse events were analyzed. The global safety database of eslicarbazepine acetate was analyzed for all cases from post-marketing surveillance from 1 October, 2009 to 21 October, 2015. From a pooled analysis of four phase III studies, it was concluded that the incidence of treatment-emergent adverse events, treatment-emergent adverse events leading to discontinuation, and adverse drug reactions were dose dependent. Dizziness, somnolence, headache, and nausea were the most common treatment-emergent adverse events (≥10% of patients) and the majority were of mild-to-moderate intensity. No dose-dependent trend was observed for serious adverse events and individual serious adverse events were reported in less than 1% of patients. Hyponatremia was classified as a possibly related treatment-emergent adverse event in phase III studies (1.2%); however, after 6 years of post-marketing surveillance it represents the most frequently (10.2%) reported adverse drug reaction, with more than half of these cases occurring with eslicarbazepine acetate at

  7. Efficacy and safety of cross-linked hyaluronic acid single injection on osteoarthritis of the knee: a post-marketing phase IV study

    Directory of Open Access Journals (Sweden)

    Bashaireh K

    2015-04-01

    Full Text Available Khaldoon Bashaireh,1 Ziad Naser,2 Khaled Al Hawadya,2 Sorour Sorour,2 Rami Nabeel Al-Khateeb3 1Department of Orthopedics Surgery, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, Jordan; 2Private Clinic, 3Elaf Medical Supplies Company, Amman, Jordan Purpose: The primary objective of this study was to evaluate the efficacy, safety, and duration of action of viscosupplementation with Crespine® Gel over a 9-month period.Materials and methods: The study was a post-marketing phase IV study. A total of 109 participants with osteoarthritis of the knee (grades 1–4 in the tibio–femoral compartment were recruited in Jordan. Data were collected from each participant during the baseline visit. Each participant received Crespine® Gel injection, and follow-up visits took place at 3 months, 6 months, and 9 months post-injection.Main outcome measure(s: An assessment of participants by phone was conducted at 1 month, 2 months, 4 months, 5 months, 7 months, and 8 months post-injection. Western Ontario and McMaster Universities Arthritis Index questionnaires were completed during each visit. A 72-hour visit questionnaire was used to assess the safety of the injection. Statistical analysis included a two-sided 95% confidence interval for the difference between pain scores across visits, and the percent change from baseline was calculated.Main results: The full analysis included 84 participants who gave their informed consent and finished the necessary baseline and follow-up visits needed to assess efficacy and safety. Peak improvement was noted at 5 months post-injection, when pain and physical performance scores had decreased to 2.60 and 9.90, respectively, and the stiffness score was 0.33. The peak improvement in stiffness was noted at 8 months post-injection, when the stiffness score had decreased to 0.32. Significant improvements were still apparent at 9 months post-injection, when the pain score was 3

  8. Efficacy and safety of cross-linked hyaluronic acid single injection on osteoarthritis of the knee: a post-marketing Phase IV study.

    Science.gov (United States)

    Bashaireh, Khaldoon; Naser, Ziad; Hawadya, Khaled Al; Sorour, Sorour; Al-Khateeb, Rami Nabeel

    2015-01-01

    The primary objective of this study was to evaluate the efficacy, safety, and duration of action of viscosupplementation with Crespine® Gel over a 9-month period. The study was a post-marketing Phase IV study. A total of 109 participants with osteoarthritis of the knee (grades 1-4) in the tibio-femoral compartment were recruited in Jordan. Data were collected from each participant during the baseline visit. Each participant received Crespine® Gel injection, and follow-up visits took place at 3 months, 6 months, and 9 months post-injection. An assessment of participants by phone was conducted at 1 month, 2 months, 4 months, 5 months, 7 months, and 8 months post-injection. Western Ontario and McMaster Universities Arthritis Index questionnaires were completed during each visit. A 72-hour visit questionnaire was used to assess the safety of the injection. Statistical analysis included a two-sided 95% confidence interval for the difference between pain scores across visits, and the percent change from baseline was calculated. The full analysis included 84 participants who gave their informed consent and finished the necessary baseline and follow-up visits needed to assess efficacy and safety. Peak improvement was noted at 5 months post-injection, when pain and physical performance scores had decreased to 2.60 and 9.90, respectively, and the stiffness score was 0.33. The peak improvement in stiffness was noted at 8 months post-injection, when the stiffness score had decreased to 0.32. Significant improvements were still apparent at 9 months post-injection, when the pain score was 3.36, the stiffness score was 0.42, and the physical performance score was 11.5. All side effects were local and transient, and included pain, swelling, and redness of the knee. Most side effects were treated. Hyaluronan should be encouraged as an alternative or adjunct treatment to oral analgesics to reduce their required doses, and delay potential future surgical intervention.

  9. Repeat confirmatory testing for persons with discordant whole blood and oral fluid rapid HIV test results: findings from post marketing surveillance.

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    Laura G Wesolowski

    Full Text Available BACKGROUND: Reactive oral fluid and whole blood rapid HIV tests must be followed with a confirmatory test (Western blot (WB, immunofluorescent assay (IFA or approved nucleic acid amplification test (NAAT. When the confirmatory result is negative or indeterminate (i.e. discordant with rapid result, repeat confirmatory testing should be conducted using a follow-up specimen. Previous reports have not described whether repeat testing adequately resolves the HIV-infection status of persons with discordant results. METHODOLOGY: Post-marketing surveillance was conducted in 368 testing sites affiliated with 14 state and 2 city health departments from August 11, 2004 to June 30, 2005 and one health department through December 31, 2005. For persons with discordant results, data were collected on demographics, risk behaviors, HIV test results and specimen types. Persons with repeat confirmatory results were classified as HIV-infected or uninfected. Regression models were created to assess risk factors for not having repeat testing. PRINCIPAL FINDINGS: Of 167,371 rapid tests conducted, 2589 (1.6% were reactive: of these, 2417 (93% had positive WB/IFA, 172 (7% had negative or indeterminate WB/IFA. Of 89/172 (52% persons with a repeat confirmatory test: 17 (19% were HIV-infected, including 3 with indeterminate WB and positive NAAT; 72 (81% were uninfected, including 12 with repeat indeterminate WB. Factors associated with HIV-infection included having an initial indeterminate WB/IFA (vs. negative (p<0.001 and having an initial oral fluid WB (vs. serum (p<0.001. Persons who had male-female sex (vs. male-male sex were at increased risk for not having a repeat test [adjusted OR 2.6, 95% CI (1.3, 4.9]. CONCLUSIONS: Though only half of persons with discordant results had repeat confirmatory testing, of those who did, nearly one in five were HIV-infected. These findings underscore the need for rapid HIV testing programs to increase repeat confirmatory testing for

  10. Safety and Efficacy of Teneligliptin in Patients with Type 2 Diabetes Mellitus and Impaired Renal Function: Interim Report from Post-marketing Surveillance.

    Science.gov (United States)

    Haneda, Masakazu; Kadowaki, Takashi; Ito, Hiroshi; Sasaki, Kazuyo; Hiraide, Sonoe; Ishii, Manabu; Matsukawa, Miyuki; Ueno, Makoto

    2018-06-01

    Teneligliptin is a novel oral dipeptidyl peptidase-4 inhibitor for the treatment of type 2 diabetes mellitus (T2DM). Safety and efficacy of teneligliptin have been demonstrated in clinical studies; however, data supporting its use in patients with moderate or severe renal impairment are limited. This interim analysis of a post-marketing surveillance of teneligliptin, exploRing the long-term efficacy and safety included cardiovascUlar events in patients with type 2 diaBetes treated bY teneligliptin in the real-world (RUBY), aims to verify the long-term safety and efficacy of teneligliptin in Japanese patients with T2DM and impaired renal function. For this analysis, we used the data from case report forms of the RUBY surveillance between May 2013 and June 2017. The patients were classified into G1-G5 stages of chronic kidney disease according to estimated glomerular filtration rate (eGFR) at initiation of teneligliptin treatment. Safety and efficacy were evaluated in these subgroups. Patients on dialysis were also assessed. Safety was assessed from adverse drug reactions (ADRs). Glycemic control was evaluated up to 2 years after teneligliptin initiation. A total of 11,677 patients were enrolled in the surveillance and 11,425 patient case-report forms were collected for the interim analysis. The incidence of ADRs in each subgroup was 2.98-6.98% of patients, with no differences in the ADR profile (including hypoglycemia and renal function ADRs) between subgroups. At 1 and 2 years after starting teneligliptin, the least-squares mean change in HbA1c adjusted to the baseline was - 0.68 to - 0.85% and - 0.71 to - 0.85% across the eGFR groups, respectively. Treatment with teneligliptin in patients on dialysis reduced or tended to reduce glycated albumin levels [- 2.29%, (p < 0.001) after 1 year; - 1.64%, (p = 0.064) after 2 years]. During long-term treatment, teneligliptin was generally well tolerated in patients with any stage of renal impairment from

  11. Relationship of Eating Patterns and Metabolic Parameters, and Teneligliptin Treatment: Interim Results from Post-marketing Surveillance in Japanese Type 2 Diabetes Patients.

    Science.gov (United States)

    Kadowaki, Takashi; Haneda, Masakazu; Ito, Hiroshi; Sasaki, Kazuyo; Hiraide, Sonoe; Matsukawa, Miyuki; Ueno, Makoto

    2018-06-01

    Healthy eating is a critical aspect of the prevention and management of type 2 diabetes (T2DM). Disrupted eating patterns can result in poor glucose control and increase the likelihood of diabetic complications. Teneligliptin inhibits dipeptidyl peptidase-4 activity for 24 h and suppresses postprandial hyperglycemia after all three daily meals. This interim analysis of data from the large-scale post-marketing surveillance of teneligliptin (RUBY) in Japan examined eating patterns and their relationship with metabolic parameters and diabetic complications. We also examined whether eating patterns affected safety and efficacy of teneligliptin. We analyzed baseline data from survey forms collected in RUBY between May 2013 and June 2017, including patient characteristics, metabolic parameters, and eating patterns (eating three meals per day or not; timing of evening meal) before teneligliptin treatment was initiated. Safety and efficacy of 12 months' teneligliptin (20-40 mg/day) treatment was assessed. Data from 10,532 patients were available for analysis. Most patients who did not eat three meals per day (n  =757) or who ate their evening meal after 10 PM (n  =206) were 64 years old or younger. At baseline, glycated hemoglobin (HbA1c), fasting blood glucose, triglycerides, total and low-density lipoprotein cholesterol, body mass index, alanine aminotransferase, and aspartate aminotransferase levels were higher in those patients who did not eat three meals per day (p < 0.05) or who ate their evening meal late (p < 0.05). Diabetic complications were more common in patients who did not eat three meals per day. Treatment with teneligliptin reduced HbA1c over 6 or 12 months across all eating patterns, with a low incidence of adverse drug reactions. Eating patterns may be associated with altered metabolic parameters and diabetic complications among Japanese patients with T2DM. Teneligliptin may be well tolerated and improve hyperglycemia in patients

  12. Scattering of ECRF waves by edge density fluctuations and blobs

    Directory of Open Access Journals (Sweden)

    Ram Abhay K.

    2015-01-01

    Full Text Available The scattering of electron cyclotron waves by density blobs embedded in the edge region of a fusion plasma is studied using a full-wave model. The full-wave theory is a generalization of the usual approach of geometric optics ray scattering by blobs. While the latter allows for only refraction of waves, the former, more general formulation, includes refraction, reflection, and diffraction of waves. Furthermore, the geometric optics, ray tracing, model is limited to blob densities that are slightly different from the background plasma density. Observations in tokamak experiments show that the fluctuating density differs from the background plasma density by 20% or more. Thus, the geometric optics model is not a physically realistic model of scattering of electron cyclotron waves by plasma blobs. The differences between the ray tracing approach and the full-wave approach to scattering are illustrated in this paper.

  13. A prospective, multicenter, post marketing surveillance study to evaluate the safety and effectiveness of the Superia-Sirolimus Eluting Coronary Stent System (SSECSS) implanted during routine clinical practice in India.

    Science.gov (United States)

    Chandra, Praveen; Kumar, Tarun

    2014-01-01

    A prospective, multicenter, post marketing surveillance study to evaluate the safety and effectiveness of the Superia-Sirolimus Eluting Coronary Stent System (SSECSS) implanted during routine clinical practice in India. 1. To study the MACE and in stent and In-segment Loss at Six Months (in a pre selected group of 50 patients). 1. Clinical and procedural success. This is a prospective, open label, single-arm, multicenter (16 sites), post marketing observational study enrolling patients implanted with Superia-Sirolimus Eluting Coronary Stent (SSECS) in routine clinical practice in India. A total of 200 Patients of coronary Artery Disease (CAD) implanted with Superia-Sirolimus Eluting Coronary Stent (SSECS) were enrolled. Clinical assessments were done at 30 days, 180 days and at 1, 2 years either telephonically or office visit. A cohort of 50 pre-selected patients were followed up for angiographic evaluation at 180 days. MACE at 12 month of follow up was 1.71%.Late lumen loss, in segment was 0.14 and in stent was 0.10 mm at 6 month of follow-up. TLR was required only in 2 patients. Superia stent is as safe as other biodegradable polymer stent in the market and time has come for biodegradable polymer stent with thin struts. Copyright © 2014 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  14. Impact of Chronic Renal Failure on Safety and Effectiveness of Paclitaxel-Eluting Stents for Femoropopliteal Artery Disease: Subgroup Analysis from Zilver PTX Post-Market Surveillance Study in Japan.

    Science.gov (United States)

    Ogawa, Yukihisa; Yokoi, Hiroyoshi; Ohki, Takao; Kichikawa, Kimihiko; Nakamura, Masato; Komori, Kimihiro; Nanto, Shinsuke; O'Leary, Erin E; Lottes, Aaron E; Saunders, Alan T; Dake, Michael D

    2017-11-01

    Favorable long-term outcomes of the Zilver PTX drug-eluting stent (DES) in femoropopliteal lesions have been demonstrated. Chronic renal failure (CRF) has been shown to be a risk factor for restenosis and decreased limb salvage. The results of the DES in patients with CRF have not previously been reported. This study compares the results with the DES in patients with CRF and those without CRF. This retrospective analysis from the Zilver PTX Japan Post-Market Surveillance Study included 321 patients with CRF and 584 patients without CRF. Outcomes included freedom from target lesion revascularization (TLR) and patency. Of the patients included in this subgroup analysis, 2-year data were available for 209 patients in the CRF group and 453 patients in the non-CRF group. The two groups were similar in terms of lesion length and the frequency of in-stent restenosis. Critical limb ischemia, severe calcification, and diabetes were more common in patients with CRF, whereas total occlusion was more common in patients without CRF. Freedom from TLR rates were 81.4 versus 84.9% (p = 0.24), and patency rates were 70.7 versus 70.3% (p = 0.95) in patients with and without CRF at 2 years, respectively. This is the first comparative study of the DES in femoropopliteal artery lesions in patients with and without CRF. These results indicate that the DES placed in femoropopliteal artery lesions of CRF patients is safe and effective with similar patency and TLR rates to patients without CRF. Level 3, Post-Market Surveillance Study.

  15. Optimal Implantation Depth and Adherence to Guidelines on Permanent Pacing to Improve the Results of Transcatheter Aortic Valve Replacement With the Medtronic CoreValve System: The CoreValve Prospective, International, Post-Market ADVANCE-II Study.

    Science.gov (United States)

    Petronio, Anna S; Sinning, Jan-Malte; Van Mieghem, Nicolas; Zucchelli, Giulio; Nickenig, Georg; Bekeredjian, Raffi; Bosmans, Johan; Bedogni, Francesco; Branny, Marian; Stangl, Karl; Kovac, Jan; Schiltgen, Molly; Kraus, Stacia; de Jaegere, Peter

    2015-05-01

    The aim of the CoreValve prospective, international, post-market ADVANCE-II study was to define the rates of conduction disturbances and permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement with the Medtronic CoreValve System (Minneapolis, Minnesota) using optimized implantation techniques and application of international guidelines on cardiac pacing. Conduction disturbances are a frequent complication of transcatheter aortic valve replacement. The rates of PPI in the published reports vary according to bioprosthesis type and the indications for PPI. The primary endpoint was the 30-day incidence of PPI with Class I/II indications when the Medtronic CoreValve System was implanted at an optimal depth (≤6 mm below the aortic annulus). The timing and resolution of all new-onset conduction disturbances were analyzed. A total of 194 patients were treated. The overall rate of PPI for Class I/II indications was 18.2%. An optimal depth was reached in 43.2% of patients, with a nonsignificantly lower incidence of PPI in patients with depths ≤6 mm, compared with those with deeper implants (13.3% vs. 21.1%; p = 0.14). In a paired analysis, new-onset left bundle branch block and first-degree atrioventricular block occurred in 45.4% and 39.0% of patients, respectively, and resolved spontaneously within 30 days in 43.2% and 73.9%, respectively. In patients with new PPI, the rate of intrinsic sinus rhythm increased from 25.9% at 7 days to 59.3% at 30 days (p = 0.004). Optimal Medtronic CoreValve System deployment and adherence to international guidelines on cardiac pacing are associated with a lower rate of new PPI after transcatheter aortic valve replacement, compared with results reported in previous studies. (CoreValve Advance-II Study: Prospective International Post-Market Study [ADVANCE II]; NCT01624870). Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  16. Surveillance on The Safety and Efficacy of Ambrisentan (Volibris Tablet 2.5 mg) in Patients with Pulmonary Arterial Hypertension in Real Clinical Practice: Post-marketing Surveillance (Interim Analysis Report).

    Science.gov (United States)

    Takahashi, Tomohiko; Hayata, Satoru; Kobayashi, Akihiro; Onaka, Yuna; Ebihara, Takeshi; Hara, Terufumi

    2018-03-01

    Pulmonary arterial hypertension (PAH) is an intractable and rare disease and the accumulation of clinical evidence under real-world setting is needed. A post-marketing surveillance for the endothelin receptor antagonist ambrisentan (Volibris tablet) has been conducted by all-case investigation since September 2010. This paper is an interim report on the safety and efficacy of ambrisentan in 702 patients with PAH. PAH patients aged 15 years or older were subjected to the analysis. The safety analysis by overall cases or stratification of patient backgrounds and the efficacy analysis were investigated. Regarding patient characteristics, the 702 patients subjected to safety analysis included 543 (77.4%) women and 546 (77.8%) patients at WHO functional class II/III. The mean observational time was 392.7 days. A total of 324 adverse drug reaction (ADR) occurred in 204 (29.1%) patients. Common ADRs (≥ 2%) included anemia (4.6%), peripheral edema (4.1%), headache (3.6%), edema and face edema (2.6% each), abnormal hepatic function (2.3%), and epistaxis (2.1%). There were 82 serious ADRs occurring in 44 (6.3%) patients (385 serious adverse events in 184 (26.2%) patients). Although 11 (1.6%) interstitial lung disease (ILD) cases were reported, all were observed in patients with disease that may contribute to ILD and therefore it is difficult to assess if ambrisentan was associated with these events. There was no difference in safety in relation to the presence/absence of connective tissue disease-related PAH (CTD-PAH) or combination therapy. Among 677 patients subjected to efficacy analysis, those in whom hemodynamic status was determined before and after treatment showed improvement in the mean pulmonary arterial pressure and pulmonary vascular resistance after treatment. The interim results showed safety consistent with the known profile of ambrisentan in terms of the types and frequencies of ADRs in patients with PAH in real clinical practice, in comparison with

  17. Post-marketing surveillance study of the safety and efficacy of nalfurafine hydrochloride (Remitch® capsules 2.5 μg in 3,762 hemodialysis patients with intractable pruritus

    Directory of Open Access Journals (Sweden)

    Kozono H

    2018-01-01

    Full Text Available Hideki Kozono,* Hiroshi Yoshitani,* Ryoko Nakano* Pharmaceutical and Medical Device Vigilance Department, Toray Industries, Inc., Tokyo, Japan *The authors contributed equally to this work Background: Intractable pruritus in hemodialysis patients can significantly decrease their quality of life and is also associated with poor vital prognosis. Although combined multiple causes of intractable pruritus in these patients have been identified, no existing treatments are proven to be sufficiently effective. We conducted a post-marketing surveillance to follow-up and assess the safety and efficacy of nalfurafine, a selective κ-opioid receptor agonist, for the treatment of intractable pruritus in patients undergoing hemodialysis. Patients and methods: Hemodialysis patients with intractable pruritus from institutions in Japan who received oral nalfurafine hydrochloride between January 2010 and December 2013 were enrolled in the surveillance. Surveillance was completed in July 2015. Safety data during 1 year after nalfurafine treatment onset, and efficacy data of nalfurafine evaluating the first 12-week treatment period and the following period until 1 year after the initial dose of nalfurafine (using global assessment of the itch improvement by the physician, Visual Analog Scale, and the Shiratori’s severity scores were collected and analyzed. Results: In total, 3,762 patients were analyzed for safety. Adverse drug reactions were experienced by 402/3,762 (10.69% patients. The most frequent adverse drug reactions were insomnia (127/3,762 [3.38%] patients, constipation (34 [0.90%], somnolence (32 [0.85%], dizziness (23 [0.61%], nausea (13 [0.35%], and malaise (9 [0.24%]. No patients developed dependence on nalfurafine. Nalfurafine was effective in 82.50% (2,880/3,491 of patients during the first 12 weeks and in 84.95% (2,167/2,551 on treatment during the subsequent period until 1 year after nalfurafine treatment initiation. Statistically significant

  18. gender-specific outcome after paclitaxel-eluting stent implantation in japanese patients with coronary artery disease--sub-analysis of the Japan TAXUS Express2 post-marketing survey.

    Science.gov (United States)

    Okura, Hiroyuki; Nakamura, Masato; Kotani, Jun-Ichi; Kozuma, Ken

    2013-01-01

     Although previous randomized and non-randomized studies have demonstrated the safety and efficacy of paclitaxel-eluting stents (PES), a higher revascularization rate has been reported in women than in men. A sub-analysis of the TAXUS Japan Post-market Surveillance Study (TAXUS-PMS) was done to assess the influence of gender on clinical outcome.  A total of 2,132 PES-treated Japanese patients (women, n=551) from this registry were analyzed. Subjects were stratified by gender to compare 1-year clinical outcome. PES-treated women were older and more likely to have insulin-treated diabetes and hypertension. In contrast, PES-treated men were more likely to be smokers, have a previous history of myocardial infarction, and lower ejection fraction. While cardiac death, myocardial infarction and stent thrombosis were similar between men and women, major cardiac events tended to be lower in women than in men (6.4% vs. 8.8%, P=0.08). Although women had significantly smaller reference vessel size (2.46±0.53 mm vs. 2.59±0.60 mm, Ptarget lesion revascularization rate was significantly lower in women than in men (4.2% vs. 6.5%, P<0.05).  Despite a higher risk profile, Japanese women treated with PES did not have a higher rate of repeat revascularization or major adverse clinical outcome than PES-treated men at 1 year. 

  19. Safety and effectiveness of 24-week treatment with iguratimod, a new oral disease-modifying antirheumatic drug, for patients with rheumatoid arthritis: interim analysis of a post-marketing surveillance study of 2679 patients in Japan.

    Science.gov (United States)

    Mimori, Tsuneyo; Harigai, Masayoshi; Atsumi, Tatsuya; Fujii, Takao; Kuwana, Masataka; Matsuno, Hiroaki; Momohara, Shigeki; Takei, Syuji; Tamura, Naoto; Takasaki, Yoshinari; Ikeuchi, Satoshi; Kushimoto, Satoru; Koike, Takao

    2017-09-01

    To determine the real-world safety and effectiveness of iguratimod (IGU) for rheumatoid arthritis (RA), a 52-week, Japanese, post-marketing surveillance study was conducted. An interim analysis at week 24 was performed. This study included all RA patients who received IGU following its introduction to the market. All adverse events (AEs) and adverse drug reactions (ADRs) were collected. Effectiveness was evaluated by the change in Disease Activity Score 28-C-reactive protein (DAS28-CRP) from baseline to week 24. Safety was analyzed in 2679 patients. The overall incidences of AEs, ADRs, and serious ADRs were 38.41, 31.65, and 3.21%, respectively; the most commonly reported serious ADRs were pneumonia/bacterial pneumonia, interstitial lung disease, and Pneumocystis jiroveci pneumonia. Concomitant glucocorticoid use and comorbid conditions associated with respiratory disease were identified as risk factors for serious infections. Pulmonary alveolar hemorrhage and increased international normalized ratio of prothrombin time were observed with concomitant use of IGU and warfarin. The DAS28-CRP decreased from baseline to week 24. Although a safety concern was identified with concomitant use of IGU and warfarin, this real-world study showed no other new safety concerns and similar effectiveness to clinical trials. IGU is a new therapeutic option for RA patients.

  20. Safety and effectiveness of tacrolimus add-on therapy for rheumatoid arthritis patients without an adequate response to biological disease-modifying anti-rheumatic drugs (DMARDs): Post-marketing surveillance in Japan.

    Science.gov (United States)

    Takeuchi, Tsutomu; Ishida, Kota; Shiraki, Katsuhisa; Yoshiyasu, Takashi

    2018-01-01

    Post-marketing surveillance (PMS) was conducted to assess the safety and effectiveness of tacrolimus (TAC) add-on therapy for patients with rheumatoid arthritis (RA) and an inadequate response to biological disease-modifying anti-rheumatic drugs (DMARDs). Patients with RA from 180 medical sites across Japan were registered centrally with an electronic investigation system. The observational period was 24 weeks from the first day of TAC administration concomitantly with biological DMARDs. Safety and effectiveness populations included 624 and 566 patients, respectively. Patients were predominantly female (81.1%), with a mean age of 61.9 years. Overall, 125 adverse drug reactions (ADRs) occurred in 94 patients (15.1%), and 15 serious ADRs occurred in 11 patients (1.8%). These incidences were lower compared with previously reported incidences after TAC treatment in PMS, and all of the observed ADRs were already known. A statistically significant improvement was observed in the primary effectiveness variable of Simplified Disease Activity Index after TAC treatment; 62.7% of patients achieved remission or low disease activity at week 24. TAC is well tolerated and effective when used as an add-on to biological DMARDs in Japanese patients with RA who do not achieve an adequate response to biological DMARDs in a real-world clinical setting.

  1. Use of endpoint adjudication to improve the quality and validity of endpoint assessment for medical device development and post marketing evaluation: Rationale and best practices. A report from the cardiac safety research consortium.

    Science.gov (United States)

    Seltzer, Jonathan H; Heise, Ted; Carson, Peter; Canos, Daniel; Hiatt, Jo Carol; Vranckx, Pascal; Christen, Thomas; Cutlip, Donald E

    2017-08-01

    This white paper provides a summary of presentations, discussions and conclusions of a Thinktank entitled "The Role of Endpoint Adjudication in Medical Device Clinical Trials". The think tank was cosponsored by the Cardiac Safety Research Committee, MDEpiNet and the US Food and Drug Administration (FDA) and was convened at the FDA's White Oak headquarters on March 11, 2016. Attention was focused on tailoring best practices for evaluation of endpoints in medical device clinical trials, practical issues in endpoint adjudication of therapeutic, diagnostic, biomarker and drug-device combinations, and the role of adjudication in regulatory and reimbursement issues throughout the device lifecycle. Attendees included representatives from medical device companies, the FDA, Centers for Medicare and Medicaid Services (CMS), end point adjudication specialist groups, clinical research organizations, and active, academically based adjudicators. The manuscript presents recommendations from the think tank regarding (1) rationale for when adjudication is appropriate, (2) best practices establishment and operation of a medical device adjudication committee and (3) the role of endpoint adjudication for post market evaluation in the emerging era of real world evidence. Copyright © 2017. Published by Elsevier Inc.

  2. Safety and efficacy of ipragliflozin in Japanese patients with type 2 diabetes in real-world clinical practice: interim results of the STELLA-LONG TERM post-marketing surveillance study.

    Science.gov (United States)

    Nakamura, Ichiro; Maegawa, Hiroshi; Tobe, Kazuyuki; Tabuchi, Hiromi; Uno, Satoshi

    2018-02-01

    Data regarding the efficacy and safety of sodium-glucose cotransporter 2 inhibitors in the real-world setting in Japan are limited. The STELLA-LONG TERM study is an ongoing 3-year post-marketing surveillance study of ipragliflozin in type 2 diabetes (T2D) patients. Here, we report the interim results (including 3-, 12-, and 24-month data). All Japanese patients with T2D who were first prescribed ipragliflozin between 17 July 2014 and 16 October 2015 at participating centers in Japan were registered in STELLA-LONG TERM. At 3, 12, and 24 months, the safety analysis set comprised 11,053, 5475, and 138 patients, respectively; the efficacy analysis set comprised 8757 patients. Ipragliflozin treatment resulted in statistically significant improvements versus baseline in hemoglobin A1c, fasting plasma glucose concentration, body weight, blood pressure, heart rate, and serum concentrations of low-density lipoprotein cholesterol and triglycerides. The adverse drug reaction incidence rate was 10.71%, the most common reactions being renal and urinary disorders (5.06%), infections and infestations (1.24%), and skin and subcutaneous tissue disorders (1.14%). Ipragliflozin was well tolerated and effective in Japanese patients with T2D; no new safety issues were identified.

  3. Registries in European post-marketing surveillance

    DEFF Research Database (Denmark)

    Bouvy, Jacoline C; Blake, Kevin; Slattery, Jim

    2017-01-01

    at gaining further insight into the European Medicines Agency's (EMA) requests for new registries and registry studies using existing registries and to review the experience gained in their conduct. METHODS: European Public Assessment Reports were consulted to identify products for which a request...

  4. Innovations in Post-Marketing Safety Research

    NARCIS (Netherlands)

    Stefánsdóttir, G.

    2012-01-01

    Safety surveillance is important during the entire life cycle of a drug. Pre-marketing trials have been shown to be ineffective in establishing the full safety profile of the drug, mainly due to their relatively small sample size and characteristics of the patients, which are usually younger and

  5. Basics of case report form designing in clinical research

    Directory of Open Access Journals (Sweden)

    Shantala Bellary

    2014-01-01

    Full Text Available Case report form (CRF is a specialized document in clinical research. It should be study protocol driven, robust in content and have material to collect the study specific data. Though paper CRFs are still used largely, use of electronic CRFs (eCRFS are gaining popularity due to the advantages they offer such as improved data quality, online discrepancy management and faster database lock etc. Main objectives behind CRF development are preserving and maintaining quality and integrity of data. CRF design should be standardized to address the needs of all users such as investigator, site coordinator, study monitor, data entry personnel, medical coder and statistician. Data should be organized in a format that facilitates and simplifies data analysis. Collection of large amount of data will result in wasted resources in collecting and processing it and in many circumstances, will not be utilized for analysis. Apart from that, standard guidelines should be followed while designing the CRF. CRF completion manual should be provided to the site personnel to promote accurate data entry by them. These measures will result in reduced query generations and improved data integrity. It is recommended to establish and maintain a library of templates of standard CRF modules as they are time saving and cost-effective. This article is an attempt to describe the methods of CRF designing in clinical research and discusses the challenges encountered in this process.

  6. Basics of case report form designing in clinical research.

    Science.gov (United States)

    Bellary, Shantala; Krishnankutty, Binny; Latha, M S

    2014-10-01

    Case report form (CRF) is a specialized document in clinical research. It should be study protocol driven, robust in content and have material to collect the study specific data. Though paper CRFs are still used largely, use of electronic CRFs (eCRFS) are gaining popularity due to the advantages they offer such as improved data quality, online discrepancy management and faster database lock etc. Main objectives behind CRF development are preserving and maintaining quality and integrity of data. CRF design should be standardized to address the needs of all users such as investigator, site coordinator, study monitor, data entry personnel, medical coder and statistician. Data should be organized in a format that facilitates and simplifies data analysis. Collection of large amount of data will result in wasted resources in collecting and processing it and in many circumstances, will not be utilized for analysis. Apart from that, standard guidelines should be followed while designing the CRF. CRF completion manual should be provided to the site personnel to promote accurate data entry by them. These measures will result in reduced query generations and improved data integrity. It is recommended to establish and maintain a library of templates of standard CRF modules as they are time saving and cost-effective. This article is an attempt to describe the methods of CRF designing in clinical research and discusses the challenges encountered in this process.

  7. MAGNETIC VT study: a prospective, multicenter, post-market randomized controlled trial comparing VT ablation outcomes using remote magnetic navigation-guided substrate mapping and ablation versus manual approach in a low LVEF population.

    Science.gov (United States)

    Di Biase, Luigi; Tung, Roderick; Szili-Torok, Tamás; Burkhardt, J David; Weiss, Peter; Tavernier, Rene; Berman, Adam E; Wissner, Erik; Spear, William; Chen, Xu; Neužil, Petr; Skoda, Jan; Lakkireddy, Dhanunjaya; Schwagten, Bruno; Lock, Ken; Natale, Andrea

    2017-04-01

    Patients with ischemic cardiomyopathy (ICM) are prone to scar-related ventricular tachycardia (VT). The success of VT ablation depends on accurate arrhythmogenic substrate localization, followed by optimal delivery of energy provided by constant electrode-tissue contact. Current manual and remote magnetic navigation (RMN)-guided ablation strategies aim to identify a reentry circuit and to target a critical isthmus through activation and entrainment mapping during ongoing tachycardia. The MAGNETIC VT trial will assess if VT ablation using the Niobe™ ES magnetic navigation system results in superior outcomes compared to a manual approach in subjects with ischemic scar VT and low ejection fraction. This is a randomized, single-blind, prospective, multicenter post-market study. A total of 386 subjects (193 per group) will be enrolled and randomized 1:1 between treatment with the Niobe ES system and treatment via a manual procedure at up to 20 sites. The study population will consist of patients with ischemic cardiomyopathy with left ventricular ejection fraction (LVEF) of ≤35% and implantable cardioverter defibrillator (ICD) who have sustained monomorphic VT. The primary study endpoint is freedom from any recurrence of VT through 12 months. The secondary endpoints are acute success; freedom from any VT at 1 year in a large-scar subpopulation; procedure-related major adverse events; and mortality rate through 12-month follow-up. Follow-up will consist of visits at 3, 6, 9, and 12 months, all of which will include ICD interrogation. The MAGNETIC VT trial will help determine whether substrate-based ablation of VT with RMN has clinical advantages over manual catheter manipulation. Clinicaltrials.gov identifier: NCT02637947.

  8. Long-Term Effectiveness of the Zilver PTX Drug-Eluting Stent for Femoropopliteal Peripheral Artery Disease in Patients with No Patent Tibial Runoff Vessels-Results from the Zilver PTX Japan Post-Market Surveillance Study.

