Generic environmental impact statement for license renewal of nuclear plants

International Nuclear Information System (INIS)

1996-05-01

Volume 2 of the Generic Environmental Impact Statement for License Renewal of Nuclear Plants contains the appendices. These include: (A) General characterisitics and environmental settings of domestic nuclear plants, (B) Definition of impact initiators, (C) Socioeconomics and case studies, (D) Aquatic organisms and human health, (E) Radiation protection considerations, (F) Methodology for assessing impacts to aquatic ecology and water resources, (G) Postulated accidents, and (H) Environmental statutes and regulations affecting license renewal

Measuring the impact of cataract surgery on generic and vision-specific quality of life.

Science.gov (United States)

Groessl, Erik J; Liu, Lin; Sklar, Marisa; Tally, Steven R; Kaplan, Robert M; Ganiats, Theodore G

2013-08-01

Cataracts are the leading cause of blindness worldwide and cause visual impairment for millions of adults in the United States. We compared the sensitivity of a vision-specific health-related quality of life (HRQOL) measure to that of multiple generic measures of HRQOL before and at 2 time points after cataract surgery. Participants completed 1 vision-specific and 5 generic quality of life measures before cataract surgery, and again 1 and 6 months after surgery. Random effects modeling was used to measure changes over the three assessment points. The NEI-VFQ25 total score and all 11 subscales showed significant improvements during the first interval (baseline and 1 month). During the second interval (1-6 months post-surgery), significant improvements were observed on the total score and 5 of 11 NEI-VFQ25 subscales. There were significant increases in HRQOL during the first interval on some preference-based generic HRQOL measures, though changes during the second interval were mostly non-significant. None of the SF-36v2™ or SF6D scales changed significantly between any of the assessment periods. The NEI-VFQ25 was sensitive to changes in vision-specific domains of QOL. Some preference-based generic HRQOL measures were also sensitive to change and showed convergence with the NEI-VFQ25, but the effects were small. The SF-36v2™ and SF-6D did not change in a similar manner, possibly reflecting a lack of vision-related content. Studies seeking to document both the vision-specific and generic HRQOL improvements of cataract surgery should consider these results when selecting measures.

Peritumoral Artery Scoring System: a Novel Scoring System to Predict Renal Function Outcome after Laparoscopic Partial Nephrectomy.

Science.gov (United States)

Zhang, Ruiyun; Wu, Guangyu; Huang, Jiwei; Shi, Oumin; Kong, Wen; Chen, Yonghui; Xu, Jianrong; Xue, Wei; Zhang, Jin; Huang, Yiran

2017-06-06

The present study aimed to assess the impact of peritumoral artery characteristics on renal function outcome prediction using a novel Peritumoral Artery Scoring System based on computed tomography arteriography. Peritumoral artery characteristics and renal function were evaluated in 220 patients who underwent laparoscopic partial nephrectomy and then validate in 51 patients with split and total glomerular filtration rate (GFR). In particular, peritumoral artery classification and diameter were measured to assign arteries into low, moderate, and high Peritumoral Artery Scoring System risk categories. Univariable and multivariable logistic regression analyses were then used to determine risk factors for major renal functional decline. The Peritumoral Artery Scoring System and four other nephrometry systems were compared using receiver operating characteristic curve analysis. The Peritumoral Artery Scoring System was significantly superior to the other systems for predicting postoperative renal function decline (p system was a superior independent predictor of estimated glomerular filtration rate (eGFR) decline (area-under-the-curve = 0.865, p renal function outcome after laparoscopic partial nephrectomy.

Application of the ICRP approach for radiological protection of the marine environment in generic impact assessments

Energy Technology Data Exchange (ETDEWEB)

Kliaus, Viktoryia [Republican Scientific-Practical Centre of Hygiene, Laboratory of Radiation Safety, Akademicheskaya str. 8, 220012, Minsk (Belarus); Telleria, Diego M. [IAEA-Assessment and Management of Environmental Releases Unit, Wagramer Strasse 5 - PO Box 100, A-1400, Vienna (Austria); Cabianca, Tiberio [Centre for Radiation, Chemical and Environmental Hazards, PHE, Chilton, Didcot, Oxfordshire OX11 0RQ (United Kingdom)

2014-07-01

This paper presents a way to use the ICRP approach for protection of the environment in generic assessments of the radiological impact of radioactive releases to the marine environment. Generic assessments of radiological impact to the environment are needed in certain circumstances, for example, when input data are limited or when the likely radiological consequences are expected to be not significant. Under these circumstances the effort in performing the assessment must be commensurate with the potential radiological consequences. The generic assessment described in this paper is a simple tool which provides reasonable and cautious results and is applicable to multiple exposure scenarios associated with the assessment of the radiological impact of releases to the marine the environment. This generic assessment can be also used to provide preliminary results which, when compared to radiological criteria, may determine the need of further specific assessments. The ICRP based its approach to protect the environment in the definition of a set of reference animals and plants and the use of related radiological criteria, in the form of derived consideration reference levels. The paper discusses selection and exposure conditions of the reference animals and plants, methods to estimate their doses and the use of the radiological criteria, for the purpose of a generic assessment. The IAEA is elaborating applications of these generic impact assessments presented in the paper to be included in international guidance under development. (authors)

Impact of a new simplified disability scoring system for adult patients with localized scleroderma.

Science.gov (United States)

Okiyama, Naoko; Asano, Yoshihide; Hamaguchi, Yasuhito; Jinnin, Masatoshi; Motegi, Sei-Ichiro; Koizumi, Haruka; Hasegawa, Minoru; Ishikawa, Osamu; Sato, Shinichi; Takehara, Kazuhiko; Yamamoto, Toshiyuki; Fujimoto, Manabu; Ihn, Hironobu

2018-04-01

Localized scleroderma (LoS) involves dermal but not internal inflammation and fibrosis. Cosmetic changes often impact quality of life (QOL), however, impairment of activities of daily living (ADL) in LoS patients has not been investigated. To determine what factor(s) are associated with ADL in adult patients with LoS, we performed a retrospective observational study in 177 Japanese adult LoS patients using a novel LoS disability score based on Barthel's indices of ADL: feeding, bathing, grooming, dressing, bowels, bladder, toilet use, transfers, mobility and stairs. LoS disability scores increased in proportion to the number of affected body parts but were not correlated to age and duration of illness. The presence of leg lesions significantly impaired ADL of LoS patients compared with lesions on other body parts. Patients treated with systemic medications, who tended to have multiple lesions, presented higher LoS disability scores than those without systemic treatments. Our study proposes that physicians evaluate ADL, not only QOL, in LoS patients. Our findings using LoS disability scoring indicate that multiple affected body parts and leg lesions are risk factors for ADL impairment. © 2018 Japanese Dermatological Association.

Generic 12-Bus Test System for Wind Power Integration Studies

DEFF Research Database (Denmark)

Adamczyk, Andrzej Grzegorz; Altin, Müfit; Göksu, Ömer

2012-01-01

, inertial response, frequency control, damping of electromechanical oscillations, balanced and unbalanced fault management, etc. Hence, the power system components: conventional power plants with controls, transmission lines, transformers and loads should be represented accurately to achieve realistic power......High wind power penetration levels into power systems requires an appropriate power system model when assessing impact on the overall system stability. The model should capture the wide range of dynamics related to the wind integration studies, such as voltage control, synchronizing power control...... system characteristics. Additionally, the power system model should be simple and computationally manageable in order to simulate multiple scenarios with different control parameters in a reasonable time. In this paper, a generic power system model is presented in order to comprehend the wind integration...

The impact of generic reference pricing in Italy, a decade on.

Science.gov (United States)

Ghislandi, Simone; Armeni, Patrizio; Jommi, Claudio

2013-12-01

The generic reference price (GRP) was introduced in Italy in 2001. The main purpose of this paper is: (a) producing evidence regarding the effect of GRP on prices; (b) testing the hypothesis that there is a reallocation of demand from the genericated (and reference-priced) molecules to patent-protected products that have the same therapeutic indication. The analysis used a unique dataset of quantities and revenues of six therapeutic groups that were observed for more than a decade. Difference-in-differences analysis is applied. Prices are adjusted for all the regulatory interventions in the ten years of observations, to control for confounding impact of these interventions. On average, prices dropped 13% more in groups to which GRP was applied than in other groups. Moreover, each entry of a new generic was associated with a price drop of around 2.8%. On the other hand, GRP did not induce any significant switching towards in-patent molecules. We provide the first empirical results of the impact of GRP on prices in Italy and evidence that GRP cannot be held solely responsible for the often reported demand reallocation towards new and in-patent molecules.

The impact of price-cap regulations on market entry by generic pharmaceutical firms.

Science.gov (United States)

Zhang, Wei; Sun, Huiying; Guh, Daphne; Anis, Aslam H

2017-04-01

In 1998, the province of Ontario, Canada implemented price-cap '70/90' regulations: the first generic must be priced at ≤70% of the associated brand-name price and subsequent generics must be priced at ≤90% of the first generics' price. The price-cap was further lowered to 50% in 2006 and 25% in 2010 for all generic drugs regardless of the first or subsequent generic entrants. This study assessed the impact of such price-cap regulations on market entry by generic firms using the formulary database from 9 provinces (January 2004-March 2013). A logistic regression was estimated to compare the probability of entry during the three policy periods in Ontario ('70/90', '25', versus '50'). Since different price-caps were subsequently introduced in other provinces, Alberta, British Columbia, New Brunswick and Saskatchewan, difference-in-differences was used to compare market entry. In Ontario, compared with the period '50', generic firms were 76% and 63% less likely to enter markets in the periods '25' and '70/90', respectively. The difference-in-differences showed that the entry probability decreased the most in Ontario during the '25' period from the '50' period. Lowering the price-cap level to 25% leads to a significantly lower probability of market entry by generic firms.

Comparison of the responsiveness of the Harris Hip Score with generic measures for hip function in osteoarthritis of the hip.

NARCIS (Netherlands)

Hoeksma, H.L.; Ende, C.H.M. van den; Ronday, H.K.; Heering, A.; Breedveld, F.C.; Dekker, J.

2003-01-01

OBJECTIVE: To compare responsiveness of the Harris Hip Score with generic measures (that is, the Short Form-36 (SF-36), and a test of walking speed and pain during walking) in patients with osteoarthritis (OA) of the hip. METHOD: The first 75 cases within the population of a randomised clinical

Impact of brand or generic labeling on medication effectiveness and side effects.

Science.gov (United States)

Faasse, Kate; Martin, Leslie R; Grey, Andrew; Gamble, Greg; Petrie, Keith J

2016-02-01

Branding medication with a known pharmaceutical company name or product name bestows on the drug an added assurance of authenticity and effectiveness compared to a generic preparation. This study examined the impact of brand name and generic labeling on medication effectiveness and side effects. 87 undergraduate students with frequent headaches took part in the study. Using a within-subjects counterbalanced design, each participant took tablets labeled either as brand name "Nurofen" or "Generic Ibuprofen" to treat each of 4 headaches. In reality, half of the tablets were placebos, and half were active ibuprofen (400 mg). Participants recorded their headache pain on a verbal descriptor and visual analogue scale prior to taking the tablets, and again 1 hour afterward. Medication side effects were also reported. Pain reduction following the use of brand name labeled tablets was similar in active ibuprofen or a placebo. However, if the tablets had a generic label, placebo tablets were significantly less effective compared to active ibuprofen. Fewer side effects were attributed to placebo tablets with brand name labeling compared to the same placebo tablets with a generic label. Branding of a tablet appears to have conferred a treatment benefit in the absence of an active ingredient, while generic labeled tablets were substantially less effective if they contained no active ingredient. Branding is also associated with reduced attribution of side effects to placebo tablets. Future interventions to improve perceptions of generics may have utility in improving treatment outcomes from generic drugs. (c) 2016 APA, all rights reserved).

The impact of reference pricing and extension of generic substitution on the daily cost of antipsychotic medication in Finland.

Science.gov (United States)

Koskinen, Hanna; Ahola, Elina; Saastamoinen, Leena K; Mikkola, Hennamari; Martikainen, Jaana E

2014-12-01

To assess the impact of reference pricing and extension of generic substitution on the daily cost of antipsychotic drugs in Finland during the first year after its launch. Furthermore, the additional impact of reference pricing on prior implemented generic substitution is assessed. A retrospective analysis was performed between 2006 and 2010. A segmented linear regression analysis of interrupted time series was used to estimate changes in the levels and trends in the cost of one day of treatment. Of the study drugs, clozapine belonged to generic substitution already at the start of the study period while olanzapine and quetiapine were included in generic substitution alongside with reference pricing in 2009. Risperidone was included in generic substitution in 2008, before reference pricing. A substantial decrease in the daily cost of all four antipsychotic substances was seen after one year of the implementation of reference pricing and the extension of generic substitution. The impact ranged from -29.9% to -66.3%, and it was most substantial on the daily cost of olanzapine. Also in the daily cost of risperidone a substantial decrease of -43.3% was observed. However, most of these savings, -32.6%, were generated by generic substitution which had been adopted prior. Reference pricing and the extension of generic substitution produced substantial savings on antipsychotic medication costs during the first year after its launch, but the intensity of the impact differed between active substances. Furthermore, our results suggest that the additional cost savings from reference pricing after prior implemented generic substitution, are comparatively low.

Brand vs generic adverse event reporting patterns: An authorized generic-controlled evaluation of cardiovascular medications.

Science.gov (United States)

Alatawi, Y; Rahman, Md M; Cheng, N; Qian, J; Peissig, P L; Berg, R L; Page, C D; Hansen, R A

2018-06-01

Some public scepticism exists about generics in terms of whether brand and generic drugs produce identical outcomes. This study explores whether adverse event (AE) reporting patterns are similar between brand and generic drugs, using authorized generics (AGs) as a control for possible generic drug perception biases. Events reported to the FDA Adverse Event Reporting System from the years 2004-2015 were analysed. Drugs were classified as brand, AG or generic based on drug and manufacturer names. Reports were included if amlodipine, losartan, metoprolol extended release (ER) or simvastatin were listed as primary or secondary suspect drugs. Disproportionality analyses using the reporting odds ratio (ROR) assessed the relative rate of reporting labelled AEs compared to reporting these AEs with all other drugs. The Breslow-Day test compared RORs across brand, AG and generic. Interrupted time series analysis evaluated the impact of generic entry on reporting trends. Generics accounted for significant percentages of total U.S. reports, but AGs accounted for smaller percentages of reports, including for amlodipine (14.26%), losartan (1.48%), metoprolol ER (0.35%) and simvastatin (0.70%). Whereas the RORs were significantly different for multiple brand vs generic comparisons, the AG vs generic comparisons yielded fewer statistically significant findings. Namely, only the ROR for AG differed from generic for amlodipine with peripheral oedema (P brand and generic compared with AG and generic. Use of AGs as a control for perception biases against generics is useful, but this approach can be limited by small AG report numbers. Requiring the manufacturer name to be printed on the prescription bottle or packaging could improve the accuracy of assignment for products being reported. © 2017 John Wiley & Sons Ltd.

Establishment of a general NAFLD scoring system for rodent models and comparison to human liver pathology.

Directory of Open Access Journals (Sweden)

Wen Liang

Full Text Available The recently developed histological scoring system for non-alcoholic fatty liver disease (NAFLD by the NASH Clinical Research Network (NASH-CRN has been widely used in clinical settings, but is increasingly employed in preclinical research as well. However, it has not been systematically analyzed whether the human scoring system can directly be converted to preclinical rodent models. To analyze this, we systematically compared human NAFLD liver pathology, using human liver biopsies, with liver pathology of several NAFLD mouse models. Based upon the features pertaining to mouse NAFLD, we aimed at establishing a modified generic scoring system that is applicable to broad spectrum of rodent models.The histopathology of NAFLD was analyzed in several different mouse models of NAFLD to define generic criteria for histological assessment (preclinical scoring system. For validation of this scoring system, 36 slides of mouse livers, covering the whole spectrum of NAFLD, were blindly analyzed by ten observers. Additionally, the livers were blindly scored by one observer during two separate assessments longer than 3 months apart.The criteria macrovesicular steatosis, microvesicular steatosis, hepatocellular hypertrophy, inflammation and fibrosis were generally applicable to rodent NAFLD. The inter-observer reproducibility (evaluated using the Intraclass Correlation Coefficient between the ten observers was high for the analysis of macrovesicular steatosis and microvesicular steatosis (ICC = 0.784 and 0.776, all p<0.001, respectively and moderate for the analysis of hypertrophy and inflammation (ICC = 0.685 and 0.650, all p<0.001, respectively. The intra-observer reproducibility between the different observations of one observer was high for the analysis of macrovesicular steatosis, microvesicular steatosis and hypertrophy (ICC = 0.871, 0.871 and 0.896, all p<0.001, respectively and very high for the analysis of inflammation (ICC = 0.931, p

Economic Impacts of the Generic Drug User Fee Act Fee Structure.

Science.gov (United States)

Dong, Ke; Boehm, Garth; Zheng, Qiang

2017-06-01

A Food and Drug Administration (FDA) Generic Drug User system, Generic Drug User Fee Amendment of 2012 (GDUFA), started October 1, 2012, and has been in place for over 3 years. There is controversy about the GDUFA fee structure but no analysis of GDUFA data that we could find. To look at the economic impact of the GDUFA fee structure. We compared the structure of GDUFA with that of other FDA Human Drug User fees. We then, using FDA-published information, analyzed where GDUFA facility and Drug Master File fees are coming from. We used the Orange Book to identify the sponsors of all approved Abbreviated New Drug Applications (ANDAs) and the S&P Capital IQ database to find the ultimate parent companies of sponsors of approved ANDAs. The key differences between the previous structure for Human Drug User fees and the GDUFA are as follows: GDUFA has no approved product fee and no first-time or small business fee exemptions and GDUFA charges facility fees from the time of filing and charges a foreign facility levy. Most GDUFA fees are paid by or on behalf of foreign entities. The top 10 companies hold nearly 50% of all approved ANDAs but pay about 14% of GDUFA facility fees. We conclude that the regressive nature of the GDUFA fee structure penalizes small, new, and foreign firms while benefiting the large established firms. A progressive fee structure in line with other human drug user fees is needed to ensure a healthy generic drug industry. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The impact of generic substitution on the activities of pharmaceutical companies - a survey from the companies' perspective one year and five years after the introduction of generic substitution in finland.

Science.gov (United States)

Timonen, Johanna; Bengtström, Marina; Karttunen, Pekka; Ahonen, Riitta

2010-10-22

Mandatory generic substitution (GS) was introduced in Finland on 1 April 2003. The aim of this study was to explore and compare the impacts of GS on the activities of pharmaceutical companies representing mainly original or generic pharmaceutical products in Finland. The self-reported impact of GS from pharmaceutical companies' perspective was explored with a focus on the number of employees, the range of sales packages on the market, the marketing activities, the research and development of new pharmaceutical products and storage of pharmaceuticals. A cross-sectional postal survey was conducted among pharmaceutical companies with an office in Finland and substitutable medicines in the Finnish pharmaceutical market one year (2004) and five years (2008) after the introduction of GS. Completed questionnaires were returned by 16 original and 7 generic product companies in 2004 (response rate 56%, n = 41) and by 16 original and 6 generic product companies in 2008 (response rate 56%, n = 39). Descriptive statistical analyses were performed. The number of employees (2004: n = 6/16, 2008: n = 7/16) and the amount of prescription medicine marketing (2004: n = 7/16, 2008: n = 8/16) decreased in many of the original product companies after the introduction of GS. GS resulted in problems related to the storage of pharmaceuticals in the original product companies shortly after GS was introduced (p = 0.032 between 2004 and 2008). In the generic product companies, the prescription medicine representatives' visits to pharmacies increased at the beginning of GS (p = 0.021 between 2004 and 2008). In addition, GS caused problems with the storage of pharmaceuticals one year and five years after the reform (2004: n = 4/7, 2008: n = 3/6). The differences between original and generic product companies regarding the impacts of GS were not, however, statistically significant. GS did not affect on the range of sales packages on the market or the research activities of the majority of

Using generic tool kits to build intelligent systems

Science.gov (United States)

Miller, David J.

1994-01-01

The Intelligent Systems and Robots Center at Sandia National Laboratories is developing technologies for the automation of processes associated with environmental remediation and information-driven manufacturing. These technologies, which focus on automated planning and programming and sensor-based and model-based control, are used to build intelligent systems which are able to generate plans of action, program the necessary devices, and use sensors to react to changes in the environment. By automating tasks through the use of programmable devices tied to computer models which are augmented by sensing, requirements for faster, safer, and cheaper systems are being satisfied. However, because of the need for rapid cost-effect prototyping and multi-laboratory teaming, it is also necessary to define a consistent approach to the construction of controllers for such systems. As a result, the Generic Intelligent System Controller (GISC) concept has been developed. This concept promotes the philosophy of producing generic tool kits which can be used and reused to build intelligent control systems.

Generic Sensor Failure Modeling for Cooperative Systems

Science.gov (United States)

Jäger, Georg; Zug, Sebastian

2018-01-01

The advent of cooperative systems entails a dynamic composition of their components. As this contrasts current, statically composed systems, new approaches for maintaining their safety are required. In that endeavor, we propose an integration step that evaluates the failure model of shared information in relation to an application’s fault tolerance and thereby promises maintainability of such system’s safety. However, it also poses new requirements on failure models, which are not fulfilled by state-of-the-art approaches. Consequently, this work presents a mathematically defined generic failure model as well as a processing chain for automatically extracting such failure models from empirical data. By examining data of an Sharp GP2D12 distance sensor, we show that the generic failure model not only fulfills the predefined requirements, but also models failure characteristics appropriately when compared to traditional techniques. PMID:29558435

Generic Bell inequalities for multipartite mulit-dimensional systems

International Nuclear Information System (INIS)

Son, W.; Lee, J.; Kim, M.S.

2005-01-01

Full text: We present generic Bell inequalities for multipartite multi-dimensional systems. They utilize the set of measurements, which are coincident with the generalized version of Greenberger, Horne and Zeilinger (GHZ) paradox. The inequalities that must be satisfied by any local realistic theories are violated by quantum mechanics for even-dimensional multipartite systems. It is also shown that the maximal violation of the inequality is obtained by the generalized GHZ state, which is true multi-body nonseparable state. As a special case for the multipartite two-dimensional systems, it can be shown that the inequality agrees with Bell-Mermin version of inequality. Large sets of variants are shown to naturally emerge from the generic Bell inequalities. We will discuss the particular variants of Bell inequalities that are violated for all the systems including odd-dimensional multipartite systems. Interestingly the variants can be reduced into the Clauser-Horne-Shimony-Holt (CHSH) inequality as well as Ardehali inequality. (author)

How can pharmacist remuneration systems in Europe contribute to generic medicine dispensing?

Directory of Open Access Journals (Sweden)

Dylst P

2012-03-01

Full Text Available Generic medicines can generate larger savings to health care budgets when their use is supported by incentives on both the supply-side and the demand-side. Pharmacists’ remuneration is one factor influencing the dispensing of generic medicines.Objective: The aim of this article is to provide an overview of different pharmacist remuneration systems for generic medicines in Europe, with a view to exploring how pharmacist remuneration systems can contribute to generic medicine dispensing.Methods: Data were obtained from a literature review, a Master thesis in Pharmaceutical Care at the Catholic University of Leuven and a mailing sent to all members of the Pharmaceutical Group of the European Union with a request for information about the local remuneration systems of community pharmacists and the possible existence of reports on discounting practices.Results: Pharmacists remuneration in most European countries consists of the combination of a fixed fee per item and a certain percentage of the acquisition cost or the delivery price of the medicines. This percentage component can be fixed, regressive or capped for very high-cost medicines and acts as a disincentive for dispensing generic medicines. Discounting for generic medicines is common practice in several European countries but information on this practice tends to be confidential. Nevertheless, data for Belgium, France, the Netherlands and United Kingdom indicated that discounting percentages varied from 10% to 70% of the wholesale selling price.Conclusion: Pharmacists can play an important role in the development of a generic medicines market. Pharmacists should not be financially penalized for dispensing generic medicines. Therefore, their remuneration should move towards a fee-for-performance remuneration instead of a price-dependent reimbursement which is currently used in many European countries. Such a fee-for-performance remuneration system provides a stimulus for generic medicines

Simulation system architecture design for generic communications link

Science.gov (United States)

Tsang, Chit-Sang; Ratliff, Jim

1986-01-01

This paper addresses a computer simulation system architecture design for generic digital communications systems. It addresses the issues of an overall system architecture in order to achieve a user-friendly, efficient, and yet easily implementable simulation system. The system block diagram and its individual functional components are described in detail. Software implementation is discussed with the VAX/VMS operating system used as a target environment.

Implementation of IEC Generic Model Type 1 Wind Turbine Generators using RTDS

DEFF Research Database (Denmark)

Cha, Seung-Tae; Wu, Qiuwei; Zhao, Haoran

With the ever increasing penetration of the wind power generation, transmission system operators (TSOs) and distribution system operators (DSOs) are demanding an accurate dynamic wind turbine generator (WTG) models for power system stability studies. However, the confidential requirements from wind...... are useful tools to evaluate the impact of the wind power on the power system stability. Thus, a strong stimulus exists for the development of a generic dynamic model in order to further investigate the dynamic response of WTG under grid disturbances. This paper presents the implementation of the IEC generic...... turbine manufacturers prevent the academia and researchers from working on a real or/and manufacturer specific models. A generic WTG model is of great interest that does not contain the confidential information meanwhile represents the manufacturer specific models. These generic dynamic simulation models...

78 FR 57538 - Proposed Waste Confidence Rule and Draft Generic Environmental Impact Statement

Science.gov (United States)

2013-09-19

..., Chief, Communication, Planning, and Rulemaking Branch Waste Confidence Directorate, Office of Nuclear...-2012-0246] RIN 3150-AJ20 Proposed Waste Confidence Rule and Draft Generic Environmental Impact... disposal (proposed Waste Confidence rule). In addition, the NRC will receive public comment on its...

Performance Assessment Modeling and Sensitivity Analyses of Generic Disposal System Concepts.

Energy Technology Data Exchange (ETDEWEB)

Sevougian, S. David; Freeze, Geoffrey A.; Gardner, William Payton; Hammond, Glenn Edward; Mariner, Paul

2014-09-01

directly, rather than through simplified abstractions. It also a llows for complex representations of the source term, e.g., the explicit representation of many individual waste packages (i.e., meter - scale detail of an entire waste emplacement drift). This report fulfills the Generic Disposal System Analysis Work Packa ge Level 3 Milestone - Performance Assessment Modeling and Sensitivity Analyses of Generic Disposal System Concepts (M 3 FT - 1 4 SN08080 3 2 ).

The AMC Linear Disability Score (ALDS): a cross-sectional study with a new generic instrument to measure disability applied to patients with peripheral arterial disease

NARCIS (Netherlands)

Met, R.; Reekers, J.A.; Koelemay, M.J.W.; Legemate, D.A.; de Haan, R.J.

2009-01-01

Background: The AMC Linear Disability Score (ALDS) is a calibrated generic itembank to measure the level of physical disability in patients with chronic diseases. The ALDS has already been validated in different patient populations suffering from chronic diseases. The aim of this study was to assess

Evaluation of Generic Issue 57: Effects of fire protection system actuation on safety-related equipment

International Nuclear Information System (INIS)

Lambright, J.; Bohn, M.; Lynch, J.; Ross, S.; Brosseau, D.

1992-12-01

Nuclear power plants have experienced actuations of fire protection systems (FPSs) under conditions for which these systems were not intended to actuate and also have experienced advertent actuations with the presence of a fire. These actuations have often damaged safety-related equipment. A review of the impact of past occurrences of both types of such events and their impact on plant safety systems, an analysis of the risk impacts of such events on nuclear power plant safety, and a cost-benefit analysis of potential corrective measures have been performed. Thirteen different scenarios leading to actuation of fire protection systems due to a variety of causes were identified. These scenarios ranged from inadvertent actuation caused by human error to hardware failure, and include seismic root causes and seismic/fire interactions. A quantification of these thirteen root causes, where applicable, was performed on generically applicable scenarios. This document, Volume 4, contains appendices E and F of this report

The Northeast Utilities generic plant computer system

International Nuclear Information System (INIS)

Spitzner, K.J.

1980-01-01

A variety of computer manufacturers' equipment monitors plant systems in Northeast Utilities' (NU) nuclear and fossil power plants. The hardware configuration and the application software in each of these systems are essentially one of a kind. Over the next few years these computer systems will be replaced by the NU Generic System, whose prototype is under development now for Millstone III, an 1150 Mwe Pressurized Water Reactor plant being constructed in Waterford, Connecticut. This paper discusses the Millstone III computer system design, concentrating on the special problems inherent in a distributed system configuration such as this. (auth)

Societal value of generic medicines beyond cost-saving through reduced prices.

Science.gov (United States)

Dylst, Pieter; Vulto, Arnold; Simoens, Steven

2015-01-01

This paper aims to provide an overview of the added societal value of generic medicines beyond their cost-saving potential through reduced prices. In addition, an observational case study will document the impact of generic entry on access to pharmacotherapy in The Netherlands and an illustrative exercise was carried out to highlight the budget impact of generic entry. A narrative literature review was carried out to explore the impact of generic medicines on access to pharmacotherapy, innovation and medication adherence. Data from the Medicines and Medical Devices Information Project database in The Netherlands were used for the case study in which the impact of generic medicine entrance on the budget and the number of users was calculated as an illustrative exercise. Generic medicines have an additional societal value beyond their cost-saving potential through reduced prices. Generic medicines increase access to pharmacotherapy, provide a stimulus for innovation by both originator companies and generic companies and, under the right circumstances, have a positive impact on medication adherence. Generic medicines offer more to society than just their cost-saving potential through reduced prices. As such, governments must not focus only on the prices of generic medicines as this will threaten their long-term sustainability. Governments must therefore act appropriately and implement a coherent set of policies to increase the use of generic medicines.

Potential impact of policy regulation and generic competition on sales of cholesterol lowering medication, antidepressants and acid blocking agents in Belgium.

Science.gov (United States)

Fraeyman, J; Van Hal, G; De Loof, H; Remmen, R; De Meyer, G R Y; Beutels, P

2012-01-01

Pharmaceutical expenditures are increasing as a proportion of health expenditures in most rich countries. Antidepressants, acid blocking agents and cholesterol lowering medication are major contributors to medicine sales around the globe. We aimed to document the possible impact of policy regulations and generic market penetration on the evolution of sales volume and average cost per unit (Defined Daily Doses and packages) of antidepressants, acid blocking agents and cholesterol lowering medication. We extracted data from the IMS health database regarding the public price and sales volume of the antidepressants (selective serotonin reuptake inhibitors (SSRI's), monoamine oxidase inhibitors (MAOl's) and tricyclic and remaining antidepressants (TCA's)), acid blocking agents (proton pump inhibitors (PPl's) and H2 receptor antagonists) and cholesterol lowering medication (statins and fibrates) in Belgium between 1995 and 2009. We describe these sales data in relation to various national policy measures which were systematically searched in official records. Our analysis suggests that particular policy regulations have had immediate impact on sales figures and expenditures on pharmaceuticals in Belgium: changes in reimbursement conditions, a public tender and entry of generic competitors in a reference pricing system. However, possible sustainable effects seem to be counteracted by other mechanisms such as marketing strategies, prescribing behaviour, brand loyalty and the entry of pseudogenerics. It is likely that demand-side measures have a more sustainable impact on expenditure. Compared with other European countries, generic penetration in Belgium remains low. Alternative policy regulations aimed at enlarging the generic market and influencing pharmaceutical expenditures deserve consideration. This should include policies aiming to influence physicians' prescribing and a shared responsibility of pharmacists, physicians and patients towards expenditures.

Modeling of Generic Slung Load System

DEFF Research Database (Denmark)

Bisgaard, Morten; Bendtsen, Jan Dimon; la Cour-Harbo, Anders

2009-01-01

This paper presents the result of the modelling and verification of a generic slung load system using a small-scale helicopter. The model is intended for use in simulation, pilot training, estimation, and control. The model is derived using a redundant coordinate formulation based on Gauss...... slackening and tightening as well as aerodynamic coupling between the helicopter and the load. Furthermore, it is shown how the model can be easily used for multi-lift systems either with multiple helicopters or multiple loads. A numerical stabilisation algorithm is introduced and finally the use...... of the model is illustrated through simulations and flight verifications.  ...

Generic device controller for accelerator control systems

International Nuclear Information System (INIS)

Mariotti, R.; Buxton, W.; Frankel, R.; Hoff, L.

1987-01-01

A new distributed intelligence control system has become operational at the AGS for transport, injection, and acceleration of heavy ions. A brief description of the functionality of the physical devices making up the system is given. An attempt has been made to integrate the devices for accelerator specific interfacing into a standard microprocessor system, namely, the Universal Device Controller (UDC). The main goals for such a generic device controller are to provide: local computing power; flexibility to configure; and real time event handling. The UDC assemblies and software are described

The Impact of Misspelled Words on Automated Computer Scoring: A Case Study of Scientific Explanations

Science.gov (United States)

Ha, Minsu; Nehm, Ross H.

2016-06-01

Automated computerized scoring systems (ACSSs) are being increasingly used to analyze text in many educational settings. Nevertheless, the impact of misspelled words (MSW) on scoring accuracy remains to be investigated in many domains, particularly jargon-rich disciplines such as the life sciences. Empirical studies confirm that MSW are a pervasive feature of human-generated text and that despite improvements, spell-check and auto-replace programs continue to be characterized by significant errors. Our study explored four research questions relating to MSW and text-based computer assessments: (1) Do English language learners (ELLs) produce equivalent magnitudes and types of spelling errors as non-ELLs? (2) To what degree do MSW impact concept-specific computer scoring rules? (3) What impact do MSW have on computer scoring accuracy? and (4) Are MSW more likely to impact false-positive or false-negative feedback to students? We found that although ELLs produced twice as many MSW as non-ELLs, MSW were relatively uncommon in our corpora. The MSW in the corpora were found to be important features of the computer scoring models. Although MSW did not significantly or meaningfully impact computer scoring efficacy across nine different computer scoring models, MSW had a greater impact on the scoring algorithms for naïve ideas than key concepts. Linguistic and concept redundancy in student responses explains the weak connection between MSW and scoring accuracy. Lastly, we found that MSW tend to have a greater impact on false-positive feedback. We discuss the implications of these findings for the development of next-generation science assessments.

The impact of a revised EQ-5D population scoring on preference-based utility scores in an inflammatory arthritis cohort.

LENUS (Irish Health Repository)

Adams, Roisin

2012-02-01

BACKGROUND AND OBJECTIVE: It is well established that there are problems with the EQ-5D. This is due to the original scoring methods used and how negative time trade-off (TTO) values were treated. A revised scoring method has been published. This article applies this to an inflammatory arthritis cohort. The objective is to examine the impact of a revised scoring system for the EQ-5D (UK) TTO on the utility estimates and in the case of rheumatoid arthritis, to explore the impact of using different utility metrics on the incremental cost-effectiveness ratio (ICER) results of an economic model. METHODS: A total of 504 patients with inflammatory arthritis were rescored using revised EQ-5D scoring, which uses an episodic random utility model to deal with negative TTO values. Differences in utility scores were compared and the new mapping coefficients were obtained. These were then used in an economic model to examine the impact on the ICER. RESULTS: In rheumatoid arthritis, the overall change is less for the revised EQ-5D scoring than with the original EQ-5D (TTO) but greater than the SF-6D: EQ-5D UK -0.22 (95% confidence interval [CI] -0.30 to -0.15), revised EQ-5D UK -0.16 (95% CI -0.21 to -0.10) and SF-6D -0.08 (95% CI -0.11 to -0.05). A similar trend is seen in the psoriatic arthritis group. The economic model produced different ICERs, when different utility measures were used; EQ-5D (TTO) euro42,402, SF-6D euro111,788, and revised EQ-5D (TTO) euro57,747. CONCLUSION: In the context of inflammatory arthritis, this article demonstrates that a revised scoring for EQ-5D may have a significant impact on utility estimates and on the output of the economic model.

Impact of alternative interventions on changes in generic dispensing rates.

Science.gov (United States)

O'Malley, A James; Frank, Richard G; Kaddis, Atheer; Rothenberg, Barbara M; McNeil, Barbara J

2006-10-01

To evaluate the effectiveness of four alternative interventions (member mailings, advertising campaigns, free generic drug samples to physicians, and physician financial incentives) used by a major health insurer to encourage its members to switch to generic drugs. Using claim-level data from Blue Cross Blue Shield of Michigan, we evaluated the success of four interventions implemented during 2000-2003 designed to increase the use of generic drugs among its members. Around 13 million claims involving seven important classes of drugs were used to assess the effectiveness of the interventions. For each intervention a control group was developed that most closely resembled the corresponding intervention group. Logistic regression models with interaction effects between the treatment group (intervention versus control) and the status of the intervention (active versus not active) were used to evaluate if the interventions had an effect on the generic dispensing rate (GDR). Because the mail order pharmacy was considered more aggressive at converting prescriptions to generics, separate generic purchasing models were fitted to retail and mail order claims. In secondary analyses separate models were also fitted to claims involving a new condition and claims refilled for preexisting conditions. The interventions did not appear to increase the market penetration of generic drugs for either retail or mail order claims, or for claims involving new or preexisting conditions. In addition, we found that the ratio of copayments for brand name to generic drugs had a large positive effect on the GDR. The interventions did not appear to directly influence the GDR. Financial incentives expressed to consumers through benefit designs have a large influence on their switching to generic drugs and on the less-costly mail-order mode of purchase.

Evolution of the Generic Lock System at Jefferson Lab

International Nuclear Information System (INIS)

Brian Bevins; Yves Roblin

2003-01-01

The Generic Lock system is a software framework that allows highly flexible feedback control of large distributed systems. It allows system operators to implement new feedback loops between arbitrary process variables quickly and with no disturbance to the underlying control system. Several different types of feedback loops are provided and more are being added. This paper describes the further evolution of the system since it was first presented at ICALEPCS 2001 and reports on two years of successful use in accelerator operations. The framework has been enhanced in several key ways. Multiple-input, multiple-output (MIMO) lock types have been added for accelerator orbit and energy stabilization. The general purpose Proportional-Integral-Derivative (PID) locks can now be tuned automatically. The generic lock server now makes use of the Proxy IOC (PIOC) developed at Jefferson Lab to allow the locks to be monitored from any EPICS Channel Access aware client. (Previously clients had to be Cdev aware.) The dependency on the Qt XML parser has been replaced with the freely available Xerces DOM parser from the Apache project

A generic approach for the design of organizational decision support systems (ODSS)

OpenAIRE

Chalal, Rachid; National Institute of Computer Science; Nader, Fahima; National Institute of Computer Science

2007-01-01

The paper proposes a generic approach to design and develop an Organizational Decision Support System (ODSS). This approach is based at the follows definition: the ODSS is considered as the experts' memory and their decision-taking. Therefore, the ODSS is constituted by two elements, a strategic DSS and a specific referential of the decision situation. Our generic approach for ODSS design is based on the MUSIC (Management and Use of Co-operative Information Systems) model. An illustration of ...

The Clinical and Economic Impact of Generic Locking Plate Utilization at a Level II Trauma Center.

Science.gov (United States)

Mcphillamy, Austin; Gurnea, Taylor P; Moody, Alastair E; Kurnik, Christopher G; Lu, Minggen

2016-12-01

In today's climate of cost containment and fiscal responsibility, generic implant alternatives represent an interesting area of untapped resources. As patents have expired on many commonly used trauma implants, generic alternatives have recently become available from a variety of sources. The purpose of this study was to examine the clinical and economic impact of a cost containment program using high quality, generic orthopaedic locking plates. The implants available for study were anatomically precontoured plates for the clavicle, proximal humerus, distal radius, proximal tibia, distal tibia, and distal fibula. Retrospective review. Level II Trauma center. 828 adult patients with operatively managed clavicle, proximal humerus, distal radius, proximal tibia, tibial pilon, and ankle fractures. Operative treatment with conventional or generic implants. The 414 patients treated with generic implants were compared with 414 patients treated with conventional implants. There were no significant differences in age, sex, presence of diabetes, smoking history or fracture type between the generic and conventional groups. No difference in operative time, estimated blood loss or intraoperative complication rate was observed. No increase in postoperative infection rate, hardware failure, hardware loosening, malunion, nonunion or need for hardware removal was noted. Overall, our hospital realized a 56% reduction in implant costs, an average savings of $1197 per case, and a total savings of $458,080 for the study period. Use of generic orthopaedic implants has been successful at our institution, providing equivalent clinical outcomes while significantly reducing implant expenditures. Based on our data, the use of generic implants has the potential to markedly reduce operative costs as long as quality products are used. Therapeutic Level III.

Impact of Spacing of Practice on Learning Brand Name and Generic Drugs.

Science.gov (United States)

Terenyi, James; Anksorus, Heidi; Persky, Adam M

2018-02-01

Objective. To test the impact of schedules of retrieval practice on learning brand and generic name drug information in a self-paced course. Methods. Students completed weekly quizzes on brand and generic name conversions for 100 commonly prescribed drugs. Each student completed part of the drug list on a schedule of equal, expanding, or contracting spacing, one practice (massed) or study only in a partial block design. Results. On measures of long-term retention, the contracting spacing schedule led to superior retention (67%) compared to the massed practice (50%) and study-only condition (46%); contracting practice also was significantly higher than expanding practice (58%,) or equal practice (59%). Overall performance decreased by almost 50% (final exam 95%, long-term retention 55%) over a 6-week period. Conclusion. A contracting spacing schedule was the most effective schedule of practice, and all spacing schedules were superior to massed practice or study-only conditions.

78 FR 37325 - License Renewal of Nuclear Power Plants; Generic Environmental Impact Statement and Standard...

Science.gov (United States)

2013-06-20

... Nuclear Power Plants; Generic Environmental Impact Statement and Standard Review Plans for Environmental... for Nuclear Power Plants, Supplement 1: Operating License Renewal'' (ESRP). The ESRP serves as a guide... published a final rule, ``Revisions to Environmental Review for Renewal of Nuclear Power Plant Operating...

Generic adaptation framework for unifying adaptive web-based systems

NARCIS (Netherlands)

Knutov, E.

2012-01-01

The Generic Adaptation Framework (GAF) research project first and foremost creates a common formal framework for describing current and future adaptive hypermedia (AHS) and adaptive webbased systems in general. It provides a commonly agreed upon taxonomy and a reference model that encompasses the

Generic Formal Framework for Compositional Analysis of Hierarchical Scheduling Systems

DEFF Research Database (Denmark)

Boudjadar, Jalil; Hyun Kim, Jin; Thi Xuan Phan, Linh

We present a compositional framework for the specification and analysis of hierarchical scheduling systems (HSS). Firstly we provide a generic formal model, which can be used to describe any type of scheduling system. The concept of Job automata is introduced in order to model job instantiation...

A new generic system for the pantropical Caesalpinia group (Leguminosae

Directory of Open Access Journals (Sweden)

Edeline Gagnon

2016-10-01

Full Text Available The Caesalpinia group is a large pantropical clade of ca. 205 species in subfamily Caesalpinioideae (Leguminosae in which generic delimitation has been in a state of considerable flux. Here we present new phylogenetic analyses based on five plastid and one nuclear ribosomal marker, with dense taxon sampling including 172 (84% of the species and representatives of all previously described genera in the Caesalpinia group. These analyses show that the current classification of the Caesalpinia group into 21 genera needs to be revised. Several genera (Poincianella, Erythrostemon, Cenostigma and Caesalpinia sensu Lewis, 2005 are non-monophyletic and several previously unclassified Asian species segregate into clades that merit recognition at generic rank. In addition, the near-completeness of our taxon sampling identifies three species that do not belong in any of the main clades and these are recognised as new monospecific genera. A new generic classification of the Caesalpinia group is presented including a key for the identification of genera, full generic descriptions, illustrations (drawings and photo plates of all genera, and (for most genera the nomenclatural transfer of species to their correct genus. We recognise 26 genera, with reinstatement of two previously described genera (Biancaea Tod., Denisophytum R. Vig., re-delimitation and expansion of several others (Moullava, Cenostigma, Libidibia and Erythrostemon, contraction of Caesalpinia s.s. and description of four new ones (Gelrebia, Paubrasilia, Hererolandia and Hultholia, and make 75 new nomenclatural combinations in this new generic system.

Controllability of non-linear systems: generic singularities and their stability

International Nuclear Information System (INIS)

Davydov, Alexey A; Zakalyukin, Vladimir M

2012-01-01

This paper presents an overview of the state of the art in applications of singularity theory to the analysis of generic singularities of controllability of non-linear systems on manifolds. Bibliography: 40 titles.

Methodological Considerations for Comparison of Brand Versus Generic Versus Authorized Generic Adverse Event Reports in the US Food and Drug Administration Adverse Event Reporting System (FAERS).

Science.gov (United States)

Rahman, Md Motiur; Alatawi, Yasser; Cheng, Ning; Qian, Jingjing; Peissig, Peggy L; Berg, Richard L; Page, David C; Hansen, Richard A

2017-12-01

The US Food and Drug Administration Adverse Event Reporting System (FAERS), a post-marketing safety database, can be used to differentiate brand versus generic safety signals. To explore the methods for identifying and analyzing brand versus generic adverse event (AE) reports. Public release FAERS data from January 2004 to March 2015 were analyzed using alendronate and carbamazepine as examples. Reports were classified as brand, generic, and authorized generic (AG). Disproportionality analyses compared reporting odds ratios (RORs) of selected known labeled serious adverse events stratifying by brand, generic, and AG. The homogeneity of these RORs was compared using the Breslow-Day test. The AG versus generic was the primary focus since the AG is identical to brand but marketed as a generic, therefore minimizing generic perception bias. Sensitivity analyses explored how methodological approach influenced results. Based on 17,521 US event reports involving alendronate and 3733 US event reports involving carbamazepine (immediate and extended release), no consistently significant differences were observed across RORs for the AGs versus generics. Similar results were obtained when comparing reporting patterns over all time and just after generic entry. The most restrictive approach for classifying AE reports yielded smaller report counts but similar results. Differentiation of FAERS reports as brand versus generic requires careful attention to risk of product misclassification, but the relative stability of findings across varying assumptions supports the utility of these approaches for potential signal detection.

Evaluation of modified Alvarado scoring system and RIPASA scoring system as diagnostic tools of acute appendicitis.

Science.gov (United States)

Shuaib, Abdullah; Shuaib, Ali; Fakhra, Zainab; Marafi, Bader; Alsharaf, Khalid; Behbehani, Abdullah

2017-01-01

Acute appendicitis is the most common surgical condition presented in emergency departments worldwide. Clinical scoring systems, such as the Alvarado and modified Alvarado scoring systems, were developed with the goal of reducing the negative appendectomy rate to 5%-10%. The Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system was established in 2008 specifically for Asian populations. The aim of this study was to compare the modified Alvarado with the RIPASA scoring system in Kuwait population. This study included 180 patients who underwent appendectomies and were documented as having "acute appendicitis" or "abdominal pain" in the operating theatre logbook (unit B) from November 2014 to March 2016. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, predicted negative appendectomy and receiver operating characteristic (ROC) curve of the modified Alvarado and RIPASA scoring systems were derived using SPSS statistical software. A total of 136 patients were included in this study according to our criteria. The cut-off threshold point of the modified Alvarado score was set at 7.0, which yielded a sensitivity of 82.8% and a specificity of 56%. The PPV was 89.3% and the NPV was 42.4%. The cut-off threshold point of the RIPASA score was set at 7.5, which yielded a 94.5% sensitivity and an 88% specificity. The PPV was 97.2% and the NPV was 78.5%. The predicted negative appendectomy rates were 10.7% and 2.2% for the modified Alvarado and RIPASA scoring systems, respectively. The negative appendectomy rate decreased significantly, from 18.4% to 10.7% for the modified Alvarado, and to 2.2% for the RIPASA scoring system, which was a significant difference (PAsian populations. It consists of 14 clinical parameters that can be obtained from a good patient history, clinical examination and laboratory investigations. The RIPASA scoring system is more accurate and specific than the modified Alvarado

Final generic environmental impact statement on decommissioning of nuclear facilities

International Nuclear Information System (INIS)

1988-08-01

This final generic environmental impact statement was prepared as part of the requirement for considering changes in regulations on decommissioning of commercial nuclear facilities. Consideration is given to the decommissioning of pressurized water reactors, boiling water reactors, research and test reactors, fuel reprocessing plants (FRPs) (currently, use of FRPs in the commercial sector is not being considered), small mixed oxide fuel fabrication plants, uranium hexafluoride conversion plants, uranium fuel fabrication plants, independent spent fuel storage installations, and non-fuel-cycle facilities for handling byproduct, source and special nuclear materials. Decommissioning has many positive environmental impacts such as the return of possibly valuable land to the public domain and the elimination of potential problems associated with increased numbers of radioactively contaminated facilities with a minimal use of resources. Major adverse impacts are shown to be routine occupational radiation doses and the commitment of nominally small amounts of land to radioactive waste disposal. Other impacts, including public radiation doses, are minor. Mitigation of potential health, safety, and environmental impacts requires more specific and detailed regulatory guidance than is currently available. Recommendations are made as to regulatory decommissioning particulars including such aspects as decommissioning alternatives, appropriate preliminary planning requirements at the time of commissioning, final planning requirements prior to termination of facility operations, assurance of funding for decommissioning, environmental review requirements. 26 refs., 7 figs., 68 tabs

Does educational intervention improve doctors’ knowledge and perceptions of generic medicines and their generic prescribing rate? A study from Malaysia

Science.gov (United States)

Wong, Zhi Yen; Alrasheedy, Alian A.; Saleem, Fahad; Mohamad Yahaya, Abdul Haniff; Aljadhey, Hisham

2014-01-01

Objectives: To investigate the impact of an educational intervention on doctors’ knowledge and perceptions towards generic medicines and their generic (international non-proprietary name) prescribing practice. Methods: This is a single-cohort pre-/post-intervention pilot study. The study was conducted in a tertiary care hospital in Perak, Malaysia. All doctors from the internal medicine department were invited to participate in the educational intervention. The intervention consisted of an interactive lecture, an educational booklet and a drug list. Doctors’ knowledge and perceptions were assessed by using a validated questionnaire, while the international non-proprietary name prescribing practice was assessed by screening the prescription before and after the intervention. Results: The intervention was effective in improving doctors’ knowledge towards bioequivalence, similarity of generic medicines and safety standards required for generic medicine registration (p = 0.034, p = 0.034 and p = 0.022, respectively). In terms of perceptions towards generic medicines, no significant changes were noted (p > 0.05). Similarly, no impact on international non-proprietary name prescribing practice was observed after the intervention (p > 0.05). Conclusion: Doctors had inadequate knowledge and misconceptions about generic medicines before the intervention. Moreover, international non-proprietary name prescribing was not a common practice. However, the educational intervention was only effective in improving doctors’ knowledge of generic medicines. PMID:26770747

A Review of Generic Program Visualization Systems for Introductory Programming Education

Science.gov (United States)

Sorva, Juha; Karavirta, Ville; Malmi, Lauri

2013-01-01

This article is a survey of program visualization systems intended for teaching beginners about the runtime behavior of computer programs. Our focus is on generic systems that are capable of illustrating many kinds of programs and behaviors. We inclusively describe such systems from the last three decades and review findings from their empirical…

Impact of the trade-related aspects of intellectual property rights (TRIPS) agreement on India as a supplier of generic antiretrovirals.

