Cogeneration technologies, optimisation and implementation

CERN Document Server

Frangopoulos, Christos A

2017-01-01

Cogeneration refers to the use of a power station to deliver two or more useful forms of energy, for example, to generate electricity and heat at the same time. This book provides an integrated treatment of cogeneration, including a tour of the available technologies and their features, and how these systems can be analysed and optimised.

Optimisation of pH of cadmium chloride post-growth-treatment in processing CDS/CDTE based thin film solar cells

OpenAIRE

Ojo, A. A.; Dharmadasa, I

2017-01-01

The role of Chlorine-based activation in the production of high quality CdS/CdTe photovoltaic have been well discussed and explored with an overlook of the effect of Cadmium chloride (CdCl2) post-growth treatment acidity on the property of the fabricated devices. This work focuses on the optimisation of CdCl2 post-growth treatment pH as it affects both the material and fabricated device properties of all-electrodeposited multilayer glass/FTO/n-CdS/n-CdTe/p-CdTe configuration. CdCl2 treatments...

Optimisation of surgical care for rectal cancer

NARCIS (Netherlands)

Borstlap, W.A.A.

2017-01-01

Optimisation of surgical care means weighing the risk of treatment related morbidity against the patients’ potential benefits of a surgical intervention. The first part of this thesis focusses on the anaemic patient undergoing colorectal surgery. Hypothesizing that a more profound haemoglobin

Beam position optimisation for IMRT

International Nuclear Information System (INIS)

Holloway, L.; Hoban, P.

2001-01-01

Full text: The introduction of IMRT has not generally resulted in the use of optimised beam positions because to find the global solution of the problem a time consuming stochastic optimisation method must be used. Although a deterministic method may not achieve the global minimum it should achieve a superior dose distribution compared to no optimisation. This study aimed to develop and test such a method. The beam optimisation method developed relies on an iterative process to achieve the desired number of beams from a large initial number of beams. The number of beams is reduced in a 'weeding-out' process based on the total fluence which each beam delivers. The process is gradual, with only three beams removed each time (following a small number of iterations), ensuring that the reduction in beams does not dramatically affect the fluence maps of those remaining. A comparison was made between the dose distributions achieved when the beams positions were optimised in this fashion and when the beams positions were evenly distributed. The method has been shown to work quite effectively and efficiently. The Figure shows a comparison in dose distribution with optimised and non optimised beam positions for 5 beams. It can be clearly seen that there is an improvement in the dose distribution delivered to the tumour and a reduction in the dose to the critical structure with beam position optimisation. A method for beam position optimisation for use in IMRT optimisations has been developed. This method although not necessarily achieving the global minimum in beam position still achieves quite a dramatic improvement compared with no beam position optimisation and is very efficiently achieved. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

Advanced optimisation - coal fired power plant operations

Energy Technology Data Exchange (ETDEWEB)

Turney, D.M.; Mayes, I. [E.ON UK, Nottingham (United Kingdom)

2005-03-01

The purpose of this unit optimization project is to develop an integrated approach to unit optimisation and develop an overall optimiser that is able to resolve any conflicts between the individual optimisers. The individual optimisers have been considered during this project are: on-line thermal efficiency package, GNOCIS boiler optimiser, GNOCIS steam side optimiser, ESP optimisation, and intelligent sootblowing system. 6 refs., 7 figs., 3 tabs.

Combining simulation and multi-objective optimisation for equipment quantity optimisation in container terminals

OpenAIRE

Lin, Zhougeng

2013-01-01

This thesis proposes a combination framework to integrate simulation and multi-objective optimisation (MOO) for container terminal equipment optimisation. It addresses how the strengths of simulation and multi-objective optimisation can be integrated to find high quality solutions for multiple objectives with low computational cost. Three structures for the combination framework are proposed respectively: pre-MOO structure, integrated MOO structure and post-MOO structure. The applications of ...

Optimisation of the Laser Cutting Process

DEFF Research Database (Denmark)

Dragsted, Birgitte; Olsen, Flemmming Ove

1996-01-01

The problem in optimising the laser cutting process is outlined. Basic optimisation criteria and principles for adapting an optimisation method, the simplex method, are presented. The results of implementing a response function in the optimisation are discussed with respect to the quality as well...

Association between health systems performance and treatment outcomes in patients co-infected with MDR-TB and HIV in KwaZulu-Natal, South Africa: implications for TB programmes.

Directory of Open Access Journals (Sweden)

Marian Loveday

Full Text Available To improve the treatment of MDR-TB and HIV co-infected patients, we investigated the relationship between health system performance and patient treatment outcomes at 4 decentralised MDR-TB sites.In this mixed methods case study which included prospective comparative data, we measured health system performance using a framework of domains comprising key health service components. Using Pearson Product Moment Correlation coefficients we quantified the direction and magnitude of the association between health system performance and MDR-TB treatment outcomes. Qualitative data from participant observation and interviews analysed using systematic text condensation (STC complemented our quantitative findings.We found significant differences in treatment outcomes across the sites with successful outcomes varying from 72% at Site 1 to 52% at Site 4 (p<0.01. Health systems performance scores also varied considerably across the sites. Our findings suggest there is a correlation between treatment outcomes and overall health system performance which is significant (r = 0.99, p<0.01, with Site 1 having the highest number of successful treatment outcomes and the highest health system performance. Although the 'integration' domain, which measured integration of MDR-TB services into existing services appeared to have the strongest association with successful treatment outcomes (r = 0.99, p<0.01, qualitative data indicated that the 'context' domain influenced the other domains.We suggest that there is an association between treatment outcomes and health system performance. The chance of treatment success is greater if decentralised MDR-TB services are integrated into existing services. To optimise successful treatment outcomes, regular monitoring and support are needed at a district, facility and individual level to ensure the local context is supportive of new programmes and implementation is according to guidelines.

Simulation optimisation

International Nuclear Information System (INIS)

Anon

2010-01-01

Over the past decade there has been a significant advance in flotation circuit optimisation through performance benchmarking using metallurgical modelling and steady-state computer simulation. This benchmarking includes traditional measures, such as grade and recovery, as well as new flotation measures, such as ore floatability, bubble surface area flux and froth recovery. To further this optimisation, Outotec has released its HSC Chemistry software with simulation modules. The flotation model developed by the AMIRA P9 Project, of which Outotec is a sponsor, is regarded by industry as the most suitable flotation model to use for circuit optimisation. This model incorporates ore floatability with flotation cell pulp and froth parameters, residence time, entrainment and water recovery. Outotec's HSC Sim enables you to simulate mineral processes in different levels, from comminution circuits with sizes and no composition, through to flotation processes with minerals by size by floatability components, to full processes with true particles with MLA data.

Optimising resource management in neurorehabilitation.

Science.gov (United States)

Wood, Richard M; Griffiths, Jeff D; Williams, Janet E; Brouwers, Jakko

2014-01-01

To date, little research has been published regarding the effective and efficient management of resources (beds and staff) in neurorehabilitation, despite being an expensive service in limited supply. To demonstrate how mathematical modelling can be used to optimise service delivery, by way of a case study at a major 21 bed neurorehabilitation unit in the UK. An automated computer program for assigning weekly treatment sessions is developed. Queue modelling is used to construct a mathematical model of the hospital in terms of referral submissions to a waiting list, admission and treatment, and ultimately discharge. This is used to analyse the impact of hypothetical strategic decisions on a variety of performance measures and costs. The project culminates in a hybridised model of these two approaches, since a relationship is found between the number of therapy hours received each week (scheduling output) and length of stay (queuing model input). The introduction of the treatment scheduling program has substantially improved timetable quality (meaning a better and fairer service to patients) and has reduced employee time expended in its creation by approximately six hours each week (freeing up time for clinical work). The queuing model has been used to assess the effect of potential strategies, such as increasing the number of beds or employing more therapists. The use of mathematical modelling has not only optimised resources in the short term, but has allowed the optimality of longer term strategic decisions to be assessed.

Optimisation of platelet concentrates therapy: Composition, localisation, and duration of action

Directory of Open Access Journals (Sweden)

Yuk-Lin Yung

2017-01-01

Full Text Available Platelet concentrates (PC generally refers to a group of products that are prepared from autologous blood intended to enhance healing activities. PC therapy is now very popular in treating musculoskeletal injuries; however, inconsistent clinical results urge the need to understand the working mechanism of PC. It is generally believed that the platelet-derived bioactive factors are the active constituents, and their bioavailability in the vicinity of the lesion sites determines the treatment efficacies. Therefore, the composition, localisation, and duration of the action of PC would be key determinants. In this review, we discuss how different preparations and delivery methods of PC would affect the treatment outcomes with respect to clinical evidence about PC therapy for osteoarthritis, tendinopathies, rotator cuff tears, anterior cruciate ligament injuries, and bone fractures. This review can be used as a quick guide for the use of PC therapy and provide insights for the further optimisation of the therapy in the near future.

A framework for inverse planning of beam-on times for 3D small animal radiotherapy using interactive multi-objective optimisation

International Nuclear Information System (INIS)

Balvert, Marleen; Den Hertog, Dick; Van Hoof, Stefan J; Granton, Patrick V; Trani, Daniela; Hoffmann, Aswin L; Verhaegen, Frank

2015-01-01

Advances in precision small animal radiotherapy hardware enable the delivery of increasingly complicated dose distributions on the millimeter scale. Manual creation and evaluation of treatment plans becomes difficult or even infeasible with an increasing number of degrees of freedom for dose delivery and available image data. The goal of this work is to develop an optimisation model that determines beam-on times for a given beam configuration, and to assess the feasibility and benefits of an automated treatment planning system for small animal radiotherapy.The developed model determines a Pareto optimal solution using operator-defined weights for a multiple-objective treatment planning problem. An interactive approach allows the planner to navigate towards, and to select the Pareto optimal treatment plan that yields the most preferred trade-off of the conflicting objectives. This model was evaluated using four small animal cases based on cone-beam computed tomography images. Resulting treatment plan quality was compared to the quality of manually optimised treatment plans using dose-volume histograms and metrics.Results show that the developed framework is well capable of optimising beam-on times for 3D dose distributions and offers several advantages over manual treatment plan optimisation. For all cases but the simple flank tumour case, a similar amount of time was needed for manual and automated beam-on time optimisation. In this time frame, manual optimisation generates a single treatment plan, while the inverse planning system yields a set of Pareto optimal solutions which provides quantitative insight on the sensitivity of conflicting objectives. Treatment planning automation decreases the dependence on operator experience and allows for the use of class solutions for similar treatment scenarios. This can shorten the time required for treatment planning and therefore increase animal throughput. In addition, this can improve treatment standardisation and

Biomass supply chain optimisation for Organosolv-based biorefineries.

Science.gov (United States)

Giarola, Sara; Patel, Mayank; Shah, Nilay

2014-05-01

This work aims at providing a Mixed Integer Linear Programming modelling framework to help define planning strategies for the development of sustainable biorefineries. The up-scaling of an Organosolv biorefinery was addressed via optimisation of the whole system economics. Three real world case studies were addressed to show the high-level flexibility and wide applicability of the tool to model different biomass typologies (i.e. forest fellings, cereal residues and energy crops) and supply strategies. Model outcomes have revealed how supply chain optimisation techniques could help shed light on the development of sustainable biorefineries. Feedstock quality, quantity, temporal and geographical availability are crucial to determine biorefinery location and the cost-efficient way to supply the feedstock to the plant. Storage costs are relevant for biorefineries based on cereal stubble, while wood supply chains present dominant pretreatment operations costs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Optimised Renormalisation Group Flows

CERN Document Server

Litim, Daniel F

2001-01-01

Exact renormalisation group (ERG) flows interpolate between a microscopic or classical theory and the corresponding macroscopic or quantum effective theory. For most problems of physical interest, the efficiency of the ERG is constrained due to unavoidable approximations. Approximate solutions of ERG flows depend spuriously on the regularisation scheme which is determined by a regulator function. This is similar to the spurious dependence on the ultraviolet regularisation known from perturbative QCD. Providing a good control over approximated ERG flows is at the root for reliable physical predictions. We explain why the convergence of approximate solutions towards the physical theory is optimised by appropriate choices of the regulator. We study specific optimised regulators for bosonic and fermionic fields and compare the optimised ERG flows with generic ones. This is done up to second order in the derivative expansion at both vanishing and non-vanishing temperature. An optimised flow for a ``proper-time ren...

Computer Based Optimisation Rutines

DEFF Research Database (Denmark)

Dragsted, Birgitte; Olsen, Flemmming Ove

1996-01-01

In this paper the need for optimisation methods for the laser cutting process has been identified as three different situations. Demands on the optimisation methods for these situations are presented, and one method for each situation is suggested. The adaptation and implementation of the methods...

Optimal Optimisation in Chemometrics

NARCIS (Netherlands)

Hageman, J.A.

2004-01-01

The use of global optimisation methods is not straightforward, especially for the more difficult optimisation problems. Solutions have to be found for items such as the evaluation function, representation, step function and meta-parameters, before any useful results can be obtained. This thesis aims

One-year results of the use of endovenous radiofrequency ablation utilising an optimised radiofrequency-induced thermotherapy protocol for the treatment of truncal superficial venous reflux.

Science.gov (United States)

Badham, George E; Dos Santos, Scott J; Lloyd, Lucinda Ba; Holdstock, Judy M; Whiteley, Mark S

2018-06-01

Background In previous in vitro and ex vivo studies, we have shown increased thermal spread can be achieved with radiofrequency-induced thermotherapy when using a low power and slower, discontinuous pullback. We aimed to determine the clinical success rate of radiofrequency-induced thermotherapy using this optimised protocol for the treatment of superficial venous reflux in truncal veins. Methods Sixty-three patients were treated with radiofrequency-induced thermotherapy using the optimised protocol and were followed up after one year (mean 16.3 months). Thirty-five patients returned for audit, giving a response rate of 56%. Duplex ultrasonography was employed to check for truncal reflux and compared to initial scans. Results In the 35 patients studied, there were 48 legs, with 64 truncal veins treated by radiofrequency-induced thermotherapy (34 great saphenous, 15 small saphenous and 15 anterior accessory saphenous veins). One year post-treatment, complete closure of all previously refluxing truncal veins was demonstrated on ultrasound, giving a success rate of 100%. Conclusions Using a previously reported optimised, low power/slow pullback radiofrequency-induced thermotherapy protocol, we have shown it is possible to achieve a 100% ablation at one year. This compares favourably with results reported at one year post-procedure using the high power/fast pullback protocols that are currently recommended for this device.

Infrastructure optimisation via MBR retrofit: a design guide.

Science.gov (United States)

Bagg, W K

2009-01-01

Wastewater management is continually evolving with the development and implementation of new, more efficient technologies. One of these is the Membrane Bioreactor (MBR). Although a relatively new technology in Australia, MBR wastewater treatment has been widely used elsewhere for over 20 years, with thousands of MBRs now in operation worldwide. Over the past 5 years, MBR technology has been enthusiastically embraced in Australia as a potential treatment upgrade option, and via retrofit typically offers two major benefits: (1) more capacity using mostly existing facilities, and (2) very high quality treated effluent. However, infrastructure optimisation via MBR retrofit is not a simple or low-cost solution and there are many factors which should be carefully evaluated before deciding on this method of plant upgrade. The paper reviews a range of design parameters which should be carefully evaluated when considering an MBR retrofit solution. Several actual and conceptual case studies are considered to demonstrate both advantages and disadvantages. Whilst optimising existing facilities and production of high quality water for reuse are powerful drivers, it is suggested that MBRs are perhaps not always the most sustainable Whole-of-Life solution for a wastewater treatment plant upgrade, especially by way of a retrofit.

Outcome of Minnesota's gambling treatment programs.

Science.gov (United States)

Stinchfield, R; Winters, K C

2001-01-01

This study measured the outcome of four state-supported outpatient gambling treatment programs in Minnesota. The programs were developed specifically for the treatment of pathological gamblers and offered multiple modalities of treatment including individual, group, education, twelve-step work, family groups, and financial counseling. The therapeutic orientation was eclectic with an emphasis on the twelve steps of Gamblers Anonymous (GA) and a treatment goal of abstinence. The sample included 348 men and 220 women treated between January 1992 and January 1995. A pretest-posttest design was utilized with multidimensional assessments obtained at intake, discharge, six-months, and twelve-months post-discharge. Variables assessed included a range of clinical and outcome variables. At six month follow-up, 28% reported that they had abstained from gambling during the six months following discharge and an additional 20% had gambled less than once per month. Almost half of the sample (48%) showed clinically significant improvement in gambling frequency at six month follow-up. Outcome variables of gambling frequency, SOGS scores, amount of money gambled, number of friends who gamble, psychosocial problems, and number of financial problems, all showed statistically significant improvements from pretreatment to follow-up. The treatment programs yielded outcome results similar to those reported for alcohol and drug abuse treatment programs.

Water quality modelling and optimisation of wastewater treatment network using mixed integer programming

CSIR Research Space (South Africa)

Mahlathi, Christopher

2016-10-01

Full Text Available Instream water quality management encompasses field monitoring and utilisation of mathematical models. These models can be coupled with optimisation techniques to determine more efficient water quality management alternatives. Among these activities...

Treatment Outcomes and Efficacy in the Schools.

Science.gov (United States)

Logemann, Jeri A.

1998-01-01

Introduces six articles which address treatment outcomes and efficacy in audiology and speech-language pathology in the schools. Stresses the importance of practitioners participating in studies of treatment outcomes and efficacy to demonstrate that their evaluations and treatments make a significant difference to individuals served. (DB)

Multi-Optimisation Consensus Clustering

Science.gov (United States)

Li, Jian; Swift, Stephen; Liu, Xiaohui

Ensemble Clustering has been developed to provide an alternative way of obtaining more stable and accurate clustering results. It aims to avoid the biases of individual clustering algorithms. However, it is still a challenge to develop an efficient and robust method for Ensemble Clustering. Based on an existing ensemble clustering method, Consensus Clustering (CC), this paper introduces an advanced Consensus Clustering algorithm called Multi-Optimisation Consensus Clustering (MOCC), which utilises an optimised Agreement Separation criterion and a Multi-Optimisation framework to improve the performance of CC. Fifteen different data sets are used for evaluating the performance of MOCC. The results reveal that MOCC can generate more accurate clustering results than the original CC algorithm.

Particle swarm optimisation classical and quantum perspectives

CERN Document Server

Sun, Jun; Wu, Xiao-Jun

2016-01-01

IntroductionOptimisation Problems and Optimisation MethodsRandom Search TechniquesMetaheuristic MethodsSwarm IntelligenceParticle Swarm OptimisationOverviewMotivationsPSO Algorithm: Basic Concepts and the ProcedureParadigm: How to Use PSO to Solve Optimisation ProblemsSome Harder Examples Some Variants of Particle Swarm Optimisation Why Does the PSO Algorithm Need to Be Improved? Inertia and Constriction-Acceleration Techniques for PSOLocal Best ModelProbabilistic AlgorithmsOther Variants of PSO Quantum-Behaved Particle Swarm Optimisation OverviewMotivation: From Classical Dynamics to Quantum MechanicsQuantum Model: Fundamentals of QPSOQPSO AlgorithmSome Essential ApplicationsSome Variants of QPSOSummary Advanced Topics Behaviour Analysis of Individual ParticlesConvergence Analysis of the AlgorithmTime Complexity and Rate of ConvergenceParameter Selection and PerformanceSummaryIndustrial Applications Inverse Problems for Partial Differential EquationsInverse Problems for Non-Linear Dynamical SystemsOptimal De...

Evolutionary programming for neutron instrument optimisation

Energy Technology Data Exchange (ETDEWEB)

Bentley, Phillip M. [Hahn-Meitner Institut, Glienicker Strasse 100, D-14109 Berlin (Germany)]. E-mail: phillip.bentley@hmi.de; Pappas, Catherine [Hahn-Meitner Institut, Glienicker Strasse 100, D-14109 Berlin (Germany); Habicht, Klaus [Hahn-Meitner Institut, Glienicker Strasse 100, D-14109 Berlin (Germany); Lelievre-Berna, Eddy [Institut Laue-Langevin, 6 rue Jules Horowitz, BP 156, 38042 Grenoble Cedex 9 (France)

2006-11-15

Virtual instruments based on Monte-Carlo techniques are now integral part of novel instrumentation development and the existing codes (McSTAS and Vitess) are extensively used to define and optimise novel instrumental concepts. Neutron spectrometers, however, involve a large number of parameters and their optimisation is often a complex and tedious procedure. Artificial intelligence algorithms are proving increasingly useful in such situations. Here, we present an automatic, reliable and scalable numerical optimisation concept based on the canonical genetic algorithm (GA). The algorithm was used to optimise the 3D magnetic field profile of the NSE spectrometer SPAN, at the HMI. We discuss the potential of the GA which combined with the existing Monte-Carlo codes (Vitess, McSTAS, etc.) leads to a very powerful tool for automated global optimisation of a general neutron scattering instrument, avoiding local optimum configurations.

Evolutionary programming for neutron instrument optimisation

International Nuclear Information System (INIS)

Bentley, Phillip M.; Pappas, Catherine; Habicht, Klaus; Lelievre-Berna, Eddy

2006-01-01

Virtual instruments based on Monte-Carlo techniques are now integral part of novel instrumentation development and the existing codes (McSTAS and Vitess) are extensively used to define and optimise novel instrumental concepts. Neutron spectrometers, however, involve a large number of parameters and their optimisation is often a complex and tedious procedure. Artificial intelligence algorithms are proving increasingly useful in such situations. Here, we present an automatic, reliable and scalable numerical optimisation concept based on the canonical genetic algorithm (GA). The algorithm was used to optimise the 3D magnetic field profile of the NSE spectrometer SPAN, at the HMI. We discuss the potential of the GA which combined with the existing Monte-Carlo codes (Vitess, McSTAS, etc.) leads to a very powerful tool for automated global optimisation of a general neutron scattering instrument, avoiding local optimum configurations

Topology optimised wavelength dependent splitters

DEFF Research Database (Denmark)

Hede, K. K.; Burgos Leon, J.; Frandsen, Lars Hagedorn

A photonic crystal wavelength dependent splitter has been constructed by utilising topology optimisation1. The splitter has been fabricated in a silicon-on-insulator material (Fig. 1). The topology optimised wavelength dependent splitter demonstrates promising 3D FDTD simulation results....... This complex photonic crystal structure is very sensitive against small fabrication variations from the expected topology optimised design. A wavelength dependent splitter is an important basic building block for high-performance nanophotonic circuits. 1J. S. Jensen and O. Sigmund, App. Phys. Lett. 84, 2022...

Auto-optimisation for three-dimensional conformal radiotherapy of nasopharyngeal carcinoma

Energy Technology Data Exchange (ETDEWEB)

Wu, V.W.C. E-mail: orvinwu@polyu.edu.hk; Kwong, D.W.L.; Sham, J.S.T.; Mui, A.W.L

2003-08-01

Purpose: The purpose of this study was to evaluate the application of auto-optimisation in the treatment planning of three-dimensional conformal radiotherapy (3DCRT) of nasopharyngeal carcinoma (NPC). Methods: Twenty-nine NPC patients were planned by both forward planning and auto-optimisation methods. The forward plans, which consisted of three coplanar facial fields, were produced according to the routine planning criteria. The auto-optimised plans, which consisted of 5-15 (median 9) fields, were generated by the planning system after prescribing the dose requirements and the importance weightings of the planning target volume and organs at risk. Plans produced by the two planning methods were compared by the dose volume histogram, tumour control probability (TCP), conformity index and normal tissue complication probability (NTCP). Results: The auto-optimised plans reduced the average planner's time by over 35 min. It demonstrated better TCP and conformity index than the forward plans (P=0.03 and 0.04, respectively). Besides, the parotid gland and temporo-mandibular (TM) joint were better spared with the mean dose reduction of 31.8 and 17.7%, respectively. The slight trade off was the mild dose increase in spinal cord and brain stem with their maximum doses remaining within the tolerance limits. Conclusions: The findings demonstrated the potentials of auto-optimisation for improving target dose and parotid sparing in the 3DCRT of NPC with saving of the planner's time.

Auto-optimisation for three-dimensional conformal radiotherapy of nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Wu, V.W.C.; Kwong, D.W.L.; Sham, J.S.T.; Mui, A.W.L.

2003-01-01

Purpose: The purpose of this study was to evaluate the application of auto-optimisation in the treatment planning of three-dimensional conformal radiotherapy (3DCRT) of nasopharyngeal carcinoma (NPC). Methods: Twenty-nine NPC patients were planned by both forward planning and auto-optimisation methods. The forward plans, which consisted of three coplanar facial fields, were produced according to the routine planning criteria. The auto-optimised plans, which consisted of 5-15 (median 9) fields, were generated by the planning system after prescribing the dose requirements and the importance weightings of the planning target volume and organs at risk. Plans produced by the two planning methods were compared by the dose volume histogram, tumour control probability (TCP), conformity index and normal tissue complication probability (NTCP). Results: The auto-optimised plans reduced the average planner's time by over 35 min. It demonstrated better TCP and conformity index than the forward plans (P=0.03 and 0.04, respectively). Besides, the parotid gland and temporo-mandibular (TM) joint were better spared with the mean dose reduction of 31.8 and 17.7%, respectively. The slight trade off was the mild dose increase in spinal cord and brain stem with their maximum doses remaining within the tolerance limits. Conclusions: The findings demonstrated the potentials of auto-optimisation for improving target dose and parotid sparing in the 3DCRT of NPC with saving of the planner's time

Optimising Magnetostatic Assemblies

DEFF Research Database (Denmark)

Insinga, Andrea Roberto; Smith, Anders

theorem. This theorem formulates an energy equivalence principle with several implications concerning the optimisation of objective functionals that are linear with respect to the magnetic field. Linear functionals represent different optimisation goals, e.g. maximising a certain component of the field...... approached employing a heuristic algorithm, which led to new design concepts. Some of the procedures developed for linear objective functionals have been extended to non-linear objectives, by employing iterative techniques. Even though most the optimality results discussed in this work have been derived...

Biofuels carbon footprints: Whole-systems optimisation for GHG emissions reduction.

Science.gov (United States)

Zamboni, Andrea; Murphy, Richard J; Woods, Jeremy; Bezzo, Fabrizio; Shah, Nilay

2011-08-01

A modelling approach for strategic design of ethanol production systems combining lifecycle analysis (LCA) and supply chain optimisation (SCO) can significantly contribute to assess their economic and environmental sustainability and to guide decision makers towards a more conscious implementation of ad hoc farming and processing practices. Most models applications so far have been descriptive in nature; the model proposed in this work is "normative" in that it aims to guide actions towards optimal outcomes (e.g. optimising the nitrogen balance through the whole supply chain). The modelling framework was conceived to steer strategic policies through a geographically specific design process considering economic and environmental criteria. Results shows how a crop management strategy devised from a whole systems perspective can significantly contribute to mitigate global warming even in first generation technologies. Copyright © 2011 Elsevier Ltd. All rights reserved.

Family Connections versus optimised treatment-as-usual for family members of individuals with borderline personality disorder: non-randomised controlled study.

LENUS (Irish Health Repository)

Flynn, Daniel

2017-01-01

Borderline personality disorder (BPD) is challenging for family members who are often required to fulfil multiple roles such as those of advocate, caregiver, coach and guardian. To date, two uncontrolled studies by the treatment developers suggest that Family Connections (FC) is an effective programme to support, educate and teach skills to family members of individuals with BPD. However, such studies have been limited by lack of comparison to other treatment approaches. This study aimed to compare the effectiveness of FC with an optimised treatment-as-usual (OTAU) programme for family members of individuals with BPD. A secondary aim was to introduce a long term follow-up to investigate if positive gains from the intervention would be maintained following programme completion.

Optimising the physicochemical treatment of textile effluents by supplementing it with biological processes; Optimizacion de la depuracion fisocoquimica en efluentes textiles, completandola con procesos biologicos

Energy Technology Data Exchange (ETDEWEB)

Crespi Rosell, M. [Instituto de Investigacion Textil y Cooperacion Industrial de Tarrasa (Spain)

1999-07-01

This article sets out how to increase the elimination of organic material in physicochemical coagulation/flocculation processes. It describes the optimisation of a coagulation/flocculation waste water treatment plant in a flock dyeing factory through increasing the biological activity in the homogenization pond by supplementing it with a percolating filter. Other modifications made subsequently to physicochemical waste water treatment plants for the same purpose are also described. (Author) 9 refs.

Assessing the outcomes of HIV-infected persons receiving treatment for Kaposi sarcoma in Conakry-Guinea.

Science.gov (United States)

Bekolo, Cavin E; Soumah, Mohamed M; Tiemtore, Ousseni W; Diallo, Abdourahimi; Yuma, Joseph-Desire; Di Stefano, Letizia; Metcalf, Carol; Cisse, Mohamed

2017-12-02

Médecins Sans Frontières is supporting comprehensive HIV care and treatment for Kaposi Sarcoma (KS) in Guinea, where antiretroviral coverage is low and access to KS treatment is very limited. We aimed to evaluate treatment response and survival outcomes of epidemic KS in this setting. Retrospective survival analysis of routinely collected clinical data of HIV-infected patients with clinically diagnosed KS, receiving ART and chemotherapy consisting of a combination of bleomycin and vincristine at the Donka National Hospital in Conakry between 2012 and 2015. A total of 225 patients were enrolled for KS treatment within the three-year period. Late presentation with stage T1 disease was common (82.7%). At the end of a median of 8 cycles of chemotherapy (IQR: 2-12), complete remission was observed in 65 (28.9%), partial remission in 53 (23.6%), stable disease in 15 (6.7%) and unknown response for all 92 (40.9%) patients who dropped out of care. The chances of achieving complete remission doubled after each additional cycle of chemotherapy (aOR = 2.09 95% CI: 1.44-3.01) but were reduced by about two-thirds for each additional month delay between treatment and onset of KS (aOR = 0.31, 95% CI: 0.11-0.86). Treatment response was seriously compromised in patients with woody skin oedema (aOR = 0.05, 95% CI: 0.01-0.38) and those with prior chemotherapy (aOR = 0.21, 95% CI: 0.05-0.80). The median survival time was 7.6 months (95% CI: 5.9-9.8). Attrition from care was reduced by 22% for every additional cycle of chemotherapy administered (aH0R = 0.78, 95% CI: 0.71-0.84) and was lower in those with complete remission compared with those with partial or no response (aHR = 0.05, 95% CI: 0.007-0.43). There has been an increased access to KS treatment. The overall response rate is 52.4%, which is considered a satisfactory result. Poor outcomes were common and were largely due to late presentation and defaulting on treatment. Efforts towards early HIV

Optimising Shovel-Truck Fuel Consumption using Stochastic ...

African Journals Online (AJOL)

Optimising the fuel consumption and truck waiting time can result in significant fuel savings. The paper demonstrates that stochastic simulation is an effective tool for optimising the utilisation of fossil-based fuels in mining and related industries. Keywords: Stochastic, Simulation Modelling, Mining, Optimisation, Shovel-Truck ...

Optimising molecular diagnostic capacity for effective control of tuberculosis in high-burden settings.

Science.gov (United States)

Sabiiti, W; Mtafya, B; Kuchaka, D; Azam, K; Viegas, S; Mdolo, A; Farmer, E C W; Khonga, M; Evangelopoulos, D; Honeyborne, I; Rachow, A; Heinrich, N; Ntinginya, N E; Bhatt, N; Davies, G R; Jani, I V; McHugh, T D; Kibiki, G; Hoelscher, M; Gillespie, S H

2016-08-01

The World Health Organization's 2035 vision is to reduce tuberculosis (TB) associated mortality by 95%. While low-burden, well-equipped industrialised economies can expect to see this goal achieved, it is challenging in the low- and middle-income countries that bear the highest burden of TB. Inadequate diagnosis leads to inappropriate treatment and poor clinical outcomes. The roll-out of the Xpert(®) MTB/RIF assay has demonstrated that molecular diagnostics can produce rapid diagnosis and treatment initiation. Strong molecular services are still limited to regional or national centres. The delay in implementation is due partly to resources, and partly to the suggestion that such techniques are too challenging for widespread implementation. We have successfully implemented a molecular tool for rapid monitoring of patient treatment response to anti-tuberculosis treatment in three high TB burden countries in Africa. We discuss here the challenges facing TB diagnosis and treatment monitoring, and draw from our experience in establishing molecular treatment monitoring platforms to provide practical insights into successful optimisation of molecular diagnostic capacity in resource-constrained, high TB burden settings. We recommend a holistic health system-wide approach for molecular diagnostic capacity development, addressing human resource training, institutional capacity development, streamlined procurement systems, and engagement with the public, policy makers and implementers of TB control programmes.

Optimisation of technical specifications using probabilistic methods

International Nuclear Information System (INIS)

Ericsson, G.; Knochenhauer, M.; Hultqvist, G.

1986-01-01

During the last few years the development of methods for modifying and optimising nuclear power plant Technical Specifications (TS) for plant operations has received increased attention. Probalistic methods in general, and the plant and system models of probabilistic safety assessment (PSA) in particular, seem to provide the most forceful tools for optimisation. This paper first gives some general comments on optimisation, identifying important parameters and then gives a description of recent Swedish experiences from the use of nuclear power plant PSA models and results for TS optimisation

Optimising Impact in Astronomy for Development Projects

Science.gov (United States)

Grant, Eli

2015-08-01

Positive outcomes in the fields of science education and international development are notoriously difficult to achieve. Among the challenges facing projects that use astronomy to improve education and socio-economic development is how to optimise project design in order to achieve the greatest possible benefits. Over the past century, medical scientists along with statisticians and economists have progressed an increasingly sophisticated and scientific approach to designing, testing and improving social intervention and public health education strategies. This talk offers a brief review of the history and current state of `intervention science'. A similar framework is then proposed for astronomy outreach and education projects, with applied examples given of how existing evidence can be used to inform project design, predict and estimate cost-effectiveness, minimise the risk of unintended negative consequences and increase the likelihood of target outcomes being achieved.

Turbulence optimisation in stellarator experiments

Energy Technology Data Exchange (ETDEWEB)

Proll, Josefine H.E. [Max-Planck/Princeton Center for Plasma Physics (Germany); Max-Planck-Institut fuer Plasmaphysik, Wendelsteinstr. 1, 17491 Greifswald (Germany); Faber, Benjamin J. [HSX Plasma Laboratory, University of Wisconsin-Madison, Madison, WI 53706 (United States); Helander, Per; Xanthopoulos, Pavlos [Max-Planck/Princeton Center for Plasma Physics (Germany); Lazerson, Samuel A.; Mynick, Harry E. [Plasma Physics Laboratory, Princeton University, P.O. Box 451 Princeton, New Jersey 08543-0451 (United States)

2015-05-01

Stellarators, the twisted siblings of the axisymmetric fusion experiments called tokamaks, have historically suffered from confining the heat of the plasma insufficiently compared with tokamaks and were therefore considered to be less promising candidates for a fusion reactor. This has changed, however, with the advent of stellarators in which the laminar transport is reduced to levels below that of tokamaks by shaping the magnetic field accordingly. As in tokamaks, the turbulent transport remains as the now dominant transport channel. Recent analytical theory suggests that the large configuration space of stellarators allows for an additional optimisation of the magnetic field to also reduce the turbulent transport. In this talk, the idea behind the turbulence optimisation is explained. We also present how an optimised equilibrium is obtained and how it might differ from the equilibrium field of an already existing device, and we compare experimental turbulence measurements in different configurations of the HSX stellarator in order to test the optimisation procedure.

Layout Optimisation of Wave Energy Converter Arrays

DEFF Research Database (Denmark)

Ruiz, Pau Mercadé; Nava, Vincenzo; Topper, Mathew B. R.

2017-01-01

This paper proposes an optimisation strategy for the layout design of wave energy converter (WEC) arrays. Optimal layouts are sought so as to maximise the absorbed power given a minimum q-factor, the minimum distance between WECs, and an area of deployment. To guarantee an efficient optimisation......, a four-parameter layout description is proposed. Three different optimisation algorithms are further compared in terms of performance and computational cost. These are the covariance matrix adaptation evolution strategy (CMA), a genetic algorithm (GA) and the glowworm swarm optimisation (GSO) algorithm...

Topology optimisation of natural convection problems

DEFF Research Database (Denmark)

Alexandersen, Joe; Aage, Niels; Andreasen, Casper Schousboe

2014-01-01

This paper demonstrates the application of the density-based topology optimisation approach for the design of heat sinks and micropumps based on natural convection effects. The problems are modelled under the assumptions of steady-state laminar flow using the incompressible Navier-Stokes equations...... coupled to the convection-diffusion equation through the Boussinesq approximation. In order to facilitate topology optimisation, the Brinkman approach is taken to penalise velocities inside the solid domain and the effective thermal conductivity is interpolated in order to accommodate differences...... in thermal conductivity of the solid and fluid phases. The governing equations are discretised using stabilised finite elements and topology optimisation is performed for two different problems using discrete adjoint sensitivity analysis. The study shows that topology optimisation is a viable approach...

Periodontal treatment for preventing adverse pregnancy outcomes

DEFF Research Database (Denmark)

Schwendicke, Falk; Karimbux, Nadeem; Allareddy, Veerasathpurush

2015-01-01

OBJECTIVES: Periodontal treatment might reduce adverse pregnancy outcomes. The efficacy of periodontal treatment to prevent preterm birth, low birth weight, and perinatal mortality was evaluated using meta-analysis and trial sequential analysis. METHODS: An existing systematic review was updated...... risk of random errors. RESULTS: Thirteen randomized clinical trials evaluating 6283 pregnant women were meta-analyzed. Four and nine trials had low and high risk of bias, respectively. Overall, periodontal treatment had no significant effect on preterm birth (odds ratio [95% confidence interval] 0.......79 [0.57-1.10]) or low birth weight (0.69 [0.43-1.13]). Trial sequential analysis demonstrated that futility was not reached for any of the outcomes. For populations with moderate occurrence (periodontal treatment was not efficacious for any of the outcomes...

Estimating scaled treatment effects with multiple outcomes.

Science.gov (United States)

Kennedy, Edward H; Kangovi, Shreya; Mitra, Nandita

2017-01-01

In classical study designs, the aim is often to learn about the effects of a treatment or intervention on a single outcome; in many modern studies, however, data on multiple outcomes are collected and it is of interest to explore effects on multiple outcomes simultaneously. Such designs can be particularly useful in patient-centered research, where different outcomes might be more or less important to different patients. In this paper, we propose scaled effect measures (via potential outcomes) that translate effects on multiple outcomes to a common scale, using mean-variance and median-interquartile range based standardizations. We present efficient, nonparametric, doubly robust methods for estimating these scaled effects (and weighted average summary measures), and for testing the null hypothesis that treatment affects all outcomes equally. We also discuss methods for exploring how treatment effects depend on covariates (i.e., effect modification). In addition to describing efficiency theory for our estimands and the asymptotic behavior of our estimators, we illustrate the methods in a simulation study and a data analysis. Importantly, and in contrast to much of the literature concerning effects on multiple outcomes, our methods are nonparametric and can be used not only in randomized trials to yield increased efficiency, but also in observational studies with high-dimensional covariates to reduce confounding bias.

Dose optimisation in single plane interstitial brachytherapy

DEFF Research Database (Denmark)

Tanderup, Kari; Hellebust, Taran Paulsen; Honoré, Henriette Benedicte

2006-01-01

patients,       treated for recurrent rectal and cervical cancer, flexible catheters were       sutured intra-operatively to the tumour bed in areas with compromised       surgical margin. Both non-optimised, geometrically and graphically       optimised CT -based dose plans were made. The overdose index...... on the       regularity of the implant, such that the benefit of optimisation was       larger for irregular implants. OI and HI correlated strongly with target       volume limiting the usability of these parameters for comparison of dose       plans between patients. CONCLUSIONS: Dwell time optimisation significantly......BACKGROUND AND PURPOSE: Brachytherapy dose distributions can be optimised       by modulation of source dwell times. In this study dose optimisation in       single planar interstitial implants was evaluated in order to quantify the       potential benefit in patients. MATERIAL AND METHODS: In 14...

Topology Optimisation for Coupled Convection Problems

DEFF Research Database (Denmark)

Alexandersen, Joe

This thesis deals with topology optimisation for coupled convection problems. The aim is to extend and apply topology optimisation to steady-state conjugate heat transfer problems, where the heat conduction equation governs the heat transfer in a solid and is coupled to thermal transport...... in a surrounding uid, governed by a convection-diffusion equation, where the convective velocity field is found from solving the isothermal incompressible steady-state Navier-Stokes equations. Topology optimisation is also applied to steady-state natural convection problems. The modelling is done using stabilised...... finite elements, the formulation and implementation of which was done partly during a special course as prepatory work for this thesis. The formulation is extended with a Brinkman friction term in order to facilitate the topology optimisation of fluid flow and convective cooling problems. The derived...

Rationale, design and baseline results of the Treatment Optimisation in Primary care of Heart failure in the Utrecht region (TOPHU) study : a cluster randomised controlled trial

NARCIS (Netherlands)

Valk, Mark J.; Hoes, Arno W.; Mosterd, Arend; Landman, Marcel A.; Broekhuizen, Berna D L; Rutten, Frans H.

2015-01-01

BACKGROUND: Heart failure (HF) is mainly detected and managed in primary care, but the care is considered suboptimal. We present the rationale, design and baseline results of the Treatment Optimisation in Primary care of Heart failure in the Utrecht region (TOPHU) study. In this study we assess the

Real-time optimisation of the Hoa Binh reservoir, Vietnam

DEFF Research Database (Denmark)

Richaud, Bertrand; Madsen, Henrik; Rosbjerg, Dan

2011-01-01

-time optimisation. First, the simulation-optimisation framework is applied for optimising reservoir operating rules. Secondly, real-time and forecast information is used for on-line optimisation that focuses on short-term goals, such as flood control or hydropower generation, without compromising the deviation...... in the downstream part of the Red River, and at the same time to increase hydropower generation and to save water for the dry season. The real-time optimisation procedure further improves the efficiency of the reservoir operation and enhances the flexibility for the decision-making. Finally, the quality......Multi-purpose reservoirs often have to be managed according to conflicting objectives, which requires efficient tools for trading-off the objectives. This paper proposes a multi-objective simulation-optimisation approach that couples off-line rule curve optimisation with on-line real...

Economic impact of optimising antiretroviral treatment in human immunodeficiency virus-infected adults with suppressed viral load in Spain, by implementing the grade A-1 evidence recommendations of the 2015 GESIDA/National AIDS Plan.

Science.gov (United States)

Ribera, Esteban; Martínez-Sesmero, José Manuel; Sánchez-Rubio, Javier; Rubio, Rafael; Pasquau, Juan; Poveda, José Luis; Pérez-Mitru, Alejandro; Roldán, Celia; Hernández-Novoa, Beatriz

2018-03-01

The objective of this study is to estimate the economic impact associated with the optimisation of triple antiretroviral treatment (ART) in patients with undetectable viral load according to the recommendations from the GeSIDA/PNS (2015) Consensus and their applicability in the Spanish clinical practice. A pharmacoeconomic model was developed based on data from a National Hospital Prescription Survey on ART (2014) and the A-I evidence recommendations for the optimisation of ART from the GeSIDA/PNS (2015) consensus. The optimisation model took into account the willingness to optimise a particular regimen and other assumptions, and the results were validated by an expert panel in HIV infection (Infectious Disease Specialists and Hospital Pharmacists). The analysis was conducted from the NHS perspective, considering the annual wholesale price and accounting for deductions stated in the RD-Law 8/2010 and the VAT. The expert panel selected six optimisation strategies, and estimated that 10,863 (13.4%) of the 80,859 patients in Spain currently on triple ART, would be candidates to optimise their ART, leading to savings of €15.9M/year (2.4% of total triple ART drug cost). The most feasible strategies (>40% of patients candidates for optimisation, n=4,556) would be optimisations to ATV/r+3TC therapy. These would produce savings between €653 and €4,797 per patient per year depending on baseline triple ART. Implementation of the main optimisation strategies recommended in the GeSIDA/PNS (2015) Consensus into Spanish clinical practice would lead to considerable savings, especially those based in dual therapy with ATV/r+3TC, thus contributing to the control of pharmaceutical expenditure and NHS sustainability. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Optimisation of the Management of Higher Activity Waste in the UK - 13537

Energy Technology Data Exchange (ETDEWEB)

Walsh, Ciara; Buckley, Matthew [Nuclear Decommissioning Authority, Building 587, Curie Avenue, Harwell Oxford, Didcot, Oxfordshire, OX11 0RH (United Kingdom)

2013-07-01

The Upstream Optioneering project was created in the Nuclear Decommissioning Authority (UK) to support the development and implementation of significant opportunities to optimise activities across all the phases of the Higher Activity Waste management life cycle (i.e. retrieval, characterisation, conditioning, packaging, storage, transport and disposal). The objective of the Upstream Optioneering project is to work in conjunction with other functions within NDA and the waste producers to identify and deliver solutions to optimise the management of higher activity waste. Historically, optimisation may have occurred on aspects of the waste life cycle (considered here to include retrieval, conditioning, treatment, packaging, interim storage, transport to final end state, which may be geological disposal). By considering the waste life cycle as a whole, critical analysis of assumed constraints may lead to cost savings for the UK Tax Payer. For example, it may be possible to challenge the requirements for packaging wastes for disposal to deliver an optimised waste life cycle. It is likely that the challenges faced in the UK are shared in other countries. It is therefore likely that the opportunities identified may also apply elsewhere, with the potential for sharing information to enable value to be shared. (authors)

Treatment agreement, adherence, and outcome in cognitive behavioral treatments for insomnia.

Science.gov (United States)

Dong, Lu; Soehner, Adriane M; Bélanger, Lynda; Morin, Charles M; Harvey, Allison G

2018-03-01

Patient adherence has been identified as an important barrier to the implementation of evidence-based psychological treatments. In cognitive behavioral treatments (CBT) for insomnia, the current study examined (a) the validity of therapist ratings of patient agreement and adherence against an established behavioral measure of adherence, and (b) the relationship between treatment agreement, adherence, and outcome. Participants were 188 adults meeting DSM-IV-TR criteria for chronic insomnia who were randomized to receive behavior therapy, cognitive therapy, or CBT for insomnia. Treatment agreement/adherence was measured by (a) weekly therapist ratings of patient agreement and homework completion, and (b) adherence to behavioral strategies (ABS) derived from patient-reported sleep diary. Outcome measures were Insomnia Severity Index and insomnia remission (Insomnia Severity Index adherence, and ABS measures during treatment significantly predicted insomnia remission at posttreatment, and all but therapist rating of homework completion predicted remission at 6-month follow-up. Greater patient agreement and adherence (therapist ratings and ABS) during treatment predicted better treatment outcome. Therapist-rated treatment agreement and adherence correspond well with patient-reported sleep diary-derived adherence measure. These simple, deployable therapist-rated patient agreement and adherence can potentially be useful for treatments for other disorders. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Efficient topology optimisation of multiscale and multiphysics problems

DEFF Research Database (Denmark)

Alexandersen, Joe

The aim of this Thesis is to present efficient methods for optimising high-resolution problems of a multiscale and multiphysics nature. The Thesis consists of two parts: one treating topology optimisation of microstructural details and the other treating topology optimisation of conjugate heat...

Methods for Optimisation of the Laser Cutting Process

DEFF Research Database (Denmark)

Dragsted, Birgitte

This thesis deals with the adaptation and implementation of various optimisation methods, in the field of experimental design, for the laser cutting process. The problem in optimising the laser cutting process has been defined and a structure for at Decision Support System (DSS......) for the optimisation of the laser cutting process has been suggested. The DSS consists of a database with the currently used and old parameter settings. Also one of the optimisation methods has been implemented in the DSS in order to facilitate the optimisation procedure for the laser operator. The Simplex Method has...... been adapted in two versions. A qualitative one, that by comparing the laser cut items optimise the process and a quantitative one that uses a weighted quality response in order to achieve a satisfactory quality and after that maximises the cutting speed thus increasing the productivity of the process...

Design of optimised backstepping controller for the synchronisation ...

Indian Academy of Sciences (India)

Ehsan Fouladi

2017-12-18

Dec 18, 2017 ... for the proposed optimised method compared to PSO optimised controller or any non-optimised backstepping controller. Keywords. Colpitts oscillator; backstepping controller; chaos synchronisation; shark smell algorithm; particle .... The velocity model is based on the gradient of the objective function, tilting ...

Management and treatment outcomes of patients enrolled in MDR-TB treatment in Viet Nam.

Science.gov (United States)

Phuong, N T M; Nhung, N V; Hoa, N B; Thuy, H T; Takarinda, K C; Tayler-Smith, K; Harries, A D

2016-03-21

The programmatic management of drug-resistant tuberculosis (TB) in Viet Nam has been rapidly scaled up since 2009. To document the annual numbers of patients enrolled for multidrug-resistant tuberculosis (MDR-TB) treatment during 2010-2014 and to determine characteristics and treatment outcomes of patients initiating treatment during 2010-2012. A retrospective cohort study using national reports and data from the national electronic data system for drug-resistant TB. The number of patients enrolled annually for MDR-TB treatment increased from 97 in 2010 to 1522 in 2014. The majority of patients were middle-aged men who had pulmonary disease and had failed a retreatment regimen; 77% had received ⩾2 courses of TB treatment. Favourable outcomes (cured and treatment completed) were attained in 73% of patients. Unfavourable outcomes included loss to follow-up (12.5%), death (8%) and failure (6.3%). Having had ⩾2 previous treatment courses and being human immunodeficiency virus-positive were associated with unfavourable outcomes. Increasing numbers of patients are being treated for MDR-TB each year with good treatment outcomes under national programme management in Viet Nam. However, there is a need to increase case detection-currently at 30% of the estimated 5100 MDR-TB cases per year, reduce adverse outcomes and improve monitoring and evaluation.

Extending Particle Swarm Optimisers with Self-Organized Criticality

DEFF Research Database (Denmark)

Løvbjerg, Morten; Krink, Thiemo

2002-01-01

Particle swarm optimisers (PSOs) show potential in function optimisation, but still have room for improvement. Self-organized criticality (SOC) can help control the PSO and add diversity. Extending the PSO with SOC seems promising reaching faster convergence and better solutions.......Particle swarm optimisers (PSOs) show potential in function optimisation, but still have room for improvement. Self-organized criticality (SOC) can help control the PSO and add diversity. Extending the PSO with SOC seems promising reaching faster convergence and better solutions....

Improving Vector Evaluated Particle Swarm Optimisation by incorporating nondominated solutions.

Science.gov (United States)

Lim, Kian Sheng; Ibrahim, Zuwairie; Buyamin, Salinda; Ahmad, Anita; Naim, Faradila; Ghazali, Kamarul Hawari; Mokhtar, Norrima

2013-01-01

The Vector Evaluated Particle Swarm Optimisation algorithm is widely used to solve multiobjective optimisation problems. This algorithm optimises one objective using a swarm of particles where their movements are guided by the best solution found by another swarm. However, the best solution of a swarm is only updated when a newly generated solution has better fitness than the best solution at the objective function optimised by that swarm, yielding poor solutions for the multiobjective optimisation problems. Thus, an improved Vector Evaluated Particle Swarm Optimisation algorithm is introduced by incorporating the nondominated solutions as the guidance for a swarm rather than using the best solution from another swarm. In this paper, the performance of improved Vector Evaluated Particle Swarm Optimisation algorithm is investigated using performance measures such as the number of nondominated solutions found, the generational distance, the spread, and the hypervolume. The results suggest that the improved Vector Evaluated Particle Swarm Optimisation algorithm has impressive performance compared with the conventional Vector Evaluated Particle Swarm Optimisation algorithm.

Treatment and Outcomes of Aspergillosis

Science.gov (United States)

... Testing Treatment & Outcomes Health Professionals Statistics More Resources Candidiasis Candida infections of the mouth, throat, and esophagus Vaginal candidiasis Invasive candidiasis Definition Symptoms Risk & Prevention Sources Diagnosis ...

Layout Optimisation of Wave Energy Converter Arrays

Directory of Open Access Journals (Sweden)

Pau Mercadé Ruiz

2017-08-01

Full Text Available This paper proposes an optimisation strategy for the layout design of wave energy converter (WEC arrays. Optimal layouts are sought so as to maximise the absorbed power given a minimum q-factor, the minimum distance between WECs, and an area of deployment. To guarantee an efficient optimisation, a four-parameter layout description is proposed. Three different optimisation algorithms are further compared in terms of performance and computational cost. These are the covariance matrix adaptation evolution strategy (CMA, a genetic algorithm (GA and the glowworm swarm optimisation (GSO algorithm. The results show slightly higher performances for the latter two algorithms; however, the first turns out to be significantly less computationally demanding.

Personality disorder and treatment outcome in alcohol use disorder.

Science.gov (United States)

Newton-Howes, Giles; Foulds, James

2018-01-01

As personality disorder impacts the outcome of most major mental disorders, it would be consistent for it to impact negatively on the outcome of alcohol use disorders (AUDs). This update is to provide an up-to-date overview of the recent literature examining the impact of personality disorder and personality traits on the treatment outcome of AUDs. Comorbidity between personality disorder and AUD is significant and approaches 50%. Patients with AUD and comorbid personality disorder are substantially less likely to remain in treatment, drink more per drinking day and drink more frequently. If retained in treatment, comorbidity does not, however, lead to poorer outcomes. Relapse to drinking is more common in patient with high novelty seeking and lower reward dependence and persistence. Reporting from most studies is of moderate-to-poor quality and a single high-quality study may alter these findings. Landmark alcohol studies are notably quiet on the impact of personality on AUD treatment outcome. Both personality disorder and higher novelty seeking impact negatively on the treatment outcome of AUD. As personality disorder is common in this group, clinicians engaged in AUD treatment should screen for personality disturbance, either disorder or high novelty seeking.

Involuntary admission may support treatment outcome and motivation in patients receiving assertive community treatment.

Science.gov (United States)

Kortrijk, Hans Erik; Staring, A B P; van Baars, A W B; Mulder, C L

2010-02-01

Patients with severe mental illness who are treated in assertive community treatment (ACT) teams are sometimes involuntarily admitted when they are dangerous to themselves or others, and are not motivated for treatment. However, the consequences of involuntary admission in terms of psychosocial outcome and treatment motivation are largely unknown. We hypothesized that involuntary admission would improve psychosocial outcome and not adversely affect their treatment motivation. In the context of routine 6-monthly outcome monitoring in the period January 2003-March 2008, we used the Health of the Nation Outcome Scales (HoNOS) and a motivation-for-treatment scale to assess 260 severely mentally ill patients at risk for involuntary admission. Mixed models with repeated measures were used for data analyses. During the observation period, 77 patients (30%) were involuntarily admitted. Relative to patients who were not involuntarily admitted, these patients improved significantly in HoNOS total scores (F = 17,815, df = 1, p < 0.001) and in motivation for treatment (F = 28.139, df = 1, p < 0.001). Patients who were not involuntarily admitted had better HoNOS and motivation scores at baseline, but did not improve. Involuntary admission in the context of ACT was associated with improvements in psychosocial outcome and motivation for treatment. There are no indications that involuntary admission leads to deterioration in psychosocial outcome or worsening of motivation for treatment.