    Science.gov (United States)

    Cipollari, Stefano; Yokoi, Hiroyoshi; Ohki, Takao; Kichikawa, Kimihiko; Nakamura, Masato; Komori, Kimihiro; Nanto, Shinsuke; O'Leary, Erin E; Lottes, Aaron E; Saunders, Alan T; Dake, Michael D

    2018-01-01

    To evaluate 2-year results of the Zilver PTX (Cook Medical, Bloomington, Indiana) drug-eluting stent (DES) for femoropopliteal peripheral artery disease (PAD) in patients with no continuous patent infrapopliteal runoff arteries compared with patients with ≥ 1 continuous patent runoff vessels. A retrospective analysis of patients with femoropopliteal PAD enrolled in the Zilver PTX Post-Market Surveillance Study in Japan was performed. There were no exclusion criteria. Outcomes, including freedom from target lesion revascularization (TLR), patency, and clinical benefit, for the no-runoff group (n = 54) were compared with the runoff group (n = 846). The 2 groups were similar in terms of demographics, lesion characteristics, and comorbidities (P > .05). There was a higher incidence of critical limb ischemia in the no-runoff group compared with the runoff group (44.8% vs 19.7%; P < .01). There were 3 amputations (5.6%) in the no-runoff group versus 7 amputations (0.8%) in the runoff group (P = .02). At 2 years, freedom from TLR rates were 81.3% versus 83.8% (P = .87), patency rates were 68.4% versus 70.7% (P = .95), and clinical benefit rates were 73.7% versus 80.0% (P = .16) in the no-runoff versus runoff group, respectively. Results in patients with no continuous patent tibial runoff were favorable through 2 years and similar to results for patients with ≥ 1 continuous patent runoff vessels, indicating that the Zilver PTX DES may be a valid treatment option for patients with these difficult-to-treat lesions. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  9. Safety and Effectiveness of Once-Daily Tadalafil (5 mg Therapy in Korean Men with Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms in a Real-World Clinical Setting: Results from a Post- Marketing Surveillance Study

    Directory of Open Access Journals (Sweden)

    Ji Eon Won

    2018-05-01

    Full Text Available Purpose: The aim of this study was to investigate the safety and effectiveness of tadalafil 5 mg once daily (quaque die [everyday], QD among Korean men with benign prostatic hyperplasia (BPH/lower urinary tract symptoms (LUTS in a real-world clinical setting. Materials and Methods: This was a single-country, prospective, observational cohort study in which patients newly prescribed tadalafil 5 mg QD for the treatment of BPH/LUTS were followed-up for 12±2 or 24±2 weeks, or to the last treatment, during post-marketing surveillance. Safety was evaluated in terms of the frequency of treatment-emergent adverse events (TEAEs and serious adverse events (SAEs. Effectiveness was assessed by changes in the International Prostate Symptom Score (IPSS from baseline to each endpoint. Results: All patients receiving ≥1 dose of tadalafil 5 mg QD (N=637 were included in the safety population. Two percent of patients (n=13 experienced 15 TEAEs of mild (n=10; 66.7% or moderate (n=5; 33.3% severity. No severe TEAEs and no SAEs were reported. Effectiveness evaluations included all patients receiving tadalafil who had both baseline and endpoint observations (12-week, N=265; 24-week, N=44. Compared with baseline, the mean IPSS total score (±standard error significantly improved by 4.7±0.3 and 6.4±0.7 points at the 12- and 24-week endpoints, respectively (p<0.0001, with significant improvements also observed on the storage, voiding, and quality of life subscores. In total, 69.1% of the patients had a clinically meaningful ≥3-point improvement in the IPSS total score. Conclusions: Tadalafil 5 mg QD was well tolerated and effective in Korean men with BPH/LUTS in a real-world clinical setting.

  10. Safety and Effectiveness of Once-Daily Tadalafil (5 mg) Therapy in Korean Men with Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms in a Real-World Clinical Setting: Results from a Post-Marketing Surveillance Study.

    Science.gov (United States)

    Won, Ji Eon; Chu, Ji Yeon; Choi, Hyunah Caroline; Chen, Yun; Park, Hyun Jun; Dueñas, Héctor José

    2018-05-01

    The aim of this study was to investigate the safety and effectiveness of tadalafil 5 mg once daily (quaque die [everyday], QD) among Korean men with benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) in a real-world clinical setting. This was a single-country, prospective, observational cohort study in which patients newly prescribed tadalafil 5 mg QD for the treatment of BPH/LUTS were followed-up for 12±2 or 24±2 weeks, or to the last treatment, during post-marketing surveillance. Safety was evaluated in terms of the frequency of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs). Effectiveness was assessed by changes in the International Prostate Symptom Score (IPSS) from baseline to each endpoint. All patients receiving ≥1 dose of tadalafil 5 mg QD (N=637) were included in the safety population. Two percent of patients (n=13) experienced 15 TEAEs of mild (n=10; 66.7%) or moderate (n=5; 33.3%) severity. No severe TEAEs and no SAEs were reported. Effectiveness evaluations included all patients receiving tadalafil who had both baseline and endpoint observations (12-week, N=265; 24-week, N=44). Compared with baseline, the mean IPSS total score (±standard error) significantly improved by 4.7±0.3 and 6.4±0.7 points at the 12- and 24-week endpoints, respectively (peffective in Korean men with BPH/LUTS in a real-world clinical setting. Copyright © 2018 Korean Society for Sexual Medicine and Andrology.

  11. The sirolimus-eluting Cypher Select coronary stent for the treatment of bare-metal and drug-eluting stent restenosis: insights from the e-SELECT (Multicenter Post-Market Surveillance) registry.

    Science.gov (United States)

    Abizaid, Alexandre; Costa, J Ribamar; Banning, Adrian; Bartorelli, Antonio L; Dzavik, Vladimir; Ellis, Stephen; Gao, Runlin; Holmes, David R; Jeong, Muyng Ho; Legrand, Victor; Neumann, Franz-Josef; Nyakern, Maria; Orlick, Amy; Spaulding, Christian; Worthley, Stephen; Urban, Philip M

    2012-01-01

    This study sought to compare the 1-year safety and efficacy of Cypher Select or Cypher Select Plus (Cordis Corporation, Bridgewater, New Jersey) sirolimus-eluting stents (SES) with the treatment of bare-metal stents (BMS) and drug-eluting stent (DES) in-stent restenosis (ISR) in nonselected, real-world patients. There is paucity of consistent data on DES for the treatment of ISR, especially, DES ISR. The e-SELECT (Multicenter Post-Market Surveillance) registry is a Web-based, multicenter and international registry encompassing virtually all subsets of patients and lesions treated with at least 1 SES during the period from 2006 to 2008. We enrolled in this pre-specified subanalysis all patients with at least 1 clinically relevant BMS or DES ISR treated with SES. Primary endpoint was major adverse cardiac events and stent thrombosis rate at 1 year. Of 15,147 patients enrolled, 1,590 (10.5%) presented at least 1 ISR (BMS group, n = 1,235, DES group, n = 355). Patients with DES ISR had higher incidence of diabetes (39.4% vs. 26.9%, p target lesion revascularization and definite/probable late stent thrombosis were higher in patients with DES ISR (6.9% vs. 3.1%, p = 0.003, and 1.8% vs. 0.5%, p = 0.04, respectively). Use of SES for either BMS or DES ISR treatment is safe and associated with low target lesion revascularization recurrence and no apparent safety concern. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. Design

    DEFF Research Database (Denmark)

    Volf, Mette

    This publication is unique in its demystification and operationalization of the complex and elusive nature of the design process. The publication portrays the designer’s daily work and the creative process, which the designer is a part of. Apart from displaying the designer’s work methods...... and design parameters, the publication shows examples from renowned Danish design firms. Through these examples the reader gets an insight into the designer’s reality....

  13. Safety of lornoxicam in the treatment of postoperative pain: a post-marketing study of analgesic regimens containing lornoxicam compared with standard analgesic treatment in 3752 day-case surgery patients.

    Science.gov (United States)

    Rawal, Narinder; Krøner, Karsten; Simin-Geertsen, Marija; Hejl, Charlotte; Likar, Rudolf

    2010-01-01

    Post-marketing surveillance studies can provide supplemental data on the safety of medications in the general population. This study aimed to evaluate the safety of analgesic regimens including the NSAID lornoxicam in the short-term treatment of postoperative pain in a clinically relevant population. Randomized, open-label, multicentre, multinational, observational cohort study of 4 days' duration. In-hospital postoperative setting, with discharge to home treatment within 24 hours of surgery. Adults aged > or =18 years expected to be in need of analgesic treatment after day-case surgery. Analgesic regimens containing lornoxicam were compared with a standard analgesic treatment, which was defined as the treatment that the patient would normally receive at the centre. Following day-case surgery, patients were provided with appropriate analgesic medication, and adverse events (AEs; defined as all recorded events with symptoms) were recorded by the investigator during the in-hospital stay and by the patient for the next 3 days using entries recorded morning and evening in a patient diary. Statistical analyses tested for between-treatment differences in AEs, adverse drug reactions (ADRs; defined as events probably, possibly or unlikely to be related to treatment) and gastrointestinal AEs (GI-AEs). A total of 4152 patients were randomized to treatment. Since 400 patients did not take any analgesic, the safety population consisted of 1838 patients for lornoxicam and 1914 patients for standard analgesic treatment. Demographic and disease characteristics were similar between the two treatment groups, as were the type of surgery and the anaesthesia used in surgery. In the safety population, 16.9% of patients received no analgesic in hospital, and when analgesics were provided they were often administered in combination. Similarly, approximately 17% of patients did not take any analgesics at home. AEs were reported in 27.1% and 29.4% of patients in the lornoxicam and standard

  14. A large, multicentre, observational, post-marketing surveillance study of the 2:1 formulation of follitropin alfa and lutropin alfa in routine clinical practice for assisted reproductive technology.

    Science.gov (United States)

    Bühler, Klaus; Naether, Olaf G J; Bilger, Wilma

    2014-01-14

    Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) both have a role to play in follicular development during the natural menstrual cycle. LH supplementation during controlled ovarian stimulation (COS) for assisted reproductive technology (ART) is used for patients with hypogonadotropic hypogonadism. However, the use of exogenous LH in COS in normogonadotropic women undergoing ART is the subject of debate. The aim of this study was to investigate characteristics of infertile women who received the 2:1 formulation of follitropin alfa and lutropin alfa (indicated for stimulation of follicular development in women with severe LH and FSH deficiency) in German clinical practice. A 3-year, multicentre, open-label, observational/non-interventional, post-marketing surveillance study of women (21-45 years) undergoing ART. Primary endpoint: reason for prescribing the 2:1 formulation of follitropin alfa and lutropin alfa. Secondary variables included: COS duration/dose; oocytes retrieved; fertilization; clinical pregnancy; ovarian hyperstimulation syndrome (OHSS). In total, 2220 cycles were assessed; at least one reason for prescribing the 2:1 formulation was given in 1834/2220 (82.6%) cycles. Most common reasons were: poor ovarian response (POR) (39.4%), low baseline LH (17.8%), and age (13.8%). COS: mean dose of the 2:1 formulation on first day, 183.1/91.5 IU; mean duration, 10.8 days. In 2173/2220 (97.9%) cycles, human chorionic gonadotrophin was administered. Oocyte pick-up (OPU) was attempted in 2108/2220 (95.0%) cycles; mean (standard deviation) 8.0 (5.4) oocytes retrieved/OPU cycle. Fertilization (≥1 oocyte fertilized) rates: in vitro fertilization (IVF), 391/439 (89.1%) cycles; intracytoplasmic sperm injection (ICSI)/IVF + ICSI, 1524/1613 (94.5%) cycles. Clinical pregnancy rate: all cycles, 25.9%; embryo transfer cycles, 31.3%. OHSS: hospitalization for OHSS, 8 (0.36%) cycles, Grade 2, 60 (2.7%), and Grade 3, 1 (0.05%). In German routine clinical

  15. Re-evaluation of the definition of remission on the 17-item Hamilton Depression Rating Scale based on recovery in health-related quality of life in an observational post-marketing study.

    Science.gov (United States)

    Sawamura, Jitsuki; Ishigooka, Jun; Nishimura, Katsuji

    2018-01-16

    Although a score of less than 7 for the 17-item Hamilton Depression Rating Scale (HAM-D17) has been widely adopted to define remission of depression, a full recovery from depression is closely related to the patient's quality of life as well. Accordingly, we re-evaluated this definition of remission using HAM-D17 in comparison with the corresponding score for health-related quality of life (HRQOL) measured by the SF-36. Using the data for depressive patients reported by GlaxoSmithKline K.K. (Study No. BRL29060A/863) in a post-marketing observational study of paroxetine, with a sample size of n = 722, multivariate logistic regression was performed with the HAM-D17 score as a dependent variable and with each of the eight domain scores of HRQOL (from the SF-36) transformed into a binominal form according to the national standard value for Japan. Then, area under curve of receiver operating characteristic analyses were conducted. Based on the obtained results, a multivariate analysis was performed using the HAM-D17 score in a binomial form with HAM-D17 as a dependent variable and with each of the eight HRQOL domain scores (SF-36) as binominalized independent variables. A cutoff value for the HAM-D17 score of 5 provided the maximum ROC-AUC at "0.864." The significantly associated scores of the eight HRQOL domains (SF-36) were identified for the HAM-D17 cutoff values of ≥5 and ≤4. The scores for physical functioning (odds ratio, 0.473), bodily pain (0.557), vitality (0.379), social functioning (0.540), role-emotion (0.265), and mental health (0.467) had a significant negative association with the HAM-D17 score (p < 0.05), and HRQOL domain scores for HAM-D17 ≥ 5 were significantly lower compared with those for HAM-D17 ≤ 4. A cutoff value for HAM-D17 of less than or equal to 4 was the best candidate for indicating remission of depression when the recovery of HRQOL is considered. Restoration of social function and performance should be considered

  16. Stent thrombosis and bleeding complications after implantation of sirolimus-eluting coronary stents in an unselected worldwide population: a report from the e-SELECT (Multi-Center Post-Market Surveillance) registry.

    Science.gov (United States)

    Urban, Philip; Abizaid, Alexandre; Banning, Adrian; Bartorelli, Antonio L; Baux, Ana Cebrian; Džavík, Vladimír; Ellis, Stephen; Gao, Runlin; Holmes, David; Jeong, Myung Ho; Legrand, Victor; Neumann, Franz-Josef; Nyakern, Maria; Spaulding, Christian; Worthley, Stephen

    2011-03-29

    The aim of this study was to ascertain the 1-year incidence of stent thrombosis (ST) and major bleeding (MB) in a large, unselected population treated with sirolimus-eluting stents (SES). Stent thrombosis and MB are major potential complications of drug-eluting stent implantation. Their relative incidence and predisposing factors among large populations treated worldwide are unclear. The SES were implanted in 15,147 patients who were entered in a multinational registry. We analyzed the incidence of: 1) definite and probable ST as defined by the Academic Research Consortium; and 2) MB, with the STEEPLE (Safety and efficacy of Enoxaparin in PCI) definition, together with their relation to dual antiplatelet therapy (DAPT) and to 1-year clinical outcomes. The mean age of the sample was 62 ± 11 years, 30.4% were diabetic, 10% had a Charlson comorbidity index ≥3, and 44% presented with acute coronary syndrome or myocardial infarction. At 1 year, the reported compliance with DAPT as recommended by the European Society of Cardiology guidelines was 86.3%. Adverse event rates were: ST 1.0%, MB 1.0%, mortality 1.7%, myocardial infarction 1.9%, and target lesion revascularization 2.3%. Multivariate analysis identified 9 correlates of ST and 4 correlates of MB. Advanced age and a high Charlson index were associated with an increased risk of both ST and MB. After ST, the 7-day and 1-year all-cause mortality was 30% and 35%, respectively, versus 1.5% and 10% after MB. Only 2 of 13,749 patients (0.015%) experienced both MB and ST during the entire 1-year follow-up period. In this worldwide population treated with ≥1 SES, the reported compliance with DAPT was good, and the incidence of ST and MB was low. Stent thrombosis and MB very rarely occurred in the same patient. (The e-SELECT Registry: a Multicenter Post-Market Surveillance; NCT00438919). Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  17. Hefei experimental hybrid fusion-fission reactor conceptual design

    International Nuclear Information System (INIS)

    Qiu Lijian; Luan Guishi; Xu Qiang

    1992-03-01

    A new concept of hybrid reactor is introduced. It uses JET-like(Joint European Tokamak) device worked at sub-breakeven conditions, as a source of high energy neutrons to induce a blanket fission of depleted uranium. The solid breeding material and helium cooling technique are also used. It can produce 100 kg of 239 Pu per year by partial fission suppressed. The energy self-sustained of the fusion core is not necessary. Plasma temperature is maintained by external 20 MW ICRF (ion cyclotron resonance frequency) and 10 MW ECRF (electron cyclotron resonance frequency) heating. A steady state plasma current at 1.5 Ma is driven by 10 MW LHCD (lower hybrid current driven). Plasma density will be kept by pellet injection. ICRF can produce a high energy tail in ion distribution function and lead to significant enhancement of D-T reaction rate by 2 ∼ 5 times so that the neutron source strength reaches to the level of 1 x 10 19 n/s. This system is a passive system. It's power density is 10 W/cm 3 and the wall loading is 0.6 W/cm 2 that is the lower limitation of fusion and fission technology. From the calculation of neutrons it could always be in sub-critical and has intrinsic safety. The radiation damage and neutron flux distribution on the first wall are also analyzed. According to the conceptual design the application of this type hybrid reactor earlier is feasible

  18. [Designs and thoughts of real world integrated data warehouse from HIS on re-evaluation of post-maketing traditional Chinese medicine].

    Science.gov (United States)

    Zhuang, Yan; Xie, Bangtie; Weng, Shengxin; Xie, Yanming

    2011-10-01

    To discuss the feasibility and necessity of using HIS data integration to build large data warehouse system which is extensively used on re-evaluation of post-marketing traditional Chinese medicine, and to provide the thought and method of the overall design for it. With domestic and overseas' analysis and comparison on clinical experiments' design based on real world using electronic information system, and with characteristics of HIS in China, a general framework was designed and discussed which refers to design thought, design characteristics, existing problems and solutions and so on. A design scheme of HIS data warehouse on re-evaluation of post-marketing traditional Chinese medicine was presented. The design scheme was proved to be high coherence and low coupling, safe, Universal, efficient and easy to maintain, which can effectively solve the problems many hospitals have faced during the process of HIS data integration.

  19. Design

    DEFF Research Database (Denmark)

    Volf, Mette

    Design - proces & metode iBog®  er enestående i sit fokus på afmystificering og operationalisering af designprocessens flygtige og komplekse karakter. Udgivelsen går bag om designerens daglige arbejde og giver et indblik i den kreative skabelsesproces, som designeren er en del af. Udover et bredt...... indblik i designerens arbejdsmetoder og designparametre giver Design - proces & metode en række eksempler fra anerkendte designvirksomheder, der gør det muligt at komme helt tæt på designerens virkelighed....

  20. Maintenance of vascular endothelial cell-specific properties after immortalization with an amphotrophic replication-deficient retrovirus containing human papilloma virus 16 E6/E7 DNA

    NARCIS (Netherlands)

    Fontijn, R.; Hop, C.; Brinkman, H. J.; Slater, R.; Westerveld, A.; van Mourik, J. A.; Pannekoek, H.

    1995-01-01

    Primary human vascular endothelial cells were immortalized by the integration of a single DNA copy of an amphotrophic, replication-deficient retrovirus containing the E6/E7 genes of human papilloma virus. To date, the resulting cell lines, designated EC-RF7 and EC-RF24, have been cultured for more

  1. Design

    Science.gov (United States)

    Buchanan, Richard; Cross, Nigel; Durling, David; Nelson, Harold; Owen, Charles; Valtonen, Anna; Boling, Elizabeth; Gibbons, Andrew; Visscher-Voerman, Irene

    2013-01-01

    Scholars representing the field of design were asked to identify what they considered to be the most exciting and imaginative work currently being done in their field, as well as how that work might change our understanding. The scholars included Richard Buchanan, Nigel Cross, David Durling, Harold Nelson, Charles Owen, and Anna Valtonen. Scholars…

  2. Design

    DEFF Research Database (Denmark)

    Jensen, Ole B.; Pettiway, Keon

    2017-01-01

    In this chapter, Ole B. Jensen takes a situational approach to mobilities to examine how ordinary life activities are structured by technology and design. Using “staging mobilities” as a theoretical approach, Jensen considers mobilities as overlapping, actions, interactions and decisions by desig...... by providing ideas about future research for investigating mobilities in situ as a kind of “staging,” which he notes is influenced by the “material turn” in social sciences....... with a brief description of how movement is studied within social sciences after the “mobilities turn” versus the idea of physical movement in transport geography and engineering. He then explains how “mobilities design” was derived from connections between traffic and architecture. Jensen concludes...

  3. Design study of an AC power supply system in JT-60SA

    International Nuclear Information System (INIS)

    Shimada, Katsuhiro; Baulaigue, Olivier; Cara, Philippe; Coletti, Alberto; Coletti, Roberto; Matsukawa, Makoto; Terakado, Tsunehisa; Yamauchi, Kunihito

    2011-01-01

    In the initial research phase of JT-60SA, which is the International Thermonuclear Experimental Reactor (ITER) satellite Tokamak with superconducting toroidal and poloidal magnetic field coils, the plasma heating operation of 30 MW-60 s or 20 MW-100 s is planned for 5.5 MA single null divertor plasmas. To achieve this operation, AC power source of the medium voltage of 18 kV and ∼7 GJ has to be provided in total to the poloidal field coil power supplies and additional heating devices such as neutral beam injection (NBI) and electron cyclotron radio frequency (ECRF). In this paper, the proposed AC power supply system in JT-60SA was estimated from the view point of available power, and harmonic currents based on the standard plasma operation scenario during the initial research phase. This AC power supply system consists of the reused JT-60 power supply facilities including motor generators with flywheel, AC breakers, harmonic filters, etc., to make it cost effective. In addition, the conceptual design of the upgraded AC power supply system for the ultimate heating power of 41 MW-100 s in the extended research phase is also described.

  4. Post-marketing surveillance of quinolones 1988-1990.

    Science.gov (United States)

    Davey, P G; McDonald, T; Lindsay, G

    1991-04-01

    It has been much easier to obtain original data on adverse drug reactions (ADR) of quinolones from the pharmaceutical industry than it was two years ago. This is to be welcomed and, as anticipated, the new data continue to suggest that the new 4-quinolones have an ADR profile which is very similar to that of other antimicrobials. Visual disturbance is not a prominent feature, in contrast to the ADR profile of nalidixic acid. Better definition of quinolone ADRs requires prospective study, and the results of a newly completed prescription event monitoring study are awaited with interest. The potential use of computerised databases and record linkage is examined, but at present the number of quinolone prescriptions is too small to assess documentation of serious but rare events such as convulsions. Physicians need to be aware of the limitations of current data on suspected ADRs. Further investment in computerised databases is required to satisfy the requirements for attributing causality of an event to a drug.

  5. Current French system of post-marketing drug surveillance.

    Science.gov (United States)

    Albengres, E; Gauthier, F; Tillement, J P

    1990-07-01

    The French system of drug surveillance is characterized by several original features: thirty regional centres are selected to cover all of France to collect, analyze and enter the adverse drug events in the national data bank. The system is based on a bank of well documented files submitted to a decision of imputation; the report of severe events by prescribers is mandatory; cases are collected either by spontaneous reporting (routine) or by direct request (intensive validation study); the system is being involved in studies of epidemiological type as carried out by the national system of health or a few societies of medicine as well as by the centres themselves in cooperative works on defined populations.

  6. Clinical outcomes with the STENTYS self-apposing coronary stent in patients presenting with ST-segment elevation myocardial infarction: two-year insights from the APPOSITION III (A Post-Market registry to assess the STENTYS self-exPanding COronary Stent In AcuTe MyocardIal InfarctiON) registry.

    Science.gov (United States)

    Lu, Huangling; Grundeken, Maik J; Vos, Nicola S; IJsselmuiden, Alexander J J; van Geuns, Robert-Jan; Wessely, Rainer; Dengler, Thomas; La Manna, Alessio; Silvain, Johanne; Montalescot, Gilles; Spaargaren, René; Tijssen, Jan G P; Amoroso, Giovanni; de Winter, Robbert J; Koch, Karel T

    2017-08-04

    The APPOSITION III registry evaluated the feasibility and performance of the STENTYS self-apposing stent in an ST-segment elevation myocardial infarction (STEMI) population. This novel self-apposing stent device lowers stent strut malapposition rates and therefore carries the potential to prevent stent undersizing during primary percutaneous coronary intervention (PCI) in STEMI patients. To date, no long-term data are available using this device in the setting of STEMI. We aimed to evaluate the long-term clinical outcomes of the APPOSITION III registry. This was an international, prospective, multicentre post-marketing registry. The study population consisted of 965 STEMI patients. The primary endpoint, major adverse cardiac events (MACE), was defined as the composite of cardiac death, recurrent target vessel myocardial infarction (TV-MI), and clinically driven target lesion revascularisation (CD-TLR). At two years, MACE occurred in 11.2%, cardiac death occurred in 2.3%, TV-MI occurred in 2.3% and CD-TLR in 9.2% of patients. The two-year definite stent thrombosis (ST) rate was 3.3%. Incremental event rates between one- and two-year follow-up were 1.0% for TV-MI, 1.8% for CD-TLR, and 0.5% for definite ST. Post-dilation resulted in significantly reduced CD-TLR and ST rates at 30-day landmark analyses. Results were equivalent between the BMS and PES STENTYS subgroups. This registry revealed low rates of adverse events at two-year follow-up, with an incremental ST rate as low as 0.5% in the second year, demonstrating that the self-apposing technique is feasible in STEMI patients on long-term follow-up while using post-dilatation.

  7. Design Methodology - Design Synthesis

    DEFF Research Database (Denmark)

    Andreasen, Mogens Myrup

    2003-01-01

    Design Methodology is part of our practice and our knowledge about designing, and it has been strongly supported by the establishing and work of a design research community. The aim of this article is to broaden the reader¿s view of designing and Design Methodology. This is done by sketching...... the development of Design Methodology through time and sketching some important approaches and methods. The development is mainly forced by changing industrial condition, by the growth of IT support for designing, but also by the growth of insight into designing created by design researchers.......ABSTRACT Design Methodology shall be seen as our understanding of how to design; it is an early (emerging late 60ies) and original articulation of teachable and learnable methodics. The insight is based upon two sources: the nature of the designed artefacts and the nature of human designing. Today...

  8. Mobile electronic versus paper case report forms in clinical trials: a randomized controlled trial.

    Science.gov (United States)

    Fleischmann, Robert; Decker, Anne-Marie; Kraft, Antje; Mai, Knut; Schmidt, Sein

    2017-12-01

    Regulations, study design complexity and amounts of collected and shared data in clinical trials render efficient data handling procedures inevitable. Recent research suggests that electronic data capture can be key in this context but evidence is insufficient. This randomized controlled parallel group study tested the hypothesis that time efficiency is superior when electronic (eCRF) instead of paper case report forms (pCRF) are used for data collection. We additionally investigated predictors of time saving effects and data integrity. This study was conducted on top of a clinical weight loss trial performed at a clinical research facility over six months. All study nurses and patients participating in the clinical trial were eligible to participate and randomly allocated to enter cross-sectional data obtained during routine visits either through pCRF or eCRF. A balanced randomization list was generated before enrolment commenced. 90 and 30 records were gathered for the time that 27 patients and 2 study nurses required to report 2025 and 2037 field values, respectively. The primary hypothesis, that eCRF use is faster than pCRF use, was tested by a two-tailed t-test. Analysis of variance and covariance were used to evaluate predictors of entry performance. Data integrity was evaluated by descriptive statistics. All randomized patients were included in the study (eCRF group n = 13, pCRF group n = 14). eCRF, as compared to pCRF, data collection was associated with significant time savings  across all conditions (8.29 ± 5.15 min vs. 10.54 ± 6.98 min, p = .047). This effect was not defined by participant type, i.e. patients or study nurses (F (1,112)  = .15, p = .699), CRF length (F (2,112)  = .49, p = .609) or patient age (Beta = .09, p = .534). Additional 5.16 ± 2.83 min per CRF were saved with eCRFs due to data transcription redundancy when patients answered questionnaires directly in eCRFs. Data integrity was

  9. Designing Material Materialising Design

    DEFF Research Database (Denmark)

    Nicholas, Paul

    2013-01-01

    Designing Material Materialising Design documents five projects developed at the Centre for Information Technology and Architecture (CITA) at the Royal Danish Academy of Fine Arts, School of Architecture. These projects explore the idea that new designed materials might require new design methods....... Focusing on fibre reinforced composites, this book sustains an exploration into the design and making of elastically tailored architectural structures that rely on the use of computational design to predict sensitive interdependencies between geometry and behaviour. Developing novel concepts...

  10. Designing Communication Design

    DEFF Research Database (Denmark)

    Løvlie, Anders Sundnes

    2016-01-01

    Innovating in the field of new media genres requires methods for producing designs that can succeed in being disseminated and used outside of design research labs. This article uses the author's experiences with the development of university courses in communication design to address the research...... question: How can we design courses to give students the competencies they need to work as designers of new media? Based on existing approaches from UX design and other fields, I present a model that has demonstrated its usefulness in the development of commercial products and services. The model...

  11. Emerging role of bioinformatics tools and software in evolution of clinical research

    Directory of Open Access Journals (Sweden)

    Supreet Kaur Gill

    2016-01-01

    Full Text Available Clinical research is making toiling efforts for promotion and wellbeing of the health status of the people. There is a rapid increase in number and severity of diseases like cancer, hepatitis, HIV etc, resulting in high morbidity and mortality. Clinical research involves drug discovery and development whereas clinical trials are performed to establish safety and efficacy of drugs. Drug discovery is a long process starting with the target identification, validation and lead optimization. This is followed by the preclinical trials, intensive clinical trials and eventually post marketing vigilance for drug safety. Softwares and the bioinformatics tools play a great role not only in the drug discovery but also in drug development. It involves the use of informatics in the development of new knowledge pertaining to health and disease, data management during clinical trials and to use clinical data for secondary research. In addition, new technology likes molecular docking, molecular dynamics simulation, proteomics and quantitative structure activity relationship in clinical research results in faster and easier drug discovery process. During the preclinical trials, the software is used for randomization to remove bias and to plan study design. In clinical trials software like electronic data capture, Remote data capture and electronic case report form (eCRF is used to store the data. eClinical, Oracle clinical are software used for clinical data management and for statistical analysis of the data. After the drug is marketed the safety of a drug could be monitored by drug safety software like Oracle Argus or ARISg. Therefore, softwares are used from the very early stages of drug designing, to drug development, clinical trials and during pharmacovigilance. This review describes different aspects related to application of computers and bioinformatics in drug designing, discovery and development, formulation designing and clinical research.

  12. Japanese contributions to IAEA INTOR workshop, phase two A, part 2, chapter IV: RF heating and current drive

    International Nuclear Information System (INIS)

    Sugihara, Masayoshi; Kimura, Haruyuki; Okazaki, Takashi

    1985-07-01

    This report corresponds to Chapter IV of Japanese contribution report to IAEA INTOR Workshop, phase Two A, Part 2. Data base assessments of plasma heating and launcher system design for Ion Cyclotron Range of Frequency (ICRF) wave, for Lower Hybrid Range of Frequency (LHRF) wave, and for Electron Cyclotron Range of Frequency (ECRF) wave are made. Assessments of current drive by LHRF, and of start-up assist and profile control by ECRF are also made. R and D programmes both physics and technology for each of the waves are specified. Applications of these waves to INTOR are examined. (author)

  13. Prompting Designers to Design

    DEFF Research Database (Denmark)

    Ahmed, Saeema

    2006-01-01

    Recent research suggest that engineering designers need assistance to understand what information is relevant for their particular design problem. They require guidance in formulating their queries and also to understand what information is relevant for them. This paper presents an approach to pr...

  14. Winged design; Befluegeltes Design

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Tilman

    2013-10-15

    Today the wind rotor blades are about 80 meter long. To keep them light and transportable designers and material scientists come up with a number of ideas. Will the carbon fiber prevail against the glass fiber? [German] Ueber 80 Meter messen die laengsten Rotorblaetter heute. Um sie leicht und transportfaehig zu halten, lassen sich Designer und Materialforscher einiges einfallen. Wird sich die Kohlefaser gegen die Glasfaser durchsetzen?.

  15. Dansk Design

    DEFF Research Database (Denmark)

    Dickson, Thomas

    Indhold: Hvad er design?; Hvor kommer dansk design fra?; Produktdesign; Tekstil- og tøjdesign; Design af møbler og boligindretning; Bygningen og design; Arbejdets design; Transportdesign; Offentligt design; Grafisk design; Nye tider og en ny slags design...

  16. Designing medical technology for resilience: integrating health economics and human factors approaches.

    Science.gov (United States)

    Borsci, Simone; Uchegbu, Ijeoma; Buckle, Peter; Ni, Zhifang; Walne, Simon; Hanna, George B

    2018-01-01

    The slow adoption of innovation into healthcare calls into question the manner of evidence generation for medical technology. This paper identifies potential reasons for this including a lack of attention to human factors, poor evaluation of economic benefits, lack of understanding of the existing healthcare system and a failure to recognise the need to generate resilient products. Areas covered: Recognising a cross-disciplinary need to enhance evidence generation early in a technology's life cycle, the present paper proposes a new approach that integrates human factors and health economic evaluation as part of a wider systems approach to the design of technology. This approach (Human and Economic Resilience Design for Medical Technology or HERD MedTech) supports early stages of product development and is based on the recent experiences of the National Institute for Health Research London Diagnostic Evidence Co-operative in the UK. Expert commentary: HERD MedTech i) proposes a shift from design for usability to design for resilience, ii) aspires to reduce the need for service adaptation to technological constraints iii) ensures value of innovation at the time of product development, and iv) aims to stimulate discussion around the integration of pre- and post-market methods of assessment of medical technology.