Science.gov (United States)

Babovic, Sonja; Wasan, Kishor M

2011-03-01

This is a commentary on how the trade-related aspects of intellectual property rights (TRIPS) agreement has impacted India as a supplier of generic antiretrovirals (ARVs). We provide a systematic review of the issues related to the TRIPS agreement that affects India. This includes discussion around (a) the legal landscape underpinning India as a supplier of generic ARVs; (b) supply of second-line ARVs; and (c) the future of generic drug production in India. The proclamation into force of TRIPS-compliant intellectual property law in India is likely to affect its position as a supplier of affordable ARVs, especially drugs brought to market after 2005. Currently, mechanisms exist for the generic production of almost all ARVs in India, including second-line drugs; however, the manufacture of these drugs by generic pharmaceutical companies may require additional market incentives. Compulsory licensing may emerge as an additional mechanism by which India can provide affordable versions of patented drugs to Least Developed Countries (LDCs). Copyright © 2010 Wiley-Liss, Inc.

Impact of advanced wind power ancillary services on power system

DEFF Research Database (Denmark)

Hansen, Anca Daniela; Altin, Müfit

The objective of this report is to illustrate and analyse, by means of simulation test cases, the impact of wind power advanced ancillary services, like inertial response (IR), power oscillation damping (POD) and synchronising power (SP) on the power system. Generic models for wind turbine, wind...... power plant and power system are used in the investigation....

GENERIC Integrators: Structure Preserving Time Integration for Thermodynamic Systems

Science.gov (United States)

Öttinger, Hans Christian

2018-04-01

Thermodynamically admissible evolution equations for non-equilibrium systems are known to possess a distinct mathematical structure. Within the GENERIC (general equation for the non-equilibrium reversible-irreversible coupling) framework of non-equilibrium thermodynamics, which is based on continuous time evolution, we investigate the possibility of preserving all the structural elements in time-discretized equations. Our approach, which follows Moser's [1] construction of symplectic integrators for Hamiltonian systems, is illustrated for the damped harmonic oscillator. Alternative approaches are sketched.

A Generic Modeling Process to Support Functional Fault Model Development

Science.gov (United States)

Maul, William A.; Hemminger, Joseph A.; Oostdyk, Rebecca; Bis, Rachael A.

2016-01-01

Functional fault models (FFMs) are qualitative representations of a system's failure space that are used to provide a diagnostic of the modeled system. An FFM simulates the failure effect propagation paths within a system between failure modes and observation points. These models contain a significant amount of information about the system including the design, operation and off nominal behavior. The development and verification of the models can be costly in both time and resources. In addition, models depicting similar components can be distinct, both in appearance and function, when created individually, because there are numerous ways of representing the failure space within each component. Generic application of FFMs has the advantages of software code reuse: reduction of time and resources in both development and verification, and a standard set of component models from which future system models can be generated with common appearance and diagnostic performance. This paper outlines the motivation to develop a generic modeling process for FFMs at the component level and the effort to implement that process through modeling conventions and a software tool. The implementation of this generic modeling process within a fault isolation demonstration for NASA's Advanced Ground System Maintenance (AGSM) Integrated Health Management (IHM) project is presented and the impact discussed.

78 FR 76160 - Public Housing Assessment System (PHAS) Capital Fund Interim Scoring Notice: Reinstitution of...

Science.gov (United States)

2013-12-16

... System (PHAS) Capital Fund Interim Scoring Notice: Reinstitution of Five Points for Occupancy Sub... intended to help lessen the impact of decreases in funding in recent appropriations acts. Adding automatic... to adjust their systems and procedures to the new scoring regime. As a result of automatic across-the...

Uranium milling: Volume 1, Summary and text: Generic environmental impact statement: Draft

International Nuclear Information System (INIS)

1979-04-01

This generic environmental impact statement on uranium milling has been prepared in accordance with a notice of intent published by the Nuclear Regulatory Commission (NRC). The purpose of the statement is to assess the potential environmental impacts of uranium milling operations, in a programmatic context, including the management of uranium mill tailings, and to provide an opportunity for public participation in decisions on any proposed changes in NRC regulations based on this assessment. The principal objectives of the statement are to assess the nature and extent of the environmental impacts of uranium milling in the United states from local, regional, and national perspectives on both short- and long-term bases, to determine what regulatory actions are needed; to provide information on which to determine what regulatory requirements for management and disposal of mill tailings and mill decommissioning should be; and to support any rule makings that may be determined to be necessary. 39 figs., 130 tabs

Uranium milling, project M-25. Volume I. summary and text. Final generic environmental impact statement

International Nuclear Information System (INIS)

1980-09-01

The Final Generic Environmental Impact Statement (GEIS) on Uranium Milling focuses primarily upon the matter of mill tailings disposal. It evaluates both the costs and benefits of alternative tailings disposal modes and draws conclusions about criteria which should be incorporated into regulations. Both institutional and technical controls are evaluated. Health impacts considered were both short and long term. Restatement and resolution of all public comments received on the draft (GEIS) are presented. There are three volumes: Volume I is the main text and Volumes II and III are supporting appendices

THE EFFICIENCY OF TENNIS DOUBLES SCORING SYSTEMS

Directory of Open Access Journals (Sweden)

Geoff Pollard

2010-09-01

Full Text Available In this paper a family of scoring systems for tennis doubles for testing the hypothesis that pair A is better than pair B versus the alternative hypothesis that pair B is better than A, is established. This family or benchmark of scoring systems can be used as a benchmark against which the efficiency of any doubles scoring system can be assessed. Thus, the formula for the efficiency of any doubles scoring system is derived. As in tennis singles, one scoring system based on the play-the-loser structure is shown to be more efficient than the benchmark systems. An expression for the relative efficiency of two doubles scoring systems is derived. Thus, the relative efficiency of the various scoring systems presently used in doubles can be assessed. The methods of this paper can be extended to a match between two teams of 2, 4, 8, …doubles pairs, so that it is possible to establish a measure for the relative efficiency of the various systems used for tennis contests between teams of players.

The impact of generic language about ability on children's achievement motivation.

Science.gov (United States)

Cimpian, Andrei

2010-09-01

Nuances in how adults talk about ability may have important consequences for children's sustained involvement and success in an activity. In this study, I tested the hypothesis that children would be less motivated while performing a novel activity if they were told that boys or girls in general are good at this activity (generic language) than if they were told that a particular boy or girl is good at it (non-generic language). Generic language may be detrimental because it expresses normative societal expectations regarding performance. If these expectations are negative, they may cause children to worry about confirming them; if positive, they may cause worries about failing to meet them. Moreover, generic statements may be threatening because they imply that performance is the result of stable traits rather than effort. Ninety-seven 4- to 7-year-olds were asked to play a game in which they succeeded at first but then made a few mistakes. Since young children remain optimistic in achievement situations until the possibility of failure is made clear, I hypothesized that 4- and 5-year-olds would not be affected by the implications of generic language until after they made mistakes; 6- and 7-year-olds, however, may be susceptible earlier. As expected, the older children who heard that boys or girls are good at this game displayed lower motivation (e.g., more negative emotions, lower perceived competence) from the start, while they were still succeeding and receiving praise. Four- and 5-year-olds who heard these generic statements had a similar reaction, but only after they made mistakes. These findings demonstrate that exposure to generic language about ability can be an obstacle to children's motivation and, potentially, their success.

Simulation of Quantum Many-Body Dynamics for Generic Strongly-Interacting Systems

Science.gov (United States)

Meyer, Gregory; Machado, Francisco; Yao, Norman

2017-04-01

Recent experimental advances have enabled the bottom-up assembly of complex, strongly interacting quantum many-body systems from individual atoms, ions, molecules and photons. These advances open the door to studying dynamics in isolated quantum systems as well as the possibility of realizing novel out-of-equilibrium phases of matter. Numerical studies provide insight into these systems; however, computational time and memory usage limit common numerical methods such as exact diagonalization to relatively small Hilbert spaces of dimension 215 . Here we present progress toward a new software package for dynamical time evolution of large generic quantum systems on massively parallel computing architectures. By projecting large sparse Hamiltonians into a much smaller Krylov subspace, we are able to compute the evolution of strongly interacting systems with Hilbert space dimension nearing 230. We discuss and benchmark different design implementations, such as matrix-free methods and GPU based calculations, using both pre-thermal time crystals and the Sachdev-Ye-Kitaev model as examples. We also include a simple symbolic language to describe generic Hamiltonians, allowing simulation of diverse quantum systems without any modification of the underlying C and Fortran code.

How is the injury severity scored? a brief review of scoring systems

Directory of Open Access Journals (Sweden)

Mohsen Ebrahimi

2015-06-01

Full Text Available The management of injured patients is a critical issue in pre-hospital and emergency departments. Trauma victims are usually young and the injuries may lead to mortality or severe morbidities. The severity of injury can be estimated by observing the anatomic and physiologic evidences. Scoring systems are used to present a scale of describing the severity of the injuries in the victims.We reviewed the evidences of famous scoring systems, the history of their development, applications and their evolutions. We searched electronic database PubMed and Google scholar with keywords: (trauma OR injury AND (severity OR intensity AND (score OR scale.In this paper, we are going to present a definition of scoring systems and discuss the Abbreviated Injury Scale (AIS and Injury Severity Score (ISS, the most acceptable systems, their applications and their advantages and limitations.Several injury-scoring methods have been introduced. Each method has specific features, advantages and disadvantages. The AIS is an anatomical-based scoring system, which provides a standard numerical scale of ranking and comparing injuries. The ISS was established as a platform for trauma data registry. ISS is also an anatomically-based ordinal scale, with a range of 1-75. Several databases and studies are formed based on ISS and are available for trauma management research.Although the ISS is not perfect, it is established as the basic platform of health services and public health researches. The ISS registering system can provide many opportunities for the development of efficient data recording and statistical analyzing models.

Scoring System Improvements to Three Leadership Predictors

National Research Council Canada - National Science Library

Dela

1997-01-01

.... The modified scoring systems were evaluated by rescoring responses randomly selected from the sample which had been scored according to the scoring systems originally developed for the leadership research...

A Comparison of Two Scoring Methods for an Automated Speech Scoring System

Science.gov (United States)

Xi, Xiaoming; Higgins, Derrick; Zechner, Klaus; Williamson, David

2012-01-01

This paper compares two alternative scoring methods--multiple regression and classification trees--for an automated speech scoring system used in a practice environment. The two methods were evaluated on two criteria: construct representation and empirical performance in predicting human scores. The empirical performance of the two scoring models…

Assessment of impact to non-human biota from a generic waste repository in the UK

International Nuclear Information System (INIS)

Smith, K.L.; Robinson, C.A.; Jones, S.R.; Batlle, J.V.; Norris, S.

2008-01-01

The UK Nuclear Decommissioning Authority Radioactive Waste Management Directorate (NDA RWMD, formerly Nirex UK Ltd), has played a leading role in establishing knowledge on geological disposal of radioactive waste in the UK. In 2001, a study was commissioned of the potential impact of releases of radio-nuclides from a generic repository on plants and animals). More recently, the NDA commissioned Enviros Consulting to report on developments in policy and in approaches for assessing impacts of radioactivity on non-human biota, that have occurred since the previous study. A trial application of the ERICA assessment tool, to reassess the impact of releases from a generic deep repository using similar source data as used previously (Nirex, 2003), formed part of this work. This paper summarizes the results of the reassessment exercise; key differences between the two assessments are identified and explored. The applicability and capabilities of the ERICA tool to assessments of releases from a waste repository are discussed and priorities for future work are identified. Conclusions: The peak activity concentrations predicted to arise from releases from a generic repository would not lead to a significant increase in environmental risk. Indeed, a substantial proportion of the calculated dose rates are due to natural series radio-nuclides at concentrations that are well below typical background levels. In the previous study, the highest (weighted) absorbed dose rate in an aquatic system was predicted to be around 6.5 micoGy h -1 , which is of the same order of magnitude as those predicted in the current study; the significance of the contribution of natural series radionuclides is also common to both studies. However, previously, the authors concluded that it was not possible to undertake a detailed assessment for the terrestrial system, due to the paucity of data on concentration ratios. While the derivation of default concentration factors, as part of the ERICA project

Volleyball Scoring Systems.

Science.gov (United States)

Calhoun, William; Dargahi-Noubary, G. R.; Shi, Yixun

2002-01-01

The widespread interest in sports in our culture provides an excellent opportunity to catch students' attention in mathematics and statistics classes. One mathematically interesting aspect of volleyball, which can be used to motivate students, is the scoring system. (MM)

[The patents game. Generic and biosimilar drugs].

Science.gov (United States)

Villamañán, E; González, D; Armada, E; Ruano, M; Álvarez-Sala, R; Herrero, A

2016-01-01

The protection provided by patents on medicines has a limited duration. The expiry of patents expiration allows copies of the drugs to be released, competing with original. At first, they were identical to the original, known as generic drugs, but in recent years, due to the marketing of biological therapies and the expiry of many of their patents, biosimilar drugs have also emerged. These are not exact copies of the original, but, like generic drugs, biosimilar drugs have to demonstrate equivalence to the reference drugs in quality, safety and efficacy. Nevertheless, despite their importance and contribution to sustainability of health system, doctors are sometimes unaware of differences between them, and their impact in terms of clinical and economic effects. An attempt is made to review and clarify certain aspects often unknown by physicians, despite their involvement in their use. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

Brand loyalty, patients and limited generic medicines uptake.

Science.gov (United States)

Costa-Font, Joan; Rudisill, Caroline; Tan, Stefanie

2014-06-01

The sluggish development of European generic drug markets depends heavily on demand side factors, and more specifically, patients' and doctors' loyalty to branded products. Loyalty to originator drugs, to the point where originator prices rise upon generic entry has been described as the 'generics paradox'. Originator loyalty can emerge for a plethora of reasons; including costs, perceptions about quality and physician advice. We know very little about the behavioural underpinnings of brand loyalty from the consumer or patient standpoint. This paper attempts to test the extent to which patients are brand loyal by drawing upon Spain's 2002 Health Barometer survey as it includes questions about consumer acceptance of generics in a country with exceptionally low generic uptake and substitution at the time of the study. Our findings suggest that at least 13% of the population would not accept generics as substitutes to the originator. These results confirm evidence of brand loyalty for a minority. Alongside high levels of awareness of generics, we find that low cost-sharing levels explain consumer brand loyalty but their impact on acceptance of generic substitution is very small. Higher cost-sharing and exempting fewer patients from cost-sharing have the potential to encourage generic acceptance. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Skin scoring in systemic sclerosis

DEFF Research Database (Denmark)

Zachariae, Hugh; Bjerring, Peter; Halkier-Sørensen, Lars

1994-01-01

Forty-one patients with systemic sclerosis were investigated with a new and simple skin score method measuring the degree of thickening and pliability in seven regions together with area involvement in each region. The highest values were, as expected, found in diffuse cutaneous systemic sclerosis...... (type III SS) and the lowest in limited cutaneous systemic sclerosis (type I SS) with no lesions extending above wrists and ancles. A positive correlation was found to the aminoterminal propeptide of type III procollagen, a serological marker for synthesis of type III collagen. The skin score...

Generic Modeling of a Life Support System for Process Technology Comparison

Science.gov (United States)

Ferrall, J. F.; Seshan, P. K.; Rohatgi, N. K.; Ganapathi, G. B.

1993-01-01

This paper describes a simulation model called the Life Support Systems Analysis Simulation Tool (LiSSA-ST), the spreadsheet program called the Life Support Systems Analysis Trade Tool (LiSSA-TT), and the Generic Modular Flow Schematic (GMFS) modeling technique. Results of using the LiSSA-ST and the LiSSA-TT will be presented for comparing life support system and process technology options for a Lunar Base with a crew size of 4 and mission lengths of 90 and 600 days. System configurations to minimize the life support system weight and power are explored.

Might generic OCs create contraceptive price war?

Science.gov (United States)

1987-02-01

Genora 1/35 and 1/50, the 1st generic oral contraceptives (OCs) in the world, are now being marketed in the US. Clinicians interviewed by "Contraceptive Technology Update" (CTU) offer differing opinions as to what this new OC may mean in the marketplace. Products of Rugby Laboratories, the pills are copy products of Ortho Pharmaceutical's ON 1/35 and ON 1/50 formulations. Most clinicians believe that Genora's success or failure in the OC market depends on its eventual retail price. The price difference of $3-$4 may be sufficiently substantial for retailers to charge less for the generic OCs. If that is the case, many doctors may prescribe a pill which will save their patients $4/month. Dr. Mildred Hanson, a Minneapolis gynecologist/obstetrician, feels any cost savings from Genora will have a significant impact on the OC market. She suggests that the less expensive OCs will catch the attention of health maintenance organizations (HMOs) and the business of women who participate in such health plans. Yet James Burns, director of family planning services for the Hartford City Health Department, thinks that even a full-scale retail price war won't have much effect from a clinic standpoint. He reports that clinics are able to obtain contraceptive supplies rather inexpensively through the contracting system. Hanson also expressed doubt over the potential popularity of Genora 1/50 as clinical concerns about the effects of combined OCs on serum lipid levels and carbohydrate metabolism have resulted in a nationwide push toward OCs containing less than 50 micrograms of estrogen. He indicated concern that declines in pharmaceutical house products from pricing competition with generic pills might have a negative impact on contraceptive research and development. Dick Haskitt, director of business planning for Syntex Laboratories, Inc., who will produce the OCs for Rugby, reports that their market research shows that people are very interested in having a generic OC available

Context-based object-of-interest detection for a generic traffic surveillance analysis system

NARCIS (Netherlands)

Bao, X.; Javanbakhti, S.; Zinger, S.; Wijnhoven, R.G.J.; With, de P.H.N.

2014-01-01

We present a new traffic surveillance video analysis system, focusing on building a framework with robust and generic techniques, based on both scene understanding and moving object-of-interest detection. Since traffic surveillance is widely applied, we want to design a single system that can be

Generic aging management programs for license renewal of BWR reactor coolant systems components

International Nuclear Information System (INIS)

Shah, V.N.; Liu, Y.Y.

2002-01-01

The paper reviews the existing generic aging management programs (AMPs) for the reactor coolant system (RCS) components in boiling water reactors (BWRs), including the reactor pressure vessel and internals, the reactor recirculation system, and the connected piping. These programs have been evaluated in the U.S. Nuclear Regulatory Commission (NRC) report, Generic Aging Lessons Learned (GALL), NUREG-1801, for their use in the license renewal process to manage several aging effects, including loss of material, crack initiation and growth, loss of fracture toughness, loss of preload, wall thinning, and cumulative fatigue damage. The program evaluation includes a review of ten attributes (scope of program, preventive actions, parameters monitored/inspected, detection of aging effects, monitoring and trending, acceptance criteria, corrective actions, confirmative process, administrative control, and operating experience) for their effectiveness in managing a specific aging effect in a given component(s). The generic programs are based on the ASME Section XI inservice inspection requirements; industry guidelines for inspection and evaluation of aging effects in BWR reactor vessel, internals, and recirculation piping; monitoring and control of BWR water chemistry; and operating experience as reported in the USNRC generic communications and industry reports. The review concludes that all generic AMPs are acceptable for managing aging effects in BWR RCS components during an extended period of operation and do not need further evaluation. However, the plant-specific programs for managing aging in certain RCS components during an extended period of operation do require further evaluation. For some plant-specific AMPs, the GALL report recommends an aging management activity to verify their effectiveness. An example of such an activity is a one-time inspection of Class 1 small-bore piping to ensure that service-induced weld cracking is not occurring in the piping. Several of

Generic Aging Management Programs for License Renewal of BWR Reactor Coolant System Components

International Nuclear Information System (INIS)

Shah, V.N.; Liu, Y.Y.

2002-01-01

The paper reviews the existing generic aging management programs (AMPs) for the reactor coolant system (RCS) components in boiling water reactors (BWRs), including the reactor pressure vessel and internals, the reactor recirculation system, and the connected piping. These programs have been evaluated in the U.S. Nuclear Regulatory Commission (NRC) report, Generic Aging Lessons Learned (GALL), NUREG-1801, for their use in the license renewal process to manage several aging effects, including loss of material, crack initiation and growth, loss of fracture toughness, loss of preload, wall thinning, and cumulative fatigue damage. The program evaluation includes a review of ten attributes (scope of program, preventive actions, parameters monitored/inspected, detection of aging effects, monitoring and trending, acceptance criteria, corrective actions, confirmative process, administrative control, and operating experience) for their effectiveness in managing a specific aging effect in a given component(s). The generic programs are based on the ASME Section XI inservice inspection requirements; industry guidelines for inspection and evaluation of aging effects in BWR reactor vessel, internals, and recirculation piping; monitoring and control of BWR water chemistry; and operating experience as reported in the USNRC generic communications and industry reports. The review concludes that all generic AMPs are acceptable for managing aging effects in BWR RCS components during an extended period of operation and do not need further evaluation. However, the plant-specific programs for managing aging in certain RCS components during an extended period of operation do require further evaluation. For some plant-specific AMPs, the GALL report recommends an aging management activity to verify their effectiveness. An example of such an activity is a one-time inspection of Class 1 small-bore piping to ensure that service-induced weld cracking is not occurring in the piping. Several of

Estimating structural collapse fragility of generic building typologies using expert judgment

Science.gov (United States)

Jaiswal, Kishor S.; Wald, D.J.; Perkins, D.; Aspinall, W.P.; Kiremidjian, Anne S.; Deodatis, George; Ellingwood, Bruce R.; Frangopol, Dan M.

2014-01-01

The structured expert elicitation process proposed by Cooke (1991), hereafter referred to as Cooke’s approach, is applied for the first time in the realm of structural collapse-fragility assessment for selected generic construction types. Cooke’s approach works on the principle of objective calibration scoring of judgments coupled with hypothesis testing used in classical statistics. The performance-based scoring system reflects the combined measure of an expert’s informativeness about variables in the problem area under consideration, and their ability to enumerate, in a statistically accurate way through expressing their true beliefs, the quantitative uncertainties associated with their assessments. We summarize the findings of an expert elicitation workshop in which a dozen earthquake-engineering professionals from around the world were engaged to estimate seismic collapse fragility for generic construction types. Development of seismic collapse fragility functions was accomplished by combining their judgments using weights derived from Cooke’s method. Although substantial effort was needed to elicit the inputs of these experts successfully, we anticipate that the elicitation strategy described here will gain momentum in a wide variety of earthquake seismology and engineering hazard and risk analyses where physical model and data limitations are inherent and objective professional judgment can fill gaps.

Formulation of Generic Simulation Models for Analyzing Construction Claims

Directory of Open Access Journals (Sweden)

Rifat Rustom

2012-11-01

Full Text Available While there are several techniques for analyzing the impact of claims on time schedule and productivity,very few are considered adequate and comprehensive to consider risks and uncertainties.A generic approach for claims analysis using simulation is proposed. The formulation of the generic methodology presented in this paper depends on three simulation models;As-Planned Model (APM,As-Built Model (ABM, and What-Would-HaveBeenModel(WWHBM. The proposed generic methodology as presented in this paper provides a good basis as a more elaborate approach to better analyze claims and their impacts on project time and productivity utilizing discrete event simulation.The approach proposed allows for scenario analysis to account for the disputed events and workflow disruptions. The proposed models will assist claimants in presenting their cases effectively and professionally.

Generic hyper-diversity in Stachybotriaceae

Czech Academy of Sciences Publication Activity Database

Lombard, L.; Houbraken, J.; Decock, C.; Samson, R.A.; Meijer, M.; Réblová, Martina; Groenewald, J.Z.; Crous, P. W.

2016-01-01

Roč. 36, SI Jun (2016), s. 156-246 ISSN 0031-5850 R&D Projects: GA ČR GAP506/12/0038 Institutional support: RVO:67985939 Keywords : biodegraders * generic concept * human and plant pathogens Subject RIV: EF - Botanics Impact factor: 7.511, year: 2016

New prognostic factors and scoring system for patients with skeletal metastasis.

Science.gov (United States)

Katagiri, Hirohisa; Okada, Rieko; Takagi, Tatsuya; Takahashi, Mitsuru; Murata, Hideki; Harada, Hideyuki; Nishimura, Tetsuo; Asakura, Hirofumi; Ogawa, Hirofumi

2014-10-01

The aim of this study was to update a previous scoring system for patients with skeletal metastases, that was proposed by Katagiri et al. in 2005, by introducing a new factor (laboratory data) and analyzing a new patient cohort. Between January 2005 and January 2008, we treated 808 patients with symptomatic skeletal metastases. They were prospectively registered regardless of their treatments, and the last follow-up evaluation was performed in 2012. There were 441 male and 367 female patients with a median age of 64 years. Of these patients, 749 were treated nonsurgically while the remaining 59 underwent surgery for skeletal metastasis. A multivariate analysis was conducted using the Cox proportional hazards model. We identified six significant prognostic factors for survival, namely, the primary lesion, visceral or cerebral metastases, abnormal laboratory data, poor performance status, previous chemotherapy, and multiple skeletal metastases. The first three factors had a larger impact than the remaining three. The prognostic score was calculated by adding together all the scores for individual factors. With a prognostic score of ≥7, the survival rate was 27% at 6 months, and only 6% at 1 year. In contrast, patients with a prognostic score of ≤3 had a survival rate of 91% at 1 year, and 78% at 2 years. Comparing the revised system with the previous one, there was a significantly lower number of wrongly predicted patients using the revised system. This revised scoring system was able to predict the survival rates of patients with skeletal metastases more accurately than the previous system and may be useful for selecting an optimal treatment. © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Generic information can retrieve known biological associations: implications for biomedical knowledge discovery.

Directory of Open Access Journals (Sweden)

Herman H H B M van Haagen

Full Text Available MOTIVATION: Weighted semantic networks built from text-mined literature can be used to retrieve known protein-protein or gene-disease associations, and have been shown to anticipate associations years before they are explicitly stated in the literature. Our text-mining system recognizes over 640,000 biomedical concepts: some are specific (i.e., names of genes or proteins others generic (e.g., 'Homo sapiens'. Generic concepts may play important roles in automated information retrieval, extraction, and inference but may also result in concept overload and confound retrieval and reasoning with low-relevance or even spurious links. Here, we attempted to optimize the retrieval performance for protein-protein interactions (PPI by filtering generic concepts (node filtering or links to generic concepts (edge filtering from a weighted semantic network. First, we defined metrics based on network properties that quantify the specificity of concepts. Then using these metrics, we systematically filtered generic information from the network while monitoring retrieval performance of known protein-protein interactions. We also systematically filtered specific information from the network (inverse filtering, and assessed the retrieval performance of networks composed of generic information alone. RESULTS: Filtering generic or specific information induced a two-phase response in retrieval performance: initially the effects of filtering were minimal but beyond a critical threshold network performance suddenly drops. Contrary to expectations, networks composed exclusively of generic information demonstrated retrieval performance comparable to unfiltered networks that also contain specific concepts. Furthermore, an analysis using individual generic concepts demonstrated that they can effectively support the retrieval of known protein-protein interactions. For instance the concept "binding" is indicative for PPI retrieval and the concept "mutation abnormality" is

The R.I.R.S. scoring system: An innovative scoring system for predicting stone-free rate following retrograde intrarenal surgery.

Science.gov (United States)

Xiao, Yinglong; Li, Deng; Chen, Lei; Xu, Yaoting; Zhang, Dingguo; Shao, Yi; Lu, Jun

2017-11-21

To establish and internally validate an innovative R.I.R.S. scoring system that allows urologists to preoperatively estimate the stone-free rate (SFR) after retrograde intrarenal surgery (RIRS). This study included 382 eligible samples from a total 573 patients who underwent RIRS from January 2014 to December 2016. Four reproducible factors in the R.I.R.S. scoring system, including renal stone density, inferior pole stone, renal infundibular length and stone burden, were measured based on preoperative computed tomography of urography to evaluate the possibility of stone clearance after RIRS. The median cumulative diameter of the stones was 14 mm, and the interquartile range was 10 to 21. The SFR on postoperative day 1 in the present cohort was 61.5% (235 of 382), and the final SFR after 1 month was 73.6% (281 of 382). We established an innovative scoring system to evaluate SFR after RIRS using four preoperative characteristics. The range of the R.I.R.S. scoring system was 4 to 10. The overall score showed a great significance of stone-free status (p R.I.R.S. scoring system was 0.904. The R.I.R.S. scoring system is associated with SFR after RIRS. This innovative scoring system can preoperatively assess treatment success after intrarenal surgery and can be used for preoperative surgical arrangement and comparisons of outcomes among different centers and within a center over time.

Generic maintenance immunosuppression in solid organ transplant recipients.

Science.gov (United States)

Ensor, Christopher R; Trofe-Clark, Jennifer; Gabardi, Steven; McDevitt-Potter, Lisa M; Shullo, Michael A

2011-11-01

Survival after solid organ transplantation has increased in the era of tacrolimus and mycophenolate. This increased survival could be due in part to the broad clinical use of these potent and specific agents for maintenance immunosuppression. These drugs have enhanced specificity and potency for T and B lymphocytes compared with their predecessors, cyclosporine and azathioprine. Between 2008 and 2010, the United States Food and Drug Administration approved several generic formulations of both tacrolimus and mycophenolate mofetil. Deciding whether generic products can be safely substituted for the innovator product is a clinical dilemma similar to that which occurred when generic formulations of cyclosporine became available. We describe the concerns regarding generic immunosuppression use, summarize expert opinion and consensus statements in transplantation, analyze the potential impact of generic substitution, and provide estimates of populations affected based on generic drug market penetration. Formulary considerations such as cost, availability, and potential drug ordering and drug selection errors are described, and transplant coordinator and patient perspectives are reviewed. Finally, general recommendations about the use of generic maintenance immunosuppression in solid organ transplant recipients are provided. Although more research is needed to confirm clinical and therapeutic equivalence and pharmacoeconomic benefit, generic immunosuppressants can be safely substituted for innovator products as long as patients consistently receive the same product, patients and clinicians are aware of when substitutions occur, and enhanced therapeutic drug monitoring is provided during the transition.

(abstract) Generic Modeling of a Life Support System for Process Technology Comparisons

Science.gov (United States)

Ferrall, J. F.; Seshan, P. K.; Rohatgi, N. K.; Ganapathi, G. B.

1993-01-01

This paper describes a simulation model called the Life Support Systems Analysis Simulation Tool (LiSSA-ST), the spreadsheet program called the Life Support Systems Analysis Trade Tool (LiSSA-TT), and the Generic Modular Flow Schematic (GMFS) modeling technique. Results of using the LiSSA-ST and the LiSSA-TT will be presented for comparing life support systems and process technology options for a Lunar Base and a Mars Exploration Mission.

Generic features of the dynamics of complex open quantum systems: statistical approach based on averages over the unitary group.

Science.gov (United States)

Gessner, Manuel; Breuer, Heinz-Peter

2013-04-01

We obtain exact analytic expressions for a class of functions expressed as integrals over the Haar measure of the unitary group in d dimensions. Based on these general mathematical results, we investigate generic dynamical properties of complex open quantum systems, employing arguments from ensemble theory. We further generalize these results to arbitrary eigenvalue distributions, allowing a detailed comparison of typical regular and chaotic systems with the help of concepts from random matrix theory. To illustrate the physical relevance and the general applicability of our results we present a series of examples related to the fields of open quantum systems and nonequilibrium quantum thermodynamics. These include the effect of initial correlations, the average quantum dynamical maps, the generic dynamics of system-environment pure state entanglement and, finally, the equilibration of generic open and closed quantum systems.

Comparative effectiveness of generic versus brand-name antiepileptic medications.

Science.gov (United States)

Gagne, Joshua J; Kesselheim, Aaron S; Choudhry, Niteesh K; Polinski, Jennifer M; Hutchins, David; Matlin, Olga S; Brennan, Troyen A; Avorn, Jerry; Shrank, William H

2015-11-01

The objective of this study was to compare treatment persistence and rates of seizure-related events in patients who initiate antiepileptic drug (AED) therapy with a generic versus a brand-name product. We used linked electronic medical and pharmacy claims data to identify Medicare beneficiaries who initiated one of five AEDs (clonazepam, gabapentin, oxcarbazepine, phenytoin, zonisamide). We matched initiators of generic versus brand-name versions of these drugs using a propensity score that accounted for demographic, clinical, and health service utilization variables. We used a Cox proportional hazards model to compare rates of seizure-related emergency room (ER) visit or hospitalization (primary outcome) and ER visit for bone fracture or head injury (secondary outcome) between the matched generic and brand-name initiators. We also compared treatment persistence, measured as time to first 14-day treatment gap, between generic and brand-name initiators. We identified 19,760 AED initiators who met study eligibility criteria; 18,306 (93%) initiated a generic AED. In the matched cohort, we observed 47 seizure-related hospitalizations and ER visits among brand-name initiators and 31 events among generic initiators, corresponding to a hazard ratio of 0.53 (95% confidence interval, 0.30 to 0.96). Similar results were observed for the secondary clinical endpoint and across sensitivity analyses. Mean time to first treatment gap was 124.2 days (standard deviation [sd], 125.8) for brand-name initiators and 137.9 (sd, 148.6) for generic initiators. Patients who initiated generic AEDs had fewer adverse seizure-related clinical outcomes and longer continuous treatment periods before experiencing a gap than those who initiated brand-name versions. Copyright © 2015 Elsevier Inc. All rights reserved.

Architecture design of a generic centralized adjudication module integrated in a web-based clinical trial management system.

Science.gov (United States)

Zhao, Wenle; Pauls, Keith

2016-04-01

Centralized outcome adjudication has been used widely in multicenter clinical trials in order to prevent potential biases and to reduce variations in important safety and efficacy outcome assessments. Adjudication procedures could vary significantly among different studies. In practice, the coordination of outcome adjudication procedures in many multicenter clinical trials remains as a manual process with low efficiency and high risk of delay. Motivated by the demands from two large clinical trial networks, a generic outcome adjudication module has been developed by the network's data management center within a homegrown clinical trial management system. In this article, the system design strategy and database structure are presented. A generic database model was created to transfer different adjudication procedures into a unified set of sequential adjudication steps. Each adjudication step was defined by one activate condition, one lock condition, one to five categorical data items to capture adjudication results, and one free text field for general comments. Based on this model, a generic outcome adjudication user interface and a generic data processing program were developed within a homegrown clinical trial management system to provide automated coordination of outcome adjudication. By the end of 2014, this generic outcome adjudication module had been implemented in 10 multicenter trials. A total of 29 adjudication procedures were defined with the number of adjudication steps varying from 1 to 7. The implementation of a new adjudication procedure in this generic module took an experienced programmer 1 or 2 days. A total of 7336 outcome events had been adjudicated and 16,235 adjudication step activities had been recorded. In a multicenter trial, 1144 safety outcome event submissions went through a three-step adjudication procedure and reported a median of 3.95 days from safety event case report form submission to adjudication completion. In another trial

DYNAMO-HIA--a Dynamic Modeling tool for generic Health Impact Assessments.

Directory of Open Access Journals (Sweden)

Stefan K Lhachimi

Full Text Available BACKGROUND: Currently, no standard tool is publicly available that allows researchers or policy-makers to quantify the impact of policies using epidemiological evidence within the causal framework of Health Impact Assessment (HIA. A standard tool should comply with three technical criteria (real-life population, dynamic projection, explicit risk-factor states and three usability criteria (modest data requirements, rich model output, generally accessible to be useful in the applied setting of HIA. With DYNAMO-HIA (Dynamic Modeling for Health Impact Assessment, we introduce such a generic software tool specifically designed to facilitate quantification in the assessment of the health impacts of policies. METHODS AND RESULTS: DYNAMO-HIA quantifies the impact of user-specified risk-factor changes on multiple diseases and in turn on overall population health, comparing one reference scenario with one or more intervention scenarios. The Markov-based modeling approach allows for explicit risk-factor states and simulation of a real-life population. A built-in parameter estimation module ensures that only standard population-level epidemiological evidence is required, i.e. data on incidence, prevalence, relative risks, and mortality. DYNAMO-HIA provides a rich output of summary measures--e.g. life expectancy and disease-free life expectancy--and detailed data--e.g. prevalences and mortality/survival rates--by age, sex, and risk-factor status over time. DYNAMO-HIA is controlled via a graphical user interface and is publicly available from the internet, ensuring general accessibility. We illustrate the use of DYNAMO-HIA with two example applications: a policy causing an overall increase in alcohol consumption and quantifying the disease-burden of smoking. CONCLUSION: By combining modest data needs with general accessibility and user friendliness within the causal framework of HIA, DYNAMO-HIA is a potential standard tool for health impact assessment based

Development of a generic wind farm SCADA system

Energy Technology Data Exchange (ETDEWEB)

Smith, G.

2001-07-01

The aim of the project is to develop a 'Generic Wind Farm Supervisory Control and Data Acquisition (SCADA) System' for the wind energy industry. A SCADA is a computer-based system that allows local and remote control of basic wind turbine functions and collects data from the wind farm that can be used to analyse and report on the operational performance. As wind farm size, complexity and remoteness of location increase an industry standard SCADA is vitally important to allow effective operation, monitoring, control and reporting. Turbine manufacturers offer a number of existing systems but these do not always fully meet the needs of wind farm operators and owners. Operators and owners who are involved with more than one turbine supplier end up with a number of incompatible systems. This causes operational difficulties and makes it hard to compared performance data from different turbines. This project aims to address these issues and develop a system that will communicate with all turbine types and calculate and store performance data in a consistent way. (Author)

Common generic measures of health related quality of life in injured patients.

Science.gov (United States)

Shearer, David; Morshed, Saam

2011-03-01

The measurement of health-related quality of life (HRQOL) through generic outcome instruments is important for comparisons of populations across disease states and interventions. The growing number of questionnaires available has made selection and interpretation more difficult. Profile instruments such as the SF-36 and Sickness Impact Profile provide insight into various domains of health with established population norms. Preference-based measures, including the EQ-5D, Health Utilities Index, SF-6D, and QWB-SA are used to generate utility scores, which can be used for cost-effectiveness analysis and therefore have particular relevance in health policy. Both types of generic measures have been used in clinical trials in injured populations to assess the relative impact of interventions on quality-of-life. Comparisons of internal consistency and test-retest reliability across measures reveal minimal differences between instruments, and reported values are acceptable for group comparisons but insufficient for individual clinical use. There is a dearth of studies evaluating the validity of these measures in the trauma population, but available data suggest most of the available instruments are acceptable. Populations that may require special consideration are patients with head, spinal cord, and upper-extremity injuries. Practical issues to consider in selecting a questionnaire include time for completion, which ranges from less than 2 min for the EQ-5D to 20-30 min for the Sickness Impact Profile. Selection of the appropriate measure ultimately depends largely on the population to be studied and whether utility-estimation is desired. Copyright © 2010 Elsevier Ltd. All rights reserved.

Generic dynamic wind turbine models for power system stability analysis: A comprehensive review

DEFF Research Database (Denmark)

Honrubia-Escribano, A.; Gómez-Lázaro, E.; Fortmann, J.

2018-01-01

In recent years, international working groups, mainly from the International Electrotechnical Commission (IEC) and the Western Electricity Coordinating Council (WECC), have made a major effort to develop generic —also known as simplified or standard— dynamic wind turbine models to be used for power...... system stability analysis. These models are required by power system operators to conduct the planning and operation activities of their networks since the use of detailed manufacturer models is not practical. This paper presents a comprehensive review of the work done in this field, based on the results...... obtained by IEC and WECC working groups in the course of their research, which have motivated the publication of the IEC 61400-27 in February 2015. The final published versions of the generic models developed according to the existing four wind turbine technology types are detailed, highlighting...

A Generic System-Level Framework for Self-Serve Health Monitoring System through Internet of Things (IoT).

Science.gov (United States)

Ahmed, Mobyen Uddin; Björkman, Mats; Lindén, Maria

2015-01-01

Sensor data are traveling from sensors to a remote server, data is analyzed remotely in a distributed manner, and health status of a user is presented in real-time. This paper presents a generic system-level framework for a self-served health monitoring system through the Internet of Things (IoT) to facilities an efficient sensor data management.

Assessment of the impact of phenylketonuria and its treatment on quality of life of patients and parents from seven European countries.

Science.gov (United States)

Bosch, Annet M; Burlina, Alberto; Cunningham, Amy; Bettiol, Esther; Moreau-Stucker, Flavie; Koledova, Ekaterina; Benmedjahed, Khadra; Regnault, Antoine

2015-06-18

The strict and demanding dietary treatment and mild cognitive abnormalities seen in PKU treated from a young age can be expected to affect the health-related quality of life (HRQoL) of patients and their families. Our aim was to describe the HRQoL of patients with PKU from a large international study, using generic HRQoL measures and an innovative PKU-specific HRQoL questionnaire (PKU-QOL). Analyses were exploratory, performed post-hoc on data collected primarily to validate the PKU-QOL. A multicentre, prospective, non-interventional, observational study conducted in France, Germany, Italy, The Netherlands, Spain, Turkey and the UK. Patients diagnosed with PKU aged ≥9 years old and treated with a Phe-restricted diet and/or Phe-free amino acid protein supplements and/or pharmacological therapy were included in the study; parents of at least one patient with PKU aged <18 years were also included. HRQoL was assessed by generic measures (Pediatric Quality-of-Life Inventory; Medical Outcome Survey 36 item Short Form; Child Health Questionnaire 28 item Parent Form) and the newly developed PKU-QOL. Mean generic domain scores were interpreted using published reference values from the general population. PKU-QOL domain scores were described overall and in different subgroups of patients defined according to severity of PKU, overall assessment of patient's health status by the investigator and treatment with tetrahydrobiopterin (BH4). Data from 559 subjects were analysed: 306 patients (92 children, 110 adolescents, 104 adults) and 253 parents. Mean domain scores of generic measures in the study were comparable to the general population. The highest PKU-QOL impact scores (indicating greater impact) were for emotional impact of PKU, anxiety about blood Phe levels, guilt regarding poor adherence to dietary restrictions or Phe-free amino acid supplement intake and anxiety regarding blood Phe levels during pregnancy. Patients with mild/moderate PKU and those receiving BH4

A diagnostic scoring system for myxedema coma.

Science.gov (United States)

Popoveniuc, Geanina; Chandra, Tanu; Sud, Anchal; Sharma, Meeta; Blackman, Marc R; Burman, Kenneth D; Mete, Mihriye; Desale, Sameer; Wartofsky, Leonard

2014-08-01

To develop diagnostic criteria for myxedema coma (MC), a decompensated state of extreme hypothyroidism with a high mortality rate if untreated, in order to facilitate its early recognition and treatment. The frequencies of characteristics associated with MC were assessed retrospectively in patients from our institutions in order to derive a semiquantitative diagnostic point scale that was further applied on selected patients whose data were retrieved from the literature. Logistic regression analysis was used to test the predictive power of the score. Receiver operating characteristic (ROC) curve analysis was performed to test the discriminative power of the score. Of the 21 patients examined, 7 were reclassified as not having MC (non-MC), and they were used as controls. The scoring system included a composite of alterations of thermoregulatory, central nervous, cardiovascular, gastrointestinal, and metabolic systems, and presence or absence of a precipitating event. All 14 of our MC patients had a score of ≥60, whereas 6 of 7 non-MC patients had scores of 25 to 50. A total of 16 of 22 MC patients whose data were retrieved from the literature had a score ≥60, and 6 of 22 of these patients scored between 45 and 55. The odds ratio per each score unit increase as a continuum was 1.09 (95% confidence interval [CI], 1.01 to 1.16; P = .019); a score of 60 identified coma, with an odds ratio of 1.22. The area under the ROC curve was 0.88 (95% CI, 0.65 to 1.00), and the score of 60 had 100% sensitivity and 85.71% specificity. A score ≥60 in the proposed scoring system is potentially diagnostic for MC, whereas scores between 45 and 59 could classify patients at risk for MC.

A GIS-based generic real-time risk assessment framework and decision tools for chemical spills in the river basin.

Science.gov (United States)

Jiang, Jiping; Wang, Peng; Lung, Wu-seng; Guo, Liang; Li, Mei

2012-08-15

This paper presents a generic framework and decision tools of real-time risk assessment on Emergency Environmental Decision Support System for response to chemical spills in river basin. The generic "4-step-3-model" framework is able to delineate the warning area and the impact on vulnerable receptors considering four types of hazards referring to functional area, societal impact, and human health and ecology system. Decision tools including the stand-alone system and software components were implemented on GIS platform. A detailed case study on the Songhua River nitrobenzene spill illustrated the goodness of the framework and tool Spill first responders and decision makers of catchment management will benefit from the rich, visual and dynamic hazard information output from the software. Copyright © 2012 Elsevier B.V. All rights reserved.

Floquet–Magnus theory and generic transient dynamics in periodically driven many-body quantum systems

International Nuclear Information System (INIS)

Kuwahara, Tomotaka; Mori, Takashi; Saito, Keiji

2016-01-01

This work explores a fundamental dynamical structure for a wide range of many-body quantum systems under periodic driving. Generically, in the thermodynamic limit, such systems are known to heat up to infinite temperature states in the long-time limit irrespective of dynamical details, which kills all the specific properties of the system. In the present study, instead of considering infinitely long-time scale, we aim to provide a general framework to understand the long but finite time behavior, namely the transient dynamics. In our analysis, we focus on the Floquet–Magnus (FM) expansion that gives a formal expression of the effective Hamiltonian on the system. Although in general the full series expansion is not convergent in the thermodynamics limit, we give a clear relationship between the FM expansion and the transient dynamics. More precisely, we rigorously show that a truncated version of the FM expansion accurately describes the exact dynamics for a certain time-scale. Our theory reveals an experimental time-scale for which non-trivial dynamical phenomena can be reliably observed. We discuss several dynamical phenomena, such as the effect of small integrability breaking, efficient numerical simulation of periodically driven systems, dynamical localization and thermalization. Especially on thermalization, we discuss a generic scenario on the prethermalization phenomenon in periodically driven systems. -- Highlights: •A general framework to describe transient dynamics for periodically driven systems. •The theory is applicable to generic quantum many-body systems including long-range interacting systems. •Physical meaning of the truncation of the Floquet–Magnus expansion is rigorously established. •New mechanism of the prethermalization is proposed. •Revealing an experimental time-scale for which non-trivial dynamical phenomena can be reliably observed.

Floquet–Magnus theory and generic transient dynamics in periodically driven many-body quantum systems

Energy Technology Data Exchange (ETDEWEB)

Kuwahara, Tomotaka, E-mail: tomotaka.phys@gmail.com [Department of Physics, Graduate School of Science, University of Tokyo, Bunkyo-ku, Tokyo 113-0033 (Japan); WPI, Advanced Institute for Materials Research, Tohoku University, Sendai 980-8577 (Japan); Mori, Takashi [Department of Physics, Graduate School of Science, University of Tokyo, Bunkyo-ku, Tokyo 113-0033 (Japan); Saito, Keiji [Department of Physics, Keio University, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama, 223-8522 (Japan)

2016-04-15

This work explores a fundamental dynamical structure for a wide range of many-body quantum systems under periodic driving. Generically, in the thermodynamic limit, such systems are known to heat up to infinite temperature states in the long-time limit irrespective of dynamical details, which kills all the specific properties of the system. In the present study, instead of considering infinitely long-time scale, we aim to provide a general framework to understand the long but finite time behavior, namely the transient dynamics. In our analysis, we focus on the Floquet–Magnus (FM) expansion that gives a formal expression of the effective Hamiltonian on the system. Although in general the full series expansion is not convergent in the thermodynamics limit, we give a clear relationship between the FM expansion and the transient dynamics. More precisely, we rigorously show that a truncated version of the FM expansion accurately describes the exact dynamics for a certain time-scale. Our theory reveals an experimental time-scale for which non-trivial dynamical phenomena can be reliably observed. We discuss several dynamical phenomena, such as the effect of small integrability breaking, efficient numerical simulation of periodically driven systems, dynamical localization and thermalization. Especially on thermalization, we discuss a generic scenario on the prethermalization phenomenon in periodically driven systems. -- Highlights: •A general framework to describe transient dynamics for periodically driven systems. •The theory is applicable to generic quantum many-body systems including long-range interacting systems. •Physical meaning of the truncation of the Floquet–Magnus expansion is rigorously established. •New mechanism of the prethermalization is proposed. •Revealing an experimental time-scale for which non-trivial dynamical phenomena can be reliably observed.

The Generic Data Capture Facility

Science.gov (United States)

Connell, Edward B.; Barnes, William P.; Stallings, William H.

1987-01-01

The Generic Data Capture Facility, which can provide data capture support for a variety of different types of spacecraft while enabling operations costs to be carefully controlled, is discussed. The data capture functions, data protection, isolation of users from data acquisition problems, data reconstruction, and quality and accounting are addressed. The TDM and packet data formats utilized by the system are described, and the development of generic facilities is considered.

[Generic drugs and the consumption trends of antihypertensives in Morocco].

Science.gov (United States)

Berrada El Azizi, Ghizlane; Ahid, Samir; Ghanname, Imane; Ghannam, Imane; Belaiche, Abdelmajid; Hassar, Mohammed; Cherrah, Yahia

2013-01-01

To evaluate the evolution of consumption of antihypertensive drugs generic among 1991-2010, to assess the impacts after the institution of Mandatory Health Insurance and the marketing of generic drugs. We used sales data from the Moroccan subsidiary of IMS Health Intercontinental Marketing Service. Consumption of generic antihypertensive drugs increased from 0.08 to 10.65 DDD/1 000 inhabitants/day between 1991 and 2010. In 2010, generic of the calcium channel blockers (CCBs) represented 4.08 DDD/1 000 inhabitants/day (82.09%), followed by angiotensin converting enzyme inhibitors (ACEI) by 2.40 DDD/1 000 inhabitants/day (48.29%). The generics market of CCBs is the most dominant and represented in 2010, 79.21% in volume and 62.58% in value. In developing countries like Morocco, the generic drug is a key element for access to treatment especially for the poor population. © 2013 Société Française de Pharmacologie et de Thérapeutique.

