Competitive advantage of PET/MRI.

Science.gov (United States)

Jadvar, Hossein; Colletti, Patrick M

2014-01-01

Multimodality imaging has made great strides in the imaging evaluation of patients with a variety of diseases. Positron emission tomography/computed tomography (PET/CT) is now established as the imaging modality of choice in many clinical conditions, particularly in oncology. While the initial development of combined PET/magnetic resonance imaging (PET/MRI) was in the preclinical arena, hybrid PET/MR scanners are now available for clinical use. PET/MRI combines the unique features of MRI including excellent soft tissue contrast, diffusion-weighted imaging, dynamic contrast-enhanced imaging, fMRI and other specialized sequences as well as MR spectroscopy with the quantitative physiologic information that is provided by PET. Most evidence for the potential clinical utility of PET/MRI is based on studies performed with side-by-side comparison or software-fused MRI and PET images. Data on distinctive utility of hybrid PET/MRI are rapidly emerging. There are potential competitive advantages of PET/MRI over PET/CT. In general, PET/MRI may be preferred over PET/CT where the unique features of MRI provide more robust imaging evaluation in certain clinical settings. The exact role and potential utility of simultaneous data acquisition in specific research and clinical settings will need to be defined. It may be that simultaneous PET/MRI will be best suited for clinical situations that are disease-specific, organ-specific, related to diseases of the children or in those patients undergoing repeated imaging for whom cumulative radiation dose must be kept as low as reasonably achievable. PET/MRI also offers interesting opportunities for use of dual modality probes. Upon clear definition of clinical utility, other important and practical issues related to business operational model, clinical workflow and reimbursement will also be resolved. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Competitive advantage of PET/MRI

International Nuclear Information System (INIS)

Jadvar, Hossein; Colletti, Patrick M.

2014-01-01

Multimodality imaging has made great strides in the imaging evaluation of patients with a variety of diseases. Positron emission tomography/computed tomography (PET/CT) is now established as the imaging modality of choice in many clinical conditions, particularly in oncology. While the initial development of combined PET/magnetic resonance imaging (PET/MRI) was in the preclinical arena, hybrid PET/MR scanners are now available for clinical use. PET/MRI combines the unique features of MRI including excellent soft tissue contrast, diffusion-weighted imaging, dynamic contrast-enhanced imaging, fMRI and other specialized sequences as well as MR spectroscopy with the quantitative physiologic information that is provided by PET. Most evidence for the potential clinical utility of PET/MRI is based on studies performed with side-by-side comparison or software-fused MRI and PET images. Data on distinctive utility of hybrid PET/MRI are rapidly emerging. There are potential competitive advantages of PET/MRI over PET/CT. In general, PET/MRI may be preferred over PET/CT where the unique features of MRI provide more robust imaging evaluation in certain clinical settings. The exact role and potential utility of simultaneous data acquisition in specific research and clinical settings will need to be defined. It may be that simultaneous PET/MRI will be best suited for clinical situations that are disease-specific, organ-specific, related to diseases of the children or in those patients undergoing repeated imaging for whom cumulative radiation dose must be kept as low as reasonably achievable. PET/MRI also offers interesting opportunities for use of dual modality probes. Upon clear definition of clinical utility, other important and practical issues related to business operational model, clinical workflow and reimbursement will also be resolved

The Assessment of Patient Clinical Outcome: Advantages, Models, Features of an Ideal Model

Directory of Open Access Journals (Sweden)

Mou’ath Hourani

2016-06-01

Full Text Available Background: The assessment of patient clinical outcome focuses on measuring various aspects of the health status of a patient who is under healthcare intervention. Patient clinical outcome assessment is a very significant process in the clinical field as it allows health care professionals to better understand the effectiveness of their health care programs and thus for enhancing the health care quality in general. It is thus vital that a high quality, informative review of current issues regarding the assessment of patient clinical outcome should be conducted. Aims & Objectives: 1 Summarizes the advantages of the assessment of patient clinical outcome; 2 reviews some of the existing patient clinical outcome assessment models namely: Simulation, Markov, Bayesian belief networks, Bayesian statistics and Conventional statistics, and Kaplan-Meier analysis models; and 3 demonstrates the desired features that should be fulfilled by a well-established ideal patient clinical outcome assessment model. Material & Methods: An integrative review of the literature has been performed using the Google Scholar to explore the field of patient clinical outcome assessment. Conclusion: This paper will directly support researchers, clinicians and health care professionals in their understanding of developments in the domain of the assessment of patient clinical outcome, thus enabling them to propose ideal assessment models.

The Assessment of Patient Clinical Outcome: Advantages, Models, Features of an Ideal Model

Directory of Open Access Journals (Sweden)

Mou’ath Hourani

2016-06-01

Full Text Available Background: The assessment of patient clinical outcome focuses on measuring various aspects of the health status of a patient who is under healthcare intervention. Patient clinical outcome assessment is a very significant process in the clinical field as it allows health care professionals to better understand the effectiveness of their health care programs and thus for enhancing the health care quality in general. It is thus vital that a high quality, informative review of current issues regarding the assessment of patient clinical outcome should be conducted. Aims & Objectives: 1 Summarizes the advantages of the assessment of patient clinical outcome; 2 reviews some of the existing patient clinical outcome assessment models namely: Simulation, Markov, Bayesian belief networks, Bayesian statistics and Conventional statistics, and Kaplan-Meier analysis models; and 3 demonstrates the desired features that should be fulfilled by a well-established ideal patient clinical outcome assessment model. Material & Methods: An integrative review of the literature has been performed using the Google Scholar to explore the field of patient clinical outcome assessment. Conclusion: This paper will directly support researchers, clinicians and health care professionals in their understanding of developments in the domain of the assessment of patient clinical outcome, thus enabling them to propose ideal assessment models.

Surgery planning and navigation by laser lithography plastic replica. Features, clinical applications, and advantages

International Nuclear Information System (INIS)

Kihara, Tomohiko; Tanaka, Yuuko; Furuhata, Kentaro

1995-01-01

The use of three-dimensional replicas created using laserlithography has recently become popular for surgical planning and intraoperative navigation in plastic surgery and oral maxillofacial surgery. In this study, we investigated many clinical applications that we have been involved in regarding the production of three-dimensional replicas. We have also analyzed the features, application classes, and advantages of this method. As a result, clinical applications are categorized into three classes, which are 'three-dimensional shape recognition', 'simulated surgery', and 'template'. The distinct features of three-dimensional replicas are 'direct recognition', 'fast manipulation', and 'free availability'. Meeting the requirements of surgical planning and intraoperative navigation, they have produced satisfactory results in clinical applications. (author)

Complexity versus availability for fusion: The potential advantages of inertial fusion energy

International Nuclear Information System (INIS)

Perkins, L.J.

1996-01-01

Probably the single largest advantage of the inertial route to fusion energy (IFE) is the perception that its power plant embodiments could achieve acceptable capacity factors. This is a result of its relative simplicity, the decoupling of the driver and reactor chamber, and the potential to employ thick liquid walls. We examine these issues in terms of the complexity, reliability, maintainability and, therefore, availability of both magnetic and inertial fusion power plants and compare these factors with corresponding scheduled and unscheduled outage data from present day fission experience. We stress that, given the simple nature of a fission core, the vast majority of unplanned outages in fission plants are due to failures outside the reactor vessel itself Given we must be prepared for similar outages in the analogous plant external to a fusion power core, this puts severe demands on the reliability required of the fusion core itself. We indicate that such requirements can probably be met for IFE plants. We recommend that this advantage be promoted by performing a quantitative reliability and availability study for a representative IFE power plant and suggest that databases are probably adequate for this task

[Laboratory unification: advantages and disadvantages for clinical microbiology].

Science.gov (United States)

Andreu, Antonia; Matas, Lurdes

2010-10-01

This article aims to reflect on which areas or tasks of microbiology laboratories could be unified with those of clinical biochemistry, hematology, immunology or pathology laboratories to benefit patients and the health system, as well as the areas that should remain independent since their amalgamation would not only fail to provide a benefit but could even jeopardize the quality of microbiological diagnosis, and consequently patient care. To do this, the distinct analytic phases of diagnosis are analyzed, and the advantages and disadvantages of amalgamation are evaluated in each phase. The pros and cons of the unification of certain areas such as the computer system, occupational risk units, customer service, purchasing logistics, and materials storage, etc, are also discussed. Lastly, the effect of unification on urgent microbiology diagnosis is analyzed. Microbiological diagnosis should be unique. The microbiologist should perform an overall evaluation of the distinct techniques used for a particular patient, both those that involve direct diagnosis (staining, culture, antigen detection techniques or molecular techniques) and indirect diagnosis (antibody detection). Moreover, the microbiology laboratory should be independent, with highly trained technicians and specialists in microbiology that provide added value as experts in infection and as key figures in the process of establishing a correct etiological diagnosis. Copyright © 2010 Elsevier España S.L. All rights reserved.

FCγ Chimeric Receptor-Engineered T Cells: Methodology, Advantages, Limitations, and Clinical Relevance

Directory of Open Access Journals (Sweden)

Giuseppe Sconocchia

2017-04-01

Full Text Available For many years, disappointing results have been generated by many investigations, which have utilized a variety of immunologic strategies to enhance the ability of a patient’s immune system to recognize and eliminate malignant cells. However, in recent years, immunotherapy has been used successfully for the treatment of hematologic and solid malignancies. The impressive clinical responses observed in many types of cancer have convinced even the most skeptical clinical oncologists that a patient’s immune system can recognize and reject his tumor if appropriate strategies are implemented. The success immunotherapy is due to the development of at least three therapeutic strategies. They include tumor-associated antigen (TAA-specific monoclonal antibodies (mAbs, T cell checkpoint blockade, and TAA-specific chimeric antigen receptors (CARs T cell-based immunotherapy. However, the full realization of the therapeutic potential of these approaches requires the development of strategies to counteract and overcome some limitations. They include off-target toxicity and mechanisms of cancer immune evasion, which obstacle the successful clinical application of mAbs and CAR T cell-based immunotherapies. Thus, we and others have developed the Fc gamma chimeric receptors (Fcγ-CRs-based strategy. Like CARs, Fcγ-CRs are composed of an intracellular tail resulting from the fusion of a co-stimulatory molecule with the T cell receptor ζ chain. In contrast, the extracellular CAR single-chain variable fragment (scFv, which recognizes the targeted TAA, has been replaced with the extracellular portion of the FcγRIIIA (CD16. Fcγ-CR T cells have a few intriguing features. First, given in combination with mAbs, Fcγ-CR T cells mediate anticancer activity in vitro and in vivo by an antibody-mediated cellular cytotoxicity mechanism. Second, CD16-CR T cells can target multiple cancer types provided that TAA-specific mAbs with the appropriate specificity are available

Clinical diagnostic potentials of thyroid ultrasonography and scintigraphy; An evaluation

Energy Technology Data Exchange (ETDEWEB)

Torizuka, Tatsuo; Kasagi, Kanji; Hatabu, Hiroto; Misaki, Takashi; Iida, Yasuhiro; Konishi, Junji (Kyoto Univ. (Japan). Hospital); Endo, Keigo

1993-06-01

This prospective study was designed to evaluate the potential contributions of high resolution ultrasonography (US) and Tc-99m scintigraphy in the routine diagnosis of thyroid disease. The diagnostic impacts of US and Tc-99m scintigraphy results in 177 patients visiting our thyroid clinic were assessed and scored according to the following criteria: when the information provided by either test supported, confirmed or changed the initial clinical diagnosis, they received scores of 2, 3 and 4 respectively, while score 1 was given when the test itself was useless for the differential diagnosis. US identified focal lesions that both palpation and scintigraphy had failed to detect in 14 (12.1%) of 116 patients with diffuse thyroid diseases, suggesting the necessity of Hashimoto's thyroiditis, adenoma, adenocarcinoma and adenomatous goiter, and vice versa in the diagnosis of hyperthyroid and euthyroid Graves's diseases. Thus, the advantages of US over scintigraphy for morphological evaluation were confirmed. US was particularly useful for the differential diagnosis of adenomatous goiter from Hashimoto's thyroiditis or a single nodular disease. In contrast, scintigraphy gave functional images, being especially helpful for the differential diagnosis of thyrotoxicosis. (author).

Advantages and Limitations of BiRadstm System Application in Clinical Practice

International Nuclear Information System (INIS)

Torres Tabanera, M.; Acebal Blanco, M. M.

2004-01-01

The BiRads ' T m system (Breast-Imaging Report and Database System) was created by the American College of Radiology in 1992 with the participation of other American scientific societies. It is a quality assurance tool designed to standardize mammographic reports, reduce confusion in the interpretation of breast images and facilitate the monitoring of results. It consists of five sections: breast Imaging Lexicon, Reporting System, Follow-up and Outcome Monitoring, National Mammography Database and Appendices. It was designed in order to create a common lexicon, universally accepted by breast pathology specialists, which would standardize both content and format of mammographic reports, as well as constitute a tool for continuing quality improvement. However, these promising objectives give rise to some serious controversies when sufficient experience is gained in a daily clinical use of the system. In this study, the advantages and contributions of Bi-Rads TM system use is reviewed. Drawbacks are also cited, based on then years experience, with regard to lexicon, categories and recommendations. (Author)

Thermal plasma spraying for SOFCs: Applications, potential advantages, and challenges

Energy Technology Data Exchange (ETDEWEB)

Hui, Rob; Wang, Zhenwei; Jankovic, Jasna; Yick, Sing; Maric, Radenka; Ghosh, Dave [National Research Council Institute for Fuel Cell Innovation, 4250 Wesbrook Mall, Vancouver, BC V6T 1W5 (Canada); Kesler, Olivera [National Research Council Institute for Fuel Cell Innovation, 4250 Wesbrook Mall, Vancouver, BC V6T 1W5 (Canada); Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied Science Lane, Vancouver, BC V6T 1Z4 (Canada); Rose, Lars [National Research Council Institute for Fuel Cell Innovation, 4250 Wesbrook Mall, Vancouver, BC V6T 1W5 (Canada); Department of Materials Engineering, University of British Columbia, 309-6350 Stores Road, Vancouver, BC V6T 1Z4 (Canada)

2007-07-10

In this article, the applications, potential advantages, and challenges of thermal plasma spray (PS) processing for nanopowder production and cell fabrication of solid oxide fuel cells (SOFCs) are reviewed. PS processing creates sufficiently high temperatures to melt all materials fed into the plasma. The heated material can either be quenched into oxide powders or deposited as coatings. This technique has been applied to directly deposit functional layers as well as nanopowder for SOFCs application. In particularly, low melting point and highly active electrodes can be directly fabricated on zirconia-based electrolytes. This is a simple processing technique that does not require the use of organic solvents, offering the opportunity for flexible adjustment of process parameters, and significant time saving in production of the cell and cost reduction compared with tape casting, screen printing and sintering processing steps. Most importantly, PS processing shows strong potential to enable the deposition of metal-supported SOFCs through the integrated fabrication of membrane-electrode assemblies (MEA) on porous metallic substrates with consecutive deposition steps. On the other hand, the application of PS processing to produce SOFCs faces some challenges, such as insufficient porosity of the electrodes, the difficulty of obtaining a thin (<10 {mu}m) and dense electrolyte layer. Fed with H{sub 2} as the fuel gas and oxygen as the oxidant gas, the plasma sprayed cell reached high power densities of 770 mW cm{sup -2} at 900 C and 430 mW cm{sup -2} at 800 C at a cell voltage of 0.7 V. (author)

Clinical advantages of single port laparoscopic hepatectomy.

Science.gov (United States)

Han, Jae Hyun; You, Young Kyoung; Choi, Ho Joong; Hong, Tae Ho; Kim, Dong Goo

2018-01-21

To evaluate the clinical advantages of single-port laparoscopic hepatectomy (SPLH) compare to multi-port laparoscopic hepatectomy (MPLH). We retrospectively reviewed the medical records of 246 patients who underwent laparoscopic liver resection between January 2008 and December 2015 at our hospital. We divided the surgical technique into two groups; SPLH and MPLH. We performed laparoscopic liver resection for both benign and malignant disease. Major hepatectomy such as right and left hepatectomy was also done with sufficient disease-free margin. The operative time, the volume of blood loss, transfusion rate, and the conversion rate to MPLH or open surgery was evaluated. The post-operative parameters included the meal start date after operation, the number of postoperative days spent in the hospital, and surgical complications was also evaluated. Of the 246 patients, 155 patients underwent SPLH and 91 patients underwent MPLH. Conversion rate was 22.6% in SPLH and 19.8% in MPLH ( P = 0.358). We performed major hepatectomy, which was defined as resection of more than 2 sections, in 13.5% of patients in the SPLH group and in 13.3% of patients in the MPLH group ( P = 0.962). Mean operative time was 136.9 ± 89.2 min in the SPLH group and 231.2 ± 149.7 min in the MPLH group ( P started earlier in the SPLH group (1.06 ± 0.27 d after operation) than in the MPLH group (1.63 ± 1.27 d) ( P < 0.001). The mean hospital stay after operation was non-significantly shorter in the SPLH group than in the MPLH group (7.82 ± 2.79 d vs 7.97 ± 3.69 d, P = 0.744). The complication rate was not significantly different ( P = 0.397) and there was no major perioperative complication or mortality case in both groups. Single-port laparoscopic liver surgery seems to be a feasible approach for various kinds of liver diseases.