  17. VLSI design

    CERN Document Server

    Chandrasetty, Vikram Arkalgud

    2011-01-01

    This book provides insight into the practical design of VLSI circuits. It is aimed at novice VLSI designers and other enthusiasts who would like to understand VLSI design flows. Coverage includes key concepts in CMOS digital design, design of DSP and communication blocks on FPGAs, ASIC front end and physical design, and analog and mixed signal design. The approach is designed to focus on practical implementation of key elements of the VLSI design process, in order to make the topic accessible to novices. The design concepts are demonstrated using software from Mathworks, Xilinx, Mentor Graphic

  18. Post-marketing surveillance of chemicals: organisations and databases : Workshop report

    NARCIS (Netherlands)

    Bouwmeester M; van Drongelen A; Graven C; Hernandez L; Herremans J; de Kaste D; Razenberg L; Vandebriel R; Piersma A; VTS; GZB

    2018-01-01

    The safety evaluation of chemicals is in general performed by the government, importer or manufacturer before marketing, and is based on (inter)national legislation. Less is known about the exact products in which chemicals are processed. Even though multiple institutions in the Netherlands are

  19. Post-market Surveillance Study With the HYPERION Hip Endoprosthesis System in Defect Reconstruction

    Science.gov (United States)

    2017-12-19

    Osteoarthritis; Avascular Necrosis; Rheumatoid Arthritis; Functional Deformities; Pseudoarthrosis; Revision of Endoprosthesis-treated Hips; Fracture, Proximal Humeral; Provision of Non-endoprosthetic Previous Operations of the Hip Joint (e.g., Transposition Osteotomies); Femur Fracture; Pseudarthrosis; Trochanteric Fractures; Bridging of Large Bone Defects; Revisions

  20. Jetstream Atherectomy System treatment of femoropopliteal arteries: Results of the post-market JET Registry.

    Science.gov (United States)

    Gray, William A; Garcia, Lawrence A; Amin, Ali; Shammas, Nicolas W

    2017-12-27

    To report on procedural, safety, and effectiveness outcomes of real-world practice with the Jetstream rotational atherectomy system for treatment of femoropopliteal artery lesions. Safety and effectiveness of treatment with the Jetstream device has been demonstrated in clinical trials, but outcomes during real-world clinical practice have yet to be examined. 241 patients (66% male, mean age 67years, 41% diabetes; Rutherford 1-3) with de novo or restenotic (non-stent) femoropopliteal lesions ≥4cm in length were recruited. Major adverse events (MAE), defined as amputation, death, target lesion/vessel revascularization (TLR/TVR), myocardial infarction, or angiographic distal embolization that required a separate intervention; and binary restenosis were assessed at 30days and 12months. The mean (±SD) lesion length was 16.4±13.6cm; 35% of patients received adjunctive stents. Procedural success was achieved for 98.3% of lesions. The 30-day MAE rate was 2% (5/219; 2 TLR/TVR and 3 distal embolization); there were no deaths, index limb amputations, or myocardial infarctions. At 12months, the overall estimated freedom from TLR/TVR was 81.7% and 77.2% (44/57) of patients were free from duplex ultrasound-assessed restenosis. Efficacy and patency in a diabetic subset were similar to those of the overall cohort, while maintaining a similar safety profile. In a cohort reflecting real-world practice, the Jetstream Atherectomy System demonstrated a high procedural success rate with a low rate of complications and reinterventions, especially given the relatively long lesions studied. Copyright © 2017. Published by Elsevier Inc.

  1. Labour Market Structure in Malaysia: Pre- and Post-Market Gender Comparison

    OpenAIRE

    Chung-Khain Wye; Rahmah Ismail

    2012-01-01

    Gender inequality in Malaysian labour market can be observed through labour force participation, unemployment, occupational distribution, top management employment involving decision making, and average monthly salary. Such an inequality generally works to the disadvantage of females, notwithstanding their outperformance of educational attainment over their males’ counterparts. Case study in the ICT services subsector points to the importance of imparting employability skills among females to...

  2. Post-marketing withdrawal of analgesic medications because of adverse drug reactions: a systematic review.

    Science.gov (United States)

    Onakpoya, Igho J; Heneghan, Carl J; Aronson, Jeffrey K

    2018-01-01

    Many analgesics have been withdrawn from the market because of adverse drug reactions. Controversy still surrounds the use of some approved analgesics for pain management. However, the trends and reasons for withdrawal of analgesics when harms are attributed to their use have not been systematically assessed. Areas covered: We conducted searches in PubMed; Embase; Google Scholar; clinicaltrials.gov; WHO databases of withdrawn products; websites of the European Medicines Agency, the US Food and Drug Administration, the UK Medicines and Healthcare products Regulatory Agency; Meyler's Side Effects of Drugs; Stephens' Detection of New Adverse Drug Reactions; the Pharmaceutical Manufacturing Encyclopedia; and the Merck Index. We included licensed analgesics that were withdrawn after marketing because of adverse reactions between 1950 and March 2017. We excluded herbal products, non-human medicines, and non-prescription medicines. We used the Oxford Centre for Evidence Based Medicine criteria to document the levels of evidence, and chi-squared tests to compare withdrawal patterns across geographical regions. Expert opinion: Pharmacovigilance systems in low-resource settings should be strengthened. Greater co-ordination across regulatory authorities in assessing and interpreting the benefit-harm balance of new analgesics should be encouraged. Future reporting of harms in clinical trials of analgesics should follow standardized guidelines.

  3. Effectiveness and safety of dydrogesterone in regularization of menstrual cycle: a post-marketing study.

    Science.gov (United States)

    Trivedi, Nilesh; Chauhan, Naveen; Vaidya, Vishal

    2016-08-01

    Oral administration of dydrogesterone during second half of menstrual cycle has been shown to reduce menstrual irregularities. This prospective, observational study aimed to determine continued effectiveness of dydrogesterone (prescribed between 1 and 6 cycles or longer) in menstrual cycle regularization in Indian women aged ≥18 years with irregular menstrual cycle for at least 3 months. Those achieving regular cycles (21 to 35 days, inclusive) during treatment were followed up for 6 months after cessation of dydrogesterone treatment. Of the 910 women completing dydrogesterone treatment, 880 (96.7%) achieved cycle regularization (p<0.0001 for 90% success rate) at end of treatment (EOT). Of the 788 subjects available for follow up at 6 months, 747 (94.8%) reported cycle regularity (p<0.0001 for 90% success rate). At EOT, the mean cycle duration reduced by 16.14 (±24.04) days and mean amount of menstrual bleeding decreased by 0.45 (±1.20) pads/day. While five subjects reported worst pain at baseline, none experienced it at EOT. One serious adverse event (appendicitis) and three non-serious adverse events were reported. Dydrogesterone regularizes and improves the duration of the menstrual cycle, reduces the amount of bleeding, relieves menstrual pain and prevents relapse of irregular cycles at six months after discontinuation of treatment.

  4. Initial post marketing experience with lacosamide in adult patients with epilepsy.

    Science.gov (United States)

    Harden, Cynthia L; Cohn, Aaron; Lowe, Merredith; Serrano, Enrique

    2012-02-01

    The outcomes of adult epilepsy patients prescribed lacosamide for additional seizure control. Responders were defined as having at least a 50% decrease in seizure frequency Sixty-seven patients were evaluated. Forty-six out of 67 patients (69%) were responders. Twelve of 14 patients not taking sodium channel-acting AEDs were responders (86%) and 34/53 patients taking sodium channel-acting AEDs were responders (64%) (difference not significant). Copyright © 2011 Elsevier B.V. All rights reserved.

  5. Statement on the post-marketing monitoring of the use of lycopene

    DEFF Research Database (Denmark)

    Tetens, Inge

    2015-01-01

    performed by EFSA and data on sales and product launch data provided for the period from July 2009 to June 2012, the Panel concludes that intakes of naturally occurring lycopene and from its use as a food colouring and as a novel food ingredient at permitted use levels do not lead to intakes above the ADI...... of lycopene as a novel food ingredient jointly prepared and submitted a dossier containing sales data, product launch data, an intake estimate and toxicological information. On the basis of information on sales and new product launch data for the period from July 2009 to June 2012 provided by the lycopene...

  6. Post-market monitoring: legal framework in Brazil and first results

    OpenAIRE

    Marcia A. Melo; Ederson A. Kido; Paulo P. Andrade

    2010-01-01

    Brazil is presently (2010) the second largest producer of Genetically Modified (GM) crops. The legal framework to support both research activities and the commercial release of Genetically Modified Organisms (GMOs) is, however, very recent, as the Biosafety Law dates back from 2005. After the indispensable risk analysis, done by National Technical Committee for Biosafety (CTNBio), a GM plant can be approved for commercial release. Nevertheless, as stated in the Normative Resolution nr. 5 (NR-...

  7. Beyond post-marketing research and MedWatch: Long-term studies of drug risks.

    Science.gov (United States)

    Resnik, David B

    2007-10-01

    Critics of the drug safety system have discussed many different potential reforms, ranging from mandatory registration of clinical trials to increasing the power of regulatory agencies, but few have discussed one of the most important ways of enhancing safety: increasing the number of long-term studies of medications. Long-term studies of the risks and benefits of drugs can provide useful information for regulators, healthcare professionals, and patients. Government funding agencies should lead the effort to conduct long-term studies of drugs, but private companies should also be required to lend financial support. Because cost-effectiveness is likely to be an important consideration in conducting this research, funding agencies should focus, at first, on drugs that are used to treat common, chronic conditions.

  8. Post-marketing surveillance of CustomBone Service implanted in children under 7 years old.

    Science.gov (United States)

    Frassanito, Paolo; Tamburrini, Gianpiero; Massimi, Luca; Di Rocco, Concezio; Nataloni, Angelo; Fabbri, Greta; Caldarelli, Massimo

    2015-01-01

    The CustomBone Service is a bioceramic implant suitable for cranial repair in both adults and children, although there are no clinical data about its use in children under 7 years of age. This surveillance study investigates the outcome in this age group. Twenty-eight children under 7 years old (range, 2.5-6 years) received CustomBone Service from July 2006 to May 2013 in 16 international hospitals. Data of 23 children (12 males and 11 females), harboring 24 prosthesis, were available with a minimum follow-up of 1 year. Sites of the cranial defect were frontal or parietal (20.8 % each), parieto-temporal (16.7 %), fronto-parietal or occipital (12.5 % each), fronto-parieto-temporal or fronto-temporal (8.3 % each). Initial diseases were trauma (54.2 %), malformation (37.5 %), or tumor of the bone/skin (8.3 %). Rupture of the implant occurred in a single case during the implant (1/26 surgeries, 3.8 %) and the cranial repair was achieved by means of the back-up prosthesis. Five adverse events were registered during the follow-up period consisting of three cases of fracture and two of exposure/infection of the prosthesis. All cases required the removal of the device (20.8 %). The failure rate of CustomBone Service under 7 years of age was higher than reported in adults and children over 7 years old (20.8 vs. 3.8 %), However, CustomBone Service may be considered a valid option under 7 years old since other materials are burdened by more significant rates of complications in the long-term period. Due to specific properties of this material, indication to CustomBone Service in toddlers should be carefully evaluated by the surgeon on a case-by-case basis.

  9. Design Anthropology in Participatory Design

    DEFF Research Database (Denmark)

    Smith, Rachel Charlotte; Kjærsgaard, Mette Gislev

    2015-01-01

    This focus section explores the opportunities of design anthropology in participatory design as an approach to research and design in an increasingly global and digital world. Traditionally, ethnography has been used in Participatory design to research real-life contexts and challenges, and as ways...... opportunities of using design anthropology as a holistic and critical approach to addressing societal challenges and change, and a way for anthropologists and designers to engage in participatory research and design that extend beyond the empirical....

  10. Design Anthropology in Participatory Design

    DEFF Research Database (Denmark)

    Smith, Rachel Charlotte; Gislev Kjærsgaard, Mette

    2014-01-01

    In this workshop we explore the opportunities of ethnography and design anthropology in Participatory Design (PD) as an approach to design in an increasingly global and digital world. Traditionally, ethnography has been used in PD to research real-life contexts and challenges, and as ways...... opportunities of using design anthropology as a holistic and critical approach to societal challenges, and a way for anthropologists and designers to engage in design that extends beyond the empirical....

  11. Evidensbaseret design

    DEFF Research Database (Denmark)

    Pagh, Jesper

    2013-01-01

    Debatindlæg om evidensbaseret design, som argumenterer for at det dels er en gammeldags, modernistisk tilgang til design, dels ikke baserer sig på evidens.......Debatindlæg om evidensbaseret design, som argumenterer for at det dels er en gammeldags, modernistisk tilgang til design, dels ikke baserer sig på evidens....

  12. FPGA design

    CERN Document Server

    Simpson, Philip

    2010-01-01

    This book describes best practices for successful FPGA design. It is the result of the author's meetings with hundreds of customers on the challenges facing each of their FPGA design teams. By gaining an understanding into their design environments, processes, what works and what does not work, key areas of concern in implementing system designs have been identified and a recommended design methodology to overcome these challenges has been developed. This book's content has a strong focus on design teams that are spread across sites. The goal being to increase the productivity of FPGA design t

  13. Design Games

    DEFF Research Database (Denmark)

    Johansson, Martin Wetterstrand

    2007-01-01

    In this paper design games are discussed as an approach to managing design sessions. The focus is on the collaborative design session and more particular on how to set up the collaboration and reinsure progress. Design games have the advantage of framing the collaborative assignment at hand....... Experiments can be set up to explore possible futures and design games has the qualities of elegantly focus the work at the same time as it lessens the burden for the process facilitator. The present paper goes into detail about how design games can be set up to facilitate collaboration and how the design...

  14. Design What?%

    DEFF Research Database (Denmark)

    Engholm, Ida

    2017-01-01

    processes, which require specific development methods across a wide range of disciplines, from industrial design over graphic communication to service and digital design and strategic corporate development. The book addresses both established methods and recent research in design processes at leading design...... idea to the end-result. The goal for this graphic non-fiction project is to document and present both historical and current developments in design methodology, from the early attempts at documenting procedures for design process management at the Bauhaus School in the 1920s to contemporary design...

  15. VLSI design

    CERN Document Server

    Basu, D K

    2014-01-01

    Very Large Scale Integrated Circuits (VLSI) design has moved from costly curiosity to an everyday necessity, especially with the proliferated applications of embedded computing devices in communications, entertainment and household gadgets. As a result, more and more knowledge on various aspects of VLSI design technologies is becoming a necessity for the engineering/technology students of various disciplines. With this goal in mind the course material of this book has been designed to cover the various fundamental aspects of VLSI design, like Categorization and comparison between various technologies used for VLSI design Basic fabrication processes involved in VLSI design Design of MOS, CMOS and Bi CMOS circuits used in VLSI Structured design of VLSI Introduction to VHDL for VLSI design Automated design for placement and routing of VLSI systems VLSI testing and testability The various topics of the book have been discussed lucidly with analysis, when required, examples, figures and adequate analytical and the...

  16. Design Accountability

    DEFF Research Database (Denmark)

    Koskinen, Ilpo; Krogh, Peter

    2015-01-01

    When design research builds on design practice, it may contribute to both theory and practice of design in ways richer than research that treats design as a topic. Such research, however, faces several tensions that it has to negotiate successfully in order not to lose its character as research....... This paper looks at constructive design research which takes the entanglement of theory and practice as its hallmark, and uses it as a test case in exploring how design researchers can work with theory, methodology, and practice without losing their identity as design researchers. The crux of practice based...... design research is that where classical research is interested in singling out a particular aspect and exploring it in depth, design practice is characterized by balancing numerous concerns in a heterogenous and occasionally paradoxical product. It is on this basis the notion of design accountability...

  17. Mechanical design

    CERN Document Server

    Risitano, Antonino

    2011-01-01

    METHODOLOGICAL STATEMENT OF ENGINEERING DESIGNApproaches to product design and developmentMechanical design and environmental requirementsPROPERTIES OF ENGINEERING MATERIALSMaterials for mechanical designCharacterization of metalsStress conditionsFatigue of materialsOptimum material selection in mechanical designDESIGN OF MECHANICAL COMPONENTS AND SYSTEMSFailure theoriesHertz theoryLubrificationShafts and bearingsSplines and keysSpringsFlexible machine elementsSpur gearsPress and shrink fitsPressure tubesCouplingsClutchesBrakes

  18. A glucose meter evaluation co-designed with both health professional and consumer input.

    Science.gov (United States)

    Thompson, Harmony; Chan, Huan; Logan, Florence J; Heenan, Helen F; Taylor, Lynne; Murray, Chris; Florkowski, Christopher M; Frampton, Christopher M A; Lunt, Helen

    2013-11-22

    Health consumer's input into assessment of medical device safety is traditionally given either as part of study outcome (trial participants) or during post marketing surveillance. Direct consumer input into the methodological design of device assessment is less common. We discuss the difference in requirements for assessment of a measuring device from the consumer and clinician perspectives, using the example of hand held glucose meters. Around 80,000 New Zealanders with diabetes recently changed their glucose meter system, to enable ongoing access to PHARMAC subsidised meters and strips. Consumers were most interested in a direct comparison of their 'old' meter system (Accu-Chek Performa) with their 'new' meter system (CareSens brand, including the CareSens N POP), rather than comparisons against a laboratory standard. This direct comparison of meter/strip systems showed that the CareSens N POP meter read around 0.6 mmol/L higher than the Performa system. Whilst this difference is unlikely to result in major errors in clinical decision making such as major insulin dosing errors, this information is nevertheless of interest to consumers who switched meters so that they could maintain access to PHARMAC subsidised meters and strips. We recommend that when practical, the consumer perspective be incorporated into study design related to medical device assessment.

  19. User input in iterative design for prevention product development: leveraging interdisciplinary methods to optimize effectiveness.

    Science.gov (United States)

    Guthrie, Kate M; Rosen, Rochelle K; Vargas, Sara E; Guillen, Melissa; Steger, Arielle L; Getz, Melissa L; Smith, Kelley A; Ramirez, Jaime J; Kojic, Erna M

    2017-10-01

    The development of HIV-preventive topical vaginal microbicides has been challenged by a lack of sufficient adherence in later stage clinical trials to confidently evaluate effectiveness. This dilemma has highlighted the need to integrate translational research earlier in the drug development process, essentially applying behavioral science to facilitate the advances of basic science with respect to the uptake and use of biomedical prevention technologies. In the last several years, there has been an increasing recognition that the user experience, specifically the sensory experience, as well as the role of meaning-making elicited by those sensations, may play a more substantive role than previously thought. Importantly, the role of the user-their sensory perceptions, their judgements of those experiences, and their willingness to use a product-is critical in product uptake and consistent use post-marketing, ultimately realizing gains in global public health. Specifically, a successful prevention product requires an efficacious drug, an efficient drug delivery system, and an effective user. We present an integrated iterative drug development and user experience evaluation method to illustrate how user-centered formulation design can be iterated from the early stages of preclinical development to leverage the user experience. Integrating the user and their product experiences into the formulation design process may help optimize both the efficiency of drug delivery and the effectiveness of the user.

  20. Memory design

    DEFF Research Database (Denmark)

    Tanderup, Sisse

    by cultural forms, often specifically by the concept of memory in philosophy, sociology and psychology, while Danish design traditionally has been focusing on form and function with frequent references to the forms of nature. Alessi's motivation for investigating the concept of memory is that it adds......Mind and Matter - Nordik 2009 Conference for Art Historians Design Matters Contributed Memory design BACKGROUND My research concerns the use of memory categories in the designs by the companies Alessi and Georg Jensen. When Alessi's designers create their products, they are usually inspired...... a cultural dimension to the design objects, enabling the objects to make an identity-forming impact. Whether or not the concept of memory plays a significant role in Danish design has not yet been elucidated fully. TERMINOLOGY The concept of "memory design" refers to the idea that design carries...

  1. Business design or Creative design

    DEFF Research Database (Denmark)

    Sørensen, Suna; Lassen, Astrid Heidemann; Nielsen, Louise Møller

    2008-01-01

    Business design is about turning good ideas into future business, but it requires a great entrepreneurial opportunity to be exploited via a valid strategic and organizational design. The literature says much about how entrepreneurs design strategies and organizations, but how do they design...

  2. Designing Interfaces

    CERN Document Server

    Tidwell, Jenifer

    2010-01-01

    Despite all of the UI toolkits available today, it's still not easy to design good application interfaces. This bestselling book is one of the few reliable sources to help you navigate through the maze of design options. By capturing UI best practices and reusable ideas as design patterns, Designing Interfaces provides solutions to common design problems that you can tailor to the situation at hand. This updated edition includes patterns for mobile apps and social media, as well as web applications and desktop software. Each pattern contains full-color examples and practical design advice th

  3. Design Anthropology

    DEFF Research Database (Denmark)

    Gunn, Wendy

    Design anthropology is a call for a different way of involving anthropology and participatory observation within practices of designing technologies, services, policies and infrastructure that does not aim towards changing human behavior. Here design is considered the process and not the object...... of inquiry. The paper presents a short history of design anthropology, its theoretical underpinnings and methodologies. Theoretically, the emerging field is influenced by processual, critical and action orientated approaches in anthropology. I argue that by combining anthropological methodology and knowledge...... with the future orientated imaginative praxis of design skill and collaborative design processes, anthropology and design could learn from each other. I conclude by referring to what theories, methods, and approaches are in use by practitioners of design anthropology....

  4. Danish design

    DEFF Research Database (Denmark)

    Dickson, Thomas

    2001-01-01

    Hvordan dansk design bliver innovativt og verdensberømt igen som i storhedstiden i 1950- og 60'erne......Hvordan dansk design bliver innovativt og verdensberømt igen som i storhedstiden i 1950- og 60'erne...

  5. Designing motivation

    DEFF Research Database (Denmark)

    How can products be designed to change our habits for the better? What is some of the leading research that designers can draw on to create new systems that motivate people towards healthier behaviour? Designing Motivation is an edited collection of ‘industrialist cheat sheets’: 22 single......-page summaries of research articles relating to technology design, motivation, and behaviour change. Ranging across the fields of economics, sociology, design research and behavioural science, each summary draws out the design implications of the research. It is intended as a resource for designers who...... are grappling with how to create motivating products, and as a primer for students who want a brief introduction to some of the relevant theories, findings and design interventions in these fields. The editor's introduction raises a number of issues encountered when we try to apply behavioural research...

  6. Research Design

    DEFF Research Database (Denmark)

    2019-01-01

    Gunnar Scott Reinbacher (editor) Antology.  Research Design : Validation in Social Sciences. Gunnar Scott Reinbacher: Introduction. Research design and validity. 15p Ole Riis: Creative Research design. 16 p Lennart Nørreklit: Validity in Research Design. 24p Gitte Sommer Harrits: Praxeological...... Scott Reinbacher: Multidisciplinary Research Designs in Problem Based Research. The case of an european project on chronical diseases, the Tandem project (Training Alternmative Networking Skills in Diabetes Management). 15p Niels Nørgaard Kristensen: A qualitative bottom up approach to post modern...... knowledge: An integrated strategy for combining "explaining" and "understanding". 22p Heidi Houlberg Salomonsen & Viola Burau: Comparative research designs. 40p Rasmus Antoft & Heidi Houlberg Salomonsen: Studying organizations by a Pragmatic Research Design: the case of qualitative case study  designs. 31p...

  7. Repository design

    Energy Technology Data Exchange (ETDEWEB)

    John, C M

    1982-01-01

    Various technical issues of radioactive waste design are addressed in this paper. Two approaches to repository design considered herein are: (1) design to minimize the disturbance of the hot rock; and (2) designs that intentionally modify the hot rock to insure better containment of the wastes. The latter designs range from construction of a highly impermeable barrier around a spherical cavern to creating a matrix of tunnels and boreholes to form a cage within which the hydraulic pressure is nearly constant. Examples of these design alternatives are described in some detail. It is concluded that proposed designs for repositories illustrate that performance criteria considered acceptable for such facilities can be met by appropriate site selection and repository engineering. With these technically feasible design concepts, it is also felt that socioeconomic and institutional issues can be better resolved. (BLM)

  8. Breakwater design

    OpenAIRE

    Verhagen, H.J.; van den Bos, J.P.

    2017-01-01

    For this book we have deliberately chosen that the text should follow a more or less logical design procedure for breakwaters. It follows the required design steps from the system level down to the individual crosssection level, and in time from conceptual design to construction. This systematic approach starts at the functional description of breakwaters, system analysis including side-effects and derivation of boundary conditions and continues to the actual design, first of the main armour ...

  9. Design typology and design organisation

    DEFF Research Database (Denmark)

    Andreasen, Mogens Myrup; Wognum, N.; McAloone, Timothy Charles

    2002-01-01

    research society has recognised normative procedural models of designing as being a reasonable answer to the question: How do designing proceed? The reasoning behind the models, from which the design methodology model by [Pahl & Beitz 1995], may be seen as a characteristic one, was a mix of human problem......The idea of focusing upon the creation of a design typology was articulated by [Andreasen & Wognum 2000] and detailed by [Andreasen & Wognum 2001]. The aim was to propose a typology, which could serve as identification of design types and design research contributions. For a long period the design...... solving-, design management-, and artefact nature-reasoning. Critique has been raised to that type of models as being neither explanatory nor instructive. If we accept these models as merely being pragmatically "stepping-stone" explanations of what happens during designing, it is interesting to observe...

  10. Design Processes

    DEFF Research Database (Denmark)

    Ovesen, Nis

    2009-01-01

    Inspiration for most research and optimisations on design processes still seem to focus within the narrow field of the traditional design practise. The focus in this study turns to associated businesses of the design professions in order to learn from their development processes. Through interviews...... and emerging production methods....

  11. Radiopharmacy design

    International Nuclear Information System (INIS)

    Lazarus, C.R.

    1985-01-01

    The factors which should be considered when designing a radiopharmacy are examined. These include the levels and types of radioactivity and the functions, location, size and layout of the radiopharmacy. Aspects of the design process including environmental cleanliness in enclosed spaces and microbiological safety cabinets are also discussed. Finally the current publications available on recommendations and guidelines for radiopharmacy designs are briefly reviewed. (UK)

  12. Breakwater design

    NARCIS (Netherlands)

    Verhagen, H.J.; van den Bos, J.P.

    For this book we have deliberately chosen that the text should follow a more or less logical design procedure for breakwaters. It follows the required design steps from the system level down to the individual crosssection level, and in time from conceptual design to construction. This systematic

  13. Design Aspects

    International Nuclear Information System (INIS)

    Hillary, J.J.

    1974-01-01

    Summarizing part of a seminar on iodide filter testing the author classifies the design information on iodine filters which was presented at the meeting in terms of design requirements - species to be trapped sorption materials and engineering factors -, design evaluation, applications and operational experience

  14. Design Research

    DEFF Research Database (Denmark)

    Design Research is a new interdisciplinary research area with a social science orientation at its heart, and this book explores how scientific knowledge can be put into practice in ways that are at once ethical, creative, helpful, and extraordinary in their results. In order to clarify the common...... aspects – in terms of features and approaches – that characterize all strands of research disciplines addressing design, Design Research undertakes an in depth exploration of the social processes involved in doing design, as well as analyses of the contexts for design use. The book further elicits...... ‘synergies from interdisciplinary perspectives’ by discussing and elaborating on differing academic perspectives, theoretical backgrounds, and design concept definitions, and evaluating their unique contribution to a general core of design research. This book is an exciting contribution to this little...

  15. Design spaces

    DEFF Research Database (Denmark)

    2005-01-01

    Digital technologies and media are becoming increasingly embodied and entangled in the spaces and places at work and at home. However, our material environment is more than a geometric abstractions of space: it contains familiar places, social arenas for human action. For designers, the integration...... of digital technology with space poses new challenges that call for new approaches. Creative alternatives to traditional systems methodologies are called for when designers use digital media to create new possibilities for action in space. Design Spaces explores how design and media art can provide creative...... alternatives for integrating digital technology with space. Connecting practical design work with conceptual development and theorizing, art with technology, and usesr-centered methods with social sciences, Design Spaces provides a useful research paradigm for designing ubiquitous computing. This book...

  16. Design Research as Conceptual Designing

    DEFF Research Database (Denmark)

    Ylirisku, Salu; Jacucci, Giulio; Sellen, Abigail

    2015-01-01

    define conceptual designing as a constructive framing and re-framing activity, which is mediated by and targeted at the creation of new design concepts. Conceptual designing as an approach is valuable for addressing the fuzziness and ambiguity typical of research that explores novel areas with new...... partners, methods and resources. It is by no means a new phenomenon, and the main contribution of the article is the clarification of conceptual designing as a particular approach to designing and researching. The approach embraces openness, resource-construction and collaboration. We conclude...... that conceptual designing can be especially useful in research and design projects that bring different kinds of people, organizations, technologies and domains together into the forming of new well-founded proposals for development. The presentation of conceptual designing in this paper is written...

  17. ECO DESIGN IN DESIGN PROCESS

    Directory of Open Access Journals (Sweden)

    PRALEA Jeni

    2014-05-01

    Full Text Available Eco-design is a new domain, required by the new trends and existing concerns worldwide, generated by the necessity of adopting new design principles. New design principles require the designer to provide a friendly relationship between concept created, environment and consume. This "friendly" relationship should be valid both at present and in the future, generating new opportunities for product, product components or materials from which it was made. Awareness, by the designer, the importance of this new trend, permits the establishment of concepts that have as their objective the protection of present values and ensuring the legacy of future generations. Ecodesig, by its principles, is involved in the design process, from early stage, the stage of product design. Priority objective of the designers will consist in reducing the negative effects on the environment through the entire life cycle and after it is taken out of use. The main aspects of the eco-design will consider extending product exploitation, make better use of materials, reduction of emission of waste. The design process in the "eco"domein must be started by selecting the function of the concept, materials and technological processes, causing the shape of macro and micro geometric of the product through an analysis that involves optimizing and streamlining the product. This paper presents the design process of a cross-sports footwear concept, built on the basis of the principles of ecodesign

  18. Design Education

    DEFF Research Database (Denmark)

    Brandt, Eva

    2007-01-01

    In resent years the two main design schools in Denmark (Danmarks Designskole and Designskolen Kolding ) undergo many changes. The overall goal for both is to obtain status as a university, and they will be evaluated in this regard in 2010. Transforming a vocational school with long handicraft...... traditions into a research based institution for higher education is demanding. Danmarks Designskole is in the middle of this process, many activities are initiated, both employees and students are involved, and from outside representatives from various design professions. The design process has many...... stakeholders with various interests and opinions. The aim it is not to design a computer system, a service or product but re-designing curriculum, work procedures, self images etc. which support educating designers of the future. This paper reports on two investigations that have been carried through as part...

  19. Cooperative design

    DEFF Research Database (Denmark)

    Schmidt, Kjeld

    1998-01-01

    In the contemporary world, engineers and designers face huge challenges as they shift towards novel organizational concepts such as ‘concurrent engineering’ in order to manage increasing product diversity so as to satisfy customer demands while trying to accelerate the design process to deal...... they are facing. On one hand, designers need highly flexible ‘coordination mecha-nisms’ that can support horizontal coordination of large-scale distributed design projects, and on the other hand design organizations require versatile and ubiquitous infrastructures to be able to manage their ‘common informa...... with the competitive realities of a global market and decreasing product life cycles. In this environment, the coordination and integration of the myriads of interdependent and yet distributed and concurrent design activities becomes enormously complex. It thus seems as if CSCW technologies may be indispensable...

  20. Workspace Design

    DEFF Research Database (Denmark)

    Seim, Rikke

    Arbejdsmiljø adresseres sjældent i den klassike tekniske tilgang til arbejdspladsdesign. Workspace Design konceptet er et alternativ tilgang til design eller re-design af arbejdspladser, baseret på en socio-teknisk systemforståelse, hvor hovedprincipperne er 1) transformation af...... arbejdsmiljørådgiveren til facilitator af arbejdspladsdesignprocessen og 2) transformation af medarbejderne til co-designere af deres egen arbejdsplads. Dette ph.d.-projekt er en del af Workspace Design forskningsprogrammet som har udviklet og testet Workspace Design konceptet og de tilhørende metoder ved intervention i...... arbejdspladsdesignprocesser i tre virksomheder tilhørende henholdsvis industri-, service- og sundhedssektoren. Ph.d.-projektet har belyst hvordan en medarbejderinvolverende designproces kan iscenesættes og faciliteres af arbejdsmiljøprofessionelle ved hjælp af kreative, visuelle metoder inspireret af Participatory Design...

  1. Design culture and design education

    DEFF Research Database (Denmark)

    Riisberg, Vibeke; Bang, Anne Louise

    2014-01-01

    to change the education of future designers. This is an emerging field at a number of design schools across the world, among these Design School Kolding in Denmark. In this paper we understand and discuss design education as part of a cultural phenomenon. The aim of our research is to develop new dialogue...... tools for teaching fashion and textile students in order to stimulate new ways of thinking and engaging with users. By employing participatory design methods in the field of fashion and textiles, we seek to develop an alternative transformational strategy that may further the design of products....... In this paper we discuss ways in which design education might contribute in changing the current professional culture in order to meet the need for more sustainable futures....

  2. Integrated Design

    DEFF Research Database (Denmark)

    Jørgensen, Michael; Nielsen, M. W.; Strømann-Andersen, Jakob Bjørn

    2011-01-01

    and describe the decision process. Specific attention is given to how the engineering input was presented and how it was able to facilitate the design development. Site and context, building shape, organization of functions and HVAC-systems were all included to obtain a complete picture of the building......, low-energy consumption, and high-quality indoor environment. We use this case study to investigate how technical knowledge about building performance can be integrated into the conceptual design stage. We have selected certain points during the design process that represented design challenges...

  3. Design Diversity

    DEFF Research Database (Denmark)

    Dankl, Kathrina

    2014-01-01

    . The exhibition is oriented along disciplines such as inclusive design, which calls for products to be designed in such a way that they are equally attractive to people of all ages. Despite the existence of innovative design concepts, the number of well-designed products available on the market is low. While many...... courageous projects for "best agers" and "golden agers" never get beyond the prototype stage, products that paint a more "beige" picture of everyday life can be found in large numbers. This fact raises some key questions: Does the existing product culture reflect today's views on old age? Do contemporary...

  4. Team designing

    DEFF Research Database (Denmark)

    Denise J. Stokholm, Marianne

    2012-01-01

    Future wellbeing is depending on human competences in order to strengthen a sustainable development. This requires system thinking and ability to deal with complexity, dynamic and a vast of information. `We need to move away from present principles of breaking down problems into components and gi...... thinking and communication in design. Trying to answer the question: How can visual system models facilitate learning in design thinking and team designing?......Future wellbeing is depending on human competences in order to strengthen a sustainable development. This requires system thinking and ability to deal with complexity, dynamic and a vast of information. `We need to move away from present principles of breaking down problems into components and give...... in relation to a design-engineering education at Aalborg University. It will exemplify how the model has been used in workshops on team designing, challenged design learning and affected design competence. In specific it will investigate the influence of visual models of the perception of design, design...

  5. Design Compass

    DEFF Research Database (Denmark)

    Stokholm, Marianne Denise J.

    2006-01-01

    Design is moreover recognised as an important strategic tool in achieving competitive business´, products and services in a global market. As design becomes a more complex matter, due to a general increase in knowledge, requirements and internationalisation, more professions are involved....... As such it acts a managing tool for both leaders and participants in the design process. This paper builds on long term practical experiment with development and use of a simple tool to support management of complex design matters in diverse groups. Concerning education it has supported the development of new...