The colostomy impact score: development and validation of a patient reported outcome measure for rectal cancer patients with a permanent colostomy. A population-based study.

Science.gov (United States)

Thyø, A; Emmertsen, K J; Pinkney, T D; Christensen, P; Laurberg, S

2017-01-01

The aim was to develop and validate a simple scoring system evaluating the impact of colostomy dysfunction on quality of life (QOL) in patients with a permanent stoma after rectal cancer treatment. In this population-based study, 610 patients with a permanent colostomy after previous rectal cancer treatment during the period 2001-2007 completed two questionnaires: (i) the basic stoma questionnaire consisting of 22 items about stoma function with one anchor question addressing the overall stoma impact on QOL and (ii) the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) C30. Answers from half of the cohort were used to develop the score and subsequently validated on the remaining half. Logistic regression analyses identified and selected items for the score and multivariate analysis established the score value allocated to each item. The colostomy impact score includes seven items with a total range from 0 to 38 points. A score of ≥ 10 indicates major colostomy impact (Major CI). The score has a sensitivity of 85.7% for detecting patients with significant stoma impact on QOL. Using the EORTC QLQ scales, patients with Major CI experienced significant impairment in their QOL compared to the Minor CI group. This new scoring system appears valid for the assessment of the impact on QOL from having a permanent colostomy in a Danish rectal cancer population. It requires validation in non-Danish populations prior to its acceptance as a valuable patient-reported outcome measure for patients internationally. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

Generic safety evaluation report regarding integrity of BWR scram system piping

International Nuclear Information System (INIS)

1981-08-01

Safety concerns associated with postulated pipe breaks in the boiling water reactor (BWR) scram system were identified during the staff's continuing investigation of the Browns Ferry Unit 3 control rod partial insertion failure on June 28, 1980. This report includes an evaluation of the licensing basis for the BWR scram discharge volume (SDV) piping and an assessment of the potential for the SDV piping to fail while in service. A discussion of the means available for mitigation an unlikely SDV system failure is provided. Generic recommendations are made to improve mitigation capability and ensure that system integrity is maintained in service

GET: A generic electronics system for TPCs and nuclear physics instrumentation

Science.gov (United States)

Pollacco, E. C.; Grinyer, G. F.; Abu-Nimeh, F.; Ahn, T.; Anvar, S.; Arokiaraj, A.; Ayyad, Y.; Baba, H.; Babo, M.; Baron, P.; Bazin, D.; Beceiro-Novo, S.; Belkhiria, C.; Blaizot, M.; Blank, B.; Bradt, J.; Cardella, G.; Carpenter, L.; Ceruti, S.; De Filippo, E.; Delagnes, E.; De Luca, S.; De Witte, H.; Druillole, F.; Duclos, B.; Favela, F.; Fritsch, A.; Giovinazzo, J.; Gueye, C.; Isobe, T.; Hellmuth, P.; Huss, C.; Lachacinski, B.; Laffoley, A. T.; Lebertre, G.; Legeard, L.; Lynch, W. G.; Marchi, T.; Martina, L.; Maugeais, C.; Mittig, W.; Nalpas, L.; Pagano, E. V.; Pancin, J.; Poleshchuk, O.; Pedroza, J. L.; Pibernat, J.; Primault, S.; Raabe, R.; Raine, B.; Rebii, A.; Renaud, M.; Roger, T.; Roussel-Chomaz, P.; Russotto, P.; Saccà, G.; Saillant, F.; Sizun, P.; Suzuki, D.; Swartz, J. A.; Tizon, A.; Usher, N.; Wittwer, G.; Yang, J. C.

2018-04-01

General Electronics for TPCs (GET) is a generic, reconfigurable and comprehensive electronics and data-acquisition system for nuclear physics instrumentation of up to 33792 channels. The system consists of a custom-designed ASIC for signal processing, front-end cards that each house 4 ASIC chips and digitize the data in parallel through 12-bit ADCs, concentration boards to read and process the digital data from up to 16 ASICs, a 3-level trigger and master clock module to trigger the system and synchronize the data, as well as all of the associated firmware, communication and data-acquisition software. An overview of the system including its specifications and measured performances are presented.

Generic Graph Grammar: A Simple Grammar for Generic Procedural Modelling

DEFF Research Database (Denmark)

Christiansen, Asger Nyman; Bærentzen, Jakob Andreas

2012-01-01

in a directed cyclic graph. Furthermore, the basic productions are chosen such that Generic Graph Grammar seamlessly combines the capabilities of L-systems to imitate biological growth (to model trees, animals, etc.) and those of split grammars to design structured objects (chairs, houses, etc.). This results...

Generic clearance values

International Nuclear Information System (INIS)

Bossio, M.C.; Muniz, C.C.

2009-01-01

This paper analyzes the Generic Clearance Values established for natural and artificial radionuclides with the objective of evaluating their degree of conservatism in views of adopting them into the regulatory body. Generic clearance values for natural radionuclides have been chosen by experts judgments as the optimum boundary between, on one hand, the ubiquitous unmodified soil concentrations and, on the other hand, activity concentrations in ores, mineral sands, industrial residues and wastes. For artificial radionuclides the clearance levels have been derived from the scenarios postulated in the document 'Safety Reports Series Nr 44' of the IAEA considering quantitative exemption criteria. A set of 8 scenarios were postulated covering external, ingestion and inhalation exposure pathways. For each radionuclide, the generic clearance level was derived as the more restrictive value obtained from the scenarios, that is the lowest ratio between the applicable individual dose and the dose per unit activity concentration (Bq/g). The individual dose was calculated by a formula depending on each scenario and pathway, with different parameters, such as exposure time, dosimetric factors, dilution factor, density of the material, geometric factors, etc. It was concluded that the basis and parameters used for the derivation of the generic clearance levels are quite conservative and therefore its the adoption in Argentina has been recommended. It is expected that their implementation will contribute to optimize the regulatory management system. (author)

Generic Clearance Values

International Nuclear Information System (INIS)

Bossio, M.C.; Muniz, C.C.

2010-01-01

This paper analyzes the Generic Clearance Values established for natural and artificial radionuclides with the objective of evaluating their degree of conservatism in views of adopting them into the regulatory body. Generic clearance values for natural radionuclides have been chosen by experts judgments as the optimum boundary between, on the one hand, the ubiquitous unmodified soil concentrations and, on the other hand, activity concentrations in ores, mineral sands, industrial residues and wastes. For artificial radionuclides the clearance levels have been derived from the scenarios postulated in the document Safety Reports Series 44 of the IAEA considering quantitative exemption criteria. A set of 8 scenarios were postulated covering external, ingestion and inhalation exposure pathways. For each radionuclide, the generic clearance level was derived as the more restrictive value obtained from the scenarios, that is the lowest ratio between the applicable individual dose and the dose per unit activity concentration (Bq/g). The individual dose was calculated by a formula depending on each scenario and pathway, with different parameters, such as exposure time, dosimetric factors, dilution factor, density of the material, geometric factors, etc. It was concluded that the basis and parameters used for the derivation of the generic clearance levels are quite conservative and therefore its the adoption in Argentina has been recommended. It is expected that their implementation will contribute to optimize the regulatory management system. (authors) [es

A Score Function for Optimizing the Cycle-Life of Battery-Powered Embedded Systems

NARCIS (Netherlands)

Wognsen, Erik Ramsgaard; Haverkort, Boudewijn R.H.M.; Jongerden, M.R.; Hansen, René Rydhof; Larsen, K.G.; Sankaranarayanan, Sriram; Vicario, Enrico

An ever increasing share of embedded systems is powered by rechargeable batteries. These batteries deteriorate with the number of charge/discharge cycles they are subjected to, the so-called cycle life. In this paper, we propose the wear score function to compare and evaluate the relative impact of

Correlations between disease-specific and generic health status questionnaires in patients with advanced COPD: a one-year observational study

Directory of Open Access Journals (Sweden)

Wilke Sarah

2012-08-01

Full Text Available Abstract Background Longitudinal studies analyzing the correlations between disease-specific and generic health status questionnaires at different time points in patients with advanced COPD are lacking. The aim of this study was to determine whether and to what extent a disease-specific health status questionnaire (Saint George’s Respiratory Questionnaire, SGRQ correlates with generic health status questionnaires (EuroQol-5-Dimensions, EQ-5D; Assessment of Quality of Life instrument, AQoL; Medical Outcomes Study 36-Item Short-Form Health Survey, SF-36 at four different time points in patients with advanced COPD; and to determine the correlation between the changes in these questionnaires during one-year follow-up. Methods Demographic and clinical characteristics were assessed in 105 outpatients with advanced COPD at baseline. Disease-specific health status (SGRQ and generic health status (EQ-5D, AQoL, SF-36 were assessed at baseline, four, eight, and 12 months. Correlations were determined between SGRQ and EQ-5D, AQoL, and SF-36 scores and changes in these scores. Agreement in direction of change was assessed. Results Eighty-four patients (80% completed one-year follow-up and were included for analysis. SGRQ total score and EQ-5D index score, AQoL total score and SF-36 Physical Component Summary measure (SF-36 PCS score were moderately to strongly correlated. The correlation of the changes between the SGRQ total score and EQ-5D index score, AQoL total score, SF-36 PCS, and SF-36 Mental Component Summary measure (SF-36 MCS score were weak or absent. The direction of changes in SGRQ total scores agreed slightly with the direction of changes in EQ-5D index score, AQoL total score, and SF-36 PCS score. Conclusions At four, eight and 12 months after baseline, SGRQ total scores and EQ-5D index scores, AQoL total scores and SF-36 PCS scores were moderately to strongly correlated, while SGRQ total scores were weakly correlated with SF-36 MCS scores

Towards a generic user support system (GUS)

International Nuclear Information System (INIS)

Garland, W.J.; Wilson, R.J.

1993-01-01

One relevant issue confronting the operator of a nuclear power plant is information and task overload. The goal, then, of the various developers is to improve the current situations by creating an environment where the operator can perform at optimum capacity. This is to be accomplished by providing tools and techniques which reduce operator involvement in low level tasks (freeing up time for higher level cognitive tasks) and assist in information and knowledge manipulation so that high level tasks can be performed more efficiently. This paper reviews the operational environment of nuclear plants from the viewpoint of engineering design and from the viewpoint of the operators and technical support staff. Principles are advanced for a generic operator companion. These design principles are being applied to a test case: the Point Lepreau NGS secondary side central sampling system. 6 refs., 6 figs

An audit of generic prescribing in a general surgical department.

LENUS (Irish Health Repository)

Gleeson, M

2013-01-17

BACKGROUND: The Health Service Executive introduced a generic prescription policy to reduce costs. Despite this, generic prescription rates remain low. AIM: To audit in-patient prescription practice in a single surgical department and identify potential savings which could be realised by adherence to the generic prescribing policy. METHODS: Surgical in-patient charts were obtained at the point of discharge and their drug prescription information was recorded. RESULTS: 51 % of prescriptions involved a trade-name prescription where an appropriate generic equivalent existed. The cost implications for hospital and community patients were found to be greatly affected by substitution policies that exist at hospital pharmacy level. CONCLUSION: There is a need to promote greater adherence to generic prescribing amongst hospital doctors in line with international best practice. It can have a positive impact in terms of safe prescribing and can have cost implications at both hospital and community level.

Weighing of risk factors for penetrating keratoplasty graft failure: application of Risk Score System

Directory of Open Access Journals (Sweden)

Abdo Karim Tourkmani

2017-03-01

Full Text Available AIM: To analyze the relationship between the score obtained in the Risk Score System (RSS proposed by Hicks et al with penetrating keratoplasty (PKP graft failure at 1y postoperatively and among each factor in the RSS with the risk of PKP graft failure using univariate and multivariate analysis. METHODS: The retrospective cohort study had 152 PKPs from 152 patients. Eighteen cases were excluded from our study due to primary failure (10 cases, incomplete medical notes (5 cases and follow-up less than 1y (3 cases. We included 134 PKPs from 134 patients stratified by preoperative risk score. Spearman coefficient was calculated for the relationship between the score obtained and risk of failure at 1y. Univariate and multivariate analysis were calculated for the impact of every single risk factor included in the RSS over graft failure at 1y. RESULTS: Spearman coefficient showed statistically significant correlation between the score in the RSS and graft failure (P0.05 between diagnosis and lens status with graft failure. The relationship between the other risk factors studied and graft failure was significant (P<0.05, although the results for previous grafts and graft failure was unreliable. None of our patients had previous blood transfusion, thus, it had no impact. CONCLUSION: After the application of multivariate analysis techniques, some risk factors do not show the expected impact over graft failure at 1y.

Associations between generic substitution and patients' attitudes, beliefs and experience

DEFF Research Database (Denmark)

Østergaard Rathe, Jette; Larsen, Pia Veldt; Andersen, Morten

2013-01-01

Abstract Background Generic substitution has been implemented in many countries, but knowledge about patients’ attitudes, beliefs and experiences is still sparse. Aim To assess associations between generic switching and patients’ attitudes, beliefs and experiences with previous generic switching...... on generic medicine and confidence in the healthcare system. Only prescriptions issued by the general practitioners were included. For each patient we focused on one purchase of a generically substitutable drug (index drug). Patients were identified by means of a dispensing database. Results Earlier generic...... switches within the index ATC code were statistically significantly associated with experience of a generic switch (adjusted OR 5.93 95% CI 4.70; 7.49). Having had more than 5 earlier switches within other ATC codes and having negative views on generic medicines reduced the odds of experiencing a generic...

Method of administration of PROMIS scales did not significantly impact score level, reliability, or validity

DEFF Research Database (Denmark)

Bjorner, Jakob B; Rose, Matthias; Gandek, Barbara

2014-01-01

OBJECTIVES: To test the impact of the method of administration (MOA) on score level, reliability, and validity of scales developed in the Patient Reported Outcomes Measurement Information System (PROMIS). STUDY DESIGN AND SETTING: Two nonoverlapping parallel forms each containing eight items from......, no significant mode differences were found and all confidence intervals were within the prespecified minimal important difference of 0.2 standard deviation. Parallel-forms reliabilities were very high (ICC = 0.85-0.93). Only one across-mode ICC was significantly lower than the same-mode ICC. Tests of validity...... questionnaire (PQ), personal digital assistant (PDA), or personal computer (PC) and a second form by PC, in the same administration. Method equivalence was evaluated through analyses of difference scores, intraclass correlations (ICCs), and convergent/discriminant validity. RESULTS: In difference score analyses...

Generic modelling framework for economic analysis of battery systems

DEFF Research Database (Denmark)

You, Shi; Rasmussen, Claus Nygaard

2011-01-01

opportunities, a generic modelling framework is proposed to handle this task. This framework outlines a set of building blocks which are necessary for carrying out the economic analysis of various BS applications. Further, special focus is given on describing how to use the rainflow cycle counting algorithm...... for battery cycle life estimation, since the cycle life plays a central role in the economic analysis of BS. To illustrate the modelling framework, a case study using a Sodium Sulfur Battery (NAS) system with 5-minute regulating service is performed. The economic performances of two dispatch scenarios, a so......Deregulated electricity markets provide opportunities for Battery Systems (BS) to participate in energy arbitrage and ancillary services (regulation, operating reserves, contingency reserves, voltage regulation, power quality etc.). To evaluate the economic viability of BS with different business...

A Generic Danish Distribution Grid Model for Smart Grid Technology Testing

DEFF Research Database (Denmark)

Cha, Seung-Tae; Wu, Qiuwei; Østergaard, Jacob

2012-01-01

This paper describes the development of a generic Danish distribution grid model for smart grid technology testing based on the Bornholm power system. The frequency dependent network equivalent (FDNE) method has been used in order to accurately preserve the desired properties and characteristics...... as a generic Smart Grid benchmark model for testing purposes....... by comparing the transient response of the original Bornholm power system model and the developed generic model under significant fault conditions. The results clearly show that the equivalent generic distribution grid model retains the dynamic characteristics of the original system, and can be used...

Generic Reed Solomon Encorder

Directory of Open Access Journals (Sweden)

Petrus Mursanto

2006-11-01

Full Text Available Reed Solomon (RS codes is a mechanism to detect and correct burst of errors in data transmission and storage systems. It provides a solid introduction to foundation mathematical concept of Galois Field algebra and its application. With the development of digital hardware technology, the RS concepts were brought into reality, i.e. the implementation of RS codec chips. This paper presents the development steps of a generic RS encoder using VHDL. The encoder is able to handle generic width of data, variable length of information, number of error as well as variable form of primitive polynomial and generator polynomial used in the system. The design has been implemented for FPGA chip Xilinx XC3S200-5FT256 and has a better performance than commercially available equivalent encoder.

Development of a generic virus behavioural detector: a preview ...

African Journals Online (AJOL)

The Generic Virus Behavioral Detector (GVBD) is a system (program) that monitors various system activities; reading and writing block of disks and memory and the use of Interrupts. A technique for its realisation is presented. Key Words: Computer virus, interrupts, handlers, GVBD (Generic Virus Behavioral Detector).

Guide for generic application of Reliability Centered Maintenance (RCM) recommendations

International Nuclear Information System (INIS)

Schwan, C.A.; Toomey, G.E.; Morgan, T.A.; Darling, S.S.

1991-02-01

Previously completed reliability centered maintenance (RCM) studies form the basis for developing or refining a preventive maintenance program. This report describes a generic methodology that will help utilities optimize nuclear plant maintenance programs using RCM techniques. This guide addresses the following areas: history of the generic methodology development process, and use of the generic methodology for conducting system-to-system and component-to-component evaluations. 2 refs., 2 figs., 5 tabs

Generic test platform for representative tests of safety I/C systems - 15546

International Nuclear Information System (INIS)

Fourestie, B.; Kuck, H.; Richter, J.; Rieche, S.; Waitz, M.

2015-01-01

In compliance with the IEC 61513 safety Instrumentation and Control (I/C) systems must be successfully validated in their final configuration prior to installation on site and commissioning. However the contingent need for modifications during system validation activities or subsequently during the commissioning phase may entail long and costly re-engineering of the I/C systems. With the view to ease these possible modifications, a Generic Test Platform has been developed by AREVA which allows combining a real I/C system subpart with an emulation server. This platform provides a faithful representation of the I/C System allowing crediting the validation test results carried out on this platform. (authors)

Selecting a pharmacy layout design using a weighted scoring system.

Science.gov (United States)

McDowell, Alissa L; Huang, Yu-Li

2012-05-01

A weighted scoring system was used to select a pharmacy layout redesign. Facilities layout design techniques were applied at a local hospital pharmacy using a step-by-step design process. The process involved observing and analyzing the current situation, observing the current available space, completing activity flow charts of the pharmacy processes, completing communication and material relationship charts to detail which areas in the pharmacy were related to one another and how they were related, researching applications in other pharmacies or in scholarly works that could be beneficial, numerically defining space requirements for areas within the pharmacy, measuring the available space within the pharmacy, developing a set of preliminary designs, and modifying preliminary designs so they were all acceptable to the pharmacy staff. To select a final layout that could be implemented in the pharmacy, those layouts were compared via a weighted scoring system. The weighted aspect further allowed additional emphasis on categories based on their effect on pharmacy performance. The results produced a beneficial layout design as determined through simulated models of the pharmacy operation that more effectively allocated and strategically located space to improve transportation distances and materials handling, employee utilization, and ergonomics. Facilities layout designs for a hospital pharmacy were evaluated using a weighted scoring system to identify a design that was superior to both the current layout and alternative layouts in terms of feasibility, cost, patient safety, employee safety, flexibility, robustness, transportation distance, employee utilization, objective adherence, maintainability, usability, and environmental impact.

Psychometric properties of the Slovenian adaptation of the Revised Generic Occupational Stress Index Questionnaire (RG-OSI

Directory of Open Access Journals (Sweden)

Nataša Sedlar

2014-02-01

Full Text Available The Revised Generic Occupational Stress Index questionnaire (RG-OSI employs the cognitive ergonomics approach that quantifies the burden of stressors on cognitive resources of the employee. The model is structured as a 2-dimensional matrix, where each element is scored from 0 to 2 (sometimes with intermediate values of 0.5, 1.5 or 1.75 as a combination of various items based on multiple criteria. Due to uncommon scoring system of the questionnaire, our study aimed to explore the appropriateness of the existing scoring system and to get some information on validity of the scale on a Slovenian sample. The questionnaire has been applied on 349 Slovenian employees from different occupational groups and the data were analysed by means of correspondence analysis, classical reliability and item analysis and item response theory analysis. The results of correspondence analysis demonstrate that the response categories on individual variables are not always ordered. Furthermore, we conducted reliability analysis for scales, developed short versions of the scales, and obtained some preliminary information on their validity. The current study provides evidence that the described original scoring system in psychological measures may not be appropriate from the psychometric viewpoint.

The generic article

NARCIS (Netherlands)

Farkas, D.F.; Swart, Henriëtte de

2005-01-01

We take a fresh look at the connection between genericity and (in)definiteness by reconsidering a long-standing puzzle concerning the relation between definiteness and genericity. We contrast English on the one hand and Romance languages and Hungarian on the other, focusing on generic sentences

A Novel Scoring System Approach to Assess Patients with Lyme Disease (Nutech Functional Score).

Science.gov (United States)

Shroff, Geeta; Hopf-Seidel, Petra

2018-01-01

A bacterial infection by Borrelia burgdorferi referred to as Lyme disease (LD) or borreliosis is transmitted mostly by a bite of the tick Ixodes scapularis in the USA and Ixodes ricinus in Europe. Various tests are used for the diagnosis of LD, but their results are often unreliable. We compiled a list of clinically visible and patient-reported symptoms that are associated with LD. Based on this list, we developed a novel scoring system. Nutech functional Score (NFS), which is a 43 point positional (every symptom is subgraded and each alternative gets some points according to its position) and directional (moves in direction bad to good) scoring system that assesses the patient's condition. The grades of the scoring system have been converted into numeric values for conducting probability based studies. Each symptom is graded from 1 to 5 that runs in direction BAD → GOOD. NFS is a unique tool that can be used universally to assess the condition of patients with LD.

Generic Planning and Control of Automated Material Handling Systems: Practical Requirements Versus Existing Theroy.

NARCIS (Netherlands)

Haneyah, S.W.A.; Zijm, Willem H.M.; Schutten, Johannes M.J.; Schuur, Peter

2011-01-01

This paper discusses the problem of generic planning and control of Automated Material Handling Systems (AMHSs). The paper illustrates the relevance of this research direction, and then addresses three different market sectors where AMHSs are used. These market sectors are: baggage handling,

Generic planning and control of automated material handling systems : practical requirements versus existing theory

NARCIS (Netherlands)

Haneyah, S.W.A.; Schutten, Johannes M.J.; Schuur, Peter; Zijm, Willem H.M.

2013-01-01

This paper discusses the problem to design a generic planning and control architecture for utomated material handling systems (AMHSs). We illustrate the relevance of this research direction, and then address three different market sectors where AMHSs are used, i.e., baggage handling, distribution,

Domain-based Teaching Strategy for Intelligent Tutoring System Based on Generic Rules

Science.gov (United States)

Kseibat, Dawod; Mansour, Ali; Adjei, Osei; Phillips, Paul

In this paper we present a framework for selecting the proper instructional strategy for a given teaching material based on its attributes. The new approach is based on a flexible design by means of generic rules. The framework was adapted in an Intelligent Tutoring System to teach Modern Standard Arabic language to adult English-speaking learners with no pre-knowledge of Arabic language is required.

Floquet-Magnus theory and generic transient dynamics in periodically driven many-body quantum systems

Science.gov (United States)

Kuwahara, Tomotaka; Mori, Takashi; Saito, Keiji

2016-04-01

This work explores a fundamental dynamical structure for a wide range of many-body quantum systems under periodic driving. Generically, in the thermodynamic limit, such systems are known to heat up to infinite temperature states in the long-time limit irrespective of dynamical details, which kills all the specific properties of the system. In the present study, instead of considering infinitely long-time scale, we aim to provide a general framework to understand the long but finite time behavior, namely the transient dynamics. In our analysis, we focus on the Floquet-Magnus (FM) expansion that gives a formal expression of the effective Hamiltonian on the system. Although in general the full series expansion is not convergent in the thermodynamics limit, we give a clear relationship between the FM expansion and the transient dynamics. More precisely, we rigorously show that a truncated version of the FM expansion accurately describes the exact dynamics for a certain time-scale. Our theory reveals an experimental time-scale for which non-trivial dynamical phenomena can be reliably observed. We discuss several dynamical phenomena, such as the effect of small integrability breaking, efficient numerical simulation of periodically driven systems, dynamical localization and thermalization. Especially on thermalization, we discuss a generic scenario on the prethermalization phenomenon in periodically driven systems.

Generic metrics and quantitative approaches for system resilience as a function of time

International Nuclear Information System (INIS)

Henry, Devanandham; Emmanuel Ramirez-Marquez, Jose

2012-01-01

Resilience is generally understood as the ability of an entity to recover from an external disruptive event. In the system domain, a formal definition and quantification of the concept of resilience has been elusive. This paper proposes generic metrics and formulae for quantifying system resilience. The discussions and graphical examples illustrate that the quantitative model is aligned with the fundamental concept of resilience. Based on the approach presented it is possible to analyze resilience as a time dependent function in the context of systems. The paper describes the metrics of network and system resilience, time for resilience and total cost of resilience. Also the paper describes the key parameters necessary to analyze system resilience such as the following: disruptive events, component restoration and overall resilience strategy. A road network example is used to demonstrate the applicability of the proposed resilience metrics and how these analyses form the basis for developing effective resilience design strategies. The metrics described are generic enough to be implemented in a variety of applications as long as appropriate figures-of-merit and the necessary system parameters, system decomposition and component parameters are defined. - Highlights: ► Propose a graphical model for the understanding of the resilience process. ► Mathematical description of resilience as a function of time. ► Identification of necessary concepts to define and evaluate network resilience. ► Development of cost and time to recovery metrics based on resilience formulation.

Sorption data bases for generic Swiss argillaceous rock systems

International Nuclear Information System (INIS)

Bradbury, M. H.; Baeyens, B.; Thoenen, T.

2010-09-01

implies, these factors were used to convert the (predominantly) illite sorption values into sorption values valid for the defined generic conditions with regard to mineralogy and porewater composition. Conversion factors were used to adapt sorption values to mineralogy (CF min ), to pH value (CF pH ) and to radionuclide speciation (CF spec ). Finally, a Lab→Field conversion factor (CF Lab→Field ) was applied to adapt sorption data measured in dispersed systems (batch experiments) to intact rock under in-situ conditions. Calcareous rock is used in safety analyses as being representative of a clay rock which has lost most of its favorable sorption properties due to near-field effects such as alteration by an alkaline plume and subsequent processes. It is assumed that calcareous rocks do not contain any significant quantities of phyllosilicates and that only uptake data on calcite are relevant. Sorption data on calcite are extremely sparse and the uptake mechanisms are not fully understood. However, when the existing sorption data (log R d values) are plotted against the ionic radii of the respective metals, an acceptable linear correlation between these two quantities is found. This so-called linear free energy relationship is used to complement the sparse experimental data in the SDB for calcareous systems. (authors)

Impact of delayed information in sub-second complex systems

Science.gov (United States)

Manrique, Pedro D.; Zheng, Minzhang; Johnson Restrepo, D. Dylan; Hui, Pak Ming; Johnson, Neil F.

What happens when you slow down the delivery of information in large-scale complex systems that operate faster than the blink of an eye? This question just adopted immediate commercial, legal and political importance following U.S. regulators' decision to allow an intentional 350 microsecond delay to be added in the ultrafast network of financial exchanges. However there is still no scientific understanding available to policymakers of the potential system-wide impact of such delays. Here we take a first step in addressing this question using a minimal model of a population of competing, heterogeneous, adaptive agents which has previously been shown to produce similar statistical features to real markets. We find that while certain extreme system-level behaviors can be prevented by such delays, the duration of others is increased. This leads to a highly non-trivial relationship between delays and system-wide instabilities which warrants deeper empirical investigation. The generic nature of our model suggests there should be a fairly wide class of complex systems where such delay-driven extreme behaviors can arise, e.g. sub-second delays in brain function possibly impacting individuals' behavior, and sub-second delays in navigational systems potentially impacting the safety of driverless vehicles.

Impact of delayed information in sub-second complex systems

Directory of Open Access Journals (Sweden)

Pedro D. Manrique

Full Text Available What happens when you slow down the delivery of information in large-scale complex systems that operate faster than the blink of an eye? This question just adopted immediate commercial, legal and political importance following U.S. regulators’ decision to allow an intentional 350 microsecond delay to be added in the ultrafast network of financial exchanges. However there is still no scientific understanding available to policymakers of the potential system-wide impact of such delays. Here we take a first step in addressing this question using a minimal model of a population of competing, heterogeneous, adaptive agents which has previously been shown to produce similar statistical features to real markets. We find that while certain extreme system-level behaviors can be prevented by such delays, the duration of others is increased. This leads to a highly non-trivial relationship between delays and system-wide instabilities which warrants deeper empirical investigation. The generic nature of our model suggests there should be a fairly wide class of complex systems where such delay-driven extreme behaviors can arise, e.g. sub-second delays in brain function possibly impacting individuals’ behavior, and sub-second delays in navigational systems potentially impacting the safety of driverless vehicles. Keywords: Ultra-fast networks, Temporal perturbation, Competition, Modeling

A Generic Approach to Analyze the Impact of a Future Aircraft Design on the Boarding Process

Directory of Open Access Journals (Sweden)

Bekir Yildiz

2018-01-01

Full Text Available The turnaround process constitutes an important part of the air transportation system. Airports often represent bottlenecks in air traffic management (ATM, thus operations related to the preparation of the aircraft for the next flight leg have to be executed smoothly and in a timely manner. The ATM significantly depends on a reliable turnaround process. Future paradigm changes with respect to airplane energy sources, aircraft design or propulsion concepts will also influence the airport layout. As a consequence, operational processes associated with the turnaround will be affected. Airlines aim for efficient and timely turnaround operations that are correlated with higher profits. This case study discusses an approach to investigate a new aircraft design with respect to the implications on the turnaround. The boarding process, as part of the turnaround, serves as an example to evaluate the consequences of new design concepts. This study is part of an interdisciplinary research to investigate future energy, propulsion and designs concepts and their implications on the whole ATM system. Due to these new concepts, several processes of the turnaround will be affected. For example, new energy storage concepts will influence the fueling process on the aircraft itself or might lead to a new infrastructure at the airport. This paper aims to evaluate the applied methodology in the case of a new boarding process, due to a new aircraft design, by means of a generic example. An agent-based boarding simulation is applied to assess passenger behavior during boarding, particularly with regard to cabin layout and seat configuration. The results of the generic boarding simulation are integrated into a simplified, deterministic and generic simulation of the turnaround process. This was done to assess the proposed framework for future investigations which on the one hand address the ATM system holistically and on the other, incorporate additional or adapted

[Generic drugs: good or bad? Physician's knowledge of generic drugs and prescribing habits].

Science.gov (United States)

García, A J; Martos, F; Leiva, F; Sánchez de la Cuesta, F

2003-01-01

In this article we analyze the responses of 1220 Spanish physicians who participated in a survery about generic drugs. A previously validated questionnaire was sent to physicians through the Spanish Medical Councils of the different provinces. Four items were analyzed: what doctors know about generic drugs (knowledge); physicians' prescribing habits concerning these drugs (attitude and professional competence); how prescription of generic drugs effects pharmaceutical costs amd, finally, what doctors believe a generic drug should be. The influence of physician-related variables (age, type of contract, specialty, workload, etc.) on prescribing of generic drugs was also analyzed. In view of the results, we believe that to rationalize expenditure through and appropriate policy on generic drugs Spanish health authorities should offer more and better training and information (clear and independent) about what generic drugs are.

Generic mechanisms of decoherence of quantum oscillations in magnetic double-well systems

International Nuclear Information System (INIS)

Chudnovsky, Eugene M.

2004-01-01

Fundamental conservation laws mandate parameter-free generic mechanisms of decoherence of quantum oscillations in double-well systems. We consider two examples: tunneling of the magnetic moment in nanomagnets and tunneling between macroscopic current states in SQUIDs. In both cases the decoherence occurs via emission of phonons and photons at the oscillation frequency. We also show that in a system of identical qubits the decoherence greatly increases due to the superradiance of electromagnetic and sound waves. Our findings have important implications for building elements of quantum computers based upon nanomagnets and SQUIDs

Generic mechanisms of decoherence of quantum oscillations in magnetic double-well systems

Energy Technology Data Exchange (ETDEWEB)

Chudnovsky, Eugene M. E-mail: chudnov@lehman.cuny.edu

2004-05-01

Fundamental conservation laws mandate parameter-free generic mechanisms of decoherence of quantum oscillations in double-well systems. We consider two examples: tunneling of the magnetic moment in nanomagnets and tunneling between macroscopic current states in SQUIDs. In both cases the decoherence occurs via emission of phonons and photons at the oscillation frequency. We also show that in a system of identical qubits the decoherence greatly increases due to the superradiance of electromagnetic and sound waves. Our findings have important implications for building elements of quantum computers based upon nanomagnets and SQUIDs.

A Novel Scoring System Approach to Assess Patients with Lyme Disease (Nutech Functional Score

Directory of Open Access Journals (Sweden)

Geeta Shroff

2018-01-01

Full Text Available Introduction: A bacterial infection by Borrelia burgdorferi referred to as Lyme disease (LD or borreliosis is transmitted mostly by a bite of the tick Ixodes scapularis in the USA and Ixodes ricinus in Europe. Various tests are used for the diagnosis of LD, but their results are often unreliable. We compiled a list of clinically visible and patient-reported symptoms that are associated with LD. Based on this list, we developed a novel scoring system. Methodology: Nutech functional Score (NFS, which is a 43 point positional (every symptom is subgraded and each alternative gets some points according to its position and directional (moves in direction bad to good scoring system that assesses the patient's condition. Results: The grades of the scoring system have been converted into numeric values for conducting probability based studies. Each symptom is graded from 1 to 5 that runs in direction BAD → GOOD. Conclusion: NFS is a unique tool that can be used universally to assess the condition of patients with LD.

Potential of pedestrian protection systems--a parameter study using finite element models of pedestrian dummy and generic passenger vehicles.

Science.gov (United States)

Fredriksson, Rikard; Shin, Jaeho; Untaroiu, Costin D

2011-08-01

To study the potential of active, passive, and integrated (combined active and passive) safety systems in reducing pedestrian upper body loading in typical impact configurations. Finite element simulations using models of generic sedan car fronts and the Polar II pedestrian dummy were performed for 3 impact configurations at 2 impact speeds. Chest contact force, head injury criterion (HIC(15)), head angular acceleration, and the cumulative strain damage measure (CSDM(0.25)) were employed as injury parameters. Further, 3 countermeasures were modeled: an active autonomous braking system, a passive deployable countermeasure, and an integrated system combining the active and passive systems. The auto-brake system was modeled by reducing impact speed by 10 km/h (equivalent to ideal full braking over 0.3 s) and introducing a pitch of 1 degree and in-crash deceleration of 1 g. The deployable system consisted of a deployable hood, lifting 100 mm in the rear, and a lower windshield air bag. All 3 countermeasures showed benefit in a majority of impact configurations in terms of injury prevention. The auto-brake system reduced chest force in a majority of the configurations and decreased HIC(15), head angular acceleration, and CSDM in all configurations. Averaging all impact configurations, the auto-brake system showed reductions of injury predictors from 20 percent (chest force) to 82 percent (HIC). The passive deployable countermeasure reduced chest force and HIC(15) in a majority of configurations and head angular acceleration and CSDM in all configurations, although the CSDM decrease in 2 configurations was minimal. On average a reduction from 20 percent (CSDM) to 58 percent (HIC) was recorded in the passive deployable countermeasures. Finally, the integrated system evaluated in this study reduced all injury assessment parameters in all configurations compared to the reference situations. The average reductions achieved by the integrated system ranged from 56 percent

Evaluation of a Lameness Scoring System for Dairy Cows

DEFF Research Database (Denmark)

Thomsen, P T; Munksgaard, L; Tøgersen, F A

2008-01-01

Lameness is a major problem in dairy production both in terms of reduced production and compromised animal welfare. A 5-point lameness scoring system was developed based on previously published systems, but optimized for use under field conditions. The scoring system included the words "in most...... categories by different observers before or after training. In conclusion, the results suggest that the lameness categories were not equidistant and the scoring system has reasonable reliability in terms of intra- and interobserver agreement...

A scoring system for ascertainment of incident stroke; the Risk Index Score (RISc).

Science.gov (United States)

Kass-Hout, T A; Moyé, L A; Smith, M A; Morgenstern, L B

2006-01-01

The main objective of this study was to develop and validate a computer-based statistical algorithm that could be translated into a simple scoring system in order to ascertain incident stroke cases using hospital admission medical records data. The Risk Index Score (RISc) algorithm was developed using data collected prospectively by the Brain Attack Surveillance in Corpus Christi (BASIC) project, 2000. The validity of RISc was evaluated by estimating the concordance of scoring system stroke ascertainment to stroke ascertainment by physician and/or abstractor review of hospital admission records. RISc was developed on 1718 randomly selected patients (training set) and then statistically validated on an independent sample of 858 patients (validation set). A multivariable logistic model was used to develop RISc and subsequently evaluated by goodness-of-fit and receiver operating characteristic (ROC) analyses. The higher the value of RISc, the higher the patient's risk of potential stroke. The study showed RISc was well calibrated and discriminated those who had potential stroke from those that did not on initial screening. In this study we developed and validated a rapid, easy, efficient, and accurate method to ascertain incident stroke cases from routine hospital admission records for epidemiologic investigations. Validation of this scoring system was achieved statistically; however, clinical validation in a community hospital setting is warranted.

A generic coding approach for the examination of meal patterns.

Science.gov (United States)

Woolhead, Clara; Gibney, Michael J; Walsh, Marianne C; Brennan, Lorraine; Gibney, Eileen R

2015-08-01

Meal pattern analysis can be complex because of the large variability in meal consumption. The use of aggregated, generic meal data may address some of these issues. The objective was to develop a meal coding system and use it to explore meal patterns. Dietary data were used from the National Adult Nutrition Survey (2008-2010), which collected 4-d food diary information from 1500 healthy adults. Self-recorded meal types were listed for each food item. Common food group combinations were identified to generate a number of generic meals for each meal type: breakfast, light meals, main meals, snacks, and beverages. Mean nutritional compositions of the generic meals were determined and substituted into the data set to produce a generic meal data set. Statistical comparisons were performed against the original National Adult Nutrition Survey data. Principal component analysis was carried out by using these generic meals to identify meal patterns. A total of 21,948 individual meals were reduced to 63 generic meals. Good agreement was seen for nutritional comparisons (original compared with generic data sets mean ± SD), such as fat (75.7 ± 29.4 and 71.7 ± 12.9 g, respectively, P = 0.243) and protein (83.3 ± 26.9 and 80.1 ± 13.4 g, respectively, P = 0.525). Similarly, Bland-Altman plots demonstrated good agreement (<5% outside limits of agreement) for many nutrients, including protein, saturated fat, and polyunsaturated fat. Twelve meal types were identified from the principal component analysis ranging in meal-type inclusion/exclusion, varying in energy-dense meals, and differing in the constituents of the meals. A novel meal coding system was developed; dietary intake data were recoded by using generic meal consumption data. Analysis revealed that the generic meal coding system may be appropriate when examining nutrient intakes in the population. Furthermore, such a coding system was shown to be suitable for use in determining meal-based dietary patterns. © 2015

From generic to biosimilar drugs: why take an innovative pace?

Directory of Open Access Journals (Sweden)

Fereshteh Barei

2012-12-01

Full Text Available BACKGROUND: The transition of the generic/biotechnology industry to innovation by investing in innovative R&D will enhance business expertise in biopharmaceutical development and manufacturing. The major impact of this evolution is on patient access to treatment and savings for the health care systems. OBJECTIVES: The aim of this paper is to investigate the innovative aspect of biosimilar and biobetter products, manufactured by some big generic companies. We will also try to explore the innovative business strategy, implementing this high risk product differentiation policy. METHODS: This qualitative research is conducted by a series of interviews with CEOs, physicians, and academics in different countries. The qualitative data obtained were analyzed by Nvivo9.2 software. A literature review has also contributed to our key findings. RESULTS: The results show that switching into biosimilars/biobetters is an innovative strategic choice, approved by some big generic pharmaceutical companies. The biosimilar/biobetter products can be considered innovative because of their value added quality. CONCLUSION: Expanding the product portfolio to biosimilars/biobetter can be considered as a long run strategy in the innovative business plans aiming to ensure the market access. Patients and their access to better treatments are major components of these innovative business models.

Generic Software Architecture for Launchers

Science.gov (United States)

Carre, Emilien; Gast, Philippe; Hiron, Emmanuel; Leblanc, Alain; Lesens, David; Mescam, Emmanuelle; Moro, Pierre

2015-09-01

The definition and reuse of generic software architecture for launchers is not so usual for several reasons: the number of European launcher families is very small (Ariane 5 and Vega for these last decades); the real time constraints (reactivity and determinism needs) are very hard; low levels of versatility are required (implying often an ad hoc development of the launcher mission). In comparison, satellites are often built on a generic platform made up of reusable hardware building blocks (processors, star-trackers, gyroscopes, etc.) and reusable software building blocks (middleware, TM/TC, On Board Control Procedure, etc.). If some of these reasons are still valid (e.g. the limited number of development), the increase of the available CPU power makes today an approach based on a generic time triggered middleware (ensuring the full determinism of the system) and a centralised mission and vehicle management (offering more flexibility in the design and facilitating the long term maintenance) achievable. This paper presents an example of generic software architecture which could be envisaged for future launchers, based on the previously described principles and supported by model driven engineering and automatic code generation.

Using Service Oriented Architecture in a Generic Virtual Power Plant

DEFF Research Database (Denmark)

Andersen, Peter Bach; Poulsen, Bjarne; Træholt, Chresten

2009-01-01

The purpose of this paper is to find and describe a suitable software framework that can be used to help implement the concept of a Generic Virtual Power Plant in the future power system. The Generic Virtual Power Plant concept, along with the utilization of distributed energy resources, has many...... the Generic Virtual Power Plant, an array of different software design principles, patterns and architectures must be applied. Especially Service Oriented Architecture (SOA) can aid in implementing the Generic Virtual Power Plant.......The purpose of this paper is to find and describe a suitable software framework that can be used to help implement the concept of a Generic Virtual Power Plant in the future power system. The Generic Virtual Power Plant concept, along with the utilization of distributed energy resources, has many...... interesting properties that can influence the future shape of power markets. The concept holds many promises including cheaper power to the consumer, a more flexible and responsive power production and the support of a more environment-friendly development. In order to realize a software solution supporting...

Scoring environmental and socioeconomic impacts of alien plants invasive in Europe

Czech Academy of Sciences Publication Activity Database

Rumlerová, Zuzana; Vila, M.; Pergl, Jan; Nentwig, W.; Pyšek, Petr

2016-01-01

Roč. 18, č. 12 (2016), s. 3697-3711 ISSN 1387-3547 R&D Projects: GA ČR(CZ) GAP504/11/1028; GA ČR GB14-36079G Grant - others:AV ČR(CZ) AP1002 Program:Akademická prémie - Praemium Academiae Institutional support: RVO:67985939 Keywords : invasion impacts * scoring * Europe Subject RIV: EH - Ecology, Behaviour Impact factor: 2.473, year: 2016

Development of an integrated generic model for multi-scale assessment of the impacts of agro-ecosystems on major ecosystem services in West Africa.

Science.gov (United States)

Belem, Mahamadou; Saqalli, Mehdi

2017-11-01

This paper presents an integrated model assessing the impacts of climate change, agro-ecosystem and demographic transition patterns on major ecosystem services in West-Africa along a partial overview of economic aspects (poverty reduction, food self-sufficiency and income generation). The model is based on an agent-based model associated with a soil model and multi-scale spatial model. The resulting Model for West-Africa Agro-Ecosystem Integrated Assessment (MOWASIA) is ecologically generic, meaning it is designed for all sudano-sahelian environments but may then be used as an experimentation facility for testing different scenarios combining ecological and socioeconomic dimensions. A case study in Burkina Faso is examined to assess the environmental and economic performances of semi-continuous and continuous farming systems. Results show that the semi-continuous system using organic fertilizer and fallowing practices contribute better to environment preservation and food security than the more economically performant continuous system. In addition, this study showed that farmers heterogeneity could play an important role in agricultural policies planning and assessment. In addition, the results showed that MOWASIA is an effective tool for designing, analysing the impacts of agro-ecosystems. Copyright © 2017. Published by Elsevier Ltd.

The rat whole embryo culture assay using the Dysmorphology Score system.

Science.gov (United States)

Zhang, Cindy; Panzica-Kelly, Julie; Augustine-Rauch, Karen

2013-01-01

The rat whole embryo culture (WEC) system has been used extensively for characterizing teratogenic properties of test chemicals. In this chapter, we describe the methodology for culturing rat embryos as well as a new morphological score system, the Dysmorphology Score (DMS) system for assessing morphology of mid gestation (gestational day 11) rat embryos. In contrast to the developmental stage focused scoring associated with the Brown and Fabro score system, this new score system assesses the respective degree of severity of dysmorphology, which delineates normal from abnormal morphology of specific embryonic structures and organ systems. This score system generates an approach that allows rapid identification and quantification of adverse developmental findings, making it conducive for characterization of compounds for teratogenic properties and screening activities.

Comparison of brand versus generic antiepileptic drug adverse event reporting rates in the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS).

Science.gov (United States)

Rahman, Md Motiur; Alatawi, Yasser; Cheng, Ning; Qian, Jingjing; Plotkina, Annya V; Peissig, Peggy L; Berg, Richard L; Page, David; Hansen, Richard A

2017-09-01

Despite the cost saving role of generic anti-epileptic drugs (AEDs), debate exists as to whether generic substitution of branded AEDs may lead to therapeutic failure and increased toxicity. This study compared adverse event (AE) reporting rates for brand vs. authorized generic (AG) vs. generic AEDs. Since AGs are pharmaceutically identical to brand but perceived as generics, the generic vs. AG comparison minimized potential bias against generics. Events reported to the U.S. Food and Drug Administration Adverse Event Reporting System between January 2004 to March 2015 with lamotrigine, carbamazepine, and oxcarbazepine listed as primary or secondary suspect were classified as brand, generic, or AG based on the manufacturer. Disproportionality analyses using the reporting odds ratio (ROR) assessed the relative rate of reporting of labeled AEs compared to reporting these events with all other drugs. The Breslow-Day statistic compared RORs across brand, AG, and other generics using a Bonferroni-corrected Pbrand and generics for all three drugs of interest (Breslow-Day Pbrands and generics have similar reporting rates after accounting for generic perception biases. Disproportional suicide reporting was observed for generics compared with AGs and brand, although this finding needs further study. Copyright © 2017 Elsevier B.V. All rights reserved.

Comparative analysis of the cost and effectiveness of generic and brand-name antibiotics: the case of uncomplicated urinary tract infection.

Science.gov (United States)

Lin, Yu-Shiuan; Jan, I-Shiow; Cheng, Shou-Hsia

2017-03-01

Generic medications used for chronic diseases are beneficial in containing healthcare costs and improving drug accessibility. However, the effects of generic drugs in acute and severe illness remain controversial. This study aims to investigate treatment costs and outcomes of generic antibiotics prescribed for adults with a urinary tract infection in outpatient settings. The data source was the Longitudinal Health Insurance Database of Taiwan. We included outpatients aged 20 years and above with a urinary tract infection who required one oral antibiotic for which brand-name and generic products were simultaneously available. Drug cost and overall healthcare expense of the index consultation, healthcare cost during a 42-day follow-up period, and treatment failure rates were the main dependent variables. Data were compared between brand-name and generic users from the entire cohort and a propensity score-matched samples. Results from the entire cohort and propensity score-matched samples were similar. Daily antibiotic cost was significantly lower among generic users than brand-name users. Significant lower total drug claims of the index consultation only existed in patients receiving the investigated antibiotics, while the drug price between brand-name and generic versions were relatively large (e.g., >50%). The overall healthcare cost of the index consultation, healthcare expenditure during a 42-day follow-up period, and treatment failure rates were similar between the two groups. Compared with those treated with brand-name antibiotics, outpatients who received generic antibiotics had equivalent treatment outcomes with lower drug costs. Generic antibiotics are effective and worthy of adoption among outpatients with simple infections indicating oral antibiotic treatment. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Complex dynamics of the generic and brand advertising strategies in duopoly

International Nuclear Information System (INIS)

Qi Jie; Ding Yongsheng; Chen Liang

2008-01-01

By using the optimal profit adjusting strategies, a dynamic advertising competition model in duopoly is extended from Krishnamurthy's static model. Both generic and brand effects for advertising are considered. This model can create complex bifurcating and chaotic behavior for the generic advertising efforts, which lead to chaotic dynamics for the brand advertising and even for the whole system. The asymptotic properties of the symmetric system and the asymmetric system are also investigated, which reflect interactions between the two firms' advertising strategies and relationships between the brand and the generic advertising expenditures

Complex dynamics of the generic and brand advertising strategies in duopoly

Energy Technology Data Exchange (ETDEWEB)

Qi Jie [College of Information Sciences and Technology, Donghua University, Shanghai 200051 (China)], E-mail: jieqi@dhu.edu.cn; Ding Yongsheng [College of Information Sciences and Technology, Donghua University, Shanghai 200051 (China)], E-mail: ysding@dhu.edu.cn; Chen Liang [College of Information Sciences and Technology, Donghua University, Shanghai 200051 (China)

2008-04-15

By using the optimal profit adjusting strategies, a dynamic advertising competition model in duopoly is extended from Krishnamurthy's static model. Both generic and brand effects for advertising are considered. This model can create complex bifurcating and chaotic behavior for the generic advertising efforts, which lead to chaotic dynamics for the brand advertising and even for the whole system. The asymptotic properties of the symmetric system and the asymmetric system are also investigated, which reflect interactions between the two firms' advertising strategies and relationships between the brand and the generic advertising expenditures.