Comparing Integrated and Disciplinary Clinical Training Patterns for Dental Interns: Advantages, Disadvantages, and Effect on Students' Self-Confidence.

Science.gov (United States)

Wu, Junrong; Feng, Xiaoli; Chen, Aijie; Zhang, Yanli; Liu, Qi; Shao, Longquan

2016-03-01

In China, the five-year program of undergraduate education for stomatology consists of four years of lecture courses and one year of internship focused on clinical training. Dental schools provide this clinical training either in their own clinics (referred to as the one-stage pattern because all forms of practice are completed together) or by placing students in external clinics usually at non-affiliated hospitals (referred to as the three-stage program because the three primary areas are taught separately). The aims of this study were to investigate differences in teaching effect between the one-stage and the three-stage patterns and to evaluate advantages and disadvantages of the two patterns. A three-section, 31-item questionnaire was designed to assess basic and clinic information about the interns' training and their self-confidence in performing clinical procedures. The survey was administered to graduates who finished the fifth-year internship in 2012-14. Of the 356 individuals invited to participate, 303 graduates who spent their intern years in 43 academic dental institutions returned completed surveys (response rate of 85%). The one-stage group (n=121) reported longer independent operation time than the three-stage group (n=182) (p<0.01). No significant difference was found between the groups for assessment of clinic infrastructure (p=0.121). The interns were most confident in oral hygiene instruction and scale and polish (overall median=5), but showed low confidence in rubber dam placement and four other procedures (overall median=2). The one-stage group rated their confidence level higher than the three-stage group on comprehensive skills such as arranging appointments and managing patients and procedures needing long treatment periods such as molar endodontics. The three-stage group showed higher confidence on more specialized procedures such as surgical extractions and suturing. This study found that both of the two intern patterns had advantages and

Abnormal uterine bleeding: advantages of formal classification to patients, clinicians and researchers.

Science.gov (United States)

Madhra, Mayank; Fraser, Ian S; Munro, Malcolm G; Critchley, Hilary O D

2014-07-01

To highlight the advantages of formal classification of causes of abnormal uterine bleeding from a clinical and scientific perspective. Review and recommendations for local implementation. In the past, research in the field of menstrual disorders has not been funded adequately with respect to the impact of symptoms on individuals, healthcare systems and society. This was confounded by a diverse terminology, which lead to confusion between clinical and scientific groups, ultimately harming the underlying evidence base. To address this, a formal classification system (PALM-COEIN) for the causes of abnormal uterine bleeding has been published for worldwide use by FIGO (International Federation of Gynecology and Obstetrics). This commentary explains problems created by the prior absence of such a system, the potential advantages stemming from its use, and practical suggestions for local implementation. The PALM-COEIN classification is applicable globally and, as momentum gathers, will ameliorate recurrence of historic problems, and harmonise reporting of clinical and scientific research to facilitate future progress in women's health. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Polarized phase shift mask: concept, design, and potential advantages to photolithography process and physical design

Science.gov (United States)

Wang, Ruoping; Grobman, Warren D.; Reich, Alfred J.; Thompson, Matthew A.

2002-03-01

In this paper we introduce the concept and design of a novel phase shift mask technology, Polarized Phase Shift Mask (P:PSM). The P:PSM technology utilizes non-interference between orthogonally polarized light sources to avoid undesired destructive interference seen in conventional two-phase shift mask technology. Hence P:PSM solves the well-known 'phase edge' or 'phase conflict' problem. By obviating the 2nd exposure and 2nd mask in current Complementary Phase Shift Mask (C:PSM) technology, this single mask/single exposure technology offers significant advantages towards photolithography process as well as pattern design. We use examples of typical design and process difficulties associated with the C:PSM technology to illustrate the advantages of the P:PSM technology. We present preliminary aerial image simulation results that support the potential of this new reticle technology for enhanced design flexibility. We also propose possible mask structures and manufacturing methods for building a P:PSM.

Harnessing Cerebrospinal Fluid Biomarkers in Clinical Trials for Treating Alzheimer's and Parkinson's Diseases: Potential and Challenges.

Science.gov (United States)

Kim, Dana; Kim, Young Sam; Shin, Dong Wun; Park, Chang Shin; Kang, Ju Hee

2016-10-01

No disease-modifying therapies (DMT) for neurodegenerative diseases (NDs) have been established, particularly for Alzheimer's disease (AD) and Parkinson's disease (PD). It is unclear why candidate drugs that successfully demonstrate therapeutic effects in animal models fail to show disease-modifying effects in clinical trials. To overcome this hurdle, patients with homogeneous pathologies should be detected as early as possible. The early detection of AD patients using sufficiently tested biomarkers could demonstrate the potential usefulness of combining biomarkers with clinical measures as a diagnostic tool. Cerebrospinal fluid (CSF) biomarkers for NDs are being incorporated in clinical trials designed with the aim of detecting patients earlier, evaluating target engagement, collecting homogeneous patients, facilitating prevention trials, and testing the potential of surrogate markers relative to clinical measures. In this review we summarize the latest information on CSF biomarkers in NDs, particularly AD and PD, and their use in clinical trials. The large number of issues related to CSF biomarker measurements and applications has resulted in relatively few clinical trials on CSF biomarkers being conducted. However, the available CSF biomarker data obtained in clinical trials support the advantages of incorporating CSF biomarkers in clinical trials, even though the data have mostly been obtained in AD trials. We describe the current issues with and ongoing efforts for the use of CSF biomarkers in clinical trials and the plans to harness CSF biomarkers for the development of DMT and clinical routines. This effort requires nationwide, global, and multidisciplinary efforts in academia, industry, and regulatory agencies to facilitate a new era.

What are the potential advantages and disadvantages of volumetric CT scanning?

Science.gov (United States)

Voros, Szilard

2009-01-01

After the introduction and dissemination of 64-slice multislice computed tomography systems, cardiovascular CT has arrived at a crossroad, and different philosophies lead down different paths of technologic development. Increased number of detector rows in the z-axis led to the introduction of dynamic, volumetric scanning of the heart and allows for whole-organ imaging. Dynamic, volumetric "whole-organ" scanning significantly reduces image acquisition time; "single-beat whole-heart imaging" results in improved image quality and reduced radiation exposure and reduced contrast dose. It eliminates helical and pitch artifacts and allows for simultaneous imaging of the base and apex of the heart. Beyond coronary arterial luminal imaging, such innovations open up the opportunity for myocardial perfusion and viability imaging and coronary arterial plaque imaging. Dual-source technology with 2 x-ray tubes placed at 90-degree angles provides heart rate-independent temporal resolution and has the potential for tissue characterization on the basis of different attenuation values at different energy levels. Refined detector technology allows for improved low-contrast resolution and may be beneficial for more detailed evaluation of coronary arterial plaque composition. The clinical benefit of each of these technologies will have to be evaluated in carefully designed clinical trials and in everyday clinical practice. Such combined experience will probably show the relative benefit of each of these philosophies in different patient populations and in different clinical scenarios.

Digital linear accelerator: The advantages for radiotherapy

International Nuclear Information System (INIS)

Andric, S.; Maksimovic, M.; Dekic, M.; Clark, T.

1998-01-01

Technical performances of Digital Linear Accelerator were presented to point out its advantages for clinical radiotherapy treatment. The accelerator installation is earned out at Military Medical Academy, Radiotherapy Department, by Medes and Elekta companies. The unit offers many technical advantages with possibility of introduction new conformal treatment techniques as stereotactic radiosurgery, total body and total skin irradiation. In the paper are underlined advantages in relation to running conventional accelerator units at Yugoslav radiotherapy departments, both from technical and medical point of view. (author)

A Conceptual Mapping Resource Advantage Theory, Competitive Advantage Theory, and Transient Competitive Advantage

OpenAIRE

Jasanta PERANGINANGIN

2015-01-01

Competitive advantage is the main purposed of the business entity focusing on market base view. Resource advantage theorists put their concern to empowering resources development with resources based view, in the other side needs to redefining competitive advantage. All the competitive advantage are transient, concluded the end of competitive advantage. Redefining competitive advantage by selling migration and shrewdness outward. This research to emphasize innovation capability rarely appears...

Potential advantages and disadvantages of sequentially building small nuclear units instead of a large nuclear plant

International Nuclear Information System (INIS)

Feretic, D.; Cavlina, N.; Grgic, D.

2008-01-01

Renewal of nuclear power programs in countries with modest electricity consumptions and weak electrical grid interconnections has raised the question of optimal nuclear power plants sizes for such countries. The same question would be also valid for isolated or weakly connected regions within a large country. Building large size nuclear power plant could be prevented by technical or financial limits. Research programs have been initiated in the International Atomic Energy Agency and in the USA (within the framework of the Global Nuclear Energy Partnership (GNEP) program) with the aim to inspect under which circumstances small and medium reactors could be the preferred option compared to large nuclear plants. The economy of scale is a clear advantage of large plants. This paper compares, by using probabilistic methods, the net cash flow of large and medium size plants, taking as example a large nuclear plant (around 1200 MW) and four sequentially built smaller plants (300 MW). Potential advantages and disadvantageous of both options have been considered. Main advantages of the sequential construction of several identical small units could be the reduced investor risk and reduced investment costs due to the learning effect. This analysis is a part of studies for the Croatian power generating system development. (orig.)

Construction and Potential Applications of Biosensors for Proteins in Clinical Laboratory Diagnosis.

Science.gov (United States)

Liu, Xuan; Jiang, Hui

2017-12-04

Biosensors for proteins have shown attractive advantages compared to traditional techniques in clinical laboratory diagnosis. In virtue of modern fabrication modes and detection techniques, various immunosensing platforms have been reported on basis of the specific recognition between antigen-antibody pairs. In addition to profit from the development of nanotechnology and molecular biology, diverse fabrication and signal amplification strategies have been designed for detection of protein antigens, which has led to great achievements in fast quantitative and simultaneous testing with extremely high sensitivity and specificity. Besides antigens, determination of antibodies also possesses great significance for clinical laboratory diagnosis. In this review, we will categorize recent immunosensors for proteins by different detection techniques. The basic conception of detection techniques, sensing mechanisms, and the relevant signal amplification strategies are introduced. Since antibodies and antigens have an equal position to each other in immunosensing, all biosensing strategies for antigens can be extended to antibodies under appropriate optimizations. Biosensors for antibodies are summarized, focusing on potential applications in clinical laboratory diagnosis, such as a series of biomarkers for infectious diseases and autoimmune diseases, and an evaluation of vaccine immunity. The excellent performances of these biosensors provide a prospective space for future antibody-detection-based disease serodiagnosis.

Spatially extended versus frontal cerebral near-infrared spectroscopy during cardiac surgery: a case series identifying potential advantages

Science.gov (United States)

Rummel, Christian; Basciani, Reto; Nirkko, Arto; Schroth, Gerhard; Stucki, Monika; Reineke, David; Eberle, Balthasar; Kaiser, Heiko A.

2018-01-01

Stroke due to hypoperfusion or emboli is a devastating adverse event of cardiac surgery, but early detection and treatment could protect patients from an unfavorable postoperative course. Hypoperfusion and emboli can be detected with transcranial Doppler of the middle cerebral artery (MCA). The measured blood flow velocity correlates with cerebral oxygenation determined clinically by near-infrared spectroscopy (NIRS) of the frontal cortex. We tested the potential advantage of a spatially extended NIRS in detecting critical events in three cardiac surgery patients with a whole-head fiber holder of the FOIRE-3000 continuous-wave NIRS system. Principle components analysis was performed to differentiate between global and localized hypoperfusion or ischemic territories of the middle and anterior cerebral arteries. In one patient, we detected a critical hypoperfusion of the right MCA, which was not apparent in the frontal channels but was accompanied by intra- and postoperative neurological correlates of ischemia. We conclude that spatially extended NIRS of temporal and parietal vascular territories could improve the detection of critically low cerebral perfusion. Even in severe hemispheric stroke, NIRS of the frontal lobe may remain normal because the anterior cerebral artery can be supplied by the contralateral side directly or via the anterior communicating artery.

Advantages of robotics in benign gynecologic surgery.

Science.gov (United States)

Truong, Mireille; Kim, Jin Hee; Scheib, Stacey; Patzkowsky, Kristin

2016-08-01

The purpose of this article is to review the literature and discuss the advantages of robotics in benign gynecologic surgery. Minimally invasive surgery has become the preferred route over abdominal surgery. The laparoscopic or robotic approach is recommended when vaginal surgery is not feasible. Thus far, robotic gynecologic surgery data have demonstrated feasibility, safety, and equivalent clinical outcomes in comparison with laparoscopy and better clinical outcomes compared with laparotomy. Robotics was developed to overcome challenges of laparoscopy and has led to technological advantages such as improved ergonomics, visualization with three-dimensional capabilities, dexterity and range of motion with instrument articulation, and tremor filtration. To date, applications of robotics in benign gynecology include hysterectomy, myomectomy, endometriosis surgery, sacrocolpopexy, adnexal surgery, tubal reanastomosis, and cerclage. Though further data are needed, robotics may provide additional benefits over other approaches in the obese patient population and in higher complexity cases. Challenges that arose in the earlier adoption stage such as the steep learning curve, costs, and operative times are becoming more optimized with greater experience, with implementation of robotics in high-volume centers and with improved training of surgeons and robotic teams. Robotic laparoendoscopic single-site surgery, albeit still in its infancy where technical advantages compared with laparoscopic single-site surgery are still unclear, may provide a cost-reducing option compared with multiport robotics. The cost may even approach that of laparoscopy while still conferring similar perioperative outcomes. Advances in robotic technology such as the single-site platform and telesurgery, have the potential to revolutionize the field of minimally invasive gynecologic surgery. Higher quality evidence is needed to determine the advantages and disadvantages of robotic surgery in benign

Complexity and availability for fusion power plants: The potential advantages of inertial fusion energy

International Nuclear Information System (INIS)

Perkins, L.J.

1997-01-01

Probably the single largest advantage of the inertial route to fusion energy (IFE) is the perception that its power plant embodiments could achieve acceptable capacity factors. This is a result of its relative simplicity, the decoupling of the driver and reactor chamber, and the potential to employ thick liquid walls. The author examines these issues in terms of the complexity, reliability, maintainability and, therefore, availability of both magnetic and inertial fusion power plants and compares these factors with corresponding scheduled and unscheduled outage data from present day fission experience. The author stresses that, given the simple nature of a fission core, the vast majority of unplanned outages in fission plants are due to failures outside the reactor vessel itself. Given one must be prepared for similar outages in the analogous plant external to a fusion power core, this puts severe demands on the reliability required of the fusion core itself. The author indicates that such requirements can probably be met for IFE plants. He recommends that this advantage be promoted by performing a quantitative reliability and availability study for a representative IFE power plant and suggests that databases are probably adequate for this task. 40 refs., 4 figs., 3 tabs

The entry-level occupational therapy clinical doctorate: advantages, challenges, and international issues to consider.

Science.gov (United States)

Brown, Ted; Crabtree, Jeffrey L; Mu, Keli; Wells, Joe

2015-04-01

Internationally, occupational therapy education has gone through several paradigm shifts during the last few decades, moving from certificate to diploma to bachelors to masters and now in some instances to clinical doctorate as the entry-level professional credential to practice. In the United States there is a recommendation under consideration by the American Occupational Therapy Association (AOTA) that by 2025, all occupational therapy university programs will move to the clinical doctorate level. It should be noted, however, that the AOTA Board can only make recommendations and it is the Accreditation Council for Occupational Therapy Education (ACOTE) who has regulatory authority to approve such a change. What are the potential implications for the profession, our clients, and funders of occupational therapy services? What are the primary drivers for the move towards the clinical doctorate being the educational entry point? Is the next step in the evolution of occupational therapy education globally a shift to the entry-level clinical doctorate? This article reviews current literature and discusses issues about the occupational therapy entry-level clinical doctorate. The published evidence available about the occupational therapy entry-level clinical doctorate is summarized and the perceived or frequently cited pros and cons of moving to the clinical doctorate as the singular entry point to occupational therapy practice are considered. The potential impacts of the introduction of the clinical doctorate as the entry-to-practice qualification across the United States on the occupational therapy community internationally will be briefly discussed. If the United States moves toward the entry-level clinical doctorate as the only educational starting point for the profession, will other jurisdictions follow suit? Further discourse and investigation of this issue both inside and outside of the United States is needed so that informed decisions can be made.

Advantage of fan beam collimators for contrast recovery of hyperfixation in clinical SPECT

International Nuclear Information System (INIS)

Vera, P.

1997-01-01

The influence of the collimator on the contrast recovery of hyperfixation was studied using a dual-headed single photon emission computer tomography (SPECT) system with standard clinical acquisition parameters. Three parallel collimator sets and two fan beam collimator sets were tested with a Jaszczak phantom. The six spheres of the phantom were filled with 99m Tc, and four background levels were progressively obtained by adding radioactivity to the cylinder of the phantom, providing four hyperfixation levels. The effects of angular sampling and reconstruction filters have been tested. The statistical analysis was performed with analysis of variance (ANOVA). This study demonstrates the advantage of ultra-high resolution fan beam collimators for contrast recovery of hyperfixation with SPECT when using 64 projections over 360 degree, in particular when the contrast is low. The authors also demonstrate that fan beam collimators permit smaller size hyperfixation detection

Clinical potential of implantable wireless sensors for orthopedic treatments.