  6. Designated Places

    Data.gov (United States)

    California Natural Resource Agency — Census 2000 Place Names provides a seamless statewide GIS layer of places, including census designated places (CDP), consolidated cities, and incorporated places,...

  7. Design theory

    CERN Document Server

    2009-01-01

    This book deals with the basic subjects of design theory. It begins with balanced incomplete block designs, various constructions of which are described in ample detail. In particular, finite projective and affine planes, difference sets and Hadamard matrices, as tools to construct balanced incomplete block designs, are included. Orthogonal latin squares are also treated in detail. Zhu's simpler proof of the falsity of Euler's conjecture is included. The construction of some classes of balanced incomplete block designs, such as Steiner triple systems and Kirkman triple systems, are also given.

  8. Cryostat Design

    Energy Technology Data Exchange (ETDEWEB)

    Parma, V [European Organization for Nuclear Research, Geneva (Switzerland)

    2014-07-01

    This paper aims to give non-expert engineers and scientists working in the domain of accelerators a general introduction to the main disciplines and technologies involved in the design and construction of accelerator cryostats. Far from being an exhaustive coverage of these topics, an attempt is made to provide simple design and calculation rules for a preliminary design of cryostats. Recurrent reference is made to the Large Hadron Collider magnet cryostats, as most of the material presented is taken from their design and construction at CERN.

  9. Design and rationale of dabigatran's stroke prevention in real life in Turkey (D-SPIRIT).

    Science.gov (United States)

    Türk, Uğur Önsel; Alioğlu, Emin; Tunçer, Eşref; Özpelit, Mehmet Emre; Pekel, Nihat; Tengiz, İstemihan; Çetin, Nurullah; Dalgıç, Onur; Topaloğlu, Caner; Bilgin, Nazile; Altın, Cihan; Özdemirkıran, Tolga; Tülüce, Kamil; Türkoğlu, Ebru İpek; Özpelit, Ebru

    2016-04-01

    The D-SPIRIT registry is designed to investigate the safety and efficacy of dabigatran etexilate in patients with nonvalvular atrial fibrillation (NVAF) and to collect data on outcomes in clinical practice. The D-SPIRIT is a national, prospective, observational, post-marketing registry involving patients with NVAF who have been taking dabigatran etexilate therapy for stroke prevention for a minimum of 6 months prior to enrollment. The registry will collect and analyze data from routine care, enrolling up to 600 patients in 9 centers. Patients will be followed up for 2 years to evaluate effectiveness and safety. A sample size of 600 subjects is proposed based on the following assumptions; Two-sided significance level of 0.05 (1-sided significance level of 0.025), ischemic stroke incidence rate of 0.768%-1.111%, hemorrhagic stroke incidence rate of 0.109%-0.130%, transient ischemic attack incidence rate of 0.722%-0.623%, therapy discontinuation incidence rate of 40% at day 730, and duration of enrollment period of 12 months with non-uniformed enrollment rate. Ethics approval was given by Dokuz Eylül University Ethics Committee of Clinical Research (2014/54) and approved by the Turkish Ministry of Health. Potential results of D-SPIRIT registry will add data from clinical practice to those from the RE-LY trial to expand knowledge of dabigatran etexilate treatment in patients with NVAF.

  10. Research design considerations for clinical studies of abuse-deterrent opioid analgesics: IMMPACT recommendations

    Science.gov (United States)

    Turk, Dennis C.; O’Connor, Alec B.; Dworkin, Robert H.; Chaudhry, Amina; Katz, Nathaniel P.; Adams, Edgar H.; Brownstein, John S.; Comer, Sandra D.; Dart, Richard; Dasgupta, Nabarun; Denisco, Richard A.; Klein, Michael; Leiderman, Deborah B.; Lubran, Robert; Rappaport, Bob A.; Zacny, James P.; Ahdieh, Harry; Burke, Laurie B.; Cowan, Penney; Jacobs, Petra; Malamut, Richard; Markman, John; Michna, Edward; Palmer, Pamela; Peirce-Sandner, Sarah; Potter, Jennifer S.; Raja, Srinivasa N.; Rauschkolb, Christine; Roland, Carl L.; Webster, Lynn R.; Weiss, Roger D.; Wolf, Kerry

    2013-01-01

    Opioids are essential to the management of pain in many patients, but they also are associated with potential risks for abuse, overdose, and diversion. A number of efforts have been devoted to the development of abuse-deterrent formulations of opioids to reduce these risks. This article summarizes a consensus meeting that was organized to propose recommendations for the types of clinical studies that can be used to assess the abuse deterrence of different opioid formulations. Due to the many types of individuals who may be exposed to opioids, an opioid formulation will need to be studied in several populations using various study designs in order to determine its abuse-deterrent capabilities. It is recommended that the research conducted to evaluate abuse deterrence should include studies assessing: (1) abuse liability; (2) the likelihood that opioid abusers will find methods to circumvent the deterrent properties of the formulation; (3) measures of misuse and abuse in randomized clinical trials involving pain patients with both low risk and high risk of abuse; and (4) post-marketing epidemiological studies. PMID:22770841

  11. Interior Design.

    Science.gov (United States)

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This document contains teacher's materials for an eight-unit secondary education vocational home economics course on interior design. The units cover period styles of interiors, furniture and accessories, surface treatments and lighting, appliances and equipment, design and space planning in home and business settings, occupant needs, acquisition…

  12. Opportunity Design

    DEFF Research Database (Denmark)

    Løwe Nielsen, Suna; Lassen, Astrid Heidemann; Nielsen, Louise Møller

    2013-01-01

    design”. The framework explains how opportunities intentionally and pro-actively can be designed from methods and processes of moving-in and moving-out. An illustrative case of opportunity design within the area of sustainable energy and electric cars is presented to link the theoretical discussion...

  13. Publication Design.

    Science.gov (United States)

    Nelson, Roy Paul

    This book is designed to solve the problem of coordinating art and typography with content in publications. Through text and illustrations, this book suggests ways to make pages and spreads in magazines, newspapers, and books attractive and readable. As a book of techniques, it is directed at potential and practicing art directors, designers, and…

  14. Designing friends

    NARCIS (Netherlands)

    Heylen, Dirk K.J.; Nijholt, Antinus; Stronks, B.; van der Vet, P.E.; Rosenberg, D.

    2003-01-01

    Embodied Conversational Agents are virtual humans that can interact with humans using verbal and non-verbal forms of communication. In most cases, they have been designed for short interactions. This paper asks the question how one would start to design synthetic characters that can become your

  15. Design tools

    Science.gov (United States)

    Anton TenWolde; Mark T. Bomberg

    2009-01-01

    Overall, despite the lack of exact input data, the use of design tools, including models, is much superior to the simple following of rules of thumbs, and a moisture analysis should be standard procedure for any building envelope design. Exceptions can only be made for buildings in the same climate, similar occupancy, and similar envelope construction. This chapter...

  16. Integrated Design

    DEFF Research Database (Denmark)

    Lenau, Torben Anker

    1999-01-01

    A homepage on the internet with course material, lecture plan, student exercises, etc. Continuesly updated during the course Integrated Design (80402, 80403)......A homepage on the internet with course material, lecture plan, student exercises, etc. Continuesly updated during the course Integrated Design (80402, 80403)...

  17. Persuasive Design

    DEFF Research Database (Denmark)

    Gram-Hansen, Sandra Burri

    2013-01-01

    of the specific context. This paper argues that the claim of persuasive design may not be the ability to change the user’s attitude or behaviour towards a given subject, but rather on the ability to create designs, which adapt the context in a way, which facilitates the ability to act within the opportune moment....

  18. Japansk design

    DEFF Research Database (Denmark)

    Kural, René

    2005-01-01

    Artiklen udspringer af interviews med ti af Japans bedste møbeldesignere, grafikere, arkitekter og designfirmaer. Efter samtalerne var der tre træk ved japansk design, som trådte frem: god økonomi, fantasi og vovemod. Det bedste japanske design fusionerer vovemod med den unikke japanske kultur med...

  19. Intelligent Design

    DEFF Research Database (Denmark)

    Hjorth, Poul G.

    2005-01-01

    Forestillingen om at naturen er designet af en guddommelig 'intelligens' er et smukt filosofisk princip. Teorier om Intelligent Design som en naturvidenskabeligt baseret teori er derimod helt forfærdelig.......Forestillingen om at naturen er designet af en guddommelig 'intelligens' er et smukt filosofisk princip. Teorier om Intelligent Design som en naturvidenskabeligt baseret teori er derimod helt forfærdelig....

  20. Performance Design

    DEFF Research Database (Denmark)

    Svabo, Connie

    Contribution to conference: Art and Presence The emerging field of Performance Design is unfolded as a bastard form of research/art/design/practice, with shapeshifting, monstruous, hybrid and transformational qualities. The potential for presencing, which emerges out of momentarily transgressing...

  1. Design law

    DEFF Research Database (Denmark)

    Schovsbo, Jens Hemmingsen; Riis, Thomas

    2017-01-01

    This book chapter describes, analyses and discusses the development of and the challenges to the legal protection og designs in Scandinavia and the EU......This book chapter describes, analyses and discusses the development of and the challenges to the legal protection og designs in Scandinavia and the EU...

  2. Furniture design

    CERN Document Server

    Smardzewski, Jerzy

    2015-01-01

    Maximizing reader insights into the principles of designing furniture as wooden structures, this book discusses issues related to the history of furniture structures, their classification and characteristics, ergonomic approaches to anthropometric requirements and safety of use. It presents key methods and highlights common errors in designing the characteristics of the materials, components, joints and structures, as well as looking at the challenges regarding developing associated design documentation. Including analysis of how designers may go about calculating the stiffness and endurance of parts, joints and whole structures, the book analyzes questions regarding the loss of furniture stability and the resulting threats to health of the user, putting forward a concept of furniture design as an engineering processes. Creating an attractive, functional, ergonomic and safe piece of furniture is not only the fruit of the work of individual architects and artists, but requires an effort of many people working ...

  3. Mobilities Design

    DEFF Research Database (Denmark)

    Jensen, Ole B.; Lanng, Ditte Bendix; Wind, Simon

    2016-01-01

    In this paper, we identify the nexus between design (architecture, urban design, service design, etc.) and mobilities as a new and emerging research field. In this paper, we apply a “situational mobilities” perspective and take point of departure in the pragmatist question: “What design decisions...... and interventions affords this particular mobile situation?” The paper presents the contours of an emerging research agenda within mobilities research. The advent of “mobilities design” as an emerging research field points towards a critical interest in the material as well as practical consequences of contemporary......-making. The paper proposes that increased understanding of the material affordances facilitated through design provides important insight to planning and policymaking that at times might be in risk of becoming too detached from the everyday life of the mobile subject within contemporary mobilities landscapes....

  4. ARE INCLUSIVE DESIGNERS DESIGNING INCLUSIVELY?

    DEFF Research Database (Denmark)

    Herriott, Richard

    2013-01-01

    of activity conforming to an authoritative design method. Analysis of the result showed that of the 66 cases, 4.5% reported carrying out all six categories of activity. 39.3% carried out or reported just one step. The study also found that the predominant focus of reported design activity is in the initial...

  5. Designing Users/Designing Innovation

    DEFF Research Database (Denmark)

    The paper addresses issues of user conceptualisation and representation in the processes of designing and innovating artifacts and use-practices. It is informed by early as well as more recent insights from technology studies within the new sociology of technology (e.g. Akrich 1995, Bijker & Law...... and competencies. Characteristic of these projects are the interplay between the social and the technical dimensions in the process of product development, and the students are expected to apply socio-technical methodologies in their strategies. The students’ need to inform the design through iteratively...... themes ranging from user-oriented design to product redesign and workspace design, etc. It is expected that some of the insights gained from these projects may be related outside of the immediate context of the classroom, to inform the notion of competencies in engineering design and sociotechnical...

  6. Design Anthropology

    DEFF Research Database (Denmark)

    This edited volume provides an introduction to the emerging field of design anthropology from the point of view of anthropologists engaging in its development. Contributors include young anthropologists with experience in the field and leading theoreticians, who combine to articulate the specific...... style of knowing involved in doing design anthropology. So far design anthropology has been developed mostly in the practice of industry and the public sector, in particular in Scandinavia and the US, and the sustained academic reflection to support this practice is still in its early stages. This book...... will contribute to this theoretical reflection and provide a reference for practitioners, teachers and students of anthropology, as well as design and innovation....

  7. Designing Organizations

    DEFF Research Database (Denmark)

    Book Description The design of organizations has been an ongoing concern of management theory and practice over the past several decades. Over this time, there has been little change in the fundamental theory, principles and concepts of Organization Design (OD). Recently organizational life has...... changed dramatically with the advent of: new communication systems, adaptive mechanisms, information technology, knowledge management systems, innovation processes and more. This book systemically examines these developments and their impact on OD with contributions from leading scholars in the area...... is a benchmark publication in the field of organization design. By focusing on recent developments in organization design, this book will help to create more thoughtful research and stronger empirical analyses in this important area of management and organization....

  8. Designing Organizations

    DEFF Research Database (Denmark)

    changed dramatically with the advent of: new communication systems, adaptive mechanisms, information technology, knowledge management systems, innovation processes and more. This book systemically examines these developments and their impact on OD with contributions from leading scholars in the area....... The individual chapters are organized into five sections: (1) Putting Contingency Theory in its Place, (2) Focus on Individuals who make up the Organization, (3) Innovation Processes and Organization Design, (4) Adaptation and Technology, and (5) Design for Performance. Each chapter examines aspects of the books...... is a benchmark publication in the field of organization design. By focusing on recent developments in organization design, this book will help to create more thoughtful research and stronger empirical analyses in this important area of management and organization....

  9. Design '82

    International Nuclear Information System (INIS)

    1982-01-01

    The papers in the symposium cover many aspects of the economy and effectiveness of chemical engineering design in industrial plants. Among the topics dealt with are the special problems associated with nuclear reprocessing plants. (U.K.)

  10. Persuasiv design

    DEFF Research Database (Denmark)

    Hasle, Per

    2011-01-01

    Purpose – The purpose of this paper is to introduce the theme issue on “Persuasive design”. Design/methodology/approach – This editorial describes the essential ideas and purposes of persuasive design (PD). PD's relation to other IT‐disciplines and rhetoric in general is discussed. A special...... to rhetoric and the concomitant implications for library and information systems is largely original (when compared with other discussions of PD)....

  11. Mechanical design

    Science.gov (United States)

    1976-01-01

    Design concepts for a 1000 mw thermal stationary power plant employing the UF6 fueled gas core breeder reactor are examined. Three design combinations-gaseous UF6 core with a solid matrix blanket, gaseous UF6 core with a liquid blanket, and gaseous UF6 core with a circulating blanket were considered. Results show the gaseous UF6 core with a circulating blanket was best suited to the power plant concept.

  12. Mechanisms Design

    DEFF Research Database (Denmark)

    Restrepo-Giraldo, John Dairo

    2006-01-01

    Most products and machines involve some kind of controlled movement. From window casements to DVD players, from harbor cranes to the shears to prune your garden, all these machines require mechanisms to move. This course intends to provide the analytical and conceptual tools to design such mechan......Most products and machines involve some kind of controlled movement. From window casements to DVD players, from harbor cranes to the shears to prune your garden, all these machines require mechanisms to move. This course intends to provide the analytical and conceptual tools to design...... using criteria such as size, performance parameters, operation environment, etc. Content: Understanding Mechanisms Design (2 weeks) Definitions, mechanisms representations, kinematic diagrams, the four bar linkage, mobility, applications of mechanisms, types of mechanisms, special mechanisms, the design......: equations for various mechanisms. At the end of this module you will be able to analyze existing mechanisms and to describe their movement. Designing mechanisms (7 weeks) Type synthesis and dimensional synthesis, function generation, path generation, three precision points in multi-loop mechanisms...

  13. Tank design

    International Nuclear Information System (INIS)

    Earle, F.A.

    1992-01-01

    This paper reports that aboveground tanks can be designed with innovative changes to complement the environment. Tanks can be constructed to eliminate the vapor and odor emanating from their contents. Aboveground tanks are sometimes considered eyesores, and in some areas the landscaping has to be improved before they are tolerated. A more universal concern, however, is the vapor or odor that emanates from the tanks as a result of the materials being sorted. The assertive posture some segments of the public now take may eventually force legislatures to classify certain vapors as hazardous pollutants or simply health risks. In any case, responsibility will be leveled at the corporation and subsequent remedy could increase cost beyond preventive measures. The new approach to design and construction of aboveground tanks will forestall any panic which might be induced or perceived by environmentalists. Recently, actions by local authorities and complaining residents were sufficient to cause a corporation to curtail odorous emissions through a change in tank design. The tank design change eliminated the odor from fuel oil vapor thus removing the threat to the environment that the residents perceived. The design includes reinforcement to the tank structure and the addition of an adsorption section. This section allows the tanks to function without any limitation and their contents do not foul the environment. The vapor and odor control was completed successfully on 6,000,000 gallon capacity tanks

  14. CliniProteus: A flexible clinical trials information management system

    Science.gov (United States)

    Mathura, Venkatarajan S; Rangareddy, Mahendiranath; Gupta, Pankaj; Mullan, Michael

    2007-01-01

    Clinical trials involve multi-site heterogeneous data generation with complex data input-formats and forms. The data should be captured and queried in an integrated fashion to facilitate further analysis. Electronic case-report forms (eCRF) are gaining popularity since it allows capture of clinical information in a rapid manner. We have designed and developed an XML based flexible clinical trials data management framework in .NET environment that can be used for efficient design and deployment of eCRFs to efficiently collate data and analyze information from multi-site clinical trials. The main components of our system include an XML form designer, a Patient registration eForm, reusable eForms, multiple-visit data capture and consolidated reports. A unique id is used for tracking the trial, site of occurrence, the patient and the year of recruitment. Availability http://www.rfdn.org/bioinfo/CTMS/ctms.html. PMID:21670796

  15. COM1/348: Design and Implementation of a Portal for the Market of the Medical Equipment (MEDICOM)

    Science.gov (United States)

    Palamas, S; Vlachos, I; Panou-Diamandi, O; Marinos, G; Kalivas, D; Zeelenberg, C; Nimwegen, C; Koutsouris, D

    1999-01-01

    Introduction The MEDICOM system provides the electronic means for medical equipment manufacturers to communicate online with their customers supporting the Purchasing Process and the Post Market Surveillance. The MEDICOM service will be provided over the Internet by the MEDICOM Portal, and by a set of distributed subsystems dedicated to handle structured information related to medical devices. There are three kinds of these subsystems, the Hypermedia Medical Catalogue (HMC), Virtual Medical Exhibition (VME), which contains information in a form of Virtual Models, and the Post Market Surveillance system (PMS). The Universal Medical Devices Nomenclature System (UMDNS) is used to register all products. This work was partially funded by the ESPRIT Project 25289 (MEDICOM). Methods The Portal provides the end user interface operating as the MEDICOM Portal, acts as the yellow pages for finding both products and providers, providing links to the providers servers, implements the system management and supports the subsystem database compatibility. The Portal hosts a database system composed of two parts: (a) the Common Database, which describes a set of encoded parameters (like Supported Languages, Geographic Regions, UMDNS Codes, etc) common to all subsystems and (b) the Short Description Database, which contains summarised descriptions of medical devices, including a text description, the codes of the manufacturer, UMDNS code, attribute values and links to the corresponding HTML pages of the HMC, VME and PMS servers. The Portal provides the MEDICOM user interface including services like end user profiling and registration, end user query forms, creation and hosting of newsgroups, links to online libraries, end user subscription to manufacturers' mailing lists, online information for the MEDICOM system and special messages or advertisements from manufacturers. Results Platform independence and interoperability characterise the system design. A general purpose RDBMS is used

  16. INFRASTRUCTURING DESIGN

    DEFF Research Database (Denmark)

    Ertner, Sara Marie

    The fact that the average citizen in Western societies is aging has significant implications for national welfare models. What some call ’the grey tsunami’ has resulted in suggestions for, and experiments in, re-designing healthcare systems and elderly care. In Denmark, one attempted solution...... that are imagined as the target group for welfare technology, and where are they located? Based on ethnographic explorations of ’welfare technology’ and related figures that include not only ’the elderly’, but also ’prototypes’ and ’partnership’ the dissertation analyses the processes and socio...... for collaborative design to happen. The implication of this is that technological design should not be imagined as the foundation for shaping more effective health care practices and better welfare. Instead, possibilities for improving practices through welfare technology emerge out of heterogeneous assemblages...

  17. Designing Mobilities

    DEFF Research Database (Denmark)

    Jensen, Ole B.

    are often still not engaged with in a sufficiently manner. Often social sciences keep distance to the physical and material as if the social was still to be understood as a realm separate of technology, architecture, and design (for a critique of this see; Latour 2005 and Urry 2000). This paper takes point......Within the so-called ‘mobilities turn’ (Adey 2010; Cresswell 2006; Urry 2007) much research has taken place during the last decade bringing mobilities into the centre of sociological analysis. However, the materiality and spatiality of artefacts, infrastructures, and sites hosting mobilities...... of departure in the sociological perspective termed ‘Staging Mobilities’ (Jensen 2013a) and utilizes this as an analytical frame for exploring cases of mobility design. The paper put focus on how the material shape, design and architectures of technologies, spaces and sites influence mobilities practices...

  18. Design thinking.

    Science.gov (United States)

    Brown, Tim

    2008-06-01

    In the past, design has most often occurred fairly far downstream in the development process and has focused on making new products aesthetically attractive or enhancing brand perception through smart, evocative advertising. Today, as innovation's terrain expands to encompass human-centered processes and services as well as products, companies are asking designers to create ideas rather than to simply dress them up. Brown, the CEO and president of the innovation and design firm IDEO, is a leading proponent of design thinking--a method of meeting people's needs and desires in a technologically feasible and strategically viable way. In this article he offers several intriguing examples of the discipline at work. One involves a collaboration between frontline employees from health care provider Kaiser Permanente and Brown's firm to reengineer nursing-staff shift changes at four Kaiser hospitals. Close observation of actual shift changes, combined with brainstorming and rapid prototyping, produced new procedures and software that radically streamlined information exchange between shifts. The result was more time for nursing, better-informed patient care, and a happier nursing staff. Another involves the Japanese bicycle components manufacturer Shimano, which worked with IDEO to learn why 90% of American adults don't ride bikes. The interdisciplinary project team discovered that intimidating retail experiences, the complexity and cost of sophisticated bikes, and the danger of cycling on heavily trafficked roads had overshadowed people's happy memories of childhood biking. So the team created a brand concept--"Coasting"--to describe a whole new category of biking and developed new in-store retailing strategies, a public relations campaign to identify safe places to cycle, and a reference design to inspire designers at the companies that went on to manufacture Coasting bikes.

  19. Dark Design

    DEFF Research Database (Denmark)

    Jensen, Ole B.

    Any design idea or intervention in the world is based on an underpinning logic or a set of normative principles and values. At times such will be very explicit, at other times they will be unspoken and tacit. In this paper the underpinning values leading to power exercise, social exclusion, and d...... of technologies (e.g. Graham 2010). The paper re-works how inequalities are ‘staged’ through overt and covert design ideas and interventions shaping and re-shaping the social geography of a world increasingly marked by the rights, abilities, and opportunities to move freely – or not!...

  20. Design & Innovation

    DEFF Research Database (Denmark)

    Boelskifte, Per; Jørgensen, Ulrik

    2005-01-01

    The new design and innovation programme at DTU is challenging some of the standard concepts dominating most engineering educations. The programme, its background, context and basic educational ideas are presented and discussed in this paper. To build competences that match the need for innovative...... and design oriented engineers in industry and society has turned out to challenge a number of the standard – and often taken for granted – concepts in engineering education still dominated world wide by rather strict norms and concepts of learning that do not challenge the students creativity and innovative...

  1. Lighting Design

    DEFF Research Database (Denmark)

    Hansen, Ellen Kathrine; Mullins, Michael

    2014-01-01

    of design developed from three experiments show how distinct qualitative and quantitative criteria in different disciplinary traditions can be integrated successfully, despite disparate technical/scientific, social scientific and art/humanities backgrounds. The model is applied to a pedagogical curriculum......Light as a multi-dimensional design element has fundamental importance for a sustainable environment. The paper discusses the need for an integration of scientific, technical and creative approaches to light and presents theory, methods and applications toward fulfilling this need. A theory...

  2. VLSI design

    CERN Document Server

    Einspruch, Norman G

    1986-01-01

    VLSI Electronics Microstructure Science, Volume 14: VLSI Design presents a comprehensive exposition and assessment of the developments and trends in VLSI (Very Large Scale Integration) electronics. This volume covers topics that range from microscopic aspects of materials behavior and device performance to the comprehension of VLSI in systems applications. Each article is prepared by a recognized authority. The subjects discussed in this book include VLSI processor design methodology; the RISC (Reduced Instruction Set Computer); the VLSI testing program; silicon compilers for VLSI; and special

  3. Designing Mobilities

    DEFF Research Database (Denmark)

    Jensen, Ole B.

    How is the width of the pavement shaping the urban experience? How is the material design of transport infrastructure and mobile technology affording social interaction in everyday life spaces? How do people inhabit these spaces with their bodies and in accordance to social and cultural norms...

  4. Designed communities?

    DEFF Research Database (Denmark)

    Stender, Marie

    2013-01-01

    In current residential spaces there seem to be an increasing emphasis on small-scale communities. A number of new, high profiled residential complexes thus seek to promote new ways of social living by rethinking architectural design, typologies and concepts. In this paper I explore the emergence ...

  5. Design junctions

    DEFF Research Database (Denmark)

    Jørgensen, Ulrik

    2012-01-01

    . This case study illustrates how dominant regimes of practice, established through the conception of pathogen bacteria and antibacterial treatments and disinfection, are now creating signals that call into question fundamental design of hygiene practices. By examining the epistemic assumptions of scientific...

  6. Participatory Design

    DEFF Research Database (Denmark)

    Robertson, Toni; Simonsen, Jesper

    2012-01-01

    focus of later chapters. The target audience is identified, and the structure of the book explained. A short description of each chapter highlights its particular contributions as well as the associated challenges facing designers and researchers engaged in participatory approaches. The chapter...

  7. Designer's Identity

    DEFF Research Database (Denmark)

    Kunrath, Kamila; Cash, Philip; Li-Ying, Jason

    2016-01-01

    A designer’s professional identity (DPI) develops through both education and professional experience, building on core personality traits and innate skills. In this paper a systematic literature review and a secondary narrative review were developed in order to map personal attributes and design...

  8. Appraising design

    Science.gov (United States)

    2016-05-26

    Acronyms ADM Army Design Methodology AFRICOM Africa Command CAS Complex Adaptive System COCOM...the case studies. It does not analyze the moral forces of training, quality of troops, and readiness. It also does not analyze national strength in...Second Lebanese War.110 Issues included a lack of vests, medical equipment, radios, ammunition, night vision devices (NVD), and food and water for the

  9. Dwelling Designers

    Science.gov (United States)

    Szekely, George

    2012-01-01

    Children's inventions go far beyond track housing or Ethan Allen furniture; they foreshadow the most innovative ideas in building forms and interior designs. Children improvise with containers and find places in a home that suggest enticing dwellings. A drawer left open becomes a balcony, soap trays become cots, and the space between twin beds…

  10. Probabilistic Design

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard; Burcharth, H. F.

    This chapter describes how partial safety factors can be used in design of vertical wall breakwaters and an example of a code format is presented. The partial safety factors are calibrated on a probabilistic basis. The code calibration process used to calibrate some of the partial safety factors...

  11. Intimate Design

    DEFF Research Database (Denmark)

    Søndergaard, Marie Louise Juul

    2017-01-01

    I examine how design can reflect on and critically discuss political and cultural issues of intimate technologies, such as gender and identity, embodied experiences, privacy, intimate data and sharing. In presenting my PhD project's background, research objectives, hypothesis and methodological...

  12. Collaborative Design

    Science.gov (United States)

    Broderick, Debora

    2014-01-01

    This practitioner research study investigates the power of multimodal texts within a real-world context and argues that a participatory culture focused on literary arts offers marginalized high school students opportunities for collaborative design and authoring. Additionally, this article invites educators to rethink the at-risk label. This…

  13. Integreret Design

    DEFF Research Database (Denmark)

    Helweg-Larsen, Klavs; Lenau, Torben Anker; Kristensen, Tore

    Integreret Design (ItD) var et tværdisciplinært kursus, der gennemførtes i samarbejde mellem Danmarks Designskole, Danmarks Tekniske Universitet og Handelshøjskolen i København i årene 1998 - 2001. Som støtte for undervisningen blev der udviklet et kompendium i bogform, som udgives af Danmarks...

  14. Didaktisk Design

    DEFF Research Database (Denmark)

    Sørensen, Birgitte Holm; Levinsen, Karin

    projekter - Individuelle fordybelsesprojekter. Forfatterne introducerer begrebet elever som didaktiske designere og viser med konkrete eksempler fra dansk, matematik og tværfaglige forløb, hvordan læreren med et overordnet rammedesign kan understøtte elevernes design af deres egne læreprocesser og dermed...

  15. Safety design

    International Nuclear Information System (INIS)

    Kunitomi, Kazuhiko; Shiozawa, Shusaku

    2004-01-01

    JAERI established the safety design philosophy of the HTTR based on that of current reactors such as LWR in Japan, considering inherent safety features of the HTTR. The strategy of defense in depth was implemented so that the safety engineering functions such as control of reactivity, removal of residual heat and confinement of fission products shall be well performed to ensure safety. However, unlike the LWR, the inherent design features of the high-temperature gas-cooled reactor (HTGR) enables the HTTR meet stringent regulatory criteria without much dependence on active safety systems. On the other hand, the safety in an accident typical to the HTGR such as the depressurization accident initiated by a primary pipe rupture shall be ensured. The safety design philosophy of the HTTR considers these unique features appropriately and is expected to be the basis for future Japanese HTGRs. This paper describes the safety design philosophy and safety evaluation procedure of the HTTR especially focusing on unique considerations to the HTTR. Also, experiences obtained from an HTTR safety review and R and D needs for establishing the safety philosophy for the future HTGRs are reported

  16. Design i Danmark = Danish Design?

    DEFF Research Database (Denmark)

    Lentz, Uffe

    2003-01-01

    Titlen på denne forelæsning har 3 led skønt det ser ud som om der er 4. Design i Danmark er en geografisk afgrænsning af et ikke særligt veldefineret begreb, der både kan dække over ting og aktiviteter, mens Danish Design er en fælles hat man har markedsført en række produkter under, for at få...... værdiopfattelse før fra det ene produkt til det andet. Et Brand ville det hedde i dag....

  17. Mobilities Design

    DEFF Research Database (Denmark)

    Jensen, Ole B.; Lanng, Ditte Bendix

    Contemporary society is marked and defined by the ways in which mobile goods, bodies, vehicles, objects, and data are organized, moved and staged. On the background of the ‘mobilities turn’ (e.g. Cresswell 2006, Urry 2007) this book articulates a new and emerging research field, namely that of ‘m......Contemporary society is marked and defined by the ways in which mobile goods, bodies, vehicles, objects, and data are organized, moved and staged. On the background of the ‘mobilities turn’ (e.g. Cresswell 2006, Urry 2007) this book articulates a new and emerging research field, namely...... that of ‘mobilities design’. The book revolves around the following research question: How are design decisions and interventions staging mobilities? It builds upon the Staging Mobilities model (Jensen 2013) in an explorative inquiry into the problems and potentials of the design of mobilities. The exchange value...

  18. Mobilities Design

    DEFF Research Database (Denmark)

    Jensen, Ole B.; Lanng, Ditte Bendix

    2016-01-01

    of life’ for billions of people in the everyday life. This paper is structured in three parts. After the general introduction we present the mobilities theory perspective of ‘staging mobilities’ and connects this to the empirical phenomenon of parking lots and their design. The paper ends in section three......Contemporary society is marked and defined by the ways in which mobile goods, bodies, vehicles, objects, and data are organized, moved and staged. On the backgound of the ‘mobilities turn’ (for short review paper on this see; Sheller 2011, Vannini 2010) this paper proposes a further development...... of the perspective in the direction of a material and design oriented turn. In order to fulfill this purpose we articulate a new and emerging research field, namely that of ‘mobilities design’. In our understanding time has come to articulate ‘Mobilities Design’ as a dedicated research field in and of its own...

  19. Design Transformations

    DEFF Research Database (Denmark)

    Morrison, Ann; Knoche, Hendrik

    2014-01-01

    Purpose – Taking a case study approach, we synchronised two courses to focus on the students working with learning and applying tools in the one course and acting on understandings gained to produce artefacts in the other. Design/methodology/approach – Working with real users throughout all stages...... focused evaluation methods using tangible representations; identified the relationship from these findings for subsequent re-design rationales; and discussed and critiqued each other’s work using multiple feedback, teach-back and discursive strategies. Findings – We found that in-depth coverage...... of material, working with real data and users at all stages of assessment and producing visualisations from evaluations, naturally forced student motivation to act and redesign better solutions. We noted improved attendance and students reported high engagement and content appreciation. Research limitations...

  20. Organization Design

    OpenAIRE

    Milton Harris; Artur Raviv

    2002-01-01

    This paper attempts to explain organization structure based on optimal coordination of interactions among activities. The main idea is that each manager is capable of detecting and coordinating interactions only within his limited area of expertise. Only the CEO can coordinate company wide interactions. The optimal design of the organization trades off the costs and benefits of various configurations of managers. Our results consist of classifying the characteristics of activities and manager...

  1. Designing Privacy-by-Design

    NARCIS (Netherlands)

    Rest, J.H.C. van; Boonstra, D.; Everts, M.H.; Rijn, M. van; Paassen, R.J.G. van

    2014-01-01

    The proposal for a new privacy regulation d.d. January 25th 2012 introduces sanctions of up to 2% of the annual turnover of enterprises. This elevates the importance of mitigation of privacy risks. This paper makes Privacy by Design more concrete, and positions it as the mechanism to mitigate these

  2. Design livre: cannibalistic interaction design

    NARCIS (Netherlands)

    van Amstel, Frederick; Vassao, C.A.; Ferraz, G.B.; Formia, E.M.