Interval Coded Scoring: a toolbox for interpretable scoring systems

Directory of Open Access Journals (Sweden)

Lieven Billiet

2018-04-01

Full Text Available Over the last decades, clinical decision support systems have been gaining importance. They help clinicians to make effective use of the overload of available information to obtain correct diagnoses and appropriate treatments. However, their power often comes at the cost of a black box model which cannot be interpreted easily. This interpretability is of paramount importance in a medical setting with regard to trust and (legal responsibility. In contrast, existing medical scoring systems are easy to understand and use, but they are often a simplified rule-of-thumb summary of previous medical experience rather than a well-founded system based on available data. Interval Coded Scoring (ICS connects these two approaches, exploiting the power of sparse optimization to derive scoring systems from training data. The presented toolbox interface makes this theory easily applicable to both small and large datasets. It contains two possible problem formulations based on linear programming or elastic net. Both allow to construct a model for a binary classification problem and establish risk profiles that can be used for future diagnosis. All of this requires only a few lines of code. ICS differs from standard machine learning through its model consisting of interpretable main effects and interactions. Furthermore, insertion of expert knowledge is possible because the training can be semi-automatic. This allows end users to make a trade-off between complexity and performance based on cross-validation results and expert knowledge. Additionally, the toolbox offers an accessible way to assess classification performance via accuracy and the ROC curve, whereas the calibration of the risk profile can be evaluated via a calibration curve. Finally, the colour-coded model visualization has particular appeal if one wants to apply ICS manually on new observations, as well as for validation by experts in the specific application domains. The validity and applicability

Generic legislation of new psychoactive drugs.

Science.gov (United States)

van Amsterdam, Jan; Nutt, David; van den Brink, Wim

2013-03-01

New psychoactive drugs (NPDs, new psychoactive substances) enter the market all the time. However, it takes several months to ban these NPDs and immediate action is generally not possible. Several European countries and drug enforcement officers insist on a faster procedure to ban NPDs. Introduction of generic legislation, in which clusters of psychotropic drugs are banned in advance, has been mentioned as a possible solution. Here we discuss the pros and cons of such an approach. First, generic legislation could unintentionally increase the expenditures of enforcement, black market practices, administrative burden and health risks for users. Second, it may have a negative impact on research and the development of new treatments. Third, due to the complexity of generic legislation, problems in the enforcement are anticipated due to lack of knowledge about the chemical nomenclature. Finally, various legal options are already available to ban the use, sale and trade of NPDs. We therefore conclude that the currently used scientific benefit-risk evaluation should be continued to limit the adverse health effects of NPDs. Only in emergency cases, where fatal incidents (may) occur, should this approach be overruled.

Generic communications index. Listings of communications 1971-1989

Energy Technology Data Exchange (ETDEWEB)

Hagemeyer, D; Towle, H

1991-05-01

As part of its program to feed back information on operating experience to industry, the U.S. Nuclear Regulatory Commission (NRC) issues generic communications called bulletins (about 5/yr), circulars (now discontinued), generic letters (about 20/yr), and information notices (about 100/yr). The report presents an updated Generic Communications Index (GCI; previously published in NUREG/CR-4690, Vol. 1, December 1987) of all such communications from 1971, when such documentation started, to 1989. The GCI consists of records, one for each communication, containing fields for identification number, title, NRC technical contact, general system or topic, specific component or topic, cause or defect, potential effect, remarks, and vendors involved. To facilitate information retrieval, the report also contains topical listings of generic communications numbers. (author)

Computer-Assisted Automated Scoring of Polysomnograms Using the Somnolyzer System.

Science.gov (United States)

Punjabi, Naresh M; Shifa, Naima; Dorffner, Georg; Patil, Susheel; Pien, Grace; Aurora, Rashmi N

2015-10-01

Manual scoring of polysomnograms is a time-consuming and tedious process. To expedite the scoring of polysomnograms, several computerized algorithms for automated scoring have been developed. The overarching goal of this study was to determine the validity of the Somnolyzer system, an automated system for scoring polysomnograms. The analysis sample comprised of 97 sleep studies. Each polysomnogram was manually scored by certified technologists from four sleep laboratories and concurrently subjected to automated scoring by the Somnolyzer system. Agreement between manual and automated scoring was examined. Sleep staging and scoring of disordered breathing events was conducted using the 2007 American Academy of Sleep Medicine criteria. Clinical sleep laboratories. A high degree of agreement was noted between manual and automated scoring of the apnea-hypopnea index (AHI). The average correlation between the manually scored AHI across the four clinical sites was 0.92 (95% confidence interval: 0.90-0.93). Similarly, the average correlation between the manual and Somnolyzer-scored AHI values was 0.93 (95% confidence interval: 0.91-0.96). Thus, interscorer correlation between the manually scored results was no different than that derived from manual and automated scoring. Substantial concordance in the arousal index, total sleep time, and sleep efficiency between manual and automated scoring was also observed. In contrast, differences were noted between manually and automated scored percentages of sleep stages N1, N2, and N3. Automated analysis of polysomnograms using the Somnolyzer system provides results that are comparable to manual scoring for commonly used metrics in sleep medicine. Although differences exist between manual versus automated scoring for specific sleep stages, the level of agreement between manual and automated scoring is not significantly different than that between any two human scorers. In light of the burden associated with manual scoring, automated

Generic inertia emulation controller for multi-terminal voltage-source-converter high voltage direct current systems

DEFF Research Database (Denmark)

Zhu, Jiebei; Guerrero, Josep M.; Hung, William

2014-01-01

A generic Inertia Emulation Controller (INEC) scheme for Multi-Terminal Voltage-Source-Converter based HVDC (VSC-MTDC) systems is proposed and presented in this paper. The proposed INEC can be incorporated in any Grid-side Voltage-Source-Converter (GVSC) station, allowing the MTDC terminal...

A Score Function for Optimizing the Cycle-Life of Battery-Powered Embedded Systems

DEFF Research Database (Denmark)

Wognsen, Erik Ramsgaard; Haverkort, Boudewijn; Jongerden, Marijn

2015-01-01

An ever increasing share of embedded systems is powered by rechargeable batteries. These batteries deteriorate with the number of charge/discharge cycles they are subjected to, the so-called cycle life. In this paper, we propose the wear score function to compare and evaluate the relative impact...... of usage (charge and discharge) profiles on cycle life. The wear score function can not only be used to rank different usage profiles, these rankings can also be used as a criterion for optimizing the overall lifetime of a battery-powered system. We perform such an optimization on a nano-satellite case...... checking and reinforcement learning to synthesize near-optimal scheduling strategies subject to possible hard timing-constaints. We use this to study the trade-off between optimal short-term dynamic payload selection and the operational life of the satellite....

Generic antibiotics in Japan.

Science.gov (United States)

Fujimura, Shigeru; Watanabe, Akira

2012-08-01

Generic drugs have been used extensively in many developed countries, although their use in Japan has been limited. Generic drugs reduce drug expenses and thereby national medical expenditure. Because generic drugs provide advantages for both public administration and consumers, it is expected that they will be more widely used in the future. However, the diffusion rate of generic drugs in Japan is quite low compared with that of other developed countries. An investigation on generic drugs conducted by the Ministry of Health, Labour and Welfare in Japan revealed that 17.2 % of doctors and 37.2 % of patients had not used generic drugs. The major reasons for this low use rate included distrust of off-patent products and lower drug price margin compared with the brand name drug. The generic drugs available in the market include external drugs such as wet packs, antihypertensive agents, analgesics, anticancer drugs, and antibiotics. Among them, antibiotics are frequently used in cases of acute infectious diseases. When the treatment of these infections is delayed, the infection might be aggravated rapidly. The pharmacokinetics-pharmacodynamics (PK-PD) theory has been adopted in recent chemotherapy, and in many cases, the most appropriate dosage and administration of antibiotics are determined for individual patients considering renal function; high-dosage antibiotics are used preferably for a short duration. Therefore, a highly detailed antimicrobial agent is necessary. However, some of the generic antibiotics have less antibacterial potency or solubility than the brand name products. We showed that the potency of the generic products of vancomycin and teicoplanin is lower than that of the branded drugs by 14.6 % and 17.3 %, respectively. Furthermore, we confirmed that a generic meropenem drug for injection required about 82 s to solubilize in saline, whereas the brand product required only about 21 s. It was thought that the cause may be the difference in size of bulk

Mixed Approach Retrospective Analyses of Suicide and Suicidal Ideation for Brand Compared with Generic Central Nervous System Drugs.

Science.gov (United States)

Cheng, Ning; Rahman, Md Motiur; Alatawi, Yasser; Qian, Jingjing; Peissig, Peggy L; Berg, Richard L; Page, C David; Hansen, Richard A

2018-04-01

Several different types of drugs acting on the central nervous system (CNS) have previously been associated with an increased risk of suicide and suicidal ideation (broadly referred to as suicide). However, a differential association between brand and generic CNS drugs and suicide has not been reported. This study compares suicide adverse event rates for brand versus generic CNS drugs using multiple sources of data. Selected examples of CNS drugs (sertraline, gabapentin, zolpidem, and methylphenidate) were evaluated via the US FDA Adverse Event Reporting System (FAERS) for a hypothesis-generating study, and then via administrative claims and electronic health record (EHR) data for a more rigorous retrospective cohort study. Disproportionality analyses with reporting odds ratios and 95% confidence intervals (CIs) were used in the FAERS analyses to quantify the association between each drug and reported suicide. For the cohort studies, Cox proportional hazards models were used, controlling for demographic and clinical characteristics as well as the background risk of suicide in the insured population. The FAERS analyses found significantly lower suicide reporting rates for brands compared with generics for all four studied products (Breslow-Day P brand CNS drugs in FAERS and adjusted retrospective cohort analyses remained significant only for sertraline. However, even for sertraline, temporal confounding related to the close proximity of black box warnings and generic availability is possible. Additional analyses in larger data sources with additional drugs are needed.

Assessment of three risk evaluation systems for patients aged ≥70 in East China: performance of SinoSCORE, EuroSCORE II and the STS risk evaluation system.

Science.gov (United States)

Shan, Lingtong; Ge, Wen; Pu, Yiwei; Cheng, Hong; Cang, Zhengqiang; Zhang, Xing; Li, Qifan; Xu, Anyang; Wang, Qi; Gu, Chang; Zhang, Yangyang

2018-01-01

To assess and compare the predictive ability of three risk evaluation systems (SinoSCORE, EuroSCORE II and the STS risk evaluation system) in patients aged ≥70, and who underwent coronary artery bypass grafting (CABG) in East China. Three risk evaluation systems were applied to 1,946 consecutive patients who underwent isolated CABG from January 2004 to September 2016 in two hospitals. Patients were divided into two subsets according to their age: elderly group (age ≥70) with a younger group (age evaluation system were 0.78(0.64)%, 1.43(1.14)% and 0.78(0.77)%, respectively. SinoSCORE achieved the best discrimination (the area under the receiver operating characteristic curve (AUC) = 0.829), followed by the STS risk evaluation system (AUC = 0.790) and EuroSCORE II (AUC = 0.769) in the entire cohort. In the elderly group, the observed mortality rate was 4.82% while it was 1.38% in the younger group. SinoSCORE (AUC = .829) also achieved the best discrimination in the elderly group, followed by the STS risk evaluation system (AUC = .730) and EuroSCORE II (AUC = 0.640) while all three risk evaluation systems all had good performances in the younger group. SinoSCORE, EuroSCORE II and the STS risk evaluation system all achieved positive calibrations in the entire cohort and subsets. The performance of the three risk evaluation systems was not ideal in the entire cohort. In the elderly group, SinoSCORE appeared to achieve better predictive efficiency than EuroSCORE II and the STS risk evaluation system.

Knowledge-based operation guidance system for nuclear power plants based on generic task methodology

International Nuclear Information System (INIS)

Yamada, Naoyuki; Chandrasekaran, B.; Bhatnager, R.

1989-01-01

A knowledge-based system for operation guidance of nuclear power plants is proposed. The Dynamic Procedure Management System (DPMS) is designed and developed to assist human operators interactively by selecting and modifying predefined operation procedures in a dynamic situation. Unlike most operation guidance systems, DPMS has been built based on Generic Task Methodology, which makes the overall framework of the system perspicuous and also lets domain knowledge be represented in a natural way. This paper describes the organization of the system, the definition of each task, and the form and organization of knowledge, followed by an application example. (author)

A new extranodal scoring system based on the prognostically relevant extranodal sites in diffuse large B-cell lymphoma, not otherwise specified treated with chemoimmunotherapy.

Science.gov (United States)

Hwang, Hee Sang; Yoon, Dok Hyun; Suh, Cheolwon; Huh, Jooryung

2016-08-01

Extranodal involvement is a well-known prognostic factor in patients with diffuse large B-cell lymphomas (DLBCL). Nevertheless, the prognostic impact of the extranodal scoring system included in the conventional international prognostic index (IPI) has been questioned in an era where rituximab treatment has become widespread. We investigated the prognostic impacts of individual sites of extranodal involvement in 761 patients with DLBCL who received rituximab-based chemoimmunotherapy. Subsequently, we established a new extranodal scoring system based on extranodal sites, showing significant prognostic correlation, and compared this system with conventional scoring systems, such as the IPI and the National Comprehensive Cancer Network-IPI (NCCN-IPI). An internal validation procedure, using bootstrapped samples, was also performed for both univariate and multivariate models. Using multivariate analysis with a backward variable selection, we found nine extranodal sites (the liver, lung, spleen, central nervous system, bone marrow, kidney, skin, adrenal glands, and peritoneum) that remained significant for use in the final model. Our newly established extranodal scoring system, based on these sites, was better correlated with patient survival than standard scoring systems, such as the IPI and the NCCN-IPI. Internal validation by bootstrapping demonstrated an improvement in model performance of our modified extranodal scoring system. Our new extranodal scoring system, based on the prognostically relevant sites, may improve the performance of conventional prognostic models of DLBCL in the rituximab era and warrants further external validation using large study populations.

Impact scores of invasive plants are biased by disregard of environmental co-variation and non-linearity

Directory of Open Access Journals (Sweden)

Jan Thiele

2011-10-01

Full Text Available Prioritisation of high-impact species is becoming increasingly important for management of introduced species (‘neobiota’ because of their growing number of which, however, only a small fraction has substantial impacts. Impact scores for prioritising species may be affected by the type of effect model used. Recent studies have shown that environmental co-variation and non-linearity may be significant for effect models of biological invasions. Here, we test for differences in impact scores between simple and complex effect models of three invasive plant species (Heracleum mantegazzianum, Lupinus polyphyllus, Rosa rugosa.We investigated the effects of cover percentages of the invasive plants on species richness of invaded communities using both simple linear effect models (‘basic models’ and more complex linear or non-linear models including environmental co-factors (‘full models’. Then, we calculated impact scores for each invasive species as the average reduction of species richness predicted by basic and full effect models.All three non-native species had negative effects on species richness, but the full effect models also indicated significant influence of habitat types. Heracleum mantegazzianum had uniform linear effects in all habitats, while effects of L. polyphyllus interacted strongly with habitat type, and R. rugosa showed a marked non-linear relationship. Impact scores were overestimated by basic effect models for H. mantegazzianum and R. rugosa due to disregard of habitat effects and non-linearity, respectively. In contrast, impact of L. polyphyllus was underestimated by the basic model that did not account for the strong interaction of invader cover and habitat type.We conclude that simple linear models will often yield inaccurate impact scores of non-native species. Hence, effect models should consider environmental co-variation and, if necessary, non-linearity of the effects of biological invasions on native ecosystems.

Business engineering. Generic Software Architecture in an Object Oriented View

Directory of Open Access Journals (Sweden)

Mihaela MURESAN

2006-01-01

Full Text Available The generic software architecture offers a solution for the the information system's development and implementation. A generic software/non-software model could be developed by integrating the enterprise blueprint concept (Zachman and the object oriented paradigm (Coad's archetype concept. The standardization of the generic software architecture for various specific software components could be a direction of crucial importance, offering the guarantee of the quality of the model and increasing the efficiency of the design, development and implementation of the software. This approach is also useful for the implementation of the ERP systems designed to fit the user’s particular requirements.

Analysis and study on generic models for use in assessing the impact of radioactive liquid effluent to the environment

International Nuclear Information System (INIS)

Ma Wenlin; Cao Jianzu; Fang Dong

2008-01-01

The assessment of the impact of discharges of radioactive substances into surface water under normal condition of nuclear facilities is an important part of the environmental impact analysis. Generic methods for assessing the impact of radioactive liquid effluent release into surface water provided by IAEA Safety Reports Series 19 are studied in this paper, and also an example calculation that assesses the impact of radioactive surface water discharge of HTR-PM ( High Temperature Air-cooled Reactor demonstration unit) in Anhui is presented in this paper to illustrate that a simplified but conservative assessment can be used for the purpose of screening proposed radioactive discharges. If the results meet the relevant requirements specified by the relevant regulatory authority, the further calculations are not needed. If they fails to meet the requirements, the more field data are to be sampled for calculations by more sophisticated mode or otherwise. (authors)

Scripting XML with Generic Haskell

NARCIS (Netherlands)

Atanassow, F.; Clarke, D.; Jeuring, J.T.

2003-01-01

A generic program is written once and works on values of many data types. Generic Haskell is a recent extension of the functional programming language Haskell that supports generic programming. This paper discusses how Generic Haskell can be used to implement XML tools whose behaviour depends on

Scripting XML with Generic Haskell

NARCIS (Netherlands)

Atanassow, F.; Clarke, D.; Jeuring, J.T.

2007-01-01

A generic program is written once and works on values of many data types. Generic Haskell is a recent extension of the functional programming language Haskell that supports generic programming. This paper discusses how Generic Haskell can be used to implement XML tools whose behaviour depends on

Prognostic factors and scoring system for survival in colonic perforation.

Science.gov (United States)

Komatsu, Shuhei; Shimomatsuya, Takumi; Nakajima, Masayuki; Amaya, Hirokazu; Kobuchi, Taketsune; Shiraishi, Susumu; Konishi, Sayuri; Ono, Susumu; Maruhashi, Kazuhiro

2005-01-01

No ideal and generally accepted prognostic factors and scoring systems exist to determine the prognosis of peritonitis associated with colonic perforation. This study was designed to investigate prognostic factors and evaluate the various scoring systems to allow identification of high-risk patients. Between 1996 and 2003, excluding iatrogenic and trauma cases, 26 consecutive patients underwent emergency operations for colorectal perforation and were selected for this retrospective study. Several clinical factors were analyzed as possible predictive factors, and APACHE II, SOFA, MPI, and MOF scores were calculated. The overall mortality was 26.9%. Compared with the survivors, non-survivors were found more frequently in Hinchey's stage III-IV, a low preoperative marker of pH, base excess (BE), and a low postoperative marker of white blood cell count, PaO2/FiO2 ratio, and renal output (24h). According to the logistic regression model, BE was a significant independent variable. Concerning the prognostic scoring systems, an APACHE II score of 19, a SOFA score of 8, an MPI score of 30, and an MOF score of 7 or more were significantly related to poor prognosis. Preoperative BE and postoperative white blood cell count were reliable prognostic factors and early classification using prognostic scoring systems at specific points in the disease process are useful to improve our understanding of the problems involved.

Alvarado vs Lintula Scoring Systems in Acute Appendicitis | Ojuka ...

African Journals Online (AJOL)

The gold standard of diagnosis was histopathology. Data analysis was done using SPSS. The receiver operating characteristics, sensitivity, specificity, positive predictive values and negative predictive values of both scoring systems were then calculated for each of the scoring systems and compared between the two.

Knowledge, attitudes and practices of community pharmacists on generic medicines in Palestine: a cross-sectional study.

Science.gov (United States)

Shraim, Naser Y; Al Taha, Tasneem A; Qawasmeh, Rawan F; Jarrar, Hiba N; Shtaya, Maram A N; Shayeb, Lama A; Sweileh, Waleed M

2017-12-28

Generic substitution in several countries has become a common practice. Besides, it is considered as a major cost minimizing strategy meant to contain pharmaceutical expenditure without compromising healthcare quality. However, the safety and quality issues of generic products are of top concerns of general practitioners and health work professionals. This study aimed to investigate community pharmacist's knowledge, attitudes and practices toward generic medicines in Palestine. This study was a cross-sectional observational study employing a self-administered questionnaire. The questionnaire was of four main sections: demographic and practice details of the participants, knowledge, attitudes and the influencing factors related to selection and dispensing of generic medicines. A convenience sampling technique was implemented in this study in which the data collection form was distributed in West Bank- Palestine among a set of practicing pharmacists. Mann-Whitney-U or Kruskal-Wallis tests were used to comparison of different issues as appropriate. P-values of marketing approval of generics, while 87.4% of participants agreed that they should be given the right to substitute generics and the majority (62.3%) support generic substitution for brand name drugs in all cases when a generic is available The main two factors affect pharmacists' selection and dispensing of generic medicines are personal faith in the product (86.1%) and cost effectiveness of generic medicines (84.1%). Generic medicines substitution among pharmacists is widespread and prevalent. Our data found that participant pharmacists in Palestine had basic knowledge with regards to generic medicine. However, their knowledge score pertaining the technical and regulatory aspects of bioequivalence and pharmacokinetic parameters in particular was insufficient.

Automated Quantification of the Landing Error Scoring System With a Markerless Motion-Capture System.

Science.gov (United States)

Mauntel, Timothy C; Padua, Darin A; Stanley, Laura E; Frank, Barnett S; DiStefano, Lindsay J; Peck, Karen Y; Cameron, Kenneth L; Marshall, Stephen W

2017-11-01

  The Landing Error Scoring System (LESS) can be used to identify individuals with an elevated risk of lower extremity injury. The limitation of the LESS is that raters identify movement errors from video replay, which is time-consuming and, therefore, may limit its use by clinicians. A markerless motion-capture system may be capable of automating LESS scoring, thereby removing this obstacle.   To determine the reliability of an automated markerless motion-capture system for scoring the LESS.   Cross-sectional study.   United States Military Academy.   A total of 57 healthy, physically active individuals (47 men, 10 women; age = 18.6 ± 0.6 years, height = 174.5 ± 6.7 cm, mass = 75.9 ± 9.2 kg).   Participants completed 3 jump-landing trials that were recorded by standard video cameras and a depth camera. Their movement quality was evaluated by expert LESS raters (standard video recording) using the LESS rubric and by software that automates LESS scoring (depth-camera data). We recorded an error for a LESS item if it was present on at least 2 of 3 jump-landing trials. We calculated κ statistics, prevalence- and bias-adjusted κ (PABAK) statistics, and percentage agreement for each LESS item. Interrater reliability was evaluated between the 2 expert rater scores and between a consensus expert score and the markerless motion-capture system score.   We observed reliability between the 2 expert LESS raters (average κ = 0.45 ± 0.35, average PABAK = 0.67 ± 0.34; percentage agreement = 0.83 ± 0.17). The markerless motion-capture system had similar reliability with consensus expert scores (average κ = 0.48 ± 0.40, average PABAK = 0.71 ± 0.27; percentage agreement = 0.85 ± 0.14). However, reliability was poor for 5 LESS items in both LESS score comparisons.   A markerless motion-capture system had the same level of reliability as expert LESS raters, suggesting that an automated system can accurately assess movement. Therefore, clinicians can use

[Patient reported outcome of tyrosine kinase inhibitor related side effects and their impact on daily life in Chinese patients with chronic myeloid leukemia in the chronic phase].

Science.gov (United States)

Yu, L; Wang, H B; Jiang, Q

2016-11-14

Objective: To explore the impact of patient reported outcome of tyrosine kinase inhibitor (TKI) related side effects on daily life in Chinese patients with chronic myeloid leukemia (CML) in the chronic phase (CP). Methods: From May to November in 2014, anonymous questionnaires were distributed to adult CML patients who were receiving TKI treatment in China. The impact of TKI-related side effects on daily life were assessed by the score of 1 (no impact) to 5 (high impact) from patient self-report. Results: Data from 731 respondents in the CP who reported the score of the impact of TKI-related side effects on daily life were collected. 407 (56%) were male. The median age was 41 years (range, 18 to 88 years). 560 (77%) started TKI treatment within 1 year after diagnosis. With a median treatment duration of 3 years (range, effects were edema ( n =323, 44% ), fatigue ( n =277, 38% ), gastrointestinal disorders ( n =235, 32% ), skin color changes ( n =142, 19% ), muscle cramps ( n =137, 19% ), rash ( n =105, 14% ), hepatic function abnormalities ( n =91, 12%), weight gain ( n =86, 12%), and cytopenia ( n =59, 8%). Multivariate analyses showed that TKI treatment duration effects on daily life in 218 (30%)respondents (1 score). 375 (51%)respondents reported their daily life were slightly or moderately decreased (2 or 3 score), while 138 (19%) significantly decreased (4 or 5 score). Multivariate analyses showed that female, ≥40 years old, use of generic TKI, TKI treatment duration negative effect on their daily life. When taking TKI related side-effects into considderation, secondary school and below, use of generic TKI, TKI treatment duration negative effect on their daily life. Conclusion: Edema, fatigue, gastrointestinal disorders, rash, skin color changes and hepatic function abnormalities were common TKI-related side effects and influenced CML patients' daily life in China. In addition, female, older age, lower education level, use of generic TKI and shorter TKI

Nutech functional score: A novel scoring system to assess spinal cord injury patients.

Science.gov (United States)

Shroff, Geeta; Barthakur, Jitendra Kumar

2017-06-26

To develop a new scoring system, nutech functional scores (NFS) for assessing the patients with spinal cord injury (SCI). The conventional scale, American Spinal Injury Association's (ASIA) impairment scale is a measure which precisely describes the severity of the SCI. However, it has various limitations which lead to incomplete assessment of SCI patients. We have developed a 63 point scoring system, i . e ., NFS for patients suffering with SCI. A list of symptoms either common or rare that were found to be associated with SCI was recorded for each patient. On the basis of these lists, we have developed NFS. These lists served as a base to prepare NFS, a 63 point positional (each symptom is sub-graded and get points based on position) and directional (moves in direction BAD → GOOD) scoring system. For non-progressive diseases, 1, 2, 3, 4, 5 denote worst, bad, moderate, good and best (normal), respectively. NFS for SCI has been divided into different groups based on the affected part of the body being assessed, i . e ., motor assessment (shoulders, elbow, wrist, fingers-grasp, fingers-release, hip, knee, ankle and toe), sensory assessment, autonomic assessment, bed sore assessment and general assessment. As probability based studies required a range of (-1, 1) or at least the range of (0, 1) to be useful for real world analysis, the grades were converted to respective numeric values. NFS can be considered as a unique tool to assess the improvement in patients with SCI as it overcomes the limitations of ASIA impairment scale.

Endogenous versus exogenous generic reference pricing for pharmaceuticals.

Science.gov (United States)

Antoñanzas, F; Juárez-Castelló, C A; Rodríguez-Ibeas, R

2017-12-01

In this paper we carry out a vertical differentiation duopoly model applied to pharmaceutical markets to analyze how endogenous and exogenous generic reference pricing influence competition between generic and branded drugs producers. Unlike the literature, we characterize for the exogenous case the equilibrium prices for all feasible relevant reference prices. Competition is enhanced after the introduction of a reference pricing system. We also compare both reference pricing systems on welfare grounds, assuming two different objective functions for health authorities: (i) standard social welfare and (ii) gross consumer surplus net of total pharmaceutical expenditures. We show that regardless of the objective function, health authorities will never choose endogenous reference pricing. When health authorities are paternalistic, the exogenous reference price that maximizes standard social welfare is such that the price of the generic drug is the reference price while the price of the branded drug is higher than the reference price. When health authorities are not paternalistic, the optimal exogenous reference price is such that the price of the branded drug is the reference price while the price of the generic drug is lower than the reference price.

Determining utility values in patients with anterior cruciate ligament tears using clinical scoring systems

Directory of Open Access Journals (Sweden)

Szucs Thomas

2011-08-01

Full Text Available Abstract Background Several instruments and clinical scoring systems have been established to evaluate patients with ligamentous knee injuries. A comparison of individual articles in the literature is challenging, not only because of heterogeneity in methodology, but also due to the variety of the scoring systems used to document clinical outcomes. There is limited information about the correlation between used scores and quality of life with no information being available on the impact of each score on the utility values. The aim of this study was to compare the most commonly used scores for evaluating patients with anterior cruciate ligament (ACL injuries, and to establish corresponding utility values. These values will be used for the interpretation and comparison of outcome results in the currently available literature for different treatment options. Methods Four hypothetical vignettes were defined, based on different levels of activities after rupture of the ACL to simulate typical situations seen in daily practice. A questionnaire, including the Health Utility Index (HUI for utility values, the IKDC subjective score, the Lysholm and the Tegner score, was created and 25 orthopedic surgeons were asked to fill the questionnaire for each hypothetical patient as proxies for all patients they had treated and who would fit in that hypothetical vignette. Results The utility value as an indicator for quality of life increased with the level of activity. Having discomforts already during normal activities of daily living was rated with a mean utility value of 0.37 ± 0.19, half of that of a situation where mild sport activity was possible without discomfort (0.78 ± 0.11. All investigated scores were able to distinguish clearly (p Conclusions Here we report the correlation between the most commonly used scores for the assessment of patients with a ruptured ACL and utility values as an indicator of quality of life. Assumptions were based on expert

Status of generic actions items and safety analysis system of PHWR

Energy Technology Data Exchange (ETDEWEB)

Park, Joo Hwan; Min, Byung Joo

2001-05-01

This report described the review results of a GAIs(Generic Action Item) currently issued on safety analysis of PHWR(Pressurized Heavy Water Reactor) and the research activities and positions to solve the GAIs in each country which possess PHWRs. eviewing the Final Safety Analysis Report for Wolsong-2/3/4 Units, the safety analysis methodology, classification for accident scenarios, safety analysis codes, their interface, etc.. were described. From the present review report, it is intended to establish the CANDU safety analysis system by providing the better understandings and development plans for the safety analysis of PHWR. esults.

Concept for a Satellite-Based Advanced Air Traffic Management System : Volume 8. Operational Logic Flow Diagrams for a Generic Advanced Air Traffic Management system

Science.gov (United States)

1974-02-01

The volume presents a description of the services a generic Advanced Air Traffic Management System (AATMS) should provide to the useres of the system to facilitate the safe, efficient flow of traffic. It provides a definition of the functions which t...

A generic method for assignment of reliability scores applied to solvent accessibility predictions

Directory of Open Access Journals (Sweden)

Nielsen Morten

2009-07-01

Full Text Available Abstract Background Estimation of the reliability of specific real value predictions is nontrivial and the efficacy of this is often questionable. It is important to know if you can trust a given prediction and therefore the best methods associate a prediction with a reliability score or index. For discrete qualitative predictions, the reliability is conventionally estimated as the difference between output scores of selected classes. Such an approach is not feasible for methods that predict a biological feature as a single real value rather than a classification. As a solution to this challenge, we have implemented a method that predicts the relative surface accessibility of an amino acid and simultaneously predicts the reliability for each prediction, in the form of a Z-score. Results An ensemble of artificial neural networks has been trained on a set of experimentally solved protein structures to predict the relative exposure of the amino acids. The method assigns a reliability score to each surface accessibility prediction as an inherent part of the training process. This is in contrast to the most commonly used procedures where reliabilities are obtained by post-processing the output. Conclusion The performance of the neural networks was evaluated on a commonly used set of sequences known as the CB513 set. An overall Pearson's correlation coefficient of 0.72 was obtained, which is comparable to the performance of the currently best public available method, Real-SPINE. Both methods associate a reliability score with the individual predictions. However, our implementation of reliability scores in the form of a Z-score is shown to be the more informative measure for discriminating good predictions from bad ones in the entire range from completely buried to fully exposed amino acids. This is evident when comparing the Pearson's correlation coefficient for the upper 20% of predictions sorted according to reliability. For this subset, values of 0

A new pathological scoring system by the Japanese classification to predict renal outcome in diabetic nephropathy.

Science.gov (United States)

Hoshino, Junichi; Furuichi, Kengo; Yamanouchi, Masayuki; Mise, Koki; Sekine, Akinari; Kawada, Masahiro; Sumida, Keiichi; Hiramatsu, Rikako; Hasegawa, Eiko; Hayami, Noriko; Suwabe, Tatsuya; Sawa, Naoki; Hara, Shigeko; Fujii, Takeshi; Ohashi, Kenichi; Kitagawa, Kiyoki; Toyama, Tadashi; Shimizu, Miho; Takaichi, Kenmei; Ubara, Yoshifumi; Wada, Takashi

2018-01-01

The impact of the newly proposed pathological classification by the Japan Renal Pathology Society (JRPS) on renal outcome is unclear. So we evaluated that impact and created a new pathological scoring to predict outcome using this classification. A multicenter cohort of 493 biopsy-proven Japanese patients with diabetic nephropathy (DN) were analyzed. The association between each pathological factor-Tervaert' and JRPS classifications-and renal outcome (dialysis initiation or 50% eGFR decline) was estimated by adjusted Cox regression. The overall pathological risk score (J-score) was calculated, whereupon its predictive ability for 10-year risk of renal outcome was evaluated. The J-scores of diffuse lesion classes 2 or 3, GBM doubling class 3, presence of mesangiolysis, polar vasculosis, and arteriolar hyalinosis were, respectively, 1, 2, 4, 1, and 2. The scores of IFTA classes 1, 2, and 3 were, respectively, 3, 4, and 4, and those of interstitial inflammation classes 1, 2, and 3 were 5, 5, and 4 (J-score range, 0-19). Renal survival curves, when dividing into four J-score grades (0-5, 6-10, 11-15, and 16-19), were significantly different from each other (prenal outcome. Ability to predict 10-year renal outcome was improved when the J-score was added to the basic model: c-statistics from 0.661 to 0.685; category-free net reclassification improvement, 0.154 (-0.040, 0.349, p = 0.12); and integrated discrimination improvement, 0.015 (0.003, 0.028, p = 0.02). Mesangiolysis, polar vasculosis, and doubling of GBM-features of the JRPS system-were significantly associated with renal outcome. Prediction of DN patients' renal outcome was better with the J-score than without it.

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

Energy Technology Data Exchange (ETDEWEB)

Vult von Steyern, Kristina; Bjoerkman-Burtscher, Isabella M.; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats [Skaane University Hospital, Lund University, Centre for Medical Imaging and Physiology, Lund (Sweden); Hoeglund, Peter [Skaane University Hospital, Competence Centre for Clinical Research, Lund (Sweden)

2012-12-15

To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. (orig.)

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

International Nuclear Information System (INIS)

Vult von Steyern, Kristina; Bjoerkman-Burtscher, Isabella M.; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats; Hoeglund, Peter

2012-01-01

To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. (orig.)

Enhancing Safety through Generic Competencies

Directory of Open Access Journals (Sweden)

S. Mockel

2014-03-01

Full Text Available This article provides insights into proactive safety management and mitigation. An analysis of accident reports reveals categories of supervening causes of accidents which can be directly linked to the concept of generic competencies (information management, communication and coordination, problem solving, and effect control. These findings strongly suggest adding the human element as another safety-constituting pillar to the concept of ship safety next to technology and regulation. We argue that the human element has unique abilities in dealing with critical and highly dynamic situations which can contribute to the system's recovery from non-routine or critical situations. By educating seafarers in generic competencies we claim to enable the people onboard to successfully deal with critical situations.

Non-commutative Chern numbers for generic aperiodic discrete systems

Science.gov (United States)

Bourne, Chris; Prodan, Emil

2018-06-01

The search for strong topological phases in generic aperiodic materials and meta-materials is now vigorously pursued by the condensed matter physics community. In this work, we first introduce the concept of patterned resonators as a unifying theoretical framework for topological electronic, photonic, phononic etc (aperiodic) systems. We then discuss, in physical terms, the philosophy behind an operator theoretic analysis used to systematize such systems. A model calculation of the Hall conductance of a 2-dimensional amorphous lattice is given, where we present numerical evidence of its quantization in the mobility gap regime. Motivated by such facts, we then present the main result of our work, which is the extension of the Chern number formulas to Hamiltonians associated to lattices without a canonical labeling of the sites, together with index theorems that assure the quantization and stability of these Chern numbers in the mobility gap regime. Our results cover a broad range of applications, in particular, those involving quasi-crystalline, amorphous as well as synthetic (i.e. algorithmically generated) lattices.

A generic approach to integrate biodiversity considerations in screening and scoping for EIA

International Nuclear Information System (INIS)

Slootweg, Roel; Kolhoff, Arend

2003-01-01

The Convention on Biological Diversity (CBD) requires parties to apply environmental impact assessment (EIA) to projects that potentially negatively impact on biodiversity. As members of the International Association of Impact Assessment, the authors have developed a conceptual framework to integrate biodiversity considerations in EIA. By defining biodiversity in terms of composition, structure, and key processes, and by describing the way in which human activities affect these so-called components of biodiversity, it is possible to assess the potential impacts of human activities on biodiversity. Furthermore, the authors have translated this conceptual framework in generic guidelines for screening and scoping in impact assessment. Countries can use these generic guidelines to further operationalise the framework within the existing national procedures for impact assessment. This paper is fully coherent and partly overlapping with the guidelines recently adopted by the CBD, but differs in the sense that it provides more scientific background and is less policy-oriented

Generic transmission zeros in time-reversal symmetric single channel transport through quasi-1d systems

International Nuclear Information System (INIS)

Lee, H. W.

1999-01-01

Wh study phase coherent transport in a single channel system using the scattering matrix approach. It is show that the Friedel sum rule and the time-reversal symmetry result in the generic appearance of transmission zeros in quasi-1d systems. The transmission zeros naturally lead to abrupt phase changes (without any intrinsic energy scale) and in-phase resonances, thus providing insights to recent experiments on phase coherent transport through a quantum dot

Interpreting Quality of Life after Brain Injury Scores: Cross-Walk with the Short Form-36.

Science.gov (United States)

Wilson, Lindsay; Marsden-Loftus, Isaac; Koskinen, Sanna; Bakx, Wilbert; Bullinger, Monika; Formisano, Rita; Maas, Andrew; Neugebauer, Edmund; Powell, Jane; Sarajuuri, Jaana; Sasse, Nadine; von Steinbuechel, Nicole; von Wild, Klaus; Truelle, Jean-Luc

2017-01-01

The Quality of Life after Brain Injury (QOLIBRI) instruments are traumatic brain injury (TBI)-specific assessments of health-related quality of life (HRQoL), with established validity and reliability. The purpose of the study is to help improve the interpretability of the two QOLIBRI summary scores (the QOLIBRI Total score and the QOLBRI Overall Scale [OS] score). An analysis was conducted of 761 patients with TBI who took part in the QOLIBRI validation studies. A cross-walk between QOLIBRI scores and the SF-36 Mental Component Summary norm-based scoring system was performed using geometric mean regression analysis. The exercise supports a previous suggestion that QOLIBRI Total scores GOSE), as a measure of global function, are presented in the form of means and standard deviations that allow comparison with other studies, and data on age and sex are presented for the QOLIBRI-OS. While bearing in mind the potential imprecision of the comparison, the findings provide a framework for evaluating QOLIBRI summary scores in relation to generic HRQoL that improves their interpretability.

[Users sceptical about generic drugs: an anthropological approach].

Science.gov (United States)

Sarradon-Eck, A; Blanc, M-A; Faure, M

2007-06-01

Since the enactment of the 2002 legislative measures favoring the prescription of generic drugs, various quantitative studies have shown that approval by prescribers and users has risen in France. Nevertheless, scepticism remains as well as distrust towards these drugs focusing on their effectiveness compared with brand-name drugs, on potential dangers, and on the interruption they cause in prescription and consumption habits. Using a comprehensive approach, this article analyzes the social and cultural logic behind the negative image of generic drugs. The materials issued from an ethnographic study on the prescription of drugs for high blood pressure. Sixty-eight interviews were undertaken between April 2002 and October 2004 with people (39 women and 29 men, between the age of 40 and 95, 52 over the age of 60) treated for over a year for high blood pressure in rural areas in the Southeast of France. Thirteen people provided unsolicited opinions about generic drugs. Analysis of the information collected shows that users have various representations of generic drugs, including the idea of counterfeited and foreign drugs. These representations interfere with the adjustment process and the development of consumer loyalty. They are part of a set of social representations about drugs which form and express the user's reality. In these representations, the drug is an ambivalent object, carrier of both biological effectiveness and toxicity; it is also the metonymical extension of the prescriber, bestowing upon the prescription a symbolic value. By placing the generic drug in its network of symbolic and social meaning, this study highlights the coherence of the scepticism towards generic drugs by consumers (and prescribers) with a system of common opinion in which drugs are everyday things, personalized and compatible with users, symbolic exchange carriers in the physician-patient relationship, and in which confidence in the drug is also that given to the health care

Optimizing Generic Functions

NARCIS (Netherlands)

Alimarine, A.; Smetsers, J.E.W.

2004-01-01

Generic functions are defined by induction on the structural representation of types. As a consequence, by defining just a single generic operation, one acquires this operation over any particular type. An instance on a specific type is generated by interpretation of the type's structure. A direct

A Novel Risk Scoring System Reliably Predicts Readmission Following Pancreatectomy

Science.gov (United States)

Valero, Vicente; Grimm, Joshua C.; Kilic, Arman; Lewis, Russell L.; Tosoian, Jeffrey J.; He, Jin; Griffin, James; Cameron, John L.; Weiss, Matthew J.; Vollmer, Charles M.; Wolfgang, Christopher L.

2015-01-01

Background Postoperative readmissions have been proposed by Medicare as a quality metric and may impact provider reimbursement. Since readmission following pancreatectomy is common, we sought to identify factors associated with readmission in order to establish a predictive risk scoring system (RSS). Study Design A retrospective analysis of 2,360 pancreatectomies performed at nine, high-volume pancreatic centers between 2005 and 2011 was performed. Forty-five factors strongly associated with readmission were identified. To derive and validate a RSS, the population was randomly divided into two cohorts in a 4:1 fashion. A multivariable logistic regression model was constructed and scores were assigned based on the relative odds ratio of each independent predictor. A composite Readmission After Pancreatectomy (RAP) score was generated and then stratified to create risk groups. Results Overall, 464 (19.7%) patients were readmitted within 90-days. Eight pre- and postoperative factors, including prior myocardial infarction (OR 2.03), ASA Class ≥ 3 (OR 1.34), dementia (OR 6.22), hemorrhage (OR 1.81), delayed gastric emptying (OR 1.78), surgical site infection (OR 3.31), sepsis (OR 3.10) and short length of stay (OR 1.51), were independently predictive of readmission. The 32-point RAP score generated from the derivation cohort was highly predictive of readmission in the validation cohort (AUC 0.72). The low (0-3), intermediate (4-7) and high risk (>7) groups correlated to 11.7%, 17.5% and 45.4% observed readmission rates, respectively (preadmission following pancreatectomy. Identification of patients with increased risk of readmission using the RAP score will allow efficient resource allocation aimed to attenuate readmission rates. It also has potential to serve as a new metric for comparative research and quality assessment. PMID:25797757

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis.

Science.gov (United States)

Vult von Steyern, Kristina; Björkman-Burtscher, Isabella M; Höglund, Peter; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats

2012-12-01

To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. Tomosynthesis is more sensitive than conventional radiography for pulmonary cystic fibrosis changes. The radiation dose from chest tomosynthesis is low compared with computed tomography. Tomosynthesis may become useful in the regular follow-up of patients with cystic fibrosis.

How Abbott’s Fenofibrate Franchise Avoided Generic Competition

Science.gov (United States)

Downing, Nicholas S.; Ross, Joseph S.; Jackevicius, Cynthia A.; Krumholz, Harlan M.

2013-01-01

The ongoing debate concerning the efficacy of fenofibrate has overshadowed an important aspect of the drug’s history: Abbott, the maker of branded fenofibrate, has produced several bioequivalent reformulations, which dominate the market even though generic fenofibrate has been available for almost a decade. This continued use of branded formulations, which cost twice as much as generic versions of fenofibrate, imposes an annual cost of approximately $700 million on our healthcare system. Abbott maintained its dominance of the fenofibrate market, in part, through a complex switching strategy involving the sequential launch of branded reformulations that had not been shown to be superior to the first generation product and patent litigation that delayed the approval of generic formulations. The small differences in dose of the newer branded formulations prevented substitution with generics of older generation products. As soon as direct generic competition seemed likely at the new dose level where substitution would be allowed, Abbott would launch another reformulation and the cycle would repeat. Our objective, using the fenofibrate example, is to describe how current policy can allow pharmaceutical companies to maintain market share using reformulations of branded medications without demonstrating the superiority of next generation products. PMID:22493409

Classifying snakebite in South Africa: Validating a scoring system ...

African Journals Online (AJOL)

Factors predictive of ATI and the optimal cut-off score for predicting an ATI were identified. These factors were then used to develop a standard scoring system. The score was then tested prospectively for accuracy in a new validation cohort consisting of 100 patients admitted for snakebite to our unit from 1 December 2014 to ...

A validated risk score to estimate mortality risk in patients with dementia and pneumonia: barriers to clinical impact

NARCIS (Netherlands)

van der Steen, J.T.; Albers, G.; Strunk, E.; Muller, M.T.; Ribbe, M.W.

2011-01-01

Background: The clinical impact of risk score use in end-of-life settings is unknown, with reports limited to technical properties. Methods: We conducted a mixed-methods study to evaluate clinical impact of a validated mortality risk score aimed at informing prognosis and supporting clinicians in

Development of methodology to construct a generic conceptual model of river-valley evolution for performance assessment of HLW geological disposal

International Nuclear Information System (INIS)

Kawamura, Makoto; Tanikawa, Shin-ichi; Yasue, Ken-ichi; Niizato, Tadafumi

2011-01-01

In order to assess the long-term safety of a geological disposal system for high-level radioactive waste (HLW), it is important to consider the impact of uplift and erosion, which cannot be precluded on a timescale in the order of several hundred thousand years for many locations in Japan. Geomorphic evolution, caused by uplift and erosion and coupled to climatic and sea-level changes, will impact the geological disposal system due to resulting spatial and temporal changes in the disposal environment. Degradation of HLW barrier performance will be particularly significant when the remnant repository structures near, and are eventually exposed at, the ground surface. In previous studies, fluvial erosion was densified as the key concern in most settings in Japan. Interpretation of the impact of the phenomena at relevant locations in Japan has led to development of a generic conceptual model which contains the features typical at middle reach of rivers. Here, therefore, we present a methodology for development of a generic conceptual model based on best current understanding of fluvial erosion in Japan, which identifies the simplifications and uncertainties involved and assesses their consequences in the context of repository performance. (author)

The dark side of gendered language: The masculine-generic form as a cause for self-report bias.

Science.gov (United States)

Vainapel, Sigal; Shamir, Opher Y; Tenenbaum, Yulie; Gilam, Gadi

2015-12-01

Language reflects sociocultural structures, such as gender, and affects individuals' perceptions and cognitions. In gendered languages, male-inflected parts of speech are generally used for both sexes (i.e., masculine generics), thus proliferating stereotypes, inequality, and misattributions. We hypothesized that masculine-generic inflection in a questionnaire would bias women's reports compared with a gender-neutral inflection (e.g., "he or she"). We tested our prediction using an academic motivation questionnaire. We found that women reported lower task value and intrinsic goal orientation in the masculine-generic form compared with the gender-neutral form, and lower self-efficacy than men in the masculine-generic form. These findings suggest that questionnaires and surveys written in gendered languages or translated into them may contain construct-irrelevant variance that may undermine the validity of their scores' interpretations, thus risking the possibility of false conclusions. (c) 2015 APA, all rights reserved).

Generic Example Proving Criteria for All

Science.gov (United States)

Yopp, David; Ely, Rob; Johnson­-Leung, Jennifer

2015-01-01

We review literature that discusses generic example proving and highlight ambiguities that pervade our research community's discourse about generic example arguments. We distinguish between pedagogical advice for choosing good examples that can serve as generic examples when teaching and advice for developing generic example arguments. We provide…

Validity and reliability of a novel immunosuppressive adverse effects scoring system in renal transplant recipients.

Science.gov (United States)

Meaney, Calvin J; Arabi, Ziad; Venuto, Rocco C; Consiglio, Joseph D; Wilding, Gregory E; Tornatore, Kathleen M

2014-06-12

After renal transplantation, many patients experience adverse effects from maintenance immunosuppressive drugs. When these adverse effects occur, patient adherence with immunosuppression may be reduced and impact allograft survival. If these adverse effects could be prospectively monitored in an objective manner and possibly prevented, adherence to immunosuppressive regimens could be optimized and allograft survival improved. Prospective, standardized clinical approaches to assess immunosuppressive adverse effects by health care providers are limited. Therefore, we developed and evaluated the application, reliability and validity of a novel adverse effects scoring system in renal transplant recipients receiving calcineurin inhibitor (cyclosporine or tacrolimus) and mycophenolic acid based immunosuppressive therapy. The scoring system included 18 non-renal adverse effects organized into gastrointestinal, central nervous system and aesthetic domains developed by a multidisciplinary physician group. Nephrologists employed this standardized adverse effect evaluation in stable renal transplant patients using physical exam, review of systems, recent laboratory results, and medication adherence assessment during a clinic visit. Stable renal transplant recipients in two clinical studies were evaluated and received immunosuppressive regimens comprised of either cyclosporine or tacrolimus with mycophenolic acid. Face, content, and construct validity were assessed to document these adverse effect evaluations. Inter-rater reliability was determined using the Kappa statistic and intra-class correlation. A total of 58 renal transplant recipients were assessed using the adverse effects scoring system confirming face validity. Nephrologists (subject matter experts) rated the 18 adverse effects as: 3.1 ± 0.75 out of 4 (maximum) regarding clinical importance to verify content validity. The adverse effects scoring system distinguished 1.75-fold increased gastrointestinal adverse

Generic and biosimilar medicines: quid?

Directory of Open Access Journals (Sweden)

Steven Simoens

2012-12-01

Full Text Available Once intellectual property protection, data and marketing exclusivity of reference medicines have expired, generic medicines and biosimilar medicines can enter the off-patent market. This market entry is conditional on the approval of marketing authorization, pricing and reimbursement. Given that there tends to be confusion surrounding generic and biosimilar medicines, this Editorial introduces basic concepts related to generic and biosimilar medicines and presents the different studies and articles included in this supplement dedicated to generic and biosimilar medicines.

Scoring the full extent of periodontal disease in the dog: development of a total mouth periodontal score (TMPS) system.

Science.gov (United States)

Harvey, Colin E; Laster, Larry; Shofer, Frances; Miller, Bonnie

2008-09-01

The development of a total mouth periodontal scoring system is described. This system uses methods to score the full extent of gingivitis and periodontitis of all tooth surfaces, weighted by size of teeth, and adjusted by size of dog.

Least Squares Approach to the Alignment of the Generic High Precision Tracking System

Science.gov (United States)

de Renstrom, Pawel Brückman; Haywood, Stephen

2006-04-01

A least squares method to solve a generic alignment problem of a high granularity tracking system is presented. The algorithm is based on an analytical linear expansion and allows for multiple nested fits, e.g. imposing a common vertex for groups of particle tracks is of particular interest. We present a consistent and complete recipe to impose constraints on either implicit or explicit parameters. The method has been applied to the full simulation of a subset of the ATLAS silicon tracking system. The ultimate goal is to determine ≈35,000 degrees of freedom (DoF's). We present a limited scale exercise exploring various aspects of the solution.