Optimisation of key performance measures in air cargo demand management

OpenAIRE

Alexander May; Adrian Anslow; Udechukwu Ojiako; Yue Wu; Alasdair Marshall; Maxwell Chipulu

2014-01-01

This article sought to facilitate the optimisation of key performance measures utilised for demand management in air cargo operations. The focus was on the Revenue Management team at Virgin Atlantic Cargo and a fuzzy group decision-making method was used. Utilising intelligent fuzzy multi-criteria methods, the authors generated a ranking order of ten key outcome-based performance indicators for Virgin Atlantic air cargo Revenue Management. The result of this industry-driven study showed that ...

Improving Vector Evaluated Particle Swarm Optimisation by Incorporating Nondominated Solutions

Directory of Open Access Journals (Sweden)

Kian Sheng Lim

2013-01-01

Full Text Available The Vector Evaluated Particle Swarm Optimisation algorithm is widely used to solve multiobjective optimisation problems. This algorithm optimises one objective using a swarm of particles where their movements are guided by the best solution found by another swarm. However, the best solution of a swarm is only updated when a newly generated solution has better fitness than the best solution at the objective function optimised by that swarm, yielding poor solutions for the multiobjective optimisation problems. Thus, an improved Vector Evaluated Particle Swarm Optimisation algorithm is introduced by incorporating the nondominated solutions as the guidance for a swarm rather than using the best solution from another swarm. In this paper, the performance of improved Vector Evaluated Particle Swarm Optimisation algorithm is investigated using performance measures such as the number of nondominated solutions found, the generational distance, the spread, and the hypervolume. The results suggest that the improved Vector Evaluated Particle Swarm Optimisation algorithm has impressive performance compared with the conventional Vector Evaluated Particle Swarm Optimisation algorithm.

Optimising intratumoral treatment of head and neck squamous cell carcinoma models with the diterpene ester Tigilanol tiglate.

Science.gov (United States)

Barnett, Catherine M E; Broit, Natasa; Yap, Pei-Yi; Cullen, Jason K; Parsons, Peter G; Panizza, Benedict J; Boyle, Glen M

2018-04-18

The five-year survival rate for patients with head and neck squamous cell carcinoma (HNSCC) has remained at ~50% for the past 30 years despite advances in treatment. Tigilanol tiglate (TT, also known as EBC-46) is a novel diterpene ester that induces cell death in HNSCC in vitro and in mouse models, and has recently completed Phase I human clinical trials. The aim of this study was to optimise efficacy of TT treatment by altering different administration parameters. The tongue SCC cell line (SCC-15) was identified as the line with the lowest efficacy to treatment. Subcutaneous xenografts of SCC-15 cells were grown in BALB/c Foxn1 nu and NOD/SCID mice and treated with intratumoral injection of 30 μg TT or a vehicle only control (40% propylene glycol (PG)). Greater efficacy of TT treatment was found in the BALB/c Foxn1 nu mice compared to NOD/SCID mice. Immunohistochemical analysis indicated a potential role of the host's innate immune system in this difference, specifically neutrophil infiltration. Neither fractionated doses of TT nor the use of a different excipiant led to significantly increased efficacy. This study confirmed that TT in 40% PG given intratumorally as a single bolus dose was the most efficacious treatment for a tongue SCC mouse model.

Barriers to Implementing Treatment Integrity Procedures: Survey of Treatment Outcome Researchers

Science.gov (United States)

Perepletchikova, Francheska; Hilt, Lori M.; Chereji, Elizabeth; Kazdin, Alan E.

2009-01-01

Treatment integrity refers to implementing interventions as intended. Treatment integrity is critically important for experimental validity and for drawing valid inferences regarding the relationship between treatment and outcome. Yet, it is rarely adequately addressed in psychotherapy research. The authors examined barriers to treatment integrity…

Optimised electroporation mediated DNA vaccination for treatment of prostate cancer.

LENUS (Irish Health Repository)

Ahmad, Sarfraz

2010-01-01

, preventing tumour occurrence in 54% of treated animals. Vaccination with phPSA resulted in anti-hPSA Abs production and a significant production of IFNgamma was observed in immunised animals (p < 0.05). Immune responses were tumour specific and were transferable in adoptive T cell transfer experiments. CONCLUSIONS: This phPSA plasmid electroporation vaccination strategy can effectively activate tumour specific immune responses. Optimisation of the approach indicated that a four-dose regimen provided highest tumour protection. In vivo electroporation mediated vaccination is a safe and effective modality for the treatment of prostate cancer and has a potential to be used as a neo-adjuvant or adjuvant therapy.

Treatment Outcome of Tuberculosis Patients under Directly Observed Treatment Short Course and Factors Affecting Outcome in Southern Ethiopia: A Five-Year Retrospective Study.

Directory of Open Access Journals (Sweden)

Gebremedhin Gebrezgabiher

Full Text Available Tuberculosis (TB is one of the major public health and socio-economic issues in the 21st century globally. Assessment of TB treatment outcomes, and monitoring and evaluation of its risk factors in Directly Observed Treatment Short Course (DOTS are among the major indicators of the performance of a national TB control program. Hence, this institution-based retrospective study was conducted to determine the treatment outcome of TB patients and investigate factors associated with unsuccessful outcome at Dilla University Referral Hospital, southern Ethiopia. Five years (2008 to 2013 TB record of TB clinic of the hospital was reviewed. A total 1537 registered TB patients with complete information were included. Of these, 942 (61.3% were male, 1015 (66% were from rural areas, 544 (35.4% were smear positive pulmonary TB (PTB+, 816 (53.1% were smear negative pulmonary TB (PTB- and 177(11.5% were extra pulmonary TB (EPTB patients. Records of the 1537 TB patients showed that 181 (11.8% were cured, 1129(73.5% completed treatment, 171 (11.1% defaulted, 52 (3.4% died and 4 (0.3% had treatment failure. The overall mean treatment success rate of the TB patients was 85.2%. The treatment success rate of the TB patients increased from 80.5% in September 2008-August 2009 to 84.8% in September 2012-May 2013. Tuberculosis type, age, residence and year of treatment were significantly associated with unsuccessful treatment outcome. The risk of unsuccessful outcome was significantly higher among TB patients from rural areas (AOR = 1.63, 95% CI: 1.21-2.20 compared to their urban counterparts. Unsuccessful treatment outcome was also observed in PTB- patients (AOR = 1.77, 95% CI: 1.26-2.50 and EPTB (AOR = 2.07, 95% CI: 1.28-3.37 compared to the PTB+ patients. In conclusion, it appears that DOTS have improved treatment success in the hospital during five years. Regular follow-up of patients with poor treatment outcome and provision of health information on TB treatment to

An Optimisation Approach for Room Acoustics Design

DEFF Research Database (Denmark)

Holm-Jørgensen, Kristian; Kirkegaard, Poul Henning; Andersen, Lars

2005-01-01

This paper discuss on a conceptual level the value of optimisation techniques in architectural acoustics room design from a practical point of view. It is chosen to optimise one objective room acoustics design criterium estimated from the sound field inside the room. The sound field is modeled...... using the boundary element method where absorption is incorporated. An example is given where the geometry of a room is defined by four design modes. The room geometry is optimised to get a uniform sound pressure....

Optimisation: how to develop stake holder involvement

International Nuclear Information System (INIS)

Weiss, W.

2003-01-01

The Precautionary Principle is an internationally recognised approach for dealing with risk situations characterised by uncertainties and potential irreversible damages. Since the late fifties, ICRP has adopted this prudent attitude because of the lack of scientific evidence concerning the existence of a threshold at low doses for stochastic effects. The 'linear, no-threshold' model and the 'optimisation of protection' principle have been developed as a pragmatic response for the management of the risk. The progress in epidemiology and radiobiology over the last decades have affirmed the initial assumption and the optimisation remains the appropriate response for the application of the precautionary principle in the context of radiological protection. The basic objective of optimisation is, for any source within the system of radiological protection, to maintain the level of exposure as low as reasonably achievable, taking into account social and economical factors. Methods tools and procedures have been developed over the last two decades to put into practice the optimisation principle with a central role given to the cost-benefit analysis as a means to determine the optimised level of protection. However, with the advancement in the implementation of the principle more emphasis was progressively given to good practice, as well as on the importance of controlling individual levels of exposure through the optimisation process. In the context of the revision of its present recommendations, the Commission is reenforcing the emphasis on protection of the individual with the adoption of an equity-based system that recognizes individual rights and a basic level of health protection. Another advancement is the role that is now recognised to 'stakeholders involvement' in the optimisation process as a mean to improve the quality of the decision aiding process for identifying and selecting protection actions considered as being accepted by all those involved. The paper

Statistical meandering wake model and its application to yaw-angle optimisation of wind farms

International Nuclear Information System (INIS)

Thøgersen, E; Tranberg, B; Greiner, M; Herp, J

2017-01-01

The wake produced by a wind turbine is dynamically meandering and of rather narrow nature. Only when looking at large time averages, the wake appears to be static and rather broad, and is then well described by simple engineering models like the Jensen wake model (JWM). We generalise the latter deterministic models to a statistical meandering wake model (SMWM), where a random directional deflection is assigned to a narrow wake in such a way that on average it resembles a broad Jensen wake. In a second step, the model is further generalised to wind-farm level, where the deflections of the multiple wakes are treated as independently and identically distributed random variables. When carefully calibrated to the Nysted wind farm, the ensemble average of the statistical model produces the same wind-direction dependence of the power efficiency as obtained from the standard Jensen model. Upon using the JWM to perform a yaw-angle optimisation of wind-farm power output, we find an optimisation gain of 6.7% for the Nysted wind farm when compared to zero yaw angles and averaged over all wind directions. When applying the obtained JWM-based optimised yaw angles to the SMWM, the ensemble-averaged gain is calculated to be 7.5%. This outcome indicates the possible operational robustness of an optimised yaw control for real-life wind farms. (paper)

Statistical meandering wake model and its application to yaw-angle optimisation of wind farms

Science.gov (United States)

Thøgersen, E.; Tranberg, B.; Herp, J.; Greiner, M.

2017-05-01

The wake produced by a wind turbine is dynamically meandering and of rather narrow nature. Only when looking at large time averages, the wake appears to be static and rather broad, and is then well described by simple engineering models like the Jensen wake model (JWM). We generalise the latter deterministic models to a statistical meandering wake model (SMWM), where a random directional deflection is assigned to a narrow wake in such a way that on average it resembles a broad Jensen wake. In a second step, the model is further generalised to wind-farm level, where the deflections of the multiple wakes are treated as independently and identically distributed random variables. When carefully calibrated to the Nysted wind farm, the ensemble average of the statistical model produces the same wind-direction dependence of the power efficiency as obtained from the standard Jensen model. Upon using the JWM to perform a yaw-angle optimisation of wind-farm power output, we find an optimisation gain of 6.7% for the Nysted wind farm when compared to zero yaw angles and averaged over all wind directions. When applying the obtained JWM-based optimised yaw angles to the SMWM, the ensemble-averaged gain is calculated to be 7.5%. This outcome indicates the possible operational robustness of an optimised yaw control for real-life wind farms.

Psychosocial predictors of treatment outcome for trauma-affected refugees

Directory of Open Access Journals (Sweden)

Charlotte Sonne

2016-05-01

Full Text Available Background: The effects of treatment in trials with trauma-affected refugees vary considerably not only between studies but also between patients within a single study. However, we know little about why some patients benefit more from treatment, as few studies have analysed predictors of treatment outcome. Objective: The objective of the study was to examine possible psychosocial predictors of treatment outcome for trauma-affected refugees. Method: The participants were 195 adult refugees with posttraumatic stress disorder (PTSD who were enrolled in a 6- to 7-month treatment programme at the Competence Centre for Transcultural Psychiatry (CTP, Denmark. The CTP Predictor Index used in the study included 15 different possible outcome predictors concerning the patients’ past, chronicity of mental health problems, pain, treatment motivation, prerequisites for engaging in psychotherapy, and social situation. The primary outcome measure was PTSD symptoms measured on the Harvard Trauma Questionnaire (HTQ. Other outcome measures included the Hopkins Symptom Check List-25, the WHO-5 Well-being Index, Sheehan Disability Scale, Hamilton Depression and Anxiety Scales, the somatisation scale of the Symptoms Checklist-90, Global Assessment of Functioning scales, and pain rated on visual analogue scales. The relations between treatment outcomes and the total score as well as subscores of the CTP Predictor Index were analysed. Results: Overall, the total score of the CTP Predictor Index was significantly correlated to pre- to post treatment score changes on the majority of the ratings mentioned above. While employment status was the only single item significantly correlated to HTQ-score changes, a number of single items from the CTP Predictor Index correlated significantly with changes in depression and anxiety symptoms, but the size of the correlation coefficients were modest. Conclusions: The total score of the CTP Predictor Index correlated significantly

Results of the 2010 IGSC Topical Session on Optimisation

International Nuclear Information System (INIS)

Bailey, Lucy

2014-01-01

Document available in abstract form only. Full text follows: The 2010 IGSC topical session on optimisation explored a wide range of issues concerning optimisation throughout the radioactive waste management process. Philosophical and ethical questions were discussed, such as: - To what extent is the process of optimisation more important than the end result? - How do we balance long-term environmental safety with near-term operational safety? - For how long should options be kept open? - In balancing safety and excessive cost, when is BAT achieved and who decides on this? * How should we balance the needs of current society with those of future generations? It was clear that optimisation is about getting the right balance between a range of issues that cover: radiation protection, environmental protection, operational safety, operational requirements, social expectations and cost. The optimisation process will also need to respect various constraints, which are likely to include: regulatory requirements, site restrictions, community-imposed requirements or restrictions and resource constraints. These issues were explored through a number of presentations that discussed practical cases of optimisation occurring at different stages of international radioactive waste management programmes. These covered: - Operations and decommissioning - management of large disused components, from the findings of an international study, presented by WPDD; - Concept option selection, prior to site selection - upstream and disposal system optioneering in the UK; - Siting decisions - examples from both Germany and France, explaining how optimisation is being used to support site comparisons and communicate siting decisions; - Repository design decisions - comparison of KBS-3 horizontal and vertical deposition options in Finland; and - On-going optimisation during repository operation - operational experience from WIPP in the US. The variety of the remarks and views expressed during the

Optimisation on processing parameters for minimising warpage on side arm using response surface methodology (RSM) and particle swarm optimisation (PSO)

Science.gov (United States)

Rayhana, N.; Fathullah, M.; Shayfull, Z.; Nasir, S. M.; Hazwan, M. H. M.; Sazli, M.; Yahya, Z. R.

2017-09-01

This study presents the application of optimisation method to reduce the warpage of side arm part. Autodesk Moldflow Insight software was integrated into this study to analyse the warpage. The design of Experiment (DOE) for Response Surface Methodology (RSM) was constructed and by using the equation from RSM, Particle Swarm Optimisation (PSO) was applied. The optimisation method will result in optimised processing parameters with minimum warpage. Mould temperature, melt temperature, packing pressure, packing time and cooling time was selected as the variable parameters. Parameters selection was based on most significant factor affecting warpage stated by previous researchers. The results show that warpage was improved by 28.16% for RSM and 28.17% for PSO. The warpage improvement in PSO from RSM is only by 0.01 %. Thus, the optimisation using RSM is already efficient to give the best combination parameters and optimum warpage value for side arm part. The most significant parameters affecting warpage are packing pressure.

The association between patient-therapist MATRIX congruence and treatment outcome.

Science.gov (United States)

Mendlovic, Shlomo; Saad, Amit; Roll, Uri; Ben Yehuda, Ariel; Tuval-Mashiah, Rivka; Atzil-Slonim, Dana

2018-03-14

The present study aimed to examine the association between patient-therapist micro-level congruence/incongruence ratio and psychotherapeutic outcome. Nine good- and nine poor-outcome psychodynamic treatments (segregated by comparing pre- and post-treatment BDI-II) were analyzed (N = 18) moment by moment using the MATRIX (total number of MATRIX codes analyzed = 11,125). MATRIX congruence was defined as similar adjacent MATRIX codes. the congruence/incongruence ratio tended to increase as the treatment progressed only in good-outcome treatments. Progression of MATRIX codes' congruence/incongruence ratio is associated with good outcome of psychotherapy.

Conducting Systematic Outcome Assessment in Private Addictions Treatment Settings

Directory of Open Access Journals (Sweden)

Gerard J Connors

2017-07-01

Full Text Available Systematic outcome assessment is central to ascertaining the impact of treatment services and to informing future treatment initiatives. This project was designed to be conducted within the clinical operations of 4 private addictions treatment centers. A structured interview was used to assess patients’ alcohol and other drug use and related variables (on treatment entry and at 1, 3, and 6 months following treatment discharge. The primary outcomes were percentage of days abstinent (PDA from alcohol and drugs, PDA from alcohol, and PDA from other drugs. Collateral reports during follow-up also were gathered. A total of 280 patients (56% men across the 4 programs participated. Percentage of days abstinent for each outcome increased significantly from baseline to the 1-month follow-up assessment, and this change was maintained at the 3- and 6-month follow-up assessments. Collateral reports mirrored the patient follow-up reports. Secondary outcomes of patient ratings of urges/cravings, depression, anxiety, and general life functioning all indicated significant improvement from baseline over the course of the follow-up. The results suggest the feasibility of conducting systematic outcome assessment in freestanding private addictions treatment environments.

Treatment outcomes of using inhalation sedation for comprehensive dental care.

Science.gov (United States)

Madouh, M; BaniHani, A; Tahmassebi, J F

2018-02-01

To assess the outcomes of dental treatment under inhalation sedation within a UK specialist hospital setting. This was a retrospective cohort study of the case notes of patients under 17 years of age who received dental treatment using inhalation sedation at a UK specialist setting during the period 2006-2011. Treatment outcomes were categorised into five groups: (1) treatment completed as planned, (2) modified treatment completed, (3) treatment abandoned in sedation unit and patient referred for treatment under general analgesia (GA), (4) treatment abandoned in sedation unit and patient referred for treatment under local analgesia (LA), (5) child failed to return to complete treatment. In total, the case notes of 453 patients were evaluated. The mean age of the patients was 10.3 ± 2.9 years. Treatment was completed successfully in 63.6% of the cases, 15.9% were referred for treatment under GA, 11.2% failed to return to complete the treatment, 7.1% received modified treatment completed, and only 2.2% were referred for treatment under LA. Treatment outcomes were significantly associated with patient`s age (p = 0.002). The treatment outcome "treatment abandoned and child referred to be treated under GA" had significantly lower mean patient ages than the other outcomes. The majority of children referred for inhalation sedation, completed their course of treatment. A significantly higher proportion of those in the younger age group required GA to complete their treatment.

(MBO) algorithm in multi-reservoir system optimisation

African Journals Online (AJOL)

A comparative study of marriage in honey bees optimisation (MBO) algorithm in ... A practical application of the marriage in honey bees optimisation (MBO) ... to those of other evolutionary algorithms, such as the genetic algorithm (GA), ant ...

Mechatronic System Design Based On An Optimisation Approach

DEFF Research Database (Denmark)

Andersen, Torben Ole; Pedersen, Henrik Clemmensen; Hansen, Michael Rygaard

The envisaged objective of this paper project is to extend the current state of the art regarding the design of complex mechatronic systems utilizing an optimisation approach. We propose to investigate a novel framework for mechatronic system design. The novelty and originality being the use...... of optimisation techniques. The methods used to optimise/design within the classical disciplines will be identified and extended to mechatronic system design....

Optimisation of Investment Resources at Small Enterprises

Directory of Open Access Journals (Sweden)

Shvets Iryna B.

2014-03-01

Full Text Available The goal of the article lies in the study of the process of optimisation of the structure of investment resources, development of criteria and stages of optimisation of volumes of investment resources for small enterprises by types of economic activity. The article characterises the process of transformation of investment resources into assets and liabilities of the balances of small enterprises and conducts calculation of the structure of sources of formation of investment resources in Ukraine at small enterprises by types of economic activity in 2011. On the basis of the conducted analysis of the structure of investment resources of small enterprises the article forms main groups of criteria of optimisation in the context of individual small enterprises by types of economic activity. The article offers an algorithm and step-by-step scheme of optimisation of investment resources at small enterprises in the form of a multi-stage process of management of investment resources in the context of increase of their mobility and rate of transformation of existing resources into investments. The prospect of further studies in this direction is development of a structural and logic scheme of optimisation of volumes of investment resources at small enterprises.

Warpage optimisation on the moulded part with straight-drilled and conformal cooling channels using response surface methodology (RSM) and glowworm swarm optimisation (GSO)

Science.gov (United States)

Hazwan, M. H. M.; Shayfull, Z.; Sharif, S.; Nasir, S. M.; Zainal, N.

2017-09-01

In injection moulding process, quality and productivity are notably important and must be controlled for each product type produced. Quality is measured as the extent of warpage of moulded parts while productivity is measured as a duration of moulding cycle time. To control the quality, many researchers have introduced various of optimisation approaches which have been proven enhanced the quality of the moulded part produced. In order to improve the productivity of injection moulding process, some of researches have proposed the application of conformal cooling channels which have been proven reduced the duration of moulding cycle time. Therefore, this paper presents an application of alternative optimisation approach which is Response Surface Methodology (RSM) with Glowworm Swarm Optimisation (GSO) on the moulded part with straight-drilled and conformal cooling channels mould. This study examined the warpage condition of the moulded parts before and after optimisation work applied for both cooling channels. A front panel housing have been selected as a specimen and the performance of proposed optimisation approach have been analysed on the conventional straight-drilled cooling channels compared to the Milled Groove Square Shape (MGSS) conformal cooling channels by simulation analysis using Autodesk Moldflow Insight (AMI) 2013. Based on the results, melt temperature is the most significant factor contribute to the warpage condition and warpage have optimised by 39.1% after optimisation for straight-drilled cooling channels and cooling time is the most significant factor contribute to the warpage condition and warpage have optimised by 38.7% after optimisation for MGSS conformal cooling channels. In addition, the finding shows that the application of optimisation work on the conformal cooling channels offers the better quality and productivity of the moulded part produced.

Optimisation of industrial wastes reuse as construction materials.

Science.gov (United States)

Collivignarelli, C; Sorlini, S

2001-12-01

This study concerns the reuse of two inorganic wastes, foundry residues and fly ashes from municipal solid waste incineration, as "recycled aggregate" in concrete production. This kind of reuse was optimised by waste treatment with the following steps: waste washing with water; waste stabilisation-solidification treatment with inorganic reagents; final grinding of the stabilised waste after curing for about 10-20 days. Both the treated wastes were reused in concrete production with different mix-designs. Concrete specimens were characterised by means of conventional physical-mechanical tests (compression, elasticity modulus, shrinkage) and different leaching tests. Experimental results showed that a good structural and environmental quality of "recycled concrete" is due both to a correct waste treatment and to a correct mix-design for concrete mixture.

Total knee replacement plus physical and medical therapy or treatment with physical and medical therapy alone

DEFF Research Database (Denmark)

Skou, Søren Thorgaard; Roos, Ewa M.; Laursen, Mogens Berg

2012-01-01

ABSTRACT: BACKGROUND: There is a lack of high quality evidence concerning the efficacy of total knee arthroplasty (TKA). According to international evidence-based guidelines, treatment of knee osteoarthritis (KOA) should include patient education, exercise and weight loss. Insoles....../or NSAIDs. Patients will be randomised to either receiving or not receiving a TKA in addition to the optimised non-surgical treatment. The primary outcome will be the change from baseline to 12 months on the Knee Injury and Osteoarthritis Outcome Score (KOOS)4 defined as the average score for the subscale...

Predictors of outcome in residential cognitive and interpersonal treatment for social phobia: do cognitive and social dysfunction moderate treatment outcome?

Science.gov (United States)

Borge, Finn-Magnus; Hoffart, Asle; Sexton, Harold

2010-09-01

The predictors of residential cognitive (RCT) and residential interpersonal Treatment (RIPT) for social phobia were explored. (1) Sotsky et al. (1991) found differential effects of CT and IPT for depression, suggesting that the level of cognitive or social dysfunction predicted differential outcome. We examined whether an analogous effect could be demonstrated in 10 weeks of residential treatment of 80 social phobia subjects. (2) We also included expectations, age of onset, severity of illness, concurrent anxiety, mood, avoidant personality disorder, and body dysmorphic disorder as predictors in this exploratory study. Main outcome was the social phobia subscale of Social Phobia and Anxiety Inventory (SPAI SP). DSM-IV axis I and II interviews were completed. (1) Sotsky et al. (1991) findings were not reproduced. However, RIPT subjects with poor general functioning were less improved following treatment. Subjects with concurrent agoraphobia responded better with RCT than subjects without agoraphobia. (2) Age of onset and expectations were the most powerful predictors of post treatment outcome. Some patient characteristics appear to impact outcome with RIPT and RCT differentially. The findings are discussed. (c) 2010 Elsevier Ltd. All rights reserved.

A supportive architecture for CFD-based design optimisation

Science.gov (United States)

Li, Ni; Su, Zeya; Bi, Zhuming; Tian, Chao; Ren, Zhiming; Gong, Guanghong

2014-03-01

Multi-disciplinary design optimisation (MDO) is one of critical methodologies to the implementation of enterprise systems (ES). MDO requiring the analysis of fluid dynamics raises a special challenge due to its extremely intensive computation. The rapid development of computational fluid dynamic (CFD) technique has caused a rise of its applications in various fields. Especially for the exterior designs of vehicles, CFD has become one of the three main design tools comparable to analytical approaches and wind tunnel experiments. CFD-based design optimisation is an effective way to achieve the desired performance under the given constraints. However, due to the complexity of CFD, integrating with CFD analysis in an intelligent optimisation algorithm is not straightforward. It is a challenge to solve a CFD-based design problem, which is usually with high dimensions, and multiple objectives and constraints. It is desirable to have an integrated architecture for CFD-based design optimisation. However, our review on existing works has found that very few researchers have studied on the assistive tools to facilitate CFD-based design optimisation. In the paper, a multi-layer architecture and a general procedure are proposed to integrate different CFD toolsets with intelligent optimisation algorithms, parallel computing technique and other techniques for efficient computation. In the proposed architecture, the integration is performed either at the code level or data level to fully utilise the capabilities of different assistive tools. Two intelligent algorithms are developed and embedded with parallel computing. These algorithms, together with the supportive architecture, lay a solid foundation for various applications of CFD-based design optimisation. To illustrate the effectiveness of the proposed architecture and algorithms, the case studies on aerodynamic shape design of a hypersonic cruising vehicle are provided, and the result has shown that the proposed architecture

Risk based test interval and maintenance optimisation - Application and uses

International Nuclear Information System (INIS)

Sparre, E.

1999-10-01

The project is part of an IAEA co-ordinated Research Project (CRP) on 'Development of Methodologies for Optimisation of Surveillance Testing and Maintenance of Safety Related Equipment at NPPs'. The purpose of the project is to investigate the sensitivity of the results obtained when performing risk based optimisation of the technical specifications. Previous projects have shown that complete LPSA models can be created and that these models allow optimisation of technical specifications. However, these optimisations did not include any in depth check of the result sensitivity with regards to methods, model completeness etc. Four different test intervals have been investigated in this study. Aside from an original, nominal, optimisation a set of sensitivity analyses has been performed and the results from these analyses have been compared to the original optimisation. The analyses indicate that the result of an optimisation is rather stable. However, it is not possible to draw any certain conclusions without performing a number of sensitivity analyses. Significant differences in the optimisation result were discovered when analysing an alternative configuration. Also deterministic uncertainties seem to affect the result of an optimisation largely. The sensitivity of failure data uncertainties is important to investigate in detail since the methodology is based on the assumption that the unavailability of a component is dependent on the length of the test interval

Optimisation of X-ray examinations: General principles and an Irish perspective

International Nuclear Information System (INIS)

Matthews, Kate; Brennan, Patrick C.

2009-01-01

In Ireland, the European Medical Exposures Directive [Council Directive 97/43] was enacted into national law in Statutory Instrument 478 of 2002. This series of three review articles discusses the status of justification and optimisation of X-ray examinations nationally, and progress with the establishment of Irish diagnostic reference levels. In this second article, literature relating to optimisation issues arising in SI 478 of 2002 is reviewed. Optimisation associated with X-ray equipment and optimisation during day-to-day practice are considered. Optimisation proposals found in published research are summarised, and indicate the complex nature of optimisation. A paucity of current, research-based guidance documentation is identified. This is needed in order to support a range of professional staff in their practical implementation of optimisation.

Work management to optimise occupational radiological protection

International Nuclear Information System (INIS)

Ahier, B.

2009-01-01

Although work management is no longer a new concept, continued efforts are still needed to ensure that good performance, outcomes and trends are maintained in the face of current and future challenges. The ISOE programme thus created an Expert Group on Work Management in 2007 to develop an updated report reflecting the current state of knowledge, technology and experience in the occupational radiological protection of workers at nuclear power plants. Published in 2009, the new ISOE report on Work Management to Optimise Occupational Radiological Protection in the Nuclear Power Industry provides up-to-date practical guidance on the application of work management principles. Work management measures aim at optimising occupational radiological protection in the context of the economic viability of the installation. Important factors in this respect are measures and techniques influencing i) dose and dose rate, including source- term reduction; ii) exposure, including amount of time spent in controlled areas for operations; and iii) efficiency in short- and long-term planning, worker involvement, coordination and training. Equally important due to their broad, cross-cutting nature are the motivational and organisational arrangements adopted. The responsibility for these aspects may reside in various parts of an installation's organisational structure, and thus, a multi-disciplinary approach must be recognised, accounted for and well-integrated in any work. Based on the operational experience within the ISOE programme, the following key areas of work management have been identified: - regulatory aspects; - ALARA management policy; - worker involvement and performance; - work planning and scheduling; - work preparation; - work implementation; - work assessment and feedback; - ensuring continuous improvement. The details of each of these areas are elaborated and illustrated in the report through examples and case studies arising from ISOE experience. They are intended to

Cytokine treatment optimises the immunotherapeutic effects of umbilical cord-derived MSC for treatment of inflammatory liver disease.

Science.gov (United States)

de Witte, Samantha F H; Merino, Ana M; Franquesa, Marcella; Strini, Tanja; van Zoggel, Johanna A A; Korevaar, Sander S; Luk, Franka; Gargesha, Madhu; O'Flynn, Lisa; Roy, Debashish; Elliman, Steve J; Newsome, Philip N; Baan, Carla C; Hoogduijn, Martin J

2017-06-08

modulatory capacity compared to untreated ucMSC. The present study demonstrates the responsiveness of ucMSC to in vitro optimisation treatment. The observed improvements in immunomodulatory capacity as well as immunogenicity after MC treatment may improve the efficacy of ucMSC as immunotherapy targeted towards liver inflammation.

Solar photo-Fenton optimisation in treating carbofuran-contaminated water

Directory of Open Access Journals (Sweden)

Manuel Alejandro Hernández-Shek

2012-01-01

Full Text Available Box-Benkhen design response-surface methodology was developed to optimise photo-Fenton degradation of carbofuran (C12H15NO3 by using a compound parabolic collector pilot plant. The four variables considered in Box-Benkhen design model included carbofuran degradation percentage, initial carbofuran concentration, hydrogen peroxide [H2O2] concentration and iron [Fe2+] concentration. Degradation was monitored by using total organic carbon concentration and high-performance liquid chromatography. A 93.2 mg l-1 carbofuran concentration was completely degraded in t30W = 15 min with 17.1 mg l-1 Fe2+ and 121.6 mg l-1 H2O2. Photo-Fenton degradation led to 76.7% mineralisation. Biodegradability during optimisation was evaluated by using the BOD5/COD ratio; this value increased from 0.04 at the beginning of the process to 0.52 in t30W = 20 min, thereby showing the effectiveness of using biological treatments.

Improving treatment outcome assessment in a mouse tuberculosis model.

Science.gov (United States)

Mourik, Bas C; Svensson, Robin J; de Knegt, Gerjo J; Bax, Hannelore I; Verbon, Annelies; Simonsson, Ulrika S H; de Steenwinkel, Jurriaan E M

2018-04-09

Preclinical treatment outcome evaluation of tuberculosis (TB) occurs primarily in mice. Current designs compare relapse rates of different regimens at selected time points, but lack information about the correlation between treatment length and treatment outcome, which is required to efficiently estimate a regimens' treatment-shortening potential. Therefore we developed a new approach. BALB/c mice were infected with a Mycobacterium tuberculosis Beijing genotype strain and were treated with rifapentine-pyrazinamide-isoniazid-ethambutol (R p ZHE), rifampicin-pyrazinamide-moxifloxacin-ethambutol (RZME) or rifampicin-pyrazinamide-moxifloxacin-isoniazid (RZMH). Treatment outcome was assessed in n = 3 mice after 9 different treatment lengths between 2-6 months. Next, we created a mathematical model that best fitted the observational data and used this for inter-regimen comparison. The observed data were best described by a sigmoidal E max model in favor over linear or conventional E max models. Estimating regimen-specific parameters showed significantly higher curative potentials for RZME and R p ZHE compared to RZMH. In conclusion, we provide a new design for treatment outcome evaluation in a mouse TB model, which (i) provides accurate tools for assessment of the relationship between treatment length and predicted cure, (ii) allows for efficient comparison between regimens and (iii) adheres to the reduction and refinement principles of laboratory animal use.

Pattern of intensive phase treatment outcomes of multi-drug resistant ...

African Journals Online (AJOL)

Pattern of intensive phase treatment outcomes of multi-drug resistant tuberculosis in University of Port Harcourt Treatment Centre: a review of records from ... Data on patients' age, sex, HIV status, treatment outcomes were extracted from the hospital book records into a computer data sheet at the UPTH treatment centre.

Wilms Tumor Treatment Outcomes: Perspectives From a Low-Income Setting.

Science.gov (United States)

Njuguna, Festus; Martijn, Hugo A; Kuremu, Robert Tenge; Saula, Peter; Kirtika, Patel; Olbara, Gilbert; Langat, Sandra; Martin, Steve; Skiles, Jodi; Vik, Terry; Kaspers, Gertjan J L; Mostert, Saskia

2017-10-01

Wilms tumor is the commonest renal malignancy in childhood. Survival in high-income countries is approximately 90%, whereas in low-income countries, it is less than 50%. This study assessed treatment outcomes of patients with Wilms tumor at a Kenyan academic hospital. We conducted a retrospective medical record review of all children diagnosed with Wilms tumor between 2010 and 2012. Data on treatment outcomes and various sociodemographic and clinical characteristics were collected. Of the 39 patients with Wilms tumor, 41% had event-free survival, 31% abandoned treatment, 23% died, and 5% had progressive or relapsed disease. Most patients presented at an advanced stage: stage I (0%), II (7%), III (43%), IV (40%), or V (10%). The most likely treatment outcome in patients with low-stage (I to III) disease was event-free survival (67%), whereas in those with high-stage (IV to V) disease, it was death (40%). No deaths or instances of progressive or relapsed disease were recorded among patients with low-stage disease; their only reason for treatment failure was abandonment of treatment. Stage of disease significantly affected treatment outcomes ( P = .014) and event-free survival estimates ( P abandonment is the most common cause of treatment failure. Stage of disease at diagnosis statistically significantly affects treatment outcomes and survival.

Psychosocial predictors of treatment outcome for trauma-affected refugees

DEFF Research Database (Denmark)

Sonne, Charlotte Kærgaard; Mortensen, Erik Lykke; Carlsson, Jessica

2016-01-01

outcome. Objective The objective of the study was to examine possible psychosocial predictors of treatment outcome for trauma-affected refugees. Method The participants were 195 adult refugees with posttraumatic stress disorder (PTSD) who were enrolled in a 6- to 7-month treatment programme...

CONTRACT Study - CONservative TReatment of Appendicitis in Children (feasibility): study protocol for a randomised controlled Trial.

Science.gov (United States)

Hutchings, Natalie; Wood, Wendy; Reading, Isabel; Walker, Erin; Blazeby, Jane M; Van't Hoff, William; Young, Bridget; Crawley, Esther M; Eaton, Simon; Chorozoglou, Maria; Sherratt, Frances C; Beasant, Lucy; Corbett, Harriet; Stanton, Michael P; Grist, Simon; Dixon, Elizabeth; Hall, Nigel J

2018-03-02

Currently, the routine treatment for acute appendicitis in the United Kingdom is an appendicectomy. However, there is increasing scientific interest and research into non-operative treatment of appendicitis in adults and children. While a number of studies have investigated non-operative treatment of appendicitis in adults, this research cannot be applied to the paediatric population. Ultimately, we aim to perform a UK-based multicentre randomised controlled trial (RCT) to test the clinical and cost effectiveness of non-operative treatment of acute uncomplicated appendicitis in children, as compared with appendicectomy. First, we will undertake a feasibility study to assess the feasibility of performing such a trial. The study involves a feasibility RCT with a nested qualitative research to optimise recruitment as well as a health economic substudy. Children (aged 4-15 years inclusive) diagnosed with acute uncomplicated appendicitis that would normally be treated with an appendicectomy are eligible for the RCT. Exclusion criteria include clinical/radiological suspicion of perforated appendicitis, appendix mass or previous non-operative treatment of appendicitis. Participants will be randomised into one of two arms. Participants in the intervention arm are treated with antibiotics and regular clinical assessment to ensure clinical improvement. Participants in the control arm will receive appendicectomy. Randomisation will be minimised by age, sex, duration of symptoms and centre. Children and families who are approached for the RCT will be invited to participate in the embedded qualitative substudy, which includes recording of recruitment consultants and subsequent interviews with participants and non-participants and their families and recruiters. Analyses of these will inform interventions to optimise recruitment. The main study outcomes include recruitment rate (primary outcome), identification of strategies to optimise recruitment, performance of trial treatment

Mutual information-based LPI optimisation for radar network

Science.gov (United States)

Shi, Chenguang; Zhou, Jianjiang; Wang, Fei; Chen, Jun

2015-07-01

Radar network can offer significant performance improvement for target detection and information extraction employing spatial diversity. For a fixed number of radars, the achievable mutual information (MI) for estimating the target parameters may extend beyond a predefined threshold with full power transmission. In this paper, an effective low probability of intercept (LPI) optimisation algorithm is presented to improve LPI performance for radar network. Based on radar network system model, we first provide Schleher intercept factor for radar network as an optimisation metric for LPI performance. Then, a novel LPI optimisation algorithm is presented, where for a predefined MI threshold, Schleher intercept factor for radar network is minimised by optimising the transmission power allocation among radars in the network such that the enhanced LPI performance for radar network can be achieved. The genetic algorithm based on nonlinear programming (GA-NP) is employed to solve the resulting nonconvex and nonlinear optimisation problem. Some simulations demonstrate that the proposed algorithm is valuable and effective to improve the LPI performance for radar network.

Wilms Tumor Treatment Outcomes: Perspectives From a Low-Income Setting

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Festus Njuguna

2017-10-01

Full Text Available Purpose: Wilms tumor is the commonest renal malignancy in childhood. Survival in high-income countries is approximately 90%, whereas in low-income countries, it is less than 50%. This study assessed treatment outcomes of patients with Wilms tumor at a Kenyan academic hospital. Patients and Methods: We conducted a retrospective medical record review of all children diagnosed with Wilms tumor between 2010 and 2012. Data on treatment outcomes and various sociodemographic and clinical characteristics were collected. Results: Of the 39 patients with Wilms tumor, 41% had event-free survival, 31% abandoned treatment, 23% died, and 5% had progressive or relapsed disease. Most patients presented at an advanced stage: stage I (0%, II (7%, III (43%, IV (40%, or V (10%. The most likely treatment outcome in patients with low-stage (I to III disease was event-free survival (67%, whereas in those with high-stage (IV to V disease, it was death (40%. No deaths or instances of progressive or relapsed disease were recorded among patients with low-stage disease; their only reason for treatment failure was abandonment of treatment. Stage of disease significantly affected treatment outcomes (P = .014 and event-free survival estimates (P < .001. Age at diagnosis, sex, duration of symptoms, distance to hospital, and health insurance status did not statistically significantly influence treatment outcomes or event-free survival estimates. Conclusion: Survival of patients with Wilms tumor in Kenya is lower compared with that in high-income countries. Treatment abandonment is the most common cause of treatment failure. Stage of disease at diagnosis statistically significantly affects treatment outcomes and survival.

Is treatment outcome improved if patients match themselves to treatment options?

DEFF Research Database (Denmark)

Hell, Morten Ellegaard; Miller, William R; Nielsen, Bent

2018-01-01

standardized measures of alcohol problems: the Addiction Severity Index, Timeline Followback, the World Health Organization quality of life questionnaire, the NEO Five-Factor Inventory 3, and the Personal Happiness Form. For each outcome measure, two analyses will be conducted. Intention-to-treat analyses (ITT....... The primary outcome is decrease in number of monthly excessive drinking days 6 months after initiation of treatment. Secondary outcomes are compliance and 2 quality of life. The influence of personality traits on outcome will also be examined in both groups. DISCUSSION: The debate on matching patients...

Multicriteria Optimisation in Logistics Forwarder Activities

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Tanja Poletan Jugović

2007-05-01

Full Text Available Logistics forwarder, as organizer and planner of coordinationand integration of all the transport and logistics chains elements,uses adequate ways and methods in the process of planningand decision-making. One of these methods, analysed inthis paper, which could be used in optimisation of transportand logistics processes and activities of logistics forwarder, isthe multicriteria optimisation method. Using that method, inthis paper is suggested model of multicriteria optimisation of logisticsforwarder activities. The suggested model of optimisationis justified in keeping with method principles of multicriteriaoptimization, which is included in operation researchmethods and it represents the process of multicriteria optimizationof variants. Among many different processes of multicriteriaoptimization, PROMETHEE (Preference Ranking OrganizationMethod for Enrichment Evaluations and Promcalc& Gaia V. 3.2., computer program of multicriteria programming,which is based on the mentioned process, were used.

A novel sleep optimisation programme to improve athletes' well-being and performance.

Science.gov (United States)

Van Ryswyk, Emer; Weeks, Richard; Bandick, Laura; O'Keefe, Michaela; Vakulin, Andrew; Catcheside, Peter; Barger, Laura; Potter, Andrew; Poulos, Nick; Wallace, Jarryd; Antic, Nick A

2017-03-01

To improve well-being and performance indicators in a group of Australian Football League (AFL) players via a six-week sleep optimisation programme. Prospective intervention study following observations suggestive of reduced sleep and excessive daytime sleepiness in an AFL group. Athletes from the Adelaide Football Club were invited to participate if they had played AFL senior-level football for 1-5 years, or if they had excessive daytime sleepiness (Epworth Sleepiness Scale [ESS] >10), measured via ESS. An initial education session explained normal sleep needs, and how to achieve increased sleep duration and quality. Participants (n = 25) received ongoing feedback on their sleep, and a mid-programme education and feedback session. Sleep duration, quality and related outcomes were measured during week one and at the conclusion of the six-week intervention period using sleep diaries, actigraphy, ESS, Pittsburgh Sleep Quality Index, Profile of Mood States, Training Distress Scale, Perceived Stress Scale and the Psychomotor Vigilance Task. Sleep diaries demonstrated an increase in total sleep time of approximately 20 min (498.8 ± 53.8 to 518.7 ± 34.3; p sleep efficiency (p sleep efficiency, fatigue and vigour indicate that a sleep optimisation programme may improve athletes' well-being. More research is required into the effects of sleep optimisation on athletic performance.

Optimisation by hierarchical search

Science.gov (United States)

Zintchenko, Ilia; Hastings, Matthew; Troyer, Matthias

2015-03-01

Finding optimal values for a set of variables relative to a cost function gives rise to some of the hardest problems in physics, computer science and applied mathematics. Although often very simple in their formulation, these problems have a complex cost function landscape which prevents currently known algorithms from efficiently finding the global optimum. Countless techniques have been proposed to partially circumvent this problem, but an efficient method is yet to be found. We present a heuristic, general purpose approach to potentially improve the performance of conventional algorithms or special purpose hardware devices by optimising groups of variables in a hierarchical way. We apply this approach to problems in combinatorial optimisation, machine learning and other fields.

Factors Associated with Effectiveness of Treatment and Reproductive Outcomes in Patients with Thin Endometrium Undergoing Estrogen Treatment

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Si-Miao Liu

2015-01-01

Conclusions: Thinner EMT before estrogen treatment requires longer treatment duration and predicts poorer treatment outcomes. The effectiveness of treatment depends on the duration of estrogen administration. Assisted reproductive outcomes of patients whose treatment is successful (i.e., achieves an EMT ≥8 mm are similar to those of controls. The quality of embryos transferred is an important predictor of assisted reproductive outcomes in patients treated successfully with exogenous estrogen.

TB treatment in a chronic complex emergency: treatment outcomes and experiences in Somalia.

Science.gov (United States)

Liddle, Karin Fischer; Elema, Riekje; Thi, Sein Sein; Greig, Jane; Venis, Sarah

2013-11-01

Médecins Sans Frontières (MSF) provides TB treatment in Galkayo and Marere in Somalia. MSF international supervisory staff withdrew in 2008 owing to insecurity but maintained daily communication with Somali staff. In this paper, we aimed to assess the feasibility of treating TB in a complex emergency setting and describe the programme adaptations implemented to facilitate acceptable treatment outcomes. Routinely collected treatment data from 2005-2012 were retrospectively analysed. In multivariate analyses, factors associated with successful outcome (cure or completion versus failure, death and default) were assessed, including the presence of international supervisory staff. Informal interviews were conducted with Somali staff regarding programmatic factors affecting patient management and perceived reasons for default. In total, 6167 patients were admitted (34.8% female; median age 24.0 years [IQR 13.0-38.0 years]). Treatment success was 79% (programme range 69-87%). Presence of international staff did not improve outcomes (adjusted OR 0.85, 95% CI 0.66-1.09; p=0.27). Perceived reasons for default included being away from family, nomadic group, insecurity, travel cost, need to return to grazing land or feeling better. Despite the challenges, a high percentage of patients were successfully treated. Treatment outcomes were not adversely affected by withdrawal of international supervisory staff.

Systematic Review of Treatment Outcome Measures for Vulvodynia.

Science.gov (United States)

Sadownik, Leslie A; Yong, Paul J; Smith, Kelly B

2018-07-01

To systematically evaluate the literature regarding vulvodynia treatment outcome measures. A systematic literature search on OVID, PubMed, and PsycINFO databases was conducted from inception until May 2016. Studies were included/excluded based on prespecified criteria. Reported outcome measures were organized into 6 core outcome domains recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT): pain; physical functioning, emotional functioning, participant ratings of global improvement and satisfaction with treatment, symptoms and adverse events, and participant disposition. Of the 206 articles identified for full-text screening, 33 met our criteria. One study adhered to all IMMPACT recommendations. The number of outcomes measured per study ranged from 1 to greater than 20. Patient-reported pain outcomes were found in the majority (27/33; 82%) of studies. Pain severity with intercourse was reported by 24 (73%) of 33 studies-9 different scales were used to measure this outcome. Clinician-reported outcomes were present in 14 (42%) of 33 studies. Methods of measuring vestibular sensitivity by "cotton swab" test were different in 8 of 10 studies. Other domains reported included; physical function (8/33 studies; 24%), sexual function (23/33 studies; 70%), and emotional function (13/33 studies; 39%). Symptoms and adverse events were reported by 15 (45%) of 33 studies. One study formally reported participant disposition using all the information recommended by CONSORT. Comparison of clinical trial results in vulvodynia is not possible because of a lack of standard treatment outcome measures. Vulvodynia researchers should apply the IMMPACT criteria to guide the development of a minimum core set of standard outcome measures that measure holistic health.

Towards optimised information about clinical trials; identification and validation of key issues in collaboration with cancer patient advocates

DEFF Research Database (Denmark)

Dellson, P; Nilbert, M; Bendahl, P-O

2011-01-01

for improvements, 21 key issues were defined and validated through a questionnaire in an independent group of breast cancer patient advocates. Clear messages, emotionally neutral expressions, careful descriptions of side effects, clear comparisons between different treatment alternatives and information about......Clinical trials are crucial to improve cancer treatment but recruitment is difficult. Optimised patient information has been recognised as a key issue. In line with the increasing focus on patients' perspectives in health care, we aimed to study patients' opinions about the written information used...... the possibility to discontinue treatment were perceived as the most important issues. Patients' views of the information in clinical trials provide new insights and identify key issues to consider in optimising future written information and may improve recruitment to clinical cancer trials....

A test of faith in God and treatment: the relationship of belief in God to psychiatric treatment outcomes.

Science.gov (United States)

Rosmarin, David H; Bigda-Peyton, Joseph S; Kertz, Sarah J; Smith, Nasya; Rauch, Scott L; Björgvinsson, Thröstur

2013-04-25

Belief in God is very common and tied to mental health/illness in the general population, yet its relevance to psychiatric patients has not been adequately studied. We examined relationships between belief in God and treatment outcomes, and identified mediating mechanisms. We conducted a prospective study with n=159 patients in a day-treatment program at an academic psychiatric hospital. Belief in God, treatment credibility/expectancy, emotion regulation and congregational support were assessed prior to treatment. Primary outcomes were treatment response as well as degree of reduction in depression over treatment. Secondary outcomes were improvements in psychological well-being and reduction in self-harm. Belief in God was significantly higher among treatment responders than non-responders F(1,114)=4.81, pGod and reductions in depression. No variables mediated relationships to other outcomes. Religious affiliation was also associated with treatment credibility/expectancy but not treatment outcomes. Belief in God, but not religious affiliation, was associated with better treatment outcomes. With respect to depression, this relationship was mediated by belief in the credibility of treatment and expectations for treatment gains. Copyright © 2012 Elsevier B.V. All rights reserved.

Modified cuckoo search: A new gradient free optimisation algorithm

International Nuclear Information System (INIS)

Walton, S.; Hassan, O.; Morgan, K.; Brown, M.R.

2011-01-01

Highlights: → Modified cuckoo search (MCS) is a new gradient free optimisation algorithm. → MCS shows a high convergence rate, able to outperform other optimisers. → MCS is particularly strong at high dimension objective functions. → MCS performs well when applied to engineering problems. - Abstract: A new robust optimisation algorithm, which can be regarded as a modification of the recently developed cuckoo search, is presented. The modification involves the addition of information exchange between the top eggs, or the best solutions. Standard optimisation benchmarking functions are used to test the effects of these modifications and it is demonstrated that, in most cases, the modified cuckoo search performs as well as, or better than, the standard cuckoo search, a particle swarm optimiser, and a differential evolution strategy. In particular the modified cuckoo search shows a high convergence rate to the true global minimum even at high numbers of dimensions.

Techno-Economic Models for Optimised Utilisation of Jatropha curcas Linnaeus under an Out-Grower Farming Scheme in Ghana

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Isaac Osei

2016-11-01

Full Text Available Techno-economic models for optimised utilisation of jatropha oil under an out-grower farming scheme were developed based on different considerations for oil and by-product utilisation. Model 1: Out-grower scheme where oil is exported and press cake utilised for compost. Model 2: Out-grower scheme with six scenarios considered for the utilisation of oil and by-products. Linear programming models were developed based on outcomes of the models to optimise the use of the oil through profit maximisation. The findings revealed that Model 1 was financially viable from the processors’ perspective but not for the farmer at seed price of $0.07/kg. All scenarios considered under Model 2 were financially viable from the processors perspective but not for the farmer at seed price of $0.07/kg; however, at seed price of $0.085/kg, financial viability was achieved for both parties. Optimising the utilisation of the oil resulted in an annual maximum profit of $123,300.

Tuberculosis treatment outcome in a tertiary care setting

International Nuclear Information System (INIS)

Bukhary, Zakeya A.; Alrajhi, Abdulrahman A.

2007-01-01

The outcome of the chemotherapy for pulmonary, extraplumonary and disseminated tuberculosis is not well documented, especially in developing countries. This study assessed tuberculosis treatment outcome, cure-to-treatment ratio and mortality among all types of tuberculosis patients in a tertiary care setting in Saudi Arabia. All cases diagnosed and treated for active Mycobacterium tuberculosis infection between 1991 and 2000 were included retrospectively. Data collected included type of tuberculosis involvement, treatment outcome, relapse and co-morbidities. Over a ten-year period, 535 case of tuberculosis were diagnosed and treated. Isolated pulmonary tuberculosis was identified in 141 cases (26.4%), extrapulmonary tuberculosis in 339 cases (63.3%). Co-morbidities were noted in 277 (52%) patients. Immunosuppression was found in 181 (34%) cases. The cure rate was 82%. The cure-to-treatment ratio was 86% in extrapulmonary tuberculosis and 65% in disseminated tuberculosis. Overall mortality was 18%. Disseminated tuberculosis had the highest mortality (34.9%), followed by pulmonary (21.8%), the extrapulmonary tuberculosis (13.6%). Forty-seven percent of all mortalities were directly related to tuberculosis. Relapse was documented in 14 out of 349 patients (4%) who had 24 months of follow-up. Despite tertiary care support, complicated tuberculosis carries a high mortality. Earlier diagnosis and complete appropriate chemotherapy are essential for improved outcome. (author)

A methodological approach to the design of optimising control strategies for sewer systems

DEFF Research Database (Denmark)

Mollerup, Ane Loft; Mikkelsen, Peter Steen; Sin, Gürkan

2016-01-01

This study focuses on designing an optimisation based control for sewer system in a methodological way and linking itto a regulatory control. Optimisation based design is found to depend on proper choice of a model, formulation of objective function and tuning of optimisation parameters. Accordin......This study focuses on designing an optimisation based control for sewer system in a methodological way and linking itto a regulatory control. Optimisation based design is found to depend on proper choice of a model, formulation of objective function and tuning of optimisation parameters....... Accordingly, two novel optimisation configurations are developed, where the optimisation either acts on the actuators or acts on the regulatory control layer. These two optimisation designs are evaluated on a sub-catchment of the sewer system in Copenhagen, and found to perform better than the existing...

Do treatment quality indicators predict cardiovascular outcomes in patients with diabetes?