Science.gov (United States)

Karipott, Salil Sidharthan; Nelson, Bradley D; Guldberg, Robert E; Ong, Keat Ghee

2018-04-01

Implantable wireless sensors have been used for real-time monitoring of chemicals and physical conditions of bones, tendons and muscles to diagnose and study orthopedic diseases and injuries. Due to the importance of these sensors in orthopedic care, a critical review, which not only analyzes the underlying technologies but also their clinical implementations and challenges, will provide a landscape view on their current state and their future clinical role. Areas covered: By conducting an extensive literature search and following the leaders of orthopedic implantable wireless sensors, this review covers the battery-powered and battery-free wireless implantable sensor technologies, and describes their implementation for hips, knees, spine, and shoulder stress/strain monitoring. Their advantages, limitations, and clinical challenges are also described. Expert commentary: Currently, implantable wireless sensors are mostly limited for scientific investigations and demonstrative experiments. Although rapid advancement in sensors and wireless technologies will push the reliability and practicality of these sensors for clinical realization, regulatory constraints and financial viability in medical device industry may curtail their continuous adoption for clinical orthopedic applications. In the next five years, these sensors are expected to gain increased interest from researchers, but wide clinical adoption is still unlikely.

MOLDOVA: MISSED ADVANTAGES OF EURASIAN INTEGRATION

Directory of Open Access Journals (Sweden)

Ludmila Vasiljevna Fokina

2015-01-01

Full Text Available The article is devoted to potentially missed advantages of Eurasian integration (EAEU for Moldova. Special attention is given to the branches in which the country could get evident advantages including agriculture, power engineering, external trade ties with the EAEU countries. Possible positive effects of Eurasian integration in solution of the Transnistrian problem, in the sphere of labour migration and other fields are also shown.

Does being female provide a neuroprotective advantage following spinal cord injury?

Directory of Open Access Journals (Sweden)

Jeffrey P Datto

2015-01-01

Full Text Available It has been controversial whether gender has any effect on recovery following spinal cord injury (SCI. Past experimental and clinical research aimed at addressing this subject has led to constrasting findings on whether females hold any advantage in locomotor recovery. Additionally, for studies supporting the notion of a female gender related advantage, a definite cause has not been explained. In a recent study, using large sample sizes for comparative male and female spinal cord injury cohorts, we reported that a significant gender advantage favoring females existed in both tissue preservation and functional recovery after taking into consideration discrepancies in age and weight of the animals across sexes. Prior animal research frequently used sample sizes that were too small to determine significance with certainty and also did not account for two other factors that influence locomotor performance: age and weight. Our finding is important in light of controversy surrounding the effect of gender on outcome and the fact that SCI affects more than ten thousand new individuals annually, a population that is disproportionately male. By deepening our understanding of why a gender advantage exists, potential new therapeutics can be designed to improve recovery for the male population following the initial trauma or putatively augment the neuroprotective privilege in females for enhanced outcomes.

The Advantages, Potentials and Safety of VTOL Suborbital Space Tourism Operations

Science.gov (United States)

Ridzuan Zakaria, N.; Nasrun, N.; Abu, J.; Jusoh, A.; Azim, L.; Said, A.; Ishak, S.; Rafidi Zakaria, N.

2012-01-01

more risky for a suborbital vehicle to fly above such objects after taking off from a spaceport far away from the object, and later returning to the spaceport, the way to go is to have the operation of the suborbital vehicle near the exotic locations. Unfortunately, some exotic locations such as a tropical archipelago in the middle of a clear blue ocean or a permanent icecap on a mountain range with variety of vegetation around it due to differences in height may not have suitable runway to function as spaceport, and for such reason, VTOL (vertical take-off and landing) capability for suborbital tourism vehicle may be worth considered. VTOL suborbital space tourism vehicle may not operate from a remote uneconomical location even though the location is near an exotic viewing target, but such vehicle may operate from a luxury super yacht that can sail to exotic locations around the world, and during the journey, the passengers can be trained and prepared for the flight of their life. Such is an advantage and potential of VTOL suborbital space tourism vehicle, but VTOL operation can be more complex than a conventional operation and therefore will increase the risk of operation, and for this reason the safety issue for such operation is very significant. This paper explores and discusses some advantages and potentials of VTOL suborbital space tourism operations and safety issues related to them. It also describes a couple of proposed concepts of VTOL suborbital tourism vehicles and potential exotic locations on Earth to be viewed from such vehicles.

Assessment of potential advantages of relevant ions for particle therapy: A model based study

Energy Technology Data Exchange (ETDEWEB)

Grün, Rebecca, E-mail: r.gruen@gsi.de [Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt 64291 (Germany); Institute of Medical Physics and Radiation Protection, University of Applied Sciences Gießen, Gießen 35390 (Germany); Medical Faculty of Philipps-University Marburg, Marburg 35032 (Germany); Friedrich, Thomas; Krämer, Michael; Scholz, Michael [Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt 64291 (Germany); Zink, Klemens [Institute of Medical Physics and Radiation Protection, University of Applied Sciences Gießen, Gießen 35390, Germany and Department of Radiotherapy and Radiation Oncology, University Medical Center Giessen and Marburg, Marburg 35043 (Germany); Durante, Marco [Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt 64291, Germany and Department of Condensed Matter Physics, Darmstadt University of Technology, Darmstadt 64289 (Germany); Engenhart-Cabillic, Rita [Medical Faculty of Philipps-University Marburg, Marburg 35032, Germany and Department of Radiotherapy and Radiation Oncology, University Medical Center Giessen and Marburg, Marburg 35043 (Germany)

2015-02-15

Purpose: Different ion types offer different physical and biological advantages for therapeutic applications. The purpose of this work is to assess the advantages of the most commonly used ions in particle therapy, i.e., carbon ({sup 12}C), helium ({sup 4}He), and protons ({sup 1}H) for different treatment scenarios. Methods: A treatment planning analysis based on idealized target geometries was performed using the treatment planning software TRiP98. For the prediction of the relative biological effectiveness (RBE) that is required for biological optimization in treatment planning the local effect model (LEM IV) was used. To compare the three ion types, the peak-to-entrance ratio (PER) was determined for the physical dose (PER{sub PHY} {sub S}), the RBE (PER{sub RBE}), and the RBE-weighted dose (PER{sub BIO}) resulting for different dose-levels, field configurations, and tissue types. Further, the dose contribution to artificial organs at risk (OAR) was assessed and a comparison of the dose distribution for the different ion types was performed for a patient with chordoma of the skull base. Results: The study showed that the advantages of the ions depend on the physical and biological properties and the interplay of both. In the case of protons, the consideration of a variable RBE instead of the clinically applied generic RBE of 1.1 indicates an advantage in terms of an increased PER{sub RBE} for the analyzed configurations. Due to the fact that protons show a somewhat better PER{sub PHY} {sub S} compared to helium and carbon ions whereas helium shows a higher PER{sub RBE} compared to protons, both protons and helium ions show a similar RBE-weighted dose distribution. Carbon ions show the largest variation of the PER{sub RBE} with tissue type and a benefit for radioresistant tumor types due to their higher LET. Furthermore, in the case of a two-field irradiation, an additional gain in terms of PER{sub BIO} is observed when using an orthogonal field configuration

Medicare Advantage and Fee-for-Service Performance on Clinical Quality and Patient Experience Measures: Comparisons from Three Large States.

Science.gov (United States)

Timbie, Justin W; Bogart, Andy; Damberg, Cheryl L; Elliott, Marc N; Haas, Ann; Gaillot, Sarah J; Goldstein, Elizabeth H; Paddock, Susan M

2017-12-01

To compare performance between Medicare Advantage (MA) and Fee-for-Service (FFS) Medicare during a time of policy changes affecting both programs. Performance data for 16 clinical quality measures and 6 patient experience measures for 9.9 million beneficiaries living in California, New York, and Florida. We compared MA and FFS performance overall, by plan type, and within service areas associated with contracts between CMS and MA organizations. Case mix-adjusted analyses (for measures not typically adjusted) were used to explore the effect of case mix on MA/FFS differences. Performance measures were submitted by MA organizations, obtained from the nationwide fielding of the Medicare Consumer Assessment of Healthcare Providers and Systems (MCAHPS) Survey, or derived from claims. Overall, MA outperformed FFS on all 16 clinical quality measures. Differences were large for HEDIS measures and small for Part D measures and remained after case mix adjustment. MA enrollees reported better experiences overall, but FFS beneficiaries reported better access to care. Relative to FFS, performance gaps were much wider for HMOs than PPOs. Excluding HEDIS measures, MA/FFS differences were much smaller in contract-level comparisons. Medicare Advantage/Fee-for-Service differences are often large but vary in important ways across types of measures and contracts. © Health Research and Educational Trust.

Drivers of Collaborative Advantage

DEFF Research Database (Denmark)

Weihe, Gudrid

processes and behavioural dimensions is practically non-existent. This article tries to remedy the current gap in the literature by reviewing research findings on interfirm collaboration (alliances). On that basis a conceptual framework for analyzing partnership processes is developed. Finally......, the antecedents of collaborative advantage are theoretically examined, and the organizational competences contributing to collaborative success are identified. The conclusion is that operational processes and social dynamics are vital drivers of collaborative advantage. Another significant conclusion...... is that public management research can benefit from drawing upon existing alliance research. Alliance scholars have during the past couple of decades accumulated an impressive amount of knowledge on different aspects of inter-firm cooperation, and therefore the learning potential for public management scholars...

Institutional advantage

NARCIS (Netherlands)

Martin, Xavier

Is there such a thing as institutional advantage—and what does it mean for the study of corporate competitive advantage? In this article, I develop the concept of institutional competitive advantage, as distinct from plain competitive advantage and from comparative institutional advantage. I first

Point-of-care testing (POCT) and evidence-based laboratory medicine (EBLM) - does it leverage any advantage in clinical decision making?

Science.gov (United States)

Florkowski, Christopher; Don-Wauchope, Andrew; Gimenez, Nuria; Rodriguez-Capote, Karina; Wils, Julien; Zemlin, Annalise

Point-of-care testing (POCT) is the analysis of patient specimens outside the clinical laboratory, near or at the site of patient care, usually performed by clinical staff without laboratory training, although it also encompasses patient self-monitoring. It is able to provide a rapid result near the patient and which can be acted upon immediately. The key driver is the concept that clinical decision making may be delayed when samples are sent to the clinical laboratory. Balanced against this are considerations of increased costs for purchase and maintenance of equipment, staff training, connectivity to the laboratory information system (LIS), quality control (QC) and external quality assurance (EQA) procedures, all required for accreditation under ISO 22870. The justification for POCT depends upon being able to demonstrate that a more timely result (shorter turnaround times (TATs)) is able to leverage a clinically important advantage in decision making compared with the central laboratory (CL). In the four decades since POCT was adapted for the self-monitoring of blood glucose levels by subjects with diabetes, numerous new POCT methodologies have become available, enabling the clinician to receive results and initiate treatment more rapidly. However, these instruments are often operated by staff not trained in laboratory medicine and hence are prone to errors in the analytical phase (as opposed to laboratory testing where the analytical phase has the least errors). In some environments, particularly remote rural settings, the CL may be at a considerable distance and timely availability of cardiac troponins and other analytes can triage referrals to the main centers, thus avoiding expensive unnecessary patient transportation costs. However, in the Emergency Department, availability of more rapid results with POCT does not always translate into shorter stays due to other barriers to implementation of care. In this review, we apply the principles of evidence

Advantages and Applications of CAR-Expressing Natural Killer Cells

Directory of Open Access Journals (Sweden)

Wolfgang eGlienke

2015-02-01

Full Text Available In contrast to donor T cells, natural killer (NK cells are known to mediate anti-cancer effects without the risk of inducing graft-versus-host disease (GvHD. In order to improve cytotoxicity against resistant cancer cells, auspicious efforts have been made with chimeric antigen receptor (CAR expressing T- and NK cells. These CAR-modified cells express antigen receptors against tumor-associated surface antigens, thus redirecting the effector cells and enhancing tumor-specific immunosurveillance. However, many cancer antigens are also expressed on healthy tissues, potentially leading to off tumor/ on target toxicity by CAR-engineered cells. In order to control such potentially severe side effects, the insertion of suicide genes into CAR-modified effectors can provide a means for efficient depletion of these cells. While CAR-expressing T cells have entered successfully clinical trials, experience with CAR-engineered NK cells is mainly restricted to pre-clinical investigations and predominantly to NK cell lines. In this review we summarize the data on CAR expressing NK cells focusing on the possible advantage using these short-lived effector cells and discuss the necessity of suicide switches. Furthermore, we address the compliance of such modified NK cells with regulatory requirements as a new field in cellular immunotherapy.

Multipotent Mesenchymal Stromal Stem Cell Expansion by Plating Whole Bone Marrow at a Low Cellular Density: A More Advantageous Method for Clinical Use

Directory of Open Access Journals (Sweden)

Katia Mareschi

2012-01-01

Full Text Available Mesenchymal stem cells (MSCs are a promising source for cell therapy due to their pluripotency and immunomodulant proprieties. As the identification of “optimal” conditions is important to identify a standard procedure for clinical use. Percoll, Ficoll and whole bone marrow directly plated were tested from the same sample as separation methods. The cells were seeded at the following densities: 100 000, 10 000, 1000, 100, 10 cells/cm2. After reaching confluence, the cells were detached, pooled and re-plated at 1000, 500, 100, and 10 cells/cm2. Statistical analyses were performed. Cumulative Population Doublings (PD did not show significant differences for the separation methods and seeding densities but only for the plating density. Some small quantity samples plated in T25 flasks at plating densities of 10 and 100 cells/cm2 did not produce any expansion. However, directly plated whole bone marrow resulted in a more advantageous method in terms of CFU-F number, cellular growth and minimal manipulation. No differences were observed in terms of gross morphology, differentiation potential or immunophenotype. These data suggest that plating whole bone marrow at a low cellular density may represent a good procedure for MSC expansion for clinical use.

Multipotent Mesenchymal Stromal Stem Cell Expansion by Plating Whole Bone Marrow at a Low Cellular Density: A More Advantageous Method for Clinical Use

Science.gov (United States)

Mareschi, Katia; Rustichelli, Deborah; Calabrese, Roberto; Gunetti, Monica; Sanavio, Fiorella; Castiglia, Sara; Risso, Alessandra; Ferrero, Ivana; Tarella, Corrado; Fagioli, Franca

2012-01-01

Mesenchymal stem cells (MSCs) are a promising source for cell therapy due to their pluripotency and immunomodulant proprieties. As the identification of “optimal” conditions is important to identify a standard procedure for clinical use. Percoll, Ficoll and whole bone marrow directly plated were tested from the same sample as separation methods. The cells were seeded at the following densities: 100 000, 10 000, 1000, 100, 10 cells/cm2. After reaching confluence, the cells were detached, pooled and re-plated at 1000, 500, 100, and 10 cells/cm2. Statistical analyses were performed. Cumulative Population Doublings (PD) did not show significant differences for the separation methods and seeding densities but only for the plating density. Some small quantity samples plated in T25 flasks at plating densities of 10 and 100 cells/cm2 did not produce any expansion. However, directly plated whole bone marrow resulted in a more advantageous method in terms of CFU-F number, cellular growth and minimal manipulation. No differences were observed in terms of gross morphology, differentiation potential or immunophenotype. These data suggest that plating whole bone marrow at a low cellular density may represent a good procedure for MSC expansion for clinical use. PMID:23715383

Does cultural integration explain a mental health advantage for adolescents?

Science.gov (United States)

Bhui, Kamaldeep S; Lenguerrand, Erik; Maynard, Maria J; Stansfeld, Stephen A; Harding, Seeromanie

2012-06-01

A mental health advantage has been observed among adolescents in urban areas. This prospective study tests whether cultural integration measured by cross-cultural friendships explains a mental health advantage for adolescents. A prospective cohort of adolescents was recruited from 51 secondary schools in 10 London boroughs. Cultural identity was assessed by friendship choices within and across ethnic groups. Cultural integration is one of four categories of cultural identity. Using gender-specific linear-mixed models we tested whether cultural integration explained a mental health advantage, and whether gender and age were influential. Demographic and other relevant factors, such as ethnic group, socio-economic status, family structure, parenting styles and perceived racism were also measured and entered into the models. Mental health was measured by the Strengths and Difficulties Questionnaire as a 'total difficulties score' and by classification as a 'probable clinical case'. A total of 6643 pupils in first and second years of secondary school (ages 11-13 years) took part in the baseline survey (2003/04) and 4785 took part in the follow-up survey in 2005-06. Overall mental health improved with age, more so in male rather than female students. Cultural integration (friendships with own and other ethnic groups) was associated with the lowest levels of mental health problems especially among male students. This effect was sustained irrespective of age, ethnicity and other potential explanatory variables. There was a mental health advantage among specific ethnic groups: Black Caribbean and Black African male students (Nigerian/Ghanaian origin) and female Indian students. This was not fully explained by cultural integration, although cultural integration was independently associated with better mental health. Cultural integration was associated with better mental health, independent of the mental health advantage found among specific ethnic groups: Black Caribbean and

Does cultural integration explain a mental health advantage for adolescents?