A randomized, double-blind, cross-over, phase IV trial of oros-methylphenidate (CONCERTA(®)) and generic novo-methylphenidate ER-C (NOVO-generic).

Science.gov (United States)

Fallu, Angelo; Dabouz, Farida; Furtado, Melissa; Anand, Leena; Katzman, Martin A

2016-08-01

Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral disorder with onset during childhood. Multiple aspects of a child's development are hindered, in both home and school settings, with negative impacts on social, emotional, and cognitive functioning. If left untreated, ADHD is commonly associated with poor academic achievement and low occupational status, as well as increased risk of substance abuse and delinquency. The objective of this study was to evaluate adult ADHD subject reported outcomes when switched from a stable dose of CONCERTA(®) to the same dose of generic Novo-methylphenidate ER-C(®). Randomized, double-blind, cross-over, phase IV trial consisted of two phases in which participants with a primary diagnosis of ADHD were randomized in a 1:1 ratio to 3 weeks of treatment with CONCERTA or generic Novo-Methylphenidate ER-C. Following 3 weeks of treatment, participants were crossed-over to receive the other treatment for an additional 3 weeks. Primary efficacy was assessed through the use of the Treatment Satisfaction Questionnaire for Medication, Version II (TSQM-II). Participants with ADHD treated with CONCERTA were more satisfied in terms of efficacy and side effects compared to those receiving an equivalent dose of generic Novo-Methylphenidate ER-C. All participants chose to continue with CONCERTA treatment at the conclusion of the study. Although CONCERTA and generic Novo-Methylphenidate ER-C have been deemed bioequivalent, however the present findings demonstrate clinically and statistically significant differences between generic and branded CONCERTA. Further investigation of these differences is warranted.

Assessing responsiveness of generic and specific health related quality of life measures in heart failure

Directory of Open Access Journals (Sweden)

Johnson Jeffrey A

2006-11-01

Full Text Available Abstract Background Responsiveness, or sensitivity to clinical change, is an important consideration in selection of a health-related quality of life (HRQL measure for trials or clinical applications. Many approaches can be used to assess responsiveness, which may affect the interpretation of study results. We compared the relative responsiveness of generic and heart failure specific HRQL instruments, as measured both by common psychometric indices and by external clinical criteria. Methods We analyzed data collected at baseline and 6-weeks in 298 subjects with heart failure on the following HRQL measures: EQ-5D (US, UK, and VAS Scoring, Kansas City Cardiomyopathy Questionnaire (KCCQ (Clinical and Overall Summary Score, and RAND12 (Physical and Mental Component Summaries. Three external indicators of clinical change were used to classify subjects as improved, deteriorated, or unchanged: 6-minute walk test, New York Heart Association (NYHA class, and physician global rating of change. Four responsiveness statistics (T-test, effect size, Guyatt's responsiveness statistic, and standardized response mean were used to evaluate the responsiveness of the select measures. The median rank of each HRQL measure across responsiveness indices and clinical criteria was then determined. Results Average age of subjects was 60 years, 75 percent were male, and had moderate to severe heart failure symptoms. Overall, the KCCQ Summary Scores had the highest relative ranking, irrespective of the responsiveness index or external criterion used. Importantly, we observed that the relative ranking of responsiveness of the generic measures (i.e. EQ-5D, RAND12 was influenced by both the responsive indices and external criterion used. Conclusion The disease specific KCCQ was the most responsive HRQL measure assessing change over a 6-week period, although generic measures provide information for which the KCCQ is not suitable. The responsiveness of generic HRQL measures may

Validation of Persian Version of PedsQL™ 4.0™ Generic Core Scales in Toddlers and Children

Science.gov (United States)

Gheissari, Alaleh; Farajzadegan, Ziba; Heidary, Maryam; Salehi, Fatemeh; Masaeli, Ali; Mazrooei, Amin; Varni, James W; Fallah, Zahra; Zandieh, Fariborz

2012-01-01

Introduction: To evaluate the reliability, validity and feasibility of the Persian version of the Pediatric Quality of Life inventory (PedsQL™ 4.0™ 4.0) Generic Core Scales in Iranian healthy students ages 7-15 and chronically ill children ages 2-18. Methods: We followed the translation methodology proposed by developer to validate Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales for children. Six hundred and sixty children and adolescents and their parents were enrolled. Sample of 160 healthy students were chosen by random cluster method between 4 regions of Isfahan education offices and 60 chronically ill children were recruited from St. Alzahra hospital private clinics. The questionnaires were fulfilled by the participants. Results: The Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales discriminated between healthy and chronically ill children (healthy students mean score was 12.3 better than chronically ill children, Presearches. It is necessary to alternate scoring for 2-4 years old questionnaire and to find a way to increase reliability for healthy children aged 8-12 years especially, according to Iranian culture. PMID:22701775

Advertising and generic market entry.

Science.gov (United States)

Königbauer, Ingrid

2007-03-01

The effect of purely persuasive advertising on generic market entry and social welfare is analysed. An incumbent has the possibility to invest in advertising which affects the prescribing physician's perceived relative qualities of the brand-name and the generic version of the drug. Advertising creates product differentiation and can induce generic market entry which is deterred without differentiation due to strong Bertrand competition. However, over-investment in advertising can deter generic market entry under certain conditions and reduces welfare as compared to accommodated market entry.

Predictive value of seven preoperative prognostic scoring systems for spinal metastases.

Science.gov (United States)

Leithner, Andreas; Radl, Roman; Gruber, Gerald; Hochegger, Markus; Leithner, Katharina; Welkerling, Heike; Rehak, Peter; Windhager, Reinhard

2008-11-01

Predicting prognosis is the key factor in selecting the proper treatment modality for patients with spinal metastases. Therefore, various assessment systems have been designed in order to provide a basis for deciding the course of treatment. Such systems have been proposed by Tokuhashi, Sioutos, Tomita, Van der Linden, and Bauer. The scores differ greatly in the kind of parameters assessed. The aim of this study was to evaluate the prognostic value of each score. Eight parameters were assessed for 69 patients (37 male, 32 female): location, general condition, number of extraspinal bone metastases, number of spinal metastases, visceral metastases, primary tumour, severity of spinal cord palsy, and pathological fracture. Scores according to Tokuhashi (original and revised), Sioutos, Tomita, Van der Linden, and Bauer were assessed as well as a modified Bauer score without scoring for pathologic fracture. Nineteen patients were still alive as of September 2006 with a minimum follow-up of 12 months. All other patients died after a mean period of 17 months after operation. The mean overall survival period was only 3 months for lung cancer, followed by prostate (7 months), kidney (23 months), breast (35 months), and multiple myeloma (51 months). At univariate survival analysis, primary tumour and visceral metastases were significant parameters, while Karnofsky score was only significant in the group including myeloma patients. In multivariate analysis of all seven parameters assessed, primary tumour and visceral metastases were the only significant parameters. Of all seven scoring systems, the original Bauer score and a Bauer score without scoring for pathologic fracture had the best association with survival (P < 0.001). The data of the present study emphasize that the original Bauer score and a modified Bauer score without scoring for pathologic fracture seem to be practicable and highly predictive preoperative scoring systems for patients with spinal metastases

Scoring methods and results for qualitative evaluation of public health impacts from the Hanford high-level waste tanks. Integrated Risk Assessment Program

International Nuclear Information System (INIS)

Buck, J.W.; Gelston, G.M.; Farris, W.T.

1995-09-01

The objective of this analysis is to qualitatively rank the Hanford Site high-level waste (HLW) tanks according to their potential public health impacts through various (groundwater, surface water, and atmospheric) exposure pathways. Data from all 149 single-shell tanks (SSTs) and 23 of the 28 double-shell tanks (DSTs) in the Tank Waste Remediation System (TWRS) Program were analyzed for chemical and radiological carcinogenic as well as chemical noncarcinogenic health impacts. The preliminary aggregate score (PAS) ranking system was used to generate information from various release scenarios. Results based on the PAS ranking values should be considered relative health impacts rather than absolute risk values

Ideas on a generic control systems based on the experience on the 4 LEP experiments control system

International Nuclear Information System (INIS)

Barillere, R.; Le Goff, J.M.; Milcent, H.; Stampfli, R.

1992-01-01

Most of the large slow control systems in the LEP collider experiments are distributed heterogeneous and multi-standard. But in spite of the appearances, they have a lot in common. From our direct experience on the L-3 slow control system and from the informations we obtained on the 3 other LEP experiments control systems we have come to the conclusion that it should be possible to build a Generic Control Package from which any control system could be derived. This software package is entirely based on relational databases and is intended to provide all the necessary tools to build a modular, coherent, easy to update and to maintain control system. Among other things this package should include user friendly interfaces, expert systems, and powerful graphic monitoring and control tools. This paper will present our general ideas about the realization of such a package. (author)

The Impact of Overreporting on MMPI-2-RF Substantive Scale Score Validity

Science.gov (United States)

Burchett, Danielle L.; Ben-Porath, Yossef S.

2010-01-01

This study examined the impact of overreporting on the validity of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) substantive scale scores by comparing correlations with relevant external criteria (i.e., validity coefficients) of individuals who completed the instrument under instructions to (a) feign psychopathology…

The efficacy and safety of on-demand Elonza; a generic product of sildenafil in Thai men with erectile dysfunction.

Science.gov (United States)

Wijitsettakul, Udomsak; Pempongkosol, Sompol

2013-06-01

To evaluate the efficacy and safety of Elonza (generic product of sildenafil) 100 mg, a phosphodiesterase type 5 (PDE5) inhibitor, in Thai men with erectile dysfunction (ED). This prospective, Cohort study was conducted for eight weeks. Two hundred ten male patients, older than 20 years of age with ED were enrolled to receive generic product of sildenafil 100 mg taken as needed. Efficacy is evaluated through the International Index of Erectile Function (IIEF) scores for the five separate response domains, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction domain. After sildenafil administration, erectile function domain scores were significantly increased from baseline, 5.02 (p product of sildenafil, was an effective and well-tolerated treatment for ED in Thai men.

Optimum design for rotor-bearing system using advanced generic algorithm

International Nuclear Information System (INIS)

Kim, Young Chan; Choi, Seong Pil; Yang, Bo Suk

2001-01-01

This paper describes a combinational method to compute the global and local solutions of optimization problems. The present hybrid algorithm uses both a generic algorithm and a local concentrate search algorithm (e.g simplex method). The hybrid algorithm is not only faster than the standard genetic algorithm but also supplies a more accurate solution. In addition, this algorithm can find the global and local optimum solutions. The present algorithm can be supplied to minimize the resonance response (Q factor) and to yield the critical speeds as far from the operating speed as possible. These factors play very important roles in designing a rotor-bearing system under the dynamic behavior constraint. In the present work, the shaft diameter, the bearing length, and clearance are used as the design variables

Modifying scoring system at South African University rugby level ...

African Journals Online (AJOL)

Success in rugby is measured by winning the game and in order to do so, teams need to score more points ... if modifying the scoring system at South African University rugby level changes the game dynamics. ... AJOL African Journals Online.

Explaining the black-white gap in cognitive test scores: Toward a theory of adverse impact.

Science.gov (United States)

Cottrell, Jonathan M; Newman, Daniel A; Roisman, Glenn I

2015-11-01

In understanding the causes of adverse impact, a key parameter is the Black-White difference in cognitive test scores. To advance theory on why Black-White cognitive ability/knowledge test score gaps exist, and on how these gaps develop over time, the current article proposes an inductive explanatory model derived from past empirical findings. According to this theoretical model, Black-White group mean differences in cognitive test scores arise from the following racially disparate conditions: family income, maternal education, maternal verbal ability/knowledge, learning materials in the home, parenting factors (maternal sensitivity, maternal warmth and acceptance, and safe physical environment), child birth order, and child birth weight. Results from a 5-wave longitudinal growth model estimated on children in the NICHD Study of Early Child Care and Youth Development from ages 4 through 15 years show significant Black-White cognitive test score gaps throughout early development that did not grow significantly over time (i.e., significant intercept differences, but not slope differences). Importantly, the racially disparate conditions listed above can account for the relation between race and cognitive test scores. We propose a parsimonious 3-Step Model that explains how cognitive test score gaps arise, in which race relates to maternal disadvantage, which in turn relates to parenting factors, which in turn relate to cognitive test scores. This model and results offer to fill a need for theory on the etiology of the Black-White ethnic group gap in cognitive test scores, and attempt to address a missing link in the theory of adverse impact. (c) 2015 APA, all rights reserved).

Generic nuclear power plant component failure data bank

International Nuclear Information System (INIS)

Araujo Goes, A.G. de; Gibelli, S.M.O.

1988-11-01

This report consist in the development of a generic nuclear power plant component failure data bank. This data bank was implemented in a PC-XT microcomputer, IBM compatible, using the Open Access II program. Generic failure data tables for Westinghouse nuclear power plants and for general PWR power plants are presented. They are the final product of a research which included a preselection and a selection of data collected from the available sources in the library of CNEN (National Nuclear Energy Commission) and from the CIN/CNEN (Neclear Information Center). Futhermore, a proposal of evaluating models of average failure rates of pumps and valves are also presented. Through the electronic data bank one can easily have a generic view of failure rate ranges as well as failure models foe a certain component. It is very importante to develop procedures to collect and store generic failure data that can be quickly accessed, in order to update the Probabilistic Safety Study of Angra-1 and to used in studies which may have component failures of nuclear power plant safety systems. In the future, data specialization can be achieved by means of statistical calculations involving specific data collected from the operational experience of Angra-1 nuclear power plant and the generic data bank. (author) [pt

A Novel Scoring System Approach to Assess Patients with Lyme Disease (Nutech Functional Score)

OpenAIRE

Geeta Shroff; Petra Hopf-Seidel

2018-01-01

Introduction: A bacterial infection by Borrelia burgdorferi referred to as Lyme disease (LD) or borreliosis is transmitted mostly by a bite of the tick Ixodes scapularis in the USA and Ixodes ricinus in Europe. Various tests are used for the diagnosis of LD, but their results are often unreliable. We compiled a list of clinically visible and patient-reported symptoms that are associated with LD. Based on this list, we developed a novel scoring system. Methodology: Nutech functional Score (NF...

Sway Area and Velocity Correlated With MobileMat Balance Error Scoring System (BESS) Scores.

Science.gov (United States)

Caccese, Jaclyn B; Buckley, Thomas A; Kaminski, Thomas W

2016-08-01

The Balance Error Scoring System (BESS) is often used for sport-related concussion balance assessment. However, moderate intratester and intertester reliability may cause low initial sensitivity, suggesting that a more objective balance assessment method is needed. The MobileMat BESS was designed for objective BESS scoring, but the outcome measures must be validated with reliable balance measures. Thus, the purpose of this investigation was to compare MobileMat BESS scores to linear and nonlinear measures of balance. Eighty-eight healthy collegiate student-athletes (age: 20.0 ± 1.4 y, height: 177.7 ± 10.7 cm, mass: 74.8 ± 13.7 kg) completed the MobileMat BESS. MobileMat BESS scores were compared with 95% area, sway velocity, approximate entropy, and sample entropy. MobileMat BESS scores were significantly correlated with 95% area for single-leg (r = .332) and tandem firm (r = .474), and double-leg foam (r = .660); and with sway velocity for single-leg (r = .406) and tandem firm (r = .601), and double-leg (r = .575) and single-leg foam (r = .434). MobileMat BESS scores were not correlated with approximate or sample entropy. MobileMat BESS scores were low to moderately correlated with linear measures, suggesting the ability to identify changes in the center of mass-center of pressure relationship, but not higher-order processing associated with nonlinear measures. These results suggest that the MobileMat BESS may be a clinically-useful tool that provides objective linear balance measures.

Encouraging generic use can yield significant savings.

Science.gov (United States)

Zimmerman, Christina

2012-11-01

Key findings. (1) Zero copayment for generic drugs is the greatest influencer of generic statin utilization. (2) Both higher copayments for generic drugs and lower copayments for competing brands are associated with a decreased probability of using generic statins. (3) Prior authorization and step therapy requirements for brand-name statins are associated with an increased use of generic drugs. (4) Greater use of generic statins should reduce costs for patients, plans, and Medicare.

A new prognostic scoring system for perforation peritonitis secondary to duodenal ulcers

International Nuclear Information System (INIS)

Nomani, A.Z.; Qureshi, M.S.

2014-01-01

Objective: To identify prognostic factors for perforated duodenal ulcers and to devise and assess a new scoring system. Methods: The observational prospective study was conducted at the Mayo Hospital, Lahore in two phases: from March 2010 to September 2011; and from October 2011 to July 2012. It included patients with duodenal ulcer perforation who were observed for identifying factors predicting 30-day prognosis. Each of the predictive factor was given a score based on its severity to devise a new scoring system. Chi-square was used for univariate analysis. Multivariate analysis was done using forward stepwise regression. Accuracy of the new scoring system was calculated using receiver operating curve analysis and its validity was evaluated in the second phase of the study. Results: Predictors of poor prognosis included multiple gut perforations, size of largest perforation >0.5cm, amount of peritoneal fluid >1000ml, simple closure, development of complications, post-operative systemic septicaemia and winter/autumn season of presentation. Overall 30-day mortality rate was 32.3% (n=32) and morbidity rate was 21.2% (n=21). The mean score was higher in the ones with poor prognosis (p=0.001). Similarly, the mean score was greater in those with grave prognosis (p=0.001). The scoring system had an overall sensitivity of 85.12% and specificity of 80.67% and was favourably comparable to other scoring systems. Conclusion: The new scoring system is a useful tool in predicting 30-day prognosis for perforated duodenal ulcers in acid peptic disease. (author)

Assistance tools for generic definition of ITER maintenance tasks and scenarios in advanced supervisory control systems

International Nuclear Information System (INIS)

Zieba, Stéphane; Russotto, François-Xavier; Da Silva Simoes, Max; Measson, Yvan

2013-01-01

Highlights: ► Improve supervisory control systems for ITER in-vessel and hot cell maintenance. ► Optimize remote handling operations effectiveness, reliability and safety. ► Provide a generic description of the maintenance tasks and scenarios. ► Development of context-based assistances for operators and supervisor. ► Improvement of operator's situation awareness. -- Abstract: This paper concerns the improvement of supervisory control systems in the context of remote handling for the maintenance tasks in ITER. This work aims at providing a single formalism and tools to define in a generic way the ITER maintenance tasks and scenarios for in-vessel and hot cell operations. A three-layered approach is proposed to model these tasks and scenarios. Physical actions are defined for the scene elements. From these physical actions, behaviours are defined to represent high-level functionalities. Finally, interaction modes define the way that behaviours are achieved in terms of human–machine interactions. Case study concerning the blanket maintenance procedure is discussed concerning the contributions of the descriptive model and the context-based assistances to the activities of supervisory control

A simple scoring system for breast MRI interpretation: does it compensate for reader experience?

International Nuclear Information System (INIS)

Marino, Maria Adele; Clauser, Paola; Woitek, Ramona; Wengert, Georg J.; Kapetas, Panagiotis; Bernathova, Maria; Pinker-Domenig, Katja; Helbich, Thomas H.; Baltzer, Pascal A.T.; Preidler, Klaus

2016-01-01

To investigate the impact of a scoring system (Tree) on inter-reader agreement and diagnostic performance in breast MRI reading. This IRB-approved, single-centre study included 100 patients with 121 consecutive histopathologically verified lesions (52 malignant, 68 benign). Four breast radiologists with different levels of MRI experience and blinded to histopathology retrospectively evaluated all examinations. Readers independently applied two methods to classify breast lesions: BI-RADS and Tree. BI-RADS provides a reporting lexicon that is empirically translated into likelihoods of malignancy; Tree is a scoring system that results in a diagnostic category. Readings were compared by ROC analysis and kappa statistics. Inter-reader agreement was substantial to almost perfect (kappa: 0.643-0.896) for Tree and moderate (kappa: 0.455-0.657) for BI-RADS. Diagnostic performance using Tree (AUC: 0.889-0.943) was similar to BI-RADS (AUC: 0.872-0.953). Less experienced radiologists achieved AUC: improvements up to 4.7 % using Tree (P-values: 0.042-0.698); an expert's performance did not change (P = 0.526). The least experienced reader improved in specificity using Tree (16 %, P = 0.001). No further sensitivity and specificity differences were found (P > 0.1). The Tree scoring system improves inter-reader agreement and achieves a diagnostic performance similar to that of BI-RADS. Less experienced radiologists, in particular, benefit from Tree. (orig.)

Prioritization of generic safety issues

International Nuclear Information System (INIS)

Emrit, R.; Minners, W.; VanderMolen, H.

1983-12-01

This report presents the priority rankings for generic safety issues related to nuclear power plants. The purpose of these rankings is to assist in the timely and efficient allocation of NRC resources for the resolution of those safety issues that have a significant potential for reducing risk. The report focuses on the prioritization of generic safety issues. Issues primarily concerned with the licensing process or environmental protection and not directly related to safety have been excluded from prioritization. The prioritized issues include: TMI Action Plan items under development; previously proposed issues covered by Task Action Plans, except issues designated at Unresolved Safety Issues (USIs) which had already been assigned high priority; and newly-proposed issues. Future supplements to this report will include the prioritization of additional issues. The safety priority rankings are HIGH, MEDIUM, LOW, and DROP and have been assigned on the basis of risk significance estimates, the ratio of risk to costs and other impacts estimated to result if resolutions of the safety issues were implemented, and the consideration of uncertainties and other quantitative or qualitative factors. To the extent practical, estimates are quantitative

76 FR 57767 - Proposed Generic Communication; Draft NRC Generic Letter 2011-XX: Seismic Risk Evaluations for...

Science.gov (United States)

2011-09-16

... NUCLEAR REGULATORY COMMISSION [NRC-2011-0204] Proposed Generic Communication; Draft NRC Generic Letter 2011-XX: Seismic Risk Evaluations for Operating Reactors AGENCY: Nuclear Regulatory Commission... FR 54507), that requested public comment on Draft NRC Generic Letter 2011- XX: Seismic Risk...

Dream content: Individual and generic aspects.

Science.gov (United States)

Hobson, Allan; Kahn, David

2007-12-01

Dream reports were collected from normal subjects in an effort to determine the degree to which dream reports can be used to identify individual dreamers. Judges were asked to group the reports by their authors. The judges scored the reports correctly at chance levels. This finding indicated that dreams may be at least as much like each other as they are the signature of individual dreamers. Our results suggest that dream reports cannot be used to identify the individuals who produced them when identifiers like names and gender of friends and family members are removed from the dream report. In addition to using dreams to learn about an individual, we must look at dreams as telling us about important common or generic aspects of human consciousness.

An Evaluation of the IntelliMetric[SM] Essay Scoring System

Science.gov (United States)

Rudner, Lawrence M.; Garcia, Veronica; Welch, Catherine

2006-01-01

This report provides a two-part evaluation of the IntelliMetric[SM] automated essay scoring system based on its performance scoring essays from the Analytic Writing Assessment of the Graduate Management Admission Test[TM] (GMAT[TM]). The IntelliMetric system performance is first compared to that of individual human raters, a Bayesian system…

Do higher-priced generic medicines enjoy a competitive advantage under reference pricing?

Science.gov (United States)

Puig-Junoy, Jaume

2012-11-01

In many countries with generic reference pricing, generic producers and distributors compete by means of undisclosed discounts offered to pharmacies in order to reduce acquisition costs and to induce them to dispense their generic to patients in preference over others. The objective of this article is to test the hypothesis that under prevailing reference pricing systems for generic medicines, those medicines sold at a higher consumer price may enjoy a competitive advantage. Real transaction prices for 179 generic medicines acquired by pharmacies in Spain have been used to calculate the discount rate on acquisition versus reimbursed costs to pharmacies. Two empirical hypotheses are tested: the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical presentations for which there are more generic competitors; and, the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical forms for which the consumer price has declined less in relation to the consumer price of the brand drug before generic entry (higher-priced generic medicines). An average discount rate of 39.3% on acquisition versus reimbursed costs to pharmacies has been observed. The magnitude of the discount positively depends on the number of competitors in the market. The higher the ratio of the consumer price of the generic to that of the brand drug prior to generic entry (i.e. the smaller the price reduction of the generic in relation to the brand drug), the larger the discount rate. Under reference pricing there is intense price competition among generic firms in the form of unusually high discounts to pharmacies on official ex-factory prices reimbursed to pharmacies. However, this effect is highly distorting because it favours those medicines with a higher relative price in relation to the brand price before generic entry.

Development and validation of a composite scoring system for robot-assisted surgical training--the Robotic Skills Assessment Score.

Science.gov (United States)

Chowriappa, Ashirwad J; Shi, Yi; Raza, Syed Johar; Ahmed, Kamran; Stegemann, Andrew; Wilding, Gregory; Kaouk, Jihad; Peabody, James O; Menon, Mani; Hassett, James M; Kesavadas, Thenkurussi; Guru, Khurshid A

2013-12-01

A standardized scoring system does not exist in virtual reality-based assessment metrics to describe safe and crucial surgical skills in robot-assisted surgery. This study aims to develop an assessment score along with its construct validation. All subjects performed key tasks on previously validated Fundamental Skills of Robotic Surgery curriculum, which were recorded, and metrics were stored. After an expert consensus for the purpose of content validation (Delphi), critical safety determining procedural steps were identified from the Fundamental Skills of Robotic Surgery curriculum and a hierarchical task decomposition of multiple parameters using a variety of metrics was used to develop Robotic Skills Assessment Score (RSA-Score). Robotic Skills Assessment mainly focuses on safety in operative field, critical error, economy, bimanual dexterity, and time. Following, the RSA-Score was further evaluated for construct validation and feasibility. Spearman correlation tests performed between tasks using the RSA-Scores indicate no cross correlation. Wilcoxon rank sum tests were performed between the two groups. The proposed RSA-Score was evaluated on non-robotic surgeons (n = 15) and on expert-robotic surgeons (n = 12). The expert group demonstrated significantly better performance on all four tasks in comparison to the novice group. Validation of the RSA-Score in this study was carried out on the Robotic Surgical Simulator. The RSA-Score is a valid scoring system that could be incorporated in any virtual reality-based surgical simulator to achieve standardized assessment of fundamental surgical tents during robot-assisted surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

Intermediates and Generic Convergence to Equilibria

DEFF Research Database (Denmark)

Marcondes de Freitas, Michael; Wiuf, Carsten; Feliu, Elisenda

2017-01-01

Known graphical conditions for the generic and global convergence to equilibria of the dynamical system arising from a reaction network are shown to be invariant under the so-called successive removal of intermediates, a systematic procedure to simplify the network, making the graphical conditions...

Generic phase transitions and profit singularities in Arnol'd's model

International Nuclear Information System (INIS)

Davydov, Aleksei A; Matos, Helena Mena

2007-01-01

For a smooth one-parameter family of pairs of control systems and profit densities on a circle, the generic transitions between optimal rotations and stationary strategies are studied in the problem of maximization of the time-averaged profit on the infinite horizon. It is shown that there are only two types of such transitions, the corresponding singularities of the average profit as a function of the family parameter are found, and it is proved that these singularities are stable under small perturbations of a generic family. The classification of singularities of the maximum average profit is completed for generic families. Bibliography: 16 titles.

The global biopharma industry and the rise of Indian drug multinationals: implications for Australian generics policy.

Science.gov (United States)

Löfgren, Hans

2007-06-01

This article provides a synopsis of the new dynamics of the global biopharma industry. The emergence of global generics companies with capabilities approximating those of 'big pharma' has accelerated the blurring of boundaries between the innovator and generics sectors. Biotechnology-based products form a large and growing segment of prescription drug markets and regulatory pathways for biogenerics are imminent. Indian biopharma multinationals with large-scale efficient manufacturing plants and growing R&D capabilities are now major suppliers of Active Pharmaceutical Ingredients (APIs) and generic drugs across both developed and developing countries. In response to generic competition, innovator companies employ a range of life cycle management techniques, including the launch of 'authorised generics'. The generics segment in Australia will see high growth rates in coming years but the prospect for local manufacturing is bleak. The availability of cheap generics in international markets has put pressure on Pharmaceutical Benefits Scheme (PBS) pricing arrangements, and a new policy direction was announced in November 2006. Lower generics prices will have a negative impact on some incumbent suppliers but industrial renewal policies for the medicines industry in Australia are better focused on higher value R&D activities and niche manufacturing of sophisticated products.

Generics Pricing: The Greek Paradox.

Science.gov (United States)

Karafyllis, Ioannis; Variti, Lamprini

2017-01-01

This paper explains and develops a methodological framework to help evaluate the performance of generic pharmaceutical policies and the correct evaluation of generics sales. Until today erroneous recording of generics does not help proper pricing and their penetration in the Greek market. This classifies Greece on the outliners in every study or comparison that is referred on papers or studies.

LCA of contaminated site remediation - integration of site-specific impact assessment of local toxic impacts

DEFF Research Database (Denmark)

Lemming, Gitte; Hauschild, Michael Zwicky; Chambon, Julie Claire Claudia

2011-01-01

impacts have typically been assessed using site-generic characterization models representing a continental scale and excluding the groundwater compartment. Soil contaminants have therefore generally been assigned as emissions to surface soil or surface water compartments. However, such site-generic...... assessments poorly reflect the fate of frequent soil contaminants such as chloroethenes as they exclude the groundwater compartment and assume that the main part escapes to the atmosphere. Another important limitation of the generic impact assessment models is that they do not include the formation......The environmental impacts from remediation can be divided into primary and secondary impacts. Primary impacts cover the local impacts associated with the on-site contamination, whereas the secondary impacts are impacts on the local, regional and global scale generated by the remediation activities...

Predictors of generic substitution: The role of psychological, sociodemographic, and contextual factors.

Science.gov (United States)

Drozdowska, Aleksandra; Hermanowski, Tomasz

2016-01-01

Escalating pharmaceutical costs have become a global challenge for both governments and patients. Generic substitution is one way of decreasing these costs. The aim of this study was to investigate factors associated with patients' choice between generic drugs and innovator drugs. The survey was conducted in June 2013, 1000 people from across Poland were chosen as a representative population sample. The outcome (a preference for generics/a preference for innovator pharmaceuticals/no preference) was modeled by multinomial logistic regression, adjusted for several variables describing patients' sensitivity to selected generic features (price, brand, and country of origin), to third-party opinions about generics (information on generics in the mass media, opinions of health professionals (i.e. physicians, pharmacists), relatives/friends), as well as patients' personal experiences and income per household. The results supported the predictive capacity of most independent variables (except for patient sensitivity to the country of origin and to the information on generics in the mass media), denoting patients' preferences toward generic substitution. Patient sensitivity to recommendations by physicians, generic brand, and household income were the strongest predictors of the choice between generic and innovator pharmaceuticals (P brand or their physician's opinion, as well as in respondents who were sensitive to recommendations by pharmacists or attached a greater value to a past experience with generics (their own experience or that of relatives/friends). In consideration of the foregoing, awareness-raising campaigns may be recommended, supported by a variety of systemic solutions and tools to encourage generic substitution. Copyright © 2016 Elsevier Inc. All rights reserved.

Improvement in Generic Problem-Solving Abilities of Students by Use of Tutor-less Problem-Based Learning in a Large Classroom Setting

Science.gov (United States)

Klegeris, Andis; Bahniwal, Manpreet; Hurren, Heather

2013-01-01

Problem-based learning (PBL) was originally introduced in medical education programs as a form of small-group learning, but its use has now spread to large undergraduate classrooms in various other disciplines. Introduction of new teaching techniques, including PBL-based methods, needs to be justified by demonstrating the benefits of such techniques over classical teaching styles. Previously, we demonstrated that introduction of tutor-less PBL in a large third-year biochemistry undergraduate class increased student satisfaction and attendance. The current study assessed the generic problem-solving abilities of students from the same class at the beginning and end of the term, and compared student scores with similar data obtained in three classes not using PBL. Two generic problem-solving tests of equal difficulty were administered such that students took different tests at the beginning and the end of the term. Blinded marking showed a statistically significant 13% increase in the test scores of the biochemistry students exposed to PBL, while no trend toward significant change in scores was observed in any of the control groups not using PBL. Our study is among the first to demonstrate that use of tutor-less PBL in a large classroom leads to statistically significant improvement in generic problem-solving skills of students. PMID:23463230

NET 40 Generics Beginner's Guide

CERN Document Server

Mukherjee, Sudipta

2012-01-01

This is a concise, practical guide that will help you learn Generics in .NET, with lots of real world and fun-to-build examples and clear explanations. It is packed with screenshots to aid your understanding of the process. This book is aimed at beginners in Generics. It assumes some working knowledge of C# , but it isn't mandatory. The following would get the most use out of the book: Newbie C# developers struggling with Generics. Experienced C++ and Java Programmers who are migrating to C# and looking for an alternative to other generic frameworks like STL and JCF would find this book handy.

Energy systems. Tome 3: advanced cycles, low environmental impact innovative systems; Systeme energetiques, TOME 3: cycles avances, systemes innovants a faible impact environnemental

Energy Technology Data Exchange (ETDEWEB)

Gicquel, R

2009-07-01

This third tome about energy systems completes the two previous ones by showing up advanced thermodynamical cycles, in particular having a low environmental impact, and by dealing with two other questions linked with the study of systems with a changing regime operation: - the time management of energy, with the use of thermal and pneumatic storage systems and time simulation (schedule for instance) of systems (solar energy type in particular); - the technological dimensioning and non-nominal regime operation studies. Because this last topic is particularly complex, new functionalities have been implemented mainly by using the external classes mechanism, which allows the user to freely personalize his models. This tome is illustrated with about 50 examples of cycles modelled with Thermoptim software. Content: foreword; 1 - generic external classes; 2 - advanced gas turbine cycles; 3 - evaporation-concentration, mechanical steam compression, desalination, hot gas drying; 4 - cryogenic cycles; 5 - electrochemical converters; 6 - global warming, CO{sub 2} capture and sequestration; 7 - future nuclear reactors (coupled to Hirn and Brayton cycles); 8 - thermodynamic solar cycles; 10 - pneumatic and thermal storage; 11 - calculation of thermodynamic solar facilities; 12 - problem of technological dimensioning and non-nominal regime; 13 - exchangers modeling and parameterizing for the dimensioning and the non-nominal regime; 14 - modeling and parameterizing of volumetric compressors; 15 - modeling and parameterizing of turbo-compressors and turbines; 16 - identification methodology of component parameters; 17 - case studies. (J.S.)

Baldrige Theory into Practice: A Generic Model

Science.gov (United States)

Arif, Mohammed

2007-01-01

Purpose: The education system globally has moved from a push-based or producer-centric system to a pull-based or customer centric system. Malcolm Baldrige Quality Award (MBQA) model happens to be one of the latest additions to the pull based models. The purpose of this paper is to develop a generic framework for MBQA that can be used by…

The SPOTS System: An Ocular Scoring System Optimized for Use in Modern Preclinical Drug Development and Toxicology.

Science.gov (United States)

Eaton, Joshua Seth; Miller, Paul E; Bentley, Ellison; Thomasy, Sara M; Murphy, Christopher J

2017-12-01

To present a semiquantitative ocular scoring system comprising elements and criteria that address many of the limitations associated with systems commonly used in preclinical studies, providing enhanced cross-species applicability and predictive value in modern ocular drug and device development. Revisions to the ocular scoring systems of McDonald-Shadduck and Hackett-McDonald were conducted by board-certified veterinary ophthalmologists at Ocular Services On Demand (OSOD) over the execution of hundreds of in vivo preclinical ocular drug and device development studies and general toxicological investigations. This semiquantitative preclinical ocular toxicology scoring (SPOTS) system was driven by limitations of previously published systems identified by our group's recent review of slit lamp-based scoring systems in clinical ophthalmology, toxicology, and vision science. The SPOTS system provides scoring criteria for the anterior segment, posterior segment, and characterization of intravitreal test articles. Key elements include: standardized slit lamp settings; expansion of criteria to enhance applicability to nonrabbit species; refinement and disambiguation of scoring criteria for corneal opacity, fluorescein staining severity, and aqueous flare; introduction of novel criteria for scoring of aqueous and anterior vitreous cell; and introduction of criteria for findings observed with drugs/devices targeting the posterior segment. A modified Standardization of Uveitis Nomenclature (SUN) system is also introduced to facilitate accurate use of SUN's criteria in laboratory species. The SPOTS systems provide criteria that stand to enhance the applicability of semiquantitative scoring criteria to the full range of laboratory species, in the context of modern approaches to ocular therapeutics and drug delivery and drug and device development.

Impact of Toxicity Grade and Scoring System on the Relationship Between Mean Lung Dose and Risk of Radiation Pneumonitis in a Large Cohort of Patients With Non-Small Cell Lung Cancer

International Nuclear Information System (INIS)

Tucker, Susan L.; Jin Hekun; Wei Xiong

2010-01-01

Purpose: To compute the risk of radiation pneumonitis (RP) as a function of mean lung dose (MLD), with RP scored using three grading systems and analyzed at four threshold levels of toxicity in a large cohort of patients with non-small cell lung cancer (NSCLC) treated with definitive radiotherapy (RT). Methods and Materials: On the basis of medical records and radiographic images, RP was scored retrospectively in 442 patients with NSCLC who had ≥6 months of follow-up after the end of RT. The severity of RP was scored for each patient using the National Cancer Institute (NCI) Common Toxicity Criteria, version 2.0 (CTC2.0); the NCI Common Terminology Criteria for Adverse Events, version 3.0 (CTCAE3.0); and the grading system of the Radiation Therapy Oncology Group (RTOG). For each grading system and for each of four levels of toxicity (Grade ≥1, ≥2, ≥3, ≥4), the Lyman, logistic, and log-logistic normal tissue complication probability (NTCP) models were fitted to the data as functions of MLD. The parameter estimates from the model fits are listed in table form, and the RP risk estimates are presented graphically for the Lyman and log-logistic NTCP models. Results: The results presented here illustrate the impact of scoring system and level of toxicity on the relationship between MLD and RP risk. Conclusions: These results facilitate quantitative comparisons between our data and studies of RP risk reported by others, and several examples of such comparisons are provided.

Some drugs more equal than others: pseudo-generics and commercial practice.

Science.gov (United States)

Probyn, Andrew J

2004-11-08

This article analyses the impact of the Department of Health and Ageing's brand price premium policy for some products listed on the Pharmaceutical Benefits Scheme. The policy, introduced in 1990, allows pharmaceutical companies to charge patients an out-of-pocket expense for post-patent brands of pharmaceuticals. One of the policy's intended goals was to increase consumer awareness of price differentials between competing brands, with a view to encouraging greater use of cheaper generic products. More than fourteen years since its introduction, it is debatable whether the policy has achieved this aim. This article looks at how the brand price premium policy can be exploited by global pharmaceutical giants to entrench big-name brands in the Australian pharmaceutical market and, in some cases, prevent 'true' competition from generic pharmaceuticals. This is being done through the establishment of 'pseudo-generics' that are sourced from the same factory floor as the original product.

Making the Cut in Gifted Selection: Score Combination Rules and Their Impact on Program Diversity

Science.gov (United States)

Lakin, Joni M.

2018-01-01

The recommendation of using "multiple measures" is common in policy guidelines for gifted and talented assessment systems. However, the integration of multiple test scores in a system that uses cut-scores requires choosing between different methods of combining quantitative scores. Past research has indicated that OR combination rules…

The Analysis of the Impact of Individual Weighting Factor on Individual Scores

Science.gov (United States)

Kilic, Gulsen Bagci; Cakan, Mehtap

2006-01-01

In this study, category-based self and peer assessment were applied twice in a semester in an Elementary Science Teaching Methods course in order to assess individual contributions of group members to group projects as well as to analyze the impact of Individual Weighting Factors (IWF) on individual scores and individual grades. IWF were…

Zonal NePhRO scoring system: a superior renal tumor complexity classification model.

Science.gov (United States)

Hakky, Tariq S; Baumgarten, Adam S; Allen, Bryan; Lin, Hui-Yi; Ercole, Cesar E; Sexton, Wade J; Spiess, Philippe E

2014-02-01

Since the advent of the first standardized renal tumor complexity system, many subsequent scoring systems have been introduced, many of which are complicated and can make it difficult to accurately measure data end points. In light of these limitations, we introduce the new zonal NePhRO scoring system. The zonal NePhRO score is based on 4 anatomical components that are assigned a score of 1, 2, or 3, and their sum is used to classify renal tumors. The zonal NePhRO scoring system is made up of the (Ne)arness to collecting system, (Ph)ysical location of the tumor in the kidney, (R)adius of the tumor, and (O)rganization of the tumor. In this retrospective study, we evaluated patients exhibiting clinical stage T1a or T1b who underwent open partial nephrectomy performed by 2 genitourinary surgeons. Each renal unit was assigned both a zonal NePhRO score and a RENAL (radius, exophytic/endophytic properties, nearness of tumor to the collecting system or sinus in millimeters, anterior/posterior, location relative to polar lines) score, and a blinded reviewer used the same preoperative imaging study to obtain both scores. Additional data points gathered included age, clamp time, complication rate, urine leak rate, intraoperative blood loss, and pathologic tumor size. One hundred sixty-six patients underwent open partial nephrectomy. There were 37 perioperative complications quantitated using the validated Clavien-Dindo system; their occurrence was predicted by the NePhRO score on both univariate and multivariate analyses (P = .0008). Clinical stage, intraoperative blood loss, and tumor diameter were all correlated with the zonal NePhRO score on univariate analysis only. The zonal NePhRO scoring system is a simpler tool that accurately predicts the surgical complexity of a renal lesion. Copyright © 2014 Elsevier Inc. All rights reserved.

Efficient Generic Functional Programming

NARCIS (Netherlands)

Alimarine, A.; Smetsers, J.E.W.

2005-01-01

Generic functions are defined by induction on the structural representation of types. As a consequence, by defining just a single generic operation, one acquires this operation over any particular data type. An instance on a specific type is generated by interpretation of the type's structure. A

Generic superweak chaos induced by Hall effect

Science.gov (United States)

Ben-Harush, Moti; Dana, Itzhack

2016-05-01

We introduce and study the "kicked Hall system" (KHS), i.e., charged particles periodically kicked in the presence of uniform magnetic (B ) and electric (E ) fields that are perpendicular to each other and to the kicking direction. We show that for resonant values of B and E and in the weak-chaos regime of sufficiently small nonintegrability parameter κ (the kicking strength), there exists a generic family of periodic kicking potentials for which the Hall effect from B and E significantly suppresses the weak chaos, replacing it by "superweak" chaos (SWC). This means that the system behaves as if the kicking strength were κ2 rather than κ . For E =0 , SWC is known to be a classical fingerprint of quantum antiresonance, but it occurs under much less generic conditions, in particular only for very special kicking potentials. Manifestations of SWC are a decrease in the instability of periodic orbits and a narrowing of the chaotic layers, relative to the ordinary weak-chaos case. Also, for global SWC, taking place on an infinite "stochastic web" in phase space, the chaotic diffusion on the web is much slower than the weak-chaos one. Thus, the Hall effect can be relatively stabilizing for small κ . In some special cases, the effect is shown to cause ballistic motion for almost all parameter values. The generic global SWC on stochastic webs in the KHS appears to be the two-dimensional closest analog to the Arnol'd web in higher dimensional systems.

Wearable PPG sensor based alertness scoring system.

Science.gov (United States)

Dey, Jishnu; Bhowmik, Tanmoy; Sahoo, Saswata; Tiwari, Vijay Narayan

2017-07-01

Quantifying mental alertness in today's world is important as it enables the person to adopt lifestyle changes for better work efficiency. Miniaturized sensors in wearable devices have facilitated detection/monitoring of mental alertness. Photoplethysmography (PPG) sensors through Heart Rate Variability (HRV) offer one such opportunity by providing information about one's daily alertness levels without requiring any manual interference from the user. In this paper, a smartwatch based alertness estimation system is proposed. Data collected from PPG sensor of smartwatch is processed and fed to machine learning based model to get a continuous alertness score. Utility functions are designed based on statistical analysis to give a quality score on different stages of alertness such as awake, long sleep and short duration power nap. An intelligent data collection approach is proposed in collaboration with the motion sensor in the smartwatch to reduce battery drainage. Overall, our proposed wearable based system provides a detailed analysis of alertness over a period in a systematic and optimized manner. We were able to achieve an accuracy of 80.1% for sleep/awake classification along with alertness score. This opens up the possibility for quantifying alertness levels using a single PPG sensor for better management of health related activities including sleep.

Generic robot architecture

Science.gov (United States)

Bruemmer, David J [Idaho Falls, ID; Few, Douglas A [Idaho Falls, ID

2010-09-21

The present invention provides methods, computer readable media, and apparatuses for a generic robot architecture providing a framework that is easily portable to a variety of robot platforms and is configured to provide hardware abstractions, abstractions for generic robot attributes, environment abstractions, and robot behaviors. The generic robot architecture includes a hardware abstraction level and a robot abstraction level. The hardware abstraction level is configured for developing hardware abstractions that define, monitor, and control hardware modules available on a robot platform. The robot abstraction level is configured for defining robot attributes and provides a software framework for building robot behaviors from the robot attributes. Each of the robot attributes includes hardware information from at least one hardware abstraction. In addition, each robot attribute is configured to substantially isolate the robot behaviors from the at least one hardware abstraction.

An exploration of the impact of invalid MMPI-2 protocols on collateral self-report measure scores.

Science.gov (United States)

Forbey, Johnathan D; Lee, Tayla T C

2011-11-01

Although a number of studies have examined the impact of invalid MMPI-2 (Butcher et al., 2001) response styles on MMPI-2 scale scores, limited research has specifically explored the effects that such response styles might have on conjointly administered collateral self-report measures. This study explored the potential impact of 2 invalidating response styles detected by the Validity scales of the MMPI-2, overreporting and underreporting, on scores of collateral self-report measures administered conjointly with the MMPI-2. The final group of participants included in analyses was 1,112 college students from a Midwestern university who completed all measures as part of a larger study. Results of t-test analyses suggested that if either over- or underreporting was indicated by the MMPI-2 Validity scales, the scores of most conjointly administered collateral measures were also significantly impacted. Overall, it appeared that test-takers who were identified as either over- or underreporting relied on such a response style across measures. Limitations and suggestions for future study are discussed.

Generic Crystalline Disposal Reference Case

Energy Technology Data Exchange (ETDEWEB)

Painter, Scott Leroy [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Chu, Shaoping [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Harp, Dylan Robert [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Perry, Frank Vinton [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wang, Yifeng [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2015-02-20

A generic reference case for disposal of spent nuclear fuel and high-level radioactive waste in crystalline rock is outlined. The generic cases are intended to support development of disposal system modeling capability by establishing relevant baseline conditions and parameters. Establishment of a generic reference case requires that the emplacement concept, waste inventory, waste form, waste package, backfill/buffer properties, EBS failure scenarios, host rock properties, and biosphere be specified. The focus in this report is on those elements that are unique to crystalline disposal, especially the geosphere representation. Three emplacement concepts are suggested for further analyses: a waste packages containing 4 PWR assemblies emplaced in boreholes in the floors of tunnels (KBS-3 concept), a 12-assembly waste package emplaced in tunnels, and a 32-assembly dual purpose canister emplaced in tunnels. In addition, three failure scenarios were suggested for future use: a nominal scenario involving corrosion of the waste package in the tunnel emplacement concepts, a manufacturing defect scenario applicable to the KBS-3 concept, and a disruptive glaciation scenario applicable to both emplacement concepts. The computational approaches required to analyze EBS failure and transport processes in a crystalline rock repository are similar to those of argillite/shale, with the most significant difference being that the EBS in a crystalline rock repository will likely experience highly heterogeneous flow rates, which should be represented in the model. The computational approaches required to analyze radionuclide transport in the natural system are very different because of the highly channelized nature of fracture flow. Computational workflows tailored to crystalline rock based on discrete transport pathways extracted from discrete fracture network models are recommended.

Merger mania: mergers and acquisitions in the generic drug sector from 1995 to 2016.

Science.gov (United States)

Gagnon, Marc-André; Volesky, Karena D

2017-08-22

Drug shortages and increasing generic drug prices are associated with low levels of competition. Mergers and acquisitions impact the level of competition. Record merger and acquisition activity was reported for the pharmaceutical sector in 2014/15, yet information on mergers and acquisitions in the generic drug sector are absent from the literature. This information is necessary to understand if and how such mergers and acquisitions can be a factor in drug shortages and increasing prices. Data on completed merger and acquisition deals that had a generic drug company being taken over (i.e. 'target') were extracted from Bloomberg Finance L.P. The number and announced value of deals are presented globally, for the United States, and globally excluding the United States annually from 1995 to 2016 in United States dollars. Generic drug companies comprised 9.3% of the value of all deals with pharmaceutical targets occurring from 1995 to 2016. Globally, in 1995 there were no deals, in 2014 there were 22 deals worth $1.86 billion, in 2015 there were 34 deals totalling $33.56 billion, and in 2016 there were 42 deals worth in excess of $44 billion. This substantial increase was partially attributed to Teva's 2016 acquisition of Allergan's generic drug business. The surge in mergers and acquisitions for 2015/16 was driven by deals in the United States, where they represented 89.7% of the dollar value of deals in those years. The recent blitz in mergers and acquisitions signals that the generic drug industry is undergoing a transformation, especially in the United States. This restructuring can negatively affect the level of competition that might impact prices and shortages for some products, emphasizing the importance of updating regulations and procurement policies.

Impacts of generic competition and benefit management practices on spending for prescription drugs: evidence from Medicare's Part D benefit.

Science.gov (United States)

Sheingold, Steven; Nguyen, Nguyen Xuan

2014-01-01

This study estimates the effects of generic competition, increased cost-sharing, and benefit practices on utilization and spending for prescription drugs. We examined changes in Medicare price and utilization from 2007 to 2009 of all drugs in 28 therapeutic classes. The classes accounted for 80% of Medicare Part D spending in 2009 and included the 6 protected classes and 6 classes with practically no generic competition. All variables were constructed to measure each drug relative to its class at a specific plan sponsor. We estimated that the shift toward generic utilization had cut in half the rate of increase in the price of a prescription during 2007-2009. Specifically, the results showed that (1) rapid generic penetration had significantly held down costs per prescription, (2) copayment and other benefit practices shifted utilization to generics and favored brands, and (3) price increases were generally greater in less competitive classes of drugs. In many ways, Part D was implemented at a fortuitous time; since 2006, there have been relatively few new blockbuster drugs introduced, and many existing high-volume drugs used by beneficiaries were in therapeutic classes with multiple brands and generic alternatives. Under these conditions, our paper showed that plan sponsors have been able to contain costs by encouraging use of generics or drugs offering greater value within therapeutic classes. It is less clear what will happen to future Part D costs if a number of new and effective drugs for beneficiaries enter the market with no real competitors.