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Grigory Sidorenkov

Full Text Available BACKGROUND: Landmark clinical trials have led to optimal treatment recommendations for patients with diabetes. Whether optimal treatment is actually delivered in practice is even more important than the efficacy of the drugs tested in trials. To this end, treatment quality indicators have been developed and tested against intermediate outcomes. No studies have tested whether these treatment quality indicators also predict hard patient outcomes. METHODS: A cohort study was conducted using data collected from >10.000 diabetes patients in the Groningen Initiative to Analyze Type 2 Treatment (GIANTT database and Dutch Hospital Data register. Included quality indicators measured glucose-, lipid-, blood pressure- and albuminuria-lowering treatment status and treatment intensification. Hard patient outcome was the composite of cardiovascular events and all-cause death. Associations were tested using Cox regression adjusting for confounding, reporting hazard ratios (HR with 95% confidence intervals. RESULTS: Lipid and albuminuria treatment status, but not blood pressure lowering treatment status, were associated with the composite outcome (HR = 0.77, 0.67-0.88; HR = 0.75, 0.59-0.94. Glucose lowering treatment status was associated with the composite outcome only in patients with an elevated HbA1c level (HR = 0.72, 0.56-0.93. Treatment intensification with glucose-lowering but not with lipid-, blood pressure- and albuminuria-lowering drugs was associated with the outcome (HR = 0.73, 0.60-0.89. CONCLUSION: Treatment quality indicators measuring lipid- and albuminuria-lowering treatment status are valid quality measures, since they predict a lower risk of cardiovascular events and mortality in patients with diabetes. The quality indicators for glucose-lowering treatment should only be used for restricted populations with elevated HbA1c levels. Intriguingly, the tested indicators for blood pressure-lowering treatment did not predict patient

Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study

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Kerkum Yvette L

2013-02-01

Full Text Available Abstract Background Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs, are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP, walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations. The primary aim of this study is to evaluate the effect of FROs optimised for ankle stiffness on the walking energy cost in children with SCP, compared to walking with shoes alone. In addition, effects on various secondary outcome measures will be evaluated in order to identify possible working mechanisms and potential predictors of FRO treatment success. Method/Design A pre-post experimental study design will include 32 children with SCP, walking with excessive knee flexion in midstance, recruited from our university hospital and affiliated rehabilitation centres. All participants will receive a newly designed FRO, allowing ankle stiffness to be varied into three configurations by means of a hinge. Gait biomechanics will be assessed for each FRO configuration. The FRO that results in the greatest reduction in knee flexion during the single stance phase will be selected as the subject’s optimal FRO. Subsequently, the effects of wearing this optimal FRO will be evaluated after 12–20 weeks. The primary study parameter will be walking energy cost, with the most important secondary outcomes being intensity of participation, daily activity, walking speed and gait biomechanics. Discussion The AFO-CP trial will be the first experimental study to evaluate the effect of individually optimised FROs on mobility and participation. The evaluation will include outcome measures at all levels of the International Classification of Functioning, Disability and Health, providing a unique

Treatment of attention deficit hyperactivity disorder in children: Predictors of treatment outcome

NARCIS (Netherlands)

van der Oord, S.; Prins, P.J.M.; Oosterlaan, J.; Emmelkamp, P.M.G.

2008-01-01

Objective: The present study investigated the predictive power of anxiety, IQ, severity of ADHD and parental depression on the outcome of treatment in children with ADHD. Method: Fifty children with ADHD (ages 8-12) were randomized to a 10-week treatment of methylphenidate or to a treatment of

Estimation of treatment preference effects in clinical trials when some participants are indifferent to treatment choice

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Stephen D. Walter

2017-02-01

Full Text Available Abstract Background In the two-stage randomised trial design, a randomly sampled subset of study participants are permitted to choose their own treatment, while the remaining participants are randomised to treatment in the usual way. Appropriate analysis of the data from both arms of the study allows investigators to estimate the impact on study outcomes of treatment preferences that patients may have, in addition to evaluating the usual direct effect of treatment. In earlier work, we showed how to optimise this design by making a suitable choice of the proportion of participants who should be assigned to the choice arm of the trial. However, we ignored the possibility of some participants being indifferent to the treatments under study. In this paper, we extend our earlier work to consider the analysis of two-stage randomised trials when some participants have no treatment preference, even if they are assigned to the choice arm and allowed to choose. Methods We compare alternative characterisations of the response profiles of the indifferent or undecided participants, and derive estimates of the treatment and preference effects on study outcomes. We also present corresponding test statistics for these parameters. The methods are illustrated with data from a clinical trial contrasting medical and surgical interventions. Results Expressions are obtained to estimate and test the impact of treatment choices on study outcomes, as well as the impact of the actual treatment received. Contrasts are defined between patients with stated treatment preferences and those with no preference. Alternative assumptions concerning the outcomes of undecided participants are described, and an approach leading to unbiased estimation and testing is identified. Conclusions Use of the two-stage design can provide important insights into determinants of study outcomes that are not identifiable with other designs. The design can remain attractive even in the presence of

Optimised mounting conditions for poly (ether sulfone) in radiation detection.

Science.gov (United States)

Nakamura, Hidehito; Shirakawa, Yoshiyuki; Sato, Nobuhiro; Yamada, Tatsuya; Kitamura, Hisashi; Takahashi, Sentaro

2014-09-01

Poly (ether sulfone) (PES) is a candidate for use as a scintillation material in radiation detection. Its characteristics, such as its emission spectrum and its effective refractive index (based on the emission spectrum), directly affect the propagation of light generated to external photodetectors. It is also important to examine the presence of background radiation sources in manufactured PES. Here, we optimise the optical coupling and surface treatment of the PES, and characterise its background. Optical grease was used to enhance the optical coupling between the PES and the photodetector; absorption by the grease of short-wavelength light emitted from PES was negligible. Diffuse reflection induced by surface roughening increased the light yield for PES, despite the high effective refractive index. Background radiation derived from the PES sample and its impurities was negligible above the ambient, natural level. Overall, these results serve to optimise the mounting conditions for PES in radiation detection. Copyright © 2014 Elsevier Ltd. All rights reserved.

Automatic optimisation of gamma dose rate sensor networks: The DETECT Optimisation Tool

DEFF Research Database (Denmark)

Helle, K.B.; Müller, T.O.; Astrup, Poul

2014-01-01

of the EU FP 7 project DETECT. It evaluates the gamma dose rates that a proposed set of sensors might measure in an emergency and uses this information to optimise the sensor locations. The gamma dose rates are taken from a comprehensive library of simulations of atmospheric radioactive plumes from 64......Fast delivery of comprehensive information on the radiological situation is essential for decision-making in nuclear emergencies. Most national radiological agencies in Europe employ gamma dose rate sensor networks to monitor radioactive pollution of the atmosphere. Sensor locations were often...... source locations. These simulations cover the whole European Union, so the DOT allows evaluation and optimisation of sensor networks for all EU countries, as well as evaluation of fencing sensors around possible sources. Users can choose from seven cost functions to evaluate the capability of a given...

Optimising Aesthetic Reconstruction of Scalp Soft Tissue by an Algorithm Based on Defect Size and Location.

Science.gov (United States)

Ooi, Adrian Sh; Kanapathy, Muholan; Ong, Yee Siang; Tan, Kok Chai; Tan, Bien Keem

2015-11-01

Scalp soft tissue defects are common and result from a variety of causes. Reconstructive methods should maximise cosmetic outcomes by maintaining hair-bearing tissue and aesthetic hairlines. This article outlines an algorithm based on a diverse clinical case series to optimise scalp soft tissue coverage. A retrospective analysis of scalp soft tissue reconstruction cases performed at the Singapore General Hospital between January 2004 and December 2013 was conducted. Forty-one patients were included in this study. The majority of defects aesthetic outcome while minimising complications and repeat procedures.

Automatic optimisation of beam orientations using the simplex algorithm and optimisation of quality control using statistical process control (S.P.C.) for intensity modulated radiation therapy (I.M.R.T.); Optimisation automatique des incidences des faisceaux par l'algorithme du simplexe et optimisation des controles qualite par la Maitrise Statistique des Processus (MSP) en Radiotherapie Conformationnelle par Modulation d'Intensite (RCMI)

Energy Technology Data Exchange (ETDEWEB)

Gerard, K

2008-11-15

Intensity Modulated Radiation Therapy (I.M.R.T.) is currently considered as a technique of choice to increase the local control of the tumour while reducing the dose to surrounding organs at risk. However, its routine clinical implementation is partially held back by the excessive amount of work required to prepare the patient treatment. In order to increase the efficiency of the treatment preparation, two axes of work have been defined. The first axis concerned the automatic optimisation of beam orientations. We integrated the simplex algorithm in the treatment planning system. Starting from the dosimetric objectives set by the user, it can automatically determine the optimal beam orientations that best cover the target volume while sparing organs at risk. In addition to time sparing, the simplex results of three patients with a cancer of the oropharynx, showed that the quality of the plan is also increased compared to a manual beam selection. Indeed, for an equivalent or even a better target coverage, it reduces the dose received by the organs at risk. The second axis of work concerned the optimisation of pre-treatment quality control. We used an industrial method: Statistical Process Control (S.P.C.) to retrospectively analyse the absolute dose quality control results performed using an ionisation chamber at Centre Alexis Vautrin (C.A.V.). This study showed that S.P.C. is an efficient method to reinforce treatment security using control charts. It also showed that our dose delivery process was stable and statistically capable for prostate treatments, which implies that a reduction of the number of controls can be considered for this type of treatment at the C.A.V.. (author)

Improved Binocular Outcomes Following Binocular Treatment for Childhood Amblyopia.

Science.gov (United States)

Kelly, Krista R; Jost, Reed M; Wang, Yi-Zhong; Dao, Lori; Beauchamp, Cynthia L; Leffler, Joel N; Birch, Eileen E

2018-03-01

Childhood amblyopia can be treated with binocular games or movies that rebalance contrast between the eyes, which is thought to reduce depth of interocular suppression so the child can experience binocular vision. While visual acuity gains have been reported following binocular treatment, studies rarely report gains in binocular outcomes (i.e., stereoacuity, suppression) in amblyopic children. Here, we evaluated binocular outcomes in children who had received binocular treatment for childhood amblyopia. Data for amblyopic children enrolled in two ongoing studies were pooled. The sample included 41 amblyopic children (6 strabismic, 21 anisometropic, 14 combined; age 4-10 years; ≤4 prism diopters [PD]) who received binocular treatment (20 game, 21 movies; prescribed 9-10 hours treatment). Amblyopic eye visual acuity and binocular outcomes (Randot Preschool Stereoacuity, extent of suppression, and depth of suppression) were assessed at baseline and at 2 weeks. Mean amblyopic eye visual acuity (P suppression (P = 0.003) were reduced from baseline at the 2-week visit (87% game adherence, 100% movie adherence). Depth of suppression was reduced more in children aged suppression was correlated with a larger depth of suppression reduction at 2 weeks (P = 0.001). After 2 weeks, binocular treatment in amblyopic children improved visual acuity and binocular outcomes, reducing the extent and depth of suppression and improving stereoacuity. Binocular treatments that rebalance contrast to overcome suppression are a promising additional option for treating amblyopia.

Imaging defined risk factors in neuroblastoma -guidelines for optimising imaging interpretations

International Nuclear Information System (INIS)

Valchev, G.; Balev, B.

2017-01-01

Neuroblastoma is the most frequent extracranial tumor in children, arising from the primitive sympathetic cells and the adrenal medulla. Two separate mutually complementing staging systems exist - INSS and INRGSS - one is based on post-operative findings, the other - on pre-treatment imaging. INRGSS consists of a list of 20 separate imaging defined risk factors (IDRF), the presence of which could alter the treatment plan. Radiologists need to be aware of certain intricacies in interpreting the individual IDRFs in order to optimise clinical decision-making. Key words: neuroblastoma. imaging defined risk factors (IDRF). interpretation guidelines [bg

Spatial-structural interaction and strain energy structural optimisation

NARCIS (Netherlands)

Hofmeyer, H.; Davila Delgado, J.M.; Borrmann, A.; Geyer, P.; Rafiq, Y.; Wilde, de P.

2012-01-01

A research engine iteratively transforms spatial designs into structural designs and vice versa. Furthermore, spatial and structural designs are optimised. It is suggested to optimise a structural design by evaluating the strain energy of its elements and by then removing, adding, or changing the

Energy Savings from Optimised In-Field Route Planning for Agricultural Machinery

Directory of Open Access Journals (Sweden)

Efthymios Rodias

2017-10-01

Full Text Available Various types of sensors technologies, such as machine vision and global positioning system (GPS have been implemented in navigation of agricultural vehicles. Automated navigation systems have proved the potential for the execution of optimised route plans for field area coverage. This paper presents an assessment of the reduction of the energy requirements derived from the implementation of optimised field area coverage planning. The assessment regards the analysis of the energy requirements and the comparison between the non-optimised and optimised plans for field area coverage in the whole sequence of operations required in two different cropping systems: Miscanthus and Switchgrass production. An algorithmic approach for the simulation of the executed field operations by following both non-optimised and optimised field-work patterns was developed. As a result, the corresponding time requirements were estimated as the basis of the subsequent energy cost analysis. Based on the results, the optimised routes reduce the fuel energy consumption up to 8%, the embodied energy consumption up to 7%, and the total energy consumption from 3% up to 8%.

Profile control studies for JET optimised shear regime

Energy Technology Data Exchange (ETDEWEB)

Litaudon, X.; Becoulet, A.; Eriksson, L.G.; Fuchs, V.; Huysmans, G.; How, J.; Moreau, D.; Rochard, F.; Tresset, G.; Zwingmann, W. [Association Euratom-CEA, CEA/Cadarache, Dept. de Recherches sur la Fusion Controlee, DRFC, 13 - Saint-Paul-lez-Durance (France); Bayetti, P.; Joffrin, E.; Maget, P.; Mayorat, M.L.; Mazon, D.; Sarazin, Y. [JET Abingdon, Oxfordshire (United Kingdom); Voitsekhovitch, I. [Universite de Provence, LPIIM, Aix-Marseille 1, 13 (France)

2000-03-01

This report summarises the profile control studies, i.e. preparation and analysis of JET Optimised Shear plasmas, carried out during the year 1999 within the framework of the Task-Agreement (RF/CEA/02) between JET and the Association Euratom-CEA/Cadarache. We report on our participation in the preparation of the JET Optimised Shear experiments together with their comprehensive analyses and the modelling. Emphasis is put on the various aspects of pressure profile control (core and edge pressure) together with detailed studies of current profile control by non-inductive means, in the prospects of achieving steady, high performance, Optimised Shear plasmas. (authors)

Machine learning for outcome prediction of acute ischemic stroke post intra-arterial therapy.

Directory of Open Access Journals (Sweden)

Hamed Asadi

Full Text Available INTRODUCTION: Stroke is a major cause of death and disability. Accurately predicting stroke outcome from a set of predictive variables may identify high-risk patients and guide treatment approaches, leading to decreased morbidity. Logistic regression models allow for the identification and validation of predictive variables. However, advanced machine learning algorithms offer an alternative, in particular, for large-scale multi-institutional data, with the advantage of easily incorporating newly available data to improve prediction performance. Our aim was to design and compare different machine learning methods, capable of predicting the outcome of endovascular intervention in acute anterior circulation ischaemic stroke. METHOD: We conducted a retrospective study of a prospectively collected database of acute ischaemic stroke treated by endovascular intervention. Using SPSS®, MATLAB®, and Rapidminer®, classical statistics as well as artificial neural network and support vector algorithms were applied to design a supervised machine capable of classifying these predictors into potential good and poor outcomes. These algorithms were trained, validated and tested using randomly divided data. RESULTS: We included 107 consecutive acute anterior circulation ischaemic stroke patients treated by endovascular technique. Sixty-six were male and the mean age of 65.3. All the available demographic, procedural and clinical factors were included into the models. The final confusion matrix of the neural network, demonstrated an overall congruency of ∼ 80% between the target and output classes, with favourable receiving operative characteristics. However, after optimisation, the support vector machine had a relatively better performance, with a root mean squared error of 2.064 (SD: ± 0.408. DISCUSSION: We showed promising accuracy of outcome prediction, using supervised machine learning algorithms, with potential for incorporation of larger multicenter

Cognitive-behavioral therapy for persistent pain: does adherence after treatment affect outcome?

Science.gov (United States)

Curran, Charlotte; Williams, Amanda C de C; Potts, Henry W W

2009-02-01

It is a tenet of cognitive behavioral treatment of persistent pain problems that ex-patients should adhere to treatment methods over the longer term, in order to maintain and to extend treatment gains. However, no research has quantified the causal influence of adherence on short-term outcome in this field. The aims of this study are to assess determinants of adherence to treatment recommendations in several domains, and to examine the extent to which cognitive and behavioral adherence predicts better outcome of cognitive behavioral treatment for persistent pain. Longitudinal data from a sample of 2345 persistent pain patients who attended a multicomponent treatment programme were subjected to structural equation modeling. Adherence emerged as a mediating factor linking post-treatment and follow-up treatment outcome, but contributed only 3% unique variance to follow-up outcomes. Combined end-of-treatment outcomes and adherence factors accounted for 72% of the variance in outcome at one-month follow-up. Notwithstanding shortcomings in the measurement of adherence, these findings question the emphasis normally given to adherence in the maintenance of behavioral and cognitive change, and clinical implications are discussed.

Exploiting Genomic Knowledge in Optimising Molecular Breeding Programmes: Algorithms from Evolutionary Computing

Science.gov (United States)

O'Hagan, Steve; Knowles, Joshua; Kell, Douglas B.

2012-01-01

Comparatively few studies have addressed directly the question of quantifying the benefits to be had from using molecular genetic markers in experimental breeding programmes (e.g. for improved crops and livestock), nor the question of which organisms should be mated with each other to best effect. We argue that this requires in silico modelling, an approach for which there is a large literature in the field of evolutionary computation (EC), but which has not really been applied in this way to experimental breeding programmes. EC seeks to optimise measurable outcomes (phenotypic fitnesses) by optimising in silico the mutation, recombination and selection regimes that are used. We review some of the approaches from EC, and compare experimentally, using a biologically relevant in silico landscape, some algorithms that have knowledge of where they are in the (genotypic) search space (G-algorithms) with some (albeit well-tuned ones) that do not (F-algorithms). For the present kinds of landscapes, F- and G-algorithms were broadly comparable in quality and effectiveness, although we recognise that the G-algorithms were not equipped with any ‘prior knowledge’ of epistatic pathway interactions. This use of algorithms based on machine learning has important implications for the optimisation of experimental breeding programmes in the post-genomic era when we shall potentially have access to the full genome sequence of every organism in a breeding population. The non-proprietary code that we have used is made freely available (via Supplementary information). PMID:23185279

Optimisation of radiation protection

International Nuclear Information System (INIS)

1988-01-01

Optimisation of radiation protection is one of the key elements in the current radiation protection philosophy. The present system of dose limitation was issued in 1977 by the International Commission on Radiological Protection (ICRP) and includes, in addition to the requirements of justification of practices and limitation of individual doses, the requirement that all exposures be kept as low as is reasonably achievable, taking social and economic factors into account. This last principle is usually referred to as optimisation of radiation protection, or the ALARA principle. The NEA Committee on Radiation Protection and Public Health (CRPPH) organised an ad hoc meeting, in liaison with the NEA committees on the safety of nuclear installations and radioactive waste management. Separate abstracts were prepared for individual papers presented at the meeting

TEM turbulence optimisation in stellarators

Science.gov (United States)

Proll, J. H. E.; Mynick, H. E.; Xanthopoulos, P.; Lazerson, S. A.; Faber, B. J.

2016-01-01

With the advent of neoclassically optimised stellarators, optimising stellarators for turbulent transport is an important next step. The reduction of ion-temperature-gradient-driven turbulence has been achieved via shaping of the magnetic field, and the reduction of trapped-electron mode (TEM) turbulence is addressed in the present paper. Recent analytical and numerical findings suggest TEMs are stabilised when a large fraction of trapped particles experiences favourable bounce-averaged curvature. This is the case for example in Wendelstein 7-X (Beidler et al 1990 Fusion Technol. 17 148) and other Helias-type stellarators. Using this knowledge, a proxy function was designed to estimate the TEM dynamics, allowing optimal configurations for TEM stability to be determined with the STELLOPT (Spong et al 2001 Nucl. Fusion 41 711) code without extensive turbulence simulations. A first proof-of-principle optimised equilibrium stemming from the TEM-dominated stellarator experiment HSX (Anderson et al 1995 Fusion Technol. 27 273) is presented for which a reduction of the linear growth rates is achieved over a broad range of the operational parameter space. As an important consequence of this property, the turbulent heat flux levels are reduced compared with the initial configuration.

Analysis and optimisation of heterogeneous real-time embedded systems

DEFF Research Database (Denmark)

Pop, Paul; Eles, Petru; Peng, Zebo

2005-01-01

. The success of such new design methods depends on the availability of analysis and optimisation techniques. Analysis and optimisation techniques for heterogeneous real-time embedded systems are presented in the paper. The authors address in more detail a particular class of such systems called multi...... of application messages to frames. Optimisation heuristics for frame packing aimed at producing a schedulable system are presented. Extensive experiments and a real-life example show the efficiency of the frame-packing approach....

Analysis and optimisation of heterogeneous real-time embedded systems

DEFF Research Database (Denmark)

Pop, Paul; Eles, Petru; Peng, Zebo

2006-01-01

. The success of such new design methods depends on the availability of analysis and optimisation techniques. Analysis and optimisation techniques for heterogeneous real-time embedded systems are presented in the paper. The authors address in more detail a particular class of such systems called multi...... of application messages to frames. Optimisation heuristics for frame packing aimed at producing a schedulable system are presented. Extensive experiments and a real-life example show the efficiency of the frame-packing approach....

Optimisation of process parameters on thin shell part using response surface methodology (RSM) and genetic algorithm (GA)

Science.gov (United States)

Faiz, J. M.; Shayfull, Z.; Nasir, S. M.; Fathullah, M.; Hazwan, M. H. M.

2017-09-01

This study conducts the simulation on optimisation of injection moulding process parameters using Autodesk Moldflow Insight (AMI) software. This study has applied some process parameters which are melt temperature, mould temperature, packing pressure, and cooling time in order to analyse the warpage value of the part. Besides, a part has been selected to be studied which made of Polypropylene (PP). The combination of the process parameters is analysed using Analysis of Variance (ANOVA) and the optimised value is obtained using Response Surface Methodology (RSM). The RSM as well as Genetic Algorithm are applied in Design Expert software in order to minimise the warpage value. The outcome of this study shows that the warpage value improved by using RSM and GA.

Isogeometric Analysis and Shape Optimisation

DEFF Research Database (Denmark)

Gravesen, Jens; Evgrafov, Anton; Gersborg, Allan Roulund

of the whole domain. So in every optimisation cycle we need to extend a parametrisation of the boundary of a domain to the whole domain. It has to be fast in order not to slow the optimisation down but it also has to be robust and give a parametrisation of high quality. These are conflicting requirements so we...... will explain how the validity of a parametrisation can be checked and we will describe various ways to parametrise a domain. We will in particular study the Winslow functional which turns out to have some desirable properties. Other problems we touch upon is clustering of boundary control points (design...

Personality disorder and alcohol treatment outcome: systematic review and meta-analysis.

Science.gov (United States)

Newton-Howes, Giles M; Foulds, James A; Guy, Nicola H; Boden, Joseph M; Mulder, Roger T

2017-07-01

Background Personality disorders commonly coexist with alcohol use disorders (AUDs), but there is conflicting evidence on their association with treatment outcomes. Aims To determine the size and direction of the association between personality disorder and the outcome of treatment for AUD. Method We conducted a systematic review and meta-analysis of randomised trials and longitudinal studies. Results Personality disorders were associated with more alcohol-related impairment at baseline and less retention in treatment. However, during follow-up people with a personality disorder showed a similar amount of improvement in alcohol outcomes to that of people without such disorder. Synthesis of evidence was hampered by variable outcome reporting and a low quality of evidence overall. Conclusions Current evidence suggests the pessimism about treatment outcomes for this group of patients may be unfounded. However, there is an urgent need for more consistent and better quality reporting of outcomes in future studies in this area. © The Royal College of Psychiatrists 2017.

Effects of efforts to optimise morbidity and mortality rounds to serve contemporary quality improvement and educational goals: a systematic review.

Science.gov (United States)

Smaggus, Andrew; Mrkobrada, Marko; Marson, Alanna; Appleton, Andrew

2018-01-01

The quality and safety movement has reinvigorated interest in optimising morbidity and mortality (M&M) rounds. We performed a systematic review to identify effective means of updating M&M rounds to (1) identify and address quality and safety issues, and (2) address contemporary educational goals. Relevant databases (Medline, Embase, PubMed, Education Resource Information Centre, Cumulative Index to Nursing and Allied Health Literature, Healthstar, and Global Health) were searched to identify primary sources. Studies were included if they (1) investigated an intervention applied to M&M rounds, (2) reported outcomes relevant to the identification of quality and safety issues, or educational outcomes relevant to quality improvement (QI), patient safety or general medical education and (3) included a control group. Study quality was assessed using the Medical Education Research Study Quality Instrument and Newcastle-Ottawa Scale-Education instruments. Given the heterogeneity of interventions and outcome measures, results were analysed thematically. The final analysis included 19 studies. We identified multiple effective strategies (updating objectives, standardising elements of rounds and attaching rounds to a formal quality committee) to optimise M&M rounds for a QI/safety purpose. These efforts were associated with successful integration of quality and safety content into rounds, and increased implementation of QI interventions. Consistent effects on educational outcomes were difficult to identify, likely due to the use of methodologies ill-fitted for educational research. These results are encouraging for those seeking to optimise the quality and safety mission of M&M rounds. However, the inability to identify consistent educational effects suggests the investigation of M&M rounds could benefit from additional methodologies (qualitative, mixed methods) in order to understand the complex mechanisms driving learning at M&M rounds. © Article author(s) (or their

Time varying acceleration coefficients particle swarm optimisation (TVACPSO): A new optimisation algorithm for estimating parameters of PV cells and modules

International Nuclear Information System (INIS)

Jordehi, Ahmad Rezaee

2016-01-01

Highlights: • A modified PSO has been proposed for parameter estimation of PV cells and modules. • In the proposed modified PSO, acceleration coefficients are changed during run. • The proposed modified PSO mitigates premature convergence problem. • Parameter estimation problem has been solved for both PV cells and PV modules. • The results show that proposed PSO outperforms other state of the art algorithms. - Abstract: Estimating circuit model parameters of PV cells/modules represents a challenging problem. PV cell/module parameter estimation problem is typically translated into an optimisation problem and is solved by metaheuristic optimisation problems. Particle swarm optimisation (PSO) is considered as a popular and well-established optimisation algorithm. Despite all its advantages, PSO suffers from premature convergence problem meaning that it may get trapped in local optima. Personal and social acceleration coefficients are two control parameters that, due to their effect on explorative and exploitative capabilities, play important roles in computational behavior of PSO. In this paper, in an attempt toward premature convergence mitigation in PSO, its personal acceleration coefficient is decreased during the course of run, while its social acceleration coefficient is increased. In this way, an appropriate tradeoff between explorative and exploitative capabilities of PSO is established during the course of run and premature convergence problem is significantly mitigated. The results vividly show that in parameter estimation of PV cells and modules, the proposed time varying acceleration coefficients PSO (TVACPSO) offers more accurate parameters than conventional PSO, teaching learning-based optimisation (TLBO) algorithm, imperialistic competitive algorithm (ICA), grey wolf optimisation (GWO), water cycle algorithm (WCA), pattern search (PS) and Newton algorithm. For validation of the proposed methodology, parameter estimation has been done both for

Treatment outcome in psychiatric inpatients: the discriminative value of self-esteem.

Science.gov (United States)

Talbot, France; Harris, Gregory E; French, Douglas J

2009-01-01

Self-esteem has been identified as an important clinical variable within various psychological and psychiatric conditions. Surprisingly, its prognostic and discriminative value in predicting treatment outcome has been understudied. The current study aims to assess, in an acute psychiatric setting, the comparative role of self-esteem in predicting treatment outcome in depression, anxiety, and global symptom severity, while controlling for socio-demographic variables, pre-treatment symptom severity, and personality pathology. Treatment outcome was assessed with pre- and post-treatment measures. A heterogeneous convenience sample of 63 psychiatric inpatients completed upon admission and discharge self-report measures of depression, anxiety, global symptom severity, and self-esteem. A significant one-way repeated-measures multivariate analysis of variance (MANOVA) followed up by analyses of variance (ANOVAs) revealed significant reductions in depression (eta2 = .72), anxiety (eta2 = .55), and overall psychological distress (eta2 = .60). Multiple regression analyses suggested that self-esteem was a significant predictor of short-term outcome in depression but not for anxiety or overall severity of psychiatric symptoms. The regression model predicting depression outcome explained 32% of the variance with only pre-treatment self-esteem contributing significantly to the prediction. The current study lends support to the importance of self-esteem as a pre-treatment patient variable predictive of psychiatric inpatient treatment outcome in relation with depressive symptomatology. Generalization to patient groups with specific diagnoses is limited due to the heterogeneous nature of the population sampled and the treatments provided. Implications for clinical practice and future research are discussed.

Economic advantages to optimising chemical products in pre-treatment in reverse osmosis desalination plants; Ventajas economicas al optimizar los productos quimicos en el pretratamiento de plantas desaladoras por osmosis inversa

Energy Technology Data Exchange (ETDEWEB)

Munoz Elguera, A.; Alday Ansola, J.; Perez Baez, S. O.

2001-07-01

This article reports the results of a process of optimising the dosage of Sodium hypochlorite and Metabisulphite, performed on sea water in the pre-treatment division of the Las Palmas III reverse osmosis desalination plant, currently operated by Empresa Mixta de Aguas de las Palmas (EMALSA), responsible for providing drinking water to more than 400.000 people in the city of Las Palmas, capital of Grand Canary Island. The results of this optimisation process, contrary to the opinion of the operators of the plant, after reducing the amount of Metabisulphite normally used in the plant by 70%, and Sodium hypochlorite by 30%, there were no adverse effects on the microbiological quality of the sea water. Moreover, the performance of the membranes was improved (bad odors disappeared, along with organic material sediments, etc.). (Author) 9 refs.

Share-of-Surplus Product Line Optimisation with Price Levels

Directory of Open Access Journals (Sweden)

X. G. Luo

2014-01-01

Full Text Available Kraus and Yano (2003 established the share-of-surplus product line optimisation model and developed a heuristic procedure for this nonlinear mixed-integer optimisation model. In their model, price of a product is defined as a continuous decision variable. However, because product line optimisation is a planning process in the early stage of product development, pricing decisions usually are not very precise. In this research, a nonlinear integer programming share-of-surplus product line optimization model that allows the selection of candidate price levels for products is established. The model is further transformed into an equivalent linear mixed-integer optimisation model by applying linearisation techniques. Experimental results in different market scenarios show that the computation time of the transformed model is much less than that of the original model.

Multiobjective optimisation of bogie suspension to boost speed on curves

Science.gov (United States)

Milad Mousavi-Bideleh, Seyed; Berbyuk, Viktor

2016-01-01

To improve safety and maximum admissible speed on different operational scenarios, multiobjective optimisation of bogie suspension components of a one-car railway vehicle model is considered. The vehicle model has 50 degrees of freedom and is developed in multibody dynamics software SIMPACK. Track shift force, running stability, and risk of derailment are selected as safety objective functions. The improved maximum admissible speeds of the vehicle on curves are determined based on the track plane accelerations up to 1.5 m/s2. To attenuate the number of design parameters for optimisation and improve the computational efficiency, a global sensitivity analysis is accomplished using the multiplicative dimensional reduction method (M-DRM). A multistep optimisation routine based on genetic algorithm (GA) and MATLAB/SIMPACK co-simulation is executed at three levels. The bogie conventional secondary and primary suspension components are chosen as the design parameters in the first two steps, respectively. In the last step semi-active suspension is in focus. The input electrical current to magnetorheological yaw dampers is optimised to guarantee an appropriate safety level. Semi-active controllers are also applied and the respective effects on bogie dynamics are explored. The safety Pareto optimised results are compared with those associated with in-service values. The global sensitivity analysis and multistep approach significantly reduced the number of design parameters and improved the computational efficiency of the optimisation. Furthermore, using the optimised values of design parameters give the possibility to run the vehicle up to 13% faster on curves while a satisfactory safety level is guaranteed. The results obtained can be used in Pareto optimisation and active bogie suspension design problems.

Original Paper Treatment and Outcome of Ankle Fractures at the Moi ...

African Journals Online (AJOL)

KIGZ

Key Words: Ankle fractures, Treatment outcome, Developing country ... protocols, surgeons still face unfavorable treatment outcomes. The injury .... and require special tests like Magnetic Resonance Imaging, ankle arthroscopy and nerve.

Establishing Local Reference Dose Values and Optimisation Strategies

International Nuclear Information System (INIS)

Connolly, P.; Moores, B.M.

2000-01-01

The revised EC Patient Directive 97/43 EURATOM introduces the concepts of clinical audit, diagnostic reference levels and optimisation of radiation protection in diagnostic radiology. The application of reference dose levels in practice involves the establishment of reference dose values as actual measurable operational quantities. These values should then form part of an ongoing optimisation and audit programme against which routine performance can be compared. The CEC Quality Criteria for Radiographic Images provides guidance reference dose values against which local performance can be compared. In many cases these values can be improved upon quite considerably. This paper presents the results of a local initiative in the North West of the UK aimed at establishing local reference dose values for a number of major hospital sites. The purpose of this initiative is to establish a foundation for both optimisation strategies and clinical audit as an ongoing and routine practice. The paper presents results from an ongoing trial involving patient dose measurements for several radiological examinations upon the sites. The results of an attempt to establish local reference dose values from measured dose values and to employ them in optimisation strategies are presented. In particular emphasis is placed on the routine quality control programmes necessary to underpin this strategy including the effective data management of results from such programmes and how they can be employed to optimisation practices. (author)

Treatment beliefs, health behaviors and their association with treatment outcome in type 2 diabetes

Science.gov (United States)

von Arx, Lill-Brith Wium; Gydesen, Helge; Skovlund, Søren

2016-01-01

Objective While the prevalence of type 2 diabetes is growing, it is increasingly well recognized that treatment outcomes in primary care practice are often suboptimal. The aim of this study is to examine the extent to which treatment beliefs and health behaviors predict diabetes health outcome as measured by glycated hemoglobin (HbA1c) level, blood pressure, and lipid profile. Research design and methods This was a large-scale cross-sectional, registry-based study involving a well-defined type 2 diabetes population, in the county of Funen, Denmark. Registry data were combined with a 27-item self-reported survey administered to all insulin-treated people in the registry (n=3160). The survey was constructed to operationalize key concepts of diabetes management, diabetes treatment beliefs, and health behaviors. Results In total, 1033 respondents answered the survey. The majority of treatment beliefs and health behaviors examined were predictors of glycemic control and, to a large extent, lipid profile. Absence from, or a low frequency of, self-measured blood glucose, non-adherence to general medical advice and the prescribed treatment, a low primary care utilization, and perceived low treatment efficacy were factors positively associated with HbA1c levels, s-cholesterol, and low-density lipoprotein. Conversely, infrequent self-measured blood glucose was associated with a significantly higher likelihood of having a blood pressure below 130/80 mm Hg. Perceived low treatment efficacy was the only health belief associated with poorer levels of health outcome other than HbA1c. Conclusions Health behaviors were stronger predictors for health outcomes than treatment beliefs. Self-reported adherence to either the treatment regimen or general medical advice most consistently predicted both glycemic control and cardiovascular risk factors. PMID:27110367

For Time-Continuous Optimisation

DEFF Research Database (Denmark)

Heinrich, Mary Katherine; Ayres, Phil

2016-01-01

Strategies for optimisation in design normatively assume an artefact end-point, disallowing continuous architecture that engages living systems, dynamic behaviour, and complex systems. In our Flora Robotica investigations of symbiotic plant-robot bio-hybrids, we re- quire computational tools...

Treatment outcomes among pulmonary tuberculosis patients at ...

African Journals Online (AJOL)

2009-10-05

Oct 5, 2009 ... in our environment. Keywords: Pulmonary tuberculosis; treatment centers; treatment outcome. Résumé paramètre: Centres de traitement de la tuberculose en Ibadan, Nigeria objectif: Pour évaluer les résultats de traitement et les déterminants de résultat entre la tuberculose patients. design: A plan d'étude ...

Optimisation in X-ray and Molecular Imaging 2015

International Nuclear Information System (INIS)

Baath, Magnus; Hoeschen, Christoph; Mattsson, Soeren; Mansson, Lars Gunnar

2016-01-01

This issue of Radiation Protection Dosimetry is based on contributions to Optimisation in X-ray and Molecular Imaging 2015 - the 4. Malmoe Conference on Medical Imaging (OXMI 2015). The conference was jointly organised by members of former and current research projects supported by the European Commission EURATOM Radiation Protection Research Programme, in cooperation with the Swedish Society for Radiation Physics. The conference brought together over 150 researchers and other professionals from hospitals, universities and industries with interests in different aspects of the optimisation of medical imaging. More than 100 presentations were given at this international gathering of medical physicists, radiologists, engineers, technicians, nurses and educational researchers. Additionally, invited talks were offered by world-renowned experts on radiation protection, spectral imaging and medical image perception, thus covering several important aspects of the generation and interpretation of medical images. The conference consisted of 13 oral sessions and a poster session, as reflected by the conference title connected by their focus on the optimisation of the use ionising radiation in medical imaging. The conference included technology-specific topics such as computed tomography and tomosynthesis, but also generic issues of interest for the optimisation of all medical imaging, such as image perception and quality assurance. Radiation protection was covered by e.g. sessions on patient dose benchmarking and occupational exposure. Technically-advanced topics such as modelling, Monte Carlo simulation, reconstruction, classification, and segmentation were seen taking advantage of recent developments of hardware and software, showing that the optimisation community is at the forefront of technology and adapts well to new requirements. These peer-reviewed proceedings, representing a continuation of a series of selected reports from meetings in the field of medical imaging

User perspectives in public transport timetable optimisation

DEFF Research Database (Denmark)

Jensen, Jens Parbo; Nielsen, Otto Anker; Prato, Carlo Giacomo

2014-01-01

The present paper deals with timetable optimisation from the perspective of minimising the waiting time experienced by passengers when transferring either to or from a bus. Due to its inherent complexity, this bi-level minimisation problem is extremely difficult to solve mathematically, since tim...... on the large-scale public transport network in Denmark. The timetable optimisation approach yielded a yearly reduction in weighted waiting time equivalent to approximately 45 million Danish kroner (9 million USD)....

Optimising of Steel Fiber Reinforced Concrete Mix Design | Beddar ...

African Journals Online (AJOL)

Optimising of Steel Fiber Reinforced Concrete Mix Design. ... as a result of the loss of mixture workability that will be translated into a difficult concrete casting in site. ... An experimental study of an optimisation method of fibres in reinforced ...

Neuroblastoma: treatment outcome after incomplete resection of primary tumors.

Science.gov (United States)

Moon, Suk-Bae; Park, Kwi-Won; Jung, Sung-Eun; Youn, Woong-Jae

2009-09-01

For International Neuroblastoma Staging System (INSS) stages III or IV neuroblastoma (intermediate or high risk), complete excision of the primary tumor is not always feasible. Most current studies on the treatment outcome of these patients have reported on the complete excision status. The aim of this study is to review the treatment outcome after the incomplete resection. The medical records of 37 patients that underwent incomplete resection between January 1986 and December 2005 were reviewed retrospectively. Incomplete resection was assessed by review of the operative notes and postoperative computerized tomography. Age, gender, tumor location, INSS stage, N-myc gene copy number, pre- and postoperative therapy, and treatment outcome were reviewed. The treatment outcome was evaluated according to the postoperative treatment protocol in the high-risk group. Intermediate-risk patients were treated with conventional chemotherapy, isotretinoin (ITT) and interleukin-2 (IL-2). High-risk patients were treated with peripheral blood stem cell transplantation (PBSCT), ITT, and IL-2 (N = 11). Before the introduction of PBSCT, the high-risk patients were also treated with the conventional chemotherapy (N = 19). Intermediate-risk patients (N = 5) currently have no evidence of disease (NED). For the high-risk patients (N = 32), 19 patients were treated with chemotherapy alone; 15 patients died of their disease while four patients currently have an NED status. Eight of 11 patients that underwent PBSCT are currently alive. For intermediate risk, conventional chemotherapy appears to be acceptable treatment. However, for high-risk patients, every effort should be made to control residual disease including the use of myeloablative chemotherapy, differentiating agents and immune-modulating agents.

Optimisation of chemical solution deposition of indium tin oxide thin films

Energy Technology Data Exchange (ETDEWEB)

Sunde, Tor Olav Løveng; Einarsrud, Mari-Ann; Grande, Tor, E-mail: grande@ntnu.no

2014-12-31

An environmentally friendly aqueous sol–gel process has been optimised to deposit indium tin oxide (ITO) thin films, aiming to improve the film properties and reduce the deposition costs. It was demonstrated how parameters such as cation concentration and viscosity could be applied to modify the physical properties of the sol and thereby reduce the need for multiple coatings to yield films with sufficient conductivity. The conductivity of the thin films was enhanced by adjusting the heat treatment temperature and atmosphere. Both increasing the heat treatment temperature of the films from 530 to 800 °C and annealing in reducing atmosphere significantly improved the electrical conductivity, and conductivities close to the state of the art sputtered ITO films were obtained. A pronounced decreased conductivity was observed after exposing the thin films to air and the thermal reduction and ageing of the film was studied by in situ conductivity measurements. - Highlights: • Spin coating of indium tin oxide using an aqueous solution was optimised. • The conductivity was enhanced by thermal annealing in reducing atmosphere. • The conductivity of is comparable to the conductivity of sputtered films. • A relaxation process in the reduced thin film was observed after exposure in air.

The influence of the dwell time deviation constraint (DTDC) parameter on dosimetry with IPSA optimisation for HDR prostate brachytherapy

International Nuclear Information System (INIS)

Smith, Ryan L.; Millar, Jeremy L.; Panettieri, Vanessa; Mason, Natasha; Lancaster, Craig; Francih, Rick D.

2015-01-01

To investigate how the dwell time deviation constraint (DTDC) parameter, applied to inverse planning by simulated annealing (IPSA) optimisation limits large dwell times from occurring in each catheter and to characterise the effect on the resulting dosimetry for prostate high dose rate (HDR) brachytherapy treatment plans. An unconstrained IPSA optimised treatment plan, using the Oncentra Brachytherapy treatment planning system (version 4.3, Nucletron an Elekta company, Elekta AB, Stockholm, Sweden), was generated for 20 consecutive HDR prostate brachytherapy patients, with the DTDC set to zero. Successive constrained optimisation plans were also created for each patient by increasing the DTDC parameter by 0.2, up to a maximum value of 1.0. We defined a “plan modulation index”, to characterise the change of dwell time modulation as the DTDC parameter was increased. We calculated the dose volume histogram indices for the PTV (D90, V100, V150, V200%) and urethra (D10%) to characterise the effect on the resulting dosimetry. The average PTV D90% decreases as the DTDC is applied, on average by only 1.5 %, for a DTDC = 0.4. The measures of high dose regions in the PTV, V150 and V200%, increase on average by less than 5 and 2 % respectively. The net effect of DTDC on the modulation of dwell times has been characterised by the introduction of the plan modulation index. DTDC applied during IPSA optimisation of HDR prostate brachytherapy plans reduce the occurrence of large isolated dwell times within individual catheters. The mechanism by which DTDC works has been described and its effect on the modulation of dwell times has been characterised. The authors recommend using a DTDC parameter no greater than 0.4 to obtain a plan with dwell time modulation comparable to a geometric optimised plan. This yielded on average a 1.5 % decrease in PTV coverage and an acceptable increase in V150%, without compromising the urethral dose.

Treatment beliefs, health behaviors and their association with treatment outcome in type 2 diabetes

DEFF Research Database (Denmark)

von Arx, Lill-Brith Wium; Gydesen, Helge; Skovlund, Søren

2016-01-01

Objective: While the prevalence of type 2 diabetes is growing, it is increasingly well recognized that treatment outcomes in primary care practice are often suboptimal. The aim of this study is to examine the extent to which treatment beliefs and health behaviors predict diabetes health outcome......-reported survey administered to all insulin-treated people in the registry (n=3160). The survey was constructed to operationalize key concepts of diabetes management, diabetes treatment beliefs, and health behaviors. Results: In total, 1033 respondents answered the survey. The majority of treatment beliefs...... and health behaviors examined were predictors of glycemic control and, to a large extent, lipid profile. Absence from, or a low frequency of, self-measured blood glucose, non-adherence to general medical advice and the prescribed treatment, a low primary care utilization, and perceived low treatment efficacy...

Prioritizing treatment outcomes: How people with acne vulgaris decide if their treatment is working.

Science.gov (United States)

Layton, Alison M; Whitehouse, Heather; Eady, E Anne; Cowdell, Fiona; Warburton, Katharine L; Fenton, Mark

2017-08-01

To collect information about how people with acne make day-to-day decisions concerning the effectiveness of their treatment. Between May and August 2013, an optional question was embedded in the James Lind Alliance Acne Priority Setting Partnership's online survey to collect treatment uncertainties. The question asked people with acne to "Tell us in your own words how you decide if your treatment has been effective." A total of 742 respondents specified at least one outcome or means of assessing change (outcome measure). Fewer spots were the most commonly cited outcome, identified by 272 respondents (36.7%). Other frequently mentioned outcomes were in descending order: less redness (19.4%), reduction in spot size (12.1%), and less pain/discomfort (11.4%). Signs were much more commonly used than symptoms and surrogate outcomes such as changes in aspects of life quality were infrequently mentioned. Visual inspection of the skin was the most widely adopted outcome measure (16.3%). Although the most frequently used methods map well onto the outcome measures adopted in the majority of acne trials, namely physician-assessed changes in lesion counts and global acne severity, people with acne often take into account several factors that cannot be assessed by a third party at a single point in time. The minimal use of changes in psychosocial wellbeing and mood may reflect that these are regarded as secondary consequences of improvements in appearance. The robustness of these findings now requires independent evaluation. If confirmed, they could form the basis of a new patient-reported outcome measure. © 2017 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

Optimisation of key performance measures in air cargo demand management

Directory of Open Access Journals (Sweden)

Alexander May

2014-04-01

Full Text Available This article sought to facilitate the optimisation of key performance measures utilised for demand management in air cargo operations. The focus was on the Revenue Management team at Virgin Atlantic Cargo and a fuzzy group decision-making method was used. Utilising intelligent fuzzy multi-criteria methods, the authors generated a ranking order of ten key outcome-based performance indicators for Virgin Atlantic air cargo Revenue Management. The result of this industry-driven study showed that for Air Cargo Revenue Management, ‘Network Optimisation’ represents a critical outcome-based performance indicator. This collaborative study contributes to existing logistics management literature, especially in the area of Revenue Management, and it seeks to enhance Revenue Management practice. It also provides a platform for Air Cargo operators seeking to improve reliability values for their key performance indicators as a means of enhancing operational monitoring power.

Automatic optimisation of beam orientations using the simplex algorithm and optimisation of quality control using statistical process control (S.P.C.) for intensity modulated radiation therapy (I.M.R.T.)

International Nuclear Information System (INIS)

Gerard, K.

2008-11-01

Intensity Modulated Radiation Therapy (I.M.R.T.) is currently considered as a technique of choice to increase the local control of the tumour while reducing the dose to surrounding organs at risk. However, its routine clinical implementation is partially held back by the excessive amount of work required to prepare the patient treatment. In order to increase the efficiency of the treatment preparation, two axes of work have been defined. The first axis concerned the automatic optimisation of beam orientations. We integrated the simplex algorithm in the treatment planning system. Starting from the dosimetric objectives set by the user, it can automatically determine the optimal beam orientations that best cover the target volume while sparing organs at risk. In addition to time sparing, the simplex results of three patients with a cancer of the oropharynx, showed that the quality of the plan is also increased compared to a manual beam selection. Indeed, for an equivalent or even a better target coverage, it reduces the dose received by the organs at risk. The second axis of work concerned the optimisation of pre-treatment quality control. We used an industrial method: Statistical Process Control (S.P.C.) to retrospectively analyse the absolute dose quality control results performed using an ionisation chamber at Centre Alexis Vautrin (C.A.V.). This study showed that S.P.C. is an efficient method to reinforce treatment security using control charts. It also showed that our dose delivery process was stable and statistically capable for prostate treatments, which implies that a reduction of the number of controls can be considered for this type of treatment at the C.A.V.. (author)

Combining clinical variables to optimize prediction of antidepressant treatment outcomes.

Science.gov (United States)

Iniesta, Raquel; Malki, Karim; Maier, Wolfgang; Rietschel, Marcella; Mors, Ole; Hauser, Joanna; Henigsberg, Neven; Dernovsek, Mojca Zvezdana; Souery, Daniel; Stahl, Daniel; Dobson, Richard; Aitchison, Katherine J; Farmer, Anne; Lewis, Cathryn M; McGuffin, Peter; Uher, Rudolf

2016-07-01

The outcome of treatment with antidepressants varies markedly across people with the same diagnosis. A clinically significant prediction of outcomes could spare the frustration of trial and error approach and improve the outcomes of major depressive disorder through individualized treatment selection. It is likely that a combination of multiple predictors is needed to achieve such prediction. We used elastic net regularized regression to optimize prediction of symptom improvement and remission during treatment with escitalopram or nortriptyline and to identify contributing predictors from a range of demographic and clinical variables in 793 adults with major depressive disorder. A combination of demographic and clinical variables, with strong contributions from symptoms of depressed mood, reduced interest, decreased activity, indecisiveness, pessimism and anxiety significantly predicted treatment outcomes, explaining 5-10% of variance in symptom improvement with escitalopram. Similar combinations of variables predicted remission with area under the curve 0.72, explaining approximately 15% of variance (pseudo R(2)) in who achieves remission, with strong contributions from body mass index, appetite, interest-activity symptom dimension and anxious-somatizing depression subtype. Escitalopram-specific outcome prediction was more accurate than generic outcome prediction, and reached effect sizes that were near or above a previously established benchmark for clinical significance. Outcome prediction on the nortriptyline arm did not significantly differ from chance. These results suggest that easily obtained demographic and clinical variables can predict therapeutic response to escitalopram with clinically meaningful accuracy, suggesting a potential for individualized prescription of this antidepressant drug. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Methodological principles for optimising functional MRI experiments

International Nuclear Information System (INIS)

Wuestenberg, T.; Giesel, F.L.; Strasburger, H.

2005-01-01

Functional magnetic resonance imaging (fMRI) is one of the most common methods for localising neuronal activity in the brain. Even though the sensitivity of fMRI is comparatively low, the optimisation of certain experimental parameters allows obtaining reliable results. In this article, approaches for optimising the experimental design, imaging parameters and analytic strategies will be discussed. Clinical neuroscientists and interested physicians will receive practical rules of thumb for improving the efficiency of brain imaging experiments. (orig.) [de

Greater expectations: using hierarchical linear modeling to examine expectancy for treatment outcome as a predictor of treatment response.

Science.gov (United States)

Price, Matthew; Anderson, Page; Henrich, Christopher C; Rothbaum, Barbara Olasov

2008-12-01

A client's expectation that therapy will be beneficial has long been considered an important factor contributing to therapeutic outcomes, but recent empirical work examining this hypothesis has primarily yielded null findings. The present study examined the contribution of expectancies for treatment outcome to actual treatment outcome from the start of therapy through 12-month follow-up in a clinical sample of individuals (n=72) treated for fear of flying with either in vivo exposure or virtual reality exposure therapy. Using a piecewise hierarchical linear model, outcome expectancy predicted treatment gains made during therapy but not during follow-up. Compared to lower levels, higher expectations for treatment outcome yielded stronger rates of symptom reduction from the beginning to the end of treatment on 2 standardized self-report questionnaires on fear of flying. The analytic approach of the current study is one potential reason that findings contrast with prior literature. The advantages of using hierarchical linear modeling to assess interindividual differences in longitudinal data are discussed.

Noise aspects at aerodynamic blade optimisation projects

International Nuclear Information System (INIS)

Schepers, J.G.

1997-06-01

The Netherlands Energy Research Foundation (ECN) has often been involved in industrial projects, in which blade geometries are created automatic by means of numerical optimisation. Usually, these projects aim at the determination of the aerodynamic optimal wind turbine blade, i.e. the goal is to design a blade which is optimal with regard to energy yield. In other cases, blades have been designed which are optimal with regard to cost of generated energy. However, it is obvious that the wind turbine blade designs which result from these optimisations, are not necessarily optimal with regard to noise emission. In this paper an example is shown of an aerodynamic blade optimisation, using the ECN-program PVOPT. PVOPT calculates the optimal wind turbine blade geometry such that the maximum energy yield is obtained. Using the aerodynamic optimal blade design as a basis, the possibilities of noise reduction are investigated. 11 figs., 8 refs

Depressive personality and treatment outcome in major depressive disorder.

Science.gov (United States)

Ryder, Andrew G; Quilty, Lena C; Vachon, David D; Bagby, R Michael

2010-06-01

Depressive personality disorder (DPD) is currently included in the DSM-IV Appendix B, Criteria Sets and Axes Provided for Further Study. Evidence of the clinical utility of DPD will likely play an important role in the determination of whether it warrants inclusion in future editions of DSM. The current investigation examines the capacity of DPD traits to predict overall and preferential treatment outcome for patients with Major Depressive Disorder (MDD) (N = 120) using data from a randomized control trial, which included cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and antidepressant medication (ADM) treatment arms. Patients were treated for 16-20 weeks and completed the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Questionnaire (SCID-II/PQ) and the 17-item Hamilton Rating Scale for Depression immediately before and after treatment. Higher scores on a dimensionalized SCID-II/PQ subscale assessing DPD traits were associated with poor outcome for IPT, but not CBT or ADM. This result remained after accounting for variance associated with other personality disorder (PD) traits; none of the other 10 main text PDs predicted treatment outcome.

Uncertainties in model-based outcome predictions for treatment planning

International Nuclear Information System (INIS)

Deasy, Joseph O.; Chao, K.S. Clifford; Markman, Jerry

2001-01-01

Purpose: Model-based treatment-plan-specific outcome predictions (such as normal tissue complication probability [NTCP] or the relative reduction in salivary function) are typically presented without reference to underlying uncertainties. We provide a method to assess the reliability of treatment-plan-specific dose-volume outcome model predictions. Methods and Materials: A practical method is proposed for evaluating model prediction based on the original input data together with bootstrap-based estimates of parameter uncertainties. The general framework is applicable to continuous variable predictions (e.g., prediction of long-term salivary function) and dichotomous variable predictions (e.g., tumor control probability [TCP] or NTCP). Using bootstrap resampling, a histogram of the likelihood of alternative parameter values is generated. For a given patient and treatment plan we generate a histogram of alternative model results by computing the model predicted outcome for each parameter set in the bootstrap list. Residual uncertainty ('noise') is accounted for by adding a random component to the computed outcome values. The residual noise distribution is estimated from the original fit between model predictions and patient data. Results: The method is demonstrated using a continuous-endpoint model to predict long-term salivary function for head-and-neck cancer patients. Histograms represent the probabilities for the level of posttreatment salivary function based on the input clinical data, the salivary function model, and the three-dimensional dose distribution. For some patients there is significant uncertainty in the prediction of xerostomia, whereas for other patients the predictions are expected to be more reliable. In contrast, TCP and NTCP endpoints are dichotomous, and parameter uncertainties should be folded directly into the estimated probabilities, thereby improving the accuracy of the estimates. Using bootstrap parameter estimates, competing treatment

Breast Cancer: Treatment, Outcomes, and Cost-Effectiveness

National Research Council Canada - National Science Library

McClellan, Mark

2000-01-01

...) use Medicare data, linked SEER cancer registry data, and claims data from large firms to analyze trends in diagnosis rates and staging, treatment, expenditures, and outcomes for Americans with breast cancer; and (3...