Science.gov (United States)

Bhui, Kamaldeep S; Lenguerrand, Erik; Maynard, Maria J; Stansfeld, Stephen A; Harding, Seeromanie

2012-01-01

Background A mental health advantage has been observed among adolescents in urban areas. This prospective study tests whether cultural integration measured by cross-cultural friendships explains a mental health advantage for adolescents. Methods A prospective cohort of adolescents was recruited from 51 secondary schools in 10 London boroughs. Cultural identity was assessed by friendship choices within and across ethnic groups. Cultural integration is one of four categories of cultural identity. Using gender-specific linear-mixed models we tested whether cultural integration explained a mental health advantage, and whether gender and age were influential. Demographic and other relevant factors, such as ethnic group, socio-economic status, family structure, parenting styles and perceived racism were also measured and entered into the models. Mental health was measured by the Strengths and Difficulties Questionnaire as a ‘total difficulties score’ and by classification as a ‘probable clinical case’. Results A total of 6643 pupils in first and second years of secondary school (ages 11–13 years) took part in the baseline survey (2003/04) and 4785 took part in the follow-up survey in 2005–06. Overall mental health improved with age, more so in male rather than female students. Cultural integration (friendships with own and other ethnic groups) was associated with the lowest levels of mental health problems especially among male students. This effect was sustained irrespective of age, ethnicity and other potential explanatory variables. There was a mental health advantage among specific ethnic groups: Black Caribbean and Black African male students (Nigerian/Ghanaian origin) and female Indian students. This was not fully explained by cultural integration, although cultural integration was independently associated with better mental health. Conclusions Cultural integration was associated with better mental health, independent of the mental health advantage

Seven-day human biological rhythms: An expedition in search of their origin, synchronization, functional advantage, adaptive value and clinical relevance.

Science.gov (United States)

Reinberg, Alain E; Dejardin, Laurence; Smolensky, Michael H; Touitou, Yvan

2017-01-01

This fact-finding expedition explores the perspectives and knowledge of the origin and functional relevance of the 7 d domain of the biological time structure, with special reference to human beings. These biological rhythms are displayed at various levels of organization in diverse species - from the unicellular sea algae of Acetabularia and Goniaulax to plants, insects, fish, birds and mammals, including man - under natural as well as artificial, i.e. constant, environmental conditions. Nonetheless, very little is known about their derivation, functional advantage, adaptive value, synchronization and potential clinical relevance. About 7 d cosmic cycles are seemingly too weak, and the 6 d work/1 d rest week commanded from G-d through the Laws of Mosses to the Hebrews is too recent an event to be the origin in humans. Moreover, human and insect studies conducted under controlled constant conditions devoid of environmental, social and other time cues report the persistence of 7 d rhythms, but with a slightly different (free-running) period (τ), indicating their source is endogenous. Yet, a series of human and laboratory rodent studies reveal certain mainly non-cyclic exogenous events can trigger 7 d rhythm-like phenomena. However, it is unknown whether such triggers unmask, amplify and/or synchronize previous non-overtly expressed oscillations. Circadian (~24 h), circa-monthly (~30 d) and circannual (~1 y) rhythms are viewed as genetically based features of life forms that during evolution conferred significant functional advantage to individual organisms and survival value to species. No such advantages are apparent for endogenous 7 d rhythms, raising several questions: What is the significance of the 7 d activity/rest cycle, i.e. week, storied in the Book of Genesis and adopted by the Hebrews and thereafter the residents of nearby Mediterranean countries and ultimately the world? Why do humans require 1 d off per 7 d span? Do 7 d rhythms bestow functional

Adaptive Treatment Strategies in Youth Mental Health: A Commentary on Advantages, Challenges, and Potential Directions.

Science.gov (United States)

Sherrill, Joel T

2016-01-01

This commentary underscores the importance and potential of the research approaches and intervention strategies described in the JCCAP special issue on the Science of Adaptive Treatment Strategies in Child and Adolescent Mental Health for addressing the widely observed heterogeneity in response to even our most promising research-informed interventions. First, the commentary briefly summarizes the advantages of these approaches and highlights how these programs of research are responsive to widely agreed-upon calls for more personalized, prescriptive interventions. Next, the commentary briefly discusses key common challenges and gaps in our knowledge that might be addressed to advance the development, testing, and implementation of adaptive intervention strategies. For example, research to identify robust moderators that might serve as potential tailoring variables for initial assignment and sequencing of interventions, efforts to operationalize surrogate endpoints for early identification of individuals who are unlikely to respond to first-line interventions, and research that helps define what constitutes an adequate exposure (i.e., dose) or response threshold (e.g., response that suggests the need to intensify, switch, or augment interventions) would inform decision rules for adaptive algorithms. The commentary concludes with a discussion of potential strategies and current initiatives that might ultimately help facilitate research on more targeted, prescriptive approaches to intervening, including efforts to encourage investigators to use common data elements, to share and integrate data across trials, and to employ a more mechanism-based approach to intervention development and testing.

Mobile Device-Based Electronic Data Capture System Used in a Clinical Randomized Controlled Trial: Advantages and Challenges.

Science.gov (United States)

Zhang, Jing; Sun, Lei; Liu, Yu; Wang, Hongyi; Sun, Ningling; Zhang, Puhong

2017-03-08

Electronic data capture (EDC) systems have been widely used in clinical research, but mobile device-based electronic data capture (mEDC) system has not been well evaluated. The aim of our study was to evaluate the feasibility, advantages, and challenges of mEDC in data collection, project management, and telemonitoring in a randomized controlled trial (RCT). We developed an mEDC to support an RCT called "Telmisartan and Hydrochlorothiazide Antihypertensive Treatment (THAT)" study, which was a multicenter, double-blinded, RCT, with the purpose of comparing the efficacy of telmisartan and hydrochlorothiazide (HCTZ) monotherapy in high-sodium-intake patients with mild to moderate hypertension during a 60 days follow-up. Semistructured interviews were conducted during and after the trial to evaluate the feasibility, advantage, and challenge of mEDC. Nvivo version 9.0 (QSR International) was used to analyze records of interviews, and a thematic framework method was used to obtain outcomes. The mEDC was successfully used to support the data collection and project management in all the 14 study hospitals. A total of 1333 patients were recruited with support of mEDC, of whom 1037 successfully completed all 4 visits. Across all visits, the average time needed for 141 questions per patient was 53 min, which were acceptable to both doctors and patients. All the interviewees, including 24 doctors, 53 patients, 1 clinical research associate (CRA), 1 project manager (PM), and 1 data manager (DM), expressed their satisfaction to nearly all the functions of the innovative mEDC in randomization, data collection, project management, quality control, and remote monitoring in real time. The average satisfaction score was 9.2 (scale, 0-10). The biggest challenge came from the stability of the mobile or Wi-Fi signal although it was not a problem in THAT study. The innovative mEDC has many merits and is well acceptable in supporting data collection and project management in a timely

Transnasal endoscopy: Technical considerations, advantages and limitations.

Science.gov (United States)

Atar, Mustafa; Kadayifci, Abdurrahman

2014-02-16

Transnasal endoscopy (TNE) is an upper endoscopy method which is performed by the nasal route using a thin endoscope less than 6 mm in diameter. The primary goal of this method is to improve patient tolerance and convenience of the procedure. TNE can be performed without sedation and thus eliminates the risks associated with general anesthesia. In this way, TNE decreases the cost and total duration of endoscopic procedures, while maintaining the image quality of standard caliber endoscopes, providing good results for diagnostic purposes. However, the small working channel of the ultra-thin endoscope used for TNE makes it difficult to use for therapeutic procedures except in certain conditions which require a thinner endoscope. Biopsy is possible with special forceps less than 2 mm in diameter. Recently, TNE has been used for screening endoscopy in Far East Asia, including Japan. In most controlled studies, TNE was found to have better patient tolerance when compared to unsedated endoscopy. Nasal pain is the most significant symptom associated with endoscopic procedures but can be reduced with nasal pretreatment. Despite the potential advantage of TNE, it is not common in Western countries, usually due to a lack of training in the technique and a lack of awareness of its potential advantages. This paper briefly reviews the technical considerations as well as the potential advantages and limitations of TNE with ultra-thin scopes.

Transnasal endoscopy: Technical considerations, advantages and limitations

Science.gov (United States)

Atar, Mustafa; Kadayifci, Abdurrahman

2014-01-01

Transnasal endoscopy (TNE) is an upper endoscopy method which is performed by the nasal route using a thin endoscope less than 6 mm in diameter. The primary goal of this method is to improve patient tolerance and convenience of the procedure. TNE can be performed without sedation and thus eliminates the risks associated with general anesthesia. In this way, TNE decreases the cost and total duration of endoscopic procedures, while maintaining the image quality of standard caliber endoscopes, providing good results for diagnostic purposes. However, the small working channel of the ultra-thin endoscope used for TNE makes it difficult to use for therapeutic procedures except in certain conditions which require a thinner endoscope. Biopsy is possible with special forceps less than 2 mm in diameter. Recently, TNE has been used for screening endoscopy in Far East Asia, including Japan. In most controlled studies, TNE was found to have better patient tolerance when compared to unsedated endoscopy. Nasal pain is the most significant symptom associated with endoscopic procedures but can be reduced with nasal pretreatment. Despite the potential advantage of TNE, it is not common in Western countries, usually due to a lack of training in the technique and a lack of awareness of its potential advantages. This paper briefly reviews the technical considerations as well as the potential advantages and limitations of TNE with ultra-thin scopes. PMID:24567791

The reactivation of the natural potentials of Belgrade: Biophilia and biomimicry as new competitive advantages?

Directory of Open Access Journals (Sweden)

Stupar Aleksandra

2013-01-01

Full Text Available Climate changes have influenced a new comprehension of living environment and instigated a number of trends noticeable in society, architecture and development strategies. The shaping of a purified, sustainable and 'low/no carbon' urban context, which has a higher environmental quality, has become an imperative which should be achieved by ecologically responsible behavior. Cities, as major nodes of global transmission and dissemination, act as experimental polygons. They simultaneously test the latest ecological and technological concepts, especially those based on the logic of natural systems - such as biophilia and biomimicry. Their application enables an intensive integration of nature into urban space, while the manifestation of nature - as a shape, function or a level of adaptability - becomes a new competitive advantage. The planning practice in Serbia has also started its gradual adjustment to the new imperatives but the pace of change is slow. Belgrade has recognized the importance of the latest ecoideas but they have not been materialized so far. The natural core of Belgrade, which consists of several river isles, river banks, forests and forelands, is nowadays emphasized as an important comparative advantage which could generate further changes in 'green' perception of urban environment. Therefore, the purpose of this article is to identify the potential of two natural areas within this core (Ada Ciganlija and Ada Medjica, critically evaluate their development possibilities based on biophilia and biomimicry, and to provide a set of recommendations which would support the activation and development of a similar natural area - Ada Čaplja.

Clinically relevant potential drug-drug interactions among outpatients: A nationwide database study.

Science.gov (United States)

Jazbar, Janja; Locatelli, Igor; Horvat, Nejc; Kos, Mitja

2018-06-01

Adverse drug events due to drug-drug interactions (DDIs) represent a considerable public health burden, also in Slovenia. A better understanding of the most frequently occurring potential DDIs may enable safer pharmacotherapy and minimize drug-related problems. The aim of this study was to evaluate the prevalence and predictors of potential DDIs among outpatients in Slovenia. An analysis of potential DDIs was performed using health claims data on prescription drugs from a nationwide database. The Lexi-Interact Module was used as the reference source of interactions. The influence of patient-specific predictors on the risk of potential clinically relevant DDIs was evaluated using logistic regression model. The study population included 1,179,803 outpatients who received 15,811,979 prescriptions. The total number of potential DDI cases identified was 3,974,994, of which 15.6% were potentially clinically relevant. Altogether, 9.3% (N = 191,213) of the total population in Slovenia is exposed to clinically relevant potential DDIs, and the proportion is higher among women and the elderly. After adjustment for cofactors, higher number of medications and older age are associated with higher odds of clinically relevant potential DDIs. The burden of DDIs is highest with drug combinations that increase risk of bleeding, enhance CNS depression or anticholinergic effects or cause cardiovascular complications. The current study revealed that 1 in 10 individuals in the total Slovenian population is exposed to clinically relevant potential DDIs yearly. Taking into account the literature based conservative estimate that approximately 1% of potential DDIs result in negative health outcomes, roughly 1800 individuals in Slovenia experience an adverse health outcome each year as a result of clinically relevant potential interactions alone. Copyright © 2017 Elsevier Inc. All rights reserved.

Existing data sources for clinical epidemiology: Aarhus University Clinical Trial Candidate Database, Denmark.

Science.gov (United States)

Nørrelund, Helene; Mazin, Wiktor; Pedersen, Lars

2014-01-01

Denmark is facing a reduction in clinical trial activity as the pharmaceutical industry has moved trials to low-cost emerging economies. Competitiveness in industry-sponsored clinical research depends on speed, quality, and cost. Because Denmark is widely recognized as a region that generates high quality data, an enhanced ability to attract future trials could be achieved if speed can be improved by taking advantage of the comprehensive national and regional registries. A "single point-of-entry" system has been established to support collaboration between hospitals and industry. When assisting industry in early-stage feasibility assessments, potential trial participants are identified by use of registries to shorten the clinical trial startup times. The Aarhus University Clinical Trial Candidate Database consists of encrypted data from the Danish National Registry of Patients allowing an immediate estimation of the number of patients with a specific discharge diagnosis in each hospital department or outpatient specialist clinic in the Central Denmark Region. The free access to health care, thorough monitoring of patients who are in contact with the health service, completeness of registration at the hospital level, and ability to link all databases are competitive advantages in an increasingly complex clinical trial environment.

Next-Generation Sequencing in Clinical Molecular Diagnostics of Cancer: Advantages and Challenges

Directory of Open Access Journals (Sweden)

Rajyalakshmi Luthra

2015-10-01

Full Text Available The application of next-generation sequencing (NGS to characterize cancer genomes has resulted in the discovery of numerous genetic markers. Consequently, the number of markers that warrant routine screening in molecular diagnostic laboratories, often from limited tumor material, has increased. This increased demand has been difficult to manage by traditional low- and/or medium-throughput sequencing platforms. Massively parallel sequencing capabilities of NGS provide a much-needed alternative for mutation screening in multiple genes with a single low investment of DNA. However, implementation of NGS technologies, most of which are for research use only (RUO, in a diagnostic laboratory, needs extensive validation in order to establish Clinical Laboratory Improvement Amendments (CLIA and College of American Pathologists (CAP-compliant performance characteristics. Here, we have reviewed approaches for validation of NGS technology for routine screening of tumors. We discuss the criteria for selecting gene markers to include in the NGS panel and the deciding factors for selecting target capture approaches and sequencing platforms. We also discuss challenges in result reporting, storage and retrieval of the voluminous sequencing data and the future potential of clinical NGS.

[Motivation of patients to participate in clinical trials. An explorative survey].

Science.gov (United States)

Gaul, Charly; Malcherczyk, Annett; Schmidt, Thomas; Helm, Jürgen; Haerting, Johannes

2010-02-01

Difficulties in recruiting patients for clinical trials lead to increasing costs, and prolonged implementation of evidences into medical practice. Knowledge about motivation and barriers in potential participants would be helpful to develop successful recruitment strategies. Currently, no systematic research of determining factors affecting the decision to participate in clinical studies is available from German samples. After been given details about a potential participation in a clinical or diagnostic study in nine study centers, patients were recruited for an additional structured questionnaire survey concerning motivation and barriers to participation. 62 patients were included into the survey. 95.1% did not have any experience with clinical studies before. 66.1% met the physician explaining the study and asking for informed consent for the first time. Despite this, 96.6% judged the physician to be competent. Family and friends were important for decision-making about the participation in a study. Gender was only of marginal influence. The majority of patients (91.4%) expected advantages of the study for their own. 88% of the patients denominated potential advantages for other patients as an additional motivator. The possibility of adverse events was inferior for patients in decision-making about participation in a clinical trial. Physicians recruiting patients for clinical studies should be well prepared about details of the study and should have adequate time for an introductory conversation in a quiet environment. Including relatives into the introductory conversation may enhance the motivation and therefore the success of recruitment. Potential advantages of a participation for the own treatment and additionally for other patients should be highlighted. Possible side effects should be explained in a realistic manner.

ALTERNATIVE ROUTES OF DRUG ADMINISTRATION: ADVANTAGES AND DISADVANTAGES (SUBJECT REVIEW OF AMERICAN ACADEMY OF PEDIATRICS

Directory of Open Access Journals (Sweden)

article editorial

2006-01-01

Full Text Available During the past 20 years advances in drug formulations and innovative routes of administration have been made. Our understanding of drug transport across tissues has increased. These changes have often resulted in improved patient adherence to the therapeutic regiment and pharmacologic response. The administration of drugs by transdermal or transmucosal routes offers the advantage of being relatively painless. Also, the potential for greater flexibility in a variety of clinical situations exists, often precluding the need to establish intravinus access which is a particular benefit for children. This statement focuses on the advantages and disadvantages of alternative routes of drug administration. Issues of particular importance in the care of pediatric patients especially factors that could lead to drug-relaxed toxicity or adverse responses are emphasized.Key words: drug formulation, pharmacoKINETICS, pharmacodynamics, drug, children.