Disease scoring systems for oral lichen planus; a critical appraisal

Science.gov (United States)

Wang, Jing

2015-01-01

The aim of the present study has been to critically review 22 disease scoring systems (DSSs) on oral lichen planus (OLP) that have been reported in the literature during the past decades. Although the presently available DSSs may all have some merit, particularly for research purposes, the diversity of both the objective and subjective parameters used in these systems and the lack of acceptance of one of these systems for uniform use, there is a need for an international, authorized consensus meeting on this subject. Because of the natural course of OLP characterized by remissions and exacerbations and also due to the varying distribution pattern and the varying clinical types, e.g. reticular and erosive, the relevance of a DSS based on morphologic parameters is somewhat questionable. Instead, one may consider to only look for a quality of life scoring system adapted for use in OLP patients. Key words:Oral lichen planus, disease scoring system, classification. PMID:25681372

Generic models for use in assessing the impact of discharges of radioactive substances to the environment

International Nuclear Information System (INIS)

2001-01-01

The concern of society in general for the quality of the environment and the realization that all human activities have some environmental effect has led to the development of a procedure for environmental impact analysis. This procedure is a predictive one, which forecasts probable environmental effects before some action, such as the construction and operation of a nuclear power station, is decided upon. The method of prediction is by the application of models that describe the environmental processes in mathematical terms in order to produce a quantitative result which can be used in the decision making process. This report describes such a procedure for application to radioactive discharges and is addressed to the national regulatory bodies and technical and administrative personnel responsible for performing environmental impact analyses. The report is also intended to support the recently published IAEA Safety Guide on Regulatory Control of Radioactive Discharges to the Environment. It expands on and supersedes previous advice published in IAEA Safety Series No. 57 on Generic Models and Parameters for Assessing the Environmental Transfer of Radionuclides from Routine Releases. This Safety Report was developed through a series of consultants meetings and three Advisory Group Meetings

Validation of generic cost estimates for construction-related activities at nuclear power plants: Final report

International Nuclear Information System (INIS)

Simion, G.; Sciacca, F.; Claiborne, E.; Watlington, B.; Riordan, B.; McLaughlin, M.

1988-05-01

This report represents a validation study of the cost methodologies and quantitative factors derived in Labor Productivity Adjustment Factors and Generic Methodology for Estimating the Labor Cost Associated with the Removal of Hardware, Materials, and Structures From Nuclear Power Plants. This cost methodology was developed to support NRC analysts in determining generic estimates of removal, installation, and total labor costs for construction-related activities at nuclear generating stations. In addition to the validation discussion, this report reviews the generic cost analysis methodology employed. It also discusses each of the individual cost factors used in estimating the costs of physical modifications at nuclear power plants. The generic estimating approach presented uses the /open quotes/greenfield/close quotes/ or new plant construction installation costs compiled in the Energy Economic Data Base (EEDB) as a baseline. These baseline costs are then adjusted to account for labor productivity, radiation fields, learning curve effects, and impacts on ancillary systems or components. For comparisons of estimated vs actual labor costs, approximately four dozen actual cost data points (as reported by 14 nuclear utilities) were obtained. Detailed background information was collected on each individual data point to give the best understanding possible so that the labor productivity factors, removal factors, etc., could judiciously be chosen. This study concludes that cost estimates that are typically within 40% of the actual values can be generated by prudently using the methodologies and cost factors investigated herein

Exploring community pharmacists' views on generic medicines: a nationwide study from Malaysia.

Science.gov (United States)

Chong, Chee Ping; Hassali, Mohamed Azmi; Bahari, Mohd Baidi; Shafie, Asrul Akmal

2011-02-01

To evaluate the Malaysian community pharmacists' views on generic medicines. A sample of 1419 Malaysian community pharmacies with resident pharmacists. A cross-sectional nationwide survey using a self-completed mailing questionnaire. Pharmacists' views on generic medicines including issues surrounding efficacy, safety, quality and bioequivalence. Responses were received from 219 pharmacies (response rate 15.4%). Only 50.2% of the surveyed pharmacists agreed that all products that are approved as generic equivalents can be considered therapeutically equivalent with the innovator medicines. Around 76% of respondents indicated that generic substitution of narrow therapeutic index medicines is inappropriate. The majority of the pharmacists understood that a generic medicine must contain the same amount of active ingredient (84.5%) and must be in the same dosage form as the innovator brand (71.7%). About 21% of respondents though that generic medicines are of inferior quality compared to innovator medicines. Most of the pharmacists (61.6%) disagreed that generic medicines produce more side-effects than innovator brand. Pharmacists graduated from Malaysian universities, twinning program and overseas universities were not differed significantly in their views on generic medicines. Additionally, the respondents appeared to have difficulty in ascertaining the bioequivalent status of the marketed generic products in Malaysia. The Malaysian pharmacists' have lack of information and/or trust in the generic manufacturing and/or approval system in Malaysia. This issue should be addressed by pharmacy educators and relevant government agencies.

Introducing the HOPE (Hypospadias Objective Penile Evaluation)-score : A validation study of an objective scoring system for evaluating cosmetic appearance in hypospadias patients

NARCIS (Netherlands)

van der Toorn, Fred; de Jong, Tom P. V. M.; de Gier, Robert P. E.; Callewaert, Piet R. H.; van der Horst, Eric H. J. R.; Steffens, Martijn G.; Hoebeke, Piet; Nijman, Rien J. M.; Bush, Nicol C.; Wolffenbuttel, Katja P.; van den Heijkant, Marleen M. C.; van Capelle, Jan-Willem; Wildhagen, Mark; Timman, Reinier; van Busschbach, Jan J. V.

2013-01-01

Objective: To determine the reliability and internal validity of the Hypospadias Objective Penile Evaluation (HOPE)-score, a newly developed scoring system assessing the cosmetic outcome in hypospadias. Patients and methods: The HOPE scoring system incorporates all surgically-correctable items:

Evaluation of a daily practice composite score for the assessment of Crohn's disease: the treatment impact of certolizumab pegol.

Science.gov (United States)

Feagan, B G; Hanauer, S B; Coteur, G; Schreiber, S

2011-05-01

Successful treatment of systemic inflammatory symptoms is essential for improving health-related quality of life in patients with active Crohn's disease. Patient-reported outcomes provide unique perspectives on the impact of chronic disease. It is unknown whether a combination of different instruments might improve sensitivity to clinically relevant changes in health status. To develop a composite score based upon Crohn's Disease Activity Index (CDAI) and Inflammatory Bowel Disease Questionnaire (IBDQ) items. Patients from the PRECiSE 2 trial who responded at week 6 to certolizumab pegol (CZP) were randomised to receive treatment with CZP 400 mg or placebo for up to 26 weeks. IBDQ and CDAI scores were assessed at weeks 0, 6, 16 and 26. A 'daily practice' composite score (DP-6) containing two items from the CDAI and four items from IBDQ was constructed. Correlation coefficients between the CDAI score and IBDQ total score at baseline and at week 26 were -0.344 and -0.603, respectively (Pimpact of different treatments on patient-reported outcomes, and to determine if the use of the DP-6 improves the care of patients in clinical practice. © 2011 Blackwell Publishing Ltd.

The Impact of the 2004 Hurricanes on Florida Comprehensive Assessment Test Scores: Implications for School Counselors

Science.gov (United States)

Baggerly, Jennifer; Ferretti, Larissa K.

2008-01-01

What is the impact of natural disasters on students' statewide assessment scores? To answer this question, Florida Comprehensive Assessment Test (FCAT) scores of 55,881 students in grades 4 through 10 were analyzed to determine if there were significant decreases after the 2004 hurricanes. Results reveal that there was statistical but no practical…

Development and validation of the International Hidradenitis Suppurativa Severity Score System (IHS4), a novel dynamic scoring system to assess HS severity

DEFF Research Database (Denmark)

Zouboulis, C C; Tzellos, T; Kyrgidis, A

2017-01-01

BACKGROUND: A validated tool for the dynamic severity assessment of hidradenitis suppurativa/acne inversa (HS) is lacking. OBJECTIVES: To develop and validate a novel dynamic scoring system to assess the severity of HS. METHODS: A Delphi voting procedure was conducted among the members......, as well as examination for correlation (Spearman's rho) and agreement (Cohen's kappa) with existing scores, were engaged to recognize the variables for a new International HS4 (IHS4) that was established by a second Delphi round. RESULTS: Consensus HS4 was based on number of skin lesions, number of skin....... Three candidate scores were presented to the second Delphi round. The resulting IHS4 score is arrived at by the number of nodules (multiplied by 1) plus the number of abscesses (multiplied by 2) plus the number of draining tunnels (multiplied by 4). A total score of 3 or less signifies mild, 4...

Medication persistence and the use of generic and brand-name blood pressure-lowering agents.

Science.gov (United States)

Corrao, Giovanni; Soranna, Davide; La Vecchia, Carlo; Catapano, Alberico; Agabiti-Rosei, Enrico; Gensini, Gianfranco; Merlino, Luca; Mancia, Giuseppe

2014-05-01

Because of their lower cost, healthcare systems recommend physicians to prefer generic products, rather than brand-name medicaments. There is then considerable interest and debate concerning safety and effectiveness of generic products. Few studies have compared patients treated with brand-name and generic drugs for adherence to treatment, with somewhat inconsistent results. The primary objective of this study was to compare the risk of discontinuing antihypertensive drug therapy in patients treated with generic or brand-name agents. The 101,618 beneficiaries of the Healthcare system of Lombardy, Italy, aged 18 years or older who were newly treated on monotherapy with antihypertensive generic or brand-name drugs during 2008, were followed until the earliest date among those of the occurrence of treatment discontinuation to whatever antihypertensive drug therapy (outcome), or censoring (death, emigration, 12 months after treatment initiation). Hazard ratios of discontinuation associated with starting on generic or brand-name products (intention-to-treat analysis), and incidence rate ratio of discontinuation during periods on generic and brand-name products (as-treated analysis) were respectively estimated from a cohort and self-controlled case series analyses. Patients who started on generics did not experience a different risk of discontinuation compared with those starting on brand-name agents (hazard ratio: 1.00; 95% confidence interval 0.98-1.02). Discontinuation did not occur with different rates during periods covered by generics or brand-name agents (incidence rate ratio: 1.01; 95% confidence interval 0.96-1.11) within the same individuals. A number of sensitivity and subgroup analyses confirmed the robustness of these findings. Generic products are not responsible for the high rate of discontinuation from antihypertensive drug therapy. Assuming therapeutic equivalence, clinical implication is of prescribing generic drug therapies.

Symptom scoring systems to diagnose distal polyneuropathy in diabetes : the Diabetic Neuropathy Symptom score

NARCIS (Netherlands)

Meijer, J.W.G.; Smit, A.J.; van Sonderen, E.; Groothoff, J.W.; Eisma, W.H.; Links, T.P.

2002-01-01

AIMS: To provide one of the diagnostic categories for distal diabetic polyneuro-pathy,several symptom scoring systems are available, which are often extensive andlack in validation. We validated a new four-item Diabetic Neuropathy Symptom (DNS) scorefor diagnosing distal diabetic polyneuropathy.

Towards a Generic and Adaptive System-On-Chip Controller for Space Exploration Instrumentation

Science.gov (United States)

Iturbe, Xabier; Keymeulen, Didier; Yiu, Patrick; Berisford, Dan; Hand, Kevin; Carlson, Robert; Ozer, Emre

2015-01-01

This paper introduces one of the first efforts conducted at NASA’s Jet Propulsion Laboratory (JPL) to develop a generic System-on-Chip (SoC) platform to control science instruments that are proposed for future NASA missions. The SoC platform is named APEX-SoC, where APEX stands for Advanced Processor for space Exploration, and is based on a hybrid Xilinx Zynq that combines an FPGA and an ARM Cortex-A9 dual-core processor on a single chip. The Zynq implements a generic and customizable on-chip infrastructure that can be reused with a variety of instruments, and it has been coupled with a set of off-chip components that are necessary to deal with the different instruments. We have taken JPL’s Compositional InfraRed Imaging Spectrometer (CIRIS), which is proposed for NASA icy moons missions, as a use-case scenario to demonstrate that the entire data processing, control and interface of an instrument can be implemented on a single device using the on-chip infrastructure described in this paper. We show that the performance results achieved in this preliminary version of the instrumentation controller are sufficient to fulfill the science requirements demanded to the CIRIS instrument in future NASA missions, such as Europa.

42 CFR 447.506 - Authorized generic drugs.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Authorized generic drugs. 447.506 Section 447.506... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payment for Drugs § 447.506 Authorized generic drugs. (a) Authorized generic drug defined. For the purposes of this subpart, an authorized generic drug...

PedsQLTM 4.0 Generic Core Scales for adolescents in the Yoruba language: translation and general psychometric properties.

Science.gov (United States)

Atilola, Olayinka; Stevanović, Dejan

2014-04-01

Quality of life (QOL) is a universally accepted concept for measuring the impact of different aspects of life on general well-being. Adaptation of existing QOL instruments to local cultures has been identified as a better strategy than development of new ones. To translate and adapt the Paediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales (PedsQL™) to the Yoruba language and culture and to test the psychometric properties of the adapted instrument among adolescents. Psychometric properties including internal consistency reliability, construct and factorial validity of the Yoruba version of PedsQL™ were evaluated using standard procedures. The self report and proxy scales of the Yoruba PedsQL™ were developed with good cultural relevance and semantic/conceptual equivalence. Results from 527 adolescents revealed a Cronbach's coefficient which exceeded 0.7 for internal consistency reliability for all scores. The healthy subjects reported higher PedsQL™ scores than those with mental health and physical problems, which confirmed construct validity. Confirmatory factor analysis revealed a good model fit for the Psychosocial Health score, but not for the other measures. The Yoruba PedsQL™ is culturally appropriate and with good internal consistency, reliability and construct validity. More work is needed regarding its factorial validity.

Comparison of Generic Drug Reviews for Marketing Authorization between Japan and Canada.

Science.gov (United States)

Kuribayashi, Ryosuke; Appleton, Scott

2017-09-01

Generic drugs are assuming an increasingly important role in sustaining modern healthcare systems, as the cost of healthcare, including drug usage, is gradually expanding around the world. To date, published articles comparing generic drug reviews between different countries are scarce. The objective of this study was to examine generic drug reviews in Japan and Canada. We surveyed generic drug reviews from Japan and Canada and compared the following points: general matter (application types, type of partial change or Supplement to an Abbreviated New Drug Submission, application and approval numbers, review period, application format, review report, responsibility for review), bioequivalence studies for solid oral dosage forms, and bioequivalence guidelines, guidance, or basic principles regarding various dosage forms. This survey described the many similarities and differences in generic drug reviews between the two countries and points that should be improved to promote better generic drug reviews. In particular, regulations for the definition of the same or different active pharmaceutical ingredients (APIs) are similar for both authorities. The results clarified the future challenges of generic drug reviews, and the differences highlighted by this survey will be important considerations for the future. This is the first article to present and discuss the details of generic drug reviews between Japan and Canada.

Avoidance of generic competition by Abbott Laboratories' fenofibrate franchise.

Science.gov (United States)

Downing, Nicholas S; Ross, Joseph S; Jackevicius, Cynthia A; Krumholz, Harlan M

2012-05-14

The ongoing debate concerning the efficacy of fenofibrate has overshadowed an important aspect of the drug's history: Abbott Laboratories, the maker of branded fenofibrate, has produced several bioequivalent reformulations that dominate the market, although generic fenofibrate has been available for almost a decade. This continued use of branded formulations, which cost twice as much as generic versions of fenofibrate, imposes an annual cost of approximately $700 million on the US health care system. Abbott Laboratories maintained its dominance of the fenofibrate market in part through a complex switching strategy involving the sequential launch of branded reformulations that had not been shown to be superior to the first-generation product and patent litigation that delayed the approval of generic formulations. The small differences in dose of the newer branded formulations prevented their substitution with generics of older-generation products. As soon as direct generic competition seemed likely at the new dose level, where substitution would be allowed, Abbott would launch another reformulation, and the cycle would repeat. Based on the fenofibrate example, our objective is to describe how current policy can allow pharmaceutical companies to maintain market share using reformulations of branded medications, without demonstrating the superiority of next-generation products.

Scoring system for differentiating perforated and non-perforated pediatric appendicitis.

Science.gov (United States)

Blumfield, Einat; Yang, Daniel; Grossman, Joshua

2017-10-01

Appendicitis is the most common indication for emergency pediatric surgery and its most significant complication is perforation. Perforated appendicitis (PA) may be managed conservatively, whereas non-perforated appendicitis (NP) is managed surgically. Recent studies have shown that ultrasound (US) is effective for differentiating between PA and NP, and does not expose pediatric patients to ionizing radiation. The purpose of this study is to enhance the accuracy of differentiation with a novel scoring system based on clinical, laboratory, and US findings. This retrospective study included 243 patients aged 2-17 years who presented between 2006 and 2013 with surgically proven appendicitis, of whom 60 had perforation. Clinical and laboratory data were collected and US images evaluated by a pediatric radiologist. To create the scoring system, point values were assigned to each parameter. A randomly selected training sample of 137 subjects was used to create a scoring prediction model. The model was tested on the remaining 106 patients. Scores of ≥6, ≥11, and ≥15 yielded specificities of 64, 91, and 99%, and sensitivities of 96, 61, and 29%, respectively (p < 0.001). We have designed a scoring system incorporating clinical, laboratory, and sonographic findings which can differentiate PA from NP with high specificity.

Building an Image-Based System to automatically Score psoriasis

DEFF Research Database (Denmark)

G{'o}mez, D. Delgado; Carstensen, Jens Michael; Ersbøll, Bjarne Kjær

2003-01-01

Nowadays the medical tracking of dermatological diseases is imprecise. The main reason is the lack of suitable objective methods to evaluate the lesion. The severity of the disease is scored by doctors just through their visual examination. In this work, a system to take accurate images of dermat......Nowadays the medical tracking of dermatological diseases is imprecise. The main reason is the lack of suitable objective methods to evaluate the lesion. The severity of the disease is scored by doctors just through their visual examination. In this work, a system to take accurate images...

Validation of the Rockall risk scoring system in upper gastrointestinal bleeding

NARCIS (Netherlands)

Vreeburg, E. M.; Terwee, C. B.; Snel, P.; Rauws, E. A.; Bartelsman, J. F.; Meulen, J. H.; Tytgat, G. N.

1999-01-01

Several scoring systems have been developed to predict the risk of rebleeding or death in patients with upper gastrointestinal bleeding (UGIB). These risk scoring systems have not been validated in a new patient population outside the clinical context of the original study. To assess internal and

Generic phytosanitary irradiation treatments

International Nuclear Information System (INIS)

Hallman, Guy J.

2012-01-01

The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zealand, 300 Gy for all arthropods on mango shipped from Australia to Malaysia, 350 Gy for all arthropods on lychee shipped from Australia to New Zealand and 400 Gy for all hosts of insects other than pupae and adult Lepidoptera shipped to the United States. Efforts to develop additional generic PI treatments and reduce the dose for the 400 Gy treatment are ongoing with a broad based 5-year, 12-nation cooperative research project coordinated by the joint Food and Agricultural Organization/International Atomic Energy Agency Program on Nuclear Techniques in Food and Agriculture. Key groups identified for further development of generic PI treatments are Lepidoptera (eggs and larvae), mealybugs and scale insects. A dose of 250 Gy may suffice for these three groups plus others, such as thrips, weevils and whiteflies. - Highlights: ► The history of phytosanitary irradiation (PI) treatments is given. ► Generic PI treatments in use today are discussed. ► Suggestions for future research are presented. ► A dose of 250 Gy for most insects may suffice.

A generic methodology for the optimisation of sewer systems using stochastic programming and self-optimizing control

DEFF Research Database (Denmark)

Maurico-Iglesias, Miguel; Castro, Ignacio Montero; Mollerup, Ane Loft

2015-01-01

. Such controller is aimed at keeping the system close to the optimal performance, thanks to an optimal selection of controlled variables. The definition of an optimal performance was carried out by a two-stage optimisation (stochastic and deterministic) to take into account both the overflow during the current......The design of sewer system control is a complex task given the large size of the sewer networks, the transient dynamics of the water flow and the stochastic nature of rainfall. This contribution presents a generic methodology for the design of a self-optimising controller in sewer systems...

Determinants of generic drug substitution in Switzerland

Directory of Open Access Journals (Sweden)

Lufkin Thomas M

2011-01-01

Full Text Available Abstract Background Since generic drugs have the same therapeutic effect as the original formulation but at generally lower costs, their use should be more heavily promoted. However, a considerable number of barriers to their wider use have been observed in many countries. The present study examines the influence of patients, physicians and certain characteristics of the generics' market on generic substitution in Switzerland. Methods We used reimbursement claims' data submitted to a large health insurer by insured individuals living in one of Switzerland's three linguistic regions during 2003. All dispensed drugs studied here were substitutable. The outcome (use of a generic or not was modelled by logistic regression, adjusted for patients' characteristics (gender, age, treatment complexity, substitution groups and with several variables describing reimbursement incentives (deductible, co-payments and the generics' market (prices, packaging, co-branded original, number of available generics, etc.. Results The overall generics' substitution rate for 173,212 dispensed prescriptions was 31%, though this varied considerably across cantons. Poor health status (older patients, complex treatments was associated with lower generic use. Higher rates were associated with higher out-of-pocket costs, greater price differences between the original and the generic, and with the number of generics on the market, while reformulation and repackaging were associated with lower rates. The substitution rate was 13% lower among hospital physicians. The adoption of the prescribing practices of the canton with the highest substitution rate would increase substitution in other cantons to as much as 26%. Conclusions Patient health status explained a part of the reluctance to substitute an original formulation by a generic. Economic incentives were efficient, but with a moderate global effect. The huge interregional differences indicated that prescribing behaviours and

A dysmorphology score system for assessing embryo abnormalities in rat whole embryo culture.

Science.gov (United States)

Zhang, Cindy X; Danberry, Tracy; Jacobs, Mary Ann; Augustine-Rauch, Karen

2010-12-01

The rodent whole embryo culture (WEC) system is a well-established model for characterizing developmental toxicity of test compounds and conducting mechanistic studies. Laboratories have taken various approaches in describing type and severity of developmental findings of organogenesis-stage rodent embryos, but the Brown and Fabro morphological score system is commonly used as a quantitative approach. The associated score criteria is based upon developmental stage and growth parameters, where a series of embryonic structures are assessed and assigned respective scores relative to their gestational stage, with a Total Morphological Score (TMS) assigned to the embryo. This score system is beneficial because it assesses a series of stage-specific anatomical landmarks, facilitating harmonized evaluation across laboratories. Although the TMS provides a quantitative approach to assess growth and determine developmental delay, it is limited to its ability to identify and/or delineate subtle or structure-specific abnormalities. Because of this, the TMS may not be sufficiently sensitive for identifying compounds that induce structure or organ-selective effects. This study describes a distinct morphological score system called the "Dysmorphology Score System (DMS system)" that has been developed for assessing gestation day 11 (approximately 20-26 somite stage) rat embryos using numerical scores to differentiate normal from abnormal morphology and define the respective severity of dysmorphology of specific embryonic structures and organ systems. This method can also be used in scoring mouse embryos of the equivalent developmental stage. The DMS system enhances capabilities to rank-order compounds based upon teratogenic potency, conduct structure- relationships of chemicals, and develop statistical prediction models to support abbreviated developmental toxicity screens. © 2010 Wiley-Liss, Inc.

Deeply discounted medications: Implications of generic prescription drug wars.

Science.gov (United States)

Czechowski, Jessica L; Tjia, Jennifer; Triller, Darren M

2010-01-01

To describe the history of generic prescription pricing programs at major pharmacy chains and their potential implications on prescribing, quality of care, and patient safety. Publicly available generic prescription discount program drug lists as of May 1, 2009. Fierce competition among major pharmacy chains such as Walgreens, CVS, and Walmart has led to a generic prescription pricing war with unclear public health implications. Introduced in 2006, currently 7 of the 10 largest pharmacy chains advertise a version of a deeply discounted medication (DDM) program, accounting for more than 25,000 locations nationally. By early 2008, almost 70 million Americans had used these programs. Although DDM programs lower drug costs for many patients, DDM formularies include potentially ineffective or harmful medications, have the potential to influence physician prescribing behavior, and may impair pharmacists' ability to review complete drug-dispensing records. DDMs are widespread but have the potential for unintended consequences on patients, providers, and the health care system. A systematic review of DDMs needs to evaluate the clinical, economic, and system-level implications of such programs.

Generic phytosanitary irradiation treatments

Energy Technology Data Exchange (ETDEWEB)

Hallman, Guy J [United States Department of Agriculture, Agricultural Research Service, Weslaco, TX (United States)

2013-01-15

The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zealand, 300 Gy for all arthropods on mango shipped from Australia to Malaysia, 350 Gy for all arthropods on lychee shipped from Australia to New Zealand and 400 Gy for all hosts of insects other than pupae and adult Lepidoptera shipped to the United States. Efforts to develop additional generic PI treatments and reduce the dose for the 400 Gy treatment are ongoing with a broad based 5-year, 12-nation cooperative research project coordinated by the joint Food and Agricultural Organization/International Atomic Energy Agency Program on Nuclear Techniques in Food and Agriculture. Key groups identified for further development of generic PI treatments are Lepidoptera (eggs and larvae), mealybugs and scale insects. A dose of 250 Gy may suffice for these three groups plus others, such as thrips, weevils and whiteflies. (author)

Generic phytosanitary irradiation treatments

Science.gov (United States)

Hallman, Guy J.

2012-07-01

The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zealand, 300 Gy for all arthropods on mango shipped from Australia to Malaysia, 350 Gy for all arthropods on lychee shipped from Australia to New Zealand and 400 Gy for all hosts of insects other than pupae and adult Lepidoptera shipped to the United States. Efforts to develop additional generic PI treatments and reduce the dose for the 400 Gy treatment are ongoing with a broad based 5-year, 12-nation cooperative research project coordinated by the joint Food and Agricultural Organization/International Atomic Energy Agency Program on Nuclear Techniques in Food and Agriculture. Key groups identified for further development of generic PI treatments are Lepidoptera (eggs and larvae), mealybugs and scale insects. A dose of 250 Gy may suffice for these three groups plus others, such as thrips, weevils and whiteflies.

Generic Advantages

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. Generic Advantages. Scalability an incremental coverage. Standardization. Business Plan Flexibility. Lifecycle Flexibility. Reliability. Service Interoperability. Changed Industry dynamics.

Generic Energy Matching Model and Figure of Matching Algorithm for Combined Renewable Energy Systems

Directory of Open Access Journals (Sweden)

J.C. Brezet

2009-08-01

Full Text Available In this paper the Energy Matching Model and Figure of Matching Algorithm which originally was dedicated only to photovoltaic (PV systems [1] are extended towards a Model and Algorithm suitable for combined systems which are a result of integration of two or more renewable energy sources into one. The systems under investigation will range from mobile portable devices up to the large renewable energy system conceivably to be applied at the Afsluitdijk (Closure- dike in the north of the Netherlands. This Afsluitdijk is the major dam in the Netherlands, damming off the Zuiderzee, a salt water inlet of the North Sea and turning it into the fresh water lake of the IJsselmeer. The energy chain of power supplies based on a combination of renewable energy sources can be modeled by using one generic Energy Matching Model as starting point.

Nuclear Regulatory Commission's antitrust review process: an analysis of the impacts

International Nuclear Information System (INIS)

1981-06-01

The Nuclear Regulatory Commission's (NRC) antitrust process is reviewed and its impacts to small systems and applicant systems are studied. This process takes the form of a description of the NRC's antitrust review process as implemented, a generic categorization of potential impacts and individual case-by-case studies of four different utilities

Generic penetration in the retail antidepressant market.

Science.gov (United States)

Ventimiglia, Jeffrey; Kalali, Amir H

2010-06-01

In this article, we explore the accelerated penetration of generic antidepressants in the United States market following the availability of generic citalopram and sertraline. Analysis suggests that overall, generic penetration into the antidepressant market has grown from approximately 41 percent in January 2004 to over 73 percent in January 2010. Similar trends are uncovered when branded and generic prescriptions are analyzed by specialty.

Generic Performance Measures. Chapter 8

Energy Technology Data Exchange (ETDEWEB)

Daube-Witherspoon, M. E. [Department of Radiology, University of Pennsylvania, Philadelphia, PA (United States)

2014-12-15

The generic nuclear medicine imager, whether a gamma camera, single photon emission computed tomography (SPECT) system or positron emission tomography (PET) scanner, comprises several main components: a detection system, a form of collimation to select γ rays at specific angles, electronics and a computing system to create the map of the radiotracer distribution. This section discusses these components in more detail. The first stage of a generic nuclear medicine imager is the detection of the γ rays emitted by the radionuclide. In the case of PET, the radiation of interest are the 511 keV annihilation photons that result from the interaction of the positron emitted by the radionuclide with an electron in the tissue. For general nuclear medicine and SPECT, there is one or sometimes more than one γ ray of interest, with energies in the range of <100 to >400 keV. The γ rays are detected when they interact and deposit energy in the crystal(s) of the imaging system. There are two main types of detector: crystals that give off light that can be converted to an electrical signal when the γ ray interacts (‘scintillators’) and semiconductors, crystals that generate an electrical signal directly when the γ ray deposits energy in the crystal. Scintillation detectors include NaI(Tl), bismuth germanate (BGO) and lutetium oxyorthosilicate (LSO); semiconductor detectors used in nuclear medicine imagers include cadmium zinc telluride (CZT). Radiation detectors are described in more detail in Chapter 6.

Alvarado vs Lintula Scoring Systems in Acute Appendicitis

African Journals Online (AJOL)

communication. Clinicians attending to these patients were continuously appraised and trained on the two scoring systems to be compared including the cut off points for diagnosis. This was done by one author or a trained research assistant who was a qualified clinical officer. A written card with the two systems was placed ...

A prioritization of generic safety issues

International Nuclear Information System (INIS)

Emrit, R.; Riggs, R.; Milstead, W.; Pittman, J.

1991-07-01

This report presents the priority rankings for generic safety issues and related to nuclear power plants. The purpose of these rankings is to assist in the timely and efficient allocation of NRC resources for the resolution of those safety issues that have a significant potential for reducing risk. The report focuses on the prioritization of generic safety issues. Issues primarily concerned with the licensing process or environmental protection and not directly related to safety have been excluded from prioritization. The prioritized issues include: TMI Action Plan items under development; previously proposed issues covered by Task Action Plans, except issues designated as Un-resolved Safety Issues (USIs) which had already been assigned high priority; and newly-proposed issues. Future supplements to this report will include the prioritization of additional issues. The safety priority rankings are High, Medium, Low, and Drop and have been assigned on the basis of risk significance estimates, the ratio of risk to costs and other impacts estimated to result if resolutions of the safety issues were implemented, and the consideration of uncertainties and other quantitative or qualitative factors. To the extent practical, estimates are quantitative. 1310 refs

GLAD: a generic lattice debugger

International Nuclear Information System (INIS)

Lee, M.J.

1992-01-01

Today, numerous simulation and analysis codes exist for the design, commission, and operation of accelerator beam lines. There is a need to develop a common user interface and database link to run these codes interactively. This paper will describe a proposed system, GLAD (Generic LAttice Debugger), to fulfill this need. Specifically, GLAD can be used to find errors in beam lines during commissioning, control beam parameters during operation, and design beam line optics and error correction systems for the next generation of linear accelerators and storage rings. (author)

The tissue microarray data exchange specification: Extending TMA DES to provide flexible scoring and incorporate virtual slides

Directory of Open Access Journals (Sweden)

Alexander Wright

2011-01-01

Full Text Available Background: Tissue MicroArrays (TMAs are a high throughput technology for rapid analysis of protein expression across hundreds of patient samples. Often, data relating to TMAs is specific to the clinical trial or experiment it is being used for, and not interoperable. The Tissue Microarray Data Exchange Specification (TMA DES is a set of eXtensible Markup Language (XML-based protocols for storing and sharing digitized Tissue Microarray data. XML data are enclosed by named tags which serve as identifiers. These tag names can be Common Data Elements (CDEs, which have a predefined meaning or semantics. By using this specification in a laboratory setting with increasing demands for digital pathology integration, we found that the data structure lacked the ability to cope with digital slide imaging in respect to web-enabled digital pathology systems and advanced scoring techniques. Materials and Methods: By employing user centric design, and observing behavior in relation to TMA scoring and associated data, the TMA DES format was extended to accommodate the current limitations. This was done with specific focus on developing a generic tool for handling any given scoring system, and utilizing data for multiple observations and observers. Results: DTDs were created to validate the extensions of the TMA DES protocol, and a test set of data containing scores for 6,708 TMA core images was generated. The XML was then read into an image processing algorithm to utilize the digital pathology data extensions, and scoring results were easily stored alongside the existing multiple pathologist scores. Conclusions: By extending the TMA DES format to include digital pathology data and customizable scoring systems for TMAs, the new system facilitates the collaboration between pathologists and organizations, and can be used in automatic or manual data analysis. This allows complying systems to effectively communicate complex and varied scoring data.

A Posterior Circulation Ischemia Risk Score System to Assist the Diagnosis of Dizziness.

Science.gov (United States)

Chen, Ru; Su, Rui; Deng, Mingzhu; Liu, Jia; Hu, Qing; Song, Zhi

2018-02-01

We aimed to establish a risk score system without radio-image examination, which could help clinicians to differentiate patients with vertigo and posterior circulation ischemia (PCI) rapidly from the other dizzy patients. We analyzed 304 patients with vertigo (50% PCI). The attributes with more significant contributions were selected as the risk factors for the PCI risk score system, and every one of them was assigned a value according to their respective odds ratio values. We also compared the respective receiver operating characteristic curves of the 3 diagnostic methods (PCI score system, ABCD 2 , and Essen score systems) to evaluate their prediction effectiveness. Nine risk factors were ultimately selected for PCI score system, including high blood pressure (1'), diabetes mellitus (1'), ischemic stroke (1'), rotating and rocking (-1'), difficulty in speech (5'), tinnitus (-5'), limb and sensory deficit (5'), gait ataxia (1'), and limb ataxia (5'). According to their respective PCI risk scores, the patients were divided into 3 subgroups: low risk (≤0', risk 95.0%). When 0' was selected as a cutoff point for differentiating the patients with PCI from patients without PCI, the sensitivity was 94.1%, with a specificity of 41.4%. The areas under the receiver operator curve value of PCI score system was .82 (P = .000), much higher than the areas under the receiver operator curve value of ABCD 2 (.69, P = .000) and that of the Essen system (.67, P = .000) CONCLUSION: The PCI score system could help clinicians to differentiate patients with vertigo and PCI rapidly from the other dizzy patients. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Development of Generic Tools for Coastal Early Warning and Decision Support

Directory of Open Access Journals (Sweden)

Bogaard Tom

2016-01-01

Full Text Available Recent and historic high-impact events demonstrated coastal risk (Xynthia, Europe, 2010; Katrina, USA, 2005. This is only to get worse, because risk is increasing due to increase in both hazard intensity, frequency and increase in consequences (increased coastal development. Adaptation requires a re-evaluation of coastal disaster risk reduction (DRR strategies and a new mix of prevention, mitigation (e.g. limiting construction in flood-prone areas and preparedness (e.g. Early warning systems, EWS measures. Within the EU funded project RISC-KIT the focus is on preparedness measures and its aim is to demonstrate robustness and applicability of coastal EWS (Early Warning Systems and DSS (Decision Support Systems. Delft-FEWS, a generic tool for Early Warning Systems has been extended, to be applied at sites all across Europe. The challenges for developing a modern EWS are found in the integration of large data sets, specialised modules to process the data, and open interfaces to allow easy integration of existing modelling capacities. In response to these challenges, Delft-FEWS provides a state of the art EWS framework, which is highly customizable to the specific requirements of an individual organisation. For ten case study sites on all EU regional seas a EWS has been developed, to provide real-time (short-term forecasts and early warnings. The EWS component is a 2D model framework of hydro-meteo and morphological models which computes hazard intensities. The total expected impact of a hazard can be obtained by using a Bayesian network DSS. This DSS, which is incorporated in the Delft-FEWS platform is a tool that links coastal multi-hazards to their socioeconomic and environmental consequences. An important innovation of the EWS/DSS lies in its application in dual mode: as a forecast and warning system and as a consistent ex-ante planning tool to evaluate the long-term vulnerability due to multiple (low-frequency coastal hazards, under various

Do generic utility measures capture what is important to the quality of life of people with multiple sclerosis?

Science.gov (United States)

Kuspinar, Ayse; Mayo, Nancy E

2013-04-25

The three most widely used utility measures are the Health Utilities Index Mark 2 and 3 (HUI2 and HUI3), the EuroQol-5D (EQ-5D) and the Short-Form-6D (SF-6D). In line with guidelines for economic evaluation from agencies such as the National Institute for Health and Clinical Excellence (NICE) and the Canadian Agency for Drugs and Technologies in Health (CADTH), these measures are currently being used to evaluate the cost-effectiveness of different interventions in MS. However, the challenge of using such measures in people with a specific health condition, such as MS, is that they may not capture all of the domains that are impacted upon by the condition. If important domains are missing from the generic measures, the value derived will be higher than the real impact creating invalid comparisons across interventions and populations. Therefore, the objective of this study is to estimate the extent to which generic utility measures capture important domains that are affected by MS. The available study population consisted of men and women who had been registered after 1994 in three participating MS clinics in Greater Montreal, Quebec, Canada. Subjects were first interviewed on an individualized measure of quality of life (QOL) called the Patient Generated Index (PGI). The domains identified with the PGI were then classified and grouped together using the World Health Organization's International Classification of Functioning, Disability and Health (ICF), and mapped onto the HUI2, HUI3, EQ-5D and SF-6D. A total of 185 persons with MS were interviewed on the PGI. The sample was relatively young (mean age 43) and predominantly female. Both men and women had mild disability with a median Expanded Disability Status Scale (EDSS) score of 2. The top 10 domains that patients identified to be the most affected by their MS were, work (62%), fatigue (48%), sports (39%), social life (28%), relationships (23%), walking/mobility (22%), cognition (21%), balance (14%), housework (12

Effect of generic issues program on improving safety

International Nuclear Information System (INIS)

Fard, M. R.; Kauffman, J. V.

2010-01-01

The U.S. Nuclear Regulatory Commission (NRC) identifies (by its assessment of plant operation) certain issues involving public health and safety, the common defense and security, or the environment that could affect multiple entities under NRC jurisdiction. The Generic Issues Program (GIP) addresses the resolution of these Generic Issues (GIs). The resolution of these issues may involve new or revised rules, new or revised guidance, or revised interpretation of rules or guidance that affect nuclear power plant licensees, nuclear material certificate holders, or holders of other regulatory approvals. U.S. NRC provides information related to the past and ongoing GIP activities to the general public by the use of three main resources, namely NUREG-0933, 'Resolution of Generic Safety Issues, ' Generic Issues Management Control System (GIMCS), and GIP public web page. GIP information resources provide information such as historical information on resolved GIs, current status of the open GIs, policy documents, program procedures, GIP annual and quarterly reports and the process to contact GIP and propose a GI This paper provides an overview of the GIP and several examples of safety improvements resulting from the resolution of GIs. In addition, the paper provides a brief discussion of a few recent GIs to illustrate how the program functions to improve safety. (authors)

Generic procedure for designing and implementing plan management systems for space science missions operations

Science.gov (United States)

Chaizy, P. A.; Dimbylow, T. G.; Allan, P. M.; Hapgood, M. A.

2011-09-01

This paper is one of the components of a larger framework of activities whose purpose is to improve the performance and productivity of space mission systems, i.e. to increase both what can be achieved and the cost effectiveness of this achievement. Some of these activities introduced the concept of Functional Architecture Module (FAM); FAMs are basic blocks used to build the functional architecture of Plan Management Systems (PMS). They also highlighted the need to involve Science Operations Planning Expertise (SOPE) during the Mission Design Phase (MDP) in order to design and implement efficiently operation planning systems. We define SOPE as the expertise held by people who have both theoretical and practical experience in operations planning, in general, and in space science operations planning in particular. Using ESA's methodology for studying and selecting science missions we also define the MDP as the combination of the Mission Assessment and Mission Definition Phases. However, there is no generic procedure on how to use FAMs efficiently and systematically, for each new mission, in order to analyse the cost and feasibility of new missions as well as to optimise the functional design of new PMS; the purpose of such a procedure is to build more rapidly and cheaply such PMS as well as to make the latter more reliable and cheaper to run. This is why the purpose of this paper is to provide an embryo of such a generic procedure and to show that the latter needs to be applied by people with SOPE during the MDP. The procedure described here proposes some initial guidelines to identify both the various possible high level functional scenarii, for a given set of possible requirements, and the information that needs to be associated with each scenario. It also introduces the concept of catalogue of generic functional scenarii of PMS for space science missions. The information associated with each catalogued scenarii will have been identified by the above procedure and

Usefulness of a clinical scoring system to anticipate difficulty of Norplant removal.

Science.gov (United States)

Blumenthal, P D; Remsburg, R E; Glew, G; McGrath, J A; Gaffikin, L

1995-12-01

Removal of contraceptive implants (e.g. Norplant) is an issue affecting its worldwide acceptability. Reports of difficult, painful removals have resulted in lawsuits and reduced demand. To improve quality of care, we developed a scoring system to anticipate difficult removals. We report on the usefulness of such a system and present client perspectives about the removal experience. A 9-point scoring system based on the visibility, arrangement, and position (VAP) of Norplant capsules was used to assess the anticipated difficulty of removal in 53 consecutive patients. The VAP score was then correlated with removal time and related parameters. Mean removal time was 14.74 min (range 4.75-47). In 20% of patients, the VAP score indicated a potentially difficult removal and the VAP score correlated significantly with removal time (r = 0.3, p = 0.05). Patients expected removal to be moderately difficult (mean visual analog score 4.7 out of a possible 10), but after removal they rated the actual removal experience as relatively easy (mean score 2.6/10). Before the removal, only 48% of patients said they would recommend Norplant to a friend but after removal, 70% said they would do so. A scoring system such as the VAP score can help identify potentially difficult removals so that an experienced remover can be present at the time of removal or an appropriate referral made. However, the VAP score cannot predict variables such as the density of the subcutaneous fibrous tissue "envelope". Although patient anxiety concerning removal may be high, the presence of a competent remover and an easy removal experience reduces this anxiety and encourages patients to be more positive about this method. The value of having properly trained, competent personnel available to perform removals cannot be over-emphasized.

A stage is a stage is a stage: a direct comparison of two scoring systems.

Science.gov (United States)

Dawson, Theo L

2003-09-01

L. Kohlberg (1969) argued that his moral stages captured a developmental sequence specific to the moral domain. To explore that contention, the author compared stage assignments obtained with the Standard Issue Scoring System (A. Colby & L. Kohlberg, 1987a, 1987b) and those obtained with a generalized content-independent stage-scoring system called the Hierarchical Complexity Scoring System (T. L. Dawson, 2002a), on 637 moral judgment interviews (participants' ages ranged from 5 to 86 years). The correlation between stage scores produced with the 2 systems was .88. Although standard issue scoring and hierarchical complexity scoring often awarded different scores up to Kohlberg's Moral Stage 2/3, from his Moral Stage 3 onward, scores awarded with the two systems predominantly agreed. The author explores the implications for developmental research.

Transforming Cobol Legacy Software to a Generic Imperative Model

National Research Council Canada - National Science Library

Moraes, DinaL

1999-01-01

.... This research develops a transformation system to convert COBOL code into a generic imperative model, recapturing the initial design and deciphering the requirements implemented by the legacy code...

Comparison of Glasgow-Blatchford score and full Rockall score systems to predict clinical outcomes in patients with upper gastrointestinal bleeding

Directory of Open Access Journals (Sweden)

Mokhtare M

2016-10-01

Full Text Available Marjan Mokhtare, Vida Bozorgi, Shahram Agah, Mehdi Nikkhah, Amirhossein Faghihi, Amirhossein Boghratian, Neda Shalbaf, Abbas Khanlari, Hamidreza Seifmanesh Colorectal Research Center, Rasoul Akram Hospital, Tehran, Iran Background: Various risk scoring systems have been recently developed to predict clinical outcomes in patients with upper gastrointestinal bleeding (UGIB. The two commonly used scoring systems include full Rockall score (RS and the Glasgow-Blatchford score (GBS. Bleeding scores were assessed in terms of prediction of clinical outcomes in patients with UGIB. Patients and methods: Two hundred patients (age >18 years with obvious symptoms of UGIB in the emergency department of Rasoul Akram Hospital were enrolled. Full RS and GBS were calculated. We followed the patients for records of rebleeding and 1-month mortality. A receiver operating characteristic curve by using areas under the curve (AUCs was used to statistically identify the best cutoff point. Results: Eighteen patients were excluded from the study due to failure to follow-up. Rebleeding and mortality rate were 9.34% (n=17 and 11.53% (n=21, respectively. Regarding 1-month mortality, full RS was better than GBS (AUC, 0.648 versus 0.582; P=0.021. GBS was more accurate in terms of detecting transfusion need (AUC, 0.757 versus 0.528; P=0.001, rebleeding rate (AUC, 0.722 versus 0.520; P=0.002, intensive care unit admission rate (AUC, 0.648 versus 0.582; P=0.021, and endoscopic intervention rate (AUC, 0.771 versus 0.650; P<0.001. Conclusion: We found the full RS system is better for 1-month mortality prediction while GBS system is better for prediction of other outcomes. Keywords: full Rockall score, Glasgow-Blatchford score, gastrointestinal bleeding, mortality, prognosis

MRI assessment of knee osteoarthritis: Knee Osteoarthritis Scoring System (KOSS) - inter-observer and intra-observer reproducibility of a compartment-based scoring system

International Nuclear Information System (INIS)

Kornaat, Peter R.; Ceulemans, Ruth Y.T.; Kroon, Herman M.; Bloem, Johan L.; Riyazi, Naghmeh; Kloppenburg, Margreet; Carter, Wayne O.; Woodworth, Thasia G.

2005-01-01

To develop a scoring system for quantifying osteoarthritic changes of the knee as identified by magnetic resonance (MR) imaging, and to determine its inter- and intra-observer reproducibility, in order to monitor medical therapy in research studies. Two independent observers evaluated 25 consecutive MR examinations of the knee in patients with previously defined clinical symptoms and radiological signs of osteoarthritis. We acquired on a 1.5 T system: coronal and sagittal proton density- and T2-weighted dual spin echo (SE) images, sagittal three-dimensional T1-weighted gradient echo (GE) images with fat suppression, and axial dual turbo SE images with fat suppression. Images were scored for the presence of cartilaginous lesions, osteophytes, subchondral cysts, bone marrow edema, and for meniscal abnormalities. Presence and size of effusion, synovitis and Baker's cyst were recorded. All parameters were ranked on a previously defined, semiquantitative scale, reflecting increasing severity of findings. Kappa, weighted kappa and intraclass correlation coefficient (ICC) were used to determine inter- and intra-observer variability. Inter-observer reproducibility was good (ICC value 0.77). Inter- and intra-observer reproducibility for individual parameters was good to very good (inter-observer ICC value 0.63-0.91; intra-observer ICC value 0.76-0.96). The presented comprehensive MR scoring system for osteoarthritic changes of the knee has a good to very good inter-observer and intra-observer reproducibility. Thus the score form with its definitions can be used for standardized assessment of osteoarthritic changes to monitor medical therapy in research studies. (orig.)

Severity scoring in the critically ill: part 2: maximizing value from outcome prediction scoring systems.

Science.gov (United States)

Breslow, Michael J; Badawi, Omar

2012-02-01

Part 2 of this review of ICU scoring systems examines how scoring system data should be used to assess ICU performance. There often are two different consumers of these data: lCU clinicians and quality leaders who seek to identify opportunities to improve quality of care and operational efficiency, and regulators, payors, and consumers who want to compare performance across facilities. The former need to know how to garner maximal insight into their care practices; this includes understanding how length of stay (LOS) relates to quality, analyzing the behavior of different subpopulations, and following trends over time. Segregating patients into low-, medium-, and high-risk populations is especially helpful, because care issues and outcomes may differ across this severity continuum. Also, LOS behaves paradoxically in high-risk patients (survivors often have longer LOS than nonsurvivors); failure to examine this subgroup separately can penalize ICUs with superior outcomes. Consumers of benchmarking data often focus on a single score, the standardized mortality ratio (SMR). However, simple SMRs are disproportionately affected by outcomes in high-risk patients, and differences in population composition, even when performance is otherwise identical, can result in different SMRs. Future benchmarking must incorporate strategies to adjust for differences in population composition and report performance separately for low-, medium- and high-acuity patients. Moreover, because many ICUs lack the resources to care for high-acuity patients (predicted mortality >50%), decisions about where patients should receive care must consider both ICU performance scores and their capacity to care for different types of patients.