Instrumental variable estimation of treatment effects for duration outcomes

NARCIS (Netherlands)

G.E. Bijwaard (Govert)

2007-01-01

textabstractIn this article we propose and implement an instrumental variable estimation procedure to obtain treatment effects on duration outcomes. The method can handle the typical complications that arise with duration data of time-varying treatment and censoring. The treatment effect we

DACIA LOGAN LIVE AXLE OPTIMISATION USING COMPUTER GRAPHICS

Directory of Open Access Journals (Sweden)

KIRALY Andrei

2017-05-01

Full Text Available The paper presents some contributions to the calculus and optimisation of a live axle used at Dacia Logan using computer graphics software for creating the model and afterwards using FEA evaluation to determine the effectiveness of the optimisation. Thus using specialized computer software, a simulation is made and the results were compared to the measured real prototype.

Experiential acceptance, motivation for recovery, and treatment outcome in eating disorders.

Science.gov (United States)

Espel, Hallie M; Goldstein, Stephanie P; Manasse, Stephanie M; Juarascio, Adrienne S

2016-06-01

This study sought to test whether the relationship between experiential acceptance (EA) and treatment outcome among eating disorder (ED) patients was mediated by motivation. Upon admission to a residential ED treatment facility, female patients completed measures of EA, motivation, and baseline ED symptom severity (covariate); symptom severity was reassessed at discharge. Higher levels of baseline EA predicted significantly greater symptom reduction during treatment. Moreover, results from bootstrapped mediation analyses indicated that the relationship between EA and treatment outcome was partially mediated by motivation: increased EA was associated with greater motivation to give up ED behaviors at the beginning of treatment, and this led to greater symptom reduction from admission to discharge. Motivation appears to be one mechanism by which EA facilitates improved treatment outcomes in EDs. Further development of interventions that promote EA as a means for improving motivation and subsequent ED treatment response may be warranted.

Mesh dependence in PDE-constrained optimisation an application in tidal turbine array layouts

CERN Document Server

Schwedes, Tobias; Funke, Simon W; Piggott, Matthew D

2017-01-01

This book provides an introduction to PDE-constrained optimisation using finite elements and the adjoint approach. The practical impact of the mathematical insights presented here are demonstrated using the realistic scenario of the optimal placement of marine power turbines, thereby illustrating the real-world relevance of best-practice Hilbert space aware approaches to PDE-constrained optimisation problems. Many optimisation problems that arise in a real-world context are constrained by partial differential equations (PDEs). That is, the system whose configuration is to be optimised follows physical laws given by PDEs. This book describes general Hilbert space formulations of optimisation algorithms, thereby facilitating optimisations whose controls are functions of space. It demonstrates the importance of methods that respect the Hilbert space structure of the problem by analysing the mathematical drawbacks of failing to do so. The approaches considered are illustrated using the optimisation problem arisin...

CLIC crab cavity design optimisation for maximum luminosity

Energy Technology Data Exchange (ETDEWEB)

Dexter, A.C., E-mail: a.dexter@lancaster.ac.uk [Lancaster University, Lancaster, LA1 4YR (United Kingdom); Cockcroft Institute, Daresbury, Warrington, WA4 4AD (United Kingdom); Burt, G.; Ambattu, P.K. [Lancaster University, Lancaster, LA1 4YR (United Kingdom); Cockcroft Institute, Daresbury, Warrington, WA4 4AD (United Kingdom); Dolgashev, V. [SLAC, Menlo Park, CA 94025 (United States); Jones, R. [University of Manchester, Manchester, M13 9PL (United Kingdom)

2011-11-21

The bunch size and crossing angle planned for CERN's compact linear collider CLIC dictate that crab cavities on opposing linacs will be needed to rotate bunches of particles into alignment at the interaction point if the desired luminosity is to be achieved. Wakefield effects, RF phase errors between crab cavities on opposing linacs and unpredictable beam loading can each act to reduce luminosity below that anticipated for bunches colliding in perfect alignment. Unlike acceleration cavities, which are normally optimised for gradient, crab cavities must be optimised primarily for luminosity. Accepting the crab cavity technology choice of a 12 GHz, normal conducting, travelling wave structure as explained in the text, this paper develops an analytical approach to optimise cell number and iris diameter.

Advances in eating disorder therapy

DEFF Research Database (Denmark)

Davidsen, Annika Helgadóttir; Lau, Marianne Engelbrecht

2014-01-01

Researchers at the Stolpegaard Psychotherapy Centre are seeking to improve outcomes for patients with eating disorders by gathering their feedback on group psychotherapy sessions with the aim of optimising treatment.......Researchers at the Stolpegaard Psychotherapy Centre are seeking to improve outcomes for patients with eating disorders by gathering their feedback on group psychotherapy sessions with the aim of optimising treatment....

A conceptual optimisation strategy for radiography in a digital environment

International Nuclear Information System (INIS)

Baath, M.; Haakansson, M.; Hansson, J.; Maansson, L. G.

2005-01-01

Using a completely digital environment for the entire imaging process leads to new possibilities for optimisation of radiography since many restrictions of screen/film systems, such as the small dynamic range and the lack of possibilities for image processing, do not apply any longer. However, at the same time these new possibilities lead to a more complicated optimisation process, since more freedom is given to alter parameters. This paper focuses on describing an optimisation strategy that concentrates on taking advantage of the conceptual differences between digital systems and screen/film systems. The strategy can be summarised as: (a) always include the anatomical background during the optimisation, (b) perform all comparisons at a constant effective dose and (c) separate the image display stage from the image collection stage. A three-step process is proposed where the optimal setting of the technique parameters is determined at first, followed by an optimisation of the image processing. In the final step the optimal dose level - given the optimal settings of the image collection and image display stages - is determined. (authors)

Trends in treatment and outcomes of pediatric craniopharyngioma, 1975-2011.

Science.gov (United States)

Cohen, Michal; Bartels, Ute; Branson, Helen; Kulkarni, Abhaya V; Hamilton, Jill

2013-06-01

Craniopharyngioma tumors and their treatment can lead to significant long-term morbidity due to their proximity to vital structures. The optimal treatment has been debated for many years. We aimed to review the long-term outcomes of children treated for craniopharyngioma in our institution over the past decade and describe trends in treatment and outcomes over the past 3 decades. Charts of children with craniopharyngioma treated and followed at The Hospital for Sick Children between 2001 and 2011 were reviewed. Data regarding findings at diagnosis, treatment, and long-term outcomes were analyzed. Comparison was made with previously published data from our institution. Data from 33 patients are included; mean age at treatment, 10.7 ± 4.8 years. In 18 children (55%), the initial surgical approach was tumor cyst decompression with or without adjuvant therapy, compared with only 0-2% in the preceding decades (P < .01). Diabetes insipidus occurred in 55% of children and panhypopituitarism in 58% compared with 88% (P < .01) and 86% (P < .01), respectively, in the previous 10 years. Overall, there was a 36% reduction in the number of children who developed severe obesity compared with the preceding decade. Body mass index at follow-up was associated with body mass index at diagnosis (P = .004) and tumor resection as an initial treatment approach (P = .028). A shift in surgical treatment approach away from gross total resection has led to improved endocrine outcomes. This may have beneficial implications for quality of life in survivors.

Optimisation and evaluation of the foetal dose during a radiotherapy of the right parotid; Optimisation et evaluation de la dose foetale pendant une radiotherapie de la parotide droite

Energy Technology Data Exchange (ETDEWEB)

Marchesi, V.; Noel, A. [Centre Alexis-Vautrin, Unite de Radiophysique Medicale, 54 - Vandoeuvre-les-Nancy (France); Graff, P.; Beckendorf, V.; Peiffert, D. [Centre Alexis-Vautrin, Dept. de Radiotherapie, 54 - Vandoeuvre-les-Nancy (France); Noel, A. [Institut National Polytechnique de Lorraine, CRAN, CNRS UMR-7039, 54 - Vandoeuvre-les-Nancy (France)

2008-09-15

Purpose was to optimize and to estimate the dose delivered to the foetus during a postoperative irradiation of a 5-month twin pregnant woman presenting with adenocarcinoma of the right parotid. The treatment protocol aimed to deliver 66 Gy conformal radiation therapy on the tumour bed associated to a prophylactic irradiation of 50 Gy on the upper cervical nodes. A series of measurements allowed to estimate the delivered dose in the abdomen by the means of an ion chamber inserted in a water phantom placed side by side of an anthropomorphic Alderson Rando phantom simulating the body of the patient from the head to the pelvis. An appropriate optimisation of the number and orientation of beams were performed in order to minimize the peripheral dose, which is mostly dependent of the total number of monitor unit per fraction: cervical nodes and tumour site included in the same fields, limitation of the irradiated volume, 6 MV X-ray beams rather than Cobalt beams. The measured doses at the upper, in the middle and at the lower part of the abdomen were 17.0, 11.0 and 11.9 mGy, respectively, for the entire treatment, representing 0.025, 0.016 and 0.017%, respectively of the prescribed dose. The actions conducted to optimise the treatment allowed to lower doses delivered to the foetus under the limits proposed by international recommendations (100 mGy). Thus, the treatment of the pregnant patient had been performed with a minimized risk for the foetus. (authors)

Optimisation of a novel trailing edge concept for a high lift device

CSIR Research Space (South Africa)

Botha, JDM

2014-09-01

Full Text Available A novel concept (referred to as the flap extension) is implemented on the leading edge of the flap of a three element high lift device. The concept is optimised using two optimisation approaches based on Genetic Algorithm optimisations. A zero order...

Distributed optimisation problem with communication delay and external disturbance

Science.gov (United States)

Tran, Ngoc-Tu; Xiao, Jiang-Wen; Wang, Yan-Wu; Yang, Wu

2017-12-01

This paper investigates the distributed optimisation problem for the multi-agent systems (MASs) with the simultaneous presence of external disturbance and the communication delay. To solve this problem, a two-step design scheme is introduced. In the first step, based on the internal model principle, the internal model term is constructed to compensate the disturbance asymptotically. In the second step, a distributed optimisation algorithm is designed to solve the distributed optimisation problem based on the MASs with the simultaneous presence of disturbance and communication delay. Moreover, in the proposed algorithm, each agent interacts with its neighbours through the connected topology and the delay occurs during the information exchange. By utilising Lyapunov-Krasovskii functional, the delay-dependent conditions are derived for both slowly and fast time-varying delay, respectively, to ensure the convergence of the algorithm to the optimal solution of the optimisation problem. Several numerical simulation examples are provided to illustrate the effectiveness of the theoretical results.

A Bayesian Approach for Sensor Optimisation in Impact Identification

Directory of Open Access Journals (Sweden)

Vincenzo Mallardo

2016-11-01

Full Text Available This paper presents a Bayesian approach for optimizing the position of sensors aimed at impact identification in composite structures under operational conditions. The uncertainty in the sensor data has been represented by statistical distributions of the recorded signals. An optimisation strategy based on the genetic algorithm is proposed to find the best sensor combination aimed at locating impacts on composite structures. A Bayesian-based objective function is adopted in the optimisation procedure as an indicator of the performance of meta-models developed for different sensor combinations to locate various impact events. To represent a real structure under operational load and to increase the reliability of the Structural Health Monitoring (SHM system, the probability of malfunctioning sensors is included in the optimisation. The reliability and the robustness of the procedure is tested with experimental and numerical examples. Finally, the proposed optimisation algorithm is applied to a composite stiffened panel for both the uniform and non-uniform probability of impact occurrence.

SINGLE FIXED CRANE OPTIMISATION WITHIN A DISTRIBUTION CENTRE

Directory of Open Access Journals (Sweden)

J. Matthews

2012-01-01

Full Text Available

ENGLISH ABSTRACT: This paper considersthe optimisation of the movement of a fixed crane operating in a single aisle of a distribution centre. The crane must move pallets in inventory between docking bays, storage locations, and picking lines. Both a static and a dynamic approach to the problem are presented. The optimisation is performed by means of tabu search, ant colony metaheuristics,and hybrids of these two methods. All these solution approaches were tested on real life data obtained from an operational distribution centre. Results indicate that the hybrid methods outperform the other approaches.

AFRIKAANSE OPSOMMING: Die optimisering van die beweging van 'n vaste hyskraan in 'n enkele gang van 'n distribusiesentrum word in hierdie artikel beskou. Die hyskraan moet pallette vervoer tussen dokhokke, stoorposisies, en opmaaklyne. Beide 'n statiese en 'n dinamiese benadering tot die probleem word aangebied. Die optimisering word gedoen met behulp van tabu-soektogte, mierkolonieoptimisering,en hibriede van hierdie twee metodes. Al die oplossingsbenaderings is getoets met werklike data wat van 'n operasionele distribusiesentrum verkry is. Die resultate toon aan dat die hibriedmetodes die beste oplossings lewer.

Multi-objective evolutionary optimisation for product design and manufacturing

CERN Document Server

2011-01-01

Presents state-of-the-art research in the area of multi-objective evolutionary optimisation for integrated product design and manufacturing Provides a comprehensive review of the literature Gives in-depth descriptions of recently developed innovative and novel methodologies, algorithms and systems in the area of modelling, simulation and optimisation

Childhood Tuberculosis in Nigeria: Disease Presentation and Treatment Outcomes

Directory of Open Access Journals (Sweden)

Chidubem L Ogbudebe

2018-02-01

Full Text Available Objectives: Understanding the factors that influence tuberculosis (TB treatment outcomes in children is key to designing interventions to address them. This study aimed to determine the case category distribution of childhood TB in Nigeria and assess which clinical and demographic factors are associated with different treatment outcomes in childhood TB. Materials and methods: This was a retrospective cohort study involving a review of medical records of children (0-14 years with TB in 3 states in Nigeria in 2015. Results: Of 724 childhood TB cases registered during the review period, 220 (30.4% were aged 0–4 years. A high proportion of patients had pulmonary TB 420/724 (58.0%, new TB infection 713/724 (98.5%, and human immunodeficiency virus (HIV coinfection 108/724 (14.7%. About 28% (n = 201 were bacteriologically diagnosed. The proportion of TB treatment success was 601/724 (83.0%. Treatment success was significantly higher in children aged 5–14 years than those 0–4 years (85.3% vs 77.7%, P  = .01. Factors associated with unsuccessful outcomes in patients aged 0–4 years are male sex (adjusted odds ratio [aOR]: 1.2, HIV-positive status (aOR: 1.2, and clinical method of diagnosis (aOR: 5.6. Conclusions: Efforts should be made to improve TB treatment outcomes in children by ensuring early and accurate diagnosis, focused training of health workers on childhood TB-HIV care, and effective adherence counseling of caregivers.

Concordance of programmatic and laboratory-based multidrug-resistant tuberculosis treatment outcomes in Peru.

Science.gov (United States)

Alexy, E R; Podewils, L J; Mitnick, C D; Becerra, M C; Laserson, K F; Bonilla, C

2012-01-01

Confirmation of cure for multidrug-resistant tuberculosis (MDR-TB) patients requires laboratory tests for Mycobacterium tuberculosis growth on culture media. Outcome decisions dictate patient management, and inaccuracies place patients at an increased risk of morbidity and mortality, and may contribute to continued transmission of MDR-TB. To examine concordance between programmatic and laboratory-based MDR-TB treatment outcomes. The study population included 1658 MDR-TB patients in Peru treated between 1996 and 2002 with both program and laboratory-based outcomes. Laboratory-based outcomes were assigned according to international standards requiring at least five consecutive negative cultures in the last 12 months of treatment to confirm cure. Compared to the global culture-defined standard classification, only 1.1% of treatment successes, but 54.3% of failures, were misclassified programmatically. Overall, 10.4% of patients identified by a clinician as having a successful treatment outcome still had cultures positive for MDR-TB. Most patients with successful treatment outcomes by strict culture definitions were also classified by clinicians as having successful outcomes. However, many culture-confirmed failures were missed. In light of delays and incomplete access to culture in MDR-TB programs, efforts should be made to improve the accuracy of programmatically determined treatment outcomes.

Natural Erosion of Sandstone as Shape Optimisation.

Science.gov (United States)

Ostanin, Igor; Safonov, Alexander; Oseledets, Ivan

2017-12-11

Natural arches, pillars and other exotic sandstone formations have always been attracting attention for their unusual shapes and amazing mechanical balance that leave a strong impression of intelligent design rather than the result of a stochastic process. It has been recently demonstrated that these shapes could have been the result of the negative feedback between stress and erosion that originates in fundamental laws of friction between the rock's constituent particles. Here we present a deeper analysis of this idea and bridge it with the approaches utilized in shape and topology optimisation. It appears that the processes of natural erosion, driven by stochastic surface forces and Mohr-Coulomb law of dry friction, can be viewed within the framework of local optimisation for minimum elastic strain energy. Our hypothesis is confirmed by numerical simulations of the erosion using the topological-shape optimisation model. Our work contributes to a better understanding of stochastic erosion and feasible landscape formations that could be found on Earth and beyond.

Including a range of outcome targets offers a broader view of fibromyalgia treatment outcome: results from a retrospective review of multidisciplinary treatment.

Science.gov (United States)

Marcus, Dawn A; Bernstein, Cheryl D; Haq, Adeel; Breuer, Paula

2014-06-01

Fibromyalgia is associated with substantial functional disability. Current drug and non-drug treatments result in statistically significant but numerically small improvements in typical numeric measures of pain severity and fibromyalgia impact. The aim of the present study was to evaluate additional measures of pain severity and functional outcome that might be affected by fibromyalgia treatment. This retrospective review evaluated outcomes from 274 adults with fibromyalgia who participated in a six-week, multidisciplinary treatment programme. Pain and function were evaluated on the first and final treatment visit. Pain was evaluated using an 11-point numerical scale to determine clinically meaningful pain reduction (decrease ≥ 2 points) and from a pain drawing. Function was evaluated by measuring active range of motion (ROM), walking distance and speed, upper extremity exercise repetitions, and self-reports of daily activities. Numerical rating scores for pain decreased by 10-13% (p Fibromyalgia Impact Questionnaire (FIQ) scores decreased by 20% (p fibromyalgia treatment effectiveness. © 2013 John Wiley & Sons, Ltd.

Formulation and optimisation of raft-forming chewable tablets containing H2 antagonist.

Science.gov (United States)

Prajapati, Shailesh T; Mehta, Anant P; Modhia, Ishan P; Patel, Chhagan N

2012-10-01

The purpose of this research work was to formulate raft-forming chewable tablets of H2 antagonist (Famotidine) using a raft-forming agent along with an antacid- and gas-generating agent. Tablets were prepared by wet granulation and evaluated for raft strength, acid neutralisation capacity, weight variation, % drug content, thickness, hardness, friability and in vitro drug release. Various raft-forming agents were used in preliminary screening. A 2(3) full-factorial design was used in the present study for optimisation. The amount of sodium alginate, amount of calcium carbonate and amount sodium bicarbonate were selected as independent variables. Raft strength, acid neutralisation capacity and drug release at 30 min were selected as responses. Tablets containing sodium alginate were having maximum raft strength as compared with other raft-forming agents. Acid neutralisation capacity and in vitro drug release of all factorial batches were found to be satisfactory. The F5 batch was optimised based on maximum raft strength and good acid neutralisation capacity. Drug-excipient compatibility study showed no interaction between the drug and excipients. Stability study of the optimised formulation showed that the tablets were stable at accelerated environmental conditions. It was concluded that raft-forming chewable tablets prepared using an optimum amount of sodium alginate, calcium carbonate and sodium bicarbonate could be an efficient dosage form in the treatment of gastro oesophageal reflux disease.

Techno-economic optimisation of energy systems; Contribution a l'optimisation technico-economique de systemes energetiques

Energy Technology Data Exchange (ETDEWEB)

Mansilla Pellen, Ch

2006-07-15

The traditional approach currently used to assess the economic interest of energy systems is based on a defined flow-sheet. Some studies have shown that the flow-sheets corresponding to the best thermodynamic efficiencies do not necessarily lead to the best production costs. A method called techno-economic optimisation was proposed. This method aims at minimising the production cost of a given energy system, including both investment and operating costs. It was implemented using genetic algorithms. This approach was compared to the heat integration method on two different examples, thus validating its interest. Techno-economic optimisation was then applied to different energy systems dealing with hydrogen as well as electricity production. (author)

Application of Surpac and Whittle Software in Open Pit Optimisation ...

African Journals Online (AJOL)

Application of Surpac and Whittle Software in Open Pit Optimisation and Design. ... This paper studies the Surpac and Whittle software and their application in designing an optimised pit. ... EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

Topology Optimisation of Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

Thike Aye Min

2016-01-01

Full Text Available Wireless sensor networks are widely used in a variety of fields including industrial environments. In case of a clustered network the location of cluster head affects the reliability of the network operation. Finding of the optimum location of the cluster head, therefore, is critical for the design of a network. This paper discusses the optimisation approach, based on the brute force algorithm, in the context of topology optimisation of a cluster structure centralised wireless sensor network. Two examples are given to verify the approach that demonstrate the implementation of the brute force algorithm to find an optimum location of the cluster head.

Application of ant colony optimisation in distribution transformer sizing

African Journals Online (AJOL)

This study proposes an optimisation method for transformer sizing in power system using ant colony optimisation and a verification of the process by MATLAB software. The aim is to address the issue of transformer sizing which is a major challenge affecting its effective performance, longevity, huge capital cost and power ...

Outcomes of surgical treatment of thyroid disease in children

Directory of Open Access Journals (Sweden)

Olga S. Rogova

2017-01-01

Full Text Available Background. In recent years there has been a tendency of increase in the proportion of nodular goiter and Graves’ disease in thyroid pathology in children, which necessitates a choice of rational tactics for treatment of these diseases. At present there is no optimal method of treatment for thyroid gland pathology, but one of the methods is surgery. Thyroid surgery due to the determination of the indications and choice of the optimal volume of the surgical intervention continues to be under debate as postoperative complications of surgical treatment of thyroid diseases in children are possible.Aim: to study the outcomes of surgical treatment for thyroid pathology in children, depending on the volume of operation.Materials and methods. This article presents the results of a survey of 77 children operated on in the period of 2002–2016 for Graves’ disease, single-node goiter, and multinodular goiter. The examination included the determination of the levels of ionized calcium and TSH, FT4, FT3 in the blood serum, the evaluation of the functional state of the pituitary-thyroid system, thyroid ultrasound examination, and examination by an otolaryngologist.Results. The incidence of adverse outcomes of surgical treatment in children with nodular goiter was 27%. Adverse outcomes were observed equally often after organ-preserving operations and after thyroidectomy, but they were of different structure. The frequency of postoperative complications after thyroidectomy performed on the nodular goiter was 27%. Complications presented as postsurgical hypoparathyroidism and vocal cord paresis. In children with nodular goiter, after thyroidectomy hypoparathyroidism occurred more frequently than paresis of the vocal folds. Symptomatic hypocalcemia was observed more frequently than the asymptomatic variant, and in most cases hypoparathyrodism was transient. Among children with a single-node goiter who underwent organ-preserving surgery on the thyroid gland

Adverse pregnancy outcomes following syphilis treatment in pregnancy in the UK.

Science.gov (United States)

Wallace, Harriet E; Isitt, Catherine E; Broomhall, Harriet M; Perry, Alison E; Wilson, Janet D

2016-10-01

Syphilis infection in pregnancy is known to cause a number of severe adverse pregnancy outcomes, including second-trimester miscarriage, stillbirth, very pre-term delivery and neonatal death, in addition to congenital syphilis. A retrospective review of women with positive syphilis serology and a pregnancy outcome between 2005 and 2012 in Leeds, UK, was performed. In all, 57 cases of positive syphilis serology in pregnancy were identified: 24 with untreated syphilis treated in the current pregnancy (Group 1); seven with reported but unconfirmed prior treatment who were retreated (Group 2); and 26 adequately treated prior to pregnancy (Group 3). The rate of severe adverse pregnancy outcomes in Group 1 at 21% was significantly higher than the 0% outcome of Group 3 (p = 0.02). The severe adverse pregnancy outcomes were two second-trimester miscarriages, two pre-term births at 25 and 28 weeks and one stillbirth at 32 weeks. There were no cases of term congenital syphilis or term neonatal death, but we observed high rates of other adverse pregnancy outcomes despite treatment during pregnancy. Rapid referral for treatment is needed before 18 weeks in order to minimise adverse pregnancy outcomes. © The Author(s) 2016.

Tuberculosis treatment outcome and predictors in northern Ethiopian prisons: a five-year retrospective analysis.

Science.gov (United States)

Adane, Kelemework; Spigt, Mark; Dinant, Geert-Jan

2018-02-20

The prison situations are notorious for causing interruptions of tuberculosis (TB) treatment and occurrence of unfavorable outcomes. In Ethiopian prisons, though TB treatment programs exist, treatment outcome results and factors contributing to unsuccessful outcome are not well documented. In this study, we assessed the treatment outcome of TB cases and identified risk factors for unsuccessful outcome in northern Ethiopian prisons. A retrospective record review was conducted for all prisoners diagnosed with TB between September 2011 and August 2015. Outcome variables were defined following WHO guidelines. Out of the 496 patients, 11.5% were cured, 68% completed treatment, 2.5% were lost to follow-up, 1.6% were with a treatment failure, 1.4% died, and 15% were transferred out. All transferred out or released prisoners were not appropriately linked to health facilities and might be lost to treatment follow-up. The overall treatment success rate (TSR) of the 5 years was 94% among the patients who were not transferred out. The odds of unsuccessful outcome were 4.68 times greater among re-treatment cases compared to the newly treated cases. The year of treatment was also associated with variations in TSR; those treated during the earlier year were more likely to have unsuccessful outcome. Sputum non-conversion at the second-month check-up was strongly associated with unsuccessful outcome among the smear-positive cases. The mean TSR of the prisoners in the study prisons was quite satisfactory when gauged against the target level set by the End TB Strategy. However, the lack of appropriate linkage and tracking systems for those prisoners transferred or released before their treatment completion would have a negative implication for the national TB control program as such patients might interrupt their treatment and develop drug-resistant TB. Being in a re-treatment regimen and sputum non-conversion at the second-month check-up were significantly associated with

Optimisation of Software-Defined Networks Performance Using a Hybrid Intelligent System

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Ann Sabih

2017-06-01

Full Text Available This paper proposes a novel intelligent technique that has been designed to optimise the performance of Software Defined Networks (SDN. The proposed hybrid intelligent system has employed integration of intelligence-based optimisation approaches with the artificial neural network. These heuristic optimisation methods include Genetic Algorithms (GA and Particle Swarm Optimisation (PSO. These methods were utilised separately in order to select the best inputs to maximise SDN performance. In order to identify SDN behaviour, the neural network model is trained and applied. The maximal optimisation approach has been identified using an analytical approach that considered SDN performance and the computational time as objective functions. Initially, the general model of the neural network was tested with unseen data before implementing the model using GA and PSO to determine the optimal performance of SDN. The results showed that the SDN represented by Artificial Neural Network ANN, and optmised by PSO, generated a better configuration with regards to computational efficiency and performance index.

Pancreaticoduodenectomy in children: optimising outcome of uncommon paediatric procedures.

LENUS (Irish Health Repository)

Yeap, B H

2012-02-01

Contemporary surgical practice is increasingly dominated by subspecialisation in response to improved outcome from high volume centres, though uncertainties persist for uncommon paediatric procedures. Three paediatric pancreaticoduodenectomies performed at Our Lady\\'s Children\\'s Hospital, Dublin, over a period of 9 years were evaluated to substantiate their continuing performance by paediatric rather than adult pancreatic surgeons. With ages ranging from 18 months to 8 years old, the mean operating time was 263 minutes, while the average hospital stay was 12 days. There was no perioperative mortality, although complication rate was 100%. Re-operation was required in 33%. The long term outcome of this small paediatric cohort was comparable to adult series despite the low patient accrual, underscoring the advantages of a multidisciplinary approach afforded by tertiary paediatric institutions for intricate yet infrequent operations in children.

Effect of HIV-1 infection on malaria treatment outcome in Ugandan ...

African Journals Online (AJOL)

Background: Malaria and HIV-1 infection cause significant morbidity and mortality in sub-Saharan Africa. HIV-1 increases risk for malaria with the risk increasing as immunity declines.The effect of HIV-1 infection on antimalarial treatment outcome is still inconclusive. Objective: To compare antimalarial treatment outcome ...

Factors affecting visual outcomes after treatment of infectious endophthalmitis in northeastern Thailand

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Yospaiboon Y

2018-04-01

Full Text Available Yosanan Yospaiboon, Anocha Intarapanich, Wipada Laovirojjanakul, Tanapat Ratanapakorn, Suthasinee Sinawat, Thuss Sanguansak, Chavakij Bhoomibunchoo KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand Objective: To determine factors affecting visual outcomes after treatment of infectious endophthalmitis during 2012–2016 at a large referral eye center in northeastern Thailand. Patients and methods: Medical charts of patients with a diagnosis of infectious endophthalmitis including demographic data, types of endophthalmitis, causative organisms, methods of treatment, anatomical, and functional outcomes were retrospectively reviewed. Factors associated with improved visual outcomes were analyzed.Results: Four hundred and eleven patients (417 eyes were recruited for the study. The three most common types were post-traumatic (44.53%, post-operative (31.87%, and endogenous endophthalmitis (17.52%. Vitreous cultures revealed causative organisms in 41.25%. Most common Gram-positive organisms were coagulase-negative Staphylococcus 30% (36/120, Bacillus spp. 20% (24/120, and Streptococcus pneumoniae 18.33% (20/120. Most common Gram-negatives were Pseudomonas spp. 24.32% (9/37, Klebsiella spp. 24.32% (9/37, and Enterobacter spp. 16.21% (6/37. Methods of treatment were medical treatment (18.71% and surgical treatment (81.29%, including pars plana vitrectomy with or without silicone oil tamponade (62.59% and destructive surgery (18.71%. After treatment, visual improvement was noted in 44.6%, stable vision in 18.47%, and worse vision in 36.93%. Factors associated with improved visual outcomes were post-operative endophthalmitis (P<0.001, coagulase-negative Staphylococcus (P=0.003, and initial visual acuity before treatment of hand motion or better (P=0.017.Conclusion: Most infectious endophthalmitis patients were post-traumatic, post-operative, and endogenous. The most common method of treatment was

Optimisation of colorectal cancer treatment

NARCIS (Netherlands)

Broek, Colette Bernadine Maria-Theresia van den

2014-01-01

Colorectal cancer is one of the most common cancers worldwide. Although there have been several improvements in screening, staging, and treatment in the past decades, survival differences remain. For example among certain subgroups of patients, such as elderly patients and patients with

Ants Colony Optimisation of a Measuring Path of Prismatic Parts on a CMM

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Stojadinovic Slavenko M.

2016-03-01

Full Text Available This paper presents optimisation of a measuring probe path in inspecting the prismatic parts on a CMM. The optimisation model is based on: (i the mathematical model that establishes an initial collision-free path presented by a set of points, and (ii the solution of Travelling Salesman Problem (TSP obtained with Ant Colony Optimisation (ACO. In order to solve TSP, an ACO algorithm that aims to find the shortest path of ant colony movement (i.e. the optimised path is applied. Then, the optimised path is compared with the measuring path obtained with online programming on CMM ZEISS UMM500 and with the measuring path obtained in the CMM inspection module of Pro/ENGINEER® software. The results of comparing the optimised path with the other two generated paths show that the optimised path is at least 20% shorter than the path obtained by on-line programming on CMM ZEISS UMM500, and at least 10% shorter than the path obtained by using the CMM module in Pro/ENGINEER®.

Treatment outcomes of rifabutin-containing regimens for rifabutin-sensitive multidrug-resistant pulmonary tuberculosis

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Hyun Lee

2017-12-01

Full Text Available Objectives: The aim of this study was to evaluate whether rifabutin can improve treatment outcomes in patients with rifabutin-sensitive MDR-TB. Methods: A retrospective cohort study was performed on 76 patients with rifabutin-sensitive MDR-TB who were treated with or without rifabutin between 2006 and 2011. Results: Overall, 75% (57/76 of patients achieved favorable outcomes, including cure (53/76, 70% and treatment completion (4/76, 5%. In contrast, 25% (19/76 had unfavorable treatment outcomes, which included treatment failure (6/76, 8%, death (2/76, 3%, loss to follow-up (4/76. 5%, and no evaluation due to transfer to other institutions (7/76, 9%. Rifabutin was given to 52 (68% of the 76 patients with rifabutin-sensitive MDR-TB. Although favorable treatment outcomes were more frequent in patients who received rifabutin [81% (42/52] than in those who did not receive rifabutin [63% (15/24], this difference was not statistically significant (P = 0.154. However, in multivariable regression logistic analysis, use of rifabutin was significantly associated with favorable treatment outcomes in patients with rifabutin-sensitive MDR-TB (adjusted odds ratio = 9.80, 95% confidence interval = 1.65–58.37, P = 0.012. Conclusions: These results suggest that the use of rifabutin can improve treatment outcomes in patients with rifabutin-sensitive MDR-TB. Keywords: Multidrug-resistant tuberculosis, Extensively drug-resistant tuberculosis, Rifabutin, Treatment outcome

Associations between nutritional status, weight loss, radiotherapy treatment toxicity and treatment outcomes in gastrointestinal cancer patients.

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Hill, Amanda; Kiss, Nicole; Hodgson, Belinda; Crowe, Timothy C; Walsh, Adam D

2011-02-01

Patients with gastrointestinal cancers are susceptible to nutritional deterioration which may be compounded by radiotherapy treatment toxicities. This study aimed to determine whether nutritional status at radiotherapy commencement or changes in nutritional status throughout radiotherapy were associated with treatment toxicity and outcomes in gastrointestinal cancer patients. Seventy-three gastrointestinal cancer patients receiving curative radiotherapy underwent medical record audits assessing body weight, radiotherapy toxicity, unplanned treatment breaks or hospital admissions and completion of prescribed treatment/s. Nutritional status was assessed in a subset of patients (n = 11) using the Patient-Generated Subjective Global Assessment tool. Seventy-five percent of patients lost weight throughout radiotherapy. Weight loss was significantly greater in patients experiencing unplanned radiotherapy breaks (-3.1% vs -1.6%, p nutritional status during radiotherapy (as measured by weight loss) may be associated with poorer short-term treatment outcomes in gastrointestinal cancer patients. Patient numbers were too small to definitively determine the effect of nutritional status at radiotherapy commencement or changes in nutritional status throughout radiotherapy (defined by PG-SGA) on treatment outcomes. Further research is required to investigate this in larger, longer-term studies. Copyright © 2010. Published by Elsevier Ltd.

PHYSICAL-MATEMATICALSCIENCE MECHANICS SIMULATION CHALLENGES IN OPTIMISING THEORETICAL METAL CUTTING TASKS

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Rasul V. Guseynov

2017-01-01

Full Text Available Abstract. Objectives In the article, problems in the optimising of machining operations, which provide end-unit production of the required quality with a minimum processing cost, are addressed. Methods Increasing the effectiveness of experimental research was achieved through the use of mathematical methods for planning experiments for optimising metal cutting tasks. The minimal processing cost model, in which the objective function is polynomial, is adopted as a criterion for the selection of optimal parameters. Results Polynomial models of the influence of angles φ, α, γ on the torque applied when cutting threads in various steels are constructed. Optimum values of the geometrical tool parameters were obtained using the criterion of minimum cutting forces during processing. The high stability of tools having optimal geometric parameters is determined. It is shown that the use of experimental planning methods allows the optimisation of cutting parameters. In optimising solutions to metal cutting problems, it is found to be expedient to use multifactor experimental planning methods and to select the cutting force as the optimisation parameter when determining tool geometry. Conclusion The joint use of geometric programming and experiment planning methods in order to optimise the parameters of cutting significantly increases the efficiency of technological metal processing approaches. 

Optimising treatment resources for OCD: a review of the evidence base for technology-enhanced delivery.

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Lovell, Karina; Bee, Penny

2011-12-01

Obsessive-compulsive disorder (OCD) is a chronic and disabling mental health problem. Only a minority of people receive evidence-based psychological treatments, and this deficit has prompted an increasing focus on delivering cognitive behaviour therapy (CBT) in new and innovative ways. To conduct a scoping review of the published evidence base for CBT-based interventions incorporating a health technology in the treatment of OCD. The questions posed by the review were (a) are technology-assisted treatments clinically effective, (b) are patient outcomes durable and (c) are more innovative services deemed acceptable by those individuals who engage in them? Scoping review of published studies using any study design examining CBT interventions incorporating a health technology for OCD. Electronic databases searched included MEDLINE (1966-2010), PsycInfo (1967-2010), EMBASE (1980-2010) and CINAHL databases (1982-2010). Thirteen studies were identified, of these, five used bibliotherapy, five examined computerised CBT (cCBT), two investigated telephone delivered CBT and one evaluated video conferencing. Overall studies were small and methodologically flawed, which precludes definitive conclusions of clinical effectiveness, durability or stakeholder satisfaction. To date the evidence base for technology-enhanced OCD treatments has undergone limited development. Future research should seek to overcome the methodological shortcomings of published work by conducting large-scale trials that incorporate clinical, cost and acceptability outcomes.

Optimisation of rocker sole footwear for prevention of first plantar ulcer: comparison of group-optimised and individually-selected footwear designs.

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Preece, Stephen J; Chapman, Jonathan D; Braunstein, Bjoern; Brüggemann, Gert-Peter; Nester, Christopher J

2017-01-01

Appropriate footwear for individuals with diabetes but no ulceration history could reduce the risk of first ulceration. However, individuals who deem themselves at low risk are unlikely to seek out bespoke footwear which is personalised. Therefore, our primary aim was to investigate whether group-optimised footwear designs, which could be prefabricated and delivered in a retail setting, could achieve appropriate pressure reduction, or whether footwear selection must be on a patient-by-patient basis. A second aim was to compare responses to footwear design between healthy participants and people with diabetes in order to understand the transferability of previous footwear research, performed in healthy populations. Plantar pressures were recorded from 102 individuals with diabetes, considered at low risk of ulceration. This cohort included 17 individuals with peripheral neuropathy. We also collected data from 66 healthy controls. Each participant walked in 8 rocker shoe designs (4 apex positions × 2 rocker angles). ANOVA analysis was then used to understand the effect of two design features and descriptive statistics used to identify the group-optimised design. Using 200 kPa as a target, this group-optimised design was then compared to the design identified as the best for each participant (using plantar pressure data). Peak plantar pressure increased significantly as apex position was moved distally and rocker angle reduced ( p  footwear which was individually selected. In terms of optimised footwear designs, healthy participants demonstrated the same response as participants with diabetes, despite having lower plantar pressures. This is the first study demonstrating that a group-optimised, generic rocker shoe might perform almost as well as footwear selected on a patient by patient basis in a low risk patient group. This work provides a starting point for clinical evaluation of generic versus personalised pressure reducing footwear.

Optimisation of searches for Supersymmetry with the ATLAS detector

Energy Technology Data Exchange (ETDEWEB)

Zvolsky, Milan

2012-01-15

The ATLAS experiment is one of the four large experiments at the Large Hadron Collider which is specifically designed to search for the Higgs boson and physics beyond the Standard Model. The aim of this thesis is the optimisation of searches for Supersymmetry in decays with two leptons and missing transverse energy in the final state. Two different optimisation studies have been performed for two important analysis aspects: The final signal region selection and the choice of the trigger selection. In the first part of the analysis, a cut-based optimisation of signal regions is performed, maximising the signal for a minimal background contamination. By this, the signal yield can in parts be more than doubled. The second approach is to introduce di-lepton triggers which allow to lower the lepton transverse momentum threshold, thus enhancing the number of selected signal events significantly. The signal region optimisation was considered for the choice of the final event selection in the ATLAS di-lepton analyses. The trigger study contributed to the incorporation of di-lepton triggers to the ATLAS trigger menu. (orig.)

Dimensional personality traits and alcohol treatment outcome: a systematic review and meta-analysis.

Science.gov (United States)

Foulds, James; Newton-Howes, Giles; Guy, Nicola H; Boden, Joseph M; Mulder, Roger T

2017-08-01

To identify dimensional personality traits associated with treatment outcome for patients with an alcohol use disorder (AUD). Systematic review and meta-analysis of clinical trials and longitudinal studies of ≥ 8 weeks in patients receiving treatment for AUD, in which the association between personality dimensions and treatment outcome was reported. Primary outcomes were relapse and alcohol consumption measures. Treatment retention was a secondary outcome. Eighteen studies, including 4783 subjects, were identified. Twelve studies used Cloninger's Temperament and Personality Questionnaire (TPQ) or Temperament and Character Inventory (TCI). Remaining studies used a broad range of other personality measures. Compared with non-relapsers, patients who relapsed had higher novelty-seeking [standardized mean difference in novelty-seeking score 0.28; 95% confidence interval (CI) = 0.12, 0.44], lower persistence (-0.30, 95% = CI -0.48, -0.12), lower reward dependence (-0.16, 95% CI = -0.31, -0.01) and lower cooperativeness (-0.23, 95% CI = -0.41, -0.04). Few studies reported on alcohol consumption outcomes, therefore findings for those outcomes were inconclusive. Lower novelty-seeking predicted better retention in treatment in two of three studies. Most studies reported findings only for those retained in treatment, and did not attempt to account for missing data; therefore, findings for the primary outcomes cannot be generalized to patients who dropped out of treatment. Studies using personality instruments other than the TCI or TPQ reported no consistent findings on the association between personality variables and treatment outcome. Among patients receiving treatment for an alcohol use disorder, those who relapse during follow-up have higher novelty-seeking, lower persistence, lower reward dependence and lower cooperativeness than those who do not relapse. © 2017 Society for the Study of Addiction.

Evaluating herbivore management outcomes and associated vegetation impacts

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Rina C.C. Grant

2011-05-01

Conservation implications: In rangeland, optimising herbivore numbers to achieve the management objectives without causing unacceptable or irreversible change in the vegetation is challenging. This manuscript explores different avenues to evaluate herbivore impact and the outcomes of management approaches that may affect vegetation.

GAOS: Spatial optimisation of crop and nature within agricultural fields

NARCIS (Netherlands)

Bruin, de S.; Janssen, H.; Klompe, A.; Lerink, P.; Vanmeulebrouk, B.

2010-01-01

This paper proposes and demonstrates a spatial optimiser that allocates areas of inefficient machine manoeuvring to field margins thus improving the use of available space and supporting map-based Controlled Traffic Farming. A prototype web service (GAOS) allows farmers to optimise tracks within

Techno-economic optimisation of energy systems

International Nuclear Information System (INIS)

Mansilla Pellen, Ch.

2006-07-01

The traditional approach currently used to assess the economic interest of energy systems is based on a defined flow-sheet. Some studies have shown that the flow-sheets corresponding to the best thermodynamic efficiencies do not necessarily lead to the best production costs. A method called techno-economic optimisation was proposed. This method aims at minimising the production cost of a given energy system, including both investment and operating costs. It was implemented using genetic algorithms. This approach was compared to the heat integration method on two different examples, thus validating its interest. Techno-economic optimisation was then applied to different energy systems dealing with hydrogen as well as electricity production. (author)

Robustness analysis of bogie suspension components Pareto optimised values

Science.gov (United States)

Mousavi Bideleh, Seyed Milad

2017-08-01

Bogie suspension system of high speed trains can significantly affect vehicle performance. Multiobjective optimisation problems are often formulated and solved to find the Pareto optimised values of the suspension components and improve cost efficiency in railway operations from different perspectives. Uncertainties in the design parameters of suspension system can negatively influence the dynamics behaviour of railway vehicles. In this regard, robustness analysis of a bogie dynamics response with respect to uncertainties in the suspension design parameters is considered. A one-car railway vehicle model with 50 degrees of freedom and wear/comfort Pareto optimised values of bogie suspension components is chosen for the analysis. Longitudinal and lateral primary stiffnesses, longitudinal and vertical secondary stiffnesses, as well as yaw damping are considered as five design parameters. The effects of parameter uncertainties on wear, ride comfort, track shift force, stability, and risk of derailment are studied by varying the design parameters around their respective Pareto optimised values according to a lognormal distribution with different coefficient of variations (COVs). The robustness analysis is carried out based on the maximum entropy concept. The multiplicative dimensional reduction method is utilised to simplify the calculation of fractional moments and improve the computational efficiency. The results showed that the dynamics response of the vehicle with wear/comfort Pareto optimised values of bogie suspension is robust against uncertainties in the design parameters and the probability of failure is small for parameter uncertainties with COV up to 0.1.

Sex reassignment: outcomes and predictors of treatment for adolescent and adult transsexuals

OpenAIRE

Smith, Y. L. S.; Van Goozen, Stephanie Helena Maria; Kuiper, A. J.; Cohen-Kettenis, P. T.

2005-01-01

Background. We prospectively studied outcomes of sex reassignment, potential differences between subgroups of transsexuals, and predictors of treatment course and outcome.\\ud \\ud Method. Altogether 325 consecutive adolescent and adult applicants for sex reassignment participated: 222 started hormone treatment, 103 did not; 188 completed and 34 dropped out of treatment. Only data of the 162 adults were used to evaluate treatment. Results between subgroups were compared to determine post-operat...

Treatment outcomes of childhood tuberculosis in Addis Ababa: a five-year retrospective analysis

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Genene Tilahun

2016-07-01

Full Text Available Abstract Background Tuberculosis (TB kills one child every 5 min. Childhood TB is given low priority in most national health programmes particularly in TB-endemic areas. TB among children is an indicator of a recent transmission of the disease in the community. Treatment outcome results serve as a proxy of the quality of treatment provided by a health care system. In Ethiopia, data on treatment outcomes of childhood TB are limited. The aim of the study was to determine the treatment outcomes of childhood TB in a hospital setting in Addis Ababa. Methods The study was conducted during June to August 2014. The data of 491 children treated for TB in Zewditu Memorial Hospital during a 5 year (2009–2013 was analysed. TB was diagnosed using standard methods. Demographic and clinical data including type of TB, TB-HIV co-infection and treatment outcomes were collected from registry of the TB clinic. Treatment outcome definitions are used according to the World Health Organization. Results Of the 491 children, 272(55.4 % were females, 107(21.8 % were under 5 year old, 454(92.5 % of them were new cases. The types of TB were extra-pulmonary tuberculosis (EPTB 243(49.5 % and 248(50.5 % pulmonary tuberculosis (PTB. Of the PTB cases, 42(16.9 % were sputum smear positive. Of the 291 children tested for HIV, 82(28.2 % were positive. The overall treatment success rate was 420(85.5 % and the poor treatment outcome was 71(14.5 %. Of the children with poor treatment outcome, 9(1.8 % died, 3(0.6 % defaulted from treatment, 2(0.4 % were treatment failure and 55(11.2 % were transferred out. Males and females had similar treatment success rates of 85.8 % and 85.3 %, respectively. Infants under one year had significantly lower treatment success rate of 72.7 % compared to those above 1 years of age of 86.5 % (P < 0.001. Treatment success rate ranged from 78.0 to 92.6 % during the study period. Associated factors for treatment outcome were age above

Does adherence to treatment mediate the relationship between patients' treatment outcome expectancies and the outcomes of pain intensity and recovery from acute low back pain?

Science.gov (United States)

Haanstra, Tsjitske M; Kamper, Steven J; Williams, Christopher M; Spriensma, Alette S; Lin, Chung-Wei Christine; Maher, Christopher G; de Vet, Henrica C W; Ostelo, Raymond W J G

2015-08-01

It is believed that patients' expectancies about the effectiveness of treatment influence their treatment outcomes, but the working mechanism is rarely studied in patients with low back pain. Theoretical models suggest that adherence to treatment may be an important pathway. The aim of this study was to assess the mediating role of adherence to treatment in the relationship between expectancies and the outcomes of recovery and pain intensity in patients with acute low back pain. This study used data from a randomized placebo-controlled trial of paracetamol for acute low back pain. Expectancies were measured with the Credibility Expectancy Questionnaire. Adherence was measured with a medication diary. Pain intensity was recorded daily in a diary on a 0 to 10 pain scale, and recovery was defined as the first of 7 consecutive days scoring 0 or 1 on a 6-point pain scale. Cox regression (dependent variable: recovery) and linear mixed-model analyses (dependent variable: daily pain intensity scores) were performed. The "difference in coefficients" approach was used to establish mediation. A total of 1573 participants were included in current analyses. There was a small but highly significant relationship between expectancies and outcomes; 3.3% of the relationship between expectancies and recovery and 14.2% of the relationship between expectancies and pain intensity were mediated by adherence to treatment. This study does not convincingly support the theory that adherence is a key pathway in the relationship between treatment outcome expectancies and recovery and pain intensity in this acute low back pain population.

Operational Radiological Protection and Aspects of Optimisation

International Nuclear Information System (INIS)

Lazo, E.; Lindvall, C.G.

2005-01-01

Since 1992, the Nuclear Energy Agency (NEA), along with the International Atomic Energy Agency (IAEA), has sponsored the Information System on Occupational Exposure (ISOE). ISOE collects and analyses occupational exposure data and experience from over 400 nuclear power plants around the world and is a forum for radiological protection experts from both nuclear power plants and regulatory authorities to share lessons learned and best practices in the management of worker radiation exposures. In connection to the ongoing work of the International Commission on Radiological Protection (ICRP) to develop new recommendations, the ISOE programme has been interested in how the new recommendations would affect operational radiological protection application at nuclear power plants. Bearing in mind that the ICRP is developing, in addition to new general recommendations, a new recommendation specifically on optimisation, the ISOE programme created a working group to study the operational aspects of optimisation, and to identify the key factors in optimisation that could usefully be reflected in ICRP recommendations. In addition, the Group identified areas where further ICRP clarification and guidance would be of assistance to practitioners, both at the plant and the regulatory authority. The specific objective of this ISOE work was to provide operational radiological protection input, based on practical experience, to the development of new ICRP recommendations, particularly in the area of optimisation. This will help assure that new recommendations will best serve the needs of those implementing radiation protection standards, for the public and for workers, at both national and international levels. (author)

Measuring treatment outcomes in gambling disorders: a systematic review.

Science.gov (United States)

Pickering, Dylan; Keen, Brittany; Entwistle, Gavin; Blaszczynski, Alex

2018-03-01

Considerable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross-study evaluations and hindered the development of best-practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery. A systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum 6-month follow-up. Data from eligible studies were tabulated and analysis conducted using a narrative approach. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adhered to. Thirty-four studies were reviewed systematically (RCTs = 17, comparative designs = 17). Sixty-three different outcome measures were identified: 25 (39.7%) assessed gambling-specific constructs, 36 (57.1%) assessed non-gambling specific constructs, and two instruments were used across both categories (3.2%). Self-report instruments ranged from psychometrically validated to ad-hoc author-designed questionnaires. Units of measurement were inconsistent, particularly in the assessment of gambling behaviour. All studies assessed indices of gambling behaviour and/or symptoms of gambling disorder. Almost all studies (n = 30; 88.2%) included secondary measures relating to psychiatric comorbidities, psychological processes linked to treatment approach, or global functioning and wellbeing. In research on gambling disorders, the incorporation of broader outcome domains that extend beyond disorder-specific symptoms and behaviours suggests a multi-dimensional conceptualization of recovery. Development of a single comprehensive scale to measure all aspects of gambling recovery could help to facilitate uniform reporting practices

Associations between therapists' occupational burnout and their patients' depression and anxiety treatment outcomes.

Science.gov (United States)

Delgadillo, Jaime; Saxon, David; Barkham, Michael

2018-05-02

Occupational burnout is common in mental health professionals, but its impact on patient outcomes is as yet uncertain. This study aimed to investigate associations between therapist-level burnout and patient-level treatment outcomes after psychological therapy. We used multilevel modeling using depression (PHQ-9) and anxiety (GAD-7) outcomes data from 2,223 patients nested within 49 therapists. Therapists completed a survey including the Oldenburg Burnout Inventory (OLBI) and a job satisfaction scale (JDSS). After controlling for case-mix, around 5% of variability in treatment outcomes was explained by therapist effects (TE). Higher therapist OLBI-disengagement and lower JDSS scores were significantly associated with poorer treatment outcomes, explaining between 31 and 39% of the TE estimate. Higher OLBI scores were also correlated with lower job satisfaction ratings. Therapist burnout has a negative impact on treatment outcomes and could be the target of future preventive and remedial action. © 2018 Wiley Periodicals, Inc.

Meta-Analysis of Treatment Outcomes Measured by the Y-OQ and Y-OQ-SR Comparing Wilderness and Non-Wilderness Treatment Programs

Science.gov (United States)

Gillis, Harold L.; Speelman, Elizabeth; Linville, Noelle; Bailey, Emily; Kalle, Ashley; Oglesbee, Nathan; Sandlin, James; Thompson, Lauren; Jensen, Jennifer

2016-01-01

Background: Monitoring youth treatments requires outcome instruments sensitive to change. The Y-OQ and the Y-OQ-SR measure behavioral change during psychological treatment. Objective: The focus of this study was to compare treatment progress of youth in studies using the Youth Outcome Questionnaire (YOQ) or the Youth Outcome Questionnaire Self…

Optimising polarised neutron scattering measurements--XYZ and polarimetry analysis

International Nuclear Information System (INIS)

Cussen, L.D.; Goossens, D.J.

2002-01-01

The analytic optimisation of neutron scattering measurements made using XYZ polarisation analysis and neutron polarimetry techniques is discussed. Expressions for the 'quality factor' and the optimum division of counting time for the XYZ technique are presented. For neutron polarimetry the optimisation is identified as analogous to that for measuring the flipping ratio and reference is made to the results already in the literature

Optimising polarised neutron scattering measurements--XYZ and polarimetry analysis

CERN Document Server

Cussen, L D

2002-01-01

The analytic optimisation of neutron scattering measurements made using XYZ polarisation analysis and neutron polarimetry techniques is discussed. Expressions for the 'quality factor' and the optimum division of counting time for the XYZ technique are presented. For neutron polarimetry the optimisation is identified as analogous to that for measuring the flipping ratio and reference is made to the results already in the literature.