Thoracoscopic versus robotic approaches: advantages and disadvantages.

Science.gov (United States)

Wei, Benjamin; D'Amico, Thomas A

2014-05-01

The overall advantages of thoracoscopy over thoracotomy in terms of patient recovery have been fairly well established. The use of robotics, however, is a newer and less proven modality in the realm of thoracic surgery. Robotics offers distinct advantages and disadvantages in comparison with video-assisted thoracoscopic surgery. Robotic technology is now used for a variety of complex cardiac, urologic, and gynecologic procedures including mitral valve repair and microsurgical treatment of male infertility. This article addresses the potential benefits and limitations of using the robotic platform for the performance of a variety of thoracic operations. Copyright © 2014 Elsevier Inc. All rights reserved.

TRIENNIAL GROWTH AND DEVELOPMENT SYMPOSIUM: Dedifferentiated fat cells: Potential and perspectives for their use in clinical and animal science purpose.

Science.gov (United States)

Duarte, M S; Bueno, R; Silva, W; Campos, C F; Gionbelli, M P; Guimarães, S E F; Silva, F F; Lopes, P S; Hausman, G J; Dodson, M V

2017-05-01

An increasing body of evidences has demonstrated the ability of the mature adipocyte to dedifferentiate into a population of proliferative-competent cells known as dedifferentiated fat (DFAT) cells. As early as the 1970s, in vitro studies showed that DFAT cells may be obtained by ceiling culture, which takes advantage of the buoyancy property of lipid-filled cells. It was documented that DFAT cells may acquire a phenotype similar to mesenchymal stem cells and yet may differentiate into multiple cell lineages, such as skeletal and smooth muscle cells, cardiomyocytes, osteoblasts, and adipocytes. Additionally, recent studies showed the ability of isolated mature adipocytes to dedifferentiate in vivo and the capacity of the progeny cells to redifferentiate into mature adipocytes, contributing to the increase of body fatness. These findings shed light on the potential for use of DFAT cells, not only for clinical purposes but also within the animal science field, because increasing intramuscular fat without excessive increase in other fat depots is a challenge in livestock production. Knowledge of the mechanisms underlying the dedifferentiation and redifferentiation of DFAT cells will allow the development of strategies for their use for clinical and animal science purposes. In this review, we highlight several aspects of DFAT cells, their potential for clinical purposes, and their contribution to adipose tissue mass in livestock.

Maximizing scientific knowledge from randomized clinical trials

DEFF Research Database (Denmark)

Gustafsson, Finn; Atar, Dan; Pitt, Bertram

2010-01-01

, in particular with respect to collaboration with the trial sponsor and to analytic pitfalls. The advantages of creating screening databases in conjunction with a given clinical trial are described; and finally, the potential for posttrial database studies to become a platform for training young scientists...

Submitted for your consideration: potential advantages of a novel clinical trial design and initial patient reaction

Directory of Open Access Journals (Sweden)

Matthew Shane Loop

2012-08-01

Full Text Available In many circumstances, individuals do not respond identically to the same treatment. This phenomenon, which is called treatment response heterogeneity (TRH, appears to be present in treatments for many conditions, including obesity. Estimating the total amount of TRH, predicting an individual’s response, and identifying the mediators of TRH are of interest to biomedical researchers. Clinical investigators and physicians commonly postulate that some of these mediators could be genetic. Current designs can estimate TRH as a function of specific, measurable observed factors; however, they cannot estimate the total amount of TRH, nor provide reliable estimates of individual persons’ responses. We propose a new repeated randomizations design (RRD, which can be conceived as a generalization of the Balaam design, that would allow estimates of that variability and facilitate estimation of the total amount of TRH, prediction of an individual’s response, and identification of the mediators of TRH. In a pilot study, we asked 118 subjects entering a weight loss trial for their opinion of the RRD, and they stated a preference for the RRD over the conventional 2-arm parallel groups design. Research is needed as to how the RRD will work in practice and its relative statistical properties, and we invite dialogue about it.

Nitrogen-Based Diazeniumdiolates: Versatile Nitric Oxide-Releasing Compounds for Biomedical Research and Potential Clinical Applications

Science.gov (United States)

Saavedra, Joseph E.; Keefer, Larry K.

2002-12-01

Nitric oxide-generating ions of the nitrogen-diazeniumdiolate class with the general structure R1R2N-[N(O)NO]1 have been prepared by exposing primary, secondary, and polyamines to nitric oxide (NO). The resulting complexes regenerate bioactive NO at physiological pH with half-lives ranging from 2 seconds to 20 hours. An important goal in our research is to deliver NO to a specific organ or cell type where it is needed without affecting other NO-sensitive parts of the anatomy. By taking advantage of the remarkable chemical versatility of diazeniumdiolates, we have developed general strategies to prepare either tissue-selective NO donor drugs or materials containing NO delivery agents that can be physically placed near the target sites. Inhibition of blood coagulation, induction of penile erection, relief of pulmonary hypertension, and reversal of cerebral vasospasm are a few examples of their potential clinical applications. See Featured Molecules.

Potential of adaptive clinical trial designs in pharmacogenetic research, A simulation based on the IPASS trial

NARCIS (Netherlands)

Van Der Baan, Frederieke H.; Knol, Mirjam J.|info:eu-repo/dai/nl/304820350; Klungel, Olaf H.|info:eu-repo/dai/nl/181447649; Egberts, Toine C.G.|info:eu-repo/dai/nl/162850050; Grobbee, Diederick E.; Roes, Kit C.B.

2011-01-01

Background: An adaptive clinical trial design that allows population enrichment after interim analysis can be advantageous in pharmacogenetic research if previous evidence is not strong enough to exclude part of the patient population beforehand.With this design, underpowered studies or unnecessary

Virtual online consultations: advantages and limitations (VOCAL) study.

Science.gov (United States)

Greenhalgh, Trisha; Vijayaraghavan, Shanti; Wherton, Joe; Shaw, Sara; Byrne, Emma; Campbell-Richards, Desirée; Bhattacharya, Satya; Hanson, Philippa; Ramoutar, Seendy; Gutteridge, Charles; Hodkinson, Isabel; Collard, Anna; Morris, Joanne

2016-01-29

Remote video consultations between clinician and patient are technically possible and increasingly acceptable. They are being introduced in some settings alongside (and occasionally replacing) face-to-face or telephone consultations. To explore the advantages and limitations of video consultations, we will conduct in-depth qualitative studies of real consultations (microlevel) embedded in an organisational case study (mesolevel), taking account of national context (macrolevel). The study is based in 2 contrasting clinical settings (diabetes and cancer) in a National Health Service (NHS) acute trust in London, UK. Main data sources are: microlevel--audio, video and screen capture to produce rich multimodal data on 45 remote consultations; mesolevel--interviews, ethnographic observations and analysis of documents within the trust; macrolevel--key informant interviews of national-level stakeholders and document analysis. Data will be analysed and synthesised using a sociotechnical framework developed from structuration theory. City Road and Hampstead NHS Research Ethics Committee, 9 December 2014, reference 14/LO/1883. We plan outputs for 5 main audiences: (1) academics: research publications and conference presentations; (2) service providers: standard operating procedures, provisional operational guidance and key safety issues; (3) professional bodies and defence societies: summary of relevant findings to inform guidance to members; (4) policymakers: summary of key findings; (5) patients and carers: 'what to expect in your virtual consultation'. The research literature on video consultations is sparse. Such consultations offer potential advantages to patients (who are spared the cost and inconvenience of travel) and the healthcare system (eg, they may be more cost-effective), but fears have been expressed that they may be clinically risky and/or less acceptable to patients or staff, and they bring significant technical, logistical and regulatory challenges. We

Absolute advantage

NARCIS (Netherlands)

J.G.M. van Marrewijk (Charles)

2008-01-01

textabstractA country is said to have an absolute advantage over another country in the production of a good or service if it can produce that good or service using fewer real resources. Equivalently, using the same inputs, the country can produce more output. The concept of absolute advantage can

Mammography - recent technical developments and their clinical potential

Energy Technology Data Exchange (ETDEWEB)

Hemdal, Bengt; Mattsson, Soeren [Malmoe Univ. Hospital (Sweden). Dept. of Radiation Physics; Andersson, Ingvar [Malmoe Univ. Hospital (Sweden). Dept. of Diagnostic Radiology; Thilander Klang, Anne [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Medical Physics and Biomedical Engineering; Bengtsson, Gert; Jarlman, O. [Lund Univ. Hospital (Sweden). Dept. of Diagnostic Radiology; Leitz, Wolfram [Swedish Radiation Protection Authority, Stockholm (Sweden); Bjurstam, Nils [Univ. of North Norway, Troms (Norway). Dept. of Radiology

2002-05-01

The recent technical developments in digital as well as screen-film X-ray mammography have been reviewed in order to evaluate their clinical potential and to analyse possible lines for future development. Material and methods: The scientific literature has been reviewed, conferences covered and contacts with colleagues developed. Companies in the field have been inquired and invited for presentations. Own experience has been gathered from different screen-film and digital mammography systems. Results and conclusions: Although there are important complementary techniques such as ultrasound and magnetic resonance imaging (MRI), X-ray mammography is still the golden standard for breast imaging. It is relatively simple and cost-effective, and it is presently the only realistic technique for screening in a large scale. It is still largely the only technique that can detect breast cancer in a pre invasive stage. Equipment for digital mammography is commercially available both with small area and full field technique (FFDM). The development of FFDM systems is now intense, as well as the development of dedicated workstations and computer-aided detection (CAD). In spite of this, the introduction of digital mammography has been very slow compared to most other X-ray examinations due to high costs and technical challenges to meet the high demands on image quality and dose in mammography as well as the demands on specialised workflow support for screening mammography and suitable display techniques. Film reading of digital mammograms has been the most common display mode so far, but to take full advantage of the digital concept, diagnostic as well as logistic, monitor reading must be applied. There is a potential of FFDM systems for significantly higher image quality or significantly lower dose than screen-film mammography (SFM), or both. Further research is necessary to fully use this potential. The investment costs are much higher for digital than screen-film mammography

Mammography - recent technical developments and their clinical potential

International Nuclear Information System (INIS)

Hemdal, Bengt; Mattsson, Soeren; Bjurstam, Nils

2002-05-01

The recent technical developments in digital as well as screen-film X-ray mammography have been reviewed in order to evaluate their clinical potential and to analyse possible lines for future development. Material and methods: The scientific literature has been reviewed, conferences covered and contacts with colleagues developed. Companies in the field have been inquired and invited for presentations. Own experience has been gathered from different screen-film and digital mammography systems. Results and conclusions: Although there are important complementary techniques such as ultrasound and magnetic resonance imaging (MRI), X-ray mammography is still the golden standard for breast imaging. It is relatively simple and cost-effective, and it is presently the only realistic technique for screening in a large scale. It is still largely the only technique that can detect breast cancer in a pre invasive stage. Equipment for digital mammography is commercially available both with small area and full field technique (FFDM). The development of FFDM systems is now intense, as well as the development of dedicated workstations and computer-aided detection (CAD). In spite of this, the introduction of digital mammography has been very slow compared to most other X-ray examinations due to high costs and technical challenges to meet the high demands on image quality and dose in mammography as well as the demands on specialised workflow support for screening mammography and suitable display techniques. Film reading of digital mammograms has been the most common display mode so far, but to take full advantage of the digital concept, diagnostic as well as logistic, monitor reading must be applied. There is a potential of FFDM systems for significantly higher image quality or significantly lower dose than screen-film mammography (SFM), or both. Further research is necessary to fully use this potential. The investment costs are much higher for digital than screen-film mammography

Explaining Asian Americans’ academic advantage over whites

Science.gov (United States)

Hsin, Amy; Xie, Yu

2014-01-01

The superior academic achievement of Asian Americans is a well-documented phenomenon that lacks a widely accepted explanation. Asian Americans’ advantage in this respect has been attributed to three groups of factors: (i) socio-demographic characteristics, (ii) cognitive ability, and (iii) academic effort as measured by characteristics such as attentiveness and work ethic. We combine data from two nationally representative cohort longitudinal surveys to compare Asian-American and white students in their educational trajectories from kindergarten through high school. We find that the Asian-American educational advantage is attributable mainly to Asian students exerting greater academic effort and not to advantages in tested cognitive abilities or socio-demographics. We test explanations for the Asian–white gap in academic effort and find that the gap can be further attributed to (i) cultural differences in beliefs regarding the connection between effort and achievement and (ii) immigration status. Finally, we highlight the potential psychological and social costs associated with Asian-American achievement success. PMID:24799702

Explaining Asian Americans' academic advantage over whites.

Science.gov (United States)

Hsin, Amy; Xie, Yu

2014-06-10

The superior academic achievement of Asian Americans is a well-documented phenomenon that lacks a widely accepted explanation. Asian Americans' advantage in this respect has been attributed to three groups of factors: (i) socio-demographic characteristics, (ii) cognitive ability, and (iii) academic effort as measured by characteristics such as attentiveness and work ethic. We combine data from two nationally representative cohort longitudinal surveys to compare Asian-American and white students in their educational trajectories from kindergarten through high school. We find that the Asian-American educational advantage is attributable mainly to Asian students exerting greater academic effort and not to advantages in tested cognitive abilities or socio-demographics. We test explanations for the Asian-white gap in academic effort and find that the gap can be further attributed to (i) cultural differences in beliefs regarding the connection between effort and achievement and (ii) immigration status. Finally, we highlight the potential psychological and social costs associated with Asian-American achievement success.

Competitive versus comparative advantage

OpenAIRE

Neary, J. Peter

2002-01-01

I explore the interactions between comparative, competitive and absolute advantage in a two-country model of oligopoly in general equilibrium. Comparative advantage always determines the direction of trade, but both competitive and absolute advantage affect resource allocation, trade patterns and trade volumes. Competitive advantage in the sense of more home firms drives foreign firms out of marginal sectors but also makes some marginal home sectors uncompetitive. Absolute advantage in the se...

LASIK vs LASEK vs PRK: advantages and indications.

Science.gov (United States)

Ambrósio, Renato; Wilson, Steven

2003-03-01

The advent of the excimer laser as an instrument for use in reshaping the corneal stroma was a great step forward in refractive surgery. Laser energy can be delivered on the stromal surface in the photorefractive keratectomy (PRK) procedure or deeper on the corneal stroma by the means of a lamellar surgery in which a flap is created with the microkeratome in the laser in situ keratomileusis (LASIK) procedure. LASIK is currently the dominant procedure in refractive surgery. The main advantage of LASIK over PRK is related to maintaining the central corneal epithelium. This increases comfort during the early post-operative period, allows for rapid visual recovery, and reduces the wound healing response. Reduced wound healing correlates with less regression for high corrections and a lower rate of complications such as significant stromal opacity (haze). PRK, however, remains as an excellent option for mild to moderate corrections, particularly for cases associated with thin corneas, recurrent erosions, or a predisposition for trauma (Martial arts, military, etc.). Recently, a modification of PRK, laser subepithelial keratomileusis (LASEK), was introduced. In the LASEK procedure, an epithelial flap is created and replaced after the ablation. The benefits, if any, of the creation of an epithelial flap compared to traditional PRK are not fully appreciated. Advocates of LASEK suggest that there is less discomfort in the early postoperative period, faster visual recovery, and less haze compared to standard PRK for correction of similar levels of refractive error. Additional long-term clinical studies, along with laboratory research, will be crucial to validate these potential advantages of LASEK procedure.

Safety and environmental advantages of breeding blanketless fusion reactors

International Nuclear Information System (INIS)

Zucchetti, M.; Merola, M.; Matera, R.

1994-01-01

Next-step reactors will use DT cycle. However, environmental advantage will be the main chance for fusion to compete with other energy sources. The environmental problems of DT cycle due to tritium and neutron activation, are examined. Fusion commercial reactors could be based on alternative fuel cycles like D-He3. Advantages and disadvantages of this fuel cycle are outlined. All the technologies related with the self-breeding of tritium and the concept of breeding blanket itself may be not reactor relevant. In the frame of the Next-step studies, the potential advantages of intermediate DT devices without breeding blanket are discussed. Simplified design, lower cost, higher safety are the main ones. The problem of the source of tritium is examined. (author)

Tunable resistive pulse sensing: potential applications in nanomedicine.

Science.gov (United States)

Sivakumaran, Muttuswamy; Platt, Mark

2016-08-01

An accurate characterization of nanomaterials used in clinical diagnosis and therapeutics is of paramount importance to realize the full potential of nanotechnology in medicine and to avoid unexpected and potentially harmful toxic effects due to these materials. A number of technical modalities are currently in use to study the physical, chemical and biological properties of nanomaterials but they all have advantages and disadvantages. In this review, we discuss the potential of a relative newcomer, tunable resistive pulse sensing, for the characterization of nanomaterials and its applications in nanodiagnostics.