    2012-01-01

    This paper provides a historical account of cannibalism as used to explain how Brazilians integrate foreign cultural influences into their own culture and introduces a design praxis based on it. From Modernism to Digital Culture, cannibalism is a recurring tactic used to overcome cultural traditions

  3. Mechanical Design

    Energy Technology Data Exchange (ETDEWEB)

    Shook, Richard; /Marquette U. /SLAC

    2010-08-25

    The particle beam of the SXR (soft x-ray) beam line in the LCLS (Linac Coherent Light Source) has a high intensity in order to penetrate through samples at the atomic level. However, the intensity is so high that many experiments fail because of severe damage. To correct this issue, attenuators are put into the beam line to reduce this intensity to a level suitable for experimentation. Attenuation is defined as 'the gradual loss in intensity of any flux through a medium' by [1]. It is found that Beryllium and Boron Carbide can survive the intensity of the beam. At very thin films, both of these materials work very well as filters for reducing the beam intensity. Using a total of 12 filters, the first 9 being made of Beryllium and the rest made of Boron Carbide, the beam's energy range of photons can be attenuated between 800 eV and 9000 eV. The design of the filters allows attenuation for different beam intensities so that experiments can obtain different intensities from the beam if desired. The step of attenuation varies, but is relative to the thickness of the filter as a power function of 2. A relationship for this is f(n) = x{sub 0}2{sup n} where n is the step of attenuation desired and x{sub 0} is the initial thickness of the material. To allow for this desired variation, a mechanism must be designed within the test chamber. This is visualized using a 3D computer aided design modeling tool known as Solid Edge.

  4. Mechanical Design

    International Nuclear Information System (INIS)

    2010-01-01

    The particle beam of the SXR (soft x-ray) beam line in the LCLS (Linac Coherent Light Source) has a high intensity in order to penetrate through samples at the atomic level. However, the intensity is so high that many experiments fail because of severe damage. To correct this issue, attenuators are put into the beam line to reduce this intensity to a level suitable for experimentation. Attenuation is defined as 'the gradual loss in intensity of any flux through a medium' by (1). It is found that Beryllium and Boron Carbide can survive the intensity of the beam. At very thin films, both of these materials work very well as filters for reducing the beam intensity. Using a total of 12 filters, the first 9 being made of Beryllium and the rest made of Boron Carbide, the beam's energy range of photons can be attenuated between 800 eV and 9000 eV. The design of the filters allows attenuation for different beam intensities so that experiments can obtain different intensities from the beam if desired. The step of attenuation varies, but is relative to the thickness of the filter as a power function of 2. A relationship for this is f(n) = x 0 2 n where n is the step of attenuation desired and x 0 is the initial thickness of the material. To allow for this desired variation, a mechanism must be designed within the test chamber. This is visualized using a 3D computer aided design modeling tool known as Solid Edge.

  5. Designed Places

    DEFF Research Database (Denmark)

    Stender, Marie

    The 2008 financial crisis has left traces in the built environment of Copenhagen like many other places: Building projects are left unfinished or their function or finish is changed due to new economic circumstances. An ethnographic exploration of these traces exposes central aspects of what is a......, and when the ceilings leak water, the residents suspect it to be a consequence of the crisis. The paper discusses how market forces interact with the material surroundings we inhabit and explores the relationship between controlled and uncontrollable in the design of places....

  6. Group Design Problems in Engineering Design Graphics.

    Science.gov (United States)

    Kelley, David

    2001-01-01

    Describes group design techniques used within the engineering design graphics sequence at Western Washington University. Engineering and design philosophies such as concurrent engineering place an emphasis on group collaboration for the solving of design problems. (Author/DDR)

  7. Democratic design experiments

    DEFF Research Database (Denmark)

    Ehn, Pelle; Brandt, Eva; Halse, Joachim

    2016-01-01

    Designers and design researchers are increasingly exploring societal challenges through engagements with issues that call forward new publics and new modes of democratic citizenship. Whatever this is called design activism, social design, adversarial design, participatory design or something else...

  8. Contract design

    International Nuclear Information System (INIS)

    Bradley, P.

    2006-01-01

    The current state of the electric power industry in Ontario was discussed with particular reference to the procurement of contracts and why the Ontario Power Authority (OPA) must be contracting to resolve many of Ontario's electricity issues. As Ontario increasingly relies on imports and natural gas-fired generation, the price of electricity continues to rise given that supply is at a low level. In addition to the generation gap, there are also several transmission constrained areas in Ontario, particularly in the Greater Toronto Area (GTA). The OPA announced 2 projects totalling 1900 MW to relieve congestion. According to the Independent Electricity System Operator (IESO), the total potential opportunity for new generation by 2015 is about 5,000 to 7,000 megawatts. OPA is expected to launch procurement processes for up to 1000 MW of cogeneration, 250 MW of province-wide conservation initiatives, 1900 MW of generation in the western part of the GTA, and 600 MW of generation in downtown Toronto. New nuclear capacity is also anticipated in addition to renewables and conservation/demand management (CDM) initiatives. The OPA's competitive procurement processes will include requests for expressions of interest, requests for qualifications and requests for proposals. The challenge of balancing the technical complexities and realities of procuring generation assets with the need for a fair procurement process was discussed. Contracts will be designed to react to market signals and will include 3 styles: tariff style, tolling style and standard offer contract. OPA will make every effort to balance generator and ratepayer interests. 6 figs

  9. Post-marketing safety surveillance for inactivated and live-attenuated Japanese encephalitis vaccines in China, 2008-2013.

    Science.gov (United States)

    Wu, Wendi; Liu, Dawei; Li, Keli; Nuorti, J Pekka; Nohynek, Hanna M; Xu, Disha; Ye, Jiakai; Zheng, Jingshan; Wang, Huaqing

    2017-06-22

    Two types of Japanese encephalitis (JE) vaccines, inactivated JE vaccine (JE-I) and live-attenuated JE vaccine (JE-L), are available and used in China. In particular, one JE-L, produced by a domestic manufacturer in China, was prequalified by WHO in 2013. We assessed the safety of JE vaccines in China during 2008-2013 using the Chinese National Adverse Events Following Immunization Information System (CNAEFIS) data. We retrieved AEFI reporting data about JE vaccines from CNAEFIS, 2008-2013, examined demographic characteristics of AEFI cases, and used administrative data on vaccine doses as denominator to calculate and compare crude reporting rates. We also used disproportionality reporting analysis between JE-I and JE-L to assess potential safety signals. A total of 34,879 AEFIs related with JE-I and JE-L were reported, with a ratio of male to female as 1.3:1; 361 (1.0%) cases were classified as serious. JE vaccines were administered concurrently with one or more other vaccines in 13,592 (39.0%) of cases. The overall AEFI reporting rates were 214.4 per million vaccination doses for JE-L and 176.9 for JE-I (rate ratio [RR]: 1.2, 95% confidence interval [CI]: 1.1-1.3) in 2010-2013. Febrile convulsions (FC) following JE-I was found as a signal of disproportionate reporting (SDR). However, there was no significant difference between the reporting rates of FC of JE-I and JE-L (0.3 per million vaccination doses for JE-L, 0.4 for JE-I, p=0.05). While our analysis did not find apparent safety concern of JE vaccines in China, further study should consider JE-I vaccines and febrile convulsion, and taking more sensitive methods to detect signals. Copyright © 2017. Published by Elsevier Ltd.

  10. Evaluation of Aryoseven Safety (Recombinant Activated Factor VII) in Patients with Bleeding Disorders (An Observational Post-Marketing Surveillance Study).

    Science.gov (United States)

    Toogeh, Gholamreza; Abolghasemi, Hassan; Eshghi, Peyman; Managhchi, Mohammadreza; Shaverdi-Niasari, Mohammadreza; Karimi, Katayoon; Roostaei, Samin; Emran, Neda; Abdollahi, Alireza

    2016-01-01

    Recombinant activated factor VII induces hemostasis in patients with coagulopathy disorders. AryoSeven™ as a safe Iranian Recombinant activated factor VII has been available on our market. This study was performed to establish the safety of AryoSeven on patients with coagulopathy disorder. This single-center, descriptive, cross sectional study was carried out in Thrombus and Homeostasis Research Center ValiAsr Hospital during 2013-2014. Fifty one patients with bleeding disorders who received at least one dose of Aryoseven were enrolled. Patients' demographic data and adverse effect of drug and reaction related to Aryoseven or previous usage of Recombinant activated FVII were recorded in questionnaires. Finally data were analyzed to compare side effects of Aryoseven and other Recombinant activated FVII brands. Aryoseven was prescribed for 51 Patients. Of all participants with mean age 57.18+21.38 yr, 31 cases were male and 26 subjects had past history of recombinant activated FVII usage. Glanzman was the most frequent disorder followed by congenital FVII deficiency, hemophilia with inhibitors, factor 5 deficiency, acquired hemophilia, hemophilia A with inhibitor, and hemophilia A or B with inhibitor. The majority of bleeding episodes had occurred in joints. Three patients (5.9%) complained about adverse effects of Aryoseven vs. 11.5 % about adverse effects of other brands. However this difference was not significant, statistically. Based on monitor patients closely for any adverse events, we concluded that Aryoseven administration under careful weighing of benefit versus potential harm may comparable with other counterpart drugs.

  11. Post-marketing assessment of content and efficacy of preservatives in artemisinin-derived antimalarial dry suspensions for paediatric use

    Directory of Open Access Journals (Sweden)

    Plaizier-Vercammen Jacqueline

    2007-01-01

    Full Text Available Abstract Background Artemisinin-derivative formulations are now widely used to treat falciparum malaria. However, the dry powder suspensions developed for children are few and/or are of poor quality. In addition to the active compound, the presence of a suitable preservative in these medicines is essential. In this study, an evaluation of the preservative content and efficacy in some dry suspensions available on the Kenyan market was performed. Method UV spectrophotometry was used to identify the preservatives in each sample while HPLC-UV was used for quantification. After reconstitution of the powders in water, the dissolution of the preservatives was followed for 7 days. Antimicrobial efficacy of the preservatives was assessed by conducting a preservative efficacy test (PET following the European pharmacopoeia standards. Results Four different preservatives were identified namely methylparahydroxybenzoate (MP, propylparahydroxybenzoate (PP, benzoic acid and sorbic acid. MP and PP were identified in Artesiane® (artemether 300 mg/100 ml, Alaxin® (dihydroartemisinin 160 mg/80 ml andGvither ® (artemether 300 mg/100 ml respectively. Sorbic acid was presentin Artenam® (artemether 180 mg/60 ml while benzoic acid was identified in Santecxin® (dihydroartemisinin 160 mg/80 ml andArtexin® (dihydroartemisinin 160 mg/80 ml respectively. Cotecxin® (dihydroartemisinin 160 mg/80 ml did not contain any of the above preservatives. After reconstitution in water, preservativesin 50%(3/6 of the products did not completely dissolve and the PET results revealed that only Artenam® and Gvither® met the requirements for antimicrobial efficacy. The other products did not conform. Conclusion These results show that paediatric antimalarial dry powder formulations on the market may contain ineffective or incorrect amounts of preservatives. This is a potential risk to the patient. Studies conducted on the dry powder suspensions should include the analysis of both the active ingredient and the preservative, including the efficacy of the latter.

  12. Post-Marketing Safety Surveillance of the Salvia Miltiorrhiza Depside Salt for Infusion: A Real World Study.

    Directory of Open Access Journals (Sweden)

    Ying-Ying Yan

    Full Text Available Salvia Miltiorrhiza Depside Salt for Infusion (SMDS is made of a group of highly purified listed drugs. However, its safety data is still reported limitedly. Compared with the clinical trials, its safety in the real world setting is barely assessed.To investigate the safety issues, including adverse events (AEs, adverse events related to SMDS (ADEs, and adverse drug reactions (ADRs of the SMDS in the real world clinical practice.This is a prospective, multicenter, pharmacist-led, cohort study in the real world setting. Consecutive patients prescribed with SMDS were all included in 36 sites. Pharmacists were well trained to standardized collect the patients information, including demographics, medical history, prescribing patterns of SMDS, combined medications, adverse events, laboratory investigations, outcomes of the treatment when discharge, and interventions by pharmacists. Adverse events and adverse drug reactions were collected in details. Multivariate possion regression analysis was applied to identify risk factors associated with ADEs using the significance level (α 0.05. ClinicalTrials.gov Identifier: NCT01872520.Thirty six hospitals were participated in the study and 30180 consecutive inpatients were included. The median age was 62 (interquartile range [IQR], 50-73 years, and male was 17384 (57.60% among the 30180 patients. The incidences of the AEs, ADEs and ADRs were 6.40%, 1.57% and 0.79%, respectively. There were 9 kinds of new ADEs which were not on the approved label found in the present study. According to the multivariate analysis, male (RR = 1.381, P = 0.009, 95%CI [1.085~1.759], more concomitant medications (RR = 1.049, P<0.001, 95%CI [1.041~1.057], longer duration of SMDS therapy (RR = 1.027, P<0.001, 95%CI [1.013~1.041], higher drug concentration (RR = 1.003, P = 0.014, 95%CI [1.001~1.006], and resolvent unapproved (RR = 1.900, P = 0.002, 95%CI [1.260~2.866] were the independent risk factors of the ADEs. Moreover, following the approved indication (RR = 0.655, P<0.001, 95%CI [0.532~0.807] was associated with lower incidence of ADEs.SMDS was well tolerated in the general population. The incidences of the AEs, ADEs and ADRs were 6.40%, 1.57% and 0.79%, respectively. Several risk factors of its ADEs have been identified. It is recommended to follow the instructions when prescribing and administrating SMDS in the real world clinical practice.

  13. Determination of Sodium Benzoate and Potassium Sorbate in “Doogh” Samples in Post Market Surveillance in Iran 2012

    Directory of Open Access Journals (Sweden)

    B. Akbari-adergani

    2013-06-01

    Full Text Available Sodium benzoate and potassium sorbate are two major chemical preservatives which are used in Doogh (Iranian traditional dairy drink. In this study, a total of 27 commercial brands of highly consumed of Doogh samples were analyzed. The means and standard deviation for concentration of these preservatives based on HPLC results for analysis of benzoate and sorbate were 195·9 (SD 1·8 and 328·8 (SD 2·1 mg.Kg-1 respectively. The minimum and maximum of benzoate content in various brands were 18.3 and 2345.1 mg.Kg-1 and for sorbate were not detected and 4961.3 mg.Kg-1 respectively. The study revealed that there was not significant difference in preservative concentration in the samples that belonged to various dates. However, a few samples had a high preservative concentration, which could be a risk factor for human health, especially when their intake was being occurred by various foodstuffs simultaneously.

  14. [Susceptibility surveillance of clinical isolates to fluoroquinolone antimicrobial agents from 2003 to 2008: post-marketing study of prulifloxacin].

    Science.gov (United States)

    Kawai, Shin; Yoshida, Atsushi; Okazaki, Mitsuhiro; Tsujihara, Yoshito; Inuzuka, Kazuhisa; Takeuchi, Kazuhide; Yamashita, Naoko; Onodera, Makoto; Hiraishi, Toru; Ida, Takashi; Maebashi, Kazunori

    2010-06-01

    Yearly changes in the susceptibility of clinical isolates to ulifloxacin (UFX) and other fluoroquinolones were examined through surveys over 3 periods. In the first survey, 534 strains derived from 19 species were collected from clinical specimens during 6 months from December 2003 to May 2004. In the same way, 805 strains were collected from December 2005 to May 2006 in the second survey, and 863 strains were from December 2007 to May 2008 in the third survey. Over these 3 study periods, the susceptibilities of fluoroquinolones against methicillin-susceptible Staphylococcus aureus and Escherichia coli were decreased. The isolation frequency of levofloxacin-nonsusceptible strain was increased from 0% to 11.8% and from 14.6% to 20.8%, respectively. MIC90s of UFX against these pathogens were also increased, but its MIC90 for E. coli was 2 to 4 times lower than that of levofloxacin. On the other hand, the susceptibility of strains of Klebsiella pneumoniae to UFX was increased. Among the fluoroquinolones tested, UFX showed the most potent activity against Pseudomonas aeruginosa, and no changes in the MIC90s occurred during the surveillance. Although one strain of Streptococcus pneumoniae isolated in the third study period showed levofloxacin-resistance (MIC, 8 microg/mL), there were nearly no changes in the MIC90s of any agents tested including UFX against S. pneumoniae during the surveillance. As for other bacterial species, a tendency to increase in resistance to UFX was not observed. The activity of UFX against Salmonella spp. and Shigella spp. was superior/equal to those of fluoroquinolones tested.

  15. The End of Work: The Decline of the Global Labor Force and the Dawn of the Post-Market Era.

    Science.gov (United States)

    Rifkin, Jeremy

    This book explores the global economic and social changes that will likely occur as continued technological advancements (especially in the field of computer science) reduce the number of workers needed to produce the goods and services needed by the global population. The book is divided into five sections. Section 1 presents an overview of the…

  16. Methodological approaches to developing and establishing the body of evidence on post-marketing Chinese medicine safety.

    Science.gov (United States)

    Liao, Xing; Robinson, Nicola

    2013-07-01

    Evidence based medicine demands the highest form of scientific evidence to demonstrate the efficacy and clinical effectiveness for any therapeutic intervention in order to provide best care. It is however accepted that in the absence of scientific evidence, personal experience and expert opinion together with professional judgement are critical. Obtaining evidence for drug safety, postmarketing surveillance (PMS) has focussed on follow up of observational cohorts exposed to a particular drug in order to estimate the incidence of adverse drug reactions (ADRs). Evidence on PMS of Chinese herbal products is still limited, in particular for herbal injections. The aim of this article is to suggest a new model of ascertaining the safety of Chinese medicine using a more comprehensive approach for collecting data. To collect safety data on the Chinese herbal injection, Kudiezi, a mixed methods approach is proposed using 18 hospital information systems to detect ADRs in order to prospectively observe 30,000 patients over 3 years. Evidence will also be collected using a questionnaire survey and through a sample of semi structured interviews. This information based on the expert opinion and the experience of clinicians will produce additional data on the frequency and types of side effects in clinical practice. Furthermore semi structured interviews with a random sample of patients receiving the injection will be carried out to ascertain any potential side effects missed. It is hoped that this comprehensive approach to data collection will accumulate wider evidence based on individual traditional Chinese medicine care and treatment and provide important feedback to the national data collection system to ensure completeness of ADR data recording, monitoring and any potential wider effects through developing improved ADR guidelines.

  17. Post-Marketing Regulation of Medicines Withdrawn from the Market Because of Drug-Attributed Deaths: An Analysis of Justification.

    Science.gov (United States)

    Onakpoya, Igho J; Heneghan, Carl J; Aronson, Jeffrey K

    2017-05-01

    Several medicinal products have been withdrawn from the market because of drug-attributed deaths. However, there has been no investigation of whether such withdrawals were justified, and the extent to which confirmatory studies are used to investigate drug-adverse event relationships when deaths are reported is uncertain. We documented medicinal products withdrawn from the market because of drug-attributed deaths, identified confirmatory studies investigating the drug-adverse event relationships, examined whether withdrawals of medicinal products because of drug-attributed deaths after marketing were justified based on a mechanistic analysis, and examined the trends over time. We searched electronic and non-electronic sources to identify medicinal products that were withdrawn because of drug-attributed deaths. We used a previously published algorithm to examine whether the withdrawals of products were justified. We then searched PubMed and Google Scholar to identify studies investigating the drug-adverse event relationships, used the Oxford Centre for Evidence-Based Medicine criteria to document the levels of evidence, and assessed whether the evidence of an association was confirmed. We included 83 medicinal products. The reasons for withdrawal appeared to have been justified in 80 cases (96%). The median interval between the first reported adverse reaction that was related to the cause of death and the first reported death was 1 year (interquartile range = 1-3); products were withdrawn sooner when the interval between the first reported relevant adverse reaction and the first death was shorter. Confirmatory studies were conducted in 57 instances (69%), and there was evidence of an association in 52 cases (63%). Four products (5%) were re-introduced after initial withdrawal. Regulatory authorities have been justified in making withdrawal decisions when deaths have been attributed to medicinal products, using the precautionary principle when alternative decisions could have been made. Medicinal products are likely to be quickly withdrawn from the market when there is a short interval to the first reported deaths. The use of an algorithm such as we have used in this study could help to expedite the process of decision making.

  18. Tocilizumab use in pregnancy: Analysis of a global safety database including data from clinical trials and post-marketing data.

    Science.gov (United States)

    Hoeltzenbein, Maria; Beck, Evelin; Rajwanshi, Richa; Gøtestam Skorpen, Carina; Berber, Erhan; Schaefer, Christof; Østensen, Monika

    2016-10-01

    Analyze the cumulative evidence for pregnancy outcomes after maternal exposure to tocilizumab, an anti-interleukin-6-receptor monoclonal antibody used for the treatment of rheumatoid arthritis and juvenile idiopathic arthritis. At present, published experience on tocilizumab use during pregnancy is very limited. We have analyzed all pregnancy-related reports documented in the Roche Global Safety Database until December 31, 2014 (n = 501). After exclusion of ongoing pregnancies, duplicates, and cases retrieved from the literature, 399 women were found to have been exposed to tocilizumab shortly before or during pregnancy, with pregnancy outcomes being reported in 288 pregnancies (72.2%). Of these 288 pregnancies, 180 were prospectively reported resulting in 109 live births (60.6%), 39 spontaneous abortions (21.7%), 31 elective terminations of pregnancy (17.2%), and 1 stillbirth. The rate of malformations was 4.5%. Co-medications included methotrexate in 21.1% of the prospectively ascertained cases. Compared to the general population, an increased rate of preterm birth (31.2%) was observed. Retrospectively reported pregnancies (n = 108) resulted in 55 live births (50.9%), 31 spontaneous abortions (28.7%), and 22 elective terminations (20.4%). Three infants/fetuses with congenital anomalies were reported in this group. No increased risks for adverse pregnancy outcomes were observed after paternal exposure in 13 pregnancies with known outcome. No indication for a substantially increased malformation risk was observed. Considering the limitations of global safety databases, the data do not yet prove safety, but provide information for physicians and patients to make informed decisions. This is particularly important after inadvertent exposure to tocilizumab, shortly before or during early pregnancy. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. [The significance of introducing registry study in the post-marketing safety research for Chinese medicine and pharmacy].

    Science.gov (United States)

    Liao, Xing; Xie, Yan-Ming; Yang, Wei; Chang, Yan-Peng

    2014-03-01

    There is a new research model named 'registry study/patient registry' in Western medicine, which could be referred to by Chinese medicine researchers, such as active safety surveillance. This article will introduce registry study from different aspects as the developing history, features, and application in order to inform Chinese medicine researchers of future studies.

  20. Adverse events following immunisation with a meningococcal serogroup B vaccine: report from post-marketing surveillance, Germany, 2013 to 2016.

    Science.gov (United States)

    Mentzer, Dirk; Oberle, Doris; Keller-Stanislawski, Brigitte

    2018-04-01

    Background and aimIn January 2013, a novel vaccine against Neisseria meningitidis serogroup B, the multicomponent meningococcal serogroup B vaccine (4CMenB), was approved by the European Medicines Agency. We aimed to evaluate the safety profile of this vaccine. Methods: All adverse events following immunisation (AEFI) reported from Germany since the vaccine's launch in Germany in November 2013 through December 2016 were reviewed and analysed. Results: Through December 2016, a total of 664 individual case safety reports (ICSR) notifying 1,960 AEFI were received. A majority of vaccinees for whom AEFI were reported were children 2 to 11 years of age (n = 280; 42.2%) followed by infants and toddlers aged 28 days to 23 months (n = 170; 25.6%). General disorders and administration site conditions was the System Organ Class (SOC) with the majority of AEFI (n = 977; 49.8%), followed by nervous system disorders (n = 249; 12.7%), and skin and subcutaneous tissue disorders (n = 191; 9.7%). Screening of patient records for immune-mediated and neurological diseases did not raise any safety signal in terms of an increased proportional reporting ratio (PRR). Conclusions: The safety profile described in the Summary of Product Characteristics, in general, is confirmed by data from spontaneous reporting. No safety concerns were identified.

  1. Interchangeability of biosimilar and biological reference product: updated regulatory positions and pre- and post-marketing evidence.

    Science.gov (United States)

    Trifirò, Gianluca; Marcianò, Ilaria; Ingrasciotta, Ylenia

    2018-03-01

    Since 2006, biosimilars have been available in several countries worldwide, thus allowing for potential savings in pharmaceutical expenditure. However, there have been numerous debates about the interchangeability of biosimilars and reference products based on concerns of immunogenicity by switching between biological products, which may cause lack of effect and toxicity. Areas covered: The authors provide the reader with an overview of the different positions of regulatory authorities on the interchangeability and automatic substitution of biosimilars and reference products. Presently, the FDA allows automatic substitution without prescriber intervention if the biosimilar is interchangeable with reference products, while the European Medicines Agency delegate to each single EU member state. Expert opinion: Different approaches in defining interchangeability and automatic substitution call for harmonization to increase confidence of healthcare professionals and patients about the clinical impact of switching. Networks of electronic healthcare records and administrative databases, potentially linkable to clinical charts and registries may rapidly assess frequency and benefit-risk profile of different switching patterns in routine care at different levels, thus integrating and strengthening pre-marketing evidence.

  2. Communities of ground-dwelling arthropods in conventional and transgenic maize: background data for the post-market environmental monitoring

    Czech Academy of Sciences Publication Activity Database

    Skoková Habuštová, Oxana; Svobodová, Zdeňka; Spitzer, Lukáš; Doležal, Petr; Hussein, Hany; Sehnal, František

    2015-01-01

    Roč. 139, 1-2 (2015), s. 31-45 ISSN 0931-2048 Institutional support: RVO:60077344 Keywords : Bt maize * MON810 * European corn borer Subject RIV: EH - Ecology, Behaviour Impact factor: 1.517, year: 2015

  3. Malignancies in children and young adults on etanercept: summary of cases from clinical trials and post marketing reports.

    Science.gov (United States)

    Hooper, Michele; Wenkert, Deborah; Bitman, Bojena; Dias, Virgil C; Bartley, Yessenia

    2013-10-02

    Malignancy risk may be increased in chronic inflammatory conditions that are mediated by tumor necrosis factor (TNF), such as juvenile idiopathic arthritis (JIA), but the role of TNF in human cancer biology is unclear. In response to a 2011 United States Food & Drug Administration requirement of TNF blocker manufacturers, we evaluated reporting rates of all malignancies in patients =30 years old who received the TNF blocker etanercept. All malignancies in etanercept-exposed patients aged =30 years from the Amgen clinical trial database (CTD) and postmarketing global safety database (PMD) were reviewed. PMD reporting rates were generated using exposure information based on commercial sources. Age-specific incidence rates of malignancy for the general US population were generated from the Surveillance Epidemiology and End Results (SEER) database v7.0.9. There were 2 malignancies in the CTD: 1 each in etanercept and placebo/comparator arms (both in patients 18-30 years old). Postmarketing etanercept exposure was 231,404 patient-years (62,379 patient-years in patients 0-17 years; 168,485 patient-years in patients 18-30 years). Reporting rates of malignancy per 100,000 patient-years in the PMD and incidence rates in SEER were 32.0 and 15.9, respectively, for patients 0-17 years and 46.9 and 42.1 for patients 18-30 years old. Reporting rates were higher than SEER incidence rates for Hodgkin lymphoma in the 0-17 years age group. PMD reporting rates per 100,000 patient-years and SEER incidence rates per 100,000 person-years for Hodgkin lymphoma were 9.54 and 0.9, respectively, for patients 0-17 years and 1.8 and 4.2 for patients 18-30 years old. There were =5 cases of leukemia, lymphoma, melanoma, thyroid, and cervical cancers. Leukemia, non-Hodgkin lymphoma, melanoma, thyroid cancer, and cervical cancer rates were similar in the PMD and SEER. Overall PMD malignancy reporting rates in etanercept-treated patients 0-17 years appeared higher than incidence rates in SEER, attributable to rates of Hodgkin lymphoma. Comparison to patients with similar burden of disease cannot be made; JIA, particularly very active disease, may be a risk factor for lymphoma. No increased malignancy reporting rate in the PMD relative to SEER was observed in the young-adult age group.

  4. Outcome after one year of upper airway stimulation for obstructive sleep apnea in a multicenter German post-market study.

    Science.gov (United States)

    Steffen, Armin; Sommer, J Ulrich; Hofauer, Benedikt; Maurer, Joachim T; Hasselbacher, Katrin; Heiser, Clemens

    2018-02-01

    Upper airway stimulation (UAS) of the hypoglossal nerve has been implemented in the routine clinical practice for patients with moderate-to-severe obstructive sleep apnea (OSA) who could not adhere to continuous positive airway pressure. This study reports objective and patient-reported outcome after 12 months of implantation. Multicenter prospective single-arm study. Consecutive patients who received the UAS system (Inspire Medical Systems, Inc., Minneapolis, Minnesota, Maple Grove, MN, U.S.A.) were enrolled in three German centers. Key study exclusion criteria included body mass index > 35 kg/m 2 , apnea-hypopnea index (AHI)  65, or complete concentric collapse at the soft palate during sedated endoscopy. Data collection at 6- and 12-month visit include home sleep test and patient-reported outcome measures. Among the total of 60 participants, the median AHI reduced from 28.6 to 9.5 from baseline to 12 months. Patient-reported outcome measured in Epworth Sleepiness Scale and Functional Outcomes of Sleep Questionnaire both improved significantly from baseline to 12 months. The average usage time was 39.1 ± 14.9 hours per week among all participants based on recordings by the implanted device. One patient requested a removal of the device for cosmetic and other personal reasons and was completed without sequelae. This study supported that UAS is a safe and effective treatment option for patients with OSA in routine clinical practice. 4. Laryngoscope, 128:509-515, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  5. [Post-marketing re-evaluation of Kudiezi injection study on early treatment in patients with ischemic stroke].

    Science.gov (United States)

    Ye, Xiaoqin; Wei, Xu; Xie, Yanming; Zou, Yihuai; Zhao, Xingquan; Han, Jianhua; Wang, Xinzhi; Ma, Yunzhi; Bi, Qi; Xie, Qingfan; Zhao, Jianjun; Cao, Xiaolan; Chen, Hongxia; Wang, Shizhong; Yan, Rongmei; Han, Zucheng; Yi, Danhui; Wang, Yongyan

    2011-10-01

    To study the effect and safety of Kudiezi injection on patients with acute ischemic stroke. Seven hundreds patients were divided into two groups by central randomization system. The study group, 346 cases, was treated with kudiezi injection plus traditional Chinese medicine (TCM) synthesis rehabilitation project, and the control group, 354 cases, was treated with synthetic rehabilitation project. The patients were treated for 10 to 21 days. Before treatment and at the 7th, 14th and 21th day of treatment, the indexes include NIHSS used for evaluating the neurological deficit degree and the motor function score (Fugl-Meyer) for evaluating motor function were observed. The safety index is defined by adverse observation event and laboratory test. The incidence of adverse events and laboratory tests results were observed before and after treatment at the same time. Application of generalized estimating equation model, we found that as the treatment time, NIHSS score and FMI score of the two groups showed a trend of improvement. And at the 14th days and 21th days of treatment, compared to the control group the treatment group showed significant statistical difference on the impact of NIHSS and FMI (Pinjection plus TCM rehabilitation project of ischemic stroke showed some superiority to western medicine rehabilitation program on improving the neurological deficit and motor function. Kudiezi injection is safe and effective in the treatment of acute ischemic stroke.

  6. [Post-marketing re-evaluation about usage and dosage of Chinese medicine based on human population pharmacokinetics].

    Science.gov (United States)

    Jiang, Junjie; Xie, Yanming

    2011-10-01

    The usage and dosage of Chinese patent medicine are determined by rigorous evaluation which include four clinical trail stages: I, II, III. But the usage and dosage of Chinese patent medicine are lacked re-evaluation after marketing. And this lead to unchanging or fixed of the usage and dosage of Chinese patent medicine instead of different quantity based on different situations in individual patients. The situation of Chinese patent medicine used in clinical application is far away from the idea of the "Treatment based on syndrome differentiation" in traditional Chinese medicine and personalized therapy. Human population pharmacokinetics provides data support to the personalized therapy in clinical application, and achieved the postmarking reevaluating of the usage and dosage of Chinese patent medicine. This paper briefly introduced the present situation, significance and the application of human population pharmacokinetics about re-evaluation of the usage and dosage of Chinese patent medicine after marketing.

  7. Design Argumentation in Academic Design Education

    DEFF Research Database (Denmark)

    Dalsgaard, Peter; Dindler, Christian; Fritsch, Jonas

    2013-01-01

    We explore design argumentation as a resource when teaching interaction design in a university setting. We propose that design argumentation can help bridge between practice-based design education and theoretical issues from university curricula. In this paper, we outline the idea of design...

  8. Dansk design - English edition

    DEFF Research Database (Denmark)

    Dickson, Thomas

    Indhold: Hvad er design?; Hvor kommer dansk design fra?; Produktdesign; Tekstil- og tøjdesign; Design af møbler og boligindretning; Bygningen og design; Arbejdets design; Transportdesign; Offentligt design; Grafisk design; Nye tider og en ny slags design...

  9. System design projects for undergraduate design education

    Science.gov (United States)

    Batill, S. M.; Pinkelman, J.

    1993-01-01

    Design education has received considerable in the recent past. This paper is intended to address one aspect of undergraduate design education and that is the selection and development of the design project for a capstone design course. Specific goals for a capstone design course are presented and their influence on the project selection are discussed. The evolution of a series of projects based upon the design of remotely piloted aircraft is presented along with students' perspective on the capstone experience.

  10. Sharing the design intent between industrial designers and engineering designers

    DEFF Research Database (Denmark)

    Laursen, Esben Skov; Møller, Louise

    2016-01-01

    The aim of the paper is to understand the challenges sharing the product frame between industrial designers with the engineering designers. The study is based on six case studies. The analysis showed correspondence between industrial designers and engineering designers in their understanding...... of the key elements of the context and concept. However the analysis also showed a lack of correspondence between the industrial designers and engineering designers in regards to the product framing and thereby how the different elements of the product frame is connected and interrelated....

  11. Service design : Tuning the industrial design profession

    NARCIS (Netherlands)

    Sleeswijk Visser, F.

    2013-01-01

    Design is not only about the design and production of goods, but is increasingly addressing complex social issues nowadays. Roles of designers are becoming more and more varied, and at the same time other professionals are increasingly using design tools in their business, organizational or other

  12. Designing for critique, designing for reflection

    DEFF Research Database (Denmark)

    Løfgreen, Lars Bo

    2010-01-01

    litteraturliste og et stikordsregister. Bogen rummer kapitlerne: “Visual topography: analysing the visual context of an interactive interface” af Lise Agerbæk, “Designing (with) Creativity” af Heidi Philipsen, “Designing for critique, designing for reflection – the (re)emergence of aesthetics in current design...