Design Optimisation and Conrol of a Pilot Operated Seat Valve

DEFF Research Database (Denmark)

Nielsen, Brian; Andersen, Torben Ole; Hansen, Michael Rygaard

2004-01-01

The paper gives an approach for optimisation of the bandwidth of a pilot operated seat valve for mobile applications. Physical dimensions as well as parameters of the implemented control loop are optimised simultaneously. The frequency response of the valve varies as a function of the pressure drop...

Adjoint Optimisation of the Turbulent Flow in an Annular Diffuser

DEFF Research Database (Denmark)

Gotfredsen, Erik; Agular Knudsen, Christian; Kunoy, Jens Dahl

2017-01-01

In the present study, a numerical optimisation of guide vanes in an annular diffuser, is performed. The optimisation is preformed for the purpose of improving the following two parameters simultaneously; the first parameter is the uniformity perpen-dicular to the flow direction, a 1/3 diameter do...

Treatment outcome of schizophrenia co-morbid with obsessive-compulsive disorder

International Nuclear Information System (INIS)

Khan, M.N.S.; Arshad, N.; Naeem Ullah

2004-01-01

Objective: To evaluate the pharmacological treatment outcome of schizophrenia, co-morbid with obsessive-compulsive disorder by comparing the effects of typical neuroleptic, atypical neuroleptic and a combination of typical with anti-obsessional drugs on positive and negative symptoms of schizophrenia and obsessional symptoms. Subjects and Methods: The sample consisted of 39 patients suffering from schizophrenia co-morbid with obsessive- compulsive disorder. They were divided in three groups according to the pharmacological treatment given by the treating psychiatrists. Sample was assessed at the start of treatment and twelve weeks later. Results: Patients receiving typical neuroleptics and anti-obsessional drugs showed better outcome (p < .05) both in psychotic (pre-intervention mean scores of positive scale of PANSS 26.90 as compared to postinterventional mean scores 19.00) and obsessional symptoms (pre-intervention mean scores on Padua Inventory 165.00 compared to 84.00 postinterventional mean scores) than those receiving typical and atypical neuroleptics alone. Conclusion: Treatment outcome of schizophrenia co-morbid with obsessive-compulsive disorder shows better results if anti-obsessional drugs are added to the neuroleptics. (author)

Totality of outcomes: A different paradigm in assessing interventions for treatment of tuberculosis

Directory of Open Access Journals (Sweden)

Grace Montepiedra

2016-08-01

Full Text Available Conventional analytic methods used for tuberculosis (TB outcomes research use standardized outcomes definitions and assess safety and efficacy separately. These methods are subject to important limitations. Conventionally utilized outcome definitions fail to capture important aspects of patients' treatment experience and obscure meaningful differences between patients.Assessing safety and efficacy separately fails to yield an objective risk–benefit comparison to guide clinical practice. We propose to address these issues through an analytic approach based on prioritized outcomes. This approach enables a more comprehensive and integrated assessment of TB interventions. It simultaneously considers a “totality of outcomes”, including clinical benefit, adverse events, and quality of life. These composite outcomes are ranked terms of overall desirability and compared using statistical methods for ordinal outcomes. Here we discuss the application of this approach to TB research, the considerations involved with prioritizing TB treatment outcomes, and the statistical methods involved in comparing prioritized outcomes. Keywords: Tuberculosis, Treatment outcome, Risk–benefit assessment

Optimised anaerobic treatment of house-sorted biodegradable waste and slaughterhouse waste in a high loaded half technical scale digester.

Science.gov (United States)

Resch, C; Grasmug, M; Smeets, W; Braun, R; Kirchmayr, R

2006-01-01

Anaerobic co-digestion of organic wastes from households, slaughterhouses and meat processing industries was optimised in a half technical scale plant. The plant was operated for 130 days using two different substrates under organic loading rates of 10 and 12 kgCOD.m(-3).d(-1). Since the substrates were rich in fat and protein components (TKN: 12 g.kg(-1) the treatment was challenging. The process was monitored on-line and in the laboratory. It was demonstrated that an intensive and stable co-digestion of partly hydrolysed organic waste and protein rich slaughterhouse waste can be achieved in the balance of inconsistent pH and buffering NH4-N. In the first experimental period the reduction of the substrate COD was almost complete in an overall stable process (COD reduction >82%). In the second period methane productivity increased, but certain intermediate products accumulated constantly. Process design options for a second digestion phase for advanced degradation were investigated. Potential causes for slow and reduced propionic and valeric acid degradation were assessed. Recommendations for full-scale process implementation can be made from the experimental results reported. The highly loaded and stable codigestion of these substrates may be a good technical and economic treatment alternative.

Clinical outcomes in clinical trials of anti-HIV treatment

DEFF Research Database (Denmark)

Reekie, J; Mocroft, A; J, Neaton

2007-01-01

Since the introduction of combination antiretroviral therapy, there has been a decrease in both AIDS-defining illnesses and deaths. This decrease meant that performing clinical trials with clinical outcomes in HIV infection became more time consuming and hence costly. Improved understanding...... and knowledge of HIV led to short-term trials using surrogate outcomes such as viral load and CD4 count. This established a faster drug approval process that complimented the rapid need to evaluate and provide access to drugs based on short-term trials. However, no treatment has yet been found that eradicates...... the infection, so when treatment is started it is currently a lifelong commitment. Is it reasonable then that guidelines are based almost completely on short-term randomized trials and observational studies of surrogate markers, or is there still a need for trials with clinical outcomes?...

Physical outcome measures for conductive and mixed hearing loss treatment: A systematic review.

Science.gov (United States)

Johansson, M L; Tysome, J R; Hill-Feltham, P; Hodgetts, W E; Ostevik, A; McKinnon, B J; Monksfield, P; Sockalingam, R; Wright, T

2018-05-07

The number of potential options for rehabilitation of patients with conductive or mixed hearing loss is continually expanding. To be able to inform patients and other stakeholders there is a need to identify and develop patient-centred outcomes for treatment of hearing loss. To identify outcome measures in the physical core area used when reporting the outcome after treatment of conductive and mixed hearing loss in adult patients. Systematic review. Systematic review of literature related to reported physical outcome measures after treatment of mixed or conductive hearing loss without restrictions regarding type of intervention, treatment or device. Any measure reporting the physical outcome after treatment or intervention of mixed or conductive hearing loss was sought and categorised. The physical outcomes measures that had been extracted were then grouped into domains. The literature search resulted in the identification of 1,434 studies, of which 153 were selected for inclusion in the review. The majority (57%) of papers reported results from middle ear surgery, with the remainder reporting results from either bone conduction hearing devices or middle ear implants. Outcomes related to complications were categorised into 17 domains, whereas outcomes related to treatment success was categorised in 22 domains. The importance of these domains to patients and other stakeholders needs to be further explored in order to establish which of these domains are most relevant to interventions for conductive or mixed hearing loss. This will allow us to then assess which outcomes measures are most suitable for inclusion in the core set This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Optimisation of Protection as applicable to geological disposal: the ICRP view

International Nuclear Information System (INIS)

Weiss, W.

2010-01-01

Wolfgang Weiss (BfS), vice-chair of ICRP Committee 4, recalled that the role of optimisation is to select the best protection options under the prevailing circumstances based on scientific considerations, societal concerns and ethical aspects as well as considerations of transparency. An important role of the concept of optimisation of protection is to foster a 'safety culture' and thereby to engender a state of thinking in everyone responsible for control of radiation exposures, such that they are continuously asking themselves the question, 'Have I done all that I reasonably can to avoid or reduce these doses?' Clearly, the answer to this question is a matter of judgement and necessitates co-operation between all parties involved and, as a minimum, the operating management and the regulatory agencies, but the dialogue would be more complete if other stakeholders were also involved. What kinds of checks and balances or factors would be needed to be considered for an 'optimal' system? Can indicators be identified? Quantitative methods may provide input to this dialogue but they should never be the sole input. The ICRP considers that the parameters to take into account include also social considerations and values, environmental considerations, as well as technical and economic considerations. Wolfgang Weiss approached the question of the distinction to be made between system optimisation (in the sense of taking account of social and economic as well as of all types of hazards) and optimisation of radiological protection. The position of the ICRP is that the system of protection that it proposes is based on both science (quantification of the health risk) and value judgement (what is an acceptable risk?) and optimisation is the recommended process to integrate both aspects. Indeed, there has been evolution since the old system of intervention levels to the new system, whereby, even if the level of the dose or risk (which is called constraint in ICRP-81 ) is met

Outcome of multimodality treatment of Ewing′s sarcoma of the extremities

Directory of Open Access Journals (Sweden)

Tiwari Akshay

2010-01-01

Full Text Available Background: The management of Ewing′s sarcoma family of tumors (ESFT, Ewing′s sarcoma/primitive neuroectodermal tumor has been established as a multimodality treatment. Advances in imaging and diagnostics, chemotherapy, surgical techniques, radiotherapy and prosthetic technology have resulted in drastic changes in the outcome of this disease, with most of the recent studies having 5-year survival rates of more than 60%. The Indian patients present at a more advanced stage and the compliance of treatment is suboptimal. While there is plenty of data in the world literature on the outcome of Ewing′s sarcoma, there is paucity of data in Indian patients. Therefore, we conducted the present study to analyze the outcome of multimodality treatment of ESFT of the extremities at a tertiary nonprofit institute over a decade. Materials and Methods: 34 patients who had histopathologically proven diagnosis of Ewing′s sarcoma of the extremities and had received treatment at our institute from 1997 through 2007 were included for analysis. The majority of patients had involvement of the femur (35%, followed by tibia (17%, fibula and foot (15% each, humerus (12% and soft tissue of thigh (6%. Twenty-nine patients presented with localized disease (Enneking stage II B while five patients presented with metastases (Enneking stage III. All patients received Vincristine, Actinomycine D, Cyclofosfamide + Ifosfamide and Etoposide (VAC+IE-based chemotherapy and local treatment was offered to all but three patients having multicentric disease. The local treatment offered were, radiation (n= 15, surgery (n= 12 both surgery and radiation (n=4. All patients were analyzed for oncological outcome (event-free and overall survival, local and systemic relapses by clinical and imaging evaluation and functional outcome by using the musculoskeletal tumor society (MSTS score. These outcomes were correlated with age, sex, size of tumor, stage at presentation, modality of local

Study on the evolutionary optimisation of the topology of network control systems

Science.gov (United States)

Zhou, Zude; Chen, Benyuan; Wang, Hong; Fan, Zhun

2010-08-01

Computer networks have been very popular in enterprise applications. However, optimisation of network designs that allows networks to be used more efficiently in industrial environment and enterprise applications remains an interesting research topic. This article mainly discusses the topology optimisation theory and methods of the network control system based on switched Ethernet in an industrial context. Factors that affect the real-time performance of the industrial control network are presented in detail, and optimisation criteria with their internal relations are analysed. After the definition of performance parameters, the normalised indices for the evaluation of the topology optimisation are proposed. The topology optimisation problem is formulated as a multi-objective optimisation problem and the evolutionary algorithm is applied to solve it. Special communication characteristics of the industrial control network are considered in the optimisation process. In respect to the evolutionary algorithm design, an improved arena algorithm is proposed for the construction of the non-dominated set of the population. In addition, for the evaluation of individuals, the integrated use of the dominative relation method and the objective function combination method, for reducing the computational cost of the algorithm, are given. Simulation tests show that the performance of the proposed algorithm is preferable and superior compared to other algorithms. The final solution greatly improves the following indices: traffic localisation, traffic balance and utilisation rate balance of switches. In addition, a new performance index with its estimation process is proposed.

Optimising investment in asset management using the multivariate asset management assessment topography

Directory of Open Access Journals (Sweden)

Bam, Wouter Gideon

2014-08-01

Full Text Available The multivariate asset management assessment topography (MAMAT was developed to quantify, and represent graphically, development, adoption, and performance of a business’ asset management (AM systems, as described by standards such as PAS 55. The MAMAT provides a way to visualise clearly the strengths and weaknesses of a business’ asset management system. Building on MAMAT, a model describing the relationship between the commitment of resources and the corresponding improvement in the MAMAT assessment outcome is proposed. The goal is to develop an optimisation model that will maximise financial benefits by improving the MAMAT assessment score achieved by a business, while minimising the investment required to attain this improvement. This is achieved by determining the optimal allocation of resources to the different subcategories of the MAMAT assessment framework. The multi-objective cross-entropy method (MOO CEM is used to find the Pareto set of solutions for this problem. In order to showcase the intended industry application and use of the optimisation model, a hypothetical case study is executed and described in this paper. From this application, it was found that the MOO CEM finds useful solutions that can support the implementation of standards such as PAS 55 by prioritising and assigning resources to implementation activities.

Optimising neutron polarizers--measuring the flipping ratio and related quantities

CERN Document Server

Goossens, D J

2002-01-01

The continuing development of gaseous spin polarized sup 3 He transmission filters for use as neutron polarizers makes the choice of optimum thickness for these filters an important consideration. The 'quality factors' derived for the optimisation of transmission filters for particular measurements are general to all neutron polarizers. In this work optimisation conditions for neutron polarizers are derived and discussed for the family of studies related to measuring the flipping ratio from samples. The application of the optimisation conditions to sup 3 He transmission filters and other types of neutron polarizers is discussed. Absolute comparisons are made between the effectiveness of different types of polarizers for this sort of work.

Towards optimised information about clinical trials; identification and validation of key issues in collaboration with cancer patient advocates.

Science.gov (United States)

Dellson, P; Nilbert, M; Bendahl, P-O; Malmström, P; Carlsson, C

2011-07-01

Clinical trials are crucial to improve cancer treatment but recruitment is difficult. Optimised patient information has been recognised as a key issue. In line with the increasing focus on patients' perspectives in health care, we aimed to study patients' opinions about the written information used in three clinical trials for breast cancer. Primary data collection was done in focus group interviews with breast cancer patient advocates. Content analysis identified three major themes: comprehensibility, emotions and associations, and decision making. Based on the advocates' suggestions for improvements, 21 key issues were defined and validated through a questionnaire in an independent group of breast cancer patient advocates. Clear messages, emotionally neutral expressions, careful descriptions of side effects, clear comparisons between different treatment alternatives and information about the possibility to discontinue treatment were perceived as the most important issues. Patients' views of the information in clinical trials provide new insights and identify key issues to consider in optimising future written information and may improve recruitment to clinical cancer trials. © 2010 Blackwell Publishing Ltd.

Isoniazid-resistant tuberculosis in Denmark: mutations, transmission and treatment outcome

DEFF Research Database (Denmark)

Bang, Didi; Andersen, Peter Henrik; Andersen, Ase Bengaard

2010-01-01

A retrospective study on isoniazid-resistant tuberculosis (TB) was conducted in the low-burden country, Denmark (DK). The aim was to describe treatment outcome and transmission and to evaluate a mutation analysis for high- and low-level isoniazid resistance detection.......A retrospective study on isoniazid-resistant tuberculosis (TB) was conducted in the low-burden country, Denmark (DK). The aim was to describe treatment outcome and transmission and to evaluate a mutation analysis for high- and low-level isoniazid resistance detection....

Cultural-based particle swarm for dynamic optimisation problems

Science.gov (United States)

Daneshyari, Moayed; Yen, Gary G.

2012-07-01

Many practical optimisation problems are with the existence of uncertainties, among which a significant number belong to the dynamic optimisation problem (DOP) category in which the fitness function changes through time. In this study, we propose the cultural-based particle swarm optimisation (PSO) to solve DOP problems. A cultural framework is adopted incorporating the required information from the PSO into five sections of the belief space, namely situational, temporal, domain, normative and spatial knowledge. The stored information will be adopted to detect the changes in the environment and assists response to the change through a diversity-based repulsion among particles and migration among swarms in the population space, and also helps in selecting the leading particles in three different levels, personal, swarm and global levels. Comparison of the proposed heuristics over several difficult dynamic benchmark problems demonstrates the better or equal performance with respect to most of other selected state-of-the-art dynamic PSO heuristics.

Barriers to Implementing Treatment Integrity Procedures in School Psychology Research: Survey of Treatment Outcome Researchers

Science.gov (United States)

Sanetti, Lisa M. Hagermoser; DiGennaro Reed, Florence D.

2012-01-01

Treatment integrity data are essential to drawing valid conclusions in treatment outcome studies. Such data, however, are not always included in peer-reviewed research articles in school psychology or related fields. To gain a better understanding of why treatment integrity data are lacking in the school psychology research, we surveyed the…

Outcome of heroin-dependent adolescents presenting for opiate substitution treatment.

LENUS (Irish Health Repository)

Smyth, Bobby P

2012-01-01

Because the outcome of methadone and buprenorphine substitution treatment in adolescents is unclear, we completed a retrospective cohort study of 100 consecutive heroin-dependent adolescents who sought these treatments over an 8-year recruitment period. The participants\\' average age was 16.6 years, and 54 were female. Half of the patient group remained in treatment for over 1 year. Among those still in treatment at 12 months, 39% demonstrated abstinence from heroin. The final route of departure from the treatment program was via planned detox for 22%, dropout for 32%, and imprisonment for 8%. The remaining 39% were transferred elsewhere for ongoing opiate substitution treatment after a median period of 23 months of treatment. Males were more likely to exit via imprisonment (p < .05), but other outcomes were not predicted by gender. There were no deaths during treatment among these 100 patients who had a cumulative period of 129 person years at risk. Our findings suggest that this treatment delivers reductions in heroin use and that one fifth of patients will exit treatment following detox completion within a 1- to 2-year time frame.

Treatment outcomes for isoniazid-resistant tuberculosis under program conditions in British Columbia, Canada.

Science.gov (United States)

Romanowski, Kamila; Chiang, Leslie Y; Roth, David Z; Krajden, Mel; Tang, Patrick; Cook, Victoria J; Johnston, James C

2017-09-04

Every year, over 1 million people develop isoniazid (INH) resistant tuberculosis (TB). Yet, the optimal treatment regimen remains unclear. Given increasing prevalence, the clinical efficacy of regimens used by physicians is of interest. This study aims to examine treatment outcomes of INH resistant TB patients, treated under programmatic conditions in British Columbia, Canada. Medical charts were retrospectively reviewed for cases of culture-confirmed INH mono-resistant TB reported to the BC Centre for Disease Control (BCCDC) from 2002 to 2014. Treatment regimens, patient and strain characteristics, and clinical outcomes were analysed. One hundred sixty five cases of INH mono-resistant TB were included in analysis and over 30 different treatment regimens were prescribed. Median treatment duration was 10.5 months (IQR 9-12 months) and treatment was extended beyond 12 months for 26 patients (15.8%). Fifty six patients (22.6%) experienced an adverse event that resulted in a drug regimen modification. Overall, 140 patients (84.8%) had a successful treatment outcome while 12 (7.2%) had an unsuccessful treatment outcome of failure (n = 2; 1.2%), relapse (n = 4; 2.4%) or all cause mortality (n = 6; 3.6%). Our treatment outcomes, while consistent with findings reported from other studies in high resource settings, raise concerns about current recommendations for INH resistant TB treatment. Only a small proportion of patients completed the recommended treatment regimens. High quality studies to confirm the effectiveness of standardized regimens are urgently needed, with special consideration given to trials utilizing fluoroquinolones.

Solving dynamic multi-objective problems with vector evaluated particle swarm optimisation

CSIR Research Space (South Africa)

Greeff, M

2008-06-01

Full Text Available Many optimisation problems are multi-objective and change dynamically. Many methods use a weighted average approach to the multiple objectives. This paper introduces the usage of the vector evaluated particle swarm optimiser (VEPSO) to solve dynamic...

Psychosocial predictors of treatment outcome for trauma-affected refugees

DEFF Research Database (Denmark)

Sonne, Charlotte; Carlsson, Jessica; Bech, Per

2016-01-01

at the Competence Centre for Transcultural Psychiatry (CTP), Denmark. The CTP Predictor Index used in the study included 15 different possible outcome predictors concerning the patients' past, chronicity of mental health problems, pain, treatment motivation, prerequisites for engaging in psychotherapy, and social...... situation. The primary outcome measure was PTSD symptoms measured on the Harvard Trauma Questionnaire (HTQ). Other outcome measures included the Hopkins Symptom Check List-25, the WHO-5 Well-being Index, Sheehan Disability Scale, Hamilton Depression and Anxiety Scales, the somatisation scale of the Symptoms...

Trends in treatment and outcomes of pediatric craniopharyngioma, 1975–2011

Science.gov (United States)

Cohen, Michal; Bartels, Ute; Branson, Helen; Kulkarni, Abhaya V.; Hamilton, Jill

2013-01-01

Background Craniopharyngioma tumors and their treatment can lead to significant long-term morbidity due to their proximity to vital structures. The optimal treatment has been debated for many years. We aimed to review the long-term outcomes of children treated for craniopharyngioma in our institution over the past decade and describe trends in treatment and outcomes over the past 3 decades. Methods Charts of children with craniopharyngioma treated and followed at The Hospital for Sick Children between 2001 and 2011 were reviewed. Data regarding findings at diagnosis, treatment, and long-term outcomes were analyzed. Comparison was made with previously published data from our institution. Results Data from 33 patients are included; mean age at treatment, 10.7 ± 4.8 years. In 18 children (55%), the initial surgical approach was tumor cyst decompression with or without adjuvant therapy, compared with only 0–2% in the preceding decades (P < .01). Diabetes insipidus occurred in 55% of children and panhypopituitarism in 58% compared with 88% (P < .01) and 86% (P < .01), respectively, in the previous 10 years. Overall, there was a 36% reduction in the number of children who developed severe obesity compared with the preceding decade. Body mass index at follow-up was associated with body mass index at diagnosis (P = .004) and tumor resection as an initial treatment approach (P = .028). Conclusions A shift in surgical treatment approach away from gross total resection has led to improved endocrine outcomes. This may have beneficial implications for quality of life in survivors. PMID:23486689

Exploration of automatic optimisation for CUDA programming

KAUST Repository

Al-Mouhamed, Mayez; Khan, Ayaz ul Hassan

2014-01-01

© 2014 Taylor & Francis. Writing optimised compute unified device architecture (CUDA) program for graphic processing units (GPUs) is complex even for experts. We present a design methodology for a restructuring tool that converts C-loops into optimised CUDA kernels based on a three-step algorithm which are loop tiling, coalesced memory access and resource optimisation. A method for finding possible loop tiling solutions with coalesced memory access is developed and a simplified algorithm for restructuring C-loops into an efficient CUDA kernel is presented. In the evaluation, we implement matrix multiply (MM), matrix transpose (M-transpose), matrix scaling (M-scaling) and matrix vector multiply (MV) using the proposed algorithm. We present the analysis of the execution time and GPU throughput for the above applications, which favourably compare to other proposals. Evaluation is carried out while scaling the problem size and running under a variety of kernel configurations. The obtained speedup is about 28-35% for M-transpose compared to NVIDIA Software Development Kit, 33% speedup for MV compared to general purpose computation on graphics processing unit compiler, and more than 80% speedup for MM and M-scaling compared to CUDA-lite.

Exploration of automatic optimisation for CUDA programming

KAUST Repository

Al-Mouhamed, Mayez

2014-09-16

© 2014 Taylor & Francis. Writing optimised compute unified device architecture (CUDA) program for graphic processing units (GPUs) is complex even for experts. We present a design methodology for a restructuring tool that converts C-loops into optimised CUDA kernels based on a three-step algorithm which are loop tiling, coalesced memory access and resource optimisation. A method for finding possible loop tiling solutions with coalesced memory access is developed and a simplified algorithm for restructuring C-loops into an efficient CUDA kernel is presented. In the evaluation, we implement matrix multiply (MM), matrix transpose (M-transpose), matrix scaling (M-scaling) and matrix vector multiply (MV) using the proposed algorithm. We present the analysis of the execution time and GPU throughput for the above applications, which favourably compare to other proposals. Evaluation is carried out while scaling the problem size and running under a variety of kernel configurations. The obtained speedup is about 28-35% for M-transpose compared to NVIDIA Software Development Kit, 33% speedup for MV compared to general purpose computation on graphics processing unit compiler, and more than 80% speedup for MM and M-scaling compared to CUDA-lite.

Surgical treatment of gynecomastia: complications and outcomes.

Science.gov (United States)

Li, Chun-Chang; Fu, Ju-Peng; Chang, Shun-Cheng; Chen, Tim-Mo; Chen, Shyi-Gen

2012-11-01

Gynecomastia is defined as the benign enlargement of the male breast. Multiple surgical options have been used to improve outcomes. The aim of this study was to analyze the surgical approaches to the treatment of gynecomastia and their outcomes over a 10-year period. All patients undergoing surgical correction of gynecomastia in our department between 2000 and 2010 were included for retrospective evaluation. The data were analyzed for etiology, stage of gynecomastia, surgical technique, complications, risk factors, and revision rate. The surgical result was evaluated with self-assessment questionnaires. A total of 41 patients with 75 operations were included. Techniques included subcutaneous mastectomy alone or with additional ultrasound-assisted liposuction (UAL) and isolated UAL. The surgical revision rate for all patients was 4.8%. The skin-sparing procedure gave good surgical results in grade IIb and grade III gynecomastia with low revision and complication rates. The self-assessment report revealed a good level of overall satisfaction and improvement in self-confidence (average scores 9.4 and 9.2, respectively, on a 10-point scale). The treatment of gynecomastia requires an individualized approach. Subcutaneous mastectomy combined with UAL could be used as the first choice for surgical treatment of grade II and III gynecomastia.

Optimisation of BPMN Business Models via Model Checking

DEFF Research Database (Denmark)

Herbert, Luke Thomas; Sharp, Robin

2013-01-01

We present a framework for the optimisation of business processes modelled in the business process modelling language BPMN, which builds upon earlier work, where we developed a model checking based method for the analysis of BPMN models. We define a structure for expressing optimisation goals...... for synthesized BPMN components, based on probabilistic computation tree logic and real-valued reward structures of the BPMN model, allowing for the specification of complex quantitative goals. We here present a simple algorithm, inspired by concepts from evolutionary algorithms, which iteratively generates...

Visualisation of microtubules and actin filaments in fixed BY-2 suspension cells using an optimised whole mount immunolabelling protocol

NARCIS (Netherlands)

Szechynska-Hebda, M.; Wedzony, M.; Dubas, E.; Kieft, H.; Lammeren, van A.A.M.

2006-01-01

Excellent visualisation of microtubules and actin filaments was obtained in fixed tobacco BY-2 suspension cells after optimising a protocol for whole mount immunolabelling. The procedure is based on modification of fixation, cell wall digestion, dimethyl sulfoxide (DMSO) treatment, post fixation,

Optimisation of thermo mechanical treatments using cryogenic rolling and aging of the high strength aluminium alloy AlZn5.5MgCu (AA7075)

Energy Technology Data Exchange (ETDEWEB)

Hunger, S.; Scholze, M.; Hockauf, M.; Wagner, M.F.X. [Chemnitz University of Technology, Institute of Materials Science and Engineering, Chemnitz (Germany); Fritsch, S.

2011-07-15

In this study, we consider the optimisation of mechanical properties and the microstructure of the high strength and difficult-to-work aluminium alloy AA7075 by cryogenic rolling. In order to reduce the grain size into the (ultra)fine-grained regime, cryogenic rolling is used to introduce different amount of plastic strain. We discuss how rolling at lower temperatures allows the introduction of higher strains on the one hand, and suppresses dynamic recovery and aging effectively on the other hand. Our results demonstrate that, in combination with an appropriate post-processing aging treatment, an outstanding combination of strength and ductility can be achieved. (Copyright copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

Social capital and adverse treatment outcomes of tuberculosis: a case-control study.

Science.gov (United States)

Deshmukh, P R; Mundra, A; Dawale, A

2017-08-01

'Social capital' refers to social norms, relationships, networks and values that affect the functioning and development of society. Social capital influences health positively, but its role in the treatment outcomes of tuberculosis (TB) is not known. To study the role of social capital in determining adverse TB treatment outcomes. Of 516 patients registered under the Revised National Tuberculosis Control Programme in 2014 in Wardha Tuberculosis Unit, Wardha, India, we included 88 patients with adverse treatment outcomes as cases and 187 controls from among those without adverse outcomes. Multiple logistic regression was used to compare standardised Z-scores. A greater proportion of controls than cases belonged to higher quartiles of social capital and its domains than cases, and the mean standardised Z-score was also consistently higher among controls than cases. Respectively 47% and 15% of cases and controls were in the poorest quartile of social capital, whereas respectively 10% and 33% of cases and controls were in the richest quartile. Each unit increase in Z-score of overall social capital reduced the odds of adverse treatment outcomes by 63.1%. Appropriate interventions for building social capital for TB patients and linking them with the programme would improve programme performance.

Intelligent Support for a Computer Aided Design Optimisation Cycle

OpenAIRE

B. Dolšak; M. Novak; J. Kaljun

2006-01-01

It is becoming more and more evident that  adding intelligence  to existing computer aids, such as computer aided design systems, can lead to significant improvements in the effective and reliable performance of various engineering tasks, including design optimisation. This paper presents three different intelligent modules to be applied within a computer aided design optimisation cycle to enable more intelligent and less experience-dependent design performance. 

Short-term treatment outcomes of children starting antiretroviral ...

African Journals Online (AJOL)

Short-term treatment outcomes of children starting antiretroviral therapy in the intensive care unit, general medical wards and outpatient HIV clinics at Red Cross War Memorial Children's Hospital, Cape Town, South Africa: A retrospective cohort study.

Optimisation of logistics processes of energy grass collection

Science.gov (United States)

Bányai, Tamás.

2010-05-01

The collection of energy grass is a logistics-intensive process [1]. The optimal design and control of transportation and collection subprocesses is a critical point of the supply chain. To avoid irresponsible decisions by right of experience and intuition, the optimisation and analysis of collection processes based on mathematical models and methods is the scientific suggestible way. Within the frame of this work, the author focuses on the optimisation possibilities of the collection processes, especially from the point of view transportation and related warehousing operations. However the developed optimisation methods in the literature [2] take into account the harvesting processes, county-specific yields, transportation distances, erosion constraints, machinery specifications, and other key variables, but the possibility of more collection points and the multi-level collection were not taken into consideration. The possible areas of using energy grass is very wide (energetically use, biogas and bio alcohol production, paper and textile industry, industrial fibre material, foddering purposes, biological soil protection [3], etc.), so not only a single level but also a multi-level collection system with more collection and production facilities has to be taken into consideration. The input parameters of the optimisation problem are the followings: total amount of energy grass to be harvested in each region; specific facility costs of collection, warehousing and production units; specific costs of transportation resources; pre-scheduling of harvesting process; specific transportation and warehousing costs; pre-scheduling of processing of energy grass at each facility (exclusive warehousing). The model take into consideration the following assumptions: (1) cooperative relation among processing and production facilties, (2) capacity constraints are not ignored, (3) the cost function of transportation is non-linear, (4) the drivers conditions are ignored. The

The principle of optimisation: reasons for success and legal criticism

International Nuclear Information System (INIS)

Fernandez Regalado, Luis

2008-01-01

The International Commission on Radiological Protection (ICRP) has adopted new recommendations in 2007. In broad outlines they fundamentally continue the recommendations already approved in 1990 and later on. The principle of optimisation of protection, together with the principles of justification and dose limits, remains playing a key role of the ICRP recommendations, and it has so been for the last few years. This principle, somehow reinforced in the 2007 ICRP recommendations, has been incorporated into norms and legislation which have peacefully been in force in many countries all over the world. There are three main reasons to explain the success in the application of the principle of optimisation in radiological protection: First, the subjectivity of the sentence that embraces the principle of optimisation, 'As low as reasonably achievable' (ALARA), that allows different valid interpretations under different circumstances. Second, the pragmatism and adaptability of ALARA to all exposure situations. And third, the scientific humbleness which is behind the principle of optimisation, which makes a clear contrast with the old fashioned scientific positivism that enshrined scientist opinions. Nevertheless, from a legal point of view, there is some criticism cast over the principle of optimisation in radiological protection, where it has been transformed in compulsory norm. This criticism is based on two arguments: The lack of democratic participation in the process of elaboration of the norm, and the legal uncertainty associated to its application. Both arguments are somehow known by the ICRP which, on the one hand, has broadened the participation of experts, associations and the professional radiological protection community, increasing the transparency on how decisions on recommendations have been taken, and on the other hand, the ICRP has warned about the need for authorities to specify general criteria to develop the principle of optimisation in national

Working memory capacity and addiction treatment outcomes in adolescents.

Science.gov (United States)

Houck, Jon M; Feldstein Ewing, Sarah W

2018-01-01

Brief addiction treatments including motivational interviewing (MI) have shown promise with adolescents, but the factors that influence treatment efficacy in this population remain unknown. One candidate is working memory, the ability to hold a fact or thought in mind. This is relevant, as in therapy, a client must maintain and manipulate ideas while working with a clinician. Working memory depends upon brain structures and functions that change markedly during neurodevelopment and that can be negatively impacted by substance use. In a secondary analysis of data from a clinical trial for adolescent substance use comparing alcohol/marijuana education and MI, we evaluated the relationship between working memory and three-month treatment-outcomes with the hypothesis that the relationship between intervention conditions and outcome would be moderated by working memory. With a diverse sample of adolescents currently using alcohol and/or marijuana (N = 153, 64.7% male, 70.6% Hispanic), we examined the relationship between baseline measures of working memory and alcohol and cannabis-related problem scores measured at the three-month follow-up. The results showed that lower working memory scores were associated with poorer treatment response only for alcohol use, and only within the education group. No relationship was found between working memory and treatment outcomes in the MI group. The results suggest that issues with working memory capacity may interfere with adolescents' ability to process and implement didactic alcohol and marijuana content in standard education interventions. These results also suggest that MI can be implemented equally effectively across the range of working memory functioning in youth.

Simulation and optimisation modelling approach for operation of the Hoa Binh Reservoir, Vietnam

DEFF Research Database (Denmark)

Ngo, Long le; Madsen, Henrik; Rosbjerg, Dan

2007-01-01

Hoa Binh, the largest reservoir in Vietnam, plays an important role in flood control for the Red River delta and hydropower generation. Due to its multi-purpose character, conflicts and disputes in operating the reservoir have been ongoing since its construction, particularly in the flood season....... This paper proposes to optimise the control strategies for the Hoa Binh reservoir operation by applying a combination of simulation and optimisation models. The control strategies are set up in the MIKE 11 simulation model to guide the releases of the reservoir system according to the current storage level......, the hydro-meteorological conditions, and the time of the year. A heuristic global optimisation tool, the shuffled complex evolution (SCE) algorithm, is adopted for optimising the reservoir operation. The optimisation puts focus on the trade-off between flood control and hydropower generation for the Hoa...

Risk-informed optimisation of railway tracks inspection and maintenance procedures

International Nuclear Information System (INIS)

Podofillini, Luca; Zio, Enrico; Vatn, Jorn

2006-01-01

Nowadays, efforts are being made by the railway industry for the application of reliability-based and risk-informed approaches to maintenance optimisation of railway infrastructures, with the aim of reducing the operation and maintenance expenditures while still assuring high safety standards. In particular, in this paper, we address the use of ultrasonic inspection cars and develop a methodology for the determination of an optimal strategy for their use. A model is developed to calculate the risks and costs associated with an inspection strategy, giving credit to the realistic issues of the rail failure process and including the actual inspection and maintenance procedures followed by the railway company. A multi-objective optimisation viewpoint is adopted in an effort to optimise inspection and maintenance procedures with respect to both economical and safety-related aspects. More precisely, the objective functions here considered are such to drive the search towards solutions characterized by low expenditures and low derailment probability. The optimisation is performed by means of a genetic algorithm. The work has been carried out within a study of the Norwegian National Rail Administration (Jernbaneverket)

MIMO-Radar Waveform Design for Beampattern Using Particle-Swarm-Optimisation

KAUST Repository

Ahmed, Sajid

2012-07-31

Multiple input multiple output (MIMO) radars have many advantages over their phased-array counterparts: improved spatial resolution; better parametric identifiably and greater flexibility to acheive the desired transmit beampattern. The desired transmit beampatterns using MIMO-radar requires the waveforms to have arbitrary auto- and cross-correlations. To design such waveforms, generally a waveform covariance matrix, R, is synthesised first then the actual waveforms are designed. Synthesis of the covariance matrix, R, is a constrained optimisation problem, which requires R to be positive semidefinite and all of its diagonal elements to be equal. To simplify the first constraint the covariance matrix is synthesised indirectly from its square-root matrix U, while for the second constraint the elements of the m-th column of U are parameterised using the coordinates of the m-hypersphere. This implicitly fulfils both of the constraints and enables us to write the cost-function in closed form. Then the cost-function is optimised using a simple particle-swarm-optimisation (PSO) technique, which requires only the cost-function and can optimise any choice of norm cost-function. © 2012 IEEE.

The impact of benzodiazepine use on methadone maintenance treatment outcomes.

Science.gov (United States)

Brands, Bruna; Blake, Joan; Marsh, David C; Sproule, Beth; Jeyapalan, Renuka; Li, Selina

2008-01-01

The purposes of this study were to examine predictors of benzodiazepine use among methadone maintenance treatment patients, to determine whether baseline benzodiazepine use influenced ongoing use during methadone maintenance treatment, and to assess the effect of ongoing benzodiazepine use on treatment outcomes (i.e., opioid and cocaine use and treatment retention). A retrospective chart review of 172 methadone maintenance treatment patients (mean age = 34.6 years; standard deviation = 8.5 years; 64% male) from January 1997 to December 1999 was conducted. At baseline, 29% were "non-users" (past year) of benzodiazepine, 36% were "occasional users," and 35% were "regular/problem users." Regular/problem users were more likely to have started opioid use with prescription opioids, experienced more overdoses, and reported psychiatric comorbidity. Being female, more years of opioid use, and a history of psychiatric treatment were significant predictors of baseline benzodiazepine use. Ongoing benzodiazepine users were more likely to have opioid-positive and cocaine-positive urine screens during methadone maintenance treatment. Only ongoing cocaine use was negatively related to retention. Benzodiazepine use by methadone maintenance treatment patients is associated with a more complex clinical picture and may negatively influence treatment outcomes.

Optimisation of amplitude distribution of magnetic Barkhausen noise

Science.gov (United States)

Pal'a, Jozef; Jančárik, Vladimír

2017-09-01

The magnetic Barkhausen noise (MBN) measurement method is a widely used non-destructive evaluation technique used for inspection of ferromagnetic materials. Besides other influences, the excitation yoke lift-off is a significant issue of this method deteriorating the measurement accuracy. In this paper, the lift-off effect is analysed mainly on grain oriented Fe-3%Si steel subjected to various heat treatment conditions. Based on investigation of relationship between the amplitude distribution of MBN and lift-off, an approach to suppress the lift-off effect is proposed. Proposed approach utilizes the digital feedback optimising the measurement based on the amplitude distribution of MBN. The results demonstrated that the approach can highly suppress the lift-off effect up to 2 mm.

Design of optimised backstepping controller for the synchronisation of chaotic Colpitts oscillator using shark smell algorithm

Science.gov (United States)

Fouladi, Ehsan; Mojallali, Hamed

2018-01-01

In this paper, an adaptive backstepping controller has been tuned to synchronise two chaotic Colpitts oscillators in a master-slave configuration. The parameters of the controller are determined using shark smell optimisation (SSO) algorithm. Numerical results are presented and compared with those of particle swarm optimisation (PSO) algorithm. Simulation results show better performance in terms of accuracy and convergence for the proposed optimised method compared to PSO optimised controller or any non-optimised backstepping controller.

Experience and optimisation of ethanolamine treatment for a PWR secondary system

International Nuclear Information System (INIS)

Eeden, Nestor-van; Matthee, Felix; Montshiwagae, Maleke

2012-09-01

The secondary systems of both pressurised water reactor (PWR) units at Koeberg Nuclear Power Station (KNPS) on the West Coast of South Africa have been on ethanolamine (ETA) treatment since 1999 / 2000. Prior to conversion to ETA Chemistry the secondary regime was ammonia / hydrazine all volatile treatment (AVT) which aimed to achieve a pH 25C of 9.65 in the feedwater. ETA was selected as the preferred corrosion mitigation agent as opposed to the alternative secondary treatment technology available at the time to combat flow accelerated corrosion (FAC). The main advantage of ETA over ammonia is that ETA has a lower relative volatility and thus it favours the water phase while ammonia favours the steam phase. Plant chemistry, design and financial aspects were considered in the decision making for KNPS. Implementation of ETA at KNPS initially targeted 2 mg ETA/kg in the feedwater and 4 mg ETA/kg in the heater drains tank. It was found that under these conditions it was necessary to simultaneously inject ammonia to reach the pH specification in the feedwater. While using only pH as a limiting parameter, with ETA on manual control and ammonia on automated control, it was possible for the ETA concentration to drop below the target levels. To prevent this from occurring, during 2002 higher target concentrations for ETA were established of between 3.0 and 3.5 mg ETA/kg in the feedwater and with an upper limit value of 4 mg ETA/kg. In 2003, this upper limiting value and the target concentrations were discarded when it was decided to attain the pH specification without injecting ammonia. When dosing only ETA and hydrazine (in the absence of ammonia dosing) the pH specification was only achievable at greater than 4 mg ETA/kg. This specification was again revised in 2007 and changed to 4 mg ETA/kg as a minimum limit; with no upper limit value. Dosing was still manually controlled but now using feedwater conductivity measurement based on a correlation established with ETA

Psychosocial predictors of treatment outcome for trauma-affected refugees

DEFF Research Database (Denmark)

Sonne, Charlotte; Carlsson, Jessica; Bech, Per

2016-01-01

situation. The primary outcome measure was PTSD symptoms measured on the Harvard Trauma Questionnaire (HTQ). Other outcome measures included the Hopkins Symptom Check List-25, the WHO-5 Well-being Index, Sheehan Disability Scale, Hamilton Depression and Anxiety Scales, the somatisation scale of the Symptoms...... Checklist-90, Global Assessment of Functioning scales, and pain rated on visual analogue scales. The relations between treatment outcomes and the total score as well as subscores of the CTP Predictor Index were analysed. Results Overall, the total score of the CTP Predictor Index was significantly...

Measuring Outcome in the Treatment of Cocaine Dependence

Science.gov (United States)

Crits-Christoph, Paul; Gallop, Robert; Gibbons, Mary Beth Connolly; Sadicario, Jaclyn S.; Woody, George

2015-01-01

Background Little in known about the extent to which outcome measures used in studies of the treatment of cocaine dependence are associated with longer-term use and with broader measures of clinical improvement. The current study examined reductions in use, and abstinence-oriented measures, in relation to functioning and longer-term clinical benefits in the treatment of cocaine dependence. Methods Overall drug use, cocaine use, and functioning in a number of addiction-related domains for 487 patients diagnosed with DSM-IV cocaine dependence and treated with one of four psychosocial interventions in the NIDA Cocaine Collaborative Treatment Study were assessed monthly during 6 months of treatment and at 9, 12, 15, and 18 month follow-up. Results Measures of during-treatment reduction in use were moderately correlated with drug and cocaine use measures 12 months, but showed non-significant or small correlations with measures of functioning at 12 months. Highest correlations were evident for abstinence measures (maximum consecutive days abstinence and completely abstinent) during treatment in relation to sustained (3 month) abstinence at 12 months. Latent class analysis of patterns of change over time revealed that most patients initially (months 1 to 4 of treatment) either became abstinent immediately or continued to use every month. Over the couse of follow-up, patients either maintained abstinence or used regularly – intermittent use was less common. Conclusions There were generally small associations between various measures of cocaine use and longer-term clinical benefits, other than abstinence was associated with continued abstinence. No one method of measuring outcome of treatment of cocaine dependence appears superior to others. PMID:26366427

Design of heat treatments for 9-12%Cr steels to optimise creep resistance for power plant applications

Energy Technology Data Exchange (ETDEWEB)

Morris, P.F.; Sachadel, U.A.; Clarke, P.D. [Tata Steel Europe, Rotherham (United Kingdom). Swinden Technology Centre; CRD and T, IJmuiden (Netherlands)

2010-07-01

Optimisation of the creep rupture properties of Steel 92 (9%Cr, 0.5%Mo, 2%W) by modification of heat treatment and C:N ratio has been studied. It was shown that a higher austenization temperature and double tempering at lower temperature can significantly extend creep life of the standard composition. The increase in austenization temperature from 1060 C and double tempering at 660 C/3h instead of single tempering at 780 C/2h resulted in the increase of stress rupture life from 1,734 to 6,179h at 650 C/110MPa. Even greater improvement in creep life was achieved by the combination of the modified heat treatment and decreased C:N ratio. In this case the creep life was extended to 10,255 h at 650 C/110MPa. A further increase in austenitization temperature to 1200 C for the decreased C:N ratio variant extended the rupture life to 17,118h. Initial results indicate that this modified heat treatment schedule does not result in notch brittle behaviour and most of the improvement in creep strength remains after a simulated post weld heat treatment at 740 C. The stress rupture programme is continuing and at 600 C test durations are approaching 60,000h. To explain the effect on rupture life thermodynamic calculations, microscopic investigations and a literature study were performed. Electron metallography investigations revealed that the lower tempering temperature resulted in a finer distribution of nano-size particles. Calculations show that increasing the austenitization temperature gave more dissolved B, N, C, Nb and V. The lower C:N ratio resulted in a higher atomic fraction of N in nano-size particles on subsequent tempering. Dissolved B should stabilize M{sub 23}M{sub 6} and dissolved N, C, Nv, and V should allow precipitation of a higher volume fraction of nano-size carbo-nitrides during tempering. Literature data suggest that lower tempering temperatures could also change their type from MX to M{sub 2}X. (orig.)

Separative power of an optimised concurrent gas centrifuge

Energy Technology Data Exchange (ETDEWEB)

Bogovalov, Sergey; Boman, Vladimir [National Research Nuclear University (MEPHI), Moscow (Russian Federation)

2016-06-15

The problem of separation of isotopes in a concurrent gas centrifuge is solved analytically for an arbitrary binary mixture of isotopes. The separative power of the optimised concurrent gas centrifuges for the uranium isotopes equals to δU = 12.7 (V/700 m/s)2(300 K/T)(L/1 m) kg·SWU/yr, where L and V are the length and linear velocity of the rotor of the gas centrifuge and T is the temperature. This equation agrees well with the empirically determined separative power of optimised counter-current gas centrifuges.

Profile and treatment outcomes of patients with tuberculosis in ...

African Journals Online (AJOL)

Background: Data on the epidemiology of tuberculosis and its treatment outcomes were incomplete in the study area and this study was done to fill this gap. Methods: Institution based cross sectional study was conducted from January 2011 to December 2014. A total of 949 TB patients who were on treatment in North ...

Optimisation of microwave-assisted processing in production of pineapple jam

Science.gov (United States)

Ismail, Nur Aisyah Mohd; Abdullah, Norazlin; Muhammad, Norhayati

2017-10-01

Pineapples are available all year round since they are unseasonal fruits. Due to the continuous harvesting of the fruit, the retailers and farmers had to find a solution such as the processing of pineapple into jam, to treat the unsuccessfully sold pineapples. The direct heating of pineapple puree during the production of pineapple jam can cause over degradation of quality of the fresh pineapple. Thus, this study aims to optimise the microwave-assisted processing conditions for producing pineapple jam which could reduce water activity and meets minimum requirement for pH and total soluble solids contents of fruit jam. The power and time of the microwave processing were chosen as the factors, while the water activity, pH and total soluble solids (TSS) content of the pineapple jam were determined as responses to be optimised. The microwave treatment on the pineapple jam was able to give significant effect on the water activity and TSS content of the pineapple jam. The optimum power and time for the microwave processing of pineapple jam is 800 Watt and 8 minutes, respectively. The use of domestic microwave oven for the pineapple jam production results in acceptable pineapple jam same as conventional fruit jam sold in the marketplace.

Does impulsivity predict outcome in treatment for binge eating disorder? A multimodal investigation.

Science.gov (United States)

Manasse, Stephanie M; Espel, Hallie M; Schumacher, Leah M; Kerrigan, Stephanie G; Zhang, Fengqing; Forman, Evan M; Juarascio, Adrienne S

2016-10-01

Multiple dimensions of impulsivity (e.g., affect-driven impulsivity, impulsive inhibition - both general and food-specific, and impulsive decision-making) are associated with binge eating pathology cross-sectionally, yet the literature on whether impulsivity predicts treatment outcome is limited. The present pilot study explored impulsivity-related predictors of 20-week outcome in a small open trial (n = 17) of a novel treatment for binge eating disorder. Overall, dimensions of impulsivity related to emotions (i.e., negative urgency) and food cues emerged as predictors of treatment outcomes (i.e., binge eating frequency and global eating pathology as measured by the Eating Disorders Examination), while more general measures of impulsivity were statistically unrelated to global eating pathology or binge frequency. Specifically, those with higher levels of negative urgency at baseline experienced slower and less pronounced benefit from treatment, and those with higher food-specific impulsivity had more severe global eating pathology at baseline that was consistent at post-treatment and follow-up. These preliminary findings suggest that patients high in negative urgency and with poor response inhibition to food cues may benefit from augmentation of existing treatments to achieve optimal outcomes. Future research will benefit from replication with a larger sample, parsing out the role of different dimensions of impulsivity in treatment outcome for eating disorders, and identifying how treatment can be improved to accommodate higher levels of baseline impulsivity. Copyright © 2016 Elsevier Ltd. All rights reserved.

THORACOLUMBAR BURST FRACTURE: STRUCTURAL CHANGES AND CLINICAL OUTCOME OF TREATMENT

Directory of Open Access Journals (Sweden)

Rodrigo Arnold Tisot

2016-03-01

Full Text Available ABSTRACT Objective: To evaluate the correlation between structural changes in burst fractures of thoracic and lumbar spine with clinical outcome of the treatment. Methods: A retrospective study in 25 patients with fractures of thoracic and lumbar spine burst fractures without neurological deficit. Eleven patients underwent conservative treatment and for the remaining the treatment was surgical. All patients were followed up for at least 24 months. The cases were evaluated by a protocol that included: posttraumatic measurement of kyphosis, vertebral body collapse and narrowing of the spinal canal, the visual analog scale of pain, and the quality of life questionnaire SF-36 at the follow-up. For statistical analysis, the significance level was 5% and the software SPSS 18.0 was used. Results: No statistically significant difference was observed when comparing the clinical outcomes of one treatment over another. Similarly, there was no statistically significant correlation between kyphosis and post-traumatic narrowing of the spinal canal with clinical worsening in the follow-up, regardless of the treatment used. We found a positive correlation (p<0.05 between initial collapse and SF-36 domains in both groups (operated and non-operated. Conclusion: There was no significant superiority of one treatment over the other, and no correlation was found between kyphosis and spinal canal narrowing in burst fractures of the thoracic and lumbar spine without neurological deficit. However, there was correlation between initial collapse and clinical outcome in some domains of the SF-36 questionnaire.

ADHD, Multimodal Treatment, and Longitudinal Outcome: Evidence, Paradox, and Challenge.

Science.gov (United States)

Hinshaw, Stephen P; Arnold, L Eugene

2015-01-01

Given major increases in the diagnosis of attention-deficit hyperactivity disorder (ADHD) and in rates of medication for this condition, we carefully examine evidence for effects of single versus multimodal (i.e., combined medication and psychosocial/behavioral) interventions for ADHD. Our primary data source is the Multimodal Treatment Study of Children with ADHD (MTA), a 14-month, randomized clinical trial in which intensive behavioral, medication, and multimodal treatment arms were contrasted with one another and with community intervention (treatment-as-usual), regarding outcome domains of ADHD symptoms, comorbidities, and core functional impairments. Although initial reports emphasized the superiority of well-monitored medication for symptomatic improvement, reanalyses and reappraisals have highlighted (a) the superiority of combination treatment for composite outcomes and for domains of functional impairment (e.g., academic achievement, social skills, parenting practices); (b) the importance of considering moderator and mediator processes underlying differential patterns of outcome, including comorbid subgroups and improvements in family discipline style during the intervention period; (c) the emergence of side effects (e.g., mild growth suppression) in youth treated with long-term medication; and (d) the diminution of medication's initial superiority once the randomly assigned treatment phase turned into naturalistic follow-up. The key paradox is that whereas ADHD clearly responds to medication and behavioral treatment in the short term, evidence for long-term effectiveness remains elusive. We close with discussion of future directions and a call for greater understanding of relevant developmental processes in the attempt to promote optimal, generalized, and lasting treatments for this important and impairing neurodevelopmental disorder.

Issues in the definition and measurement of drinking outcomes in alcoholism treatment research.

Science.gov (United States)

Babor, T F; Longabaugh, R; Zweben, A; Fuller, R K; Stout, R L; Anton, R F; Randall, C L

1994-12-01

This article reviews methodological and conceptual issues regarding the choice of drinking outcome measures in alcoholism treatment research. The following issues are discussed: Should drinking outcomes be conceptualized in terms of an underlying unitary disorder, or should provision be made for independent outcomes that cover a wide variety of dimensions? Which drinking outcomes are typically measured in treatment evaluation studies and how are they operationalized? What are the empirical associations among drinking outcome measures? If multiple outcomes are measured, which should be given primary importance? Over what period of time should treatment outcome be evaluated? What procedures can be used to detect, correct or prevent the response bias associated with verbal report methods? Because outcome measures need to fit the hypotheses and practical needs of a particular study, it is unlikely that complete standardization can be achieved across all studies. Nevertheless, given the importance of drinking outcomes and the need for economy, two primary dependent measures are recommended: (1) proportion of available drinking days abstinent; and (2) intensity of drinking, as defined by the total amount consumed (in ounces absolute alcohol) during the follow-up period divided by the number of actual drinking days. This article also proposes a strategy that may help to guide the selection of outcome measures in future research.