Environmental and health impacts of fine and ultrafine metallic particles: Assessment of threat scores

Energy Technology Data Exchange (ETDEWEB)

Goix, Sylvaine [Université de Toulouse, INP-ENSAT, Av. Agrobiopôle, 31326 Castanet-Tolosan (France); UMR 5245 CNRS-INP-UPS, EcoLab (Laboratoire d' écologie fonctionnelle), Avenue de l' Agrobiopôle, BP 32607, 31326 Castanet-Tolosan (France); Lévêque, Thibaut [Université de Toulouse, INP-ENSAT, Av. Agrobiopôle, 31326 Castanet-Tolosan (France); UMR 5245 CNRS-INP-UPS, EcoLab (Laboratoire d' écologie fonctionnelle), Avenue de l' Agrobiopôle, BP 32607, 31326 Castanet-Tolosan (France); ADEME (French Agency for Environment and Energy Management), 20 Avenue du Grésillé, BP 90406, 49004 Angers Cedex 01 (France); Xiong, Tian-Tian [Université de Toulouse, INP-ENSAT, Av. Agrobiopôle, 31326 Castanet-Tolosan (France); UMR 5245 CNRS-INP-UPS, EcoLab (Laboratoire d' écologie fonctionnelle), Avenue de l' Agrobiopôle, BP 32607, 31326 Castanet-Tolosan (France); Schreck, Eva [Géosciences Environnement Toulouse (GET), Observatoire Midi Pyrénées, Université de Toulouse, CNRS, IRD, 14 Avenue E. Belin, F-31400 Toulouse (France); and others

2014-08-15

This study proposes global threat scores to prioritize the harmfulness of anthropogenic fine and ultrafine metallic particles (FMP) emitted into the atmosphere at the global scale. (Eco)toxicity of physicochemically characterized FMP oxides for metals currently observed in the atmosphere (CdO, CuO, PbO, PbSO{sub 4}, Sb{sub 2}O{sub 3}, and ZnO) was assessed by performing complementary in vitro tests: ecotoxicity, human bioaccessibility, cytotoxicity, and oxidative potential. Using an innovative methodology based on the combination of (eco)toxicity and physicochemical results, the following hazard classification of the particles is proposed: CdCl{sub 2}∼CdO>CuO>PbO>ZnO>PbSO{sub 4}>Sb{sub 2}O{sub 3}. Both cadmium compounds exhibited the highest threat score due to their high cytotoxicity and bioaccessible dose, whatever their solubility and speciation, suggesting that cadmium toxicity is due to its chemical form rather than its physical form. In contrast, the Sb{sub 2}O{sub 3} threat score was the lowest due to particles with low specific area and solubility, with no effects except a slight oxidative stress. As FMP physicochemical properties reveal differences in specific area, crystallization systems, dissolution process, and speciation, various mechanisms may influence their biological impact. Finally, this newly developed and global approach could be widely used in various contexts of pollution by complex metal particles and may improve risk management. - Highlights: • Seven micro- and nano- monometallic characterized particles were studied as references. • Bioaccessibility, eco and cytotoxicity, and oxidative potential assays were performed. • According to calculated threat scores: CdCl{sub 2}∼CdO>CuO>PbO>ZnO>PbSO{sub 4}>Sb{sub 2}O{sub 3}.

Rethinking generic skills

Directory of Open Access Journals (Sweden)

Roy Canning

2013-10-01

Full Text Available The paper provides a critical analysis of the notion of generic or transversal skillscontained with European Union policy discourses. The author presents a conceptualframework that challenges the idea that generic skills are universal, transferable andautonomous. An alternative analysis is put forward that argues the case forcontextualising skills and knowledge within particular understandings and cultures thatare more collective than individualistic in nature. The arguments are framed withinwider cross-disciplinary debates in linguistics, geosemiotics and social-cultural theoryand build upon an earlier paper exploring core skills in the UK (Canning, 2007.

Noninvasive scoring system for significant inflammation related to chronic hepatitis B

Science.gov (United States)

Hong, Mei-Zhu; Ye, Linglong; Jin, Li-Xin; Ren, Yan-Dan; Yu, Xiao-Fang; Liu, Xiao-Bin; Zhang, Ru-Mian; Fang, Kuangnan; Pan, Jin-Shui

2017-03-01

Although a liver stiffness measurement-based model can precisely predict significant intrahepatic inflammation, transient elastography is not commonly available in a primary care center. Additionally, high body mass index and bilirubinemia have notable effects on the accuracy of transient elastography. The present study aimed to create a noninvasive scoring system for the prediction of intrahepatic inflammatory activity related to chronic hepatitis B, without the aid of transient elastography. A total of 396 patients with chronic hepatitis B were enrolled in the present study. Liver biopsies were performed, liver histology was scored using the Scheuer scoring system, and serum markers and liver function were investigated. Inflammatory activity scoring models were constructed for both hepatitis B envelope antigen (+) and hepatitis B envelope antigen (-) patients. The sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve were 86.00%, 84.80%, 62.32%, 95.39%, and 0.9219, respectively, in the hepatitis B envelope antigen (+) group and 91.89%, 89.86%, 70.83%, 97.64%, and 0.9691, respectively, in the hepatitis B envelope antigen (-) group. Significant inflammation related to chronic hepatitis B can be predicted with satisfactory accuracy by using our logistic regression-based scoring system.

Quality of generic medicines in South Africa

DEFF Research Database (Denmark)

Patel, Aarti; Gauld, Robin; Norris, Pauline

2012-01-01

Generic Medicines are an important policy option allowing for access to affordable, essential medicines. Quality of generic medicines must be guaranteed through the activities of national medicines regulatory authorities. Existing negative perceptions surrounding the quality of generic medicines ...

Parenting style impacts on quality of life in children with cerebral palsy.

Science.gov (United States)

Aran, Adi; Shalev, Ruth S; Biran, Gali; Gross-Tsur, Varda

2007-07-01

To assess the impact of parenting style and disease severity on quality of life (QOL) in children with cerebral palsy (CP). Thirty-nine children with CP, their siblings, and their parents participated in the study. Probands and siblings, ages 6 to 18 years, completed questionnaires on parenting style (accepting, rejecting, controlling, and autonomy allowing) using the Children's Report of Parental Behavior Inventory. Parents completed generic (Child Health Questionnaire [CHQ]) and disease-specific (Pediatric Outcomes Data Collecting Instrument [PODCI]) QOL questionnaires for both children. A physician determined disease severity with the Gross Motor Function Classification System. In children with CP, parenting style positively correlated with the CHQ scores: physical summary and psychosocial summary (r = 0.40, P = .01) and family activities scale (r = 0.34, P = .03). Autonomy allowing parenting style impacted on psychosocial aspects of QOL, as reflected by CHQ scores, more than the degree of disability. In other domains of QOL, the effect of parenting style was greater than IQ, anxiety, and socioeconomic status. Parenting style is a significant factor in QOL in CP and the only known factor to impact on the psychosocial domains of the CHQ, exceeding the effect of disease severity. Because QOL is an important treatment goal in children with CP, early family interventions, particularly those focusing on parenting style, should be considered.

The Generic Integrity of Newspaper Editorials: A Systemic Functional Perspective

Science.gov (United States)

Ansary, Hasan; Babaii, Esmat

2005-01-01

One fruitful line of research has been to explore the local linguistic as well as global rhetorical patterns of particular genres in order to identify their recognizable structural identity, or what Bhatia (1999: 22) calls "generic integrity". In terms of methodology, to date most genre-based studies have employed one or the other of Swales'…

Generic Structure Potential of Christian Apologetics

Directory of Open Access Journals (Sweden)

Onwu Inya

2012-01-01

Full Text Available Religious texts have been examined by scholars from different theoretical standpoints. However, a close survey of the literature reveals that little attention has been paid to Christian apologetics from a linguistic perspective. Also, an examination of studies along the lines of Generic Structure Potential (henceforth GSP shows that the genre status of Christian apologetics has not been indicated. This gap provides the motivation for this paper, which investigates the GSP of Christian apologetics. Twenty texts written by various key contemporary apologetic writers were purposively selected for the study. The following generic structure potential catalogue was generated:The paper reveals that the elements of the GSP concertedly work to advance, argue for or defend the Christian belief system. The paper also suggests that the model could be applied to other forms of apologetic instances.

Dynamic competition in pharmaceuticals. Patent expiry, generic penetration, and industry structure.

Science.gov (United States)

Magazzini, Laura; Pammolli, Fabio; Riccaboni, Massimo

2004-06-01

This paper investigates patterns of industrial dynamics and competition in the pharmaceutical industry, with particular reference to the consequences of patent expiry in different countries. We focus on the competition at the level of single chemical entities, distinguishing between original brands and generic products. Quarterly data, spanning from July 1987 to December 1998, on sales of pharmaceutical products in four countries (USA, UK, Germany, and France) constitute the basis of our analysis. All the products containing major molecules whose patent expiration date lies between 1986 and 1996 are included in our sample. We show how diffusion of generics is linked to the characteristics of the market and investigate how price dynamics of original products are affected by generic competition. Our empirical investigation shows that the dynamics of drug prices and the competition by generic drugs vary significantly across countries. This heterogeneity notwithstanding, a clear distinction seems to emerge. On the one hand, systems that rely on market-based competition in pharmaceuticals promote a clear distinction between firms that act as innovators and firms that act as imitators after patent expiry. Here, original products enjoy premium prices and exclusivity profits under patent protection, and face fierce price competition after patent expiry. On the other hand, in systems that rely on administered prices, penetration by generic drugs tends to be rather limited. Its descriptive and preliminary nature notwithstanding, our analysis seems to have relevant implications at different levels of generality, especially for Europe.

Slit Lamp-Based Ocular Scoring Systems in Toxicology and Drug Development: A Literature Survey.

Science.gov (United States)

Eaton, Joshua Seth; Miller, Paul E; Bentley, Ellison; Thomasy, Sara M; Murphy, Christopher J

2017-12-01

To present a survey of the features of published slit lamp-based scoring systems and their applicability in the context of modern ocular toxicology and drug development. References describing original or modified slit lamp-based scoring systems for human or veterinary clinical patients or in investigative or toxicologic research were collected following a comprehensive literature review using textbooks and online publication searches. Each system's indications and features were compiled to facilitate comparison. Literature review identified 138 original or modified scoring systems. Most (48%) were published for evaluation of the ocular surface, 34% for the general anterior segment, and 18% for the lens. Most systems were described for assessment of human patients (50%) and small albino laboratory species such as rabbits (19%), rats (12%), and mice (8%). Systems described for pigmented laboratory species and for larger species such as dogs, cats, pigs, and nonhuman primates (NHPs) were comparatively underrepresented. No systems described a lens scoring scheme specific to the dog, cat, pig, or NHP. Scoring schemes for aqueous and vitreous cells were infrequently described for laboratory species. Many slit lamp-based scoring systems have been published, but the features of each differ and complicate translation of findings between different species. Use and interpretation of any scoring system in toxicology and drug development must be done with awareness of the limitations of the system being used.

The magazine picture collage: development of an objective scoring system.

Science.gov (United States)

Lerner, C; Ross, G

1977-03-01

A system for objectively scoring the magazine picture collage was developed and applied to the collages of 12 psychiatric inpatients and 12 paired controls. As a group, the patient collages had fewer cuttings, tended to lack an overall balance and central theme, and contained fewer pictures of people and more of animals. The results are consistent with those reported by other researchers as well as with general clinical experience, and as such, lend support to the construct validity of the scoring system.

On macroeconomic characteristics of pharmaceutical generics and the potential for manufacturing and consumption under fuzzy conditions.

Science.gov (United States)

Gascón, Fernando; de la Fuente, David; Puente, Javier; Lozano, Jesús

2007-11-01

The aim of this paper is to develop a methodology that is useful for analyzing, from a macroeconomic perspective, the aggregate demand and the aggregate supply features of the market of pharmaceutical generics. In order to determine the potential consumption and the potential production of pharmaceutical generics in different countries, two fuzzy decision support systems are proposed. Two fuzzy decision support systems, both based on the Mamdani model, were applied in this paper. These systems, generated by Matlab Toolbox 'Fuzzy' (v. 2.0), are able to determine the potential of a country for the manufacturing or the consumption of pharmaceutical generics. The systems make use of three macroeconomic input variables. In an empirical application of our proposed methodology, the potential towards consumption and manufacturing in Holland, Sweden, Italy and Spain has been estimated from national indicators. Cross-country comparisons are made and graphical surfaces are analyzed in order to interpret the results. The main contribution of this work is the development of a methodology that is useful for analyzing aggregate demand and aggregate supply characteristics of pharmaceutical generics. The methodology is valid for carrying out a systematic analysis of the potential generics have at a macrolevel in different countries. The main advantages of the use of fuzzy decision support systems in the context of pharmaceutical generics are the flexibility in the construction of the system, the speed in interpreting the results offered by the inference and surface maps and the ease with which a sensitivity analysis of the potential behavior of a given country may be performed.

Exploring knowledge, perceptions and attitudes about generic ...

African Journals Online (AJOL)

Exploring knowledge, perceptions and attitudes about generic medicines among final-year health science students. ... had knowledge deficits about the safety, quality and efficacy of generic medicines. The dissemination of information about generic medicines may strengthen future knowledge, attitudes and perceptions.

Security Policy for a Generic Space Exploration Communication Network Architecture

Science.gov (United States)

Ivancic, William D.; Sheehe, Charles J.; Vaden, Karl R.

2016-01-01

This document is one of three. It describes various security mechanisms and a security policy profile for a generic space-based communication architecture. Two other documents accompany this document- an Operations Concept (OpsCon) and a communication architecture document. The OpsCon should be read first followed by the security policy profile described by this document and then the architecture document. The overall goal is to design a generic space exploration communication network architecture that is affordable, deployable, maintainable, securable, evolvable, reliable, and adaptable. The architecture should also require limited reconfiguration throughout system development and deployment. System deployment includes subsystem development in a factory setting, system integration in a laboratory setting, launch preparation, launch, and deployment and operation in space.

Are generic and disease-specific health related quality of life correlated? The case of chronic lung disease due to sulfur mustard

Directory of Open Access Journals (Sweden)

Shervin Assari

2009-09-01

Full Text Available

• BACKGROUND: The aim of this study was to investigate the association between the two most commonly used generic and disease specific health-related quality of life (HRQoL measures in patients with chronic lung disease due to SM: Medical Outcomes Study Short Form 36-Item (SF-36 and St George's Respiratory Questionnaire (SGRQ.
• METHODS: This is a secondary analysis of Iranian Chemical Warfare Victims Health Assessment Study (ICWVHAS during October 2007 in Isfahan, Iran. In that survey, conducted in an outpatient setting, 292 patients with chronic lung disease due to SM were selected from all provinces in Iran. The total score and sub scores of correlations of SGRQ and SF-36 were assessed. Correlation of quality-of-life scores were evaluated using Pearson’s coefficient.
• RESULTS: Samples were 276 patients who were selected for our analysis. No significant correlation was found between the total score or sub scores of SF-36 and the total score or sub scores of SGRQ (p > 0.05.
• CONCLUSIONS: In patients with chronic lung disease due to SM, the SF-36 and SGRQ assess different aspects of HRQoL. Therefore applying both of them together, at least in the research setting is suggested.
• KEYWORDS: Chronic Lung Disease, Health Related Quality of Life, Generic Health Related Quality of Life, Disease Specific Health Related Quality of Life, Sulfur Mustard.

New scoring system for intra-abdominal injury diagnosis after blunt trauma

Directory of Open Access Journals (Sweden)

Shojaee Majid

2014-02-01

Full Text Available 【Abstract】Objective: An accurate scoring system for intra-abdominal injury (IAI based on clinical manifestation and examination may decrease unnecessary CT scans, save time, and reduce healthcare cost. This study is designed to provide a new scoring system for a better diagno- sis of IAI after blunt trauma. Methods: This prospective observational study was performed from April 2011 to October 2012 on patients aged above 18 years and suspected with blunt abdominal trauma (BAT admitted to the emergency department (ED of Imam Hussein Hospital and Shohadaye Hafte Tir Hospital. All patients were assessed and treated based on Advanced Trauma Life Support and ED protocol. Diagnosis was done according to CT scan findings, which was considered as the gold standard. Data were gathered based on patient's history, physical exam, ultrasound and CT scan findings by a general practitioner who was not blind to this study. Chisquare test and logistic regression were done. Factors with significant relationship with CT scan were imported in multivariate regression models, where a coefficient (β was given based on the contribution of each of them. Scoring system was developed based on the obtained total βof each factor. Results: Altogether 261 patients (80.1% male were enrolled (48 cases of IAI. A 24-point blunt abdominal trauma scoring system (BATSS was developed. Patients were divided into three groups including low (score<8, moderate (8≤score<12 and high risk (score≥12. In high risk group immediate laparotomy should be done, moderate group needs further assessments, and low risk group should be kept under observation. Low risk patients did not show positive CT-scans (specificity 100%. Conversely, all high risk patients had positive CT-scan findings (sensitivity 100%. The receiver operating characteristic curve indicated a close relationship between the results of CT scan and BATSS (sensitivity=99.3%. Conclusion: The present scoring system furnishes a

Consumers' views on generic medicines: a review of the literature.

Science.gov (United States)

Hassali, Mohamed A A; Shafie, Asrul A; Jamshed, Shazia; Ibrahim, Mohamed I M; Awaisu, Ahmed

2009-04-01

To review the literature on consumers' knowledge, attitudes and opinions of the use of generic medicines. A narrative review of studies conducted from 1970 to 2008 on consumers perceptions and views towards generic medicines was performed. An extensive literature search was undertaken using indexing services available at the authors' institution library. The following keywords were used for the search: brand, generic, multisource, medications, medicines, drugs, pharmaceuticals and consumers, customers, and patients. Electronic databases searched were Medline, Inside Web, ISI Web of Knowledge, Science Direct, Springer Link, JSTOR, Proquest, Ebsco Host and Google Scholar. These electronic databases were searched for full text papers published in English from 1970 to October 2008. Twenty studies were identified. Eleven were from the USA, four were from Europe, two were from Canada and one each was from Australia, Brazil and Malaysia. In general, consumers showed mixed reactions towards the use of generic medicines. This was evident from the divergence of views observed by country development level, consumers' socioeconomic characteristics, drug product characteristics, pharmaceutical reimbursement system, policy environment, contact with health care professionals, past experience with medications, and knowledge of the seriousness of a medical condition. Patient confidence and knowledge pertaining to generic medicines use have increased over the past four decades, especially in developed countries. Mass educational efforts, financial incentives, and greater communication among patients and health care professionals were seen as major drivers to the uptake of generic medicines among consumers.

IAEA's experience in compiling a generic component reliability data base

International Nuclear Information System (INIS)

Tomic, B.; Lederman, L.

1988-01-01

Reliability data are an essential part of probabilistic safety assessment. The quality of data can determine the quality of the study as a whole. It is obvious that component failure data originated from the plant being analyzed would be most appropriate. However, in few cases complete reliance on plant experience is possible, mainly because of the rather limited operating experience. Nuclear plants, although of different design, often use fairly similar components, so some of the experience could be combined and transferred from one plant to another. In addition information about component failures is available also from experts with knowledge on component design, manufacturing and operation. That bring us to the importance of assessing generic data. (Generic is meant to be everything that is not plant specific regarding the plant being analyzed). The generic data available in the open literature, can be divided in three broad categories. The first one includes data base used in previous analysis. These can be plant specific or updated from generic with plant specific information (latter case deserve special attention). The second one is based on compilation of plants' operating experience usually based on some kind of event reporting system. The third category includes data sources based on expert opinions (single or aggregate) or combination of expert opinions and other nuclear and non-nuclear experience. This paper reflects insights gained in compiling data from generic data sources and highlights advantages and pitfalls of using generic component reliability data in PSAs

Generic medicines: solutions for a sustainable drug market?

Science.gov (United States)

Dylst, Pieter; Vulto, Arnold; Godman, Brian; Simoens, Steven

2013-10-01

Generic medicines offer equally high-quality treatment as originator medicines do at much lower prices. As such, they represent a considerable opportunity for authorities to obtain substantial savings. At the moment, the pharmaceutical landscape is changing and many pharmaceutical companies have altered their development and commercial strategies, combining both originator and generic divisions. In spite of this, the generic medicines industry is currently facing a number of challenges: delayed market access; the limited price differential with originator medicines; the continuous downwards pressure on prices; and the negative perception regarding generic medicines held by some key stakeholder groups. This could jeopardize the long-term sustainability of the generic manufacturing industry. Therefore, governments must focus on demand-side policies, alongside policies to accelerate market access, as the generic medicines industry will only be able to deliver competitive and sustainable prices if they are ensured a high volume. In the future, the generic medicines industry will increasingly look to biosimilars and generic versions of orphan drugs to expand their business.

Generic medicines: Perceptions of Physicians in Basrah, Iraq

Directory of Open Access Journals (Sweden)

Adheed Khalid Sharrad

2009-08-01

Full Text Available BackgroundThe use of cheaper generic medicines is a strategy promotedin many countries to reduce rising health care costs. The aimof this study was to explore factors affecting generic medicineprescribing by physicians in Basrah, Iraq.MethodologyA purposive sample of ten physicians practicing in Basrahwas interviewed using a semi-structured interview guide.ResultsAnalysis of the interviews identified seven major themes:medicine prescribing practice, knowledge of therapeuticequivalency of generic medicine, patients’ acceptance ofgeneric medicine, counterfeit medicine, drug informationsource and effect of drug advertising on medicines choice,brand substitution practice by community pharmacists, and,finally strategies to improve generic medicine usefulness.Participants identified helpful strategies to increase genericprescribing including; physician and patient education ongeneric medicine; persuading physicians about the safety andefficacy of generic medicines; and finally educating seniormedical students on generic prescribing.ConclusionThe data suggest that participants were enthusiasticabout prescribing generic medicines. However physiciansinsist that pharmacists should not be allowed tosubstitute generic drugs without prior approval ofdoctors.

Binary mixtures of condensates in generic confining potentials

Energy Technology Data Exchange (ETDEWEB)

Facchi, P [Dipartimento di Matematica and MECENAS, Universita di Bari, I-70125 Bari (Italy); Florio, G; Pascazio, S; Pepe, F V, E-mail: Francesco.Pepe@ba.infn.it [INFN, Sezione di Bari, I-70126 Bari (Italy)

2011-12-16

We study a binary mixture of Bose-Einstein condensates, confined in a generic potential, in the Thomas-Fermi approximation. We search for the zero-temperature ground state of the system, both in the case of fixed numbers of particles and fixed chemical potentials. For generic potentials, we analyze the transition from mixed to separated ground-state configurations as the inter-species interaction increases. We derive a simple formula that enables one to determine the location of the domain walls. Finally, we find criteria for the energetic stability of separated configurations, depending on the number and the position of the domain walls separating the two species. (paper)

Binary mixtures of condensates in generic confining potentials

Science.gov (United States)

Facchi, P.; Florio, G.; Pascazio, S.; Pepe, F. V.

2011-12-01

We study a binary mixture of Bose-Einstein condensates, confined in a generic potential, in the Thomas-Fermi approximation. We search for the zero-temperature ground state of the system, both in the case of fixed numbers of particles and fixed chemical potentials. For generic potentials, we analyze the transition from mixed to separated ground-state configurations as the inter-species interaction increases. We derive a simple formula that enables one to determine the location of the domain walls. Finally, we find criteria for the energetic stability of separated configurations, depending on the number and the position of the domain walls separating the two species.

Binary mixtures of condensates in generic confining potentials

International Nuclear Information System (INIS)

Facchi, P; Florio, G; Pascazio, S; Pepe, F V

2011-01-01

We study a binary mixture of Bose–Einstein condensates, confined in a generic potential, in the Thomas–Fermi approximation. We search for the zero-temperature ground state of the system, both in the case of fixed numbers of particles and fixed chemical potentials. For generic potentials, we analyze the transition from mixed to separated ground-state configurations as the inter-species interaction increases. We derive a simple formula that enables one to determine the location of the domain walls. Finally, we find criteria for the energetic stability of separated configurations, depending on the number and the position of the domain walls separating the two species. (paper)

International experiences of promoting generics use and its implications to China.

Science.gov (United States)

Sun, Jing

2013-05-01

To summarize international experiences in promoting use of generics and to extract essence for China's reference. This is a commentary of two systematic reviews about policies to promote use of generics and its implications to China. Price, reimbursement, and generic substitution policies in European countries, and approaches in low and middle income countries in promoting market competition, appropriate intellectual property right protection strategy, and necessary demand side incentives, are all meaningful for China to contain soaring pharmaceutical expenditures, and to maintain the achievements and outcomes of the national health system reform. Effective promotion of generics use must be practice based on the real situation. Tailor-made and comprehensive measures are needed to address both demand and supply sides barriers before achieving tangible cost containment effect without unexpected side effects. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

Comparing approaches to generic programming in Haskell

NARCIS (Netherlands)

Hinze, R.; Jeuring, J.T.; Löh, A.

2006-01-01

The last decade has seen a number of approaches to generic programming: PolyP, Functorial ML, `Scrap Your Boilerplate', Generic Haskell, `Generics for the Masses', etc. The approaches vary in sophistication and target audience: some propose full-blown pro- gramming languages, some suggest

Generic Switching and Non-Persistence among Medicine Users

DEFF Research Database (Denmark)

Østergaard Rathe, Jette; Andersen, Morten; Jarbøl, Dorte Ejg

2015-01-01

BACKGROUND: Generic substitution means that one medicinal product is replaced by another product containing the same active substance. It is strictly regulated with respect to its bioequivalence, and all products must have undergone appropriate studies. Although generic substitution is widely...... implemented, it still remains to be answered how generic switch influences persistence to long-term treatment, and if it is modified by patients' concerns about medicine and views on generic medicine. This study focuses on users of antidepressants and antiepileptics, and their experience of generic switching....... METHODS: The study was an observational cohort study. By use of a prescription database, we identified patients who had redeemed prescriptions on generically substitutable drugs, and a questionnaire was mailed to them. We analyzed predictors of discontinuation in relation to generic switch and patients...

Article choice in plural generics

NARCIS (Netherlands)

Farkas, D.F.; Swart, Henriëtte de

2007-01-01

We discuss two groups of languages where article use contrasts in generic plural sentences but is otherwise essentially similar. The languages in the first group (English and Dutch) use bare plurals in the expression of kind reference (‘Dinosaurs are extinct’) and in generic

Commercial Building Energy Asset Score System: Program Overview and Technical Protocol (Version 1.0)

Energy Technology Data Exchange (ETDEWEB)

Wang, Na; Gorrissen, Willy J.

2013-01-11

The U.S. Department of Energy (DOE) is developing a national voluntary energy asset score system that includes an energy asset score tool to help building owners evaluate their buildings with respect to the score system. The goal of the energy asset score system is to facilitate cost-effective investment in energy efficiency improvements of commercial buildings. The system will allow building owners and managers to compare their building infrastructure against peers and track building upgrade progress over time. The system can also help other building stakeholders (e.g., building operators, tenants, financiers, and appraisers) understand the relative efficiency of different buildings in a way that is independent from their operations and occupancy. This report outlines the technical protocol used to generate the energy asset score, explains the scoring methodology, and provides additional details regarding the energy asset score tool. This report also describes alternative methods that were considered prior to developing the current approach. Finally, this report describes a few features of the program where alternative approaches are still under evaluation.

Wilson polynomials/functions and intertwining operators for the generic quantum superintegrable system on the 2-sphere

Science.gov (United States)

Miller, W., Jr.; Li, Q.

2015-04-01

The Wilson and Racah polynomials can be characterized as basis functions for irreducible representations of the quadratic symmetry algebra of the quantum superintegrable system on the 2-sphere, HΨ = EΨ, with generic 3-parameter potential. Clearly, the polynomials are expansion coefficients for one eigenbasis of a symmetry operator L2 of H in terms of an eigenbasis of another symmetry operator L1, but the exact relationship appears not to have been made explicit. We work out the details of the expansion to show, explicitly, how the polynomials arise and how the principal properties of these functions: the measure, 3-term recurrence relation, 2nd order difference equation, duality of these relations, permutation symmetry, intertwining operators and an alternate derivation of Wilson functions - follow from the symmetry of this quantum system. This paper is an exercise to show that quantum mechancal concepts and recurrence relations for Gausian hypergeometrc functions alone suffice to explain these properties; we make no assumptions about the structure of Wilson polynomial/functions, but derive them from quantum principles. There is active interest in the relation between multivariable Wilson polynomials and the quantum superintegrable system on the n-sphere with generic potential, and these results should aid in the generalization. Contracting function space realizations of irreducible representations of this quadratic algebra to the other superintegrable systems one can obtain the full Askey scheme of orthogonal hypergeometric polynomials. All of these contractions of superintegrable systems with potential are uniquely induced by Wigner Lie algebra contractions of so(3, C) and e(2,C). All of the polynomials produced are interpretable as quantum expansion coefficients. It is important to extend this process to higher dimensions.

Wilson polynomials/functions and intertwining operators for the generic quantum superintegrable system on the 2-sphere

International Nuclear Information System (INIS)

Miller, W Jr; Li, Q

2015-01-01

The Wilson and Racah polynomials can be characterized as basis functions for irreducible representations of the quadratic symmetry algebra of the quantum superintegrable system on the 2-sphere, HΨ = EΨ, with generic 3-parameter potential. Clearly, the polynomials are expansion coefficients for one eigenbasis of a symmetry operator L 2 of H in terms of an eigenbasis of another symmetry operator L 1 , but the exact relationship appears not to have been made explicit. We work out the details of the expansion to show, explicitly, how the polynomials arise and how the principal properties of these functions: the measure, 3-term recurrence relation, 2nd order difference equation, duality of these relations, permutation symmetry, intertwining operators and an alternate derivation of Wilson functions - follow from the symmetry of this quantum system. This paper is an exercise to show that quantum mechancal concepts and recurrence relations for Gausian hypergeometrc functions alone suffice to explain these properties; we make no assumptions about the structure of Wilson polynomial/functions, but derive them from quantum principles. There is active interest in the relation between multivariable Wilson polynomials and the quantum superintegrable system on the n-sphere with generic potential, and these results should aid in the generalization. Contracting function space realizations of irreducible representations of this quadratic algebra to the other superintegrable systems one can obtain the full Askey scheme of orthogonal hypergeometric polynomials. All of these contractions of superintegrable systems with potential are uniquely induced by Wigner Lie algebra contractions of so(3, C) and e(2,C). All of the polynomials produced are interpretable as quantum expansion coefficients. It is important to extend this process to higher dimensions. (paper)

Developing points-based risk-scoring systems in the presence of competing risks.

Science.gov (United States)

Austin, Peter C; Lee, Douglas S; D'Agostino, Ralph B; Fine, Jason P

2016-09-30

Predicting the occurrence of an adverse event over time is an important issue in clinical medicine. Clinical prediction models and associated points-based risk-scoring systems are popular statistical methods for summarizing the relationship between a multivariable set of patient risk factors and the risk of the occurrence of an adverse event. Points-based risk-scoring systems are popular amongst physicians as they permit a rapid assessment of patient risk without the use of computers or other electronic devices. The use of such points-based risk-scoring systems facilitates evidence-based clinical decision making. There is a growing interest in cause-specific mortality and in non-fatal outcomes. However, when considering these types of outcomes, one must account for competing risks whose occurrence precludes the occurrence of the event of interest. We describe how points-based risk-scoring systems can be developed in the presence of competing events. We illustrate the application of these methods by developing risk-scoring systems for predicting cardiovascular mortality in patients hospitalized with acute myocardial infarction. Code in the R statistical programming language is provided for the implementation of the described methods. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.

A generic inertia emulation controller for multi-terminal VSC-HVDC systems

DEFF Research Database (Denmark)

Zhu, Jiebei; Guerrero, Josep M.; Booth, Campbell

2013-01-01

A generic Inertia Emulation Controller (INEC) for Multi-Terminal Voltage-source-converter based HVDC (VSC-MTDC) is proposed in this paper. The proposed INEC can be incorporated in any grid-side-voltage-source-converter (GVSC) station, allowing the MTDC terminal to contribute an inertial response...

Comparison of Glasgow-Blatchford score and full Rockall score systems to predict clinical outcomes in patients with upper gastrointestinal bleeding.

Science.gov (United States)

Mokhtare, Marjan; Bozorgi, Vida; Agah, Shahram; Nikkhah, Mehdi; Faghihi, Amirhossein; Boghratian, Amirhossein; Shalbaf, Neda; Khanlari, Abbas; Seifmanesh, Hamidreza

2016-01-01

Various risk scoring systems have been recently developed to predict clinical outcomes in patients with upper gastrointestinal bleeding (UGIB). The two commonly used scoring systems include full Rockall score (RS) and the Glasgow-Blatchford score (GBS). Bleeding scores were assessed in terms of prediction of clinical outcomes in patients with UGIB. Two hundred patients (age >18 years) with obvious symptoms of UGIB in the emergency department of Rasoul Akram Hospital were enrolled. Full RS and GBS were calculated. We followed the patients for records of rebleeding and 1-month mortality. A receiver operating characteristic curve by using areas under the curve (AUCs) was used to statistically identify the best cutoff point. Eighteen patients were excluded from the study due to failure to follow-up. Rebleeding and mortality rate were 9.34% (n=17) and 11.53% (n=21), respectively. Regarding 1-month mortality, full RS was better than GBS (AUC, 0.648 versus 0.582; P =0.021). GBS was more accurate in terms of detecting transfusion need (AUC, 0.757 versus 0.528; P =0.001), rebleeding rate (AUC, 0.722 versus 0.520; P =0.002), intensive care unit admission rate (AUC, 0.648 versus 0.582; P =0.021), and endoscopic intervention rate (AUC, 0.771 versus 0.650; P <0.001). We found the full RS system is better for 1-month mortality prediction while GBS system is better for prediction of other outcomes.

40 CFR 721.9973 - Zirconium dichlorides (generic).

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Zirconium dichlorides (generic). 721... Substances § 721.9973 Zirconium dichlorides (generic). (a) Chemical substance and significant new uses subject to reporting. (1) The chemical substances identified generically as zirconium dichlorides (PMNs P...

Comparing approaches to generic programming in Haskell

NARCIS (Netherlands)

Hinze, R.; Jeuring, J.T.; Löh, A.

2006-01-01

The last decade has seen a number of approaches to data- type-generic programming: PolyP, Functorial ML, `Scrap Your Boiler- plate', Generic Haskell, `Generics for the Masses', etc. The approaches vary in sophistication and target audience: some propose full-blown pro- gramming languages, some

Impact of cement dust pollution on respiratory systems of Lafarge ...

African Journals Online (AJOL)

In this investigation, the impact of cement dust pollution on respiratory systems of Lafarge cement workers was evaluated. A total of 120 respondents; 60 from the factory workers and 60 (controls) from Ifo, a nearby village 22 km NE of the factory were interviewed in 2014 using a modified respiratory symptom score ...

Some design constraints required for the use of generic software in embedded systems: Packages which manage abstract dynamic structures without the need for garbage collection

Science.gov (United States)

Johnson, Charles S.

1986-01-01

The embedded systems running real-time applications, for which Ada was designed, require their own mechanisms for the management of dynamically allocated storage. There is a need for packages which manage their own internalo structures to control their deallocation as well, due to the performance implications of garbage collection by the KAPSE. This places a requirement upon the design of generic packages which manage generically structured private types built-up from application-defined input types. These kinds of generic packages should figure greatly in the development of lower-level software such as operating systems, schedulers, controllers, and device driver; and will manage structures such as queues, stacks, link-lists, files, and binary multary (hierarchical) trees. Controlled to prevent inadvertent de-designation of dynamic elements, which is implicit in the assignment operation A study was made of the use of limited private type, in solving the problems of controlling the accumulation of anonymous, detached objects in running systems. The use of deallocator prodecures for run-down of application-defined input types during deallocation operations during satellites.

Developing Generic Competences in Online Virtual Education Programmes at the University of Deusto

Science.gov (United States)

Gvaramadze, Irakli

2012-01-01

Purpose: The current paper focuses on the increasing demand for generic competences both from governments and industries. Despite this fact, there is insufficient awareness and information in education systems on how to equip graduates with appropriate generic competences for the world of work and citizenship. This is even more complicated in…

Validation of the computed assessment of cleansing score with the Mirocam® system

Directory of Open Access Journals (Sweden)

Ana Ponte

Full Text Available Background and aims: A computed assessment of cleansing (CAC score was developed to objectively evaluate small-bowel cleansing in the PillCam capsule endoscopy (CE system and to overcome the subjectivity and complexity of previous scoring systems. Our study aimed to adapt the CAC score to the Mirocam® system, evaluate its reliability with the Mirocam® CE system and compare it with three validated subjective grading scales. Patients and methods: Thirty CE were prospectively and independently reviewed by two authors who classified the degree of small-bowel cleanliness according to a quantitative index, a qualitative evaluation and an overall adequacy assessment. The authors were blinded for the CAC score of each CE, which was calculated as ([mean intensity of the red channel]/[mean intensity of the green channel] - 1 x 10. The mean intensities of the red and green channels of the small-bowel segment of the "Map View" bar in the Miroview Client® were determined using the histogram option of two photo-editing software. Results: There was a strong agreement between both CE readers for each of the three subjective scales used. The reproducibility of the CAC score was excellent and identical results were obtained with the two photo-editing software. Regarding the comparison between the CAC score and the subjective scales, there was a moderate-to-good agreement with the quantitative index, qualitative evaluation and overall adequacy assessment. Conclusions: CAC score represents an objective and feasible score in the assessment of small-bowel cleansing in the Mirocam® CE system, and could be used per se or as part of a more comprehensive score.

Investigation of the efficacy of generic and brand-name tiotropium bromide in the management of chronic obstructive pulmonary disease: A randomized comparative trial.

Science.gov (United States)

Panahi, Yunes; Ghanei, Mostafa; Behzadi, Mohammad; Salehi, Maryam; Soflaei, Sara Saffar; Sahebkar, Amirhossein

2016-03-01

The beneficial effects of tiotropium bromide, a long acting anticholinergic bronchodilator, in the management of chronic obstructive pulmonary disease have been shown in previous studies. The present study aimed to compare the efficacy and safety of generic (Tiova®) and brand-name (Spiriva®) tiotropium preparations in patients with COPD. In this randomized double-blind parallel-group trial, 79 patients with documented COPD were assigned to Tiova® or Spiriva® for a period of 4 weeks. Assessment of pulmonary function (using spirometry), quality-of-life (using St. George respiratory Questionnaire [SGRQ]) and severity of respiratory symptoms (using breathlessness, cough and sputum scale [BCSS]) was performed at baseline and at the end of treatment period. There were significant increases in FEV1 and reductions in FVC by the end of study in both Tiova® and Spiriva® groups. FEV1/FVC ratio did not change significantly neither in the Tiova® nor in Spiriva® group. Overall SGRQ score as well as subscale scores of symptoms, activity and impacts were improved by both drugs. In the BCSS scale, the frequency and severity of three main symptoms (dyspnea, cough and sputum) was decreased by both drugs. Baseline as well as post-treatment values of spirometric parameters, SGRQ and BCSS scores was comparable between the groups, apart from a lower post-treatment frequency of cough and sputum in the Spiriva® versus Tiova® group. There was no report of adverse events in either of the study groups. The findings of this comparative trial showed equivalent efficacy and safety of Spiriva® and Tiova® in lessening the symptoms as well as improving the quality of life in patients with COPD. This finding has an important translational value given the significantly lower costs of generic versus brand-name products.

Energy systems. Tome 3: advanced cycles, low environmental impact innovative systems

International Nuclear Information System (INIS)

Gicquel, R.

2009-01-01

This third tome about energy systems completes the two previous ones by showing up advanced thermodynamical cycles, in particular having a low environmental impact, and by dealing with two other questions linked with the study of systems with a changing regime operation: - the time management of energy, with the use of thermal and pneumatic storage systems and time simulation (schedule for instance) of systems (solar energy type in particular); - the technological dimensioning and non-nominal regime operation studies. Because this last topic is particularly complex, new functionalities have been implemented mainly by using the external classes mechanism, which allows the user to freely personalize his models. This tome is illustrated with about 50 examples of cycles modelled with Thermoptim software. Content: foreword; 1 - generic external classes; 2 - advanced gas turbine cycles; 3 - evaporation-concentration, mechanical steam compression, desalination, hot gas drying; 4 - cryogenic cycles; 5 - electrochemical converters; 6 - global warming, CO 2 capture and sequestration; 7 - future nuclear reactors (coupled to Hirn and Brayton cycles); 8 - thermodynamic solar cycles; 10 - pneumatic and thermal storage; 11 - calculation of thermodynamic solar facilities; 12 - problem of technological dimensioning and non-nominal regime; 13 - exchangers modeling and parameterizing for the dimensioning and the non-nominal regime; 14 - modeling and parameterizing of volumetric compressors; 15 - modeling and parameterizing of turbo-compressors and turbines; 16 - identification methodology of component parameters; 17 - case studies. (J.S.)

40 CFR 721.9959 - Polyurethane polymer (generic).

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Polyurethane polymer (generic). 721... Substances § 721.9959 Polyurethane polymer (generic). (a) Chemical substance and significant new uses subject to reporting. (1) The chemical substance identified generically as a polyurethane polymer (PMN P-01...

Proceedings Workshop on Generic Programming (WGP2000)

NARCIS (Netherlands)

Jeuring, J.T.

2000-01-01

This report contains the papers selected for presentation at the 2nd Workshop on Generic Programming (WGP2000), which was held on July 6, 2000 in Ponte de Lima, Portugal. Generic programming is about making programs more adaptable by making them more general. Generic programs often embody

Skin rash during treatment with generic itraconazole.

Science.gov (United States)

De Vuono, Antonio; Palleria, Caterina; Scicchitano, Francesca; Squillace, Aida; De Sarro, Giovambattista; Gallelli, Luca

2014-04-01

Generic drugs have the same active substance, the same pharmaceutical form, the same therapeutic indications and a similar bioequivalence with the reference medicinal product (branded). Although a similar efficacy is postulated, some cases of clinical inefficacy during treatment with generic formulations have been reported. In this case, we describe a woman with onychomycosis that developed a skin rash during treatment with a generic formulation of itraconazole. Drug administration and its re-challenge confirmed the association between itraconazole and skin rash. Both Naranjo probability scale and World Health Organization causality assessment scale documented a probable association between generic-itraconazole and skin rash. The switch from generic formulation to brand one induced an improvement of symptoms. Since we are unable to evaluate the role of each excipient in the development of skin rash, we cannot rule out their involvement. However, more data are necessary to better define the similarities or differences between branded and generic formulations.

Clinical equivalence of generic and brand-name drugs used in cardiovascular disease: a systematic review and meta-analysis.

Science.gov (United States)

Kesselheim, Aaron S; Misono, Alexander S; Lee, Joy L; Stedman, Margaret R; Brookhart, M Alan; Choudhry, Niteesh K; Shrank, William H

2008-12-03

Use of generic drugs, which are bioequivalent to brand-name drugs, can help contain prescription drug spending. However, there is concern among patients and physicians that brand-name drugs may be clinically superior to generic drugs. To summarize clinical evidence comparing generic and brand-name drugs used in cardiovascular disease and to assess the perspectives of editorialists on this issue. Systematic searches of peer-reviewed publications in MEDLINE, EMBASE, and International Pharmaceutical Abstracts from January 1984 to August 2008. Studies compared generic and brand-name cardiovascular drugs using clinical efficacy and safety end points. We separately identified editorials addressing generic substitution. We extracted variables related to the study design, setting, participants, clinical end points, and funding. Methodological quality of the trials was assessed by Jadad and Newcastle-Ottawa scores, and a meta-analysis was performed to determine an aggregate effect size. For editorials, we categorized authors' positions on generic substitution as negative, positive, or neutral. We identified 47 articles covering 9 subclasses of cardiovascular medications, of which 38 (81%) were randomized controlled trials (RCTs). Clinical equivalence was noted in 7 of 7 RCTs (100%) of beta-blockers, 10 of 11 RCTs (91%) of diuretics, 5 of 7 RCTs (71%) of calcium channel blockers, 3 of 3 RCTs (100%) of antiplatelet agents, 2 of 2 RCTs (100%) of statins, 1 of 1 RCT (100%) of angiotensin-converting enzyme inhibitors, and 1 of 1 RCT (100%) of alpha-blockers. Among narrow therapeutic index drugs, clinical equivalence was reported in 1 of 1 RCT (100%) of class 1 antiarrhythmic agents and 5 of 5 RCTs (100%) of warfarin. Aggregate effect size (n = 837) was -0.03 (95% confidence interval, -0.15 to 0.08), indicating no evidence of superiority of brand-name to generic drugs. Among 43 editorials, 23 (53%) expressed a negative view of generic drug substitution. Whereas evidence does not

A methodology for the evaluation of the turbine jet engine fragment threat to generic air transportable containers

International Nuclear Information System (INIS)

Harding, D.C.; Pierce, J.D.

1993-06-01

Uncontained, high-energy gas turbine engine fragments are a potential threat to air-transportable containers carried aboard jet aircraft. The threat to a generic example container is evaluated by probability analyses and penetration testing to demonstrate the methodology to be used in the evaluation of a specific container/aircraft/engine combination. Fragment/container impact probability is the product of the uncontained fragment release rate and the geometric probability that a container is in the path of this fragment. The probability of a high-energy rotor burst fragment from four generic aircraft engines striking one of the containment vessels aboard a transport aircraft is approximately 1.2 x 10 -9 strikes/hour. Finite element penetration analyses and tests can be performed to identify specific fragments which have the potential to penetrate a generic or specific containment vessel. The relatively low probability of engine fragment/container impacts is primarily due to the low release rate of uncontained, hazardous jet engine fragments

[Different scoring systems to evaluate the prognosis of Fournier's gangrene: A comparative study].

Science.gov (United States)

Zhu, Xiao-dong; Ding, Fei; Wang, Guo-dong; Shao, Qiang

2015-08-01

To sum up the experience in diagnosis and treatment of Fournier's gangrene and find an optimal evaluation tool for its prognosis by comparing currently used prognostic scoring systems. We retrospectively analyzed 16 cases of Fournier's gangrene diagnosed and surgically treated in our hospital between 2004 and 2012. Using Fournier's Gangrene Severity Index (FGSI), Uludag Fournier's Gangrene Severity Index (UFGSI), Age-Adjusted Charlson Comorbidity Index (ACCI), and Surgical Apgar Score (sAPGAR) , we obtained the prognostic scores of the patients and made comparisons among different scoring systems. FGSI, UFGSI, ACCI, and sAPGAR were all clinically used scoring systems. Statistically significant differences were found in the scores of ACCI and UFGSI but not in those of FGSI and sAPGAR between the death and survival groups, with the maximum area under the ROC curve and minimum standard error for the ACCI score. Both ACCI and UFGSI are useful for evaluating the prognosis of Fournier's gangrene. However, ACCI is even better for its higher sensitivity and specificity and easier clinical collection.

Is bioavailability altered in generic versus brand anticonvulsants?

Science.gov (United States)

Jankovic, Slobodan M; Ignjatovic Ristic, Dragana

2015-03-01

Therapeutic window of anticonvulsants is not a wide one, with phenytoin being one extreme, which can be classified as a narrow therapeutic index drug, since its ratio between the least toxic and the least effective concentration is less than twofold. In order to obtain marketing authorization, a generic anticonvulsant should demonstrate relative bioequivalence with its brand-name counterpart. However, although bioequivalent, generic anticonvulsants still do not have the same bioavailability as brand-name drugs, which may lead to larger fluctuations of steady-state plasma concentrations, and sometimes to loss of seizure control if a patient is switched from brand-name to generic or from generic to generic anticonvulsant. Generic anticonvulsants are effective, safe and affordable drugs for treatment of epilepsy, and patients could be successfully treated with them from the very beginning. It is switching from brand-name to generic anticonvulsant or from one generic anticonvulsant to another that should be avoided in clinical practice, since subtle differences in bioavailability may disturb optimal degree of seizure control to which the patient was previously successfully titrated.

The 2007 AASM recommendations for EEG electrode placement in polysomnography: impact on sleep and cortical arousal scoring.

Science.gov (United States)

Ruehland, Warren R; O'Donoghue, Fergal J; Pierce, Robert J; Thornton, Andrew T; Singh, Parmjit; Copland, Janet M; Stevens, Bronwyn; Rochford, Peter D

2011-01-01

To examine the impact of using American Academy of Sleep Medicine (AASM) recommended EEG derivations (F4/M1, C4/M1, O2/M1) vs. a single derivation (C4/M1) in polysomnography (PSG) on the measurement of sleep and cortical arousals, including inter- and intra-observer variability. Prospective, non-blinded, randomized comparison. Three Australian tertiary-care hospital clinical sleep laboratories. 30 PSGs from consecutive patients investigated for obstructive sleep apnea (OSA) during December 2007 and January 2008. N/A. To examine the impact of EEG derivations on PSG summary statistics, 3 scorers from different Australian clinical sleep laboratories each scored separate sets of 10 PSGs twice, once using 3 EEG derivations and once using 1 EEG derivation. To examine the impact on inter- and intra-scorer reliability, all 3 scorers scored a subset of 10 PSGs 4 times, twice using each method. All PSGs were de-identified and scored in random order according to the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Using 3 referential EEG derivations during PSG, as recommended in the AASM manual, instead of a single central EEG derivation, as originally suggested by Rechtschaffen and Kales (1968), resulted in a mean ± SE decrease in N1 sleep of 9.6 ± 3.9 min (P = 0.018) and an increase in N3 sleep of 10.6 ± 2.8 min (P = 0.001). No significant differences were observed for any other sleep or arousal scoring summary statistics; nor were any differences observed in inter-scorer or intra-scorer reliability for scoring sleep or cortical arousals. This study provides information for those changing practice to comply with the 2007 AASM recommendations for EEG placement in PSG, for those using portable devices that are unable to comply with the recommendations due to limited channel options, and for the development of future standards for PSG scoring and recording. As the use of multiple EEG derivations only led to small changes in the distribution of derived sleep

Simple Scoring System to Predict In-Hospital Mortality After Surgery for Infective Endocarditis.

Science.gov (United States)

Gatti, Giuseppe; Perrotti, Andrea; Obadia, Jean-François; Duval, Xavier; Iung, Bernard; Alla, François; Chirouze, Catherine; Selton-Suty, Christine; Hoen, Bruno; Sinagra, Gianfranco; Delahaye, François; Tattevin, Pierre; Le Moing, Vincent; Pappalardo, Aniello; Chocron, Sidney

2017-07-20

Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis. Outcomes of 361 consecutive patients (mean age, 59.1±15.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in-hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty-six (15.5%) patients died postsurgery. BMI >27 kg/m 2 (odds ratio [OR], 1.79; P =0.049), estimated glomerular filtration rate 55 mm Hg (OR, 1.78; P =0.032), and critical state (OR, 2.37; P =0.017) were independent predictors of in-hospital death. A scoring system was devised to predict in-hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734-0.822). The score performed better than 5 of 6 scoring systems for in-hospital death after cardiac surgery that were considered. A simple scoring system based on risk factors for in-hospital death was specifically created to predict mortality risk postsurgery in patients with IE. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

A multicenter experience with generic tacrolimus conversion.

Science.gov (United States)

McDevitt-Potter, Lisa M; Sadaka, Basma; Tichy, Eric M; Rogers, Christin C; Gabardi, Steven

2011-09-27

The first generic tacrolimus product gained Food and Drug Administration approval in August 2009. This prospective, observational trial sought to determine the need for dose titrations and measure drug cost savings on conversion to generic tacrolimus. Transplant recipients on stable tacrolimus doses were converted from brand to generic tacrolimus on a mg:mg basis. Data were collected at the time of generic conversion (study arm) and at a time point exactly 6 months before conversion (control arm) for all subjects. Seventy conversions from four centers are reported. Subjects were a mean of 70 months after kidney (n=37), liver (n=28), or multiorgan (n=5) transplant. In the study arm, mean tacrolimus doses were 4.4 and 4.5 mg/d and mean tacrolimus trough concentrations were 5.8 and 5.9 ng/mL before and after conversion, respectively. In the control arm, mean tacrolimus doses were 4.6 and 4.6 mg/d and mean tacrolimus trough concentrations were 6.1 and 5.9 ng/mL before and after the control time point, respectively. Dose titrations occurred in five patients (7%) in the control arm and 15 patients (21%) in the study arm (P=0.028). Mean monthly drug costs were $645 for brand, $593 for generic, and $595 for generic after dose titrations. Mean monthly patient copays were $38 for brand and $15 for generic. These cumulative data show that dose requirements and trough levels are similar between brand and generic tacrolimus and that generic substitution allows for savings. However, postconversion monitoring is prudent as patients may require dose titration.