Enzyme-potentiated desensitization in otolaryngic allergy.

Science.gov (United States)

Pulec, Jack L

2002-03-01

This is a preliminary report of a new method of treating otolaryngic allergy with enzyme-potentiated desensitization (EPD). The nature of EPD and its use in otolaryngology are described. Thirty-six patients have been treated and followed in a private medical practice since February 1997. This article reviews the clinical features of EPD and provides six cases as examples; the clinical features described include allergic rhinitis, serous otitis media, asthma, dermatitis, fixed food allergy, and Ménière's disease. EPD is an effective technique for the treatment of otolaryngic allergy and offers advantages over conventional techniques.

Advantages and disadvantages of biodegradable platforms in drug eluting stents.

Science.gov (United States)

Rodriguez-Granillo, Agustina; Rubilar, Bibiana; Rodriguez-Granillo, Gaston; Rodriguez, Alfredo E

2011-03-26

Coronary angioplasty with drug-eluting stent (DES) implantation is currently the most common stent procedure worldwide. Since the introduction of DES, coronary restenosis as well as the incidence of target vessel and target lesion revascularization have been significantly reduced. However, the incidence of very late stent thrombosis beyond the first year after stent deployment has more commonly been linked to DES than to bare-metal stent (BMS) implantation. Several factors have been associated with very late stent thrombosis after DES implantation, such as delayed healing, inflammation, stent mal-apposition and endothelial dysfunction. Some of these adverse events were associated with the presence of durable polymers, which were essential to allow the elution of the immunosuppressive drug in the first DES designs. The introduction of erodable polymers in DES technology has provided the potential to complete the degradation of the polymer simultaneously or immediately after the release of the immunosuppressive drug, after which a BMS remains in place. Several DES designs with biodegradable (BIO) polymers have been introduced in preclinical and clinical studies, including randomized trials. In this review, we analyze the clinical results from 6 observational and randomized studies with BIO polymers and discuss advantages and disadvantages of this new technology.

Scandinavian Cooperative Advantage

DEFF Research Database (Denmark)

Strand, Robert; Freeman, R. Edward

2015-01-01

. We conclude by endorsing the expression “Scandinavian cooperative advantage” in an effort to draw attention to the Scandinavian context and encourage the field of strategic management to shift its focus from achieving a competitive advantage toward achieving a cooperative advantage....

Accessing offshoring advantages

DEFF Research Database (Denmark)

Mykhaylenko, Alona; Motika, Agnes; Wæhrens, Brian Vejrum

2015-01-01

. Assuming that different levels of synergy may exist between particular offshoring strategic decisions (choosing offshore outsourcing or captive offshoring and the type of function) and different offshoring advantages, this work advocates that the actual fact of realization of certain offshoring advantages...

What are the potential benefits of clinical beta-cell imaging in diabetes mellitus?

Science.gov (United States)

Göke, Burkhard

2010-05-01

Previously, studies of the endocrine pancreatic beta-cell were mainly performed ex vivo by morphological means. This data supported the analysis of pathophysiological changes in the pancreatic islet during insults such as diabetes mellitus. Metabolic testing of the pancreatic islet by assaying hormone parameters such als plasma insulin or C-peptide combined with more or less sophisticated calculations allowed conclusions about states of insulin resistance or secretory failure. It also allowed certain correlations of endocrine function with beta-cell mass. Today, with firmer pathophysiological concepts about beta-cell failure, modern protocols of islet transplantation, and drugs on the market coming with promises of preservation or even expansion of beta-cell mass in diabetes mellitus it has become very attractive to search for tools measuring beta-cell mass, if possible even repeatingly in the same organism in vivo. From a clinical point of view, the potential of pancreatic beta-cell mass imaging technologies is looked upon with high expectations. Methodologically, the decisive question is whether it is likely that future beta-cell imaging will provide significant advantages over the metabolic methods already in hand. With new in vivo tools, studies of beta-cell mass and function may offer even new approaches stratifying patients to anti-diabetic therapies.

Repetitive transcranial magnetic stimulation as a neuropsychiatric tool: present status and future potential.

Science.gov (United States)

Post, R M; Kimbrell, T A; McCann, U D; Dunn, R T; Osuch, E A; Speer, A M; Weiss, S R

1999-03-01

Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising therapeutic intervention in the treatment of affective disorders. The differences in the type of electrical stimulation required for therapeutic efficacy by rTMS and electroconvulsive therapy (ECT) are discussed. In contrast to ECT, rTMS would not appear to require the generation of a major motor seizure to achieve therapeutic efficacy. Accordingly, it carries the potentially important clinical advantages of not requiring anesthesia and of avoiding side effects such as transient memory loss. Preclinical studies on long-term potentiation (LTP) and long-term depression (LTD) in hippocampal and amygdala slices, as well as clinical data from neuroimaging studies, have provided encouraging clues for potential frequency-dependent effects of rTMS. Preliminary evidence from position emission tomography (PET) scans suggests that higher frequency (20 Hz) stimulation may increase brain glucose metabolism in a transsynaptic fashion, whereas lower frequency (1 Hz) stimulation may decrease it. Therefore, the ability of rTMS to control the frequency as well as the location of stimulation, in addition to its other advantages, has opened up new possibilities for clinical explorations and treatments of neuropsychiatric conditions.

Which competitive advantages can firms really obtain from ISO14001 certification?

Directory of Open Access Journals (Sweden)

Josefina Lucia Murillo-Luna

2008-12-01

Full Text Available Ten years after the introduction of ISO14001, in this paper we present empirical evidence about the competitive advantages that managers associate to this environmental practice, from a sample of industrial firms located in Spain. The results indicate that the potential competitive advantages are: improvement of the internal efficiency, differentiation advantages, attention to the stakeholders’ requirements, enhancement of the competitive position in the sector and financial savings. Nevertheless managers’ expectations of improving internal efficiency might be the real reason that encourages firms to make the voluntary decision of investing in ISO14001 certification.

7T: Physics, safety, and potential clinical applications.

Science.gov (United States)

Kraff, Oliver; Quick, Harald H

2017-12-01

With more than 60 installed magnetic resonance imaging (MRI) systems worldwide operating at a magnetic field strength of 7T or higher, ultrahigh-field (UHF) MRI has been established as a platform for clinically oriented research in recent years. Profound technical and methodological developments have helped overcome the inherent physical challenges of UHF radiofrequency (RF) signal homogenization in the human body. The ongoing development of dedicated RF coil arrays was pivotal in realizing UHF body MRI, beyond mere brain imaging applications. Another precondition to clinical application of 7T MRI is the safety testing of implants and the establishment of safety concepts. Against this backdrop, 7T MRI and MR spectroscopy (MRS) recently have demonstrated capabilities and potentials for clinical diagnostics in a variety of studies. This article provides an overview of the immanent physical challenges of 7T UHF MRI and discusses recent technical solutions and safety concepts. Furthermore, recent clinically oriented studies are highlighted that span a broad application spectrum from 7T UHF brain to body MRI. 4 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1573-1589. © 2017 International Society for Magnetic Resonance in Medicine.

Advantages of digital imaging for radiological diagnostic

International Nuclear Information System (INIS)

Trapero, M. A.; Gonzalez, S.; Albillos, J. C.; Martel, J.; Rebollo, M.

2006-01-01

The advantages and limitations of radiological digital images in comparison with analogic ones are analyzed. We discuss three main topics: acquisition, post-procedure manipulation, and visualization, archive and communication. Digital acquisition with computed radiology systems present a global sensitivity very close to conventional film for diagnostic purposes. However, flat panel digital systems seems to achieve some advantages in particular clinical situations. A critical issue is the radiation dose-reduction that can be accomplished without reducing image quality nor diagnostic exactitude. The post-procedure manipulation allows, particularly in multiplanar modalities like CT or MR, to extract all implicit diagnostic information in the images: Main procedures are multiplanar and three-dimensional reformations, dynamic acquisitions, functional studies and image fusion. The use of PACS for visualization, archive and communication of images, improves the effectiveness and the efficiency of the workflow, allows a more comfortable diagnosis for the radiologist and gives way to improvements in the communication of images, allowing tele consulting and the tele radiology. (Author) 6 refs

COMPETITIVE PRODUCT ADVANTAGES

Directory of Open Access Journals (Sweden)

Adrian MICU

2006-01-01

Full Text Available Cost advantages may be either internal or external. Internal economics of scope, scale, or experience, and external economies of focus or logistical integration, enable a company to produce some products at a lower cost than the competition. The coordination of pricing with suppliers, although not actually economizing resources, can improve the efficiency of pricing by avoiding the incrementalization of a supplier's nonincremental fixed costs and profit. Any of these strategies can generate cost advantages that are, at least in the short run, sustainable. Even cost advantages that are not sustainable, however, can generate temporary savings that are often the key to building more sustainable cost or product advantages later.. Even when a product's physical attributes are not readily differentiable, opportunities to develop product advantages remain. The augmented product that customers buy is more than the particular product or service exchanged. It includes all sorts of ancillary services and intangible relationships that make buying thesame product from one company less difficult, less risky, or more pleasant than buying from a competitor. Superior augmentation of the same basic product can add substantial value in the eyes of consumers, leading them to pay willingly what are often considerable price premiums.

Mesenchymal stem cells: Properties and clinical potential for cell based therapies in reconstructive surgery with a focus on peripheral nerve surgery

Directory of Open Access Journals (Sweden)

Kuhbier, Jörn W.

2015-08-01

Full Text Available The isolation and expansion of multipotent mesenchymal stem cells (MSCs could be demonstrated from bone marrow, peripheral blood, skin, umbilical cord blood and adipose issue. They can be differentiated to different mesodermal cell lines like bone, cartilage, muscle or adipose tissue cells as well as . Thus MSCs represent an attractive cell population for the substitution of mesenchymal tissues via tissue engineering due to their potential of differentiation and their favourable expansion properties. In contrast to embryonic stem cells (ESCs they have the advantage that they can be autologously harvested in high numbers. Besides, there are fewer ethical issues in the use of MSCs. Another advantage of MSCs is the highly regenerative secretion profile of cytokines and growth factors, in particular supporting angiogenesis. A plethora of studies describe the morphological and phenotypical characterization of this cell type as well as regulatory mechanisms lying the differentiation into specific tissues aiming to optimize conditions for differentiation and thus clinical application. This review describes the definition of a mesenchymal stem cell, methods for isolation and phenotypical characterization, possibilities of differentiation and possible therapeutical applications of MSCs.

Advantages and limitations of potential methods for the analysis of bacteria in milk: a review.

Science.gov (United States)

Tabit, Frederick Tawi

2016-01-01

Contamination concerns in the dairy industry are motivated by outbreaks of disease in humans and the inability of thermal processes to eliminate bacteria completely in processed products. HACCP principles are an important tool used in the food industry to identify and control potential food safety hazards in order to meet customer demands and regulatory requirements. Milk testing is of importance to the milk industry regarding quality assurance and monitoring of processed products by researchers, manufacturers and regulatory agencies. Due to the availability of numerous methods used for analysing the microbial quality of milk in literature and differences in priorities of stakeholders, it is sometimes confusing to choose an appropriate method for a particular analysis. The objective of this paper is to review the advantages and disadvantages of selected techniques that can be used in the analysis of bacteria in milk. SSC, HRMA, REP, and RAPD are the top four techniques which are quick and cost-effective and possess adequate discriminatory power for the detection and profiling of bacteria. The following conclusions were arrived at during this review: HRMA, REP and RFLP are the techniques with the most reproducible results, and the techniques with the most discriminatory power are AFLP, PFGE and Raman Spectroscopy.

How to Achieve a Competitive Advantage

OpenAIRE

Adina Musetescu

2013-01-01

In order to succeed in any market a company has to decide which strategy is more appropriate to use, which means identifying the sources of a potential competitive advantage such as skills or resources. Superior skills in creating a special product can represent the element that is setting the company apart from its competitors. That is easily translated into a very good quality of the products. The resources of the company refer to the great number of retailers (a good distribution chain tha...

Polyploidy in haloarchaea: advantages for growth and survival

Directory of Open Access Journals (Sweden)

Karolin eZerulla

2014-06-01

Full Text Available The investigated haloarchaeal species, Halobacterium salinarum, Haloferax mediterranii, and H. volcanii, have all been shown to be polyploid. They contain several replicons that have independent copy number regulation, and most have a higher copy number during exponential growth phase than stationary phase. The possible evolutionary advantages of polyploidy for haloarchaea, most of which have experimental support for at least one species, are discussed. These advantages include a low mutation rate and high resistance towards X-ray irradiation and desiccation, which depend on homologous recombination. For H. volcanii, it has been shown that gene conversion operates in the absence of selection, which leads to the equalization of genome copies. On the other hand, selective forces might lead to heterozygous cells, which have been verified in the laboratory. Additional advantages of polyploidy are survival over geological times in halite deposits as well as at extreme conditions on earth and at simulated Mars conditions. Recently, it was found that H. volcanii uses genomic DNA as genetic material and as a storage polymer for phosphate. In the absence of phosphate, H. volcanii dramatically decreases its genome copy number, thereby enabling cell multiplication, but diminishing the genetic advantages of polyploidy. Stable storage of phosphate is proposed as an alternative driving force for the emergence of DNA in early evolution. Several additional potential advantages of polyploidy are discussed that have not been addressed experimentally for haloarchaea. An outlook summarizes selected current trends and possible future developments.

The Survival Advantage: Underlying Mechanisms and Extant Limitations

Directory of Open Access Journals (Sweden)

Stephanie A. Kazanas

2015-04-01

Full Text Available Recently, researchers have begun to investigate the function of memory in our evolutionary history. According to Nairne and colleagues (e.g., Nairne, Pandeirada, and Thompson, 2008; Nairne, Thompson, and Pandeirada, 2007, the best mnemonic strategy for learning lists of unrelated words may be one that addresses the same problems that our Pleistocene ancestors faced: fitness-relevant problems including securing food and water, as well as protecting themselves from predators. Survival processing has been shown to promote better recall and recognition memory than many well-known mnemonic strategies (e.g., pleasantness ratings, imagery, generation, etc.. However, the survival advantage does not extend to all types of stimuli and tasks. The current review presents research that has replicated Nairne et al.'s (2007 original findings, in addition to the research designs that fail to replicate the survival advantage. In other words, there are specific manipulations in which survival processing does not appear to benefit memory any more than other strategies. Potential mechanisms for the survival advantage are described, with an emphasis on those that are the most plausible. These proximate mechanisms outline the memory processes that may contribute to the advantage, although the ultimate mechanism may be the congruity between the survival scenario and Pleistocene problem-solving.

Are research papers reporting results from nutrigenetics clinical research a potential source of biohype?

Science.gov (United States)

Stenne, R; Hurlimann, T; Godard, Béatrice

2012-01-01

Nutrigenetics is a promising field, but the achievability of expected benefits is challenged by the methodological limitations that are associated with clinical research in that field. The mere existence of these limitations suggests that promises about potential outcomes may be premature. Thus, benefits claimed in scientific journal articles in which these limitations are not acknowledged might stimulate biohype. This article aims to examine whether nutrigenetics clinical research articles are a potential source of biohype. Of the 173 articles identified, 16 contained claims in which clinical applications were extrapolated from study results. The methodological limitations being incompletely acknowledged, these articles could potentially be a source of biohype.

Potential Advantages of Underground Nuclear Parks

International Nuclear Information System (INIS)

Myers, Carl W.; Elkins, Ned Z.; Kunze, Jay F.; Mahar, James M.

2006-01-01

In this paper we argue that an underground nuclear park (UNP) could potentially lead to lower capital and operating cost for the reactors installed in the UNP compared to the traditional approach, which would be to site the reactors at the earth's surface at distributed locations. The UNP approach could also lead to lower waste management cost. A secondary benefit would be the increased margins of safety and security that would be realized simply as a consequence of siting the reactors underground. Lowered capital and operating cost for a UNP relative to traditional reactor siting is possible through the aggregate effect of the elimination of containment structures, in-place decommissioning, reduced physical security costs, reduced weather-related costs, reduced cost of liability insurance and reduced unit-cost for the nth reactor made possible through the continuous construction of multiple reactors at the same underground location. Other cost reductions might be possible through the transfer of the capital cost for part of the underground construction from the reactor owners to the owners of the UNP. Lower waste management cost is possible by siting the UNP at a location where there are geological and hydrological conditions suitable for hosting both the reactors and the repository for the waste from those reactors. After adequate storage and cooling, and assuming direct disposal, this would enable the spent fuel from the reactors to be transported directly to the repository and remain entirely underground during the transport process. Community concerns and transportation costs would be significantly reduced relative to current situations where the reactors are separated from the repository by long distances and populated areas. The concept for a UNP in bedded salt is used to develop a rough order of magnitude cost estimate for excavation of the reactor array portion of a UNP. Excavation costs appear to be only a small fraction of the overall power plant costs

Potential clinical efficacy of intensity-modulated conformal therapy

International Nuclear Information System (INIS)

Meeks, Sanford L.; Buatti, John M.; Bova, Francis J.; Friedman, William A.; Mendenhall, William M.; Zlotecki, Robert A.