Interpretation of optimisation in the context of a disposal facility for long-lived radioactive waste

International Nuclear Information System (INIS)

1999-01-01

Full text: Guidance on the Requirements for Authorisation (the GRA) issued by the Environment Agency for England and Wales requires that all disposals of radioactive waste are undertaken in a manner consistent with four principles for the protection of the public. Among these is a principle of Optimisation, that: 'The radiological detriment to members of the public that may result from the disposal of radioactive waste shall be as low as reasonably achievable, economic and social factors being taken into account'. The principle of optimisation is widely accepted and has been discussed in both UK national policy and guidance and in documents from international organisations. The practical interpretation of optimisation in the context of post-closure safety of radioactive waste repositories is, however, still open to question. In particular, the strategies and procedures that a developer might employ to implement optimisation in the siting and development of a repository, and demonstrate optimisation in a safety case, are not defined. In preparation for its role of regulatory review, the Agency has undertaken a pilot study to explore the possible interpretations of optimisation stemming from the GRA, and to identify possible strategies and procedures that a developer might follow. A review has been undertaken of UK regulatory guidance and related documents, and also international guidance, referring to optimisation in relation to radioactive waste disposal facilities. In addition, diverse examples of the application of optimisation have been identified in the international and UK performance assessment literature. A one-day meeting was organised bringing together Agency staff and technical experts with different experiences and perspectives on the subject of optimisation in the context of disposal facilities for radioactive waste. This meeting identified and discussed key issues and possible approaches to optimisation, and specifically: (1) The meaning of

Application of Three Existing Stope Boundary Optimisation Methods in an Operating Underground Mine

Science.gov (United States)

Erdogan, Gamze; Yavuz, Mahmut

2017-12-01

The underground mine planning and design optimisation process have received little attention because of complexity and variability of problems in underground mines. Although a number of optimisation studies and software tools are available and some of them, in special, have been implemented effectively to determine the ultimate-pit limits in an open pit mine, there is still a lack of studies for optimisation of ultimate stope boundaries in underground mines. The proposed approaches for this purpose aim at maximizing the economic profit by selecting the best possible layout under operational, technical and physical constraints. In this paper, the existing three heuristic techniques including Floating Stope Algorithm, Maximum Value Algorithm and Mineable Shape Optimiser (MSO) are examined for optimisation of stope layout in a case study. Each technique is assessed in terms of applicability, algorithm capabilities and limitations considering the underground mine planning challenges. Finally, the results are evaluated and compared.

Impact of drug resistance on the tuberculosis treatment outcome

Directory of Open Access Journals (Sweden)

E. Lesnic

2017-03-01

Full Text Available Background. The standard treatment of a new case of multidrug-resistant tuberculosis (MDR-TB according to WHO recommendations in the Republic of Moldova is performed since 2005 showing a low treatment succes. Actually the treatment success rate increased due to excluding of MDR-TB patients from the general cohort. The major rate of patients with low outcome is represented by the failed and lost to follow-up cases. The purpose of the study was to assess the impact of multidrug-resiatnce and MDR-TB on the tuberculosis treatment outcome. Materials and methods. A retrospective selective, descriptive study targeting social, demographic, economic and epidemiological peculiarities, case-management, diagnostic radiological aspects and microbiological characteristics of 187 patients with pulmonary tuberculosis registered during 2013–2015 distributed in two groups: 1st group (61 patients with established multidrug-resistant strains using conventional cultural methods and the 2nd group (126 patients with MDR-TB. Results. Multidrug-resistance was established more frequently in new cases and MDR-TB in two thirds of retreated patients. No difference was identified in gender and age distribution, social, economical, educational characteristics; case-management assessment identified a similar proportion of patients revealed by general practitioners and specialists, with low rate of screened high risk groups. All patients from the multidrug-resistant group began the standard treatment for drug-responsiveness tuberculosis before drug susceptibility testing and one third of MDR-TB group was treated from the onset with the DOTS-Plus regimen. Highest success rate was identified in the new-case subgroups of both groups and higher rate of died patients was determined in the retreated subgroups. Such a low rate of patients aggrevates the resistance. Conclusions. Early diagnosis, drug responsiveness testing and raising awareness among about treatment compliance will

Treatment outcomes using CBT-IA with Internet-addicted patients.

Science.gov (United States)

Young, Kimberly S

2013-12-01

Internet Gaming Disorder, a subtype of Internet Addiction, is now classified in Section 3 of the DSM-5. Cognitive behavioral therapy (CBT) has been suggested in treating Internet addiction as this modality has been shown to be an effective treatment for similar impulse control disorders. Given the daily and necessary use of the Internet and technology in general compared to other compulsive syndromes, a specialized form of CBT has been developed called Cognitive-Behavioral Therapy for Internet Addiction (CBT-IA). CBT-IA is a comprehensive three phase approach that includes behavior modification to control compulsive Internet use, cognitive restructuring to identify, challenge, and modify cognitive distortions that lead to addictive use, and harm reduction techniques to address and treat co-morbid issues associated with the disorder. As the first model of its kind, this study examines 128 clients to measure treatment outcomes using CBT-IA. Clients were evaluated using the Internet Addiction Test (IAT) to classify subjects and were administered twelve weekly sessions of CBT-IA. Treatment outcomes were measured at the end of the twelve weeks, one-month, three months and at six month post-treatment. RESULTS showed that over 95% of clients were able to manage symptoms at the end of the twelve weeks and 78% sustained recovery six months following treatment. RESULTS found that CBT-IA was effective at ameliorating symptoms associated with Internet addiction after twelve weekly sessions and consistently over one-month, three months, and six months after therapy. Further research implications such as investigating long-term outcome effects of the model with larger client populations and treatment differences among the subtypes of Internet addiction or with other cultural populations using CBT-IA are discussed.

Impact of a multifactorial treatment programme on clinical outcomes and cardiovascular risk estimates

DEFF Research Database (Denmark)

Safai, Narges; Carstensen, Bendix; Vestergaard, Henrik

2018-01-01

), blood pressure (BP) and low-density lipoprotein (LDL) cholesterol as well as proportion reaching treatment targets. Our secondary outcome was to investigate changes in antidiabetic, antihypertensive and lipid-lowering treatment, together with the impact on estimated CVD risk. Linear mixed model....... SETTING: Tertiary diabetes centre in Denmark. PARTICIPANTS: Patients with type 2 diabetes (n=4299) referred to a programme with focus on treatment of hyperglycaemia, hypertension and dyslipidaemia between 1 January 2001 and 1 April 2016. OUTCOMES: Primary outcomes were changes in haemoglobin A1c (HbA1c...

Treatment outcome of Tuberculosis and HIV Co-infection at a ...

African Journals Online (AJOL)

. TB is a reemerging disease linked with HIV infections. It is necessary to compare the treatment outcome of patients with only Tuberculosis with those with HIV/AIDs co-infection. This study will also provide baseline information on treatment ...

Multiple Measures of Outcome in Assessing a Prison-Based Drug Treatment Program

Science.gov (United States)

Prendergast, Michael L.; Hall, Elizabeth A.; Wexler, Harry K.

2003-01-01

Evaluations of prison-based drug treatment programs typically focus on one or two dichotomous outcome variables related to recidivism. In contrast, this paper uses multiple measures of outcomes related to crime and drug use to examine the impact of prison treatment. Crime variables included self-report data of time to first illegal activity,…

Benchmarks for dynamic multi-objective optimisation

CSIR Research Space (South Africa)

Helbig, M

2013-06-01

Full Text Available When algorithms solve dynamic multi-objective optimisation problems (DMOOPs), benchmark functions should be used to determine whether the algorithm can overcome specific difficulties that can occur in real-world problems. However, for dynamic multi...

Optimisation and evaluation of the foetal dose during a radiotherapy of the right parotid

International Nuclear Information System (INIS)

Marchesi, V.; Noel, A.; Graff, P.; Beckendorf, V.; Peiffert, D.; Noel, A.

2008-01-01

Purpose was to optimize and to estimate the dose delivered to the foetus during a postoperative irradiation of a 5-month twin pregnant woman presenting with adenocarcinoma of the right parotid. The treatment protocol aimed to deliver 66 Gy conformal radiation therapy on the tumour bed associated to a prophylactic irradiation of 50 Gy on the upper cervical nodes. A series of measurements allowed to estimate the delivered dose in the abdomen by the means of an ion chamber inserted in a water phantom placed side by side of an anthropomorphic Alderson Rando phantom simulating the body of the patient from the head to the pelvis. An appropriate optimisation of the number and orientation of beams were performed in order to minimize the peripheral dose, which is mostly dependent of the total number of monitor unit per fraction: cervical nodes and tumour site included in the same fields, limitation of the irradiated volume, 6 MV X-ray beams rather than Cobalt beams. The measured doses at the upper, in the middle and at the lower part of the abdomen were 17.0, 11.0 and 11.9 mGy, respectively, for the entire treatment, representing 0.025, 0.016 and 0.017%, respectively of the prescribed dose. The actions conducted to optimise the treatment allowed to lower doses delivered to the foetus under the limits proposed by international recommendations (100 mGy). Thus, the treatment of the pregnant patient had been performed with a minimized risk for the foetus. (authors)

Optimisation of electron beam characteristics by simulated annealing

International Nuclear Information System (INIS)

Ebert, M.A.; University of Adelaide, SA; Hoban, P.W.

1996-01-01

Full text: With the development of technology in the field of treatment beam delivery, the possibility of tailoring radiation beams (via manipulation of the beam's phase space) is foreseeable. This investigation involved evaluating a method for determining the characteristics of pure electron beams which provided dose distributions that best approximated desired distributions. The aim is to determine which degrees of freedom are advantageous and worth pursuing in a clinical setting. A simulated annealing routine was developed to determine optimum electron beam characteristics. A set of beam elements are defined at the surface of a homogeneous water equivalent phantom defining discrete positions and angles of incidence, and electron energies. The optimal weighting of these elements is determined by the (generally approximate) solution to the linear equation, Dw = d, where d represents the dose distribution calculated over the phantom, w the vector of (50 - 2x10 4 ) beam element relative weights, and D a normalised matrix of dose deposition kernels. In the iterative annealing procedure, beam elements are randomly selected and beam weighting distributions are sampled and used to perturb the selected elements. Perturbations are accepted or rejected according to standard simulated annealing criteria. The result (after the algorithm has terminated due to meeting an iteration or optimisation specification) is an approximate solution for the beam weight vector (w) specified by the above equation. This technique has been applied for several sample dose distributions and phase space restrictions. An example is given of the phase space obtained when endeavouring to conform to a rectangular 100% dose region with polyenergetic though normally incident electrons. For regular distributions, intuitive conclusions regarding the benefits of energy/angular manipulation may be made, whereas for complex distributions, variations in intensity over beam elements of varying energy and

Internet gaming disorder treatment: a review of definitions of diagnosis and treatment outcome.

Science.gov (United States)

King, Daniel L; Delfabbro, Paul H

2014-10-01

Internet gaming disorder (IGD) is a new disorder currently positioned in the appendix of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Few clinical studies report that psychological and pharmacological interventions can significantly reduce the severity of IGD symptomatology. The aim of this review was to assess current knowledge of the short- and long-term benefits of IGD interventions. This review presents a systematic evaluation of definitions of diagnosis and treatment outcomes employed in IGD treatment studies, including an assessment of goodness of fit with the DSM-5 classification. A computer database search of Academic Search Premier, PubMed, PsychINFO, ScienceDirect, Web of Science, and Google Scholar was conducted to identify all available research evidence on Internet gaming disorder treatment (N = 8 studies). Diagnostic and treatment outcome parameters were systematically evaluated. Several weaknesses of IGD treatment literature were identified. Only 2 treatment studies have employed an equivalent method of diagnosis for IGD. Studies have not assessed formative change in diagnostic status at posttreatment or follow-up. Duration of follow-up has been inadequate to assess relapse and remission. Posttreatment assessment has been predominantly limited to IGD symptomatology, comorbidity, and frequency of gaming behavior. Currently, there is insufficient evidence to warrant suggestion that trialled IGD interventions confer a long-term therapeutic benefit. Several improvements to study design and reporting are proposed to guide future studies of IGD. © 2014 Wiley Periodicals, Inc.

Visual grading characteristics and ordinal regression analysis during optimisation of CT head examinations.

Science.gov (United States)

Zarb, Francis; McEntee, Mark F; Rainford, Louise

2015-06-01

To evaluate visual grading characteristics (VGC) and ordinal regression analysis during head CT optimisation as a potential alternative to visual grading assessment (VGA), traditionally employed to score anatomical visualisation. Patient images (n = 66) were obtained using current and optimised imaging protocols from two CT suites: a 16-slice scanner at the national Maltese centre for trauma and a 64-slice scanner in a private centre. Local resident radiologists (n = 6) performed VGA followed by VGC and ordinal regression analysis. VGC alone indicated that optimised protocols had similar image quality as current protocols. Ordinal logistic regression analysis provided an in-depth evaluation, criterion by criterion allowing the selective implementation of the protocols. The local radiology review panel supported the implementation of optimised protocols for brain CT examinations (including trauma) in one centre, achieving radiation dose reductions ranging from 24 % to 36 %. In the second centre a 29 % reduction in radiation dose was achieved for follow-up cases. The combined use of VGC and ordinal logistic regression analysis led to clinical decisions being taken on the implementation of the optimised protocols. This improved method of image quality analysis provided the evidence to support imaging protocol optimisation, resulting in significant radiation dose savings. • There is need for scientifically based image quality evaluation during CT optimisation. • VGC and ordinal regression analysis in combination led to better informed clinical decisions. • VGC and ordinal regression analysis led to dose reductions without compromising diagnostic efficacy.

Long term surgical treatment outcome of talar body fracture

Directory of Open Access Journals (Sweden)

Sen Ramesh Kumar

2012-02-01

Full Text Available 【Abstract】Objective: Talar body fractures are rare and have poor treatment outcome. The purpose of this study is to report the long term surgical treatment outcome of closed talar dome fractures. Methods: Eight closed talar body fractures, treated by open reduction and internal fixation with small fragment cancellous screws and/or Herbert screws in our level I trauma centre were retrospectively analyzed. Preoperative and postoperative radiographs of the foot (antero-posterior, lateral and oblique views and ankle (antero-posterior, lateral and mortise views were obtained. The patients were followed up both radiologically and functionally (foot function index, FFI after 3 weeks, 6 weeks, 3 months, 6 months and then annually. Results: There were five crush fractures and three shear fractures (two sagittal shear and one coronal shear, with average follow-up of 5 years. No early complications were noticed in these patients. Late complications included osteoarthrosis of subtalar/ankle joints in six patients and osteonecrosis of talar body in four patients. On functional assessment, mean FFI after 5 years was 104.63 points and worse outcome was noticed in crush injury and coronal shear fractures. Sagittal shear fractures had a good functional and radiological outcome. Conclusions: Late complications subsequent to surgically treated talar body fractures are inevitable, even though exact reduction and rigid fixation are achieved, thus patients are supposed to be counseled about the adverse outcome. Although crush and coronal shear fractures have poor outcome, sagittal injuries have good prognosis on long term evaluation. Key words: Fractures, bone; Talus; Fracture fixation, internal

Assisted reproductive technology treatment outcomes.

LENUS (Irish Health Repository)

Naasan, M

2012-05-01

Information on the outcomes of ART treatments in Ireland is not readily available to Irish practitioners. The data for hospital affiliated clinics has been made available for many years and is included in the hospital reports. We present a 10-year analysis of the Irish ART results voluntarily reported by six out of seven IVF clinics. The data was collected from published ESHRE reports and from results (2007-8) not yet published. Data collected included: number of clinics and ART cycles, female age, clinical and multiple pregnancy rates and treatment complications. The clinical pregnancy rate per embryo transfer was 31.7% for IVF and 29.8% for ICSI. The proportion of singleton, twin and triplet deliveries for IVF and ICSI combined was 75%, 23.35% and 1.64%. The rate of ovarian hyperstimulation was 0.8%. ART practice in Ireland is safe, effective and responsible. Financial and societal savings could result from the introduction of state funded IVF with compulsory eSET where recommended.

Optimisation and symmetry in experimental radiation physics

International Nuclear Information System (INIS)

Ghose, A.

1988-01-01

The present monograph is concerned with the optimisation of geometric factors in radiation physics experiments. The discussions are essentially confined to those systems in which optimisation is equivalent to symmetrical configurations of the measurement systems. They include, measurements of interaction cross section of diverse types, determination of polarisations, development of detectors with almost ideal characteristics, production of radiations with continuously variable energies and development of high efficiency spectrometers etc. The monograph is intended for use by experimental physicists investigating primary interactions of radiations with matter and associated technologies. We have illustrated the various optimisation procedures by considering the cases of the so-called ''14 MeV'' on d-t neutrons and gamma rays with energies less than 3 MeV. Developments in fusion technology are critically dependent on the availability accurate cross sections of nuclei for fast neutrons of energies at least as high as d-t neutrons. In this monograph we have discussed various techniques which can be used to improve the accuracy of such measurements and have also presented a method for generating almost monoenergetic neutrons in the 8 MeV to 13 MeV energy range which can be used to measure cross sections in this sparingly investigated region

Congenital adrenal hyperplasia: Treatment and outcomes

Directory of Open Access Journals (Sweden)

Mahdi Kamoun

2013-01-01

Full Text Available Congenital adrenal hyperplasia (CAH describes a group of autosomal recessive disorders where there is impairment of cortisol biosynthesis. CAH due to 21-hydroxylase deficiency accounts for 95% of cases and shows a wide range of clinical severity. Glucocorticoid and mineralocorticoid replacement therapies are the mainstays of treatment of CAH. The optimal treatment for adults with CAH continues to be a challenge. Important long-term health issues for adults with CAH affect both men and women. These issues may either be due to the disease or to steroid treatment and may affect final height, fertility, cardiometabolic risk, bone metabolism, neuro-cognitive development and the quality-of-life. Patients with CAH should be regularly followed-up from childhood to adulthood by multidisciplinary teams who have knowledge of CAH. Optimal replacement therapy, close clinical and laboratory monitoring, early life-style interventions, early and regular fertility assessment and continuous psychological management are needed to improve outcome.

Credit price optimisation within retail banking

African Journals Online (AJOL)

2014-02-14

Feb 14, 2014 ... cost based pricing, where the price of a product or service is based on the .... function obtained from fitting a logistic regression model .... Note that the proposed optimisation approach below will allow us to also incorporate.

Treatment of Grave's hyperthyroidism-prognostic factors for outcome

International Nuclear Information System (INIS)

Alfadda, A.; Malabu, Usman H.; El-Desouki, Mahmoud I.; Al-Rubeaan, Khalid A.; Al-Ruhaily, Atallah D.; Fouda, Mona A.; Al-Maatouq, Mohamed A.; Sulimani, Riad A.

2007-01-01

To determine clinical and biochemical features of Grave's disease at presentation predict response to medical and radioiodine treatment. We carried out a retrospective 10-year study of 194 consecutive Saudi subjects with Grave's disease who was treated with antithyroid drugs, radioiodine therapy, or both, between January 1995 and December 2004 at King Khalid University Hospital, Riyadh, Saudi Arabia. At diagnosis, the mean age was 32+-0.9 years. Only 26% of patients had successful outcome after a course of antithyroid medication. None of the clinical or biochemical factors were associated with a favorable outcome of antithyroid treatment. One dose of radioiodine [13-15 mCi (481-555 MBq)] cured hyperthyroidism in 83% of patients. Presence of ophthamopathy at presentation was shown to be a significant contributing factor to failure to respond to a single dose of radioiodine (odds ratio, 6.4; 95%CI, 1.51-24.4; p<0.01). Failure of radioiodine treatment was also associated with higher serum free T3 concentration at presentation (p=0.003). In patients with Grave's hyperthyroidism, radioiodine treatment is associated with higher success rate than antithyroid drugs. A dose of 13-15 mCi (481-555 MBq) seems to practical and effective, and should be considered as first line therapy. Patients with high free T3 concentration and, those with ophthalmopathy at presentation were more likely to fail radioiodine treatment. A higher dose of radioiodine may be advisable in such patients. (author)

Does semiology of status epilepticus have an impact on treatment response and outcome?

Science.gov (United States)

Baysal-Kirac, Leyla; Feddersen, Berend; Einhellig, Marion; Rémi, Jan; Noachtar, Soheyl

2018-06-01

This study investigated whether there is an association between semiology of status epilepticus (SE) and response to treatment and outcome. Two hundred ninety-eight consecutive adult patients (160 females, 138 males) with SE at the University of Munich Hospital were prospectively enrolled. Mean age was 63.2±17.5 (18-97) years. Patient demographics, SE semiology and electroencephalography (EEG) findings, etiology, duration of SE, treatment, and outcome measures were investigated. Status epilepticus semiology was classified according to a semiological status classification. Patient's short-term outcome was determined by Glasgow Outcome Scale (GOS). The most frequent SE type was nonconvulsive SE (NCSE) (39.2%), mostly associated with cerebrovascular etiology (46.6%). A potentially fatal etiology was found in 34.8% of the patients. More than half (60.7%) of the patients had poor short-term outcome (GOS≤3) with an overall mortality of 12.4%. SE was refractory to treatment in 21.5% of the patients. Older age, potentially fatal etiology, systemic infections, NCSE in coma, refractory SE, treatment with anesthetics, long SE duration (>24h), low Glasgow Coma Scale (GCS) (≤8) at onset, and high Status Epilepticus Severity Score (STESS-3) (≥3) were associated with poor short-term outcome and death (pStatus epilepticus semiology has no independent association with outcome, but potentially fatal etiology and low GCS were strong predictive factors for poor short-term outcome of SE. Copyright © 2018 Elsevier Inc. All rights reserved.

Neurophysiological model of tinnitus: dependence of the minimal masking level on treatment outcome.

Science.gov (United States)

Jastreboff, P J; Hazell, J W; Graham, R L

1994-11-01

Validity of the neurophysiological model of tinnitus (Jastreboff, 1990), outlined in this paper, was tested on data from multicenter trial of tinnitus masking (Hazell et al., 1985). Minimal masking level, intensity match of tinnitus, and the threshold of hearing have been evaluated on a total of 382 patients before and after 6 months of treatment with maskers, hearing aids, or combination devices. The data has been divided into categories depending on treatment outcome and type of approach used. Results of analysis revealed that: i) the psychoacoustical description of tinnitus does not possess a predictive value for the outcome of the treatment; ii) minimal masking level changed significantly depending on the treatment outcome, decreasing on average by 5.3 dB in patients reporting improvement, and increasing by 4.9 dB in those whose tinnitus remained the same or worsened; iii) 73.9% of patients reporting improvement had their minimal masking level decreased as compared with 50.5% for patients not showing improvement, which is at the level of random change; iv) the type of device used has no significant impact on the treatment outcome and minimal masking level change; v) intensity match and threshold of hearing did not exhibit any significant changes which can be related to treatment outcome. These results are fully consistent with the neurophysiological interpretation of mechanisms involved in the phenomenon of tinnitus and its alleviation.

Standardized Treatment of Neonatal Status Epilepticus Improves Outcome.

Science.gov (United States)

Harris, Mandy L; Malloy, Katherine M; Lawson, Sheena N; Rose, Rebecca S; Buss, William F; Mietzsch, Ulrike

2016-12-01

We aimed to decrease practice variation in treatment of neonatal status epilepticus by implementing a standardized protocol. Our primary goal was to achieve 80% adherence to the algorithm within 12 months. Secondary outcome measures included serum phenobarbital concentrations, number of patients progressing from seizures to status epilepticus, and length of hospital stay. Data collection occurred for 6 months prior and 12 months following protocol implementation. Adherence of 80% within 12 months was partially achieved in patients diagnosed in our hospital; in pretreated patients, adherence was not achieved. Maximum phenobarbital concentrations were decreased (56.8 vs 41.0 µg/mL), fewer patients progressed from seizures to status epilepticus (46% vs 36%), and hospital length of stay decreased by 9.7 days in survivors. In conclusion, standardized, protocol-driven treatment of neonatal status epilepticus improves consistency and short-term outcome. © The Author(s) 2016.

Correlation between pre-treatment quasispecies complexity and treatment outcome in chronic HCV genotype 3a.

LENUS (Irish Health Repository)

Moreau, Isabelle

2012-02-03

Pre-treatment HCV quasispecies complexity and diversity may predict response to interferon based anti-viral therapy. The objective of this study was to retrospectively (1) examine temporal changes in quasispecies prior to the start of therapy and (2) investigate extensively quasispecies evolution in a group of 10 chronically infected patients with genotype 3a, treated with pegylated alpha2a-Interferon and ribavirin. The degree of sequence heterogeneity within the hypervariable region 1 was assessed by analyzing 20-30 individual clones in serial serum samples. Genetic parameters, including amino acid Shannon entropy, Hamming distance and genetic distance were calculated for each sample. Treatment outcome was divided into (1) sustained virological responders (SVR) and (2) treatment failure (TF). Our results indicate, (1) quasispecies complexity and diversity are lower in the SVR group, (2) quasispecies vary temporally and (3) genetic heterogeneity at baseline can be use to predict treatment outcome. We discuss the results from the perspective of replicative homeostasis.

Outcomes of Buccinator Treatment With Botulinum Toxin in Facial Synkinesis.

Science.gov (United States)

Patel, Priyesh N; Owen, Scott R; Norton, Cathey P; Emerson, Brandon T; Bronaugh, Andrea B; Ries, William R; Stephan, Scott J

2018-05-01

The buccinator, despite being a prominent midface muscle, has been previously overlooked as a target in the treatment of facial synkinesis with botulinum toxin. To evaluate outcomes of patients treated with botulinum toxin to the buccinator muscle in the setting of facial synkinesis. Prospective cohort study of patients who underwent treatment for facial synkinesis with botulinum toxin over multiple treatment cycles during a 1-year period was carried out in a tertiary referral center. Botulinum toxin treatment of facial musculature, including treatment cycles with and without buccinator injections. Subjective outcomes were evaluated using the Synkinesis Assessment Questionnaire (SAQ) prior to injection of botulinum toxin and 2 weeks after treatment. Outcomes of SAQ preinjection and postinjection scores were compared in patients who had at least 1 treatment cycle with and without buccinator injections. Subanalysis was performed on SAQ questions specific to buccinator function (facial tightness and lip movement). Of 84 patients who received botulinum toxin injections for facial synkinesis, 33 received injections into the buccinator muscle. Of the 33, 23 met inclusion criteria (19 [82.6%] women; mean [SD] age, 46 [10] years). These patients presented for 82 treatment visits, of which 44 (53.6%) involved buccinator injections and 38 (46.4%) were without buccinator injections. The most common etiology of facial paralysis included vestibular schwannoma (10 [43.5%] participants) and Bell Palsy (9 [39.1%] participants). All patients had improved posttreatment SAQ scores compared with prebotulinum scores regardless of buccinator treatment. Compared with treatment cycles in which the buccinator was not addressed, buccinator injections resulted in lower total postinjection SAQ scores (45.9; 95% CI, 38.8-46.8; vs 42.8; 95% CI, 41.3-50.4; P = .43) and greater differences in prebotox and postbotox injection outcomes (18; 95% CI, 16.2-21.8; vs 19; 95% CI, 14.2-21.8; P�

Contralateral Vocal Fold Reactive Lesions: Nomenclature, Treatment Choice, and Outcome.

Science.gov (United States)

Koss, Shira L; Kidwai, Sarah M; Pitman, Michael J

2016-06-01

Contralateral reactive lesions (RLs) represent a distinct entity among benign bilateral vocal fold (VF) lesions. Lack of uniform nomenclature and a myriad of surgical options have hampered attempts to develop treatment guidelines. The objective of this study is to better define RLs and their prognosis, through the development of a standard nomenclature, with an aim to guide treatment and delineate the role of phonosurgery. Case series with chart review. Tertiary care center. Analysis was performed on patients with Current Procedural Terminology code 31545. Operative reports with a primary lesion and contralateral RL were included. Outcomes included the Voice Handicap Index-10 (VHI-10) and GRBAS (grade, roughness, breathiness, asthenia, and strain) scale, lesion persistence/recurrence, mucosal wave, and edge character based on blinded videostroboscopy review. A nomenclature was developed based on intraoperative RLs (n = 30), defined by lesion consistency (fibrous or polypoid) and relationship to normal VF edge (gradual or steep). Reactive lesion treatment included no intervention, excision, potassium titanyl phosphate laser, steroid injection, or a combination thereof. Observations included the following: inconsistent treatment modalities were employed, excision of RLs did not yield better outcomes, fibrous RLs were more likely to persist and polypoid lesions more likely to recur, gradual lesions were more likely to remain disease free, and most treatments showed improved mucosal wave, VHI-10, and GRBAS. Reactive lesions have not been well classified, and treatments are based on subjective intraoperative decision making with unpredictable outcomes. The nomenclature proposed will allow for a better definition of the RL and provide a framework for future research to identify optimal treatment. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Optimisation of Oil Production in Two – Phase Flow Reservoir Using Simultaneous Method and Interior Point Optimiser

DEFF Research Database (Denmark)

Lerch, Dariusz Michal; Völcker, Carsten; Capolei, Andrea

2012-01-01

in the reservoir. A promising decrease of these remained resources can be provided by smart wells applying water injections to sustain satisfactory pressure level in the reservoir throughout the whole process of oil production. Basically to enhance secondary recovery of the remaining oil after drilling, water...... is injected at the injection wells of the down-hole pipes. This sustains the pressure in the reservoir and drives oil towards production wells. There are however, many factors contributing to the poor conventional secondary recovery methods e.g. strong surface tension, heterogeneity of the porous rock...... fields, or closed loop optimisation, can be used for optimising the reservoir performance in terms of net present value of oil recovery or another economic objective. In order to solve an optimal control problem we use a direct collocation method where we translate a continuous problem into a discrete...

Causal analysis of ordinal treatments and binary outcomes under truncation by death.

Science.gov (United States)

Wang, Linbo; Richardson, Thomas S; Zhou, Xiao-Hua

2017-06-01

It is common that in multi-arm randomized trials, the outcome of interest is "truncated by death," meaning that it is only observed or well-defined conditioning on an intermediate outcome. In this case, in addition to pairwise contrasts, the joint inference for all treatment arms is also of interest. Under a monotonicity assumption we present methods for both pairwise and joint causal analyses of ordinal treatments and binary outcomes in presence of truncation by death. We illustrate via examples the appropriateness of our assumptions in different scientific contexts.

Alternatives for optimisation of rumen fermentation in ruminants

Directory of Open Access Journals (Sweden)

T. Slavov

2017-06-01

Full Text Available Abstract. The proper knowledge on the variety of events occurring in the rumen makes possible their optimisation with respect to the complete feed conversion and increasing the productive performance of ruminants. The inclusion of various dietary additives (supplements, biologically active substances, nutritional antibiotics, probiotics, enzymatic preparations, plant extracts etc. has an effect on the intensity and specific pathway of fermentation, and thus, on the general digestion and systemic metabolism. The optimisation of rumen digestion is a method with substantial potential for improving the efficiency of ruminant husbandry, increasing of quality of their produce and health maintenance.

Optimising a shaft's geometry by applying genetic algorithms

Directory of Open Access Journals (Sweden)

María Alejandra Guzmán

2005-05-01

Full Text Available Many engnieering design tasks involve optimising several conflicting goals; these types of problem are known as Multiobjective Optimisation Problems (MOPs. Evolutionary techniques have proved to be an effective tool for finding solutions to these MOPs during the last decade, Variations on the basic generic algorithm have been particulary proposed by different researchers for finding rapid optimal solutions to MOPs. The NSGA (Non-dominated Sorting Generic Algorithm has been implemented in this paper for finding an optimal design for a shaft subjected to cyclic loads, the conflycting goals being minimum weight and minimum lateral deflection.

Rethinking non-inferiority: a practical trial design for optimising treatment duration.

Science.gov (United States)

Quartagno, Matteo; Walker, A Sarah; Carpenter, James R; Phillips, Patrick Pj; Parmar, Mahesh Kb

2018-06-01

Background Trials to identify the minimal effective treatment duration are needed in different therapeutic areas, including bacterial infections, tuberculosis and hepatitis C. However, standard non-inferiority designs have several limitations, including arbitrariness of non-inferiority margins, choice of research arms and very large sample sizes. Methods We recast the problem of finding an appropriate non-inferior treatment duration in terms of modelling the entire duration-response curve within a pre-specified range. We propose a multi-arm randomised trial design, allocating patients to different treatment durations. We use fractional polynomials and spline-based methods to flexibly model the duration-response curve. We call this a 'Durations design'. We compare different methods in terms of a scaled version of the area between true and estimated prediction curves. We evaluate sensitivity to key design parameters, including sample size, number and position of arms. Results A total sample size of ~ 500 patients divided into a moderate number of equidistant arms (5-7) is sufficient to estimate the duration-response curve within a 5% error margin in 95% of the simulations. Fractional polynomials provide similar or better results than spline-based methods in most scenarios. Conclusion Our proposed practical randomised trial 'Durations design' shows promising performance in the estimation of the duration-response curve; subject to a pending careful investigation of its inferential properties, it provides a potential alternative to standard non-inferiority designs, avoiding many of their limitations, and yet being fairly robust to different possible duration-response curves. The trial outcome is the whole duration-response curve, which may be used by clinicians and policymakers to make informed decisions, facilitating a move away from a forced binary hypothesis testing paradigm.

Coil optimisation for transcranial magnetic stimulation in realistic head geometry.

Science.gov (United States)

Koponen, Lari M; Nieminen, Jaakko O; Mutanen, Tuomas P; Stenroos, Matti; Ilmoniemi, Risto J

Transcranial magnetic stimulation (TMS) allows focal, non-invasive stimulation of the cortex. A TMS pulse is inherently weakly coupled to the cortex; thus, magnetic stimulation requires both high current and high voltage to reach sufficient intensity. These requirements limit, for example, the maximum repetition rate and the maximum number of consecutive pulses with the same coil due to the rise of its temperature. To develop methods to optimise, design, and manufacture energy-efficient TMS coils in realistic head geometry with an arbitrary overall coil shape. We derive a semi-analytical integration scheme for computing the magnetic field energy of an arbitrary surface current distribution, compute the electric field induced by this distribution with a boundary element method, and optimise a TMS coil for focal stimulation. Additionally, we introduce a method for manufacturing such a coil by using Litz wire and a coil former machined from polyvinyl chloride. We designed, manufactured, and validated an optimised TMS coil and applied it to brain stimulation. Our simulations indicate that this coil requires less than half the power of a commercial figure-of-eight coil, with a 41% reduction due to the optimised winding geometry and a partial contribution due to our thinner coil former and reduced conductor height. With the optimised coil, the resting motor threshold of abductor pollicis brevis was reached with the capacitor voltage below 600 V and peak current below 3000 A. The described method allows designing practical TMS coils that have considerably higher efficiency than conventional figure-of-eight coils. Copyright © 2017 Elsevier Inc. All rights reserved.

Reduction environmental effects of civil aircraft through multi-objective flight plan optimisation

International Nuclear Information System (INIS)

Lee, D S; Gonzalez, L F; Walker, R; Periaux, J; Onate, E

2010-01-01

With rising environmental alarm, the reduction of critical aircraft emissions including carbon dioxides (CO 2 ) and nitrogen oxides (NO x ) is one of most important aeronautical problems. There can be many possible attempts to solve such problem by designing new wing/aircraft shape, new efficient engine, etc. The paper rather provides a set of acceptable flight plans as a first step besides replacing current aircrafts. The paper investigates a green aircraft design optimisation in terms of aircraft range, mission fuel weight (CO 2 ) and NO x using advanced Evolutionary Algorithms coupled to flight optimisation system software. Two multi-objective design optimisations are conducted to find the best set of flight plans for current aircrafts considering discretised altitude and Mach numbers without designing aircraft shape and engine types. The objectives of first optimisation are to maximise range of aircraft while minimising NO x with constant mission fuel weight. The second optimisation considers minimisation of mission fuel weight and NO x with fixed aircraft range. Numerical results show that the method is able to capture a set of useful trade-offs that reduce NO x and CO 2 (minimum mission fuel weight).

Topology optimisation of passive coolers for light-emitting diode lamps

DEFF Research Database (Denmark)

Alexandersen, Joe

2015-01-01

This work applies topology optimisation to the design of passive coolers for light-emitting diode (LED) lamps. The heat sinks are cooled by the natural convection currents arising from the temperature difference between the LED lamp and the surrounding air. A large scale parallel computational....... The optimisation results show interesting features that are currently being incorporated into industrial designs for enhanced passive cooling abilities....

Risk factors influencing the treatment outcome in diabetic macular oedema

Directory of Open Access Journals (Sweden)

Gupta Amod

1996-01-01

Full Text Available A multivariate analysis was done on 96 eyes to evaluate the effect of various risk factors on the final visual outcome after laser photocoagulation for clinically significant macular oedema (CSME in diabetic retinopathy. Advanced age of the patient, large size of CSME and poor baseline visual acuity were found to be significantly associated with poorer outcome (p<0.05. The association of nephropathy and hypertension with poorer visual outcome was of boderline significance (p = 0.054 and 0.07, respectively. Wavelength of the laser (argon or krypton used for treatment did not significantly influence the outcome.

Optimising parallel R correlation matrix calculations on gene expression data using MapReduce.

Science.gov (United States)

Wang, Shicai; Pandis, Ioannis; Johnson, David; Emam, Ibrahim; Guitton, Florian; Oehmichen, Axel; Guo, Yike

2014-11-05

High-throughput molecular profiling data has been used to improve clinical decision making by stratifying subjects based on their molecular profiles. Unsupervised clustering algorithms can be used for stratification purposes. However, the current speed of the clustering algorithms cannot meet the requirement of large-scale molecular data due to poor performance of the correlation matrix calculation. With high-throughput sequencing technologies promising to produce even larger datasets per subject, we expect the performance of the state-of-the-art statistical algorithms to be further impacted unless efforts towards optimisation are carried out. MapReduce is a widely used high performance parallel framework that can solve the problem. In this paper, we evaluate the current parallel modes for correlation calculation methods and introduce an efficient data distribution and parallel calculation algorithm based on MapReduce to optimise the correlation calculation. We studied the performance of our algorithm using two gene expression benchmarks. In the micro-benchmark, our implementation using MapReduce, based on the R package RHIPE, demonstrates a 3.26-5.83 fold increase compared to the default Snowfall and 1.56-1.64 fold increase compared to the basic RHIPE in the Euclidean, Pearson and Spearman correlations. Though vanilla R and the optimised Snowfall outperforms our optimised RHIPE in the micro-benchmark, they do not scale well with the macro-benchmark. In the macro-benchmark the optimised RHIPE performs 2.03-16.56 times faster than vanilla R. Benefiting from the 3.30-5.13 times faster data preparation, the optimised RHIPE performs 1.22-1.71 times faster than the optimised Snowfall. Both the optimised RHIPE and the optimised Snowfall successfully performs the Kendall correlation with TCGA dataset within 7 hours. Both of them conduct more than 30 times faster than the estimated vanilla R. The performance evaluation found that the new MapReduce algorithm and its

A Proposal for a Study on Treatment Selection and Lifestyle Recommendations in Chronic Inflammatory Diseases

DEFF Research Database (Denmark)

Andersen, Vibeke; Holmskov, Uffe; Sørensen, Signe Bek

2017-01-01

Chronic inflammatory diseases (CIDs), including Crohn's disease and ulcerative colitis (inflammatory bowel diseases, IBD), rheumatoid arthritis, psoriasis, psoriatic arthritis, spondyloarthritides, hidradenitis suppurativa, and immune-mediated uveitis, are treated with biologics targeting the pro......-inflammatory molecule tumour necrosis factor-α (TNF) (i.e., TNF inhibitors). Approximately one-third of the patients do not respond to the treatment. Genetics and lifestyle may affect the treatment results. The aims of this multidisciplinary collaboration are to identify (1) molecular signatures of prognostic value...... to help tailor treatment decisions to an individual likely to initiate TNF inhibitor therapy, followed by (2) lifestyle factors that support achievement of optimised treatment outcome. This report describes the establishment of a cohort that aims to obtain this information. Clinical data including...

Crystal structure optimisation using an auxiliary equation of state

Science.gov (United States)

Jackson, Adam J.; Skelton, Jonathan M.; Hendon, Christopher H.; Butler, Keith T.; Walsh, Aron

2015-11-01

Standard procedures for local crystal-structure optimisation involve numerous energy and force calculations. It is common to calculate an energy-volume curve, fitting an equation of state around the equilibrium cell volume. This is a computationally intensive process, in particular, for low-symmetry crystal structures where each isochoric optimisation involves energy minimisation over many degrees of freedom. Such procedures can be prohibitive for non-local exchange-correlation functionals or other "beyond" density functional theory electronic structure techniques, particularly where analytical gradients are not available. We present a simple approach for efficient optimisation of crystal structures based on a known equation of state. The equilibrium volume can be predicted from one single-point calculation and refined with successive calculations if required. The approach is validated for PbS, PbTe, ZnS, and ZnTe using nine density functionals and applied to the quaternary semiconductor Cu2ZnSnS4 and the magnetic metal-organic framework HKUST-1.

Crystal structure optimisation using an auxiliary equation of state

International Nuclear Information System (INIS)

Jackson, Adam J.; Skelton, Jonathan M.; Hendon, Christopher H.; Butler, Keith T.; 3 Institute and Department of Materials Science and Engineering, Yonsei University, Seoul 120-749 (Korea, Republic of))" data-affiliation=" (Centre for Sustainable Chemical Technologies and Department of Chemistry, University of Bath, Claverton Down, Bath BA2 7AY (United Kingdom); Global E3 Institute and Department of Materials Science and Engineering, Yonsei University, Seoul 120-749 (Korea, Republic of))" >Walsh, Aron

2015-01-01

Standard procedures for local crystal-structure optimisation involve numerous energy and force calculations. It is common to calculate an energy–volume curve, fitting an equation of state around the equilibrium cell volume. This is a computationally intensive process, in particular, for low-symmetry crystal structures where each isochoric optimisation involves energy minimisation over many degrees of freedom. Such procedures can be prohibitive for non-local exchange-correlation functionals or other “beyond” density functional theory electronic structure techniques, particularly where analytical gradients are not available. We present a simple approach for efficient optimisation of crystal structures based on a known equation of state. The equilibrium volume can be predicted from one single-point calculation and refined with successive calculations if required. The approach is validated for PbS, PbTe, ZnS, and ZnTe using nine density functionals and applied to the quaternary semiconductor Cu 2 ZnSnS 4 and the magnetic metal-organic framework HKUST-1

Crystal structure optimisation using an auxiliary equation of state

Energy Technology Data Exchange (ETDEWEB)

Jackson, Adam J.; Skelton, Jonathan M.; Hendon, Christopher H.; Butler, Keith T. [Centre for Sustainable Chemical Technologies and Department of Chemistry, University of Bath, Claverton Down, Bath BA2 7AY (United Kingdom); Walsh, Aron, E-mail: a.walsh@bath.ac.uk [Centre for Sustainable Chemical Technologies and Department of Chemistry, University of Bath, Claverton Down, Bath BA2 7AY (United Kingdom); Global E" 3 Institute and Department of Materials Science and Engineering, Yonsei University, Seoul 120-749 (Korea, Republic of)

2015-11-14

Standard procedures for local crystal-structure optimisation involve numerous energy and force calculations. It is common to calculate an energy–volume curve, fitting an equation of state around the equilibrium cell volume. This is a computationally intensive process, in particular, for low-symmetry crystal structures where each isochoric optimisation involves energy minimisation over many degrees of freedom. Such procedures can be prohibitive for non-local exchange-correlation functionals or other “beyond” density functional theory electronic structure techniques, particularly where analytical gradients are not available. We present a simple approach for efficient optimisation of crystal structures based on a known equation of state. The equilibrium volume can be predicted from one single-point calculation and refined with successive calculations if required. The approach is validated for PbS, PbTe, ZnS, and ZnTe using nine density functionals and applied to the quaternary semiconductor Cu{sub 2}ZnSnS{sub 4} and the magnetic metal-organic framework HKUST-1.

Comparison of Oncentra® Brachy IPSA and graphical optimisation techniques: a case study of HDR brachytherapy head and neck and prostate plans

International Nuclear Information System (INIS)

Jameson, Michael G; Ohanessian, Lucy; Batumalai, Vikneswary; Patel, Virendra; Holloway, Lois C

2015-01-01

There are a number of different dwell positions and time optimisation options available in the Oncentra® Brachy (Elekta Brachytherapy Solutions, Veenendaal, The Netherlands) brachytherapy treatment planning system. The purpose of this case study was to compare graphical (GRO) and inverse planning by simulated annealing (IPSA) optimisation techniques for interstitial head and neck (HN) and prostate plans considering dosimetry, modelled radiobiology outcome and planning time. Four retrospective brachytherapy patients were chosen for this study, two recurrent HN and two prostatic boosts. Manual GRO and IPSA plans were generated for each patient. Plans were compared using dose–volume histograms (DVH) and dose coverage metrics including; conformity index (CI), homogeneity index (HI) and conformity number (CN). Logit and relative seriality models were used to calculate tumour control probability (TCP) and normal tissue complication probability (NTCP). Approximate planning time was also recorded. There was no significant difference between GRO and IPSA in terms of dose metrics with mean CI of 1.30 and 1.57 (P > 0.05) respectively. IPSA achieved an average HN TCP of 0.32 versus 0.12 for GRO while for prostate there was no significant difference. Mean GRO planning times were greater than 75 min while average IPSA planning times were less than 10 min. Planning times for IPSA were greatly reduced compared to GRO and plans were dosimetrically similar. For this reason, IPSA makes for a useful planning tool in HN and prostate brachytherapy

Pleural Tuberculosis and its Treatment Outcomes | Khan | Tropical ...

African Journals Online (AJOL)

Purpose: To evaluate the incidence, treatment and clinical outcomes of tuberculosis pleuritis at a hospital in the state of Penang, Malaysia. Methods: A retrospective study was conducted in Hospital of Penang, Malaysia. Patient records were reviewed retrospectively to identify patients with confirmed diagnosis of tuberculous ...

Mapping clinical outcomes expectations to treatment decisions: an application to vestibular schwannoma management.

Science.gov (United States)

Cheung, Steven W; Aranda, Derick; Driscoll, Colin L W; Parsa, Andrew T

2010-02-01

Complex medical decision making obligates tradeoff assessments among treatment outcomes expectations, but an accessible tool to perform the necessary analysis is conspicuously absent. We aimed to demonstrate methodology and feasibility of adapting conjoint analysis for mapping clinical outcomes expectations to treatment decisions in vestibular schwannoma (VS) management. Prospective. Tertiary medical center and US-based otologists/neurotologists. Treatment preference profiles among VS stakeholders-61 younger and 74 older prospective patients, 61 observation patients, and 60 surgeons-were assessed for the synthetic VS case scenario of a 10-mm tumor in association with useful hearing and normal facial function. Treatment attribute utility. Conjoint analysis attribute levels were set in accordance to the results of a meta-analysis. Forty-five case series were disaggregated to formulate microsurgery facial nerve and hearing preservation outcomes expectations models. Attribute utilities were computed and mapped to the realistic treatment choices of translabyrinthine craniotomy, middle fossa craniotomy, and gamma knife radiosurgery. Among the treatment attributes of likelihoods of causing deafness, temporary facial weakness for 2 months, and incurable cancer within 20 years, and recovery time, permanent deafness was less important to tumor surgeons, and temporary facial weakness was more important to tumor surgeons and observation patients (Wilcoxon rank-sum, p knife radiosurgery. Mapping clinical outcomes expectations to treatment decisions for a synthetic clinical scenario revealed inhomogeneous drivers of choice selection among study cohorts. Medical decision engines that analyze personal preferences of outcomes expectations for VS and many other diseases may be developed to promote shared decision making among health care stakeholders and transparency in the informed consent process.

Serotonin transporter genotype linked to adolescent substance use treatment outcome through externalizing behavior

Directory of Open Access Journals (Sweden)

Tammy eChung

2014-07-01

Full Text Available Meta-analyses suggest that the serotonin transporter linked polymorphic region (5-HTTLPR short (S allele, relative to the long (L allele, is associated with risk for alcohol dependence, particularly among individuals with early onset antisocial alcoholism. Youth in substance use treatment tend to show antisocial or externalizing behaviors, such as conduct problems, which predict worse treatment outcome. This study examined a pathway in which 5-HTTLPR genotype is associated with externalizing behavior, and the intermediate phenotype of externalizing behavior serves as a link between 5-HTTLPR genotype and substance use treatment outcome in youth. Adolescents (n=142 who were recruited from addictions treatment were genotyped for 5-HTTLPR polymorphisms (S and LG carriers vs. LALA, assessed for externalizing and internalizing behaviors shortly after starting treatment, and followed over 6-months. 5-HTTLPR genotype was not associated with internalizing behaviors, and was not directly associated with 6-month substance use outcomes. However, 5-HTTLPR genotype was associated with externalizing behaviors (S and LG > LALA, and externalizing behaviors predicted alcohol and marijuana problem severity at 6-month follow-up. Results indicated an indirect (p<.05 and non-specific (i.e., both alcohol and marijuana severity effect of 5-HTTLPR genotype on youth substance use treatment outcomes, with externalizing behaviors as an important linking factor. Adolescents in substance use treatment with low expressing (S and LG 5-HTTLPR alleles and externalizing behavior might benefit from intervention that addresses serotonergic functioning, externalizing behaviors, and substance use to improve outcomes.

Patient Characteristics and Treatment Outcomes for African American, Hispanic, and White Adolescents in DATOS-A.

Science.gov (United States)

Rounds-Bryant, Jennifer L.; Staab, Jennifer

2001-01-01

Compared background, pre-treatment characteristics, and post-treatment outcomes of African American, Hispanic, and white adolescent substance abusers participating in the Drug Abuse Treatment Outcome Studies for Adolescents (DATOS-A). Found that patients were similar with respect to basic pre-treatment demographics. Compared to white adolescents,…

Traumatized refugees: morbidity, treatment and predictors of outcome.

Science.gov (United States)

Buhmann, Caecilie Böck

2014-08-01

Despite large numbers of traumatized refugees, little is known about effective treatment of war trauma in refugees and immigrants. Few studies evaluating treatment have been published and most studies are follow-up studies with methodological limitations and little comparability across studies. The purpose of the PhD is to characterize transcultural trauma patients in Denmark needing psychiatric treatment with regards to psychopathology and predictors of mental health and to evaluate the effects of the treatment. Two studies reported in 4 papers form the basis of the thesis. FORLOB (Paper 1-3) was a follow-up study that included all patients receiving treatment at the Competence Center for Transcultural Psychiatry in Copenhagen from April 2008 to February 2010. Patients completed self-ratings of symptoms of PTSD, depression and anxiety as well as level of functioning and quality of life (HTQ, HSCL-25, SDS & WHO-5) before treatment and after treatment. Associations of co-morbid diagnoses and predictors of the patients' health condition were examined with linear and logistic regression and Pearson's correlation coefficients. Treatment in FORLOB consisted of a combination of Sertraline, Mianserin, psycho-education and Trauma-Focused Cognitive Behavioral Therapy (TFCBT). The treatment administered to each patient was monitored in detail and changes in outcome and predictors of change were analyzed. PTF1 (Paper 4) was a randomized controlled clinical trial with 2x2 factorial design (antidepressants, TFCBT, antidepressants & TFCBT, waiting list). Potential participants were screened amongst adult patients referred to the Competence Center for Transcultural Psychiatry in the period June 2009-2011. Patients with PTSD, war trauma and without a psychotic disorder were included. The manualized treatment consisted of weekly sessions with a physician and/or psychologist over a period of 6 months. The treatment effect was evaluated with a combination of self-ratings and blinded

Treatment outcomes in 4 modes of orthodontic practice.

Science.gov (United States)

Poulton, Donald; Vlaskalic, Vicki; Baumrind, Sheldon

2005-03-01

This study is a continuation of a previously published report on the outcome of orthodontic treatment provided in offices representing different modes of practice. The sample consisted of duplicate pretreatment (T1) and posttreatment (T2) dental casts of 348 patients from traditional private orthodontic practices (5 offices, 134 patients), company-owned practices (5 offices, 107 patients), offices associated with practice-management organizations (2 offices, 60 patients), and general dental practices (2 offices, 47 patients). Methods were used to obtain random, representative samples from each office, starting with lists of patients who were treated consecutively with full fixed orthodontic appliances. The dental casts were measured by 2 independent judges who used the unweighted PAR score. Good interjudge agreement was shown on the initial casts, but the agreement was not as strong on the final casts. The measurements showed that treatment outcomes were generally satisfactory, although some significant differences between offices and management modes were shown.

Gait analysis and functional outcome in patients after Lisfranc injury treatment.

Science.gov (United States)

van Hoeve, S; Stollenwerck, G; Willems, P; Witlox, M A; Meijer, K; Poeze, M

2017-07-18

Lisfranc injuries involve any bony or ligamentous disruption of the tarsometatarsal joint. Outcome results after treatment are mainly evaluated using patient-reported outcome measures (PROM), physical examination and radiographic findings. Less is known about the kinematics during gait. Nineteen patients (19 feet) treated for Lisfranc injury were recruited. Patients with conservative treatment and surgical treatment consisting of open reduction and internal fixation (ORIF) or primary arthrodesis were included. PROM, radiographic findings and gait analysis using the Oxford Foot Model (OFM) were analysed. Results were compared with twenty-one healthy subjects (31 feet). Multivariable logistic regression was used to determine factors influencing outcome. Patients treated for Lisfranc injury had a significantly lower walking speed than healthy subjects (Ppush-off phase (ppush-off phase (β=0.707, p=0.001), stability (β=0.423, p=0.028) and BMI (β=-0.727 p=push-off phase and fracture stability. Copyright © 2017. Published by Elsevier Ltd.

Gestational surrogacy in Australia 2004-2011: treatment, pregnancy and birth outcomes.

Science.gov (United States)

Wang, Alex Y; Dill, Sandra K; Bowman, Mark; Sullivan, Elizabeth A

2016-06-01

Information on gestational surrogacy arrangement and outcomes is limited in Australia. This national population study investigates the epidemiology of gestational surrogacy arrangement in Australia: treatment procedures, pregnancy and birth outcomes. A retrospective study was conducted of 169 intended parents cycles and 388 gestational carrier cycles in Australia in 2004-2011. Demographics were compared between intended parents and gestational carrier cycles. Pregnancy and birth outcomes were compared by number of embryos transferred. Over half (54%) intended parents cycles were in women aged surrogacy treatment, including 9 liveborn twins. Of these, 22% (16) were preterm and 14% (10) were low birthweight. Preterm birth was 13% for liveborn babies following SET, lower than the 31% or liveborn babies following DET. To avoid adverse outcomes for both carriers and babies, SET should be advocated in all gestational surrogacy arrangements. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Reliability assessment and correlation analysis of evaluating orthodontic treatment outcome in Chinese patients

OpenAIRE

Song, Guang-Ying; Zhao, Zhi-He; Ding, Yin; Bai, Yu-Xing; Wang, Lin; He, Hong; Shen, Gang; Li, Wei-Ran; Baumrind, Sheldon; Geng, Zhi; Xu, Tian-Min

2013-01-01

This study aimed to assess the reliability of experienced Chinese orthodontists in evaluating treatment outcome and to determine the correlations between three diagnostic information sources. Sixty-nine experienced Chinese orthodontic specialists each evaluated the outcome of orthodontic treatment of 108 Chinese patients. Three different information sources: study casts (SC), lateral cephalometric X-ray images (LX) and facial photographs (PH) were generated at the end of treatment for 108 pat...

Tooth positioners and their effects on treatment outcome.

Science.gov (United States)

Pravindevaprasad, A; Therese, Beena Agnes

2013-07-01

Malocclusion can also be corrected by means of clear removable appliances called as "tooth positioners" or "aligners". A tooth positioner is used to control settling and to minimize or eliminate relapse of the teeth after an orthodontic treatment. In this article, a complete review of the objectives, course of treatment, fabrication, and the materials used for fabrication of tooth positioners along with their importance and disadvantages were discussed. Tooth positioners did improve the overall orthodontic treatment outcome as quantified by the ABO (American Board of orthodontics) objective scoring method. But once the initial occlusal contact was achieved, the vertical movement of teeth was found to be inhibited.