  13. Designing interfaces patterns for effective interaction design

    CERN Document Server

    Tidwell, Jenifer

    2005-01-01

    This convenient resource offers advice on creating user-friendly interface designs--whether they're delivered on the Web, a CD, or a smart" devices like a cell phone. Solutions to common UI design problems are expressed as a collection of patterns--each one containing concrete examples, recommendations, and warnings. Intended for designers with basic UI design knowledge

  14. Enhancing biomedical design with design thinking.

    Science.gov (United States)

    Kemnitzer, Ronald; Dorsa, Ed

    2009-01-01

    The development of biomedical equipment is justifiably focused on making products that "work." However, this approach leaves many of the people affected by these designs (operators, patients, etc.) with little or no representation when it comes to the design of these products. Industrial design is a "user focused" profession which takes into account the needs of diverse groups when making design decisions. The authors propose that biomedical equipment design can be enhanced, made more user and patient "friendly" by adopting the industrial design approach to researching, analyzing, and ultimately designing biomedical products.

  15. Design methods and design theory for architectural design management

    NARCIS (Netherlands)

    Achten, H.H.; Otter, den A.F.H.J.; Achten, H.H.; Pels, H.J.

    2008-01-01

    Most parties that an architectural design manager meets in daily practice are engaged to some degree with design. What these parties are actually doing in a project is contingent with the concrete design project. Additionally, each party has some stake, and may employ different strategies to solve

  16. Managing collaborative design

    NARCIS (Netherlands)

    Sebastian, R.

    2007-01-01

    Collaborative design has been emerging in building projects everywhere. The more complex a building project becomes, the closer and more intensive collaboration between the design actors is required. This research focuses on collaborative design in the conceptual architecture design phase,

  17. Design for Accessibility

    DEFF Research Database (Denmark)

    Herriott, Richard

    2012-01-01

    A report on how nine rail builder, operators and transport designers deal with design for accessibility......A report on how nine rail builder, operators and transport designers deal with design for accessibility...

  18. Design is an Attitude

    DEFF Research Database (Denmark)

    Eriksen, Kaare Riise

    2005-01-01

    Arttiklen beskriver den mexicanske designer Rafael Davidsons arbejder gennem en menneskealder, samt hans visioner for mexicansk design i fremtiden.......Arttiklen beskriver den mexicanske designer Rafael Davidsons arbejder gennem en menneskealder, samt hans visioner for mexicansk design i fremtiden....

  19. Design Research between Design and Research

    DEFF Research Database (Denmark)

    Steinø, Nicolai; Markussen, Thomas

    2011-01-01

    The discourse on architecture and design research in Denmark in the past thirty years has been stuck in a unproductive dichotomy between research through design on the one hand and a phantom image of academic and theoretical, word-based research on the other. Advocates of the research through...... design strand have argued, that architecture and design research must follow an architecture and design methodology – designing – and be communicated by means of architecture and design media – images and artefacts. Essentially, this view sees no difference between architecture and design research...... and practice, as expressed in the notion of research as ‘artistic innovation work’. On the other hand, the pressure to expand research in architecture and design has seen a movement towards adopting traditional research paradigms from the technical and social sciences and humanities. For many architects...

  20. Design Games for In-Situ Design

    DEFF Research Database (Denmark)

    Kristiansen, Erik

    2013-01-01

    The mobile culture has spawned a host of context-based products, like location-based and tag-based applications. This presents a new challenge for the designer. There is a need of design methods that acknowledge the context and allows it to influence the design ideas. This article focuses...... on a design problem where an in-situ design practice may further the early design process: the case of designing a pervasive game. Pervasive games are computer games, played using the city as a game board and often using mobile phones with GPS. Some contextual design methods exist, but we propose an approach...... sitestorming, is based on a game using Situationistic individual exploration of the site and different types of game cards, followed by a joint evaluation of the generated ideas. A series of evaluations showed that the designers found the method enjoyable to use, that the method motivated idea generation...

  1. Design of modern experiments

    International Nuclear Information System (INIS)

    Park, Sung Hweon

    1984-03-01

    This book is for researchers and engineers, which is written to focus on practical design of experiments. It gives descriptions of conception of design of experiments, basic statistics theory, one way design of experiment, two-way layout without repetition, two-way layout with repetition, partition, a correlation analysis and regression analysis, latin squares, factorial design, design of experiment by table of orthogonal arrays, design of experiment of response surface, design of experiment on compound, Evop, and design of experiment of taguchi.

  2. Computational Design Tools for Integrated Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine; Kirkegaard, Poul Henning

    2010-01-01

    In an architectural conceptual sketching process, where an architect is working with the initial ideas for a design, the process is characterized by three phases: sketching, evaluation and modification. Basically the architect needs to address three areas in the conceptual sketching phase......: aesthetical, functional and technical requirements. The aim of the present paper is to address the problem of a vague or not existing link between digital conceptual design tools used by architects and designers and engineering analysis and simulation tools. Based on an analysis of the architectural design...... process different digital design methods are related to tasks in an integrated design process....

  3. Analog circuit design designing high performance amplifiers

    CERN Document Server

    Feucht, Dennis

    2010-01-01

    The third volume Designing High Performance Amplifiers applies the concepts from the first two volumes. It is an advanced treatment of amplifier design/analysis emphasizing both wideband and precision amplification.

  4. Analog circuit design designing dynamic circuit response

    CERN Document Server

    Feucht, Dennis

    2010-01-01

    This second volume, Designing Dynamic Circuit Response builds upon the first volume Designing Amplifier Circuits by extending coverage to include reactances and their time- and frequency-related behavioral consequences.

  5. Design rules for dynamic organization design

    DEFF Research Database (Denmark)

    Burton, Richard; Obel, Børge

    2013-01-01

    Organizational design rules are contingent if-then statements about what a good design should be for a given situation. Today’s challenge is to look forward to devise organization design rules for a different future with greater uncertainty and greater interdependency – all with dynamic performance...... demands. These new demands call for new design rules for coordination, incentives and leadership, among others. Our existing rules are mostly based upon past experience and empirical studies of what is. What might be – going beyond what we have observed and explained of yesterday and today to help design...... for a future new situation – is a disciplined response to examine the new contingencies of organizational design and their design consequences. Computational laboratories permit us to go beyond what is to develop and examine new design possibilities and boundaries to explore a future world of what might be. We...

  6. Money and Design

    Directory of Open Access Journals (Sweden)

    Artur Borcuch

    2015-01-01

    Full Text Available The purpose of this article is to analyze the influence of the money design on willingness to make purchases. In this paper, we focus on three aspects that structure the relation between money and design: the link between design and finance (in general, determinants of design and perspective of currency design. The main research problem explored in this paper is: Does the money design have influence on the willingness to make purchases by employees/employers at design studios, design students and students of economics/management? The main hypothesis is as follows – the more experience in design practice, the more important is money design.

  7. Design as Value Celebration: Rethinking Design Argumentation

    DEFF Research Database (Denmark)

    Halstrøm, Per Liljenberg

    2016-01-01

    This article introduces knowledge of the rhetorical genre of epideictic to design. The aim is to provide designers with concepts that stimulate their ability to deliberate about design choices and explore the arguments they may be making about the human-made world. The article begins with explora...

  8. Ergonomics in design or design in ergonomics

    DEFF Research Database (Denmark)

    Binder, Thomas

    2005-01-01

    Design in Scandinavia has a long tradition of participation in the development of society. Designers in the Nordic countries have taken pride in concerning themselves with problems of everyday living and the design communities at large have been committed proponents of a socially responsible appr...

  9. Clinical data miner: an electronic case report form system with integrated data preprocessing and machine-learning libraries supporting clinical diagnostic model research.

    Science.gov (United States)

    Installé, Arnaud Jf; Van den Bosch, Thierry; De Moor, Bart; Timmerman, Dirk

    2014-10-20

    Using machine-learning techniques, clinical diagnostic model research extracts diagnostic models from patient data. Traditionally, patient data are often collected using electronic Case Report Form (eCRF) systems, while mathematical software is used for analyzing these data using machine-learning techniques. Due to the lack of integration between eCRF systems and mathematical software, extracting diagnostic models is a complex, error-prone process. Moreover, due to the complexity of this process, it is usually only performed once, after a predetermined number of data points have been collected, without insight into the predictive performance of the resulting models. The objective of the study of Clinical Data Miner (CDM) software framework is to offer an eCRF system with integrated data preprocessing and machine-learning libraries, improving efficiency of the clinical diagnostic model research workflow, and to enable optimization of patient inclusion numbers through study performance monitoring. The CDM software framework was developed using a test-driven development (TDD) approach, to ensure high software quality. Architecturally, CDM's design is split over a number of modules, to ensure future extendability. The TDD approach has enabled us to deliver high software quality. CDM's eCRF Web interface is in active use by the studies of the International Endometrial Tumor Analysis consortium, with over 4000 enrolled patients, and more studies planned. Additionally, a derived user interface has been used in six separate interrater agreement studies. CDM's integrated data preprocessing and machine-learning libraries simplify some otherwise manual and error-prone steps in the clinical diagnostic model research workflow. Furthermore, CDM's libraries provide study coordinators with a method to monitor a study's predictive performance as patient inclusions increase. To our knowledge, CDM is the only eCRF system integrating data preprocessing and machine-learning libraries

  10. Eindhoven school for technological design : design education and design research

    NARCIS (Netherlands)

    Trum, H.M.G.J.; Oxman, R.M.; Bax, M.F.Th.

    1995-01-01

    Nine years after starting the two-year post-graduate programme on technological design [Ackermans and Trum, 1988], Eindhoven University of Technology (EUT) decided to enhance the development of synthesis-oriented engineering education by establishing a post-graduate school for technological design.

  11. Virtual Bridge Design Challenge

    Science.gov (United States)

    Mitts, Charles R.

    2013-01-01

    This design/problem-solving activity challenges students to design a replacement bridge for one that has been designated as either structurally deficient or functionally obsolete. The Aycock MS Technology/STEM Magnet Program Virtual Bridge Design Challenge is an authentic introduction to the engineering design process. It is a socially relevant…

  12. The Distributed Criterion Design

    Science.gov (United States)

    McDougall, Dennis

    2006-01-01

    This article describes and illustrates a novel form of the changing criterion design called the distributed criterion design, which represents perhaps the first advance in the changing criterion design in four decades. The distributed criterion design incorporates elements of the multiple baseline and A-B-A-B designs and is well suited to applied…

  13. Medicines by Design

    Science.gov (United States)

    ... Home > Science Education > Medicines By Design Medicines By Design Spotlight Nature's Medicine Cabinet A Medicine's Life Inside ... hunt for drugs of the future. Medicines By Design in PDF | E-PUB Tell Us What You ...

  14. Design Sea State

    DEFF Research Database (Denmark)

    Burcharth, H. F.; Liu, Z.

    National codes of practice which specifies the design wave climate on a given location do not yet exist. Nevertheless, decision on the design wave climate is one of the most important tasks of the designer....

  15. Responsive web design workflow

    OpenAIRE

    LAAK, TIMO

    2013-01-01

    Responsive Web Design Workflow is a literature review about Responsive Web Design, a web standards based modern web design paradigm. The goals of this research were to define what responsive web design is, determine its importance in building modern websites and describe a workflow for responsive web design projects. Responsive web design is a paradigm to create adaptive websites, which respond to the properties of the media that is used to render them. The three key elements of responsi...

  16. Design of chemical plant

    International Nuclear Information System (INIS)

    Lee, Dong Il; Kim, Seung Jae; Yang, Jae Ho; Ryu, Hwa Won

    1993-01-01

    This book describes design of chemical plant, which includes chemical engineer and plan for chemical plant, development of chemical process, cost engineering pattern, design and process development, general plant construction plan, project engineering, foundation for economy on assets and depreciation, estimation for cost on capital investment and manufacturing cost, design with computers optimal design and method like fluid mechanics design chemical device and estimation for cost, such as dispatch of material and device writing on design report and appendixes.

  17. Analog circuit design

    CERN Document Server

    Dobkin, Bob

    2012-01-01

    Analog circuit and system design today is more essential than ever before. With the growth of digital systems, wireless communications, complex industrial and automotive systems, designers are being challenged to develop sophisticated analog solutions. This comprehensive source book of circuit design solutions aids engineers with elegant and practical design techniques that focus on common analog challenges. The book's in-depth application examples provide insight into circuit design and application solutions that you can apply in today's demanding designs. <

  18. The Communication Between Designer and Design Receiver

    DEFF Research Database (Denmark)

    Dai, Zheng; Dai, Yan

    2009-01-01

    When people think about a product,the first impression always mainly influences the result.Product is the medium of communication between designer and designer receiver.Because both of them have varied different experience and background,the information would be biased during the transferring...... process.The common symbols which can be recognized by both of designer and receiver are the key tools for communication.In some case,the same symbol in one product would be leads to different receiver impression.Generally,impression includes 3 aspects:aesthetics,function, and emotion.Designer needs...... to create an attractive and accurate impression in product from these 3 aspects.For facing the dilemma of communication,some experimental approaches can help designer deal with unique and diversity situations.Solving the detail problem in each step could keep the original meaning of designer....

  19. Integrated circuit design using design automation

    International Nuclear Information System (INIS)

    Gwyn, C.W.

    1976-09-01

    Although the use of computer aids to develop integrated circuits is relatively new at Sandia, the program has been very successful. The results have verified the utility of the in-house CAD design capability. Custom IC's have been developed in much shorter times than available through semiconductor device manufacturers. In addition, security problems were minimized and a saving was realized in circuit cost. The custom CMOS IC's were designed at less than half the cost of designing with conventional techniques. In addition to the computer aided design, the prototype fabrication and testing capability provided by the semiconductor development laboratory and microelectronics computer network allows the circuits to be fabricated and evaluated before the designs are transferred to the commercial semiconductor manufacturers for production. The Sandia design and prototype fabrication facilities provide the capability of complete custom integrated circuit development entirely within the ERDA laboratories

  20. Structured Analog CMOS Design

    CERN Document Server

    Stefanovic, Danica

    2008-01-01

    Structured Analog CMOS Design describes a structured analog design approach that makes it possible to simplify complex analog design problems and develop a design strategy that can be used for the design of large number of analog cells. It intentionally avoids treating the analog design as a mathematical problem, developing a design procedure based on the understanding of device physics and approximations that give insight into parameter interdependences. The proposed transistor-level design procedure is based on the EKV modeling approach and relies on the device inversion level as a fundament

  1. Design for Play

    DEFF Research Database (Denmark)

    Feder, Karen

    2017-01-01

    Abstract The purpose of the new Design for Play initiative is to inspire and educate designers to design for the future of play. To create “play ambassadors” equipped with excellent tools, methods, approaches and mind-sets to design for the playful human being in an ever-changing world. To teach...... and inspire children to grow up to be creative designers of their own life and the world around them. The Design for Play research team will study the interplay between people, processes and products in design for play and support the development of playful designers, playful solutions and playful experiences...

  2. Analyses for designing objects in mechanical design

    International Nuclear Information System (INIS)

    Nakajima, Norihiro; Miyamura, Hiroko N.; Kawakami, Yoshiaki; Kawamura, Takuma

    2015-01-01

    Defining factors to induce the damage that can be assumed in the mechanical structures, it is a loaded work to analyze a damage possibility point derived by the assumption phenomenon that can occur is, but it is the important designing process. Taking factors caused by the earthquake as an example, and simulating the phenomenon that can be assumed, the computational result was analyzed with information visualization. A damage possibility point by analyzing the result mathematically. The illustration of analytical results may give points to designers as means for a designer to recognize a damage possibility point from the sensitivity of the designer. (author)

  3. Performative Urban Design

    DEFF Research Database (Denmark)

    Samson, Kristine

    2011-01-01

    visitors and participants to engage and interact with the city. Inspired by Lefebvre statement that "the most beautiful cities were those where festivals were not planned in advance” (Lefebvre 1987:36), I will discuss how urban designers can design engaging spaces, where the potentials of the city can...... unfold. Is it, for instance, the formal aesthetics of the design or rather the socio-cultural codes of the existing urban space that engage people? The paper engages in three urban performance designs: 1) The 10th Avenue Plaza at the Highline in New York 2) The temporary installations at Boble Plads......Urban design has come to mean many things. From the architectural masterplans to the informal urban design in temporary spaces and event designs. The paper will focus on urban designs engaging urban designs. Engaging urban design can broadly be understood as temporary design installations inviting...

  4. Solar Design Workbook

    Energy Technology Data Exchange (ETDEWEB)

    Franta, G.; Baylin, F.; Crowther, R.; Dubin, F.; Grace, A., Griffith, J.W.; Holtz, M.; Kutscher, C.; Nordham, D.; Selkowitz, S.; Villecco, M.

    1981-06-01

    This Solar Design Workbook presents solar building design applications for commercial buildir^s. The book is divided into four sections. The first section describes the variety of solar applications in buildings including conservation aspects, solar fundamentals, passive systems, active systems, daylighting, and other solar options. Solar system design evaluation techniques including considerations for building energy requirements, passive systems, active systems, and economics are presented in Section II. The third section attempts to assist the designer in the building design process for energy conservation and solar applications including options and considerations for pre-design, design, and post-design phases. The information required for the solar design proee^ has not been fully developed at this time. Therefore, Section III is incomplete, but an overview of the considerations with some of the design proces elements is presented. Section IV illustrates ease studies that utilize solar applications in the building design.

  5. OPTIMIZATION OF OPTIMIZATION OF DESIGN FORMULA DESIGN ...

    African Journals Online (AJOL)

    User

    Keywords: reinforced concrete slabs, flexure, m. 1. Introduction ntroduction ntroduction. An evaluation of the flexural resistance of reinforced concrete solid slabs with the optimu weight required for structural safety a economy and as stated in design codes. 5] is presented. It is a well-known fact by many design enginee.

  6. Reframing Design: Design Thinking and Mediation Theory

    NARCIS (Netherlands)

    Verbeek, Peter P.C.C.

    2015-01-01

    Design Thinking’ has proven to be a fruitful way to deal with societal problems and challenges. But what does it in fact mean to approach problems as design problems? What does it imply for our ways to understand societal challenges, and for the ways in which we address them? In order to answer

  7. Design Thinking Pedagogy: The Educational Design Ladder

    Science.gov (United States)

    Wrigley, Cara; Straker, Kara

    2017-01-01

    As global industries change and technology advances, traditional education systems might no longer be able to supply companies with graduates who possess an appropriate mix of skills and experience. The recent increased interest in Design Thinking as an approach to innovation has resulted in its adoption by non-design-trained professionals. This…

  8. Ethical Design Fiction

    DEFF Research Database (Denmark)

    Jensen, Thessa; Vistisen, Peter

    2017-01-01

    In this paper we examine how ethical challenges can be approached in and through design fiction. To do so, we develop a new framework for analysis as well as creation of design fictions. Our main focus will be on design fiction within a strategical setting, connecting the notion of design fiction...

  9. Empirical research through design

    NARCIS (Netherlands)

    Keyson, D.V.; Bruns, M.

    2009-01-01

    This paper describes the empirical research through design method (ERDM), which differs from current approaches to research through design by enforcing the need for the designer, after a series of pilot prototype based studies, to a-priori develop a number of testable interaction design hypothesis

  10. Delimiting Inclusive Design

    DEFF Research Database (Denmark)

    Herriott, Richard

    2014-01-01

    This paper was written as an answer to the question raised by my PhD dissertation on accessibility through user-centred and Inclusive Design (ID) methods: can Inclusive Design be delimited? The literature on Inclusive Design deals almost entrirely with consumer product design and assistive...

  11. Design, Desire, and Difference

    Science.gov (United States)

    Leander, Kevin M.; Boldt, Gail

    2018-01-01

    In response to the rise in popularity of concepts of "design" in education research, pedagogy, and curriculum design, in this article we consider how the New London Group conceived of the role of student design practices as an outcome of pedagogy, as well as the parallel role of design in teaching practices. In this descriptive analysis,…

  12. Designing Healthcare Solutions

    Directory of Open Access Journals (Sweden)

    Devorah E. Klein

    2009-11-01

    Full Text Available Innovation is generated when designers collaborate with scientists and clinicians. Who are designers? Professionals trained to uncover people’s spoken and unspoken needs (human factors researchers, to generate tangible products and services that address these needs in new and better ways (industrial and graphic designers, and to ensure that the design intent is preserved in the final manufactured form (engineers.

  13. Analysis of Design Documentation

    DEFF Research Database (Denmark)

    Hansen, Claus Thorp

    1998-01-01

    In design practice a process where a satisfactory solution is created within limited resources is required. However, since the design process is not well understood, research into how engineering designers actually solve design problems is needed. As a contribution to that end a research project...

  14. Design as Gesamtkunstwerk

    DEFF Research Database (Denmark)

    Munch, Anders V.

    Three texts on the historical development of ideas of total design: "The Art of Transgression" on contemporary projects between art, design and architecture; "Design as Gesamtkunstwerk" on the early modern total designs from Morris to Gropius (but mirrored in Panton) & "Throughout any Scale...

  15. Instant responsive web design

    CERN Document Server

    Simmons, Cory

    2013-01-01

    A step-by-step tutorial approach which will teach the readers what responsive web design is and how it is used in designing a responsive web page.If you are a web-designer looking to expand your skill set by learning the quickly growing industry standard of responsive web design, this book is ideal for you. Knowledge of CSS is assumed.

  16. DOE handbook: Design considerations

    International Nuclear Information System (INIS)

    1999-04-01

    The Design Considerations Handbook includes information and suggestions for the design of systems typical to nuclear facilities, information specific to various types of special facilities, and information useful to various design disciplines. The handbook is presented in two parts. Part 1, which addresses design considerations, includes two sections. The first addresses the design of systems typically used in nuclear facilities to control radiation or radioactive materials. Specifically, this part addresses the design of confinement systems and radiation protection and effluent monitoring systems. The second section of Part 1 addresses the design of special facilities (i.e., specific types of nonreactor nuclear facilities). The specific design considerations provided in this section were developed from review of DOE 6430.1A and are supplemented with specific suggestions and considerations from designers with experience designing and operating such facilities. Part 2 of the Design Considerations Handbook describes good practices and design principles that should be considered in specific design disciplines, such as mechanical systems and electrical systems. These good practices are based on specific experiences in the design of nuclear facilities by design engineers with related experience. This part of the Design Considerations Handbook contains five sections, each of which applies to a particular engineering discipline

  17. CBETA Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Hoffstaetter, G. [Brookhaven National Lab. (BNL), Upton, NY (United States); Trbojevic, D. [Brookhaven National Lab. (BNL), Upton, NY (United States); Mayes, C. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2017-06-08

    This Design Report describes the baseline design of the Cornell-BNL ERL Test Accelerator, as it exists on the date of its publication in June 2017. The Design Report will not change frequently in the future. In contrast, the parameter sheets that summarize the CBETA design will respond as quickly and as thoroughly as necessary to maintain con guration control.

  18. CBETA Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Hoffstaetter, G. [Brookhaven National Lab. (BNL), Upton, NY (United States); Trbojevic, D. [Brookhaven National Lab. (BNL), Upton, NY (United States); Mayes, C. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2017-06-08

    This Design Report describes the baseline design of the Cornell-BNL ERL Test Accelerator, as it exists on the date of its publication in June 2017. The Design Report will not change frequently in the future. In contrast, the parameter sheets that summarize the CBETA design will respond as quickly and as thoroughly as necessary to maintain configuration control.

  19. Early Building Design

    DEFF Research Database (Denmark)

    Østergård, Torben; Jensen, Rasmus Lund; Maagaard, Steffen

    2017-01-01

    Highlights •Development of a design methodology that can handle the vast design space in early building design. •A global design space is modelled from extensive Monte Carlo simulations. •Sensitivity analysis methods applied to guide decision-makers. •Interactive visualizations help the multi-act...

  20. DOE handbook: Design considerations

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-04-01

    The Design Considerations Handbook includes information and suggestions for the design of systems typical to nuclear facilities, information specific to various types of special facilities, and information useful to various design disciplines. The handbook is presented in two parts. Part 1, which addresses design considerations, includes two sections. The first addresses the design of systems typically used in nuclear facilities to control radiation or radioactive materials. Specifically, this part addresses the design of confinement systems and radiation protection and effluent monitoring systems. The second section of Part 1 addresses the design of special facilities (i.e., specific types of nonreactor nuclear facilities). The specific design considerations provided in this section were developed from review of DOE 6430.1A and are supplemented with specific suggestions and considerations from designers with experience designing and operating such facilities. Part 2 of the Design Considerations Handbook describes good practices and design principles that should be considered in specific design disciplines, such as mechanical systems and electrical systems. These good practices are based on specific experiences in the design of nuclear facilities by design engineers with related experience. This part of the Design Considerations Handbook contains five sections, each of which applies to a particular engineering discipline.

  1. Design of canals

    CERN Document Server

    Swamee, P K

    2015-01-01

    The book presents firsthand material from the authors on design of hydraulic canals. The book discusses elements of design based on principles of hydraulic flow through canals. It covers optimization of design based on usage requirements and economic constraints. The book includes explicit design equations and design procedures along with design examples for varied cases. With its comprehensive coverage of the principles of hydraulic canal design, this book will prove useful to students, researchers, and practicing engineers. End-of-chapter pedagogical elements make it ideal for use in graduate courses on hydraulic structures offered by most civil engineering departments across the world.

  2. Design and Iconic Brands

    Directory of Open Access Journals (Sweden)

    2015-11-01

    Full Text Available The VW Beetle, Apple, Porsche … many iconic brands have reached their status with groundbreaking designs. But what makes these designs so special? And is it really the design factor that accounts for the overall success of a brand? Dr. Walter de Silva shares with us his thoughts on iconic designs, the design process and the role of design in branding. Open your heart and mind to his extensive experience in developing designs for Volkswagen, Audi and other brands of the Volkswagen Group

  3. Ergonomic Product Design 21

    International Nuclear Information System (INIS)

    Kwon, Yeong Guk

    1996-09-01

    This book explains basic of ergonomic product design with human engineering, image engineering and strategy of that design, ergonomic industrial design, which includes product design to access the human engineering in development of new product and customer satisfaction, application technology of image engineering, industrial design of human engineering item and strategy of human engineering, a good ergonomic design. It also tells of examples of convenient design for human such as hardware product and software product in automobile, telephones for ergonomic product in the future, new goods and new technology, ergonomic product in house and office, and computers and robots in the future.

  4. Organizing design work

    DEFF Research Database (Denmark)

    Scheuer, John Damm

    2016-01-01

    The aim of this paper is to demonstrate the importance of the kind of understanding of organizing that is implied by design theories for project managers' understanding and organizing of design work. Five theories and their organizing consequences for project managers organizing of design work...... are analyzed. The paper contributes to design research and organization studies by putting the organizing of design projects on the research agenda. It also contributes by demonstrating the importance of being aware of the ontological and epistemological assumptions and organizing consequences of different...... design theories. The selected theories of design thus represent different views on what design is, address different design areas and are based on different ontological and epistemological assumptions that influence their views on how design processes should be organized....

  5. Designing For Democracy

    DEFF Research Database (Denmark)

    Knutz, Eva; Markussen, Thomas; Mårbjerg Thomsen, Signe

    2014-01-01

    there are already a number of approaches available which in one way or the other address the relationship between design, democracy and power. We provide an account of participatory design, adversarial design and design activism thereby pointing towards design?s potential for re-distributing power and authority......n this paper we focus on ?patient-democracy? and ?shared decision-making? seen from the perspective of design practice and design research. In the research on democracy in healthcare it is rarely questioned what forms of democracy underlies these concepts. We have examined three different theories...... of democracy and the democratic practices that belong to each of these. For designers working to increase patient democracy it is of vital importance to be able to distinguish different structures underlying democratic practices and to work out methods for prototyping democracy. In design research...

  6. Conceptualizing Aesthetics in Design

    DEFF Research Database (Denmark)

    Folkmann, Mads Nygaard

    2018-01-01

    The aim of this chapter is to introduce and discuss aesthetics as an approach to understand how design frames experience. In doing so, the chapter combines two philosophical interests in design, design phenomenology and design aesthetics, in order to promote a framework for discussing the impact...... of aesthetic meaning construction on experience. First, the chapter raises the phenomenological question of the relationship between design and experience, specifically, how design conditions experience. Second, in looking at aesthetics in terms of a) the sensual appeal of design, b) design objects...... as aesthetic media that frame modes of understanding, and c) contextual factors, such as media, influencing what is regarded as aesthetic, it is the thesis of the chapter that a reflective concept of design aesthetics can be employed to differentiate between three different ways in which design frame our...

  7. Participatory workspace design

    DEFF Research Database (Denmark)

    Seim, Rikke; Broberg, Ole

    2010-01-01

    Ergonomics are rarely addressed directly in the design and re-design of workspaces in Denmark. Often architects, engineers and other actors design the workspaces on the basis of for example spatial, technological or finan-cial considerations, thereby making ergonomics a by-product of the design...... process. However, by introducing ergonomists in the role of ‘workspace de-signers’ early in the design process, ergonomic considerations as well as the involvement of employees, can be integrated in the design process. In this article we demonstrate the use of the workspace design approach in a case study...... where an industrial manufacturer is undergoing a major technological change: going from labour intensive manual work to a highly automated production. The workspace design team, which included the company’s OHS consultant, designed the intervention as a participatory design process by using visually...

  8. The PANGAEA study design - a prospective, multicenter, non-interventional, long-term study on fingolimod for the treatment of multiple sclerosis in daily practice.

    Science.gov (United States)

    Ziemssen, Tjalf; Kern, Raimar; Cornelissen, Christian

    2015-06-18

    Fingolimod (Gilenya) is an oral medication for patients with highly active relapsing-remitting Multiple Sclerosis (RRMS). Clinical trials and post-marketing experience on more than 114,000 patients have established a detailed safety profile. Total patient exposure now exceeds 195,000 patient-years as stated in the last financial report (Dec 2014) of the Novartis Pharma AG, Basel, Switzerland. However, less is known about the safety of long-term fingolimod use in daily practice. Here, we describe the study design of PANGAEA (Post-Authorization Non-interventional German sAfety of GilEnyA in RRMS patients), a prospective, multicenter, non-interventional, long-term study to collect safety, efficacy, and pharmacoeconomic data on RRMS patients treated with fingolimod (0.5 mg/daily) under real-world conditions in Germany. PANGAEA is striving to assess a real-world safety and efficacy profile of fingolimod, based on data from 4,000 RRMS patients, obtained during a 60-month observational phase. A pharmacoeconomic sub-study of 800 RRMS patients further collects patient-reported outcome measures of disability, quality of life, compliance, treatment satisfaction, and usage of resources during a 24-month observational phase. Descriptive statistical analyses of the safety set as well as of stratified subgroups such as patients with concomitant diabetes mellitus and pretreated patients (e.g., natalizumab) will be conducted. PANGAEA seeks to confirm the current safety profile of fingolimod obtained in phase I-III clinical trials. The study design presented here will additionally provide guidance on the therapeutic use of fingolimod in clinical practice and possibly assists physicians in making evidence-based decisions.

  9. Reliable Design Versus Trust

    Science.gov (United States)

    Berg, Melanie; LaBel, Kenneth A.

    2016-01-01

    This presentation focuses on reliability and trust for the users portion of the FPGA design flow. It is assumed that the manufacturer prior to hand-off to the user tests FPGA internal components. The objective is to present the challenges of creating reliable and trusted designs. The following will be addressed: What makes a design vulnerable to functional flaws (reliability) or attackers (trust)? What are the challenges for verifying a reliable design versus a trusted design?

  10. Managing collaborative design

    OpenAIRE

    Sebastian, R.

    2007-01-01

    Collaborative design has been emerging in building projects everywhere. The more complex a building project becomes, the closer and more intensive collaboration between the design actors is required. This research focuses on collaborative design in the conceptual architecture design phase, especially during the elaboration of the masterplan and the development of the preliminary building designs. This research is descriptive and has two aims. First, it aims at describing the characteristics a...

  11. Video Design Games

    DEFF Research Database (Denmark)

    Smith, Rachel Charlotte; Christensen, Kasper Skov; Iversen, Ole Sejer

    We introduce Video Design Games to train educators in teaching design. The Video Design Game is a workshop format consisting of three rounds in which participants observe, reflect and generalize based on video snippets from their own practice. The paper reports on a Video Design Game workshop...... in which 25 educators as part of a digital fabrication and design program were able to critically reflect on their teaching practice....

  12. Designing Futures in Indonesia

    OpenAIRE

    Alexandra Crosby

    2016-01-01

    Design is a wide reaching and unruly idea, often associated with seamless global mobility, ubiquitous consumerism, elite urban tastes, and fast paced economic growth. But design is also increasingly understood to be operating at edges, as a necessary response to the ethical and political challenges of advanced global capitalism. Design is both the problem and the solution, and effects everything. As Tony Fry writes ‘Design–the designer and designed objects, images, systems and things–shapes t...

  13. Mechanizing Exploratory Game Design

    OpenAIRE

    Smith, Adam Marshall

    2012-01-01

    Game design is an art form that deals with inherently interactive artifacts. Game designers craft games (assembled from rule systems and content), but they really seek to manipulate play: the interaction between games and players. When developing new games that are similar to past games, a designer may rely on previous experience with related designs and relatively easy access to players familiar with conventional design choices. When exploratorily venturing into uncharted territory, uncoveri...

  14. Control system design guide

    Energy Technology Data Exchange (ETDEWEB)

    Sellers, David; Friedman, Hannah; Haasl, Tudi; Bourassa, Norman; Piette, Mary Ann

    2003-05-01

    The ''Control System Design Guide'' (Design Guide) provides methods and recommendations for the control system design process and control point selection and installation. Control systems are often the most problematic system in a building. A good design process that takes into account maintenance, operation, and commissioning can lead to a smoothly operating and efficient building. To this end, the Design Guide provides a toolbox of templates for improving control system design and specification. HVAC designers are the primary audience for the Design Guide. The control design process it presents will help produce well-designed control systems that achieve efficient and robust operation. The spreadsheet examples for control valve schedules, damper schedules, and points lists can streamline the use of the control system design concepts set forth in the Design Guide by providing convenient starting points from which designers can build. Although each reader brings their own unique questions to the text, the Design Guide contains information that designers, commissioning providers, operators, and owners will find useful.

  15. Design professional activity analysis in design management

    Directory of Open Access Journals (Sweden)

    Claudia de Souza Libanio

    2013-08-01

    Full Text Available Design use perception, as an essential element for achieving competitive advantage, also suggests the need to manage the design activities in companies. However, a few is discussed about the activity of these design professionals who participate in this process, their roles, functions and competencies, including  their connections to a company and other involved sectors. This article aims to analyze, during the design management processes, the work relations of design professionals connected to organizations both internal and externally, in order to comprehend the structure and intervenient factors on the activity of these professionals, as well as the interactions with their main coworkers. The methodology was exploratory and qualitative, using in-depth interviews with three design professionals. Subsequently, the responses were analyzed allowing the comparison of these obtained data to the theoretical bases researched. Through this case study, it was possible to realize the aspects and the structure of the design professional activity, connected intern and externally to organizations, as well as its relations with the main coworkers.