Similar predictions of etravirine sensitivity regardless of genotypic testing method used: comparison of available scoring systems.

Science.gov (United States)

Vingerhoets, Johan; Nijs, Steven; Tambuyzer, Lotke; Hoogstoel, Annemie; Anderson, David; Picchio, Gaston

2012-01-01

The aims of this study were to compare various genotypic scoring systems commonly used to predict virological outcome to etravirine, and examine their concordance with etravirine phenotypic susceptibility. Six etravirine genotypic scoring systems were assessed: Tibotec 2010 (based on 20 mutations; TBT 20), Monogram, Stanford HIVdb, ANRS, Rega (based on 37, 30, 27 and 49 mutations, respectively) and virco(®)TYPE HIV-1 (predicted fold change based on genotype). Samples from treatment-experienced patients who participated in the DUET trials and with both genotypic and phenotypic data (n=403) were assessed using each scoring system. Results were retrospectively correlated with virological response in DUET. κ coefficients were calculated to estimate the degree of correlation between the different scoring systems. Correlation between the five scoring systems and the TBT 20 system was approximately 90%. Virological response by etravirine susceptibility was comparable regardless of which scoring system was utilized, with 70-74% of DUET patients determined as susceptible to etravirine by the different scoring systems achieving plasma viral load <50 HIV-1 RNA copies/ml. In samples classed as phenotypically susceptible to etravirine (fold change in 50% effective concentration ≤3), correlations with genotypic score were consistently high across scoring systems (≥70%). In general, the etravirine genotypic scoring systems produced similar results, and genotype-phenotype concordance was high. As such, phenotypic interpretations, and in their absence all genotypic scoring systems investigated, may be used to reliably predict the activity of etravirine.

PyParse: a semiautomated system for scoring spoken recall data.

Science.gov (United States)

Solway, Alec; Geller, Aaron S; Sederberg, Per B; Kahana, Michael J

2010-02-01

Studies of human memory often generate data on the sequence and timing of recalled items, but scoring such data using conventional methods is difficult or impossible. We describe a Python-based semiautomated system that greatly simplifies this task. This software, called PyParse, can easily be used in conjunction with many common experiment authoring systems. Scored data is output in a simple ASCII format and can be accessed with the programming language of choice, allowing for the identification of features such as correct responses, prior-list intrusions, extra-list intrusions, and repetitions.

Interobserver Reliability of the Total Body Score System for Quantifying Human Decomposition.

Science.gov (United States)

Dabbs, Gretchen R; Connor, Melissa; Bytheway, Joan A

2016-03-01

Several authors have tested the accuracy of the Total Body Score (TBS) method for quantifying decomposition, but none have examined the reliability of the method as a scoring system by testing interobserver error rates. Sixteen participants used the TBS system to score 59 observation packets including photographs and written descriptions of 13 human cadavers in different stages of decomposition (postmortem interval: 2-186 days). Data analysis used a two-way random model intraclass correlation in SPSS (v. 17.0). The TBS method showed "almost perfect" agreement between observers, with average absolute correlation coefficients of 0.990 and average consistency correlation coefficients of 0.991. While the TBS method may have sources of error, scoring reliability is not one of them. Individual component scores were examined, and the influences of education and experience levels were investigated. Overall, the trunk component scores were the least concordant. Suggestions are made to improve the reliability of the TBS method. © 2016 American Academy of Forensic Sciences.

Influencers of generic drug utilization: A systematic review.

Science.gov (United States)

Howard, Jennifer N; Harris, Ilene; Frank, Gavriella; Kiptanui, Zippora; Qian, Jingjing; Hansen, Richard

2017-08-04

With an increase in prescription drug spending and rising drug costs there is a need to encourage the use of generic prescription drugs. However, maximizing generic drug use is not possible without the public's positive perception and meeting their informational needs about generic drugs. Thus, improving the public's confidence in, and knowledge of generic drugs on the market is critical. The objective of this systematic review is to examine and evaluate the studies focusing on the nature and extent of key factors influencing generic drug use in the United States in order to help guide policy, education and practice interventions. Using multiple search engines and key word screening criteria, empirical studies published in English between January 1, 2005 and December 31, 2015 were identified. A qualitative synthesis of the evidence identified domains of key factors that influenced generic drug use across studies. Over 3000 citations met the key word screening criteria; 67 of these met inclusion criteria for the systematic review. Seven domains of factors that influence generic drug utilization were identified: 1) patient-related factors, 2) formulary management or cost containment, 3) healthcare policies, 4) promotional activities, 5) educational initiatives, 6) technology, and 7) physician-related factors. Patients, physicians, pharmacists, formulary managers, and policymakers play an important role in generic drug use. Understanding the factors influencing generic drug use can help guide future policy, education, and practice interventions to increase generic drug use. Copyright © 2017 Elsevier Inc. All rights reserved.

CLIC-ACM: generic modular rad-hard data acquisition system based on CERN GBT versatile link

International Nuclear Information System (INIS)

Bielawski, B.; Locci, F.; Magnoni, S.

2015-01-01

CLIC is a world-wide collaboration to study the next ''terascale'' lepton collider, relying upon a very innovative concept of two-beam-acceleration. This accelerator, currently under study, will be composed of the subsequence of 21000 two-beam-modules. Each module requires more than 300 analogue and digital signals which need to be acquired and controlled in a synchronous way. CLIC-ACM (Acquisition and Control Module) is the 'generic' control and acquisition module developed to accommodate the controls of all these signals for various sub-systems and related specification in term of data bandwidth, triggering and timing synchronization. This paper describes the system architecture with respect to its radiation-tolerance, power consumption and scalability

Implementing paediatric early warning scores systems in the Netherlands: future implications.

NARCIS (Netherlands)

Groot, J.F. de; Damen, N.; Loos, E. de; Steeg, L. van de; Rosias, P.; Bruijn, M.; Goorhuis, J.; Wagner, C.

2018-01-01

Background: Paediatric Early Warning Scores (PEWS) are increasingly being used for early identification and management of clinical deterioration in paediatric patients. A PEWS system includes scores, cut-off points and appropriate early intervention. In 2011, The Dutch Ministry of Health advised

Generic domain models in software engineering

Science.gov (United States)

Maiden, Neil

1992-01-01

This paper outlines three research directions related to domain-specific software development: (1) reuse of generic models for domain-specific software development; (2) empirical evidence to determine these generic models, namely elicitation of mental knowledge schema possessed by expert software developers; and (3) exploitation of generic domain models to assist modelling of specific applications. It focuses on knowledge acquisition for domain-specific software development, with emphasis on tool support for the most important phases of software development.

Comparison of Compounded, Generic, and Innovator-Formulated Itraconazole in Dogs and Cats.

Science.gov (United States)

Renschler, Janelle; Albers, Amanda; Sinclair-Mackling, Hanna; Wheat, Lawrence Joseph

2018-05-14

The triazole antifungal itraconazole may be cost prohibitive in brand name form; therefore, compounded and generic products are often used as alternatives. Itraconazole blood concentrations have not been studied in clinical patients receiving these formulations. Itraconazole bioassay was performed on serum/plasma from 95 dogs and 20 cats receiving itraconazole (compounded from bulk powder, generic pelletized, or brand name) for systemic mycosis treatment. Mean itraconazole concentration was lower in the compounded group (n = 42) as compared with the generic (n = 40) or brand name (n = 33) groups (0.5 µg/mL versus 8.3 µg/mL and 6.5 µg/mL, respectively; P 10 µg/mL; 37.5 and 24%, respectively). Compounded itraconazole should be avoided, but generic itraconazole appears to serve as a reasonable alternative to brand name itraconazole. Therapeutic drug monitoring may be beneficial in all cases.

Developing a cumulative anatomic scoring system for military perineal and pelvic blast injuries.

Science.gov (United States)

Mossadegh, Somayyeh; Midwinter, M; Parker, P

2013-03-01

Improvised explosive device (IED) yields in Afghanistan have increased resulting in more proximal injuries. The injury severity score (ISS) is an anatomic aggregate score of the three most severely injured anatomical areas but does not accurately predict severity in IED related pelvi-perineal trauma patients. A scoring system based on abbreviated injury score (AIS) was developed to reflect the severity of these injuries in order to better understand risk factors, develop a tool for future audit and improve performance. Using standard AIS descriptors, injury scales were constructed for the pelvis (1, minor to 6, maximal). The perineum was divided into anterior and posterior zones as relevant to injury patterns and blast direction with each soft tissue structure being allocated a score from its own severity scale. A cumulative score, from 1 to 36 for soft tissue, or a maximum of 42 if a pelvic fracture was involved, was created for all structures injured in the anterior and posterior zones. Using this new scoring system, 77% of patients survived with a pelvi-perineal trauma score (PPTS) below 5. There was a significant increase in mortality, number of pelvic fractures and amputations with increase in score when comparing the first group (score 1-5) to the second group (score 6-10). For scores between 6 and 16 survival was 42% and 22% for scores between 17 and 21. In our cohort of 62 survivors, 1 patient with an IED related pelvi-perineal injury had a 'theoretically un-survivable' maximal ISS of 75 and survived, whereas there were no survivors with a PPTS greater than 22 but this group had no-one with an ISS of 75 suggesting ISS is not an accurate reflection of the true severity of pelvi-perineal blast injury. This scoring system is the initial part of a more complex logistic regression model that will contribute towards a unique trauma scoring system to aid surgical teams in predicting fluid requirements and operative timelines. In austere environments, it may also

The impact on health outcomes and healthcare utilisation of switching to generic medicines consequent to reference pricing: the case of lamotrigine in New Zealand.

Science.gov (United States)

Lessing, Charon; Ashton, Toni; Davis, Peter

2014-10-01

Many countries have implemented generic reference pricing and substitution as methods of containing pharmaceutical expenditure. However, resistance to switching between medicines is apparent, especially in the case of anti-epileptic medicines. This study sought to exploit a nation-wide policy intervention on generic reference pricing in New Zealand to evaluate the health outcomes of patients switching from originator to generic lamotrigine, an anti-epileptic medicine. A retrospective study using the national health collections and prescription records was conducted comparing patients who switched from originator brand to generic lamotrigine with patients who remained on the originator brand. Primary outcome measures included switch behaviour, changes in utilisation of healthcare services at emergency departments, hospitalisations and use of specialist services, and mortality. Approximately one-quarter of all patients using the originator brand of lamotrigine switched to generic lamotrigine, half of whom made the switch within 60 days of the policy implementation. Multiple switches (three or more) between generic and brand products were evident for around 10% of switchers. Switch-back rates of 3% were apparent within 30 days post-switch. No difference in heath outcome measures was associated with switching from originator lamotrigine to a generic equivalent and hence no increased costs could be found for switchers. Switching from brand to generic lamotrigine is largely devoid of adverse health outcomes; however, creating an incentive to ensure a greater proportion of patients switch to generic lamotrigine is required to achieve maximal financial savings from a policy of generic reference pricing.

Evaluation of biofidelity of THUMS pedestrian model under a whole-body impact conditions with a generic sedan buck.

Science.gov (United States)

Wu, Taotao; Kim, Taewung; Bollapragada, Varun; Poulard, David; Chen, Huipeng; Panzer, Matthew B; Forman, Jason L; Crandall, Jeff R; Pipkorn, Bengt

2017-05-29

The goal of this study was to evaluate the biofidelity of the Total Human Model for Safety (THUMS; Ver. 4.01) pedestrian finite element models (PFEM) in a whole-body pedestrian impact condition using a well-characterized generic pedestrian buck model. The biofidelity of THUMS PFEM was evaluated with respect to data from 3 full-scale postmortem human subject (PMHS) pedestrian impact tests, in which a pedestrian buck laterally struck the subjects using a pedestrian buck at 40 km/h. The pedestrian model was scaled to match the anthropometry of the target subjects and then positioned to match the pre-impact postures of the target subjects based on the 3-dimensional motion tracking data obtained during the experiments. An objective rating method was employed to quantitatively evaluate the correlation between the responses of the models and the PMHS. Injuries in the models were predicted both probabilistically and deterministically using empirical injury risk functions and strain measures, respectively, and compared with those of the target PMHS. In general, the model exhibited biofidelic kinematic responses (in the Y-Z plane) regarding trajectories (International Organization for Standardization [ISO] ratings: Y = 0.90 ± 0.11, Z = 0.89 ± 0.09), linear resultant velocities (ISO ratings: 0.83 ± 0.07), accelerations (ISO ratings: Y = 0.58 ± 0.11, Z = 0.52 ± 0.12), and angular velocities (ISO ratings: X = 0.48 ± 0.13) but exhibited stiffer leg responses and delayed head responses compared to those of the PMHS. This indicates potential biofidelity issues with the PFEM for regions below the knee and in the neck. The model also demonstrated comparable reaction forces at the buck front-end regions to those from the PMHS tests. The PFEM generally predicted the injuries that the PMHS sustained but overestimated injuries in the ankle and leg regions. Based on the data considered, the THUMS PFEM was considered to be biofidelic for this pedestrian impact condition and vehicle

Contribution to draft generic environmental impact statement on commercial waste management: radioactive waste isolation in geologic formations

International Nuclear Information System (INIS)

1978-04-01

This document concentrates on deep geologic isolation of wastes in bedded salt, granite, shale, and basalt with emphasis on wastes from three fuel cycles: reprocessing wastes from uranium and plutonium recycling, reprocessing wastes from uranium-only recycling, and spent unreprocessed fuel with no recycling. The analyses presented in this document are based on preconceptual repository designs. As the repository designs progress through future phases, refinements will occur which might modify some of these results. The 12 sections in the report are: introduction; selection and description of generic repository sites; LWR wastes to be isolated in geologic formations; description of waste isolation facilities; effluents from the waste isolation facility; assessment of environment impacts for various geographical locations of a waste isolation facility; environmental monitoring; decommissioning; mine decommissioning site restoration; deep geologic alternative actions; potential mechanisms of containment failure; and considerations relevant to provisional versus final storage

The Impact of an Academic Integrity Module and Turnitin® on Similarity Index Scores of Undergraduate Student Papers

Science.gov (United States)

Ballard, Iva B.

2013-01-01

In this quasi-experimental 2 x 2 factorial design study, the impact of an academic integrity module and Turnitin® on undergraduate student similarity index scores was investigated. Similarity index scores were used to measure suggested plagiarism rates of student papers. A purposive sample consisting of 96 undergraduate education students enrolled…

The Use of the OMERACT Ultrasound Tenosynovitis Scoring System in Multicenter Clinical Trials.

Science.gov (United States)

Ammitzbøll-Danielsen, Mads; Østergaard, Mikkel; Naredo, Esperanza; Iagnocco, Annamaria; Möller, Ingrid; D'Agostino, Maria-Antonietta; Gandjbakhch, Frédérique; Terslev, Lene

2018-02-01

To test the sensitivity to change of the Outcome Measures in Rheumatology Clinical Trials (OMERACT) ultrasound (US) scoring system for tenosynovitis when applied in a multicenter design. RA patients with US-verified tenosynovitis were recruited when scheduled for treatment intensification. Tenosynovitis was assessed at baseline, and 3 and 6 months followup, using the semiquantitative OMERACT scoring system. Expressed in median (25th; 75th percentiles), the overall greyscale and Doppler score decreased significantly from baseline at 4 (2; 7) and 3 (2; 6), to 6 months at 2 (0; 3) and 0 (0; 1, p The OMERACT US scoring system for tenosynovitis showed high responsiveness, supporting its use for diagnosing and monitoring tenosynovitis in multicenter trials.

Ranking of small scale proposals for water system repair using the Rapid Impact Assessment Matrix (RIAM)

Energy Technology Data Exchange (ETDEWEB)

Shakib-Manesh, T.E.; Hirvonen, K.O.; Jalava, K.J.; Ålander, T.; Kuitunen, M.T., E-mail: markku.kuitunen@jyu.fi

2014-11-15

Environmental impacts of small scale projects are often assessed poorly, or not assessed at all. This paper examines the usability of the Rapid Impact Assessment Matrix (RIAM) as a tool to prioritize project proposals for small scale water restoration projects in relation to proposals' potential to improve the environment. The RIAM scoring system was used to assess and rank the proposals based on their environmental impacts, the costs of the projects to repair the harmful impacts, and the size of human population living around the sites. A four-member assessment group (The expert panel) gave the RIAM-scores to the proposals. The assumed impacts of the studied projects at the Eastern Finland water systems were divided into the ecological and social impacts. The more detailed assessment categories of the ecological impacts in this study were impacts on landscape, natural state, and limnology. The social impact categories were impacts to recreational use of the area, fishing, industry, population, and economy. These impacts were scored according to their geographical and social significance, their magnitude of change, their character, permanence, reversibility, and cumulativeness. The RIAM method proved to be an appropriate and recommendable method for the small-scale assessment and prioritizing of project proposals. If the assessments are well documented, the RIAM can be a method for easy assessing and comparison of the various kinds of projects. In the studied project proposals there were no big surprises in the results: the best ranks were received by the projects, which were assumed to return watersheds toward their original state.

Ranking of small scale proposals for water system repair using the Rapid Impact Assessment Matrix (RIAM)

International Nuclear Information System (INIS)

Shakib-Manesh, T.E.; Hirvonen, K.O.; Jalava, K.J.; Ålander, T.; Kuitunen, M.T.

2014-01-01

Environmental impacts of small scale projects are often assessed poorly, or not assessed at all. This paper examines the usability of the Rapid Impact Assessment Matrix (RIAM) as a tool to prioritize project proposals for small scale water restoration projects in relation to proposals' potential to improve the environment. The RIAM scoring system was used to assess and rank the proposals based on their environmental impacts, the costs of the projects to repair the harmful impacts, and the size of human population living around the sites. A four-member assessment group (The expert panel) gave the RIAM-scores to the proposals. The assumed impacts of the studied projects at the Eastern Finland water systems were divided into the ecological and social impacts. The more detailed assessment categories of the ecological impacts in this study were impacts on landscape, natural state, and limnology. The social impact categories were impacts to recreational use of the area, fishing, industry, population, and economy. These impacts were scored according to their geographical and social significance, their magnitude of change, their character, permanence, reversibility, and cumulativeness. The RIAM method proved to be an appropriate and recommendable method for the small-scale assessment and prioritizing of project proposals. If the assessments are well documented, the RIAM can be a method for easy assessing and comparison of the various kinds of projects. In the studied project proposals there were no big surprises in the results: the best ranks were received by the projects, which were assumed to return watersheds toward their original state

76 FR 54507 - Proposed Generic Communication; Draft NRC Generic Letter 2011-XX: Seismic Risk Evaluations for...

Science.gov (United States)

2011-09-01

... NUCLEAR REGULATORY COMMISSION [NRC-2011-0204] Proposed Generic Communication; Draft NRC Generic... functions. SSCs in operating nuclear power plants are designed either in accordance with, or have been... nuclear reactors. The background information relevant to this GL includes the individual plant...

Timely diagnosis of dairy calf respiratory disease using a standardized scoring system.

Science.gov (United States)

McGuirk, Sheila M; Peek, Simon F

2014-12-01

Respiratory disease of young dairy calves is a significant cause of morbidity, mortality, economic loss, and animal welfare concern but there is no gold standard diagnostic test for antemortem diagnosis. Clinical signs typically used to make a diagnosis of respiratory disease of calves are fever, cough, ocular or nasal discharge, abnormal breathing, and auscultation of abnormal lung sounds. Unfortunately, routine screening of calves for respiratory disease on the farm is rarely performed and until more comprehensive, practical and affordable respiratory disease-screening tools such as accelerometers, pedometers, appetite monitors, feed consumption detection systems, remote temperature recording devices, radiant heat detectors, electronic stethoscopes, and thoracic ultrasound are validated, timely diagnosis of respiratory disease can be facilitated using a standardized scoring system. We have developed a scoring system that attributes severity scores to each of four clinical parameters; rectal temperature, cough, nasal discharge, ocular discharge or ear position. A total respiratory score of five points or higher (provided that at least two abnormal parameters are observed) can be used to distinguish affected from unaffected calves. This can be applied as a screening tool twice-weekly to identify pre-weaned calves with respiratory disease thereby facilitating early detection. Coupled with effective treatment protocols, this scoring system will reduce post-weaning pneumonia, chronic pneumonia, and otitis media.

Scoring system development for prediction of extravesical bladder cancer

Directory of Open Access Journals (Sweden)

Prelević Rade

2014-01-01

Full Text Available Background/Aim. Staging of bladder cancer is crucial for optimal management of the disease. However, clinical staging is not perfectly accurate. The aim of this study was to derive a simple scoring system in prediction of pathological advanced muscle-invasive bladder cancer (MIBC. Methods. Logistic regression and bootstrap methods were used to create an integer score for estimating the risk in prediction of pathological advanced MIBC using precystectomy clinicopathological data: demographic, initial transurethral resection (TUR [grade, stage, multiplicity of tumors, lymphovascular invasion (LVI], hydronephrosis, abdominal and pelvic CT radiography (size of the tumor, tumor base width, and pathological stage after radical cystectomy (RC. Advanced MIBC in surgical specimen was defined as pT3-4 tumor. Receiving operating characteristic (ROC curve quantified the area under curve (AUC as predictive accuracy. Clinical usefulness was assessed by using decision curve analysis. Results. This single-center retrospective study included 233 adult patients with BC undergoing RC at the Military Medical Academy, Belgrade. Organ confined disease was observed in 101 (43.3% patients, and 132 (56.7% had advanced MIBC. In multivariable analysis, 3 risk factors most strongly associated with advanced MIBC: grade of initial TUR [odds ratio (OR = 4.7], LVI (OR = 2, and hydronephrosis (OR = 3.9. The resultant total possible score ranged from 0 to 15, with the cut-off value of > 8 points, the AUC was 0.795, showing good discriminatory ability. The model showed excellent calibration. Decision curve analysis showed a net benefit across all threshold probabilities and clinical usefulness of the model. Conclusion. We developed a unique scoring system which could assist in predicting advanced MIBC in patients before RC. The scoring system showed good performance characteristics and introducing of such a tool into daily clinical decision-making may lead to more appropriate

Practicing the Generic (City)

DEFF Research Database (Denmark)

Hansen, Lone Koefoed

2010-01-01

Flanagan proposes that most locative media artworks neglect the particularities of spaces, their historical and political layers. Koolhaas, on the other hand, states that all urban areas are alike, that we are facing a global Generic City. The paper analyses digital media artist Esther Polak......’s NomadicMILK project in light of the generic and particular properties of space as laid out by Flanagan and Koolhaas in order to discuss the possible reconfiguring practices of locative media....

Generic Software Architecture for Prognostics (GSAP) User Guide

Science.gov (United States)

Teubert, Christopher Allen; Daigle, Matthew John; Watkins, Jason; Sankararaman, Shankar; Goebel, Kai

2016-01-01

The Generic Software Architecture for Prognostics (GSAP) is a framework for applying prognostics. It makes applying prognostics easier by implementing many of the common elements across prognostic applications. The standard interface enables reuse of prognostic algorithms and models across systems using the GSAP framework.

Determination of the potential implementation impact of 2016 ministry of environmental protection generic assessment criteria for potentially contaminated sites in China.

Science.gov (United States)

Cheng, Yuanyuan; Tang, Yu-Ting; Nathanail, C Paul

2017-04-12

The Ministry of Environmental Protection of China issued a 3rd draft edition of risk-based Generic Assessment Criteria (the MEP-GAC) in March 2016. Since these will be the first authoritative GAC in China, their implementation is likely to have a significant impact on China's growing contaminated land management sector. This study aims to determine the potential implementation impact of the MEP-GAC through an in-depth analysis of the management context, land use scenarios, health criteria values adopted and exposure pathways considered. The MEP-GAC have been proposed for two broad categories of land use scenarios for contaminated land risk assessment, and these two categories of land use scenarios need to be further delved, and a MEP-GAC for Chinese cultivated land scenario ought to be developed, to ensure human health protection of Chinese farmers. The MEP-GAC have adopted 10 -6 as the acceptable lifetime cancer risk, given the widespread extent and severe level of land contamination in China, consideration should be given to the decision on excess lifetime cancer risk of 10 -5 . During risk assessment process in practice, it is better to review the 20% TDI against local circumstances to determine their suitability before adopting it. The MEP-GAC are based on a SOM value of 1%, for regions with particularly high SOM, it might be necessary to develop regional GAC, due to SOM's significant impact on the GAC developed. An authoritative risk assessment model developed based on HJ25.3-2014 would help facilitate the DQRA process in practice. The MEP-GAC could better reflect the likely exposures of China's citizens due to vapour inhalation by using characteristics of Chinese exposure scenarios, including China-generic building stock, as inputs into the Johnson and Ettinger model as opposed to adoption of the US EPA parameters. The MEP-GAC once implemented will set the trajectory for the development of the investigation, assessment and remediation of land contamination

Scoring systems of severity in patients with multiple trauma.

Science.gov (United States)

Rapsang, Amy Grace; Shyam, Devajit Chowlek

2015-04-01

Trauma is a major cause of morbidity and mortality; hence severity scales are important adjuncts to trauma care in order to characterize the nature and extent of injury. Trauma scoring models can assist with triage and help in evaluation and prediction of prognosis in order to organise and improve trauma systems. Given the wide variety of scoring instruments available to assess the injured patient, it is imperative that the choice of the severity score accurately match the application. Even though trauma scores are not the key elements of trauma treatment, they are however, an essential part of improvement in triage decisions and in identifying patients with unexpected outcomes. This article provides the reader with a compendium of trauma severity scales along with their predicted death rate calculation, which can be adopted in order to improve decision making, trauma care, research and in comparative analyses in quality assessment. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Differences of wells scores accuracy, caprini scores and padua scores in deep vein thrombosis diagnosis

Science.gov (United States)

Gatot, D.; Mardia, A. I.

2018-03-01

Deep Vein Thrombosis (DVT) is the venous thrombus in lower limbs. Diagnosis is by using venography or ultrasound compression. However, these examinations are not available yet in some health facilities. Therefore many scoring systems are developed for the diagnosis of DVT. The scoring method is practical and safe to use in addition to efficacy, and effectiveness in terms of treatment and costs. The existing scoring systems are wells, caprini and padua score. There have been many studies comparing the accuracy of this score but not in Medan. Therefore, we are interested in comparative research of wells, capriniand padua score in Medan.An observational, analytical, case-control study was conducted to perform diagnostic tests on the wells, caprini and padua score to predict the risk of DVT. The study was at H. Adam Malik Hospital in Medan.From a total of 72 subjects, 39 people (54.2%) are men and the mean age are 53.14 years. Wells score, caprini score and padua score has a sensitivity of 80.6%; 61.1%, 50% respectively; specificity of 80.65; 66.7%; 75% respectively, and accuracy of 87.5%; 64.3%; 65.7% respectively.Wells score has better sensitivity, specificity and accuracy than caprini and padua score in diagnosing DVT.

From LCAs to simplified models: a generic methodology applied to wind power electricity.

Science.gov (United States)

Padey, Pierryves; Girard, Robin; le Boulch, Denis; Blanc, Isabelle

2013-02-05

This study presents a generic methodology to produce simplified models able to provide a comprehensive life cycle impact assessment of energy pathways. The methodology relies on the application of global sensitivity analysis to identify key parameters explaining the impact variability of systems over their life cycle. Simplified models are built upon the identification of such key parameters. The methodology is applied to one energy pathway: onshore wind turbines of medium size considering a large sample of possible configurations representative of European conditions. Among several technological, geographical, and methodological parameters, we identified the turbine load factor and the wind turbine lifetime as the most influent parameters. Greenhouse Gas (GHG) performances have been plotted as a function of these key parameters identified. Using these curves, GHG performances of a specific wind turbine can be estimated, thus avoiding the undertaking of an extensive Life Cycle Assessment (LCA). This methodology should be useful for decisions makers, providing them a robust but simple support tool for assessing the environmental performance of energy systems.

Differences in rates of switchbacks after switching from branded to authorized generic and branded to generic drug products: cohort study

Science.gov (United States)

Sarpatwari, Ameet; Dejene, Sara; Khan, Nazleen F; Lii, Joyce; Rogers, James R; Dutcher, Sarah K; Raofi, Saeid; Bohn, Justin; Connolly, John; Fischer, Michael A; Kesselheim, Aaron S; Gagne, Joshua J

2018-01-01

Abstract Objectives To compare rates of switchbacks to branded drug products for patients switched from branded to authorized generic drug products, which have the same active ingredients, appearance, and excipients as the branded product, with patients switched from branded to generic drug products, which have the same active ingredients as the branded product but may differ in appearance and excipients. Design Observational cohort study. Setting Private (a large commercial health plan) and public (Medicaid) insurance programs in the US. Participants Beneficiaries of a large US commercial health insurer between 2004 and 2013 (primary cohort) and Medicaid beneficiaries between 2000 and 2010 (replication cohort). Main outcome measures Patients taking branded products for one of the study drugs (alendronate tablets, amlodipine tablets, amlodipine-benazepril capsules, calcitonin salmon nasal spray, escitalopram tablets, glipizide extended release tablets, quinapril tablets, and sertraline tablets) were identified when they switched to an authorized generic or a generic drug product after the date of market entry of generic drug products. These patients were followed for switchbacks to the branded drug product in the year after their switch to an authorized generic or a generic drug product. Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals after adjusting for demographics, including age, sex, and calendar year. Inverse variance meta-analysis was used to pool adjusted hazard ratios across all drug products. Results A total of 94 909 patients switched from branded to authorized generic drug products and 116 017 patients switched from branded to generic drug products and contributed to the switchback analysis. Unadjusted incidence rates of switchback varied across drug products, ranging from a low of 3.8 per 100 person years (for alendronate tablets) to a high of 17.8 per 100 person years (for amlodipine

Final Generic Environmental Impact Statement. Handling and storage of spent light water power reactor fuel. Volume 1. Executive summary and text

International Nuclear Information System (INIS)

1979-08-01

The Generic Environmental Impact Statement on spent fuel storage was prepared by the Nuclear Regulatory Commission staff in response to a directive from the Commissioners published in the Federal Register, September 16, 1975 (40 FR 42801). The Commission directed the staff to analyze alternatives for the handling and storage of spent light water power reactor fuel with particular emphasis on developing long range policy. Accordingly, the scope of this statement examines alternative methods of spent fuel storage as well as the possible restriction or termination of the generation of spent fuel through nuclear power plant shutdown. Volume 1 includes the executive summary and the text

Therapeutic intervention scoring system-28 (TISS-28: diretrizes para aplicação Therapeutic intervention scoring system-28 (tiss-28: directrices para su aplicación Therapeutic intervention scoring system-28 (tiss-28: directions for application

Directory of Open Access Journals (Sweden)

Katia Grillo Padilha

2005-06-01

Full Text Available O Therapeutic Intervention Scoring System-28 (TISS-28 é um instrumento que permite dimensionar carga de trabalho de enfermagem em Unidade de Terapia Intensiva e estimar gravidade da doença. Apresenta-se nesta publicação as definições operacionais para sua aplicação, proposta por um grupo de especialistas na área, com vistas a uniformizar o significado de cada um dos itens e evitar vieses de interpretação.El Therapeutic Intervention Scoring System-28 (TISS-28 es un instrumento que permite dimensionar carga de trabajo de enfermería en una Unidad de Terapia Intensiva y estimar la gravedad de la enfermedad. Se presenta en esta publicación las definiciones operacionales para su aplicación, propuesta por un grupo de especialistas en el área, con vistas a uniformizar el significado de cada uno de los items y evitar sesgos de interpretación.Therapeutic Intervention Scoring System-28 (TISS-28 is a tool that enables the measurement of the nursing work load in Intensive Care Units and the estimate of how grave the disease is. In this study are presented the operational definitions for its application, proposed by a group of specialists in the area, with the aim of rendering uniform the meaning of each of the items and preventing interpretation biases.

Brand and generic medications: Are they interchangeable

International Nuclear Information System (INIS)

Al-Jazairi, Abdulrazak S.; Blhareth, S.; Eqtefan, Iyad S.; Al-Suwayeh, Saleh A.

2008-01-01

Generic substitution has become a common practice since the late 1970s in the United States. At that time, many of these generics caused bioavailability problems, which fueled suspicions about their efficacy and safety and the Food and Drug Administration (FDA) standards for bioequivalence. In Saudi Arabia, the increasing number of local products raised several concerns with regard to switching from brands to generics. Our objective was to review and examine the basis of the controversy surrounding brand and generic interchangeability and to explore a practical approach in pursuing a switch. Articles indexed initially under terms such as generic medications, generic substitution, bioequivalence and bioinequivalence were identified. These terms were used to search the indexing service, MEDLINE (1966-2006). References from the extracted articles and additional data sources, including the Code of Federal Regulations and Regulatory Guidelines from the FDA Center for Drug Evaluation and research were also reviewed. Foe most drugs, bioequivalence testing generally should enable clinicians to routinely substitute generic for innovator products. However, for narrow therapeutic, critical dose drugs, or for highly variable drugs, safe switching between products can not be assured. These drugs need special precautions and blood level monitoring upon switching. FDA firmly believes that approved generic and brand drugs can be dispensed with the full expectation that the consumer will receive the same clinical benefit. Performing the switch process is an advisable practice to reduce health care costs in countries with strong post-marketing surveillance program, but caution is to be exercised when narrow therapeutic index drugs or highly variable drugs are prescribed. (author)

Pharmaceutical quality of seven generic Levodopa/Benserazide products compared with original Madopar® / Prolopa®.

Science.gov (United States)

Gasser, Urs E; Fischer, Anton; Timmermans, Jan P; Arnet, Isabelle

2013-04-23

By definition, a generic product is considered interchangeable with the innovator brand product. Controversy exists about interchangeability, and attention is predominantly directed to contaminants. In particular for chronic, degenerative conditions such as in Parkinson's disease (PD) generic substitution remains debated among physicians, patients and pharmacists. The objective of this study was to compare the pharmaceutical quality of seven generic levodopa/benserazide hydrochloride combination products marketed in Germany with the original product (Madopar® / Prolopa® 125, Roche, Switzerland) in order to evaluate the potential impact of Madopar® generics versus branded products for PD patients and clinicians. Madopar® / Prolopa® 125 tablets and capsules were used as reference material. The generic products tested (all 100 mg/25 mg formulations) included four tablet and three capsule formulations. Colour, appearance of powder (capsules), disintegration and dissolution, mass of tablets and fill mass of capsules, content, identity and amounts of impurities were assessed along with standard physical and chemical laboratory tests developed and routinely practiced at Roche facilities. Results were compared to the original "shelf-life" specifications in use by Roche. Each of the seven generic products had one or two parameters outside the specifications. Deviations for the active ingredients ranged from +8.4% (benserazide) to -7.6% (levodopa) in two tablet formulations. Degradation products were measured in marked excess (+26.5%) in one capsule formulation. Disintegration time and dissolution for levodopa and benserazide hydrochloride at 30 min were within specifications for all seven generic samples analysed, however with some outliers. Deviations for the active ingredients may go unnoticed by a new user of the generic product, but may entail clinical consequences when switching from original to generic during a long-term therapy. Degradation products may pose

Contact Geometry of Hyperbolic Equations of Generic Type

Directory of Open Access Journals (Sweden)

Dennis The

2008-08-01

Full Text Available We study the contact geometry of scalar second order hyperbolic equations in the plane of generic type. Following a derivation of parametrized contact-invariants to distinguish Monge-Ampère (class 6-6, Goursat (class 6-7 and generic (class 7-7 hyperbolic equations, we use Cartan's equivalence method to study the generic case. An intriguing feature of this class of equations is that every generic hyperbolic equation admits at most a nine-dimensional contact symmetry algebra. The nine-dimensional bound is sharp: normal forms for the contact-equivalence classes of these maximally symmetric generic hyperbolic equations are derived and explicit symmetry algebras are presented. Moreover, these maximally symmetric equations are Darboux integrable. An enumeration of several submaximally symmetric (eight and seven-dimensional generic hyperbolic structures is also given.

Retailing policies for generic medicines.

Science.gov (United States)

Narciso, Susana

2005-06-01

As there is general disagreement about the way generic medicines should be commercialized, two retailing policies are analyzed, taking into account their effects on the welfare of patients, government, pharmacies and physicians. In the first policy scenario, pharmacies are allowed to substitute generic medicines for branded ones, while in the second, substitution is forbidden. In both cases a pharmacies association is allowed to have a share in the production of generic medicines. The model predicts that under some conditions patients may prefer substitution by pharmacies but when doctors' decisions are binding, they are never "excessively bad". However, the policy choice belongs to the government, which prefers to allow for substitution more often than patients would like.

Generic Accounting and Reporting Software for Research Reactors

International Nuclear Information System (INIS)

Jaernry, C.

2010-01-01

This poster will give a general description of a generic accounting and reporting software for research reactors. The program has been designed to be a powerful working tool for the operator. The software is designed to be extremely easy to handle and at the same time give the operator the maximal power of searches, calculations and reports that a modern advanced system can produce. The systems are designed to take make the relevant accountancy for the site and perform the reporting to IAEA in Code 10. Generic software for accounting and reporting for research and other smaller facilities is something that has been asked for by many parties. Software like this could be distributed to facilities in need of a powerful accountancy and reporting system for a much lower cost than the systems that is now custom made for these facilities. This will greatly increase the quality of accountancy at these facilities and the quality of the reporting to IAEA and other state offices etc. The software is based on our advanced custom made software series 'STAR' that has been in use in many places for more than a decade with successful use. (author)

Generic penetration in the retail atypical antipsychotic market.

Science.gov (United States)

Lenderts, Susan; Kalali, Amir H; Buckley, Peter

2010-03-01

In this article, we explore the penetration of generic atypical antipsychotics in the United States market before and after the availability of generic risperidone in July 2008. Analysis suggests that, overall, generic penetration into the atypical antipsychotic market has grown from approximately three percent in January 2008 to more than 25 percent in December 2009. Similar trends are uncovered when branded and generic prescriptions are analyzed by specialty.

The generic structures and lexico-grammaticality in English ...

African Journals Online (AJOL)

To this end, the generic structures, as well as lexicogrammaticality systems inbuilt in introduction sections of English academic research papers of three different disciplines, linguistics, chemistry and software engineering, were explored. To collect the data, a corpus consisting of 90 papers, 30 for each discipline, published ...

Predicting hospital-acquired infections by scoring system with simple parameters.

Directory of Open Access Journals (Sweden)

Ying-Jui Chang

Full Text Available BACKGROUND: Hospital-acquired infections (HAI are associated with increased attributable morbidity, mortality, prolonged hospitalization, and economic costs. A simple, reliable prediction model for HAI has great clinical relevance. The objective of this study is to develop a scoring system to predict HAI that was derived from Logistic Regression (LR and validated by Artificial Neural Networks (ANN simultaneously. METHODOLOGY/PRINCIPAL FINDINGS: A total of 476 patients from all the 806 HAI inpatients were included for the study between 2004 and 2005. A sample of 1,376 non-HAI inpatients was randomly drawn from all the admitted patients in the same period of time as the control group. External validation of 2,500 patients was abstracted from another academic teaching center. Sixteen variables were extracted from the Electronic Health Records (EHR and fed into ANN and LR models. With stepwise selection, the following seven variables were identified by LR models as statistically significant: Foley catheterization, central venous catheterization, arterial line, nasogastric tube, hemodialysis, stress ulcer prophylaxes and systemic glucocorticosteroids. Both ANN and LR models displayed excellent discrimination (area under the receiver operating characteristic curve [AUC]: 0.964 versus 0.969, p = 0.507 to identify infection in internal validation. During external validation, high AUC was obtained from both models (AUC: 0.850 versus 0.870, p = 0.447. The scoring system also performed extremely well in the internal (AUC: 0.965 and external (AUC: 0.871 validations. CONCLUSIONS: We developed a scoring system to predict HAI with simple parameters validated with ANN and LR models. Armed with this scoring system, infectious disease specialists can more efficiently identify patients at high risk for HAI during hospitalization. Further, using parameters either by observation of medical devices used or data obtained from EHR also provided good prediction

Comparison of adherence to generic multi-tablet regimens vs. brand multi-tablet and brand single-tablet regimens likely to incorporate generic antiretroviral drugs by breaking or not fixed-dose combinations in HIV-infected patients.

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Rwagitinywa, Joseph; Lapeyre-Mestre, Maryse; Bourrel, Robert; Montastruc, Jean-Louis; Sommet, Agnès

2018-03-05

Adherence to antiretroviral (ARV) is crucial to achieve viral load suppression in HIV-infected patients. This study aimed to compare adherence to generic multi-tablet regimens (MTR) vs. brand MTR likely to incorporate ARV drugs without breaking fixed-dose combinations (FDC) and brand single-tablet regimens (STR) likely to incorporate generics by breaking the FDC. Patients aged of 18 years or over exposed to one of the generic or the brand of lamivudine (3TC), zidovudine/lamivudine (AZT/TC), nevirapine (NVP), or efavirenz (EFV), or the brand STR of efavirenz/emtricitabine/tenofovir (EFV/FTC/TDF). Adherence was measured by medication possession ratio (MPR) using both defined daily dose (DDD) and daily number of tablet recommended for adults (DNT). Adherence to generic MTR vs. brand MTR and brand STR was compared using Kruskal-Wallis. The overall median adherence was 0.97 (IQR 0.13) by DNT method and 0.97 (0.14) by DDD method. Adherence in patients exposed to generic MTR (n = 165) vs. brand MTR (n = 481) and brand STR (n = 470) was comparable by DNT and DDD methods. In conclusion, adherence to generic MTR was high and comparable with adherence to brand MTR and to STR. Utilization of DDD instead DNT to measure the MPR led to small but nonsignificant difference that has no clinical impact. © 2018 Société Française de Pharmacologie et de Thérapeutique.

A generic flexible and robust approach for intelligent real-time video-surveillance systems

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Desurmont, Xavier; Delaigle, Jean-Francois; Bastide, Arnaud; Macq, Benoit

2004-05-01

In this article we present a generic, flexible and robust approach for an intelligent real-time video-surveillance system. A previous version of the system was presented in [1]. The goal of these advanced tools is to provide help to operators by detecting events of interest in visual scenes and highlighting alarms and compute statistics. The proposed system is a multi-camera platform able to handle different standards of video inputs (composite, IP, IEEE1394 ) and which can basically compress (MPEG4), store and display them. This platform also integrates advanced video analysis tools, such as motion detection, segmentation, tracking and interpretation. The design of the architecture is optimised to playback, display, and process video flows in an efficient way for video-surveillance application. The implementation is distributed on a scalable computer cluster based on Linux and IP network. It relies on POSIX threads for multitasking scheduling. Data flows are transmitted between the different modules using multicast technology and under control of a TCP-based command network (e.g. for bandwidth occupation control). We report here some results and we show the potential use of such a flexible system in third generation video surveillance system. We illustrate the interest of the system in a real case study, which is the indoor surveillance.

Are Branded and Generic Extended-Release Ropinirole Formulations Equally Efficacious? A Rater-Blinded, Switch-Over, Multicenter Study

Directory of Open Access Journals (Sweden)

Edit Bosnyák

2014-01-01

Full Text Available The aim of this study was to compare the efficacy of the branded and a generic extended-release ropinirole formulation in the treatment of advanced Parkinson’s disease (PD. Of 22 enrolled patients 21 completed the study. A rater blinded to treatment evaluated Unified Parkinson’s Disease Rating Scale, Fahn-Tolosa-Marin Tremor Rating Scale, Nonmotor Symptoms Assessment Scale, and a structured questionnaire on ropinirole side effects. Besides, the patients self-administered EQ-5D, Parkinson’s Disease Sleep Scale (PDSS-2, and Beck Depression Inventories. Branded and generic ropinirole treatment achieved similar scores on all tests measuring severity of motor symptoms (primary endpoint, UPDRS-III: 27.0 versus 28.0 points, P=0.505. Based on patient diaries, the lengths of “good time periods” were comparable (10.5 and 10.0 hours for branded and generic ropinirole, resp., P=0.670. However, generic ropinirole therapy achieved almost 3.0 hours shorter on time without dyskinesia (6.5 versus. 9.5 hours, P<0.05 and 2.5 hours longer on time with slight dyskinesia (3.5 versus. 1.0 hours, P<0.05 than the branded ropinirole did. Except for gastrointestinal problems, nonmotor symptoms were similarly controlled. Patients did not prefer either formulation. Although this study has to be interpreted with limitations, it demonstrated that both generic and branded ropinirole administration can achieve similar control on most symptoms of PD.

Modified PADSS (Post Anaesthetic Discharge Scoring System) for monitoring outpatients discharge.

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Palumbo, Piergaspare; Tellan, Guglielmo; Perotti, Bruno; Pacilè, Maria Antonietta; Vietri, Francesco; Illuminati, Giulio

2013-01-01

The decision to discharge a patient undergoing day surgery is a major step in the hospitalization pathway, because it must be achieved without compromising the quality of care, thus ensuring the same assistance and wellbeing as for a long-term stay. Therefore, the use of an objective assessment for the management of a fair and safe discharge is essential. The authors propose the Post Anaesthetic Discharge Scoring System (PADSS), which considers six criteria: vital signs, ambulation, nausea/vomiting, pain, bleeding and voiding. Each criterion is given a score ranging from 0 to 2. Only patients who achieve a score of 9 or more are considered ready for discharge. Furthermore, PADSS has been modified to ensure a higher level of safety, thus the "vital signs" criteria must never score lower than 2, and none of the other five criteria must ever be equal to 0, even if the total score reaches 9. The effectiveness of PADSS was analyzed on 2432 patients, by recording the incidence of postoperative complications and the readmission to hospital. So far PADDS has proved to be an efficient system that guarantees safe discharge.

40 CFR 721.2083 - Polysubstituted carbomonocyclic hydroxylamine (generic).

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2010-07-01

... hydroxylamine (generic). 721.2083 Section 721.2083 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Specific Chemical Substances § 721.2083 Polysubstituted carbomonocyclic hydroxylamine (generic). (a... generically as a polysubstituted carbomonocyclic hydroxylamine (PMN P-97-878) is subject to reporting under...

Sharing, samples, and generics: an antitrust framework.

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Carrier, Michael A

Rising drug prices are in the news. By increasing price, drug companies have placed vital, even life-saving, medicines out of the reach of consumers. In a recent development, brand firms have prevented generics even from entering the market. The ruse for this strategy involves risk-management programs known as Risk Evaluation and Mitigation Strategies ("REMS"). Pursuant to legislation enacted in 2007, the FDA requires REMS when a drug's risks (such as death or injury) outweigh its rewards. Brands have used this regime, intended to bring drugs to the market, to block generic competition. Regulations such as the federal Hatch-Waxman Act and state substitution laws foster widespread generic competition. But these regimes can only be effectuated through generic entry. And that entry can take place only if a generic can use a brand's sample to show that its product is equivalent. More than 100 generic firms have complained that they have not been able to access needed samples. One study of 40 drugs subject to restricted access programs found that generics' inability to enter cost more than $5 billion a year. Brand firms have contended that antitrust law does not compel them to deal with their competitors and have highlighted concerns related to safety and product liability in justifying their refusals. This Article rebuts these claims. It highlights the importance of samples in the regulatory regime and the FDA's inability to address the issue. It shows how a sharing requirement in this setting is consistent with Supreme Court caselaw. And it demonstrates that the brands' behavior fails the defendant-friendly "no economic sense" test because the conduct literally makes no sense other than by harming generics. Brands' denial of samples offers a textbook case of monopolization. In the universe of pharmaceutical antitrust behavior, other conduct--such as "pay for delay" settlements between brands and generics and "product hopping" from one drug to a slightly modified

Development and validation of a prognostic scoring system for patients with chronic myelomonocytic leukemia.

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Such, Esperanza; Germing, Ulrich; Malcovati, Luca; Cervera, José; Kuendgen, Andrea; Della Porta, Matteo G; Nomdedeu, Benet; Arenillas, Leonor; Luño, Elisa; Xicoy, Blanca; Amigo, Mari L; Valcarcel, David; Nachtkamp, Kathrin; Ambaglio, Ilaria; Hildebrandt, Barbara; Lorenzo, Ignacio; Cazzola, Mario; Sanz, Guillermo

2013-04-11

The natural course of chronic myelomonocytic leukemia (CMML) is highly variable but a widely accepted prognostic scoring system for patients with CMML is not available. The main aim of this study was to develop a new CMML-specific prognostic scoring system (CPSS) in a large series of 558 patients with CMML (training cohort, Spanish Group of Myelodysplastic Syndromes) and to validate it in an independent series of 274 patients (validation cohort, Heinrich Heine University Hospital, Düsseldorf, Germany, and San Matteo Hospital, Pavia, Italy). The most relevant variables for overall survival (OS) and evolution to acute myeloblastic leukemia (AML) were FAB and WHO CMML subtypes, CMML-specific cytogenetic risk classification, and red blood cell (RBC) transfusion dependency. CPSS was able to segregate patients into 4 clearly different risk groups for OS (P < .001) and risk of AML evolution (P < .001) and its predictive capability was confirmed in the validation cohort. An alternative CPSS with hemoglobin instead of RBC transfusion dependency offered almost identical prognostic capability. This study confirms the prognostic impact of FAB and WHO subtypes, recognizes the importance of RBC transfusion dependency and cytogenetics, and offers a simple and powerful CPSS for accurately assessing prognosis and planning therapy in patients with CMML.

An Internet of Things Generic Reference Architecture

DEFF Research Database (Denmark)

Bhalerao, Dipashree M.; Riaz, Tahir; Madsen, Ole Brun

2013-01-01

Internet of things Network is a future application of Internet. This network has three major basic blocks as business process or Application, core network or internetwork and peripheral network as Things or objects. The assembly has the basic intention of connecting all physical and virtual things......, and keeping track of all these things for monitoring and controlling some information. IoT architecture is studied from software architecture, overall system architecture and network architecture point of view. Paper puts forward the requirements of software architecture along with, its component...... and deployment diagram, process and interface diagram at abstract level. Paper proposes the abstract generic IoT reference and concrete abstract generic IoT reference architectures. Network architecture is also put up as a state of the art. Paper shortly gives overviews of protocols used for IoT. Some...