1998-01-01

Purpose: The purpose of this study was to examine the potential benefit of using intensity-modulated conformal therapy for a variety of lesions currently treated with stereotactic radiosurgery or conventional radiotherapy. Methods and Materials: Intensity-modulated conformal treatment plans were generated for small intracranial lesions, as well as head and neck, lung, breast, and prostate cases, using the Peacock Plan[reg] treatment-planning system (Nomos Corporation). For small intracranial lesions, intensity-modulated conformal treatment plans were compared with stereotactic radiosurgery treatment plans generated for patient treatment at the University of Florida Shands Cancer Center. For other sites (head and neck, lung, breast, and prostate), plans generated using the Peacock Plan[reg] were compared with conventional treatment plans, as well as beam's-eye-view conformal treatment plans. Plan comparisons were accomplished through conventional qualitative review of two-dimensional (2D) dose distributions in conjunction with quantitative techniques, such as dose-volume histograms, dosimetric statistics, normal tissue complication probabilities, tumor control probabilities, and objective numerical scoring. Results: For small intracranial lesions, there is little difference between intensity-modulated conformal treatment planning and radiosurgery treatment planning in the conformation of high isodose lines with the target volume. However, stereotactic treatment planning provides a steeper dose gradient outside the target volume and, hence, a lower normal tissue toxicity index. For extracranial sites, objective numerical scores for beam's-eye-view and intensity-modulated conformal planning techniques are superior to scores for conventional treatment plans. The beam's-eye-view planning technique prevents geographic target misses and better excludes healthy tissues from the treatment portal. Compared with scores for the beam's-eye-view planning technique, scores for

Chir99021 and Valproic acid reduce the proliferative advantage of Apc mutant cells.

Science.gov (United States)

Langlands, Alistair J; Carroll, Thomas D; Chen, Yu; Näthke, Inke

2018-02-15

More than 90% of colorectal cancers carry mutations in Apc that drive tumourigenesis. A 'just-right' signalling model proposes that Apc mutations stimulate optimal, but not excessive Wnt signalling, resulting in a growth advantage of Apc mutant over wild-type cells. Reversal of this growth advantage constitutes a potential therapeutic approach. We utilised intestinal organoids to compare the growth of Apc mutant and wild-type cells. Organoids derived from Apc Min/+ mice recapitulate stages of intestinal polyposis in culture. They eventually form spherical cysts that reflect the competitive growth advantage of cells that have undergone loss of heterozygosity (LOH). We discovered that this emergence of cysts was inhibited by Chiron99021 and Valproic acid, which potentiates Wnt signalling. Chiron99021 and Valproic acid restrict the growth advantage of Apc mutant cells while stimulating that of wild-type cells, suggesting that excessive Wnt signalling reduces the relative fitness of Apc mutant cells. As a proof of concept, we demonstrated that Chiron99021-treated Apc mutant organoids were rendered susceptible to TSA-induced apoptosis, while wild-type cells were protected.

Potential advantages of coupling supercritical CO2 Brayton cycle to water cooled small and medium size reactor

International Nuclear Information System (INIS)

Yoon, Ho Joon; Ahn, Yoonhan; Lee, Jeong Ik; Addad, Yacine

2012-01-01

Highlights: ► S-CO 2 cycle as candidate for SMS. ► MATLAB code used for S-CO 2 cycle analysis. ► Pressure ratio and split ratio comparison analyzed. - Abstract: The supercritical carbon dioxide (S-CO 2 ) Brayton cycle is being considered as a favorable candidate for the next generation nuclear reactors power conversion systems. Major benefits of the S-CO 2 Brayton cycle compared to other Brayton cycles are: (1) high thermal efficiency in relatively low turbine inlet temperature, (2) compactness of the turbomachineries and heat exchangers and (3) simpler cycle layout at an equivalent or superior thermal efficiency. However, these benefits can be still utilized even in the water-cooled reactor technologies under special circumstances. A small and medium size water-cooled nuclear reactor (SMR) has been gaining interest due to its wide range of application such as electricity generation, seawater desalination, district heating and propulsion. Another key advantage of a SMR is that it can be transported from one place to another mostly by maritime transport due to its small size, and sometimes even through a railway system. Therefore, the combination of a S-CO 2 Brayton cycle with a SMR can reinforce any advantages coming from its small size if the S-CO 2 Brayton cycle has much smaller size components, and simpler cycle layout compared to the currently considered steam Rankine cycle. In this paper, SMART (System-integrated Modular Advanced ReacTor), a 330 MW th integral reactor developed by KAERI (Korea Atomic Energy Institute) for multipurpose utilization, is considered as a potential candidate for applying the S-CO 2 Brayton cycle and advantages and disadvantages of the proposed system will be discussed in detail. In consideration of SMART condition, the turbine inlet pressure and size of heat exchangers are analyzed by using in-house code developed by KAIST–Khalifa University joint research team. According to the cycle evaluation, the maximum cycle efficiency

Why quality of life measurement is important in dermatology clinical practice

DEFF Research Database (Denmark)

Finlay, A Y; Salek, M S; Abeni, D

2017-01-01

The aim of this study was to describe the many ways in which quality of life (QoL) measurement may potentially be advantageous in routine clinical dermatology practice. Thirteen members of the EADV Task Force on Quality of Life, eight dermatologists, three health psychologists, one epidemiologist...

Brokers and Competitive Advantage

OpenAIRE

Michael D. Ryall; Olav Sorenson

2007-01-01

The broker profits by intermediating between two (or more) parties. Using a biform game, we examine whether such a position can confer a competitive advantage, as well as whether any such advantage could persist if actors formed relations strategically. Our analysis reveals that, if one considers exogenous the relations between actors, brokers can enjoy an advantage but only if (1) they do not face substitutes either for the connections they offer or the value they can create, (2) they interm...

Generic Advantages

Indian Academy of Sciences (India)

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

[Recommendations for the clinical use of motor evoked potentials in multiple sclerosis].

Science.gov (United States)

Fernández, V; Valls-Sole, J; Relova, J L; Raguer, N; Miralles, F; Dinca, L; Taramundi, S; Costa-Frossard, L; Ferrandiz, M; Ramió-Torrentà, Ll; Villoslada, P; Saiz, A; Calles, C; Antigüedad, A; Alvarez-Cermeño, J C; Prieto, J M; Izquierdo, G; Montalbán, X; Fernández, O

2013-09-01

To establish clinical guidelines for the clinical use and interpretation of motor evoked potentials (MEP) in diagnosing and monitoring patients with multiple sclerosis (MS). Recommendations for MEP use and interpretation will help us rationalise and optimise resources used in MS patient diagnosis and follow up. We completed an extensive literature review and pooled our own data to produce a consensus statement with recommendations for the clinical use of MEPs in the study of MS. MEPs, in addition to spinal and cranial magnetic resonance imaging (MRI), help us diagnose and assess MS patients whose disease initially presents as spinal cord syndrome and those with non-specific brain MRI findings, or a normal brain MRI and clinical signs of MS. Whenever possible, a multimodal evoked potential study should be performed on patients with suspected MS in order to demonstrate involvement of the motor pathway which supports a diagnosis of dissemination in space. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Places and faces: Geographic environment influences the ingroup memory advantage.

Science.gov (United States)

Rule, Nicholas O; Garrett, James V; Ambady, Nalini

2010-03-01

The preferential allocation of attention and memory to the ingroup (the ingroup memory advantage) is one of the most replicated effects in the psychological literature. But little is known about what factors may influence such effects. Here the authors investigated a potential influence: category salience as determined by the perceiver's geographic environment. They did so by studying the ingroup memory advantage in perceptually ambiguous groups for whom perceptual cues do not make group membership immediately salient. Individuals in an environment in which a particular group membership was salient (Mormon and non-Mormon men and women living in Salt Lake City, Utah) showed better memory for faces belonging to their ingroup in an incidental encoding paradigm. Majority group participants in an environment where this group membership was not salient (non-Mormon men and women in the northeastern United States), however, showed no ingroup memory advantage whereas minority group participants (Mormons) in the same environment did. But in the same environment, when differences in group membership were made accessible via an unobtrusive priming task, non-Mormons did show an ingroup memory advantage and Mormons' memory for ingroup members increased. Environmental context cues therefore influence the ingroup memory advantage for categories that are not intrinsically salient.

Clinical applications of resting state functional connectivity

Directory of Open Access Journals (Sweden)

Michael D Fox

2010-06-01

Full Text Available During resting conditions the brain remains functionally and metabolically active. One manifestation of this activity that has become an important research tool is spontaneous fluctuations in the blood oxygen level dependent (BOLD signal of fMRI. The identification of correlation patterns in these spontaneous fluctuations has been termed resting state functional connectivity (fcMRI and has the potential to greatly increase the translation of fMRI into clinical care. In this article we review the advantages of the resting state signal for clinical applications including detailed discussion of signal to noise considerations. We include guidelines for performing resting state research on clinical populations, outline the different areas for clinical application, and identify important barriers to be addressed to facilitate the translation of resting state fcMRI into the clinical realm.

Home advantage in professional tennis

NARCIS (Netherlands)

Koning, Ruud H.

2011-01-01

Home advantage is a pervasive phenomenon in sport. It has been established in team sports such as basketball, baseball, American football, and European soccer. Attention to home advantage in individual sports has so far been limited. The aim of this study was to examine home advantage in

CpG Methylation Analysis—Current Status of Clinical Assays and Potential Applications in Molecular Diagnostics

Science.gov (United States)

Sepulveda, Antonia R.; Jones, Dan; Ogino, Shuji; Samowitz, Wade; Gulley, Margaret L.; Edwards, Robin; Levenson, Victor; Pratt, Victoria M.; Yang, Bin; Nafa, Khedoudja; Yan, Liying; Vitazka, Patrick

2009-01-01

Methylation of CpG islands in gene promoter regions is a major molecular mechanism of gene silencing and underlies both cancer development and progression. In molecular oncology, testing for the CpG methylation of tissue DNA has emerged as a clinically useful tool for tumor detection, outcome prediction, and treatment selection, as well as for assessing the efficacy of treatment with the use of demethylating agents and monitoring for tumor recurrence. In addition, because CpG methylation occurs early in pre-neoplastic tissues, methylation tests may be useful as markers of cancer risk in patients with either infectious or inflammatory conditions. The Methylation Working Group of the Clinical Practice Committee of the Association of Molecular Pathology has reviewed the current state of clinical testing in this area. We report here our summary of both the advantages and disadvantages of various methods, as well as the needs for standardization and reporting. We then conclude by summarizing the most promising areas for future clinical testing in cancer molecular diagnostics. PMID:19541921

Revitalizing Customer Value And Competitive Advantage Of Coastal Culinary Tourism In Jember

OpenAIRE

Lilik Farida; Ahmad Ahsin Kusuma

2017-01-01

Coastal culinary tourism is one of potential destination and economic source in Jember district Indonesia. Majority of coastal culinary tourism in Jember is operated by Small and Medium Enterprises SMEs with limited ability in developing their customer value and strengthening their competitive advantage. This study seeked to examine the effect of service quality and marketing mix on customer value and competitive advantage and to examine the effect of service quality and marketing mix on comp...

Rhenium-188 - advantages and clinical potential for use of a readily available, cost effective therapeutic radioisotope for applications in nuclear medicine, oncology and interventional cardiology

International Nuclear Information System (INIS)

Knapp, F.F. jr.

2002-01-01

'conditioning' prior to stem cell rescue in leukemia patients. In addition to the development of the Re-188-P2045 peptide for the potential clinical treatment of lung tumors, a variety of other Re-188-labeled peptides and antibodies are being evaluated for tumor therapy, and Re-188-Lipiodol is being used for palliative therapy of hepatocellular carcinoma in IAEA-supported trials. Installation of the W-188/Re-188 generator in a centralized radiopharmacy would be expected to optimize the availability and costs of Re-188. This presentation will provide an overview of the current and expected broader role of Re-188 as an important therapeutic radioisotope. (author)

Problem Areas in Data Warehousing and Data Mining in a Surgical Clinic

Science.gov (United States)

Tusch, Guenter; Mueller, Margarete; Rohwer-Mensching, Katrin; Heiringhoff, Karlheinz; Klempnauer, Juergen

2001-01-01

Hospitals and clinics have taken advantage of information systems to streamline many clinical and administrative processes. However, the potential of health care information technology as a source of data for clinical and administrative decision support has not been fully explored. In response to pressure for timely information, many hospitals are developing clinical data warehouses. This paper attempts to identify problem areas in the process of developing a data warehouse to support data mining in surgery. Based on the experience from a data warehouse in surgery several solutions are discussed.

Dual mobility cups provide biomechanical advantages in situations at risk for dislocation: a finite element analysis.

Science.gov (United States)

Terrier, Alexandre; Latypova, Adeliya; Guillemin, Maika; Parvex, Valérie; Guyen, Olivier

2017-03-01

Constrained devices, standard implants with large heads, and dual mobility systems have become popular options to manage instability after total hip arthroplasty (THA). Clinical results with these options have shown variable success rates and significant higher rates of aseptic loosening and mechanical failures with constrained implants. Literature suggests potential advantages of dual mobility, however little is known about its biomechanics. We present a comparative biomechanical study of a standard implant, a constrained implant, and a dual mobility system. A finite element analysis was developed to assess and compare these acetabular options with regard to the range of motion (ROM) to impingement, the angle of dislocation, the resistive torque, the volume of polyethylene (PE) with a stress above 80% of the elastic limit, and the interfacial cup/bone stress. Dual mobility implants provided the greatest ROM to impingement and allowed delaying subluxation and dislocation when compared to standard and constrained implants. Dual mobility also demonstrated the lowest resistive torque at subluxation while the constrained implant provided the greatest one. The lowest critical PE volume was observed with the dual mobility implant, and the highest stress at the interfaces was observed with the constrained implant. This study highlights the biomechanical advantages of dual mobility systems over constrained and standard implants, and is supported by the clinical results reported. Therefore, the use of dual mobility systems in situations at risk for instability should be advocated and constrained implants should be restricted to salvage situations.

European Management: an emerging competitive advantage of European nations: A reply to Michael Porter

OpenAIRE

Bosch, Frans; Prooijen, A.A.

1992-01-01

textabstractThis article extends the debate begun in the June 1992 issue of EMJ when the authors first criticized Michael Porter's explanatory framework in his Competitive Advantage of Nations (1990), over the role of national culture on the competitive advantage of nations. In this paper, Frans van den Bosch and Arno van Prooijen stress that Europe is a locus of competitive advantage if one is prepared to pay attention to the possibility of ‘European Management’ as a potential asset of Europ...

Vibrational spectroscopy: a clinical tool for cancer diagnostics.

Science.gov (United States)

Kendall, Catherine; Isabelle, Martin; Bazant-Hegemark, Florian; Hutchings, Joanne; Orr, Linda; Babrah, Jaspreet; Baker, Rebecca; Stone, Nicholas

2009-06-01

Vibrational spectroscopy techniques have demonstrated potential to provide non-destructive, rapid, clinically relevant diagnostic information. Early detection is the most important factor in the prevention of cancer. Raman and infrared spectroscopy enable the biochemical signatures from biological tissues to be extracted and analysed. In conjunction with advanced chemometrics such measurements can contribute to the diagnostic assessment of biological material. This paper also illustrates the complementary advantage of using Raman and FTIR spectroscopy technologies together. Clinical requirements are increasingly met by technological developments which show promise to become a clinical reality. This review summarises recent advances in vibrational spectroscopy and their impact on the diagnosis of cancer.

Simulated Online Adaptive Magnetic Resonance–Guided Stereotactic Body Radiation Therapy for the Treatment of Oligometastatic Disease of the Abdomen and Central Thorax: Characterization of Potential Advantages

Energy Technology Data Exchange (ETDEWEB)

Henke, Lauren; Kashani, Rojano; Yang, Deshan; Zhao, Tianyu; Green, Olga; Olsen, Lindsey; Rodriguez, Vivian; Wooten, H. Omar; Li, H. Harold; Hu, Yanle; Bradley, Jeffrey; Robinson, Clifford; Parikh, Parag; Michalski, Jeff; Mutic, Sasa [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Olsen, Jeffrey R., E-mail: Jeffrey.R.Olsen@ucdenver.edu [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)

2016-12-01

Purpose: To characterize potential advantages of online-adaptive magnetic resonance (MR)-guided stereotactic body radiation therapy (SBRT) to treat oligometastatic disease of the non-liver abdomen and central thorax. Methods and Materials: Ten patients treated with RT for unresectable primary or oligometastatic disease of the non-liver abdomen (n=5) or central thorax (n=5) underwent imaging throughout treatment on a clinical MR image guided RT system. The SBRT plans were created on the basis of tumor/organ at risk (OAR) anatomy at initial computed tomography simulation (P{sub I}), and simulated adaptive plans were created on the basis of observed MR image set tumor/OAR “anatomy of the day” (P{sub A}). Each P{sub A} was planned under workflow constraints to simulate online-adaptive RT. Prescribed dose was 50 Gy/5 fractions, with goal coverage of 95% planning target volume (PTV) by 95% of the prescription, subject to hard OAR constraints. The P{sub I} was applied to each MR dataset and compared with P{sub A} to evaluate changes in dose delivered to tumor/OARs, with dose escalation when possible. Results: Hard OAR constraints were met for all P{sub Is} based on anatomy from initial computed tomography simulation, and all P{sub As} based on anatomy from each daily MR image set. Application of the P{sub I} to anatomy of the day caused OAR constraint violation in 19 of 30 cases. Adaptive planning increased PTV coverage in 21 of 30 cases, including 14 cases in which hard OAR constraints were violated by the nonadaptive plan. For 9 P{sub A} cases, decreased PTV coverage was required to meet hard OAR constraints that would have been violated in a nonadaptive setting. Conclusions: Online-adaptive MRI-guided SBRT may allow PTV dose escalation and/or simultaneous OAR sparing compared with nonadaptive SBRT. A prospective clinical trial is underway at our institution to evaluate clinical outcomes of this technique.