Optimising adherence to childhood pneumonia treatment: the design and development of patient instructions and a job aid for amoxicillin dispersible tablets.

Science.gov (United States)

Ebels, Kelly; Faulx, Dunia; Gerth-Guyette, Emily; Murunga, Peninah; Mahapatro, Samarendra; Das, Manoja Kumar; Ginsburg, Amy Sarah

2016-01-01

Pneumonia is the leading cause of death from infection in children worldwide. Despite global treatment recommendations that call for children with pneumonia to receive amoxicillin dispersible tablets, only one-third of children with pneumonia receive any antibiotics and many do not complete the full course of treatment. Poor adherence to antibiotics may be driven in part by a lack of user-friendly treatment instructions. In order to optimise childhood pneumonia treatment adherence at the community level, we developed a user-friendly product presentation for caregivers and a job aid for healthcare providers (HCPs). This paper aims to document the development process and offers a model for future health communication tools. We employed an iterative design process that included document review, key stakeholder interviews, engagement with a graphic designer and pre-testing design concepts among target users in India and Kenya. The consolidated criteria for reporting qualitative research were used in the description of results. Though resources for pneumonia treatment are available in some countries, their content is incomplete and inconsistent with global recommendations. Document review and stakeholder interviews provided the information necessary to convey to caregivers and recommendations for how to present this information. Target users in India and Kenya confirmed the need to support better treatment adherence, recommended specific modifications to design concepts and suggested the development of a companion job aid. There was a consensus among caregivers and HCPs that these tools would be helpful and improve adherence behaviours. The development of user-friendly instructions for medications for use in low-resource settings is a critically important but time-intensive and resource-intensive process that should involve engagement with target audiences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

Regenerative Endodontic Treatment: Report of Two Cases with Different Clinical Management and Outcomes

Directory of Open Access Journals (Sweden)

Mehrfam Khoshkhounejad

2015-11-01

Full Text Available Endodontic intervention in necrotic immature permanent teeth is usually a clinical challenge. With appropriate case selection, regenerative treatment can be effective, providing a desirable outcome. However, there is still no consensus on the optimal disinfection protocol or the method to achieve predictable clinical outcome. This article presents two cases of regenerative treatment in necrotic immature teeth, using mineral trioxide aggregate (MTA and BiodentineTM as coronal barriers and different irrigants, which led to different clinical outcomes.

Adaptive plan selection vs. re-optimisation in radiotherapy for bladder cancer: A dose accumulation comparison

International Nuclear Information System (INIS)

Vestergaard, Anne; Muren, Ludvig Paul; Søndergaard, Jimmi; Elstrøm, Ulrik Vindelev; Høyer, Morten; Petersen, Jørgen B.

2013-01-01

Purpose: Patients with urinary bladder cancer are obvious candidates for adaptive radiotherapy (ART) due to large inter-fractional variation in bladder volumes. In this study we have compared the normal tissue sparing potential of two ART strategies: daily plan selection (PlanSelect) and daily plan re-optimisation (ReOpt). Materials and methods: Seven patients with bladder cancer were included in the study. For the PlanSelect strategy, a patient-specific library of three plans was generated, and the most suitable plan based on the pre-treatment cone beam CT (CBCT) was selected. For the daily ReOpt strategy, plans were re-optimised based on the CBCT from each daily fraction. Bladder contours were propagated to the CBCT scan using deformable image registration (DIR). Accumulated dose distributions for the ART strategies as well as the non-adaptive RT were calculated. Results: A considerable sparing of normal tissue was achieved with both ART approaches, with ReOpt being the superior technique. Compared to non-adaptive RT, the volume receiving more than 57 Gy (corresponding to 95% of the prescribed dose) was reduced to 66% (range 48–100%) for PlanSelect and to 41% (range 33–50%) for ReOpt. Conclusion: This study demonstrated a considerable normal tissue sparing potential of ART for bladder irradiation, with clearly superior results by daily adaptive re-optimisation

Energy balance of the optimised CVT-hybrid-driveline

Energy Technology Data Exchange (ETDEWEB)

Hoehn, Bernd-Robert; Pflaum, Hermann; Lechner, Claus [Forschungsstelle fuer Zahnraeder und Getriebebau, Technische Univ. Muenchen, Garching (Germany)

2009-07-01

Funded by the DFG (German Research Foundation) and some industry partners like GM Powertrain Europe, ZF, EPCOS the Optimised CVT-Hybrid was developed at Technische Universitaet Muenchen in close collaboration with the industry and is currently under scientific investigation. Designed as a parallel hybrid vehicle the Optimised CVT-Hybrid combines a series-production diesel engine with a small electric motor. The core element of the driveline is a two range continuously variable transmission (i{radical}i-transmission), which is based on a chain variator. By a special shifting process without interruption of traction force the ratio range of the chain variator is used twice; thereby a wide transmission-ratio spread is achieved by low complexity. Thus the transmission provides a large pull-away ratio for the small electric motor and a fuel-efficient overdrive ratio for the ic-engine. Instead of heavy and space-consuming accumulators a small efficient package of double layer capacitors (UltraCaps) is used for electric energy and power storage. The driveline management is done by an optimised vehicle controller. Within the scope of the research project two prototype drivelines were manufactured. One driveline is integrated into an Opel Vectra Caravan and is available for investigations at the roller dynamometer and in the actual road traffic. The second hybrid driveline is assembled at the powertrain test rig of the FZG for detailed analysis of system behaviour and fuel consumption. Based on measurements of standardised driving cycles system behaviour, fuel consumption and a detailed energy balance of the Optimised CVT-Hybrid are presented. In comparison to the series-production vehicle the fuel savings are shown. (orig.)

Energy thermal management in commercial bread-baking using a multi-objective optimisation framework

International Nuclear Information System (INIS)

Khatir, Zinedine; Taherkhani, A.R.; Paton, Joe; Thompson, Harvey; Kapur, Nik; Toropov, Vassili

2015-01-01

In response to increasing energy costs and legislative requirements energy efficient high-speed air impingement jet baking systems are now being developed. In this paper, a multi-objective optimisation framework for oven designs is presented which uses experimentally verified heat transfer correlations and high fidelity Computational Fluid Dynamics (CFD) analyses to identify optimal combinations of design features which maximise desirable characteristics such as temperature uniformity in the oven and overall energy efficiency of baking. A surrogate-assisted multi-objective optimisation framework is proposed and used to explore a range of practical oven designs, providing information on overall temperature uniformity within the oven together with ensuing energy usage and potential savings. - Highlights: • A multi-objective optimisation framework to design commercial ovens is presented. • High fidelity CFD embeds experimentally calibrated heat transfer inputs. • The optimum oven design minimises specific energy and bake time. • The Pareto front outlining the surrogate-assisted optimisation framework is built. • Optimisation of industrial bread-baking ovens reveals an energy saving of 637.6 GWh

High tech hypofractionation to optimise treatment

DEFF Research Database (Denmark)

Johansen, Jørgen

2015-01-01

Hypofractionation has lately been implemented as standard treatment in the adjuvant setting as well as in radical radiotherapy for various solid tumors such as in breast and lung carcinomas. Also for metastatic disease in the liver or brain, hypofractionated stereotactic radiotherapy has proven e...

How home care is essential to ensuring successful orthodontic treatment outcomes.

Science.gov (United States)

Levin, Roger

2004-09-01

Patients can significantly affect the outcome of their orthodontic treatment. A practice committed to developing the right systems, scripts, and educational materials will experience a more satisfied patient, increased efficiencies, and higher profits. Educating and motivating patients to maintain their oral health and providing recommendations or dispensing of home care tools such as a power toothbrush increases patient compliance, positively impacts treatment outcomes, enhances customer service, and generates a new revenue stream for the practice. In a tight economy and a highly competitive orthodontic market, a power toothbrush can positively impact your marketing and case close rate. Treatment and fees being relatively equal, patients will tend to accept treatment from a practice that can demonstrate concern for the patients' overall oral health and greater value-added components to the orthodontic case. Power toothbrushes as part of a comprehensive orthodontic treatment provide a great differentiating marketing strategy.

Prediction of methylphenidate treatment outcome in adults with attention-deficit/hyperactivity disorder (ADHD).

Science.gov (United States)

Retz, Wolfgang; Retz-Junginger, Petra

2014-11-01

Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent mental disorder of childhood, which often persists in adulthood. Methylphenidate (MPH) is one of the most effective medications to treat ADHD, but also few adult patients show no sufficient response to this drug. In this paper, we give an overview regarding genetic, neuroimaging, clinical and other studies which have tried to reveal the reasons for non-response in adults with ADHD, based on a systematic literature search. Although MPH is a well-established treatment for adults with ADHD, research regarding the prediction of treatment outcome is still limited and has resulted in inconsistent findings. No reliable neurobiological markers of treatment response have been identified so far. Some findings from clinical studies suggest that comorbidity with substance use disorders and personality disorders has an impact on treatment course and outcome. As MPH is widely used in the treatment of adults with ADHD, much more work is needed regarding positive and negative predictors of long-term treatment outcome in order to optimize the pharmacological treatment of adult ADHD patients.

A knowledge-based control system for air-scour optimisation in membrane bioreactors.

Science.gov (United States)

Ferrero, G; Monclús, H; Sancho, L; Garrido, J M; Comas, J; Rodríguez-Roda, I

2011-01-01

Although membrane bioreactors (MBRs) technology is still a growing sector, its progressive implementation all over the world, together with great technical achievements, has allowed it to reach a mature degree, just comparable to other more conventional wastewater treatment technologies. With current energy requirements around 0.6-1.1 kWh/m3 of treated wastewater and investment costs similar to conventional treatment plants, main market niche for MBRs can be areas with very high restrictive discharge limits, where treatment plants have to be compact or where water reuse is necessary. Operational costs are higher than for conventional treatments; consequently there is still a need and possibilities for energy saving and optimisation. This paper presents the development of a knowledge-based decision support system (DSS) for the integrated operation and remote control of the biological and physical (filtration and backwashing or relaxation) processes in MBRs. The core of the DSS is a knowledge-based control module for air-scour consumption automation and energy consumption minimisation.

Décomposition-coordination en optimisation déterministe et stochastique

CERN Document Server

Carpentier, Pierre

2017-01-01

Ce livre considère le traitement de problèmes d'optimisation de grande taille. L'idée est d'éclater le problème d'optimisation global en sous-problèmes plus petits, donc plus faciles à résoudre, chacun impliquant l'un des sous-systèmes (décomposition), mais sans renoncer à obtenir l'optimum global, ce qui nécessite d'utiliser une procédure itérative (coordination). Ce sujet a fait l'objet de plusieurs livres publiés dans les années 70 dans le contexte de l'optimisation déterministe. Nous présentans ici les principes essentiels et méthodes de décomposition-coordination au travers de situations typiques, puis nous proposons un cadre général qui permet de construire des algorithmes corrects et d'étudier leur convergence. Cette théorie est présentée aussi bien dans le contexte de l'optimisation déterministe que stochastique. Ce matériel a été enseigné par les auteurs dans divers cours de 3ème cycle et également mis en œuvre dans de nombreuses applications industrielles. Des exerc...

Child, parent and family dysfunction as predictors of outcome in cognitive-behavioral treatment of antisocial children.

Science.gov (United States)

Kazdin, A E

1995-03-01

The present study examined factors that predicted favorable treatment outcomes among clinically referred conduct problem children (N = 105, ages 7-13) who received cognitive-behavioral treatment. Three domains (severity and breadth of child impairment, parent stress and psychopathology and family dysfunction) assessed at pretreatment were predicted to affect treatment outcome. The results only partially supported the prediction. Less dysfunction in each of the domains predicted who responded favorably to treatment on parent ratings of deviance and prosocial functioning but not on teacher ratings of these outcomes. The findings have implications for identifying youths who respond to available treatments. The results also underscore fundamental questions about the assessment of treatment effects and the criteria for evaluating outcome.

A Review of Educational Outcomes in the Children's Mental Health Treatment Literature

Science.gov (United States)

Becker, Kimberly D.; Brandt, Nicole Evangelista; Stephan, Sharon H.; Chorpita, Bruce F.

2014-01-01

We examined the measurement of educational outcomes related to children's mental health treatments. A total of 85 papers describing 88 randomized controlled trials that included at least one educational outcome and one mental health outcome were included in these analyses. Forty-five different measures were identified as the primary educational…

Thickness Optimisation of Textiles Subjected to Heat and Mass Transport during Ironing

Directory of Open Access Journals (Sweden)

Korycki Ryszard

2016-09-01

Full Text Available Let us next analyse the coupled problem during ironing of textiles, that is, the heat is transported with mass whereas the mass transport with heat is negligible. It is necessary to define both physical and mathematical models. Introducing two-phase system of mass sorption by fibres, the transport equations are introduced and accompanied by the set of boundary and initial conditions. Optimisation of material thickness during ironing is gradient oriented. The first-order sensitivity of an arbitrary objective functional is analysed and included in optimisation procedure. Numerical example is the thickness optimisation of different textile materials in ironing device.

Optimisation of NMR dynamic models II. A new methodology for the dual optimisation of the model-free parameters and the Brownian rotational diffusion tensor

International Nuclear Information System (INIS)

D'Auvergne, Edward J.; Gooley, Paul R.

2008-01-01

Finding the dynamics of an entire macromolecule is a complex problem as the model-free parameter values are intricately linked to the Brownian rotational diffusion of the molecule, mathematically through the autocorrelation function of the motion and statistically through model selection. The solution to this problem was formulated using set theory as an element of the universal set U-the union of all model-free spaces (d'Auvergne EJ and Gooley PR (2007) Mol BioSyst 3(7), 483-494). The current procedure commonly used to find the universal solution is to initially estimate the diffusion tensor parameters, to optimise the model-free parameters of numerous models, and then to choose the best model via model selection. The global model is then optimised and the procedure repeated until convergence. In this paper a new methodology is presented which takes a different approach to this diffusion seeded model-free paradigm. Rather than starting with the diffusion tensor this iterative protocol begins by optimising the model-free parameters in the absence of any global model parameters, selecting between all the model-free models, and finally optimising the diffusion tensor. The new model-free optimisation protocol will be validated using synthetic data from Schurr JM et al. (1994) J Magn Reson B 105(3), 211-224 and the relaxation data of the bacteriorhodopsin (1-36)BR fragment from Orekhov VY (1999) J Biomol NMR 14(4), 345-356. To demonstrate the importance of this new procedure the NMR relaxation data of the Olfactory Marker Protein (OMP) of Gitti R et al. (2005) Biochem 44(28), 9673-9679 is reanalysed. The result is that the dynamics for certain secondary structural elements is very different from those originally reported

A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment

Directory of Open Access Journals (Sweden)

Shaw Monica

2012-09-01

Full Text Available Abstract Background In childhood, attention deficit/hyperactivity disorder (ADHD is characterized by age-inappropriate levels of inattentiveness/disorganization, hyperactivity/impulsiveness, or a combination thereof. Although the criteria for ADHD are well defined, the long-term consequences in adults and children need to be more comprehensively understood and quantified. We conducted a systematic review evaluating the long-term outcomes (defined as 2 years or more of ADHD with the goal of identifying long-term outcomes and the impact that any treatment (pharmacological, non-pharmacological, or multimodal has on ADHD long-term outcomes. Methods Studies were identified using predefined search criteria and 12 databases. Studies included were peer-reviewed, primary studies of ADHD long-term outcomes published between January 1980 to December 2010. Inclusion was agreed on by two independent researchers on review of abstracts or full text. Published statistical comparison of outcome results were summarized as poorer than, similar to, or improved versus comparators, and quantified as percentage comparisons of these categories. Results Outcomes from 351 studies were grouped into 9 major categories: academic, antisocial behavior, driving, non-medicinal drug use/addictive behavior, obesity, occupation, services use, self-esteem, and social function outcomes. The following broad trends emerged: (1 without treatment, people with ADHD had poorer long-term outcomes in all categories compared with people without ADHD, and (2 treatment for ADHD improved long-term outcomes compared with untreated ADHD, although not usually to normal levels. Only English-language papers were searched and databases may have omitted relevant studies. Conclusions This systematic review provides a synthesis of studies of ADHD long-term outcomes. Current treatments may reduce the negative impact that untreated ADHD has on life functioning, but does not usually 'normalize' the

Expressed Emotion, Family Functioning, and Treatment Outcome for Adolescents with Anorexia Nervosa.

Science.gov (United States)

Rienecke, Renee D; Accurso, Erin C; Lock, James; Le Grange, Daniel

2016-01-01

The current study examined the relation between parental expressed emotion (EE) and treatment outcome among adolescents participating in a treatment study for adolescent anorexia nervosa, as well as its impact on family functioning. One hundred and twenty-one families were assigned to family-based treatment or adolescent-focused therapy. Paternal criticism predicted lesser improvement in eating disorder psychopathology at end of treatment. There was also a significant interaction between maternal hostility and treatment, indicating that adolescents whose mothers displayed hostility had greater increases in percent of expected body weight in adolescent-focused therapy than family-based treatment. In addition, maternal hostility predicted less improvement in general family functioning and family communication at the end of treatment. Findings suggest that maternal and paternal EE may differentially impact treatment outcome and should be directly attended to in clinical settings. Future research is needed to further explore ways in which parental EE can be effectively modified in treatment. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Validation and optimisation of an ICD-10-coded case definition for sepsis using administrative health data

Science.gov (United States)

Jolley, Rachel J; Jetté, Nathalie; Sawka, Keri Jo; Diep, Lucy; Goliath, Jade; Roberts, Derek J; Yipp, Bryan G; Doig, Christopher J

2015-01-01

Objective Administrative health data are important for health services and outcomes research. We optimised and validated in intensive care unit (ICU) patients an International Classification of Disease (ICD)-coded case definition for sepsis, and compared this with an existing definition. We also assessed the definition's performance in non-ICU (ward) patients. Setting and participants All adults (aged ≥18 years) admitted to a multisystem ICU with general medicosurgical ICU care from one of three tertiary care centres in the Calgary region in Alberta, Canada, between 1 January 2009 and 31 December 2012 were included. Research design Patient medical records were randomly selected and linked to the discharge abstract database. In ICU patients, we validated the Canadian Institute for Health Information (CIHI) ICD-10-CA (Canadian Revision)-coded definition for sepsis and severe sepsis against a reference standard medical chart review, and optimised this algorithm through examination of other conditions apparent in sepsis. Measures Sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results Sepsis was present in 604 of 1001 ICU patients (60.4%). The CIHI ICD-10-CA-coded definition for sepsis had Sn (46.4%), Sp (98.7%), PPV (98.2%) and NPV (54.7%); and for severe sepsis had Sn (47.2%), Sp (97.5%), PPV (95.3%) and NPV (63.2%). The optimised ICD-coded algorithm for sepsis increased Sn by 25.5% and NPV by 11.9% with slightly lowered Sp (85.4%) and PPV (88.2%). For severe sepsis both Sn (65.1%) and NPV (70.1%) increased, while Sp (88.2%) and PPV (85.6%) decreased slightly. Conclusions This study demonstrates that sepsis is highly undercoded in administrative data, thus under-ascertaining the true incidence of sepsis. The optimised ICD-coded definition has a higher validity with higher Sn and should be preferentially considered if used for surveillance purposes. PMID:26700284

ATLAS software configuration and build tool optimisation

Science.gov (United States)

Rybkin, Grigory; Atlas Collaboration

2014-06-01

ATLAS software code base is over 6 million lines organised in about 2000 packages. It makes use of some 100 external software packages, is developed by more than 400 developers and used by more than 2500 physicists from over 200 universities and laboratories in 6 continents. To meet the challenge of configuration and building of this software, the Configuration Management Tool (CMT) is used. CMT expects each package to describe its build targets, build and environment setup parameters, dependencies on other packages in a text file called requirements, and each project (group of packages) to describe its policies and dependencies on other projects in a text project file. Based on the effective set of configuration parameters read from the requirements files of dependent packages and project files, CMT commands build the packages, generate the environment for their use, or query the packages. The main focus was on build time performance that was optimised within several approaches: reduction of the number of reads of requirements files that are now read once per package by a CMT build command that generates cached requirements files for subsequent CMT build commands; introduction of more fine-grained build parallelism at package task level, i.e., dependent applications and libraries are compiled in parallel; code optimisation of CMT commands used for build; introduction of package level build parallelism, i. e., parallelise the build of independent packages. By default, CMT launches NUMBER-OF-PROCESSORS build commands in parallel. The other focus was on CMT commands optimisation in general that made them approximately 2 times faster. CMT can generate a cached requirements file for the environment setup command, which is especially useful for deployment on distributed file systems like AFS or CERN VMFS. The use of parallelism, caching and code optimisation significantly-by several times-reduced software build time, environment setup time, increased the efficiency of

Long-term outcome of neuroparacoccidioidomycosis treatment

Directory of Open Access Journals (Sweden)

Fabio Francesconi

2011-02-01

Full Text Available INTRODUCTION: Neuroparacoccidioidomycosis (NPCM is a term used to describe the invasion of the central nervous system by the pathogenic fungus Paracoccidioides brasiliensis. NPCM has been described sporadically in some case reports and small case series, with little or no focus on treatment outcome and long-term follow-up. METHODS: All patients with NPCM from January 1991 to December 2006 were analyzed and were followed until December 2009. RESULTS: Fourteen (3.8% cases of NPCM were identified out of 367 patients with paracoccidioidomycosis (PCM. A combination of oral fluconazole and sulfamethoxazole/trimethoprim (SMZ/TMP was the regimen of choice, with no documented death due to Paracoccidioides brasiliensis infection. Residual neurological deficits were observed in 8 patients. Residual calcification was a common finding in neuroimaging follow-up. CONCLUSIONS: All the patients in this study responded positively to the association of oral fluconazole and sulfamethoxazole/trimethoprim, a regimen that should be considered a treatment option in cases of NPCM. Neurological sequela was a relatively common finding. For proper management of these patients, anticonvulsant treatment and physical therapy support were also needed.

Optimisation of efficiency of axial fans

NARCIS (Netherlands)

Kruyt, Nicolaas P.; Pennings, P.C.; Faasen, R.

2014-01-01

A three-stage research project has been executed to develop ducted axial-fans with increased efficiency. In the first stage a design method has been developed in which various conflicting design criteria can be incorporated. Based on this design method, an optimised design has been determined

MANAGEMENT OPTIMISATION OF MASS CUSTOMISATION MANUFACTURING USING COMPUTATIONAL INTELLIGENCE

Directory of Open Access Journals (Sweden)

Louwrens Butler

2018-05-01

Full Text Available Computational intelligence paradigms can be used for advanced manufacturing system optimisation. A static simulation model of an advanced manufacturing system was developed in order to simulate a manufacturing system. The purpose of this advanced manufacturing system was to mass-produce a customisable product range at a competitive cost. The aim of this study was to determine whether this new algorithm could produce a better performance than traditional optimisation methods. The algorithm produced a lower cost plan than that for a simulated annealing algorithm, and had a lower impact on the workforce.

Optimising Job-Shop Functions Utilising the Score-Function Method

DEFF Research Database (Denmark)

Nielsen, Erland Hejn

2000-01-01

During the last 1-2 decades, simulation optimisation of discrete event dynamic systems (DEDS) has made considerable theoretical progress with respect to computational efficiency. The score-function (SF) method and the infinitesimal perturbation analysis (IPA) are two candidates belonging to this ......During the last 1-2 decades, simulation optimisation of discrete event dynamic systems (DEDS) has made considerable theoretical progress with respect to computational efficiency. The score-function (SF) method and the infinitesimal perturbation analysis (IPA) are two candidates belonging...... of a Job-Shop can be handled by the SF method....

Design and Optimisation of Home Scale Greywater Recycling Package

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a/l Arugam Kalaichelvan

2018-01-01

Full Text Available Water crisis is becoming one of the biggest challenges in some countries due to over population and drought. Therefore, government and non-government organisations in well-developed countries are encouraging industries to install water recycling package to reduce water usage and consume greywater instead. However the home scale is not yet available in the market. This research focuses on design a home scale greywater treatment system for toilet flushing within 3,000 to 5,000 USD as a collaboration with DD Techniche Sdn Bhd. Greywater is the waste water produced from laundry, kitchen and bathroom except the toilet waste and contains suspended solids, microorganisms, oil, nitrates and phosphorus which needs to be treated using suitable types of treatment for safe reuse. The treatments include physical, chemical and biological water treatment in which in this study the proposed system is a combination of all three. The design is evaluated using experimental methods to meet the standard of toilet flushing quality. The greywater system consists of the mechanical parts to control the flow of greywater and store the treated water including pumps, sand filtration tank, wire mesh chassis and collection tank. The final design has dimension of 6 m3 and optimised price within the budget.

The impact of worker values on client outcomes within a drug treatment service.

Science.gov (United States)

Phillips, Rosie; Bourne, Humphrey

2008-02-01

Little attention has been paid to understanding the impact of values, attributes and characteristics of drugs workers on therapeutic relationships and treatment outcomes. Interaction of values with other variables is considered to be of importance since values play a role in determining attitudes and behaviours. This exploratory study investigates the impact of drug workers' personal values on client outcomes within a drug treatment service. Eight drug workers and 58 clients were recruited at a UK charity working with problematic drug users who are also socially excluded. Drug workers completed a validated questionnaire to elicit their personal values. Client outcomes were assessed using the Christo Inventory for Substance Misuse Services. The relationship between client outcomes and worker values were analysed using Spearman's rank test of association. Drug workers prioritising stimulation, self-direction and hedonism value types experienced more positive client outcomes compared with those prioritising security, conformity, benevolence, tradition and universalism types. The value types associated with positive outcomes fall within Schwartz's 'openness to change' superordinate dimension, whereas those related to more negative outcomes fall within the 'conservation' dimension. The study suggests that drug workers' personal values may have a significant impact upon client outcomes in the treatment of substance misuse. Reasons for this finding are explored, as are limitations of this study and suggestions for future research.

Colorectal Cancer: Late Presentation and Outcome of Treatment ...

African Journals Online (AJOL)

Background: Colorectal cancer remains a major health problem especially in developed countries where it ranks as the third most common cause of cancer in both men and women. Though incidence of colorectal cancer is low in Nigeria and other developing countries, outcome of treatment remains poor due largely to late ...

Clinical Features, Complications and Treatment Outcome of Brucella ...

African Journals Online (AJOL)

Purpose: Brucellosis is a multi-systemic infection that is endemic in some parts of the world. The purpose of this study was to examine the epidemiology as well as the clinical and haematological characteristics, complications, and treatment outcome of patients with brucellosis at the King Fahd Hospital of the University ...

Specific Infectious Organisms Associated With Poor Outcomes in Treatment for Hip Periprosthetic Infection.

Science.gov (United States)

Cunningham, Daniel J; Kavolus, Joseph J; Bolognesi, Michael P; Wellman, Samuel S; Seyler, Thorsten M

2017-06-01

Periprosthetic hip infection treatment remains a significant challenge for orthopedics. Some studies have suggested that methicillin resistance and gram-negative organism type are associated with increased treatment failure. The aim of this research is to determine if specific organisms were associated with poor outcomes in treatment for hip periprosthetic infection. Records were reviewed of all patients between 2005 and 2015 who underwent treatment for infected partial or total hip arthroplasty. Characteristics of each patient's treatment course were determined including baseline characteristics, infecting organism(s), infection status at final follow-up, surgeries for infection, and time in hospital. Baseline characteristics and organisms that were associated with clinical outcomes in univariate analysis were incorporated into multivariable outcomes models. When compared with patients infected with other organism(s), patients infected with the following organisms had significantly decreased infection-free rates: Pseudomonas, methicillin-resistant Staphylococcus aureus (MRSA), and Proteus. Infection with certain organisms was associated with 1.13-2.58 additional surgeries: methicillin-sensitive S aureus, coagulase-negative Staphylococcus, MRSA, Pseudomonas, Peptostreptococcus, Klebsiella, Candida, diphtheroids, Propionibacterium acnes, and Proteus species. Specific organisms were associated with 8.56-24.54 additional days in hospital for infection: methicillin-sensitive S aureus, coagulase-negative Staphylococcus, Proteus, MRSA, Enterococcus, Pseudomonas, Klebsiella, beta-hemolytic Streptococcus, and diphtheroids. Higher comorbidity score was also associated with greater length of hospitalization. MRSA, Pseudomonas, and Proteus were associated with all 3 outcomes of lower infection-free rate, more surgery, and more time in hospital in treatment for hip periprosthetic infection. Organism-specific outcome information may help individualize patient

Cellular internalisation kinetics and cytotoxic properties of statistically designed and optimised neo-geometric copper nanocrystals.

Science.gov (United States)

Murugan, Karmani; Choonara, Yahya E; Kumar, Pradeep; du Toit, Lisa C; Pillay, Viness

2017-09-01

This study aimed to highlight a statistic design to precisely engineer homogenous geometric copper nanoparticles (CuNPs) for enhanced intracellular drug delivery as a function of geometrical structure. CuNPs with a dual functionality comprising geometric attributes for enhanced cell uptake and exerting cytotoxic activity on proliferating cells were synthesized as a novel drug delivery system. This paper investigated the defined concentrations of two key surfactants used in the reaction to mutually control and manipulate nano-shape and optimisation of the geometric nanosystems. A statistical experimental design comprising a full factorial model served as a refining factor to achieve homogenous geometric nanoparticles using a one-pot method for the systematic optimisation of the geometric CuNPs. Shapes of the nanoparticles were investigated to determine the result of the surfactant variation as the aim of the study and zeta potential was studied to ensure the stability of the system and establish a nanosystem of low aggregation potential. After optimisation of the nano-shapes, extensive cellular internalisation studies were conducted to elucidate the effect of geometric CuNPs on uptake rates, in addition to the vital toxicity assays to further understand the cellular effect of geometric CuNPs as a drug delivery system. In addition to geometry; volume, surface area, orientation to the cell membrane and colloidal stability is also addressed. The outcomes of the study demonstrated the success of homogenous geometric NP formation, in addition to a stable surface charge. The findings of the study can be utilized for the development of a drug delivery system for promoted cellular internalisation and effective drug delivery. Copyright © 2017 Elsevier B.V. All rights reserved.

HVAC system optimisation-in-building section

Energy Technology Data Exchange (ETDEWEB)

Lu, L.; Cai, W.; Xie, L.; Li, S.; Soh, Y.C. [School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore (Singapore)

2004-07-01

This paper presents a practical method to optimise in-building section of centralised Heating, Ventilation and Air-Conditioning (HVAC) systems which consist of indoor air loops and chilled water loops. First, through component characteristic analysis, mathematical models associated with cooling loads and energy consumption for heat exchangers and energy consuming devices are established. By considering variation of cooling load of each end user, adaptive neuro-fuzzy inference system (ANFIS) is employed to model duct and pipe networks and obtain optimal differential pressure (DP) set points based on limited sensor information. A mix-integer nonlinear constraint optimization of system energy is formulated and solved by a modified genetic algorithm. The main feature of our paper is a systematic approach in optimizing the overall system energy consumption rather than that of individual component. A simulation study for a typical centralized HVAC system is provided to compare the proposed optimisation method with traditional ones. The results show that the proposed method indeed improves the system performance significantly. (author)

Pre-operative optimisation of lung function

Directory of Open Access Journals (Sweden)

Naheed Azhar

2015-01-01

Full Text Available The anaesthetic management of patients with pre-existing pulmonary disease is a challenging task. It is associated with increased morbidity in the form of post-operative pulmonary complications. Pre-operative optimisation of lung function helps in reducing these complications. Patients are advised to stop smoking for a period of 4–6 weeks. This reduces airway reactivity, improves mucociliary function and decreases carboxy-haemoglobin. The widely used incentive spirometry may be useful only when combined with other respiratory muscle exercises. Volume-based inspiratory devices have the best results. Pharmacotherapy of asthma and chronic obstructive pulmonary disease must be optimised before considering the patient for elective surgery. Beta 2 agonists, inhaled corticosteroids and systemic corticosteroids, are the main drugs used for this and several drugs play an adjunctive role in medical therapy. A graded approach has been suggested to manage these patients for elective surgery with an aim to achieve optimal pulmonary function.

Efficacy of an Optimised Bacteriophage Cocktail to Clear Clostridium difficile in a Batch Fermentation Model

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Janet Y. Nale

2018-02-01

Full Text Available Clostridium difficile infection (CDI is a major cause of infectious diarrhea. Conventional antibiotics are not universally effective for all ribotypes, and can trigger dysbiosis, resistance and recurrent infection. Thus, novel therapeutics are needed to replace and/or supplement the current antibiotics. Here, we describe the activity of an optimised 4-phage cocktail to clear cultures of a clinical ribotype 014/020 strain in fermentation vessels spiked with combined fecal slurries from four healthy volunteers. After 5 h, we observed ~6-log reductions in C. difficile abundance in the prophylaxis regimen and complete C. difficile eradication after 24 h following prophylactic or remedial regimens. Viability assays revealed that commensal enterococci, bifidobacteria, lactobacilli, total anaerobes, and enterobacteria were not affected by either regimens, but a ~2-log increase in the enterobacteria, lactobacilli, and total anaerobe abundance was seen in the phage-only-treated vessel compared to other treatments. The impact of the phage treatments on components of the microbiota was further assayed using metagenomic analysis. Together, our data supports the therapeutic application of our optimised phage cocktail to treat CDI. Also, the increase in specific commensals observed in the phage-treated control could prevent further colonisation of C. difficile, and thus provide protection from infection being able to establish.

Acoustic Resonator Optimisation for Airborne Particle Manipulation

Science.gov (United States)

Devendran, Citsabehsan; Billson, Duncan R.; Hutchins, David A.; Alan, Tuncay; Neild, Adrian

Advances in micro-electromechanical systems (MEMS) technology and biomedical research necessitate micro-machined manipulators to capture, handle and position delicate micron-sized particles. To this end, a parallel plate acoustic resonator system has been investigated for the purposes of manipulation and entrapment of micron sized particles in air. Numerical and finite element modelling was performed to optimise the design of the layered acoustic resonator. To obtain an optimised resonator design, careful considerations of the effect of thickness and material properties are required. Furthermore, the effect of acoustic attenuation which is dependent on frequency is also considered within this study, leading to an optimum operational frequency range. Finally, experimental results demonstrated good particle levitation and capture of various particle properties and sizes ranging to as small as 14.8 μm.

One session treatment for specific phobias in children: Comorbid anxiety disorders and treatment outcome.

Science.gov (United States)

Ryan, Sarah M; Strege, Marlene V; Oar, Ella L; Ollendick, Thomas H

2017-03-01

One-Session Treatment (OST) for specific phobias has been shown to be effective in reducing phobia severity; however, the effect of different types of co-occurring anxiety disorders on OST outcomes is unknown. The present study examined (1) the effects of co-occurring generalized anxiety disorder (GAD), social anxiety disorder (SAD), or another non-targeted specific phobia (OSP) on the efficacy of OST for specific phobias, and (2) the effects of OST on these co-occurring disorders following treatment. Three groups of 18 youth (7-15 years) with a specific phobia and comorbid GAD, SAD, or OSP were matched on age, gender, and phobia type. Outcome measures included diagnostic status and severity, and clinician rated improvement. All groups demonstrated an improvement in their specific phobia following treatment. Treatment was equally effective regardless of co-occurring anxiety disorder. In addition, comorbid anxiety disorders improved following OST; however, this effect was not equal across groups. The SAD group showed poorer improvement in their comorbid disorder than the GAD group post-treatment. However, the SAD group continued to improve and this differential effect was not evident six-months following treatment. The current study sample was small, with insufficient power to detect small and medium effect sizes. Further, the sample only included a portion of individuals with primary GAD or SAD, which may have attenuated the findings. The current study demonstrated that co-occurring anxiety disorders did not interfere with phobia treatment. OST, despite targeting a single specific phobia type, significantly reduced comorbid symptomatology across multiple anxiety disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Short-term outcome of posterior anorectal myectomy for treatment of ...

African Journals Online (AJOL)

Purpose: Many children with idiopathic constipation (IC) fail to improve with bowel management program. The role of surgical treatment in this subset of patients with intractable IC is still controversial. The aim of this study was to assess the outcome of anorectal myectomy in treatment of intractable IC. Patients and methods: ...

Optimisation of antimicrobial dosing based on pharmacokinetic and pharmacodynamic principles

Directory of Open Access Journals (Sweden)

Grace Si Ru Hoo

2017-01-01

Full Text Available While suboptimal dosing of antimicrobials has been attributed to poorer clinical outcomes, clinical cure and mortality advantages have been demonstrated when target pharmacokinetic (PK and pharmacodynamic (PD indices for various classes of antimicrobials were achieved to maximise antibiotic activity. Dosing optimisation requires a good knowledge of PK/PD principles. This review serves to provide a foundation in PK/PD principles for the commonly prescribed antibiotics (β-lactams, vancomycin, fluoroquinolones and aminoglycosides, as well as dosing considerations in special populations (critically ill and obese patients. PK principles determine whether an appropriate dose of antimicrobial reaches the intended pathogen(s. It involves the fundamental processes of absorption, distribution, metabolism and elimination, and is affected by the antimicrobial's physicochemical properties. Antimicrobial pharmacodynamics define the relationship between the drug concentration and its observed effect on the pathogen. The major indicator of the effect of the antibiotics is the minimum inhibitory concentration. The quantitative relationship between a PK and microbiological parameter is known as a PK/PD index, which describes the relationship between dose administered and the rate and extent of bacterial killing. Improvements in clinical outcomes have been observed when antimicrobial agents are dosed optimally to achieve their respective PK/PD targets. With the rising rates of antimicrobial resistance and a limited drug development pipeline, PK/PD concepts can foster more rational and individualised dosing regimens, improving outcomes while simultaneously limiting the toxicity of antimicrobials.

Does cannabis use affect treatment outcome in bipolar disorder? A longitudinal analysis

DEFF Research Database (Denmark)

van Rossum, Inge; Boomsma, Maarten; Tenback, Diederik

2009-01-01

Research suggests that cannabis use affects negatively on onset and outcome of schizophrenia, but less is known about possible effects in mood disorders. Bipolar in- and outpatients (N = 3459) were enrolled in an observational study. The influence of cannabis exposure on clinical and social...... treatment outcome measures was examined over the course of 1 year, as well as the effects on these associations of third mediating variables. Over 12 months of treatment, cannabis users exhibited less compliance and higher levels of overall illness severity, mania, and psychosis compared with nonusers....... Additionally, cannabis users experienced less satisfaction with life and had a lower probability of having a relationship compared with nonusers. There was little evidence that cannabis-outcome associations were mediated by third variables. An independent impact of cannabis use on psychopathologic outcomes...

Personality and mental health treatment: Traits as predictors of presentation, usage, and outcome.

Science.gov (United States)

Thalmayer, Amber Gayle

2018-03-08

Self-report scores on personality inventories predict important life outcomes, including health and longevity, marital outcomes, career success, and mental health problems, but the ways they predict mental health treatment have not been widely explored. Psychotherapy is sought for diverse problems, but about half of those who begin therapy drop out, and only about half who complete therapy experience lasting improvements. Several authors have argued that understanding how personality traits relate to treatment could lead to better targeted, more successful services. Here self-report scores on Big Five and Big Six personality dimensions are explored as predictors of therapy presentation, usage, and outcomes in a sample of community clinic clients (N = 306). Participants received evidence-based treatments in the context of individual-, couples-, or family-therapy sessions. One measure of initial functioning and three indicators of outcome were used. All personality trait scores except Openness associated with initial psychological functioning. Higher Conscientiousness scores predicted more sessions attended for family therapy but fewer for couples-therapy clients. Higher Honesty-Propriety and Extraversion scores predicted fewer sessions attended for family-therapy clients. Better termination outcome was predicted by higher Conscientiousness scores for family- and higher Extraversion scores for individual-therapy clients. Higher Honesty-Propriety and Neuroticism scores predicted more improvement in psychological functioning in terms of successive Outcome Questionnaire-45 administrations. Taken together, the results provide some support for the role of personality traits in predicting treatment usage and outcome and for the utility of a 6-factor model in this context. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Optimisation of electrical system for offshore wind farms via genetic algorithm

DEFF Research Database (Denmark)

Chen, Zhe; Zhao, Menghua; Blaabjerg, Frede

2009-01-01

An optimisation platform based on genetic algorithm (GA) is presented, where the main components of a wind farm and key technical specifications are used as input parameters and the electrical system design of the wind farm is optimised in terms of both production cost and system reliability....... The power losses, wind power production, initial investment and maintenance costs are considered in the production cost. The availability of components and network redundancy are included in the reliability evaluation. The method of coding an electrical system to a binary string, which is processed by GA......, is developed. Different GA techniques are investigated based on a real example offshore wind farm. This optimisation platform has been demonstrated as a powerful tool for offshore wind farm design and evaluation....

Are Treatment Outcomes Determined by Type of Gambling? A UK Study.

Science.gov (United States)

Ronzitti, Silvia; Soldini, Emiliano; Smith, Neil; Bayston, Andrew; Clerici, Massimo; Bowden-Jones, Henrietta

2018-01-30

One of the main difficulties faced in treating gambling disorder is compliance with psychological treatment. Gambling takes many forms and can differ greatly in its features such as speed of play and skill requirements. The type of gambling a pathological gambler opts for may play a key role in treatment compliance. The aim of the present study was to determine whether within treatment seeking sample of gambling disorder clients, gambling activity has any correlation with their resultant treatment outcomes. The study incorporated 524 treatment-seeking individuals who are clients of the National Problem Gambling Clinic in London. All of the clients were assessed prior to treatment and fulfilled the Problem Gambling Severity Index criteria for problem gambling. Data concerning clients' gambling behavior over the previous year was gathered using self-reports. Subsequently, the data was fitted to a multinomial logistic regression model, with the treatment outcome (i.e. pre-treatment dropouts, during treatment dropouts, and completed treatment) as the dependent variable and gambling behavior as the independent variable, whilst controlling for socio-demographic factors. The use of gaming machines was a significant predictor of dropping out pre-treatment (p gambling activities. Further research into the salient features of these gambling activities may help to further explain pre-treatment and during treatment dropouts within this population.

OPTIMISATION OF COMPRESSIVE STRENGTH OF PERIWINKLE ...

African Journals Online (AJOL)

In this paper, a regression model is developed to predict and optimise the compressive strength of periwinkle shell aggregate concrete using Scheffe's regression theory. The results obtained from the derived regression model agreed favourably with the experimental data. The model was tested for adequacy using a student ...

Self-optimising control of sewer systems

DEFF Research Database (Denmark)

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

2013-01-01

. The definition of an optimal performance was carried out by through a two-stage optimisation (stochastic and deterministic) to take into account both the overflow during the current rain event as well as the expected overflow, given the probability of a future rain event. The methodology is successfully applied...

Solitary rectal ulcer syndrome: clinical findings, surgical treatment, and outcomes.

Science.gov (United States)

Torres, Carlos; Khaikin, Marat; Bracho, Jorge; Luo, Cheng Hua; Weiss, Eric G; Sands, Dana R; Cera, Susan; Nogueras, Juan J; Wexner, Steven D

2007-11-01

Solitary rectal ulcer syndrome (SRUS) is a rare disorder often misdiagnosed as a malignant ulcer. Histopathological features of SRUS are characteristic and pathognomonic; nevertheless, the endoscopic and clinical presentations may be confusing. The aim of the present study was to assess the clinical findings, surgical treatment, and outcomes in patients who suffer from SRUS. A retrospective chart review was undertaken, from January 1989 to May 2005 for all patients who were diagnosed with SRUS. Data recorded included: patient's age, gender, clinical presentation, past surgical history, diagnostic and preoperative workup, operative procedure, complications, and outcomes. During the study period, 23 patients were diagnosed with SRUS. Seven patients received only medical treatment, and in three patients, the ulcer healed after medical treatment. Sixteen patients underwent surgical treatment. In four patients, the symptoms persisted after surgery. Two patients presented with postoperative rectal bleeding requiring surgical intervention. Three patients developed late postoperative sexual dysfunction. One patient continued suffering from rectal pain after a colostomy was constructed. Median follow-up was 14 (range 2-84) months. The results of this study show clearly that every patient with SRUS must be assessed individually. Initial treatment should include conservative measures. In patients with refractory symptoms, surgical treatment should be considered. Results of anterior resection and protocolectomy are satisfactory for solitary rectal ulcer.

Clinical characteristics and treatment outcomes of patients with low- and high-concentration isoniazid-monoresistant tuberculosis.

Directory of Open Access Journals (Sweden)

Tsai-Yu Wang

Full Text Available BACKGROUND: Isoniazid (INH resistance is now the most common type of tuberculosis (TB infection resistance worldwide. The aim of this study was to evaluate the clinical characteristics and treatment outcomes of patients with low- and high-concentration INH-monoresistant TB. METHODS: One hundred and thirty-four patients with culture-confirmed INH-monoresistant TB during 2006 January to 2007 December were retrospectively enrolled. INH resistance was classified as either low-concentration or high-concentration resistance according to the critical concentrations of 0.2 µg/mL or 1 µg/mL of INH, respectively. The patients' clinical outcomes, treatment regimens, and treatment duration were analyzed. RESULTS: The treatment success rates between low- and high-concentration INH-resistant TB were similar (81.8% vs. 86.7%. The treatment regimens and treatment duration were similar between both groups. Only a minor percentage of the patients in both groups received 6-month treatment regimens (low vs. high concentration resistance, 9.1% vs. 13.3%; respectively, p = 0.447 The most common reason for treatment duration longer than 6 months was pyrazinamide given for less than 6 months, followed by a delay in clinical response to treatment. Multivariable analysis showed that prior tuberculosis treatment (Odds ratio, 2.82, 95% C.I., 1.02-7.77, p = 0.045 was the only independent risk factor for unsuccessful treatment outcome. CONCLUSION: Different levels of INH resistance did not affect the treatment outcomes of patients with INH-monoresistant tuberculosis. Prolonged Rifampin-containing regimens may achieve those good outcomes in patients with low- and high-concentration INH-monoresistant TB.

Exploring the Relationship between Conduct Disorder and Residential Treatment Outcomes

Science.gov (United States)

Shabat, Julia Cathcart; Lyons, John S.; Martinovich, Zoran

2008-01-01

We examined the differential outcomes in residential treatment for youths with conduct disorder (CD)--with special attention paid to interactions with age and gender--in a sample of children and adolescents in 50 residential treatment centers and group homes across Illinois. Multi-disciplinary teams rated youths ages 6-20 (N = 457) on measures of…

Multiobjective optimisation of energy systems and building envelope retrofit in a residential community

International Nuclear Information System (INIS)

Wu, Raphael; Mavromatidis, Georgios; Orehounig, Kristina; Carmeliet, Jan

2017-01-01

Highlights: • Simultaneous optimisation of building envelope retrofit and energy systems. • Retrofit and energy systems change interact and should be considered simultaneously. • Case study quantifies cost-GHG emission tradeoffs for different retrofit options. - Abstract: In this paper, a method for a multi-objective and simultaneous optimisation of building energy systems and retrofit is presented. Tailored to be suitable for the diverse range of existing buildings in terms of age, size, and use, it combines dynamic energy demand simulation to explore individual retrofit scenarios with an energy hub optimisation. Implemented as an epsilon-constrained mixed integer linear program (MILP), the optimisation matches envelope retrofit with renewable and high efficiency energy supply technologies such as biomass boilers, heat pumps, photovoltaic and solar thermal panels to minimise life cycle cost and greenhouse gas (GHG) emissions. Due to its multi-objective, integrated assessment of building transformation options and its ability to capture both individual building characteristics and trends within a neighbourhood, this method is aimed to provide developers, neighbourhood and town policy makers with the necessary information to make adequate decisions. Our method is deployed in a case study of typical residential buildings in the Swiss village of Zernez, simulating energy demands in EnergyPlus and solving the optimisation problem with CPLEX. Although common trade-offs in energy system and retrofit choice can be observed, optimisation results suggest that the diversity in building age and size leads to optimal strategies for retrofitting and building system solutions, which are specific to different categories. With this method, GHG emissions of the entire community can be reduced by up to 76% at a cost increase of 3% compared to the current emission levels, if an optimised solution is selected for each building category.

Does outcome of neuropsychological treatment in patients with unilateral spatial neglect after stroke affect functional outcome?

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Matano, A; Iosa, M; Guariglia, C; Pizzamiglio, L; Paolucci, S

2015-12-01

Unilateral spatial neglect (USN) after stroke is associated to severe disability and to a poor rehabilitation outcome. However it is still unclear if a reduction of USN after a specific neurophsycological treatment could also favor the functional recovery. The first aim of this study was to determine if low responders to neuropsychological treatment of unilateral spatial neglect may have a worse functional prognosis for activities of daily living. The second aim was to investigate which variables can predict a low response to neuropsychological treatment. Observational study. Neurorehabilitation hospital in Italy. Two hundred inpatients with the diagnosis of ischemic stroke were screened in this observational study. Inclusion criteria were: patients in subacute phase of first ischemic stroke in right hemisphere. Exclusion criteria were: presence of previous and/or other disabling pathologies, medical conditions contraindicating physical therapy. Data of 73 patients who performed neurorehabilitation and visual scanning training for reducing USN were analysed, while the remaining others were excluded for at least one of the following reasons: hemorrhagic lesions, presence of other chronic disabling pathologies, contraindications for therapy. USN was evaluated using: Letter Cancellation Test, Barrage Test, Sentence Reading Test and Wundt-Jastrow Area Illusion Test. Barthel Index (BI), Beck Depression Inventory, and Canadian Neurological Scale were also administered. According to the aim of the study, forward binary logistic regressions were performed to evaluate the effects of different factors on functional recovery. Three factors were identified as predictors of low effectiveness in terms of BI-score: older age (odds ratio OR=9.882, P=0.002), severity of disease at admission (OR=12.594, P=0.002) and being low responders to neuropsychological treatment (OR=3.847, P=0.027). Further, the initial barrage score (OR=3.313, P=0.027) and the initial BI-score (OR=3.252, P=0

ADVERSE PREGNANCY OUTCOMES ASSOCIATED WITH MATERNAL ENALAPRIL ANTIHYPERTENSIVE TREATMENT

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Enalapril, one of several antihypertensive drugs that act as angiotensin-converting enzyme (ACE) inhibitors, is often used for treatment of hypertension in women of reproductive age. Adverse birth outcomes following the use of ACE inhibitors, including enalapril, during pregnanc...

The Bi-Directional Relationship between Parent-Child Conflict and Treatment Outcome in Treatment-Resistant Adolescent Depression

Science.gov (United States)

Rengasamy, Manivel; Mansoor, Brandon M.; Hilton, Robert; Porta, Giovanna; He, Jiayan; Emslie, Graham J.; Mayes, Taryn; Clarke, Gregory N.; Wagner, Karen Dineen; Keller, Martin B.; Ryan, Neal D.; Birmaher, Boris; Shamseddeen, Wael; Asarnow, Joan Rosenbaum; Brent, David A.

2013-01-01

Objective: To examine the bidirectional relationship between parent-child discord and treatment outcome for adolescent treatment-resistant depression. Method: Depressed youth who had not responded to an adequate course of a selective serotonin reuptake inhibitor (SSRI) were randomized to either a switch to another SSRI or venlafaxine, with or…

Optimised low-dose multidetector CT protocol for children with cranial deformity

Energy Technology Data Exchange (ETDEWEB)

Vazquez, Jose Luis [Complejo Hospitalario Universitario de Vigo, Department of Radiology, Vigo, Pontevedra (Spain); Pombar, Miguel Angel [Complejo Hospitalario Universitario de Santiago, Department of Radiophysics, Santiago de Compostela, La Coruna (Spain); Pumar, Jose Manuel [Complejo Hospitalario Universitario de Santiago, Department of Radiology, Santiago de Compostela, La Coruna (Spain); Campo, Victor Miguel del [Complejo Hospitalario Universitario de Vigo, Department of Public Health, Vigo, Pontevedra (Spain)

2013-08-15

To present an optimised low-dose multidetector computed tomography (MDCT) protocol for the study of children with cranial deformity. Ninety-one consecutive MDCT studies were performed in 80 children. Studies were performed with either our standard head CT protocol (group 1, n = 20) or a low-dose cranial deformity protocol (groups 2 and 3). Group 2 (n = 38), initial, and group 3 (n = 33), final and more optimised. All studies were performed in the same 64-MDCT equipment. Cranial deformity protocol was gradationally optimised decreasing kVp, limiting mA range, using automatic exposure control (AEC) and increasing the noise index (NI). Image quality was assessed. Dose indicators such us CT dose index volume (CTDIvol), dose-length product (DLP) and effective dose (E) were used. The optimised low-dose protocol reached the following values: 80 kVp, mA range: 50-150 and NI = 23. We achieved a maximum dose reduction of 10-22 times in the 1- to 12-month-old cranium in regard to the 2004 European guidelines for MDCT. A low-dose MDCT protocol that may be used as the first diagnostic imaging option in clinically selected patients with skull abnormalities. (orig.)

Comorbidity in youth with specific phobias: Impact of comorbidity on treatment outcome and the impact of treatment on comorbid disorders.

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Ollendick, Thomas H; Ost, Lars-Göran; Reuterskiöld, Lena; Costa, Natalie

2010-09-01

The purpose of the present study was twofold. In an analysis of data from an existing randomized control trial of brief cognitive behavioral treatment on specific phobias (One-Session Treatment, OST; Ollendick et al., 2009), we examined 1) the effect of comorbid specific phobias and other anxiety disorders on treatment outcomes, and 2) the effect of treatment of the specific phobia on these co-occurring disorders. These relations were explored in 100 youth presenting with animal, natural environment, situational, and "other" types of phobia. Youth were reliably diagnosed with the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent versions (Silverman & Albano, 1996). Clinician severity ratings at post-treatment and 6-month follow-up were examined as were parent and child treatment outcome satisfaction measures. Results indicated that the presence of comorbid phobias or anxiety disorders did not affect treatment outcomes; moreover, treatment of the targeted specific phobias led to significant reductions in the clinical severity of other co-occurring specific phobias and related anxiety disorders. These findings speak to the generalization of the effects of this time-limited treatment approach. Implications for treatment of principal and comorbid disorders are discussed, and possible mechanisms for these effects are commented upon. 2010 Elsevier Ltd. All rights reserved.

The effect of stimulant and sedative use on treatment outcome of patients admitted to methadone maintenance treatment.