  16. Digital Interior Design by Stailia Design Oy

    OpenAIRE

    Lindroos, Jaana

    2017-01-01

    The objective of the thesis work is to research and create a web based service in a field of interior design. With my project, I am hoping to find out whether this kind of web service in the field of interior design can work in general and that the process together with the actual order form on internet is smooth from both customer and company point of view. The company has interior design related services but none entirely executed on the web. The target is to create a totally new service/pr...

  17. Database modeling and design logical design

    CERN Document Server

    Teorey, Toby J; Nadeau, Tom; Jagadish, HV

    2011-01-01

    Database systems and database design technology have undergone significant evolution in recent years. The relational data model and relational database systems dominate business applications; in turn, they are extended by other technologies like data warehousing, OLAP, and data mining. How do you model and design your database application in consideration of new technology or new business needs? In the extensively revised fifth edition, you'll get clear explanations, lots of terrific examples and an illustrative case, and the really practical advice you have come to count on--with design rules

  18. Database modeling and design logical design

    CERN Document Server

    Teorey, Toby J; Nadeau, Tom; Jagadish, HV

    2005-01-01

    Database systems and database design technology have undergone significant evolution in recent years. The relational data model and relational database systems dominate business applications; in turn, they are extended by other technologies like data warehousing, OLAP, and data mining. How do you model and design your database application in consideration of new technology or new business needs? In the extensively revised fourth edition, you'll get clear explanations, lots of terrific examples and an illustrative case, and the really practical advice you have come to count on--with design rul

  19. The design explorer project

    DEFF Research Database (Denmark)

    Pejtersen, Annelise Mark; Sonnenwald, Diane H.; Buur, Jacob

    1997-01-01

    the 'Design Explorer' research project whose goal is to specify requirements for an information system that will effectively help design team members from different domains and organizational cultures to locate and utilize diverse information sources and interact more effectively throughout the design process....... The project introduces a new approach to support of design; instead of design guidelines, support is given by creating a transparent information environment in which designers can navigate freely according to their individual preferences. The project is based on a framework that structures the dimensions......, or categories, of domain information which need to be available for a system or product designer/design team in order to determine the characteristics of the artefact, or object of design. These dimensions include information about the different work domains in which the product plays a role during its lifetime...

  20. The interactive design collaboratorium

    DEFF Research Database (Denmark)

    Bødker, Susanne; Petersen, Marianne Graves; Krogh, Peter Gall

    2001-01-01

    This paper reports on experimental process in which a prototype was developed of an interactive design collaboatorium, in cooperation with a group of usability designers. In a longterm research cooperation, this usability group has changed its work practice in order to work in the design...... collaboratorium. The design collaboratorium was developed to move usability design away from a lab towards an open physical and organizational space where designer, users and engineers meet and collaborate, or work alongside each other. The cooperation between researchers and the usability gruop has resulted...... in practical experimentation in projects and in design of an experimental design collaboratorium emploing electronic whiteboards, 3D design documentation, etc. This experimental prototype has been evaluated in cooperative workshops. We report on the results of this evaluation....

  1. Building theory through design

    DEFF Research Database (Denmark)

    Markussen, Thomas

    2017-01-01

    This chapter deals with a fundamental matter of concern in research through design: how can design work lead to the building of new theory? Controversy exists about the balance between theory and design work in research through design. While some researchers see theory production as the scientific...... hallmark of this type of research, others argue for design work being the primary achievement, with theory serving the auxiliary function of inspiring new designs. This paper demonstrates how design work and theory can be appreciated as two equally important outcomes of research through design. To set...... the scene, it starts out by briefly examining ideas on this issue presented in existing research literature. Hereafter, it introduces three basic forms in which design work can lead to theory that is referred to as extending theories, scaffolding theories and blending theories. Finally, it is discussed how...

  2. Understanding representations in design

    DEFF Research Database (Denmark)

    Bødker, Susanne

    1998-01-01

    Representing computer applications and their use is an important aspect of design. In various ways, designers need to externalize design proposals and present them to other designers, users, or managers. This article deals with understanding design representations and the work they do in design....... The article is based on a series of theoretical concepts coming out of studies of scientific and other work practices and on practical experiences from design of computer applications. The article presents alternatives to the ideas that design representations are mappings of present or future work situations...... and computer applications. It suggests that representations are primarily containers of ideas and that representation is situated at the same time as representations are crossing boundaries between various design and use activities. As such, representations should be carriers of their own contexts regarding...

  3. Radiological design guide

    International Nuclear Information System (INIS)

    Evans, R.A.

    1994-01-01

    The purpose of this design guide is to provide radiological safety requirements, standards, and information necessary for designing facilities that will operate without unacceptable risk to personnel, the public, or the environment as required by the US Department of Energy (DOE). This design guide, together with WHC-CM-4-29, Nuclear Criticality Safety, WHC-CM-4-46, Nonreactor Facility Safety Analysis, and WHC-CM-7-5, Environmental Compliance, covers the radiation safety design requirements at Westinghouse Hanford Company (WHC). This design guide applies to the design of all new facilities. The WHC organization with line responsibility for design shall determine to what extent this design guide shall apply to the modifications to existing facilities. In making this determination, consideration shall include a cost versus benefit study. Specifically, facilities that store, handle, or process radioactive materials will be covered. This design guide replaces WHC-CM-4-9 and is designated a living document. This design guide is intended for design purposes only. Design criteria are different from operational criteria and often more stringent. Criteria that might be acceptable for operations might not be adequate for design

  4. Can design science be used for design?

    DEFF Research Database (Denmark)

    Rose, Jeremy; Markfoged, Kim; Andersen, Jesper Lund

    2010-01-01

    software development projects. They studied the literature, chose appropriate starting theories, designed their own development processes, used them to build small mobile applications, documented their experiences and evaluated those experiences by writing research articles. A more experienced researcher...

  5. Parametric Design Strategies for Collaborative Urban Design

    DEFF Research Database (Denmark)

    Steinø, Nicolai; Yıldırım, Miray Baş; Özkar, Mine

    2013-01-01

    to the collaboration between professionals, participation by different non-professional stakeholders, such as residents, local authorities, non-governmental organizations and investors, is another important component of collaborative urban design processes. The involvement of community in decision making process...... implications of planning and design decisions, unless they are presented with relatively detailed architectural models, whether physical or virtual. This however, typically presents steep demands in terms of time and resources. As a foundation for our work with parametric urban design lies the hypothesis...... to solve different scripting challenges. The paper is organized into an introduction, three main sections and closing section with conclusions and perspectives. The first section of the paper gives a theoretical discussion of the notion of collaborative design and the challenges of collaborative urban...

  6. The circuit designer's companion

    CERN Document Server

    Williams, Tim

    1991-01-01

    The Circuit Designer's Companion covers the theoretical aspects and practices in analogue and digital circuit design. Electronic circuit design involves designing a circuit that will fulfill its specified function and designing the same circuit so that every production model of it will fulfill its specified function, and no other undesired and unspecified function.This book is composed of nine chapters and starts with a review of the concept of grounding, wiring, and printed circuits. The subsequent chapters deal with the passive and active components of circuitry design. These topics are foll

  7. Handbook of optical design

    CERN Document Server

    Malacara-Hernández, Daniel

    2013-01-01

    Handbook of Optical Design, Third Edition covers the fundamental principles of geometric optics and their application to lens design in one volume. It incorporates classic aspects of lens design along with important modern methods, tools, and instruments, including contemporary astronomical telescopes, Gaussian beams, and computer lens design. Written by respected researchers, the book has been extensively classroom-tested and developed in their lens design courses. This well-illustrated handbook clearly and concisely explains the intricacies of optical system design and evaluation. It also di

  8. Professional ASPNET Design Patterns

    CERN Document Server

    Millett, Scott

    2010-01-01

    Professional ASP.NET Design Patterns will show you how to implement design patterns in real ASP.NET applications by introducing you to the basic OOP skills needed to understand and interpret design patterns. A sample application used throughout the book is an enterprise level ASP.NET website with multi-tiered, SOA design techniques that can be applied to your future ASP.NET projects. Read about each design pattern in detail, including how to interpret the UML design, how to implement it in ASP.NET, its importance for ASP.NET development, and how it's integrated into the final project.

  9. Introduction to combinatorial designs

    CERN Document Server

    Wallis, WD

    2007-01-01

    Combinatorial theory is one of the fastest growing areas of modern mathematics. Focusing on a major part of this subject, Introduction to Combinatorial Designs, Second Edition provides a solid foundation in the classical areas of design theory as well as in more contemporary designs based on applications in a variety of fields. After an overview of basic concepts, the text introduces balanced designs and finite geometries. The author then delves into balanced incomplete block designs, covering difference methods, residual and derived designs, and resolvability. Following a chapter on the e

  10. Optimal Hospital Layout Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine

    foundation. The basis of the present study lies in solving the architectural design problem in order to respond to functionalities and performances. The emphasis is the practical applicability for architects, engineers and hospital planners for assuring usability and a holistic approach of functionalities...... a correlation matrix. The correlation factor defines the framework for conceptual design, whereby the design considers functionalities and their requirements and preferences. It facilitates implementation of evidence-based design as it is prepared for ongoing update and it is based on actual data. Hence......, this contribution is a model for hospital design, where design derives as a response to the defined variables, requirements and preferences....

  11. REDOing Design Education

    DEFF Research Database (Denmark)

    Morelli, Nicola; Götzen, Amalia De

    2017-01-01

    that are being developed in design education and research. The value in use, the infrastructuring and the governance levels are explained with the specific tools and approaches required according to the specific aim of the design activity: that is, whether it is about understanding, transforming or communicating......Service design education is still young and it is still interpreted in many different ways, according to the design programs where it usually plays a minor role. Very few education schemes provide a complete curriculum on service design, facing the challenge of equipping a designer who will want...

  12. Microwave circulator design

    CERN Document Server

    Linkhart, Douglas K

    2014-01-01

    Circulator design has advanced significantly since the first edition of this book was published 25 years ago. The objective of this second edition is to present theory, information, and design procedures that will enable microwave engineers and technicians to design and build circulators successfully. This resource contains a discussion of the various units used in the circulator design computations, as well as covers the theory of operation. This book presents numerous applications, giving microwave engineers new ideas about how to solve problems using circulators. Design examples are provided, which demonstrate how to apply the information to real-world design tasks.

  13. KALIMER design concept report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chang Kyu; Kim, Young Cheol; Kim, Young In; Kim, Young Gyun; Kim, Eui Kwang; Song, Hoon; Chung, Hyun Tai; Hwang, Woan; Nam, Cheol; Sub, Sim Yoon; Kim, Yeon Sik; Whan, Wim Myung; Min, Byung Tae; Yoo, Bong; Lee, Jae Han; Lee, Hyeong Yeon; Kim, Jong Bum; Koo, Gyeong Hoi; Ham, Chang Shik; Kwon, Kee Choon; Kim, Jung Taek; Park, Jae Chang; Lee, Jung Woon; Lee, Yong Hee; Kim, Chang Hwoi; Sim, Bong Shick; Hahn, Do Hee; Choi, Jong Hyeun; Kwon, Sang Woon

    1997-07-01

    KAERI is working for the development of KALIMER and work is being done for methodology development, experimental facility set up and design concept development. The development target of KALIMER has been set as to make KALIMER safer, more economic, more resistant to nuclear proliferation, and yield less impact on the environment. To achieve the target, study has been made for setting up the design concept of KALIMER including the assessment of various possible design alternatives. This report is the results of the study for the KALIMER concept study and describes the design concept of KALIMER. The developed design concept study and describes the design concept of KALIMER. The developed design concept is to be used as the starting point of the next development phase of conceptual design and the concept will be refined and modified in the conceptual design phase. The scope of the work has been set as the NSSS and essential BOP systems. For systems, NSSS and functionally related major BOP are covered. Sizing and specifying conceptual structure are covered for major equipment. Equipment and piping are arranged for the parts where the arrangement is critical in fulfilling the foresaid intention of setting up the KALIMER design concept. This report consists of 10 chapters. Chapter 2 is for the top level design requirements of KALIMER and it serves as the basis of KALIMER design concept development. Chapter 3 summarizes the KALIMER concept and describes the general design features. The remaining chapters are for specific systems. (author). 29 tabs., 37 figs.

  14. KALIMER design concept report

    International Nuclear Information System (INIS)

    Park, Chang Kyu; Kim, Young Cheol; Kim, Young In; Kim, Young Gyun; Kim, Eui Kwang; Song, Hoon; Chung, Hyun Tai; Hwang, Woan; Nam, Cheol; Sim Yoon Sub; Kim, Yeon Sik; Wim Myung Whan; Min, Byung Tae; Yoo, Bong; Lee, Jae Han; Lee, Hyeong Yeon; Kim, Jong Bum; Koo, Gyeong Hoi; Ham, Chang Shik; Kwon, Kee Choon; Kim, Jung Taek; Park, Jae Chang; Lee, Jung Woon; Lee, Yong Hee; Kim, Chang Hwoi; Sim, Bong Shick; Hahn, Do Hee; Choi, Jong Hyeun; Kwon, Sang Woon.

    1997-07-01

    KAERI is working for the development of KALIMER and work is being done for methodology development, experimental facility set up and design concept development. The development target of KALIMER has been set as to make KALIMER safer, more economic, more resistant to nuclear proliferation, and yield less impact on the environment. To achieve the target, study has been made for setting up the design concept of KALIMER including the assessment of various possible design alternatives. This report is the results of the study for the KALIMER concept study and describes the design concept of KALIMER. The developed design concept study and describes the design concept of KALIMER. The developed design concept is to be used as the starting point of the next development phase of conceptual design and the concept will be refined and modified in the conceptual design phase. The scope of the work has been set as the NSSS and essential BOP systems. For systems, NSSS and functionally related major BOP are covered. Sizing and specifying conceptual structure are covered for major equipment. Equipment and piping are arranged for the parts where the arrangement is critical in fulfilling the foresaid intention of setting up the KALIMER design concept. This report consists of 10 chapters. Chapter 2 is for the top level design requirements of KALIMER and it serves as the basis of KALIMER design concept development. Chapter 3 summarizes the KALIMER concept and describes the general design features. The remaining chapters are for specific systems. (author). 29 tabs., 37 figs

  15. Designing the design at JPL'S innovation foundary

    Science.gov (United States)

    Balint, Tibor S.; Freeman, Anthony

    2017-08-01

    NASA is a dynamic and living organization. Looking at it through the optics of cybernetics, we can describe it as an autopoietic system. It has to sustain itself, and compete successfully to be viable. Its organizational elements have to interact with the broader environment by maintaining and improving its processes that generate the means for future sustainability. It also needs to bring up follow-on generations who are not simply aligning with the status quo, but also improve the system's viability. For government-run programs, organizational, programmatic and project management practices are often rigidly linear. They can be characterized as observed first-order cybernetic systems, where the paradigm is bound by well-established requirements. At the implementation level this does not readily accommodate flexibility and change. To address this, broadening the system's worldview is needed from the strategic level. This corresponds to an observing second-order cybernetic system, where strategic leadership can overwrite the rules of a first-order system. Changing the worldview of an organization can be complex and face much resistance. Still, with the appropriate strategic-level support, it can be achieved by introducing novel languages, new perspectives, and adding new disciplines to existing ones. In effect, this helps to broaden the organizational paradigm, and subsequently influence its mission, impact the culture, and open up its core processes. These changes can be effectively introduced through design conversations in the early formulation stages, when new ideas are conceived. Within NASA's Jet Propulsion Laboratory, early-stage concept developments are performed at a specially formulated environment, called the Innovation Foundry. Within this office, a continuous effort is being made on designing the design processes, which helps to broaden the variety of the option trades. It is achieved by an added focus on conversations and the inclusion of non

  16. Optimum study designs.

    Science.gov (United States)

    Gu, C; Rao, D C

    2001-01-01

    Because simplistic designs will lead to prohibitively large sample sizes, the optimization of genetic study designs is critical for successfully mapping genes for complex diseases. Creative designs are necessary for detecting and amplifying the usually weak signals for complex traits. Two important outcomes of a study design--power and resolution--are implicitly tied together by the principle of uncertainty. Overemphasis on either one may lead to suboptimal designs. To achieve optimality for a particular study, therefore, practical measures such as cost-effectiveness must be used to strike a balance between power and resolution. In this light, the myriad of factors involved in study design can be checked for their effects on the ultimate outcomes, and the popular existing designs can be sorted into building blocks that may be useful for particular situations. It is hoped that imaginative construction of novel designs using such building blocks will lead to enhanced efficiency in finding genes for complex human traits.

  17. Clothing Systems Design Lab

    Data.gov (United States)

    Federal Laboratory Consortium — The Clothing Systems Design Lab houses facilities for the design and rapid prototyping of military protective apparel.Other focuses include: creation of patterns and...

  18. Prestressed concrete design

    CERN Document Server

    Hurst, MK

    1998-01-01

    This edition provides up-to-date guidance on the detailed design of prestressed concrete structures. All major topics are dealt with, including prestressed flat slabs, an important and growing application in the design of buildings.

  19. Algebraic design theory

    CERN Document Server

    Launey, Warwick De

    2011-01-01

    Combinatorial design theory is a source of simply stated, concrete, yet difficult discrete problems, with the Hadamard conjecture being a prime example. It has become clear that many of these problems are essentially algebraic in nature. This book provides a unified vision of the algebraic themes which have developed so far in design theory. These include the applications in design theory of matrix algebra, the automorphism group and its regular subgroups, the composition of smaller designs to make larger designs, and the connection between designs with regular group actions and solutions to group ring equations. Everything is explained at an elementary level in terms of orthogonality sets and pairwise combinatorial designs--new and simple combinatorial notions which cover many of the commonly studied designs. Particular attention is paid to how the main themes apply in the important new context of cocyclic development. Indeed, this book contains a comprehensive account of cocyclic Hadamard matrices. The book...

  20. Food packaging design

    NARCIS (Netherlands)

    Dekker, M.

    2007-01-01

    'Food product design - An integrated approach' deals with food product design from a technological perspective. It presents creative techniques for the innovation process and structured methodologies to translate consumer wishes into product properties based on Quality Function Deployment.

  1. Design reliability engineering

    International Nuclear Information System (INIS)

    Buden, D.; Hunt, R.N.M.

    1989-01-01

    Improved design techniques are needed to achieve high reliability at minimum cost. This is especially true of space systems where lifetimes of many years without maintenance are needed and severe mass limitations exist. Reliability must be designed into these systems from the start. Techniques are now being explored to structure a formal design process that will be more complete and less expensive. The intent is to integrate the best features of design, reliability analysis, and expert systems to design highly reliable systems to meet stressing needs. Taken into account are the large uncertainties that exist in materials, design models, and fabrication techniques. Expert systems are a convenient method to integrate into the design process a complete definition of all elements that should be considered and an opportunity to integrate the design process with reliability, safety, test engineering, maintenance and operator training. 1 fig

  2. Adaptive Trajectory Design

    Data.gov (United States)

    National Aeronautics and Space Administration — Adaptive Trajectory Design (ATD) is an original concept for quick and efficient end-to-end trajectory designs using proven piece-wise dynamical methods. With ongoing...

  3. Participatory Design with Dyslectics

    DEFF Research Database (Denmark)

    Vangeli, Panagiota; Stage, Jan

    2017-01-01

    Participatory Design has been used successfully in many projects but the question is how participatory design works with people with a cognitive disorder like dyslexia. In this study, we analyzed observations of participatory design sessions with dyslectic participants for developing designs...... of a reading software application by applying two participatory design methods: the IDEAS and CI methods. Furthermore, we conducted online surveys to gather information on dyslectics participants’ and their special-education teachers’ opinion regarding the participatory design process, methods and final...... designs. The results indicate that participatory design works effectively with dyslectic people provided the participation of Proxy Users to represent dyslectics, when it is necessary, the participation of an experienced on dyslexia facilitator who has the knowledge to address incidents caused due...

  4. Designing an Educational Game

    DEFF Research Database (Denmark)

    Bjørner, Thomas; Hansen, Charina Benedikte Søgaard

    2010-01-01

    When designing games with learning purposes used in a classroom, there often occur problems about the lack of learning content or the lack of game contents. Other disadvantages of existing educational games are the difficulty to provide a continual balance between the challenge and the pupils......’ skill to control and solve the given task. In this paper we suggest three different perspectives that need to be communicated across in order to design a useful educational game: teachers, pupils and game designers. It is our intention with this paper to suggest some design principles for educational...... games, and to integrate teachers, pupils and game designers needs and requirements. To set up these design principles for educational games we have used a holistic perspective. This means that the design principles must be seen in coherence within the social and physical environment. The design...

  5. Photonic Design for Photovoltaics

    Energy Technology Data Exchange (ETDEWEB)

    Kosten, E.; Callahan, D.; Horowitz, K.; Pala, R.; Atwater, H.

    2014-08-28

    We describe photonic design approaches for silicon photovoltaics including i) trapezoidal broadband light trapping structures ii) broadband light trapping with photonic crystal superlattices iii) III-V/Si nanowire arrays designed for broadband light trapping.

  6. Fusion reactor design studies

    International Nuclear Information System (INIS)

    Emmert, G.A.; Kulcinski, G.L.; Santarius, J.F.

    1990-01-01

    This report discusses the following topics on the ARIES tokamak: systems; plasma power balance; impurity control and fusion ash removal; fusion product ripple loss; energy conversion; reactor fueling; first wall design; shield design; reactor safety; and fuel cost and resources

  7. Designing Human Technologies

    DEFF Research Database (Denmark)

    Simonsen, Jesper

    and the design process, in ethical and society-related concerns, and in evaluating how designs fulfill needs and solve problems. Designing Human Technologies subscribes to a broad technology concept including information and communication, mobile, environmental/sustainable and energy technologies......Design is increasingly becoming a part of the university curriculum and research agenda. The keynote present and discuss Designing Human Technologies – an initiative aiming at establishing a design oriented main subject area alongside traditional main subject areas such as Natural Science......, the Humanities, and Social Science. The initiative broadens the perspective of IS and recognize reflections on aesthetics, ethics, values, connections to politics, and strategies for enabling a better future as legitimate parts of the research agenda. Designing Human Technologies is a design-oriented Strategic...

  8. Energy design for architects

    Energy Technology Data Exchange (ETDEWEB)

    Shaw, A. (ed.)

    1989-01-01

    This book contains techniques for energy efficiency in architectural design. Many aspects are covered including: cost; comfort and health; energy use; the design process; and analytical techniques. 202 figs. (JF)

  9. Rock Slope Design Criteria

    Science.gov (United States)

    2010-06-01

    Based on the stratigraphy and the type of slope stability problems, the flat lying, Paleozoic age, sedimentary : rocks of Ohio were divided into three design units: 1) competent rock design unit consisting of sandstones, limestones, : and siltstones ...

  10. Geometric Design Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — Purpose: The mission of the Geometric Design Laboratory (GDL) is to support the Office of Safety Research and Development in research related to the geometric design...

  11. DMS message design workshops.

    Science.gov (United States)

    2009-03-01

    This report summarizes the training conducted statewide regarding the design and display of messages on : dynamic message signs. The training is based on the Dynamic Message Sign Message Design and Display : Manual (0-4023-P3). Researchers developed ...

  12. Berm Breakwater Design

    DEFF Research Database (Denmark)

    Hald, Tue; Frigaard, Peter; Burcharth, H. F.

    1996-01-01

    Traditionally, conventional rubble mound breakwaters are designed with stable armour units, and consequently, very large stones or even artificial armour units are required. Reshaping breakwater designs allow reshaping of the seward slope thus involving stone movements. Ultimately, dependent...

  13. Learning Design Tools

    NARCIS (Netherlands)

    Griffiths, David; Blat, Josep; Garcia, Rocío; Vogten, Hubert; Kwong, KL

    2005-01-01

    Griffiths, D., Blat, J., Garcia, R., Vogten, H. & Kwong, KL. (2005). Learning Design Tools. In: Koper, R. & Tattersall, C., Learning Design: A Handbook on Modelling and Delivering Networked Education and Training (pp. 109-136). Berlin-Heidelberg: Springer Verlag.

  14. Method card design dimensions

    DEFF Research Database (Denmark)

    Wölfel, Christiane; Merritt, T.

    2013-01-01

    There are many examples of cards used to assist or provide structure to the design process, yet there has not been a thorough articulation of the strengths and weaknesses of the various examples. We review eighteen card-based design tools in order to understand how they might benefit designers....... The card-based tools are explained in terms of five design dimensions including the intended purpose and scope of use, duration of use, methodology, customization, and formal/material qualities. Our analysis suggests three design patterns or archetypes for existing card-based design method tools...... and highlights unexplored areas in the design space. The paper concludes with recommendations for the future development of card-based methods for the field of interaction design....

  15. Performing Performance Design Anglonationally

    DEFF Research Database (Denmark)

    2016-01-01

    Video recording of pecha kucha style bricolage aural enactment of an international version of performance design......Video recording of pecha kucha style bricolage aural enactment of an international version of performance design...

  16. Optical system design

    CERN Document Server

    Fischer, Robert F

    2008-01-01

    Honed for more than 20 years in an SPIE professional course taught by renowned optical systems designer Robert E. Fischer, Optical System Design, Second Edition brings you the latest cutting-edge design techniques and more than 400 detailed diagrams that clearly illustrate every major procedure in optical design. This thoroughly updated resource helps you work better and faster with computer-aided optical design techniques, diffractive optics, and the latest applications, including digital imaging, telecommunications, and machine vision. No need for complex, unnecessary mathematical derivations-instead, you get hundreds of examples that break the techniques down into understandable steps. For twenty-first century optical design without the mystery, the authoritative Optical Systems Design, Second Edition features: Computer-aided design use explained through sample problems Case studies of third-millennium applications in digital imaging, sensors, lasers, machine vision, and more New chapters on optomechanic...

  17. Dwelling with design

    OpenAIRE

    Paavilainen, Heidi

    2013-01-01

    Dwelling with Design offers a throughout look at the domestic meanings of design. The research is based on studying households in and around Helsinki, in order to find out what role, if any, design plays in the domestication of a product. The picture emerging from the research is quite different from design’s public and professional image represented for example in the interior decoration magazines, where designed qualities such as usability, reliability, interesting branding and aesthetic co...

  18. Participatory design based research

    DEFF Research Database (Denmark)

    Dau, Susanne; Bach Jensen, Louise; Falk, Lars

    This poster reveal how participatory design based research by the use of a CoED inspired creative process can be used for designing solutions to problems regarding students study activities outside campus.......This poster reveal how participatory design based research by the use of a CoED inspired creative process can be used for designing solutions to problems regarding students study activities outside campus....

  19. Designing information systems

    CERN Document Server

    Blethyn, Stanley G

    2014-01-01

    Designing Information Systems focuses on the processes, methodologies, and approaches involved in designing information systems. The book first describes systems, management and control, and how to design information systems. Discussions focus on documents produced from the functional construction function, users, operators, analysts, programmers and others, process management and control, levels of management, open systems, design of management information systems, and business system description, partitioning, and leveling. The text then takes a look at functional specification and functiona

  20. Design for Disassembly

    DEFF Research Database (Denmark)

    Beim, Anne

    2018-01-01

    Design for Disassembly’ is becoming a familiar part of discourses on environmental strategies for construction and sustainable design. The concept originates in industrial design and pertains to a wide range of strategies for reuse and recycling, all of which highlight a whole-of-life approach t...... to materials and buildings. Design for Disassembly is particularly relevant to prefabricated and industrialized construction; as such methodologies already contain within them the possibility for easy deconstruction, whether for maintenance, refurbishment or reuse....

  1. Job and Work Design

    OpenAIRE

    Van den Broeck, Anja; Parker, Sharon K.

    2017-01-01

    Job design or work design refers to the content, structure, and organization of tasks and activities. It is mostly studied in terms of job characteristics, such as autonomy, workload, role problems, and feedback. Throughout history, job design has moved away from a sole focus on efficiency and productivity to more motivational job designs, including the social approach toward work, Herzberg’s two-factor model, Hackman and Oldham’s job characteristics model, the job demand control model of Kar...

  2. Designing for Interaction Proxemics

    DEFF Research Database (Denmark)

    Grønbæk, Jens Emil

    2018-01-01

    Design of interactive technology provides opportunities as well as constraints in how a group of users can organize in a shared space. The core argument of interaction proxemics is to consider this in designing for collaboration. In my thesis, I focus on conceptualizing design of ubicomp...

  3. Information Design Theories

    Science.gov (United States)

    Pettersson, Rune

    2014-01-01

    Information design has practical and theoretical components. As an academic discipline we may view information design as a combined discipline, a practical theory, or as a theoretical practice. So far information design has incorporated facts, influences, methods, practices, principles, processes, strategies, and tools from a large number of…

  4. Designing for social cohesion

    NARCIS (Netherlands)

    Hummels, C.C.M.; Trotto, A.

    2013-01-01

    The concepts that helps us to get grip on how we make sense of the world or the way we give meaning to our lives is essential for the field of design, since designers produce proposals for action and experience through their designed artefacts. They create opportunities through which a person can

  5. Bayesian Geostatistical Design

    DEFF Research Database (Denmark)

    Diggle, Peter; Lophaven, Søren Nymand

    2006-01-01

    locations to, or deletion of locations from, an existing design, and prospective design, which consists of choosing positions for a new set of sampling locations. We propose a Bayesian design criterion which focuses on the goal of efficient spatial prediction whilst allowing for the fact that model...

  6. DesignLAK17

    DEFF Research Database (Denmark)

    Ringtved, Ulla; Milligan, Sandra; Corrin, Linda

    2017-01-01

    Notions of what constitutes quality in design in traditional on-campus or online teaching and learning may not always translate into scaled digital environments. The DesignLAK17 workshop builds on the DesignLAK16 workshop to explore one aspect of this theme, namely the opportunities arising from...

  7. Lehigh Design Course

    Science.gov (United States)

    Grassi, Vincent G.; Luyben, William L.; Silebi, Cesar A.

    2011-01-01

    This paper discusses a two-semester senior design course that combines traditional steady-state economic process design with dynamic plantwide control. This unique course has been taught at Lehigh for more than a decade and has garnered rave reviews from students, industry, and ABET. Each student design group has its own industrial consultant who…

  8. DEEP EMPATHIC DESIGN

    Directory of Open Access Journals (Sweden)

    FRAQUELLI Roberto

    2015-06-01

    Full Text Available Empathic design is often described as a creative process that translates observations - typically of people and their behaviours into design ideas. Another similar and closely related expression is user centred design, which attempts to turn the attention away from an object or product towards its usefulness and usability. The central premise of empathic design is that the best-designed products and services result from understanding the needs of the people who will use them. User-centred designers engage actively with end-users to gather insights that drive design from the earliest stages of product and service development, right through the design process.[1] Our standard definitions and understanding of empathic design or user centred design are well recognised and widely practiced, particularly taught in design schools and in professional creative business. This paper extends and explores a deeper understanding of empathy within a systems thinking framework where the observer and subject are both components of empathic design. It proposes that empathy can be described as the bonds of connection with others (in its traditional interpretation, but also with an ecological, social and economic context.

  9. Mechatronic Design Automation

    DEFF Research Database (Denmark)

    Fan, Zhun

    successfully design analogue filters, vibration absorbers, micro-electro-mechanical systems, and vehicle suspension systems, all in an automatic or semi-automatic way. It also investigates the very important issue of co-designing plant-structures and dynamic controllers in automated design of Mechatronic...

  10. Designing synthetic biology.

    Science.gov (United States)

    Agapakis, Christina M

    2014-03-21

    Synthetic biology is frequently defined as the application of engineering design principles to biology. Such principles are intended to streamline the practice of biological engineering, to shorten the time required to design, build, and test synthetic gene networks. This streamlining of iterative design cycles can facilitate the future construction of biological systems for a range of applications in the production of fuels, foods, materials, and medicines. The promise of these potential applications as well as the emphasis on design has prompted critical reflection on synthetic biology from design theorists and practicing designers from many fields, who can bring valuable perspectives to the discipline. While interdisciplinary connections between biologists and engineers have built synthetic biology via the science and the technology of biology, interdisciplinary collaboration with artists, designers, and social theorists can provide insight on the connections between technology and society. Such collaborations can open up new avenues and new principles for research and design, as well as shed new light on the challenging context-dependence-both biological and social-that face living technologies at many scales. This review is inspired by the session titled "Design and Synthetic Biology: Connecting People and Technology" at Synthetic Biology 6.0 and covers a range of literature on design practice in synthetic biology and beyond. Critical engagement with how design is used to shape the discipline opens up new possibilities for how we might design the future of synthetic biology.

  11. Conceptual thermal design

    NARCIS (Netherlands)

    Strijk, R.

    2008-01-01

    Present thermal design tools and methods insufficiently support the development of structural concepts engaged by typical practicing designers. Research described in this thesis identifies the main thermal design problems in practice. In addition, models and methods are developed that support an

  12. Total design of participation

    DEFF Research Database (Denmark)

    Munch, Anders V.

    2016-01-01

    The idea of design as an art made not only for the people, but also by the people is an old dream going back at least to William Morris. It is, however, reappearing vigoriously in many kinds of design activism and grows out of the visions of a Total Design of society. The ideas of participation b...

  13. Embodied Design Ideation methods

    DEFF Research Database (Denmark)

    Wilde, Danielle; Vallgårda, Anna; Tomico, Oscar

    2017-01-01

    Embodied design ideation practices work with relationships between body, material and context to enliven design and research potential. Methods are often idiosyncratic and – due to their physical nature – not easily transferred. This presents challenges for designers wishing to develop and share ...

  14. Designing Online Education Courses.

    Science.gov (United States)

    Trentin, Guglielmo

    2001-01-01

    Focuses on the main elements that characterize online course design. Topics include design constraints; analysis of learning needs; defining objectives; course prerequisites; content structuring; course flexibility; learning strategies; evaluation criteria; course activities; course structure; communication architecture; and design evaluation.…

  15. Cryogenic moderator design

    International Nuclear Information System (INIS)

    Diplock, B.R.

    1983-01-01

    This paper describes the present design of the two cold moderators to be built for the Spallation Neutron Source. It discusses the reasons behind a number of the design features and highlights several problem areas requiring solutions before a final design can be constructed

  16. Designers in Britain 7.

    Science.gov (United States)

    New York Graphic Society, Greenwich, CT.

    The Society of Industrial Artists and Designers (SIAD) has for over 40 years been working to establish design as a profession with a status equivalent to that of architecture or engineering. Intended as a selective review of recent British illustration and design in industry, advertising, and publishing, this volume is the seventh in a series…

  17. Designers Block 2002

    DEFF Research Database (Denmark)

    Dickson, Thomas

    2002-01-01

    Artiklen indleder med: ved siden aaf Londons etablerede designmesse '100% Design', er der vokset et undergrundsmiljø af designudstillinger op. Det dominerende og mest kendte initiativ er Designers Block, der i år udstillede to steder i byen. Designers Block er et mere uformelt udstillingsforum...

  18. Prototyping Design and Business

    DEFF Research Database (Denmark)

    Rasmussen, Jørgen; Kramp, Gunnar; Schiønning Mortensen, Bo

    2011-01-01

    It is increasingly common that design firms go from working with their client’s development department on specific products, to discussing strategic issues directly with the company’s management. In this new territory designers face a number of challenges. Designers are traditionally trained to ‘...

  19. Situating universal design architecture: designing with whom?

    Science.gov (United States)

    Jones, Paul

    2014-01-01

    To respond to growing calls for a theoretical unpacking of Universal Design (UD), a disparate movement cohering around attempts to design spaces and technologies that seek to allow use by all people (to the fullest extent possible). The on-going embedding of UD into architectural practice and pedagogy represents an opportune juncture at which to draw learning from other distinct-but-related transformatory architectural movements. Sociological-theoretical commentary. UD has to date, and necessarily, been dominated by the practice contexts from which it emerged. Appealing as a short-hand for description of "designing-for-all", in most cases UD has come to stand in as a term to signal a general intent in this direction and as an umbrella term for the range of technical design resources that have been developed under these auspices. There remains a fundamental ambivalence vis-à-vis the question of users' power/capacity to influence decision-making in the design process in UD; technically-oriented typologies of bodies predominate in influential UD architectural accounts. UD represents rich technical and pedagogical resources for those architects committed to transforming the existing built environment so as to be less hostile to a wide range of users. However, within UD, unpacking the social role of the professional architect vis-à-vis a variety of publics is an important, but hitherto underdeveloped, challenge; issues concerning professional-citizen power relations continue to animate parallel architectural politics, and UD can both contribute and draw much from these on-going explorations. Implications for Rehabilitation Universal Design (UD) architecture shares a close affinity with rehabilitation practice, with the creation of built environments that allow use by individuals with a wide range of capacities a priority for both. While an effective communicative "bridge" between professions, UD's deployment typically leaves unspoken the capacity of users to

  20. Enhanced Design Alternative I: Low Temperature Design

    International Nuclear Information System (INIS)

    MacNeil, K.

    1999-01-01

    The purpose of this document is to evaluate Enhanced Design Alternative (EDA) 1, the low temperature repository design concept (CRWMS M and O 1999a). This technical document will provide supporting information for Site Recommendation (SR) and License Application (LA). Preparation of this evaluation will be in accordance with the technical document preparation plan (TDPP), (CRWMS M and O 1999b). EDA 1, one of five EDAs, was evolved from evaluation of a series of design features and alternatives developed during the first phase of the License Application Design Selection (LADS) process. Low, medium, and high temperature concepts were developed from the design features and alternatives prepared during Phase 1 of the LADS effort (CRWMS M and O 1999a). EDA 1 will first be evaluated against a single Screening Criterion, outlined in CRWMS M and O 1999a, which addresses post-closure performance of the repository. The performance of the repository is defined quantitatively as the peak radiological dose rate to an average individual of a critical group at a distance of 20 km from the repository site within 10,000 years. To satisfy this criterion the peak dose rate must not exceed the anticipated regulatory level of 25 mrem/yr within 10,000 years. If the EDA meets the screening criterion, the EDA will be further evaluated against the LADS Phase 2 Evaluation Criteria contained in CRWMS M and O 1999a

  1. Tribology in machine design

    CERN Document Server

    Stolarski, Tadeusz

    1999-01-01

    ""Tribology in Machine Design is strongly recommended for machine designers, and engineers and scientists interested in tribology. It should be in the engineering library of companies producing mechanical equipment.""Applied Mechanics ReviewTribology in Machine Design explains the role of tribology in the design of machine elements. It shows how algorithms developed from the basic principles of tribology can be used in a range of practical applications within mechanical devices and systems.The computer offers today's designer the possibility of greater stringen

  2. Intuitive analog circuit design

    CERN Document Server

    Thompson, Marc

    2013-01-01

    Intuitive Analog Circuit Design outlines ways of thinking about analog circuits and systems that let you develop a feel for what a good, working analog circuit design should be. This book reflects author Marc Thompson's 30 years of experience designing analog and power electronics circuits and teaching graduate-level analog circuit design, and is the ideal reference for anyone who needs a straightforward introduction to the subject. In this book, Dr. Thompson describes intuitive and ""back-of-the-envelope"" techniques for designing and analyzing analog circuits, including transistor amplifi

  3. Integrated Structural Design Education

    DEFF Research Database (Denmark)

    Bjerregaard Jensen, Lotte; Almegaard, Henrik

    2011-01-01

    to EU legislation. And a successful engineering student must be prepared to work in the open-ended, multidisciplinary environment necessary to produce structures which comply with EIA demands. This paper describes an innovative course developed at the Technical University of Denmark which integrates...... landscaping and structural design. The integrated courses create a setting for learning about the design of large-scale structures and involve geometry, statics, computer simulation, graphical design and landscape architecture. Together, they educate engineers who can take part in the early design phases...... of a project, function well in design teams, and comply with EU EIA demands....

  4. Learning Space Service Design

    Directory of Open Access Journals (Sweden)

    Elliot Felix

    2011-12-01

    Full Text Available Much progress has been made in creating informal learning spaces that incorporate technology and flexibly support a variety of activities. This progress has been principally in designing the right combination of furniture, technology, and space. However, colleges and universities do not design services within learning spaces with nearly the same level of sophistication or integration. Nor do they adequately assess their services. This paper calls for a focus on designing services to facilitate better learning experiences. It describes the fundamentals of service design practice, a selection of exemplary spaces, and the implications for design, budgeting, and staffing.

  5. Interior design for dentistry.

    Science.gov (United States)

    Unthank, M; True, G

    1999-11-01

    In the increasingly complex, competitive and stressful field of dentistry, effectively designed dental offices can offer significant benefits. Esthetic, functional and life-cycle cost issues to be considered when developing your interior design scheme include color, finishes, lighting, furnishings, art and accessories. An appropriately designed dental office serves as a valuable marketing tool for your practice, as well as a safe and enjoyable work environment. Qualified interior design professionals can help you make design decisions that can yield optimum results within your budget.

  6. Exemplary Design Practice

    DEFF Research Database (Denmark)

    Jørgensen, Niels

    The didactic principle of exemplary learning may be defined briefly as 'learning by example'. In design education, working with a practical example is particularly appropriate, because design by definition is about creating a solution to a practical problem. Indeed, some design theorists claim......, including: If design knowing is bound to a given practical design context, how is it possible to generalize such knowing, as presumably required by an exemplary learning approach? To explore these questions, an account is given of the theories of exemplary learning proposed by Martin Wagenschein and Oskar...

  7. MOS integrated circuit design

    CERN Document Server

    Wolfendale, E

    2013-01-01

    MOS Integral Circuit Design aims to help in the design of integrated circuits, especially large-scale ones, using MOS Technology through teaching of techniques, practical applications, and examples. The book covers topics such as design equation and process parameters; MOS static and dynamic circuits; logic design techniques, system partitioning, and layout techniques. Also featured are computer aids such as logic simulation and mask layout, as well as examples on simple MOS design. The text is recommended for electrical engineers who would like to know how to use MOS for integral circuit desi

  8. Maintainability design guide

    International Nuclear Information System (INIS)

    Pack, R.W.

    1985-01-01

    The Human Factors Design Guide for Maintainability provides guidance for systematically incorporating good human factors techniques into the design of power plants. The guide describes a means of developing a comprehensive program plan to ensure compliance with the human factors approaches specified by the utility. The guide also provides specific recommendations for design practices, with examples, bases, and references. The recommendations are formatted for easy use by nuclear power plant design teams and by utility personnel involved in specification and design review. The guide was developed under EPRI research project RP2166-4 and is currently being published

  9. Towards programmatic design research

    Directory of Open Access Journals (Sweden)

    Jonas Löwgren

    2013-12-01

    Full Text Available The notion of design research entails research where design practice forms part of the knowledge production. Based on our characterization of the nature of design, we propose to conceptualize this kind of research as programmatic design research. Two ongoing PhD projects in interaction design are presented as examples of programmatic research processes, highlighting issues to do with the virtues and qualities of the processes, the interplay of optics and engagements in a hermeneutical dynamic, and the production of takeaways for the academic community.

  10. Worldviews for Design Theory

    DEFF Research Database (Denmark)

    Galle, Per

    2006-01-01

    aware of, I demonstrate how 'insidious inconsistency ' may infect design theory if we ignore this admonition. As a possible remedy, I propose a method by which the philosophy of design may develop sound methaphysical foundations ('worldviews') for design theory - and obtain philosophical insights......I suspect that the growing 'body' of design theory may be infected by more inconsistency than is justifiable by genuine disagreement among design researchers. Taking my clue from Peirce, who argued that theory inevitably rests on basics metaphysical assumptions that theorists ought to be critically...

  11. Design Characteristics as Basis for Design Languages

    DEFF Research Database (Denmark)

    Mortensen, Niels Henrik

    1997-01-01

    The application of modern feature based CAD systems has in many companies lead to significant rationalisation of design, particulary the "down stream" acticities such as NC code generation, FEM analysis, mould flow simulation and documentation. The subject of this paper is the "up stream" activit......The application of modern feature based CAD systems has in many companies lead to significant rationalisation of design, particulary the "down stream" acticities such as NC code generation, FEM analysis, mould flow simulation and documentation. The subject of this paper is the "up stream...

  12. Scandinavian Participatory Design - Beyond Design, Beyond Scandinavia

    DEFF Research Database (Denmark)

    Zander, Pär-Ola; Georgsen, Marianne; Nyvang, Tom

    2011-01-01

    This paper presents a stream of research that is relevant for development research generally and also in South Asia, but has hitherto remained outside the discourse of mainstream development research. It goes under the name "Participatory design", referring not only generally to participatory...... approaches, of which there are many in development research, but to a specific body of work that stems from Scandinavia. Within the research fields relating to design of ICT systems the Scandinavian countries have a rich history of incorporating disadvantaged groups in societies. This paper argues...

  13. Empathic design: Research strategies

    Directory of Open Access Journals (Sweden)

    Joyce Thomas

    2013-01-01

    Full Text Available This paper explores the role of empathy within new product development from the perspective of human-centred design. The authors have developed a range of empathic design tools and strategies that help to identify authentic human needs.For products and services to be effective, they need to satisfy both functional and emotional needs of individuals. In addition, the individual user needs to feel that the product and/or service has been designed ‘just for them’, otherwise they may misuse, underuse or abandon the product/service. This becomes critical with a product such as a Zimmer frame (walker, when it fails to resonate with the patient due to any stigma the patient may perceive, and thus remains unused.When training young designers to consider the wider community (people unlike themselves during the design process, it has proven extremely valuable to take them outside their comfort zones, by seeking to develop empathy with the end user for whom they are designing. Empathic modelling offers designers the opportunity to develop greater insight and understanding, in order to support more effective design outcomes. Sensitising designers to the different ways that individuals complete daily tasks has helped to diminish the gap between themselves and others (e.g. people with disabilities.The authors intend for this paper to resonate with health care providers. Human-centred design can help to refocus the designer, by placing the individual end user’s needs at the heart of their decision-making.

  14. Empathic design: Research strategies.

    Science.gov (United States)

    Thomas, Joyce; McDonagh, Deana

    2013-01-01

    This paper explores the role of empathy within new product development from the perspective of human-centred design. The authors have developed a range of empathic design tools and strategies that help to identify authentic human needs.For products and services to be effective, they need to satisfy both functional and emotional needs of individuals. In addition, the individual user needs to feel that the product and/or service has been designed 'just for them', otherwise they may misuse, underuse or abandon the product/service. This becomes critical with a product such as a Zimmer frame (walker), when it fails to resonate with the patient due to any stigma the patient may perceive, and thus remains unused.When training young designers to consider the wider community (people unlike themselves) during the design process, it has proven extremely valuable to take them outside their comfort zones, by seeking to develop empathy with the end user for whom they are designing. Empathic modelling offers designers the opportunity to develop greater insight and understanding, in order to support more effective design outcomes. Sensitising designers to the different ways that individuals complete daily tasks has helped to diminish the gap between themselves and others (e.g. people with disabilities).The authors intend for this paper to resonate with health care providers. Human-centred design can help to refocus the designer, by placing the individual end user's needs at the heart of their decision-making.

  15. Reactor System Design

    International Nuclear Information System (INIS)

    Chi, S. K.; Kim, G. K.; Yeo, J. W.

    2006-08-01

    SMART NPP(Nuclear Power Plant) has been developed for duel purpose, electricity generation and energy supply for seawater desalination. The objective of this project IS to design the reactor system of SMART pilot plant(SMART-P) which will be built and operated for the integrated technology verification of SMART. SMART-P is an integral reactor in which primary components of reactor coolant system are enclosed in single pressure vessel without connecting pipes. The major components installed within a vessel includes a core, twelve steam generator cassettes, a low-temperature self pressurizer, twelve control rod drives, and two main coolant pumps. SMART-P reactor system design was categorized to the reactor coe design, fluid system design, reactor mechanical design, major component design and MMIS design. Reactor safety -analysis and performance analysis were performed for developed SMART=P reactor system. Also, the preparation of safety analysis report, and the technical support for licensing acquisition are performed

  16. LISA system design highlights

    Energy Technology Data Exchange (ETDEWEB)

    Sallusti, M [European Space Agency, ESTEC, Keplerlaan 1, 2200 AG Noordwijk ZH (Netherlands); Gath, P; Weise, D; Berger, M; Schulte, H R, E-mail: marcello.sallusti@esa.in, E-mail: peter.gath@astrium.eads.ne, E-mail: dennis.weise@astrium.eads.ne, E-mail: marcel.berger@astrium.eads.ne, E-mail: Hans.Reiner.Schulte@astrium.eads.ne [Astrium GmbH Satellites, Claude-Dornier-Str., 88039 Friedrichshafen (Germany)

    2009-05-07

    A contract, started in January 2005, was awarded to a consortium of Astrium GmbH and Astrium Ltd for the LISA Mission Formulation. The scope of the contract was the development of a reference design for the mission architecture and for the mission elements (with particular focus on the payload) and a successive phase of derivation of requirements, to be concluded with a mission design review. The technical starting point was the output of the previous LISA study formalized in the Final Technical Report, issued in the year 2000. During the design phase, different architecture concepts were identified and traded off, including the LISA orbits, the measurement scheme and the opto-mechanical architecture. During the Mission Design Review (July 2008) the consolidated mission baseline design, and the specifications of the flight elements and of the payload subsystem and major components were presented. This paper gives a brief overview of the major design points of the latest design of the LISA system.

  17. LISA system design highlights

    International Nuclear Information System (INIS)

    Sallusti, M; Gath, P; Weise, D; Berger, M; Schulte, H R

    2009-01-01

    A contract, started in January 2005, was awarded to a consortium of Astrium GmbH and Astrium Ltd for the LISA Mission Formulation. The scope of the contract was the development of a reference design for the mission architecture and for the mission elements (with particular focus on the payload) and a successive phase of derivation of requirements, to be concluded with a mission design review. The technical starting point was the output of the previous LISA study formalized in the Final Technical Report, issued in the year 2000. During the design phase, different architecture concepts were identified and traded off, including the LISA orbits, the measurement scheme and the opto-mechanical architecture. During the Mission Design Review (July 2008) the consolidated mission baseline design, and the specifications of the flight elements and of the payload subsystem and major components were presented. This paper gives a brief overview of the major design points of the latest design of the LISA system.

  18. Visualization Design Environment

    Energy Technology Data Exchange (ETDEWEB)

    Pomplun, A.R.; Templet, G.J.; Jortner, J.N.; Friesen, J.A.; Schwegel, J.; Hughes, K.R.

    1999-02-01

    Improvements in the performance and capabilities of computer software and hardware system, combined with advances in Internet technologies, have spurred innovative developments in the area of modeling, simulation and visualization. These developments combine to make it possible to create an environment where engineers can design, prototype, analyze, and visualize components in virtual space, saving the time and expenses incurred during numerous design and prototyping iterations. The Visualization Design Centers located at Sandia National Laboratories are facilities built specifically to promote the ''design by team'' concept. This report focuses on designing, developing and deploying this environment by detailing the design of the facility, software infrastructure and hardware systems that comprise this new visualization design environment and describes case studies that document successful application of this environment.

  19. Teaching engineering design research

    DEFF Research Database (Denmark)

    Blessing, Lucienne; Andreasen, Mogens Myrup

    2005-01-01

    The importance og engineering design as an industrial activity, and the increasingly complex and dynamic context in which it takes place, has led to the wish to improve the effectiveness and efficiency of engineering design in practice as well as in education. Although attempts have been made...... to improve design for centuries, it was not until well in the second half of the 20th century that engineering design became a research topic (see pahl and Beitz (1996), Heymann (2004) for historical overviews). Engineering research, such as research into thermodynamics, mechanics and materials, has a much...... by PhD students. This has created the demand for a clear, efficient way of learning the crafmanship of doing design research, a demand which is in strong contrast to the state of design research in general. This article reflects the authors' efforts in running a summer school om engineering design...

  20. Roller bearing geometry design

    Science.gov (United States)

    Savage, M.; Pinkston, B. H. W.

    1976-01-01

    A theory of kinematic stabilization of rolling cylinders is extended and applied to the design of cylindrical roller bearings. The kinematic stabilization mechanism puts a reverse skew into the rolling elements by changing the roller taper. Twelve basic bearing modification designs are identified amd modeled. Four have single transverse convex curvature in their rollers while eight have rollers which have compound transverse curvature made up of a central cylindrical band surrounded by symmetric bands with slope and transverse curvature. The bearing designs are modeled for restoring torque per unit axial displacement, contact stress capacity, and contact area including dynamic loading, misalignment sensitivity and roller proportion. Design programs are available which size the single transverse curvature roller designs for a series of roller slopes and load separations and which design the compound roller bearings for a series of slopes and transverse radii of curvature. The compound rollers are proportioned to have equal contact stresses and minimum size. Design examples are also given.

  1. Ethics and technology design

    DEFF Research Database (Denmark)

    Albrechtslund, Anders

    2007-01-01

    This article offers a discussion of the connection between technology and values and, specifically, I take a closer look at ethically sound design. In order to bring the discussion into a concrete context, the theory of Value Sensitive Design (VSD) will be the focus point. To illustrate my argument...... concerning design ethics, the discussion involves a case study of an augmented window, designed by the VSD Research Lab, which has turned out to be a potentially surveillance-enabling technology. I call attention to a "positivist problem" that has to do with the connection between the design context...... of design ethics, is intended as a constructive criticism, which can hopefully contribute to the further development of design ethics....

  2. Sustainable Housing Design

    DEFF Research Database (Denmark)

    Lauring, Gert Michael

    2016-01-01

    Sustainable Housing Design. Integrating technical and housing quality aspects of sustainable architecture in civil engineering education. Summary An integrated design approach to sustainable architecture is outlined that combines concerns for zero energy building, good indoor climate and adequate...... phases. The outcome shows that integrated design further solutions where sustainable urban forms of settlement can be highly energy efficient while also attractive from a user perspective. Key words: Sustainable architecture, integrated design, zero-energy-housing, dense urban living. 1. Introduction...... When designing sustainable housing, energy optimization and satisfactory indoor climates are central issues that need to be incorporated from early design phases if to reach a coherent design. It might also be argued that the energy consumption of contemporary buildings only plays a rela-tively minor...

  3. Scandinavian Participatory Design

    DEFF Research Database (Denmark)

    Iversen, Ole Sejer; Smith, Rachel Charlotte

    2012-01-01

    As Scandinavian Participatory Design (PD) approach is a highly values-led design approach, and is gaining importance in IDC research, we discuss the underlying values of democracy, quality of work and emancipation of this approach. We present a case study, Digital Natives, in which the Scandinavian...... PD approach was put into practice. Here we involved seven teenagers in the design of an interactive museum exhibition. We discuss how this particular approach effects key design activities such as the establishment of the design space, power relations among participants, the dialogical design process......, project evaluation and the final outcome of the project. We conclude that the end goal of Scandinavian PD is not necessarily the final research prototype. Rather, in Scandinavian PD, designers strive to provide children with meaningful alternatives to existing technologies. It is to help children realize...

  4. Efficient Learning Design

    DEFF Research Database (Denmark)

    Godsk, Mikkel

    This paper presents the current approach to implementing educational technology with learning design at the Faculty of Science and Technology, Aarhus University, by introducing the concept of ‘efficient learning design’. The underlying hypothesis is that implementing learning design is more than...... engaging educators in the design process and developing teaching and learning, it is a shift in educational practice that potentially requires a stakeholder analysis and ultimately a business model for the deployment. What is most important is to balance the institutional, educator, and student...... perspectives and to consider all these in conjunction in order to obtain a sustainable, efficient learning design. The approach to deploying learning design in terms of the concept of efficient learning design, the catalyst for educational development, i.e. the learning design model and how it is being used...

  5. Is Engineering Design Disappearing from Design Research?

    DEFF Research Database (Denmark)

    Andreasen, Mogens Myrup; Howard, Thomas J.

    2011-01-01

    Most systems and products need to be engineered during their design, based upon scientific insight into principles, mechanisms, materials and production pos-sibilities, leading to reliability, durability and value for the user. Despite the central importance and design’s crucial dependency...

  6. Future steam generator designs. Single wall designs

    Energy Technology Data Exchange (ETDEWEB)

    Hayden, O [Nuclear Power Company Ltd, Warrington, Cheshire (United Kingdom)

    1978-10-01

    The easily removable 'U' tube design style adopted in the UK for the existing PFR Steam Generators, the Replacement Units now in production and for the future CDFR, gives the operator an extremely valuable option in the event of a water/steam leak occurring inside the Steam Generator. He can choose to shut-down, attempt to find the leak, assess damage, repair, revalidate and return to service in situ, or he can elect to remove the defect unit and replace with a 'proven' spare before returning the circuit to power. With the latter approach the resultant outage time is a known entity of about two weeks. If a repair is attempted in situ, predictions of outage time can become a matter of guesswork since one has no 'guaranteed' method of leak location and the assessment of secondary damage may be very time consuming, depending on the size and type of the original leak together with the particular design style of the Steam Generator. A further significant advantage of the removable 'U' tube design concept is that periodic interchanging of bundles with a spare enables routine chemical cleaning and thorough scheduled tube inspections, with specimen tube sample removal if required for monitoring purposes. If necessary, bundle decontamination can be undertaken to assess engineering deterioration to various degrees of thoroughness ranging from 100% equivalent factory final assembly inspection, to partial decontamination operating via a glovebox type of maintenance bag arrangement, examining local points of both shell and tube areas of the bundle. Many lessons from the last five years' experience of PFR will be incorporated into the design of the CDFR and PFR Steam Generators have two very good examples of how the designer can ease or severely handicap the operator in coping with sodium/water leakages. Good, quick access to tube ends is achieved in the existing PFR Evaporator by simply unbolting the steam/water closure head, but on the superheater and reheater hand-caps have

  7. Future steam generator designs. Single wall designs

    International Nuclear Information System (INIS)

    Hayden, O.

    1978-01-01

    The easily removable 'U' tube design style adopted in the UK for the existing PFR Steam Generators, the Replacement Units now in production and for the future CDFR, gives the operator an extremely valuable option in the event of a water/steam leak occurring inside the Steam Generator. He can choose to shut-down, attempt to find the leak, assess damage, repair, revalidate and return to service in situ, or he can elect to remove the defect unit and replace with a 'proven' spare before returning the circuit to power. With the latter approach the resultant outage time is a known entity of about two weeks. If a repair is attempted in situ, predictions of outage time can become a matter of guesswork since one has no 'guaranteed' method of leak location and the assessment of secondary damage may be very time consuming, depending on the size and type of the original leak together with the particular design style of the Steam Generator. A further significant advantage of the removable 'U' tube design concept is that periodic interchanging of bundles with a spare enables routine chemical cleaning and thorough scheduled tube inspections, with specimen tube sample removal if required for monitoring purposes. If necessary, bundle decontamination can be undertaken to assess engineering deterioration to various degrees of thoroughness ranging from 100% equivalent factory final assembly inspection, to partial decontamination operating via a glovebox type of maintenance bag arrangement, examining local points of both shell and tube areas of the bundle. Many lessons from the last five years' experience of PFR will be incorporated into the design of the CDFR and PFR Steam Generators have two very good examples of how the designer can ease or severely handicap the operator in coping with sodium/water leakages. Good, quick access to tube ends is achieved in the existing PFR Evaporator by simply unbolting the steam/water closure head, but on the superheater and reheater hand-caps have

  8. Designer's unified cost model

    Science.gov (United States)

    Freeman, William T.; Ilcewicz, L. B.; Swanson, G. D.; Gutowski, T.

    1992-01-01

    A conceptual and preliminary designers' cost prediction model has been initiated. The model will provide a technically sound method for evaluating the relative cost of different composite structural designs, fabrication processes, and assembly methods that can be compared to equivalent metallic parts or assemblies. The feasibility of developing cost prediction software in a modular form for interfacing with state of the art preliminary design tools and computer aided design programs is being evaluated. The goal of this task is to establish theoretical cost functions that relate geometric design features to summed material cost and labor content in terms of process mechanics and physics. The output of the designers' present analytical tools will be input for the designers' cost prediction model to provide the designer with a data base and deterministic cost methodology that allows one to trade and synthesize designs with both cost and weight as objective functions for optimization. The approach, goals, plans, and progress is presented for development of COSTADE (Cost Optimization Software for Transport Aircraft Design Evaluation).

  9. Designers' unified cost model

    Science.gov (United States)

    Freeman, W.; Ilcewicz, L.; Swanson, G.; Gutowski, T.

    1992-01-01

    The Structures Technology Program Office (STPO) at NASA LaRC has initiated development of a conceptual and preliminary designers' cost prediction model. The model will provide a technically sound method for evaluating the relative cost of different composite structural designs, fabrication processes, and assembly methods that can be compared to equivalent metallic parts or assemblies. The feasibility of developing cost prediction software in a modular form for interfacing with state-of-the-art preliminary design tools and computer aided design programs is being evaluated. The goal of this task is to establish theoretical cost functions that relate geometric design features to summed material cost and labor content in terms of process mechanics and physics. The output of the designers' present analytical tools will be input for the designers' cost prediction model to provide the designer with a database and deterministic cost methodology that allows one to trade and synthesize designs with both cost and weight as objective functions for optimization. This paper presents the team members, approach, goals, plans, and progress to date for development of COSTADE (Cost Optimization Software for Transport Aircraft Design Evaluation).

  10. Learning for design reuse

    DEFF Research Database (Denmark)

    Duffy, Alex; Duffy, Sandra M.

    1996-01-01

    Over the past decade "design assistance", that is, where the computer is viewed as an Intelligent Design Assistant (IDA), has emerged in knowledge based design support and has formed the basic research strategy for the CAD Cantre, University of Strathclyde, since the mid-1980s. Within this philos......Over the past decade "design assistance", that is, where the computer is viewed as an Intelligent Design Assistant (IDA), has emerged in knowledge based design support and has formed the basic research strategy for the CAD Cantre, University of Strathclyde, since the mid-1980s. Within...... this philosophy, an IDA would act as a colleague to a designer, providing guidance, learning from past experiences, carrying out semi- and fully-automated tasks, explaining its reasoning and in essence complementing the designer's own natural skills, and thus leaving the ultimate decision-making, control......, and responsibility with the designer.The ability to learn and evolve has been recognized as one of the key components of an IDA for it to fully support the designer's activities. Consequently, we have been directing our research effort on two main fronts, formalizing our understanding and developing models...

  11. The design game in Participatory Design and design education

    DEFF Research Database (Denmark)

    Törpel, Bettina

    2006-01-01

    carefully. Cases from student projects are used as illustrating examples; work environments were redesigned and design games played. It turns out that degrees of freedom are present for the choice of (gaming) method as well as the ways of using the selected method. These degrees of freedom should be used...... in a way that will be labeled as »interested«, rather than in a way labeled as »taking for granted«. It is not possible to guarantee an interested and beneficial approach; yet the paper argues on the grounds that reflective gaming practice can be supportive in this direction....

  12. Computational Protein Design

    DEFF Research Database (Denmark)

    Johansson, Kristoffer Enøe

    Proteins are the major functional group of molecules in biology. The impact of protein science on medicine and chemical productions is rapidly increasing. However, the greatest potential remains to be realized. The fi eld of protein design has advanced computational modeling from a tool of support...... to a central method that enables new developments. For example, novel enzymes with functions not found in natural proteins have been de novo designed to give enough activity for experimental optimization. This thesis presents the current state-of-the-art within computational design methods together...... with a novel method based on probability theory. With the aim of assembling a complete pipeline for protein design, this work touches upon several aspects of protein design. The presented work is the computational half of a design project where the other half is dedicated to the experimental part...

  13. The Design Space

    DEFF Research Database (Denmark)

    Heape, Chris

    was to also understand what was meaningful to the students in their process of designing, a hermeneutic phenomenological research perspective was also adopted throughout this study, where human actions and language are considered as expressions of meaning in the context within which they occur. From......, the one effecting the other. As much as the processes of construction, exploration and expansion of a Design Space can be described in general terms as social and as design activities, it also emerged that there are a number of interrelated processes, sensibilities and skills in constant transaction...... the shifting flow of adjustments and perspectives necessary to relate to the ongoing contingency of a design task. From these interweavings a design proposal is gradually pulled to the fore as an emergent composition, a figure of parts that is directly related to the structure and ground of a Design Space...

  14. Nuclear reactor design

    CERN Document Server

    2014-01-01

    This book focuses on core design and methods for design and analysis. It is based on advances made in nuclear power utilization and computational methods over the past 40 years, covering core design of boiling water reactors and pressurized water reactors, as well as fast reactors and high-temperature gas-cooled reactors. The objectives of this book are to help graduate and advanced undergraduate students to understand core design and analysis, and to serve as a background reference for engineers actively working in light water reactors. Methodologies for core design and analysis, together with physical descriptions, are emphasized. The book also covers coupled thermal hydraulic core calculations, plant dynamics, and safety analysis, allowing readers to understand core design in relation to plant control and safety.

  15. IMPROVING CONCEPTUAL DESIGN QUALITY

    DEFF Research Database (Denmark)

    Bush, Stuart; Robotham, Antony John

    1999-01-01

    designer to identify clear targets for design improvement and to measure the effectiveness of any new solution, whilst attention to QFD ensures customer requirements are still being satisfied.Often, SME's are not aware of many of the best design practices and so are not able to meet the demand......This paper will consider how Quality Function Deployment (QFD) and Design for Manufacture and Assembly (DFMA) processes can be used to improve the design quality of products at the concept stage. We appreciate that both QFD and DFMA are techniques that have been used for some time by mature product...... quality is maintained in design project work. The projects described have been carried out with products manufactured by small to medium sized enterprises (SME's), where we have found significant opportunities for product improvement. The quantitative nature of DFMA analysis results allows the novice...

  16. Performance Aided Design

    DEFF Research Database (Denmark)

    Parigi, Dario

    2014-01-01

    paradigm where the increasing integration of parametric tools and performative analysis is changing the way we learn and design. The term Performance Aided Architectural Design (PAD) is proposed at the Master of Science of Architecture and Design at Aalborg University, with the aim of extending a tectonic...... tradition of architecture with computational tools, preparing the basis for the creation of the figure of a modern master builder, sitting at the boundary of the disciplines of architecture and engineering. Performance Aided Design focuses on the role of performative analysis, embedded tectonics......, and computational methods tools to trigger creativity and innovative understanding of relation between form material and a increasingly wide range of performances in architectural design. The ultimate goal is to pursue a design approach that aims at embracing rather than excluding the complexity implicit...

  17. Ethics and technology design

    DEFF Research Database (Denmark)

    Albrechtslund, Anders

    This article offers a discussion of the connection between technology and values and, specifically, I take a closer look at ethically sound design. In order to bring the discussion into a concrete context, the theory of Value Sensitive Design (VSD) will be the focus point. To illustrate my argument...... concerning design ethics, the discussion involves a case study of an augmented window, designed by the VSD Research Lab, which has turned out to be a potentially surveillanceenabling technology. I call attention to a “positivist problem” that has to do with the connection between the design context......, a design theory must accept that foresight is limited to anticipation rather than prediction. To overcome the positivist problem, I suggest a phenomenological approach to technology inspired by Don Ihde’s concept of multistability. This argument, which is general in nature and thus applies to any theory...

  18. Teaching sustainable design

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, P.; Haggard, K.; Knuckles, A.; Le Noble, J. [California Polytechnic State Univ., San Luis Obispo, CA (United States)

    1995-11-01

    Sustainable design is inclusive, holistic and integrative. It require humility and guts, caring and a certain degree of stubbornness. It helps to do it cooperatively in a group. Human interest in sustainability has gained a great deal of impetus over the last several years as the problems of the late 20th and the early 21st century have become clearer. Design for sustainability broadens and integrates many previously separate design concerns to create a unified approach that is both compelling and ripe with new possibilities. Ecosystem regeneration, ecological land use planning, biometric design, regional environmental and economic viability, natural landscape maintenance, resource optimization, integrated infrastructure system, neotraditional and pedestrian oriented urban design, passive solar architecture, appropriate technology, renewable building materials, healthy buildings, and the aesthetics of place; are a few of these design concerns that, when welded together, can create sustainability.

  19. Human Systems Design Criteria

    DEFF Research Database (Denmark)

    Rasmussen, Jens

    1982-01-01

    This paper deals with the problem of designing more humanised computer systems. This problem can be formally described as the need for defining human design criteria, which — if used in the design process - will secure that the systems designed get the relevant qualities. That is not only...... the necessary functional qualities but also the needed human qualities. The author's main argument is, that the design process should be a dialectical synthesis of the two points of view: Man as a System Component, and System as Man's Environment. Based on a man's presentation of the state of the art a set...... of design criteria is suggested and their relevance discussed. The point is to focus on the operator rather than on the computer. The crucial question is not to program the computer to work on its own conditions, but to “program” the operator to function on human conditions....

  20. The Strategic Design Perspective

    DEFF Research Database (Denmark)

    Rasmussen, Jørgen

    2006-01-01

    In this article I argue, and exemplify, that designers working in close relation with industry, can have significant influence on the nature and the quality of the products (or services) produced by the companies. In order to achieve this, the designer must become one of the decisive factors...... in the strategic framework of the company. This is done by taking the design process to the business floor of the company and using the design competence to innovate, not only products, but the fundamental concepts for product selection. Using design as a strategic tool will cause entirely new products to emerge...... and will make entire groups of products change into services. In this way new markets will appear to benefit the innovative companies, and if designers do their job well, the focus will be on the users, and thereby benefiting them as well. An example of this process is Novo Nordisk. This pharmaceutical company...