Science.gov (United States)

DeMaria, P A; Sterling, R; Weinstein, S P

2000-01-01

While methadone maintenance treatment (MMT) has been demonstrated to be an effective treatment for opiate dependence, its impact on the treatment outcome of other illicit drug abuse is not as clear. Using the initial urine drug screen (UDS) and follow-up UDS at 1, 6, 12, and 24 months, 167 patients consecutively admitted to MMT were evaluated for opiate, sedative (predominantly benzodiazepine), and stimulant (predominantly cocaine) use. Retention for the opiate only group was 97.32 days longer on average than for patients using opiates along with stimulants, sedatives, or both stimulants and sedatives. Patients abusing opiates only had the greatest decrease in drug use; however, MMT was also associated with decreases in cocaine and sedative use over the 24 month follow-up period. There was no evidence that patients "switched" their drugs of abuse with time in treatment. The negative impact of non-opiate drug use on outcome in MMT and its implications for treatment planning are discussed.

Tuberculosis treatment outcome monitoring in European Union countries: systematic review

Science.gov (United States)

van Hest, Rob; Ködmön, Csaba; Verver, Suzanne; Erkens, Connie G.M.; Straetemans, Masja; Manissero, Davide; de Vries, Gerard

2013-01-01

Treatment success measured by treatment outcome monitoring (TOM) is a key programmatic output of tuberculosis (TB) control programmes. We performed a systematic literature review on national-level TOM in the 30 European Union (EU)/European Economic Areas (EEA) countries to summarise methods used to collect and report data on TOM. Online reference bibliographic databases PubMed/MEDLINE and EMBASE were searched to identify relevant indexed and non-indexed literature published between January 2000 and August 2010. The search strategy resulted in 615 potentially relevant indexed citations, of which 27 full-text national studies (79 data sets) were included for final analysis. The selected studies were performed in 10 EU/EEA countries and gave a fragmented impression of TOM in the EU/EEA. Publication year, study period, sample size, databases, definitions, variables, patient and outcome categories, and population subgroups varied widely, portraying a very heterogeneous picture. This review confirmed previous reports of considerable heterogeneity in publications of TOM results across EU/EEA countries. PubMed/MEDLINE and EMBASE indexed studies are not a suitable instrument to measure representative TOM results for the 30 EU/EEA countries. Uniform and complete reporting to the centralised European Surveillance System will produce the most timely and reliable results of TB treatment outcomes in the EU/EEA. PMID:22790913

Clinical outcomes in clinical trials of anti-HIV treatment

DEFF Research Database (Denmark)

Reekie, J; Mocroft, A; J, Neaton

2007-01-01

Since the introduction of combination antiretroviral therapy, there has been a decrease in both AIDS-defining illnesses and deaths. This decrease meant that performing clinical trials with clinical outcomes in HIV infection became more time consuming and hence costly. Improved understanding...... the infection, so when treatment is started it is currently a lifelong commitment. Is it reasonable then that guidelines are based almost completely on short-term randomized trials and observational studies of surrogate markers, or is there still a need for trials with clinical outcomes?...

Optimisation of the PCR-invA primers for the detection of Salmonella ...

African Journals Online (AJOL)

A polymerase chain reaction (PCR)-based method for the detection of Salmonella species in water samples was optimised and evaluated for speed, specificity and sensitivity. Optimisation of Mg2+ and primer concentrations and cycling parameters increased the sensitivity and limit of detection of PCR to 2.6 x 104 cfu/m.

A retrospective study of long-term treatment outcomes for reduced vocal intensity in hypokinetic dysarthria

Directory of Open Access Journals (Sweden)

Christopher R. Watts

2016-02-01

Full Text Available Abstract Background Reduced vocal intensity is a core impairment of hypokinetic dysarthria in Parkinson’s disease (PD. Speech treatments have been developed to rehabilitate the vocal subsystems underlying this impairment. Intensive treatment programs requiring high-intensity voice and speech exercises with clinician-guided prompting and feedback have been established as effective for improving vocal function. Less is known, however, regarding long-term outcomes of clinical benefit in speakers with PD who receive these treatments. Methods A retrospective cohort design was utilized. Data from 78 patient files across a three year period were analyzed. All patients received a structured, intensive program of voice therapy focusing on speaking intent and loudness. The dependent variable for all analyses was vocal intensity in decibels (dBSPL. Vocal intensity during sustained vowel production, reading, and novel conversational speech was compared at pre-treatment, post-treatment, six month follow-up, and twelve month follow-up periods. Results Statistically significant increases in vocal intensity were found at post-treatment, 6 months, and 12 month follow-up periods with intensity gains ranging from 5 to 17 dB depending on speaking condition and measurement period. Significant treatment effects were found in all three speaking conditions. Effect sizes for all outcome measures were large, suggesting a strong degree of practical significance. Conclusions Significant increases in vocal intensity measured at 6 and 12 moth follow-up periods suggested that the sample of patients maintained treatment benefit for up to a year. These findings are supported by outcome studies reporting treatment outcomes within a few months post-treatment, in addition to prior studies that have reported long-term outcome results. The positive treatment outcomes experienced by the PD cohort in this study are consistent with treatment responses subsequent to other treatment

Investigating Treatment Outcomes Across OCD Symptom Dimensions in a Clinical Sample of OCD Patients.

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Chase, Tannah; Wetterneck, Chad T; Bartsch, Robert A; Leonard, Rachel C; Riemann, Bradley C

2015-01-01

Despite the heterogeneous nature of obsessive-compulsive disorder (OCD), many self-report assessments do not adequately capture the clinical picture presenting within each symptom dimension, particularly unacceptable thoughts (UTs). In addition, obsessions and ordering/arranging compulsions are often underrepresented in samples of treatment outcome studies for OCD. Such methodological discrepancies may obscure research findings comparing treatment outcomes across OCD symptom dimensions. This study aimed to improve upon previous research by investigating treatment outcomes across OCD symptom dimensions using the Dimensional Obsessive-Compulsive Scale, which offers a more comprehensive assessment of UTs. The study included a primarily residential sample of 134 OCD patients. Results indicated that there were no significant differences in treatment outcomes across symptom dimensions. However, the severity of UTs remained significantly greater than other symptom dimensions at both admission and discharge. Thus, it is possible that UTs may exhibit uniquely impairing features, compared with other symptom dimensions. It is also possible that these findings may reflect the characteristics of the residential OCD samples. These speculations as well as implications for OCD treatment and future research are discussed.

Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts.

Directory of Open Access Journals (Sweden)

Anna Davies

Full Text Available INTRODUCTION: Co-infection with Hepatitis C (HCV and HIV is common and HIV accelerates hepatic disease progression due to HCV. However, access to HCV treatment is limited and success rates are generally poor. METHODS: We conducted a systematic review and meta-analysis to assess HCV treatment outcomes in observational cohorts. Two databases (Medline and EMBASE were searched using a compound search strategy for cohort studies reporting HCV treatment outcomes (as determined by a sustained virological response, SVR in HIV-positive patients initiating HCV treatment for the first time. RESULTS: 40 studies were included for review, providing outcomes on 5339 patients from 17 countries. The pooled proportion of patients achieving SVR was 38%. Significantly poorer outcomes were observed for patients infected with HCV genotypes 1 or 4 (pooled SVR 24.5%, compared to genotypes 2 or 3 (pooled SVR 59.8%. The pooled proportion of patients who discontinued treatment due to drug toxicities (reported by 33 studies was low, at 4.3% (3.3-5.3%. Defaulting from treatment, reported by 33 studies, was also low (5.1%, 3.5-6.6%, as was on-treatment mortality (35 studies, 0.1% (0-0.2%. CONCLUSIONS: These results, reported under programmatic conditions, are comparable to those reported in randomised clinical trials, and show that although HCV treatment outcomes are generally poor in HIV co-infected patients, those infected with HCV genotypes 2 or 3 have outcomes comparable to HIV-negative patients.

Thermodynamic optimisation of a heat exchanger

NARCIS (Netherlands)

Cornelissen, Rene; Hirs, Gerard

1999-01-01

The objective of this paper is to show that for the optimal design of an energy system, where there is a trade-off between exergy saving during operation and exergy use during construction of the energy system, exergy analysis and life cycle analysis should be combined. An exergy optimisation of a

Serratia marcescens meningitis: epidemiology, prognostic factors and treatment outcomes.

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Wu, Yen-Mu; Hsu, Po-Chang; Yang, Chien-Chang; Chang, Hong-Jyun; Ye, Jung-Jr; Huang, Ching-Tai; Lee, Ming-Hsun

2013-08-01

Serratia marcescens is a rare pathogen of central nervous system infections. This study was to investigate the epidemiology, prognostic factors, and treatment outcomes of S. marcescens meningitis. This retrospective analysis included 33 patients with culture-proven S. marcescens meningitis hospitalized between January 2000 and June 2011. Of the 33 patients enrolled, only one did not receive neurosurgery before the onset of S. marcescens meningitis. Patients with S. marcescens meningitis had higher ratios of brain solid tumors (54.5%) and neurosurgery (97.0%) with a mortality rate of 15.2%. The mean interval between the first neurosurgical procedure and the diagnosis of meningitis was 17.1 days (range, 4-51 days). Only one third-generation cephalosporin-resistant S. marcescens isolate was recovered from the patients' cerebrospinal fluid (CSF) specimens. Compared with the favorable outcome group (n = 20), the unfavorable outcome group (n = 13) had a higher percentage of brain solid tumors, more intensive care unit stays, and higher Sequential Organ Failure Assessment score, CSF lactate and serum C-reactive protein concentrations at diagnosis of meningitis. Under the multiple regression analysis, CSF lactate concentration ≥2-fold the upper limit of normal (ULN) was independently associated with unfavorable outcomes (odds ratio, 7.20; 95% confidence interval, 1.08-47.96; p = 0.041). S. marcescens meningitis is highly associated with neurosurgical procedures for brain solid tumors. CSF lactate concentration ≥2x ULN may predict an unfavorable outcome. Its mortality is not high and empiric treatment with parenteral third-generation cephalosporins may have a satisfactory clinical response. Copyright © 2012. Published by Elsevier B.V.

Advantages of Task-Specific Multi-Objective Optimisation in Evolutionary Robotics.

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Trianni, Vito; López-Ibáñez, Manuel

2015-01-01

The application of multi-objective optimisation to evolutionary robotics is receiving increasing attention. A survey of the literature reveals the different possibilities it offers to improve the automatic design of efficient and adaptive robotic systems, and points to the successful demonstrations available for both task-specific and task-agnostic approaches (i.e., with or without reference to the specific design problem to be tackled). However, the advantages of multi-objective approaches over single-objective ones have not been clearly spelled out and experimentally demonstrated. This paper fills this gap for task-specific approaches: starting from well-known results in multi-objective optimisation, we discuss how to tackle commonly recognised problems in evolutionary robotics. In particular, we show that multi-objective optimisation (i) allows evolving a more varied set of behaviours by exploring multiple trade-offs of the objectives to optimise, (ii) supports the evolution of the desired behaviour through the introduction of objectives as proxies, (iii) avoids the premature convergence to local optima possibly introduced by multi-component fitness functions, and (iv) solves the bootstrap problem exploiting ancillary objectives to guide evolution in the early phases. We present an experimental demonstration of these benefits in three different case studies: maze navigation in a single robot domain, flocking in a swarm robotics context, and a strictly collaborative task in collective robotics.

Advantages of Task-Specific Multi-Objective Optimisation in Evolutionary Robotics.

Directory of Open Access Journals (Sweden)

Vito Trianni

Full Text Available The application of multi-objective optimisation to evolutionary robotics is receiving increasing attention. A survey of the literature reveals the different possibilities it offers to improve the automatic design of efficient and adaptive robotic systems, and points to the successful demonstrations available for both task-specific and task-agnostic approaches (i.e., with or without reference to the specific design problem to be tackled. However, the advantages of multi-objective approaches over single-objective ones have not been clearly spelled out and experimentally demonstrated. This paper fills this gap for task-specific approaches: starting from well-known results in multi-objective optimisation, we discuss how to tackle commonly recognised problems in evolutionary robotics. In particular, we show that multi-objective optimisation (i allows evolving a more varied set of behaviours by exploring multiple trade-offs of the objectives to optimise, (ii supports the evolution of the desired behaviour through the introduction of objectives as proxies, (iii avoids the premature convergence to local optima possibly introduced by multi-component fitness functions, and (iv solves the bootstrap problem exploiting ancillary objectives to guide evolution in the early phases. We present an experimental demonstration of these benefits in three different case studies: maze navigation in a single robot domain, flocking in a swarm robotics context, and a strictly collaborative task in collective robotics.

Risk factors for unsuccessful tuberculosis treatment outcome (failure, default and death) in public health institutions, Eastern Ethiopia.

Science.gov (United States)

Amante, Tariku Dingeta; Ahemed, Tekabe Abdosh

2015-01-01

Unsuccessful TB treatment outcome is a serious public health concern. It is compelling to identify, and deal with factors determining unsuccessful treatment outcome. Therefore, study was aimed to determine pattern of unsuccessful TB treatment outcome and associated factors in eastern Ethiopia. A case control study was used. Cases were records of TB patients registered as defaulter, dead and/or treatment failure where as controls were those cured or treatment complete. Multivariate logistic regression models were used to derive adjusted odds ratios (OR) at 95% CI to examine the relationship between the unsuccessful TB treatment outcome and patients' characteristics. A total of 990 sample size (330 cases and 660 controls) were included. Among cases (n = 330), majority 212(64.2%) were because of death, 100(30.3%) defaulters and 18(5.5%) were treatment failure. Lack of contact person(OR = 1.37; 95% CI 1.14-2.9, P, .024), sputum smear negative treatment category at initiation of treatment (OR = 1.8; 95% CI 1.3-5.5,P, .028), smear positive sputum test result at 2(nd) month after initiation treatment (OR = 14; 95% CI 5.5-36, P,0.001) and HIV positive status (OR = 2.5; 95% CI 1.34-5.7, P, 0.01) were independently associated with increased risk of unsuccessful TB treatment outcome. Death was the major cause of unsuccessful TB treatment outcome. TB patients do not have contact person, sputum smear negative treatment category at initiation of treatment, smear positive on 2(nd) month after treatment initiation and HIV positive were factors significantly associated unsuccessful treatment outcome. TB patients with sputum smear negative treatment category, HIV positive and smear positive on 2(nd) nd month of treatment initiation need strict follow up throughout DOTs period.

Cross-trial prediction of treatment outcome in depression: a machine learning approach.

Science.gov (United States)

Chekroud, Adam Mourad; Zotti, Ryan Joseph; Shehzad, Zarrar; Gueorguieva, Ralitza; Johnson, Marcia K; Trivedi, Madhukar H; Cannon, Tyrone D; Krystal, John Harrison; Corlett, Philip Robert

2016-03-01

Antidepressant treatment efficacy is low, but might be improved by matching patients to interventions. At present, clinicians have no empirically validated mechanisms to assess whether a patient with depression will respond to a specific antidepressant. We aimed to develop an algorithm to assess whether patients will achieve symptomatic remission from a 12-week course of citalopram. We used patient-reported data from patients with depression (n=4041, with 1949 completers) from level 1 of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D; ClinicalTrials.gov, number NCT00021528) to identify variables that were most predictive of treatment outcome, and used these variables to train a machine-learning model to predict clinical remission. We externally validated the model in the escitalopram treatment group (n=151) of an independent clinical trial (Combining Medications to Enhance Depression Outcomes [COMED]; ClinicalTrials.gov, number NCT00590863). We identified 25 variables that were most predictive of treatment outcome from 164 patient-reportable variables, and used these to train the model. The model was internally cross-validated, and predicted outcomes in the STAR*D cohort with accuracy significantly above chance (64·6% [SD 3·2]; p<0·0001). The model was externally validated in the escitalopram treatment group (N=151) of COMED (accuracy 59·6%, p=0.043). The model also performed significantly above chance in a combined escitalopram-buproprion treatment group in COMED (n=134; accuracy 59·7%, p=0·023), but not in a combined venlafaxine-mirtazapine group (n=140; accuracy 51·4%, p=0·53), suggesting specificity of the model to underlying mechanisms. Building statistical models by mining existing clinical trial data can enable prospective identification of patients who are likely to respond to a specific antidepressant. Yale University. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cognitive Dysfunction, Locus of Control and Treatment Outcome among Chronic Alcoholics.

Science.gov (United States)

Abbott, Max W.

While alcoholism is no longer regarded as a unitary disorder, conventional measures of congition and personality have yet to be shown capable of consistently predicting clinical outcomes. To investigate cognitive dysfunction and locus of control as predictors of post treatment outcome in a large sample of alcoholics, 106 alcoholics (74 men, 32…

Socio-economic status plays important roles in childhood cancer treatment outcome in Indonesia.

Science.gov (United States)

Mostert, Saskia; Gunawan, Stefanus; Wolters, Emma; van de Ven, Peter; Sitaresmi, Mei; Dongen, Josephine van; Veerman, Anjo; Mantik, Max; Kaspers, Gertjan

2012-01-01

The influence of parental socio-economic status on childhood cancer treatment outcome in low-income countries has not been sufficiently investigated. Our study examined this influence and explored parental experiences during cancer treatment of their children in an Indonesian academic hospital. Medical charts of 145 children diagnosed with cancer between 1999 and 2009 were reviewed retrospectively. From October 2011 until January 2012, 40 caretakers were interviewed using semi-structured questionnaires. Of all patients, 48% abandoned treatment, 34% experienced death, 9% had progressive/ relapsed disease, and 9% overall event-free survival. Prosperous patients had better treatment outcome than poor patients (Pfate or God (55%). Causes of cancer were thought to be destiny (35%) or God's punishment (23%). Alternative treatment could (18%) or might (50%) cure cancer. Most parents (95%) would like more information about cancer and treatment. More contact with doctors was desired (98%). Income decreased during treatment (55%). Parents lost employment (48% fathers, 10% mothers), most of whom stated this loss was caused by their child's cancer (84% fathers, 100% mothers). Loss of income led to financial difficulties (63%) and debts (55%). Treatment abandonment was most important reason for treatment failure. Treatment outcome was determined by parental socio-economic status. Childhood cancer survival could improve if financial constraints and provision of information and guidance are better addressed.

Discussion on Implementation of ICRP Recommendations Concerning Reference Levels and Optimisation

International Nuclear Information System (INIS)

2013-02-01

International Commission on Radiological Protection (ICRP) Publication 103, 'The 2007 Recommendations of the International Commission on Radiological Protection', issued in 2007, defines emergency exposure situations as unexpected situations that may require the implementation of urgent protective actions and perhaps longer term protective actions. The ICRP continues to recommend optimisation and the use of reference levels to ensure an adequate degree of protection in regard to exposure to ionising radiation in emergency exposure situations. Reference levels represent the level of dose or risk above which it is judged to be inappropriate to plan to allow exposures to occur and for which protective actions should therefore be planned and optimised. National authorities are responsible for establishing reference levels. The Expert Group on the Implementation of New International Recommendations for Emergency Exposure Situations (EGIRES) performed a survey to analyse the established processes for optimisation of the protection strategy for emergency exposure situations and for practical implementation of the reference level concept in several member states of the Nuclear Energy Agency (NEA). The EGIRES collected information on several national optimisation strategy definitions, on optimisation of protection for different protective actions, and also on optimisation of urgent protective actions. In addition, national criteria for setting reference levels, their use, and relevant processes, including specific triggers and dosimetric quantifies in setting reference levels, are focus points that the EGIRES also evaluated. The analysis of national responses to this 2011 survey shows many differences in the interpretation and application of the established processes and suggests that most countries are still in the early stages of implementing these processes. Since 2011, national authorities have continued their study of the ICRP recommendations to incorporate them into

Identification, optimisation and in vivo evaluation of oxadiazole DGAT-1 inhibitors for the treatment of obesity and diabetes.

Science.gov (United States)

McCoull, William; Addie, Matthew S; Birch, Alan M; Birtles, Susan; Buckett, Linda K; Butlin, Roger J; Bowker, Suzanne S; Boyd, Scott; Chapman, Stephen; Davies, Robert D M; Donald, Craig S; Green, Clive P; Jenner, Chloe; Kemmitt, Paul D; Leach, Andrew G; Moody, Graeme C; Gutierrez, Pablo Morentin; Newcombe, Nicholas J; Nowak, Thorsten; Packer, Martin J; Plowright, Alleyn T; Revill, John; Schofield, Paul; Sheldon, Chris; Stokes, Steve; Turnbull, Andrew V; Wang, Steven J Y; Whalley, David P; Wood, J Matthew

2012-06-15

A novel series of DGAT-1 inhibitors was discovered from an oxadiazole amide high throughput screening (HTS) hit. Optimisation of potency and ligand lipophilicity efficiency (LLE) resulted in a carboxylic acid containing clinical candidate 53 (AZD3988), which demonstrated excellent DGAT-1 potency (0.6 nM), good pharmacokinetics and pre-clinical in vivo efficacy that could be rationalised through a PK/PD relationship. Copyright © 2012 Elsevier Ltd. All rights reserved.

Outcome following treatment of feline gastrointestinal mast cell tumours.

Science.gov (United States)

Barrett, L E; Skorupski, K; Brown, D C; Weinstein, N; Clifford, C; Szivek, A; Haney, S; Kraiza, S; Krick, E L

2018-06-01

Prognosis of feline gastrointestinal mast cell tumours (FGIMCT), based on limited available literature, is described as guarded to poor, which may influence treatment recommendations and patient outcome. The purpose of this study is to describe the clinical findings, treatment response, and outcome of FGIMCT. Medical records of 31 cats diagnosed with and treated for FGIMCT were retrospectively reviewed. Data collected included signalment, method of diagnosis, tumour location (including metastatic sites), treatment type, cause of death and survival time. Mean age was 12.9 y. Diagnosis was made via cytology (n = 15), histopathology (n = 13) or both (n = 3). Metastatic sites included abdominal lymph node (n = 10), abdominal viscera (n = 4) and both (n = 2). Therapeutic approaches included chemotherapy alone (n = 15), surgery and chemotherapy (n = 7), glucocorticoid only (n = 6) and surgery and glucocorticoid (n = 3). Lomustine (n = 15) and chlorambucil (n = 12) were the most commonly used chemotherapy drugs. Overall median survival time was 531 d (95% confidence interval 334, 982). Gastrointestinal location, diagnosis of additional cancers, and treatment type did not significantly affect survival time. Cause of death was tumour-related or unknown (n = 12) and unrelated (n = 8) in the 20 cats dead at the time of analysis. The prognosis for cats with FGIMCT may be better than previously reported, with 26% of cats deceased from an unrelated cause. Surgical and medical treatments (including prednisolone alone) were both associated with prolonged survival times. Treatment other than prednisolone may not be necessary in some cats. Continued research into prognostic factors and most effective treatment strategies are needed. © 2017 John Wiley & Sons Ltd.

Shape optimisation and performance analysis of flapping wings

KAUST Repository

Ghommem, Mehdi

2012-09-04

In this paper, shape optimisation of flapping wings in forward flight is considered. This analysis is performed by combining a local gradient-based optimizer with the unsteady vortex lattice method (UVLM). Although the UVLM applies only to incompressible, inviscid flows where the separation lines are known a priori, Persson et al. [1] showed through a detailed comparison between UVLM and higher-fidelity computational fluid dynamics methods for flapping flight that the UVLM schemes produce accurate results for attached flow cases and even remain trend-relevant in the presence of flow separation. As such, they recommended the use of an aerodynamic model based on UVLM to perform preliminary design studies of flapping wing vehicles Unlike standard computational fluid dynamics schemes, this method requires meshing of the wing surface only and not of the whole flow domain [2]. From the design or optimisation perspective taken in our work, it is fairly common (and sometimes entirely necessary, as a result of the excessive computational cost of the highest fidelity tools such as Navier-Stokes solvers) to rely upon such a moderate level of modelling fidelity to traverse the design space in an economical manner. The objective of the work, described in this paper, is to identify a set of optimised shapes that maximise the propulsive efficiency, defined as the ratio of the propulsive power over the aerodynamic power, under lift, thrust, and area constraints. The shape of the wings is modelled using B-splines, a technology used in the computer-aided design (CAD) field for decades. This basis can be used to smoothly discretize wing shapes with few degrees of freedom, referred to as control points. The locations of the control points constitute the design variables. The results suggest that changing the shape yields significant improvement in the performance of the flapping wings. The optimisation pushes the design to "bird-like" shapes with substantial increase in the time

OPTIMISATION OF A DRIVE SYSTEM AND ITS EPICYCLIC GEAR SET

OpenAIRE

Bellegarde , Nicolas; Dessante , Philippe; Vidal , Pierre; Vannier , Jean-Claude

2007-01-01

International audience; This paper describes the design of a drive consisting of a DC motor, a speed reducer, a lead screw transformation system, a power converter and its associated DC source. The objective is to reduce the mass of the system. Indeed, the volume and weight optimisation of an electrical drive is an important issue for embedded applications. Here, we present an analytical model of the system in a specific application and afterwards an optimisation of the motor and speed reduce...

Optimisation of gas-cooled reactors with the aid of mathematical computers

Energy Technology Data Exchange (ETDEWEB)

Margen, P H

1959-04-15

Reactor optimisation is the task of finding the combination of values of the independent variables in a reactor design producing the lowest cost of electricity. In a gas-cooled reactor the number of independent variables is particularly large and the optimisation process is, therefore, laborious. The present note describes a procedure for performing the entire optimisation procedure with the aid of a mathematical computer in a single operation, thus saving time for the design staff. Detailed equations and numerical constants are proposed for the thermal and cost relations involved. The reactor physics equations, on the other hand are merely stated as general functions of the relevant variables. The task of expressing these functions as detailed equations will be covered by separate documents prepared by the reactor physics department.

Optimisation of gas-cooled reactors with the aid of mathematical computers

International Nuclear Information System (INIS)

Margen, P.H.

1959-04-01

Reactor optimisation is the task of finding the combination of values of the independent variables in a reactor design producing the lowest cost of electricity. In a gas-cooled reactor the number of independent variables is particularly large and the optimisation process is, therefore, laborious. The present note describes a procedure for performing the entire optimisation procedure with the aid of a mathematical computer in a single operation, thus saving time for the design staff. Detailed equations and numerical constants are proposed for the thermal and cost relations involved. The reactor physics equations, on the other hand are merely stated as general functions of the relevant variables. The task of expressing these functions as detailed equations will be covered by separate documents prepared by the reactor physics department

Water distribution systems design optimisation using metaheuristics ...

African Journals Online (AJOL)

The topic of multi-objective water distribution systems (WDS) design optimisation using metaheuristics is investigated, comparing numerous modern metaheuristics, including several multi-objective evolutionary algorithms, an estimation of distribution algorithm and a recent hyperheuristic named AMALGAM (an evolutionary ...

A national optimisation model for energy wood streams; Energiapuuvirtojen valtakunnallinen optimointimalli

Energy Technology Data Exchange (ETDEWEB)

Iikkanen, P.; Keskinen, S.; Korpilahti, A.; Raesaenen, T.; Sirkiae, A.

2011-07-01

In 2010 a total of 12,5 terawatt hours of forest energy was used in Finland's heat and power plants. According to studies by Metsaeteho and Poeyry, use of energy wood will nearly double to 21.6 terawatt hours by 2020. There are also plans to use energy wood as a raw material for biofuel plants. The techno-ecological supply potential of energy wood in 2020 is estimated at 42.9 terawatt hours. Energy wood has been transported almost entirely by road. The situation is changing, however, because growing demand for energy wood will expand raw wood procurement areas and lengthen transport distances. A cost-effective transport system therefore also requires the use of rail and waterway transports. In Finland, however, there is almost a complete absence of the terminals required for the use of rail and waterway transports; where energy wood is chipped, temporarily stored and loaded onto railway wagons and vessels for further transport. A national optimisation model for energy wood has been developed to serve transport system planning in particular. The linear optimisation model optimises, on a national level, goods streams between supply points and usage points based on forest energy procurement costs. The model simultaneously covers deliveries of forest chips, stumps and small-sized thinning wood. The procurement costs used in the optimisation include the costs of the energy wood's roadside price, chipping, transport and terminal handling. The transport system described in the optimisation model consists of wood supply points (2007 municipality precision), wood usage points, railway terminals and the connections between them along the main road and rail network. Elements required for the examination of waterway transports can also be easily added to the model. The optimisation model can be used to examine, for example, the effects of changes of energy wood demand and supply as well as transport costs on energy wood goods streams, the relative use of different

Treatment of HAE Attacks in the Icatibant Outcome Survey

DEFF Research Database (Denmark)

Hernández Fernandez de Rojas, Dolores; Ibañez, Ethel; Longhurst, Hilary

2015-01-01

BACKGROUND: Icatibant, a selective bradykinin B2 receptor antagonist for the treatment of acute hereditary angio-oedema (HAE) attacks in adults, can be administered by health care professionals (HCPs) or self-administered. This analysis compared characteristics and outcomes of acute HAE attacks t...

Optimisation of window settings for traditional and noise-optimised virtual monoenergetic imaging in dual-energy computed tomography pulmonary angiography

International Nuclear Information System (INIS)

D'Angelo, Tommaso; ''G. Martino'' University Hospital, Messina; Bucher, Andreas M.; Lenga, Lukas; Arendt, Christophe T.; Peterke, Julia L.; Martin, Simon S.; Leithner, Doris; Vogl, Thomas J.; Wichmann, Julian L.; Caruso, Damiano; University Hospital, Latina; Mazziotti, Silvio; Blandino, Alfredo; Ascenti, Giorgio; University Hospital, Messina; Othman, Ahmed E.

2018-01-01

To define optimal window settings for displaying virtual monoenergetic images (VMI) of dual-energy CT pulmonary angiography (DE-CTPA). Forty-five patients who underwent clinically-indicated third-generation dual-source DE-CTPA were retrospectively evaluated. Standard linearly-blended (M 0 .6), 70-keV traditional VMI (M70), and 40-keV noise-optimised VMI (M40+) reconstructions were analysed. For M70 and M40+ datasets, the subjectively best window setting (width and level, B-W/L) was independently determined by two observers and subsequently related with pulmonary artery attenuation to calculate separate optimised values (O-W/L) using linear regression. Subjective evaluation of image quality (IQ) between W/L settings were assessed by two additional readers. Repeated measures of variance were performed to compare W/L settings and IQ indices between M 0 .6, M70, and M40+. B-W/L and O-W/L for M70 were 460/140 and 450/140, and were 1100/380 and 1070/380 for M40+, respectively, differing from standard DE-CTPA W/L settings (450/100). Highest subjective scores were observed for M40+ regarding vascular contrast, embolism demarcation, and overall IQ (all p<0.001). Application of O-W/L settings is beneficial to optimise subjective IQ of VMI reconstructions of DE-CTPA. A width slightly less than two times the pulmonary trunk attenuation and a level approximately of overall pulmonary vessel attenuation are recommended. (orig.)

Access, treatment and outcomes of care: a study of ethnic minorities in Europe.

Science.gov (United States)

Hanssens, Lise G M; Detollenaere, Jens; Hardyns, Wim; Willems, Sara J T

2016-05-01

Recent research has shown that ethnic minorities still have less access to medical care and are less satisfied with the treatment they receive and the outcomes of the health care process. This article assesses how migrants in Europe experience access, treatment and outcomes in the European health care systems. Data were obtained from the QUALICOPC study (Quality and Costs of Primary Care in Europe). Regression analyses were used to estimate the access, treatment and outcomes of care for ethnic minorities. In several countries, migrants experience that the opening hours of their GP practice were too limited and indicate that the practice was too far away from their work or home (lower access). They are more likely to report negative patient-doctor communication and less continuity of care than native patients (worse treatment). In addition, they are less satisfied with the care they received and are more likely to postpone care (worse outcomes). In general, migrants are still disadvantaged during the health care process. However, our results also indicate that satisfaction with the health care process improves for second-generation migrants in comparison with first-generation migrants.

Optimising the Target and Capture Sections of the Neutrino Factory

CERN Document Server

Hansen, Ole Martin; Stapnes, Steinar

The Neutrino Factory is designed to produce an intense high energy neutrino beam from stored muons. The majority of the muons are obtained from the decay of pions, produced by a proton beam impinging on a free-flowing mercury-jet target and captured by a high magnetic field. It is important to capture a large fraction of the produced pions to maximize the intensity of the neutrino beam. Various optimisation studies have been performed with the aim of maximising the muon influx to the accelerator and thus the neutrino beam intensity. The optimisation studies were performed with the use of Monte Carlo simulation tools. The production of secondary particles, by interactions between the incoming proton beam and the mercury target, was optimised by varying the proton beam impact position and impact angles on the target. The proton beam and target interaction region was studied and showed to be off the central axis of the capture section in the baseline configuration. The off-centred interaction region resulted in ...

Optimised management of orphan wastes in the UK

International Nuclear Information System (INIS)

Doudou, Slimane; McTeer, Jennifer; Wickham, Stephen; Thied, Rob; Woodcock, Richard; Turner, Tom; Hamblin, Clive; Buckley, Matthew; Walsh, Ciara

2013-01-01

Orphan wastes have properties preventing them from being managed according to existing or currently planned management routes, or lack characterisation so that their management is uncertain. The identification of new management opportunities for orphan wastes could realise significant benefits by reducing the number of processing facilities required, reducing waste volumes, reducing hazard or leading to the development of centres of excellence for the processing of certain types of orphan wastes. Information on the characteristics of orphan waste existing at nuclear licensed sites across the UK has been collated and a database developed to act as a repository for the information gathered. The database provides a capability to analyse the data and to explore possible treatment technologies for each orphan waste type. Thirty five distinct orphan waste types have been defined and possible treatment options considered. Treatment technologies (including chemical, high temperature, immobilisation and physical technologies) that could be applied to one or more of the generic orphan waste streams have been identified. Wiring diagrams have been used to highlight the waste treatment / lifecycle management options that are available for each of the generic orphan groups as well as identifying areas for further research and development. This work has identified the potential for optimising the management of orphan wastes in a number of areas, and many potential opportunities were identified. Such opportunities could be investigated by waste managers at waste producing nuclear sites, to facilitate the development of new management routes for orphan wastes. (authors)

An efficient optimisation method in groundwater resource ...

African Journals Online (AJOL)

DRINIE

2003-10-04

Oct 4, 2003 ... theories developed in the field of stochastic subsurface hydrology. In reality, many ... Recently, some researchers have applied the multi-stage ... Then a robust solution of the optimisation problem given by Eqs. (1) to (3) is as ...

Relationship between Illness Perceptions, Treatment Adherence, And Clinical Outcomes in Patients On Maintenance Hemodialysis

OpenAIRE

Kim, Youngmee; Evangelista, Lorraine S.

2010-01-01

Previous data indicate that negative perception of disease and non-adherence to recommended treatment may lead to unfavorable clinical outcomes in patients on maintenance hemodialysis (HD). However, a paucity of research addresses clinical outcomes in the end stage renal disease (ESRD) population as a function of patients’ illness perceptions and their degree of adherence to recommended treatment. The study was conducted to examine illness perceptions and treatment adherence rates in patients...

Optimising residual stresses at a repair in a steam header to tubeplate weld

International Nuclear Information System (INIS)

Soanes, T.P.T.; Bell, W.; Vibert, A.J.

2005-01-01

Following the discovery of incorrect weld metal in the steam side shell to tubeplate weld in a type 316H stainless steel superheater steam header, a repair strategy had to be determined. The strategy adopted was to remove the incorrect weld material, which extended around the full circumference, by machining from the inside of the header, followed by rewelding from the inside using an automatic welding process and localised post-weld heat treatment. Due to concern over potential reheat cracking of the repair after return to service, a considerable amount of residual stress modelling was carried out to support the development and optimisation of a successful repair and heat treatment strategy and thus underwrite the safety case for return to service

Thermodynamic optimisation and analysis of four Kalina cycle layouts for high temperature applications

International Nuclear Information System (INIS)

Modi, Anish; Haglind, Fredrik

2015-01-01

The Kalina cycle has seen increased interest in the last few years as an efficient alternative to the conventional steam Rankine cycle. However, the available literature gives little information on the algorithms to solve or optimise this inherently complex cycle. This paper presents a detailed approach to solve and optimise a Kalina cycle for high temperature (a turbine inlet temperature of 500 °C) and high pressure (over 100 bar) applications using a computationally efficient solution algorithm. A central receiver solar thermal power plant with direct steam generation was considered as a case study. Four different layouts for the Kalina cycle based on the number and/or placement of the recuperators in the cycle were optimised and compared based on performance parameters such as the cycle efficiency and the cooling water requirement. The cycles were modelled in steady state and optimised with the maximisation of the cycle efficiency as the objective function. It is observed that the different cycle layouts result in different regions for the optimal value of the turbine inlet ammonia mass fraction. Out of the four compared layouts, the most complex layout KC1234 gives the highest efficiency. The cooling water requirement is closely related to the cycle efficiency, i.e., the better the efficiency, the lower is the cooling water requirement. - Highlights: • Detailed methodology for solving and optimising Kalina cycle for high temperature applications. • A central receiver solar thermal power plant with direct steam generation considered as a case study. • Four Kalina cycle layouts based on the placement of recuperators optimised and compared

Beyond Drug Use: A Systematic Consideration of Other Outcomes in Evaluations of Treatments for Substance Use Disorders

Science.gov (United States)

Tiffany, Stephen T.; Friedman, Lawrence; Greenfield, Shelly F.; Hasin, Deborah S.; Jackson, Ron

2011-01-01

Across the addictions field, the primary outcome in treatment research has been reduction in drug consumption. A comprehensive view of the impact of substance use disorders on human functioning suggests that effective treatments should address the many consequences and features of addiction beyond drug use, a recommendation forwarded by multiple expert panels and review articles. Despite recurring proposals, and a compelling general rationale for moving beyond drug use as the sole standard for evaluating addiction treatment, the field has yet to adopt any core set of “other” measures that are routinely incorporated into treatment research. Among the many reasons for the limited impact of previous proposals has been the absence of a clear set of guidelines for selecting candidate outcomes. This paper is the result of the deliberations of a panel of substance abuse treatment and research experts convened by the National Institute on Drug Abuse to discuss appropriate outcome measures for clinical trials of substance abuse treatments. This paper provides an overview of previous recommendations and outlines specific guidelines for consideration of candidate outcomes. A list of outcomes meeting those guidelines is described and illustrated in detail with two outcomes: craving and quality of life. The paper concludes with specific recommendations for moving beyond the outcome listing offered in this paper to promote the programmatic incorporation of these outcomes into treatment research. PMID:21981638

Aspects of approximate optimisation: overcoming the curse of dimensionality and design of experiments

NARCIS (Netherlands)

Trichon, Sophie; Bonte, M.H.A.; Ponthot, Jean-Philippe; van den Boogaard, Antonius H.

2007-01-01

Coupling optimisation algorithms to Finite Element Methods (FEM) is a very promising way to achieve optimal metal forming processes. However, many optimisation algorithms exist and it is not clear which of these algorithms to use. This paper investigates the sensitivity of a Sequential Approximate

Treatment of Phonological Disorder: A Feasibility Study With Focus on Outcome Measures.

Science.gov (United States)

Smit, Ann Bosma; Brumbaugh, Klaire Mann; Weltsch, Barbara; Hilgers, Melanie

2018-02-20

In a feasibility study for a randomized controlled trial of treatments for phonological disorders conducted over a period of 8 months, we examined 6 clinically relevant outcome measures. We took steps to reduce error variance and to maximize systematic variance. Six children received traditional treatment (Van Riper, 1939), and 7 received expansion points (Smit, 2000), a treatment program with both phonological and traditional elements. Outcome measures, which were applied to both word list and conversational samples, included percentage of consonants correct (PCC; Shriberg & Kwiatkowski, 1982), PCC for late and/or difficult (L/D) consonants and number of L/D consonants acquired. In repeated-measures analyses of variance, all measures showed significant differences from pretreatment to posttreatment, and the word list measures were associated with very high power values. In analyses of covariance for between-groups contrasts, the adjusted expansion points mean exceeded the adjusted traditional treatment mean for every measure; however, no differences reached significance. For the L/D PCC (conversation) measure, the contrast between groups was associated with a large effect size. We recommend that practitioners use outcome measures related to a word list. We recommend that researchers consider using L/D PCC on the basis of conversational samples to detect differences among treatment groups. https://doi.org/10.23641/asha.5872677.

The relationship between clinician turnover and adolescent treatment outcomes: An examination from the client perspective

Science.gov (United States)

Garner, Bryan R.; Funk, Rodney R.; Hunter, Brooke D.

2012-01-01

The turnover of substance use disorder (SUD) treatment staff has been assumed to adversely impact treatment effectiveness, yet only limited research has empirically examined this assumption. Representing an extension of prior organizational-level analyses of the impact of staff turnover on client outcomes, this study examined the impact of SUD clinician turnover on adolescent treatment outcomes using a client perspective. Multilevel regression analysis did reveal that relative to those adolescents who did not experience clinician turnover, adolescents who experienced both direct and indirect clinician turnover reported a significantly higher percentage of days using alcohol or drugs at 6-month follow-up. However, clinician turnover was not found to have significant associations (negative or positive) with the other five treatment outcomes examined (e.g., substance-related problems, involvement in illegal activity). Thus, consistent with our prior findings, the current study provides additional evidence that turnover of SUD clinicians is not necessarily associated with adverse treatment outcomes. PMID:23083980

Treatment of edentulism: optimizing outcomes with tissue management and impression techniques.

Science.gov (United States)

Salinas, Thomas J

2009-02-01

Significant numbers of patients throughout the world seek treatment for edentulism. The trend toward tissue-integrated prostheses has been a monumental step in restoring edentulous patients to function; however, this treatment can be out of reach for those who fail to qualify or those who do not have sufficient resources to afford it. In these cases, conventional dentures remain an important primary course of treatment. Attention to detail when diagnosing, treatment planning, and performing treatment for these patients is still a prime consideration for the best possible outcome. In particular, many experienced denture wearers are afflicted with chronically inflamed denture-bearing mucosa. Clinicians must recognize the need for tissue conditioning, choices of impression materials, and accepted fabrication techniques that can have favorable outcomes when matched with patients who are philosophical and realistic in their expectations. The purpose of this article is to review impression philosophies, associated materials, and methods of tissue conditioning. Retention and stability of the denture bases can be augmented by the routine use of denture adhesive, and indications for use of denture adhesive will be discussed.

Statin Treatment and Clinical Outcomes of Heart Failure Among Africans: An Inverse Probability Treatment Weighted Analysis.

Science.gov (United States)

Bonsu, Kwadwo Osei; Owusu, Isaac Kofi; Buabeng, Kwame Ohene; Reidpath, Daniel D; Kadirvelu, Amudha

2017-04-01

Randomized control trials of statins have not demonstrated significant benefits in outcomes of heart failure (HF). However, randomized control trials may not always be generalizable. The aim was to determine whether statin and statin type-lipophilic or -hydrophilic improve long-term outcomes in Africans with HF. This was a retrospective longitudinal study of HF patients aged ≥18 years hospitalized at a tertiary healthcare center between January 1, 2009 and December 31, 2013 in Ghana. Patients were eligible if they were discharged from first admission for HF (index admission) and followed up to time of all-cause, cardiovascular, and HF mortality or end of study. Multivariable time-dependent Cox model and inverse-probability-of-treatment weighting of marginal structural model were used to estimate associations between statin treatment and outcomes. Adjusted hazard ratios were also estimated for lipophilic and hydrophilic statin compared with no statin use. The study included 1488 patients (mean age 60.3±14.2 years) with 9306 person-years of observation. Using the time-dependent Cox model, the 5-year adjusted hazard ratios with 95% CI for statin treatment on all-cause, cardiovascular, and HF mortality were 0.68 (0.55-0.83), 0.67 (0.54-0.82), and 0.63 (0.51-0.79), respectively. Use of inverse-probability-of-treatment weighting resulted in estimates of 0.79 (0.65-0.96), 0.77 (0.63-0.96), and 0.77 (0.61-0.95) for statin treatment on all-cause, cardiovascular, and HF mortality, respectively, compared with no statin use. Among Africans with HF, statin treatment was associated with significant reduction in mortality. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Cognitive behavior therapy with Internet addicts: treatment outcomes and implications.

Science.gov (United States)

Young, Kimberly S

2007-10-01

Research over the last decade has identified Internet addiction as a new and often unrecognized clinical disorder that impact a user's ability to control online use to the extent that it can cause relational, occupational, and social problems. While much of the literature explores the psychological and social factors underlying Internet addiction, little if any empirical evidence exists that examines specific treatment outcomes to deal with this new client population. Researchers have suggested using cognitive behavioral therapy (CBT) as the treatment of choice for Internet addiction, and addiction recovery in general has utilized CBT as part of treatment planning. To investigate the efficacy of using CBT with Internet addicts, this study investigated 114 clients who suffered from Internet addiction and received CBT at the Center for Online Addiction. This study employed a survey research design, and outcome variables such as client motivation, online time management, improved social relationships, improved sexual functioning, engagement in offline activities, and ability to abstain from problematic applications were evaluated on the 3rd, 8th, and 12th sessions and over a 6-month follow-up. Results suggested that Caucasian, middle-aged males with at least a 4-year degree were most likely to suffer from some form of Internet addiction. Preliminary analyses indicated that most clients were able to manage their presenting complaints by the eighth session, and symptom management was sustained upon a 6-month follow-up. As the field of Internet addiction continues to grow, such outcome data will be useful in treatment planning with evidenced-based protocols unique to this emergent client population.

Effects of benchmarking on the quality of type 2 diabetes care: results of the OPTIMISE (Optimal Type 2 Diabetes Management Including Benchmarking and Standard Treatment) study in Greece

Science.gov (United States)

Tsimihodimos, Vasilis; Kostapanos, Michael S.; Moulis, Alexandros; Nikas, Nikos; Elisaf, Moses S.

2015-01-01

Objectives: To investigate the effect of benchmarking on the quality of type 2 diabetes (T2DM) care in Greece. Methods: The OPTIMISE (Optimal Type 2 Diabetes Management Including Benchmarking and Standard Treatment) study [ClinicalTrials.gov identifier: NCT00681850] was an international multicenter, prospective cohort study. It included physicians randomized 3:1 to either receive benchmarking for glycated hemoglobin (HbA1c), systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL-C) treatment targets (benchmarking group) or not (control group). The proportions of patients achieving the targets of the above-mentioned parameters were compared between groups after 12 months of treatment. Also, the proportions of patients achieving those targets at 12 months were compared with baseline in the benchmarking group. Results: In the Greek region, the OPTIMISE study included 797 adults with T2DM (570 in the benchmarking group). At month 12 the proportion of patients within the predefined targets for SBP and LDL-C was greater in the benchmarking compared with the control group (50.6 versus 35.8%, and 45.3 versus 36.1%, respectively). However, these differences were not statistically significant. No difference between groups was noted in the percentage of patients achieving the predefined target for HbA1c. At month 12 the increase in the percentage of patients achieving all three targets was greater in the benchmarking (5.9–15.0%) than in the control group (2.7–8.1%). In the benchmarking group more patients were on target regarding SBP (50.6% versus 29.8%), LDL-C (45.3% versus 31.3%) and HbA1c (63.8% versus 51.2%) at 12 months compared with baseline (p Benchmarking may comprise a promising tool for improving the quality of T2DM care. Nevertheless, target achievement rates of each, and of all three, quality indicators were suboptimal, indicating there are still unmet needs in the management of T2DM. PMID:26445642

Mechanisms of Behavioral and Affective Treatment Outcomes in a Cognitive Behavioral Intervention for Boys.

Science.gov (United States)

Burke, Jeffrey D; Loeber, Rolf

2016-01-01

Evidence for effective treatment for behavioral problems continues to grow, yet evidence about the effective mechanisms underlying those interventions has lagged behind. The Stop Now and Plan (SNAP) program is a multicomponent intervention for boys between 6 and 11. This study tested putative treatment mechanisms using data from 252 boys in a randomized controlled trial of SNAP versus treatment as usual. SNAP includes a 3 month group treatment period followed by individualized intervention, which persisted through the 15 month study period. Measures were administered in four waves: at baseline and at 3, 9 and 15 months after baseline. A hierarchical linear modeling strategy was used. SNAP was associated with improved problem-solving skills, prosocial behavior, emotion regulation skills, and reduced parental stress. Prosocial behavior, emotion regulation skills and reduced parental stress partially mediated improvements in child aggression. Improved emotion regulation skills partially mediated treatment-related child anxious-depressed outcomes. Improvements in parenting behaviors did not differ between treatment conditions. The results suggest that independent processes may drive affective and behavioral outcomes, with some specificity regarding the mechanisms related to differing treatment outcomes.

Periodontal treatment outcomes during pregnancy and postpartum.

Science.gov (United States)

Moreira, Carlos Heitor Cunha; Weidlich, Patrícia; Fiorini, Tiago; da Rocha, José Mariano; Musskopf, Marta Liliana; Susin, Cristiano; Oppermann, Rui Vicente; Rösing, Cassiano Kuchenbecker

2015-09-01

This study was conducted to compare periodontal therapy outcomes during pregnancy and after delivery. One hundred nine pregnant women up to the 20th gestational week (GW) were randomized into two groups: the test group (comprehensive periodontal therapy during pregnancy) and the control group (comprehensive periodontal therapy after delivery). Periodontal examinations comprised plaque index (PI), gingival index (GI), periodontal probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), and gingival crevicular fluid (GCF) volume. After baseline examination, women in the test group received periodontal treatment up to the 24th GW. The final examination was performed at the 26th to the 28th GW. Women in the control group were treated 30 days after delivery and reexamined 30 days after treatment. Periodontal therapy significantly reduced periodontal inflammation in both groups. The mean percentage of sites with BOP was reduced from 49.14 % (±22.49) to 11.10 % (±7.84) and from 45.71 % (±17.86) to 8.07 % (±5.21) in the test and control groups, respectively (p = 0.95). No statistically significant differences were observed between groups concerning PI, GI, PPD, CAL, and GCF. The reduction in mean percentage of sites with BOP stratified for initial PPD ≥4 mm was higher in the control group (p pregnancy do not interfere in treatment outcomes in women with widespread gingival inflammation and limited periodontal destruction. The role of these hormonal changes in pregnant women with different disease patterns remains uncertain. Periodontal health can be reestablished irrespective of the hormonal challenge that takes place during pregnancy.

Psychological distress and its effect on tuberculosis treatment outcomes in Ethiopia

Directory of Open Access Journals (Sweden)

Habteyes Hailu Tola

2015-11-01

Full Text Available Background: Psychological distress is the major comorbidity among tuberculosis (TB patients. However, its magnitude, associated factors, and effect on treatment outcome have not been adequately studied in low-income countries. Objective: This study aimed to determine the magnitude of psychological distress and its effect on treatment outcome among TB patients on treatment. Design: A follow-up study was conducted in Addis Ababa, Ethiopia, from May to December 2014. Patients (N=330 diagnosed with all types of TB who had been on treatment for 1–2 months were enrolled consecutively from 15 randomly selected health centers and one TB specialized hospital. Data on sociodemographic variables and economic status were collected using a structured questionnaire. The presence of psychological distress was assessed at baseline (within 1–2 months after treatment initiation and end point (6 months after treatment initiation using the 10-item Kessler (K-10 scale. Alcohol use and tobacco smoking history were assessed using WHO Alcohol Use Disorder Identification Test and Australian Smoking Assessment Checklist, respectively. The current WHO TB treatment outcome definition was used to differentiate the end result of each patient at completion of the treatment. Results: The overall psychological distress was 67.6% at 1–2 months and 48.5% at 6 months after treatment initiation. Multiple logistic regression analysis revealed that past TB treatment history [adjusted odds ratio (AOR: 3.76; 95% confidence interval (CI: 1.67–8.45], being on anti-TB and anti-HIV treatments (AOR: 5.35; 95% CI: 1.83–15.65, being unmarried (AOR: 4.29; 95% CI: 2.45–7.53, having alcohol use disorder (AOR: 2.95; 95% CI: 1.25–6.99, and having low economic status (AOR: 4.41; 95% CI: 2.44–7.97 were significantly associated with psychological distress at baseline. However, at 6 months after treatment initiation, only being a multidrug-resistant tuberculosis (MDR-TB patient (AOR: 3

Cognitive mediators of treatment outcomes in pediatric functional abdominal pain.

Science.gov (United States)

Levy, Rona L; Langer, Shelby L; Romano, Joan M; Labus, Jennifer; Walker, Lynn S; Murphy, Tasha B; Tilburg, Miranda A L van; Feld, Lauren D; Christie, Dennis L; Whitehead, William E

2014-12-01

Cognitive-behavioral (CB) interventions improve outcomes for many pediatric health conditions, but little is known about which mechanisms mediate these outcomes. The goal of this study was to identify whether changes in targeted process variables from baseline to 1 week posttreatment mediate improvement in outcomes in a randomized controlled trial of a brief CB intervention for idiopathic childhood abdominal pain. Two hundred children with persistent functional abdominal pain and their parents were randomly assigned to 1 of 2 conditions: a 3-session social learning and CB treatment (N=100), or a 3-session educational intervention controlling for time and attention (N=100). Outcomes were assessed at 3-, 6-, and 12-month follow-ups. The intervention focused on altering parental responses to pain and on increasing adaptive cognitions and coping strategies related to pain in both parents and children. Multiple mediation analyses were applied to examine the extent to which the effects of the social learning and CB treatment condition on child gastrointestinal (GI) symptom severity and pain as reported by children and their parents were mediated by changes in targeted cognitive process variables and parents' solicitous responses to their child's pain symptoms. Reductions in parents' perceived threat regarding their child's pain mediated reductions in both parent-reported and child-reported GI symptom severity and pain. Reductions in children's catastrophic cognitions mediated reductions in child-reported GI symptom severity but no other outcomes. Reductions in parental solicitousness did not mediate outcomes. Results suggest that reductions in reports of children's pain and GI symptoms after a social learning and CB intervention were mediated at least in part by decreasing maladaptive parent and child cognitions.

Status of achievements reached in applying optimisation of protection in prevention and mitigation of accidents in nuclear facilities

International Nuclear Information System (INIS)

Bengtsson, G.; Hoegberg, L.

1988-01-01

Optimisation of protection in a broad sense is basically a political undertaking, where the resources put into protection are balanced against other factors - quantifiable and non-quantifiable - to obtain the best protection that can be achieved under the circumstances. In a narrower sense, optimisation can be evaluated in procedures allowing for a few quantifiable factors, such as cost/effectiveness analysis. These procedures are used as inputs to the broader optimisation. The paper discusses several examples from Sweden concerning evaluations and decisions relating to prevention of accidents and mitigation of their consequences. Comparison is made with typical optimisation criteria proposed for radiation protection work and for cost/effective analysis in the USA, notably NUREG-1150 (draft). The examples show that optimisation procedures in a narrower sense have not been decisive. Individual dose limits seem to be increasingly important as compared to collective dose optimisation, and political, commercial or engineering judgements may lead to decisions far away from those suggested by simple optimisation considerations