Competitive advantage and corporate communications

Directory of Open Access Journals (Sweden)

Mitić Sanja

2013-01-01

Full Text Available Strategic importance of corporate communications and its role in the development of competitive advantage has attracted interest of numerous researchers in the fields of organization, management, marketing and public relations. Recent studies particularly emphasise the growing importance of soft factors, such as reputation in the development of competitive advantage. Concept of reputation is strongly connected with stakeholder theory, which stresses the importance of corporate communications for competitive advantage of firms. The paper focuses on competitive advantage and the link among strategy, reputation and corporate communications.

Twinkling artifact on color Doppler ultrasound: an advantage or a pitfall?

Science.gov (United States)

Ozan, Ebru; Atac, Gokce Kaan; Gundogdu, Sadi

2016-07-01

The twinkling artifact (TA) or color comet-tail artifact is characterized by a rapidly changing mixture of red and blue color Doppler signals. Even though many diseases and clinical conditions have been shown to produce this artifact, its source is not clearly understood yet. The TA may provide additional information to gray-scale ultrasound findings in several clinical situations. However, there may be pitfalls to keep in mind. We must first be aware of the TA to benefit from the advantages and avoid the pitfalls. In this review, we aim to give practicing radiologists an overview of the mechanisms and clinical applications of the TA by illustrating sample cases we have encountered.

Evaluating sub-clinical cognitive dysfunction and event-related potentials (P300) in clinically isolated syndrome.

Science.gov (United States)

Kocer, Belgin; Unal, Tugba; Nazliel, Bijen; Biyikli, Zeynep; Yesilbudak, Zulal; Karakas, Sirel; Irkec, Ceyla

2008-12-01

This study investigated the presence of sub-clinical cognitive dysfunction in patients with clinically isolated syndrome (CIS) and the abnormalities of cognitive event-related potentials (ERPs). Subclinical cognitive dysfunction was assessed in 20 patients with CIS and in 20 healthy controls. Patients had impairments in verbal learning and long-term memory, evaluating attention, executive function and visuospatial skills, in decreasing order of frequency. SDLT and SIT were the most, and COWAT and BNT were the least affected tests. The N200 and P200 latencies were prolonged, and N100, N200 and P200 amplitudes were reduced in the patients relative to the controls, from the Fz, Cz and Pz electrode positions (p<0.05). Detailed cognitive testing is valuable in determining subclinical cognitive dysfunction in CIS patients. ERP abnormalities as well as abnormalities in detailed cognitivetesting in patients with CIS are helpful in the diagnosis of sub-clinical cognitive dysfunction.

Potential role of a pharmacist to enhance medication-related aspects of clinical trials conducted in a dedicated clinical research unit

Directory of Open Access Journals (Sweden)

Kimberly A. Redic, PharmD

2017-06-01

Conclusions: This pilot study showed potential roles for pharmacy personnel involvement in medication reconciliation in the clinical research setting. Pharmacists have the opportunity to ensure that IDs are accurately included in patient medication lists and to identify the use of potential protocol prohibited concomitant medications.

Gaining Relational Competitive Advantages

DEFF Research Database (Denmark)

Hu, Yimei; Zhang, Si; Li, Jizhen

2015-01-01

Establishing strategic technological partnerships (STPs) with foreign partners is an increasingly studied topic within the innovation management literature. Partnering firms can jointly create sources of relational competitive advantage. Chinese firms often lack research and development (R......&D) capabilities but are increasingly becoming preferred technological partners for transnational corporations. We investigate an STP between a Scandinavian and a Chinese firm and try to explore how to gain relational competitive advantage by focusing on its two essential stages: relational rent generation...... and appropriation. Based on an explorative case study, we develop a conceptual framework that consists of process, organizational alliance factors, and coordination modes that we propose lead to relational competitive advantage....

The potential of telehealth for 'business as usual' in outpatient clinics.

Science.gov (United States)

Day, Karen; Kerr, Patricia

2012-04-01

A six-month pilot study was conducted to ascertain the value of using high-definition videoconferencing equipment in an outpatients' setting. The videoconferencing equipment, which included digital biometric equipment, was installed in the outpatient clinics of a remote health service in New Zealand. Use of the equipment was evaluated using action research techniques. Clinicians were interviewed about their assessment of the equipment's usefulness. Patients and their carers completed questionnaires about their clinic experience. During the pilot trial, 109 patients were seen in 25 clinics of six different specialities. Questionnaire results showed that patients and their companions had a good user experience, similar to a face-to-face appointment. Clinicians found that the large screen, sense of proximity, video clarity and definition, and lack of sound/picture lag worked well for certain types of outpatients' clinics, e.g. methadone maintenance clinics. The need for process changes made it difficult to turn telehealth into business as usual in an environment built for face-to-face appointments. We conclude that videoconference equipment has potential to become integral to outpatients' clinics.

Potential advantages of a cesium fluoride scintillator for a time-of-flight positron camera

International Nuclear Information System (INIS)

Allemand, R.; Gresset, C.; Vacher, J.

1980-01-01

In order to improve the quality of positron tomographic imaging, a time-of-flight technique combined with a classical reconstruction method has been investigated. The decay time of NaI(Tl) and bismuth germanate (BGO) scintillators is too long for this application, and efficiency of the plastic scintillators is too low. Cesium fluoride appears to be a very promising detector material. This paper presents preliminary results obtained with a time-of-flight technique using CsF scintillators. The expected advantages were realized

COMPETITIVE ADVANTAGE IN THE ENTERPRISE PERFORMANCE

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PRUNEA Ana Daniela

2014-07-01

Full Text Available Rapid changes in market characteristics and the technological innovations are common and faster challenges, resulting in products, processes and technologies. The competitive advantage is volatile, difficult to obtain and more difficult to maintain and strengthened with consumers who through their individual choices polarization confirms the recognition performance and award competitive advantages, thus causing the competitive ranking of companies present in a particular market. The competitive advantage lies in the focus of the performance of companies in competitive markets and innovation is a source for obtaining and consolidating it. Companies will need to demonstrate the capacity to adapt to changes in the business environment so as to maintain the helded positions. This paper treats this aspect behavior that companies should adopt to get on the account of innovation a sustainable competitive advantage. I started of the work in the elaboration from the theory of developed by Michael Porter in his book "Competitive Advantage: Creating and Sustaining Superior Performance" we applied methods listed thus trying to point out possible ways of creating competitive advantage by companies. We have presented the sources of competitive advantage and the factors on which depends its creation. Walking theoretical research revealed how lack of competitive advantage leads to a lack of competitiveness of companies and the benefits that arise with the creation of this type of asset. Among the most important benefits is to increase performances. Once the competitive advantage is achieved, it must be maintained and updated market conditions and the methods that can be created a sustainable competitive advantage represent the answers to many of the companies questions are fighting for survival in an environment of fierce competition. The implementation of methods for obtaining competitive advantages, but also exist dangers, that every company should know them

The Topical Factors of Development of the National Competitive Advantages

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Kolomiets Ganna M.

2017-01-01

Full Text Available The article considers the qualitative changes of the national competitive advantages as derivatives of the evolution of technological modes in the global business environment; the role of both the formal and the informal institutions in their development and implementation has been analyzed. With this in mind, topical in the development of competitive advantages will be improving the formal institutions in conjunction with the informal: recognition and use of the positive potential of the national values and attitudes. High adaptatibility towards turbulence of the economic environment, desire and capability to master new knowledge, technologies, fulfill one’s own abilities in the native country, should define the focus and content of transformations of the formal institutions. Results of the analysis show that nowadays a value shift is going on, attitudes are being changed, which suggests that there’s a necessity to understand that disposition of power institutions, mistrust to authorities can significantly slow down transformations in the direction of «competitive advantages – competitiveness»

Potential benefits and risks of clinical xenotransplantation

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Cooper DKC

2012-07-01

Full Text Available David KC Cooper,1 David Ayares21Thomas E Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 2Revivicor, Blacksburg, VA, USAAbstract: The transplantation of organs and cells from pigs into humans could overcome the critical and continuing problem of the lack of availability of deceased human organs and cells for clinical transplantation. Developments in the genetic engineering of pigs have enabled considerable progress to be made in the experimental laboratory in overcoming the immune barriers to successful xenotransplantation. With regard to pig organ xenotransplantation, antibody- and cell-mediated rejection have largely been overcome, and the current major barrier is the development of coagulation dysregulation. This is believed to be due to a combination of immune activation of the vascular endothelial cells of the graft and molecular incompatibilities between the pig and primate coagulation–anticoagulation systems. Pigs with new genetic modifications specifically directed to this problem are now becoming available. With regard to less complex tissues, such as islets (for the treatment of diabetes, neuronal cells (for the treatment of Parkinson's disease, and corneas, the remaining barriers are less problematic, and graft survival in nonhuman primate models extends for >1 year in all three cases. In planning the initial clinical trials, consideration will be concentrated on the risk–benefit ratio, based to a large extent on the results of preclinical studies in nonhuman primates. If the benefit to the patient is anticipated to be high, eg, insulin-independent control of glycemia, and the potential risks low, eg, minimal risk of transfer of a porcine infectious agent, then a clinical trial would be justified.Keywords: infection, pigs, genetically-engineered, xenotransplantation, islets, xenotransplantation, organs

Hurdles to clinical translation of human induced pluripotent stem cells.

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Neofytou, Evgenios; O'Brien, Connor Galen; Couture, Larry A; Wu, Joseph C

2015-07-01

Human pluripotent stem cells are known to have the capacity to renew indefinitely, being intrinsically able to differentiate into many different cell types. These characteristics have generated tremendous enthusiasm about the potential applications of these cells in regenerative medicine. However, major challenges remain with the development and testing of novel experimental stem cell therapeutics in the field. In this Review, we focus on the nature of the preclinical challenges and discuss potential solutions that could help overcome them. Furthermore, we discuss the use of allogeneic versus autologous stem cell products, including a review of their respective advantages and disadvantages, major clinical requirements, quality standards, time lines, and costs of clinical grade development.

Spinal Cord Stimulation: Clinical Efficacy and Potential Mechanisms.

Science.gov (United States)

Sdrulla, Andrei D; Guan, Yun; Raja, Srinivasa N

2018-03-11

Spinal cord stimulation (SCS) is a minimally invasive therapy used for the treatment of chronic neuropathic pain. SCS is a safe and effective alternative to medications such as opioids, and multiple randomized controlled studies have demonstrated efficacy for difficult-to-treat neuropathic conditions such as failed back surgery syndrome. Conventional SCS is believed mediate pain relief via activation of dorsal column Aβ fibers, resulting in variable effects on sensory and pain thresholds, and measurable alterations in higher order cortical processing. Although potentiation of inhibition, as suggested by Wall and Melzack's gate control theory, continues to be the leading explanatory model, other segmental and supraspinal mechanisms have been described. Novel, non-standard, stimulation waveforms such as high-frequency and burst have been shown in some studies to be clinically superior to conventional SCS, however their mechanisms of action remain to be determined. Additional studies are needed, both mechanistic and clinical, to better understand optimal stimulation strategies for different neuropathic conditions, improve patient selection and optimize efficacy. © 2018 World Institute of Pain.

China's energy saving potential from the perspective of energy efficiency advantages of foreign-invested enterprises

International Nuclear Information System (INIS)

Jiang, Xuemei; Zhu, Kunfu; Green, Christopher

2015-01-01

The paper investigates the energy saving potential associated with firm ownership-related differences in energy efficiency such as those between domestically and foreign-owned firms. Because of a gap in official statistics this topic has barely been touched upon in the scholarly literature. This paper employs a new energy input–output table that distinguishes firm ownership (Chinese owned enterprises, COEs; and foreign-invested enterprises, FIEs) and trade mode (export processing and normal goods production) to analyze the energy efficiency advantage of FIEs in China in 2007. The results show that the total energy intensities of COEs in the industrial sector are generally 5%–35% higher than that of FIEs across industry groups. At an aggregate level, China could save up to 20.3% of its energy use, if industrial COEs could duplicate the energy use efficiency and production technology of FIEs. This gain would require major technology upgrades among COEs. - Highlights: • A new input–output table distinguishing firm ownership and trade mode is employed. • The foreign-invested enterprises are 5%–35% energy efficient than Chinese enterprises in 2007. • China could save 20.3% of energy use if industrial COEs could duplicate the technologies of FIEs

Comparative Advantage

DEFF Research Database (Denmark)

Zhang, Jie; Jensen, Camilla

2007-01-01

that are typically explained from the supply-side variables, the comparative advantage of the exporting countries. A simple model is proposed and tested. The results render strong support for the relevance of supply-side factors such as natural endowments, technology, and infrastructure in explaining international...

Clinical applications of robotic technology in vascular and endovascular surgery.

Science.gov (United States)

Antoniou, George A; Riga, Celia V; Mayer, Erik K; Cheshire, Nicholas J W; Bicknell, Colin D

2011-02-01

Emerging robotic technologies are increasingly being used by surgical disciplines to facilitate and improve performance of minimally invasive surgery. Robot-assisted intervention has recently been introduced into the field of vascular surgery to potentially enhance laparoscopic vascular and endovascular capabilities. The objective of this study was to review the current status of clinical robotic applications in vascular surgery. A systematic literature search was performed in order to identify all published clinical studies related to robotic implementation in vascular intervention. Web-based search engines were searched using the keywords "surgical robotics," "robotic surgery," "robotics," "computer assisted surgery," and "vascular surgery" or "endovascular" for articles published between January 1990 and November 2009. An evaluation and critical overview of these studies is reported. In addition, an analysis and discussion of supporting evidence for robotic computer-enhanced telemanipulation systems in relation to their applications in laparoscopic vascular and endovascular surgery was undertaken. Seventeen articles reporting on clinical applications of robotics in laparoscopic vascular and endovascular surgery were detected. They were either case reports or retrospective patient series and prospective studies reporting laparoscopic vascular and endovascular treatments for patients using robotic technology. Minimal comparative clinical evidence to evaluate the advantages of robot-assisted vascular procedures was identified. Robot-assisted laparoscopic aortic procedures have been reported by several studies with satisfactory results. Furthermore, the use of robotic technology as a sole modality for abdominal aortic aneurysm repair and expansion of its applications to splenic and renal artery aneurysm reconstruction have been described. Robotically steerable endovascular catheter systems have potential advantages over conventional catheterization systems

Results, advantages, cost effectivity and installation potential of cooperation wind turbines

International Nuclear Information System (INIS)

Langenbach, J.; De Vries, J.

1990-01-01

September 1987 a cooperation of small electricity consumers installed the first cooperative wind turbine in Delft, Netherlands. At present there are 25 such cooperatives with more than 4000 members. In February 1990 14 cooperative wind turbines were in operation with a total capacity of 1,030 kWh. An extension to 23 wind turbines with a total capacity of circa 1.8 MW and a total investment of 3.8 million Dutch guilders is expected for 1990. In 1989 1.1 million kWh has been generated, and in 1990 a production of more than 2 million kWh is expected. The most important advantages of cooperative exploitation of wind turbines are the positive public opinion, extensive possibilities to install the wind turbines, the free choice of location, and cost effectivity. At the present level of investment subsidies and kWh compensations the installed capacity can increase to a maximum of 10 MW in 1995. If a national regulation for cooperative exploitation will be implemented, the kWh compensations increase to DFl 0.17-0.20 and the investment subsidies gradually decrease to zero, the total capacity can mount to 40 MW in 1995 and 125 MW in the year 2000. 1 fig., 3 tabs., 3 refs

ABO blood groups and malaria related clinical outcome.

Science.gov (United States)

Deepa; Alwar, Vanamala A; Rameshkumar, Karuna; Ross, Cecil

2011-03-01

The study was undertaken to correlate the blood groups and clinical presentations in malaria patients and to understand the differential host susceptibility in malaria. From October 2007 to September 2008, malaria positive patients' samples were evaluated in this study. Hemoglobin, total leukocyte count, and platelet count of each patient were done on an automated cell counter. After determining the blood groups, malarial species and the severity of clinical course were correlated. A total of 100 patients were included in the study, of which 63 cases were positive for Plasmodium falciparum and 37 cases were positive for P. vivax infection and 11 patients had mixed infection. The results of the blood groups showed 22 - 'A' group, 42 - 'B' group, 35 - 'O' group and 1 was 'AB' group. When the clinical courses between different groups were compared using the following parameters for severe infection--a parasitic load of >10/1000 RBCs, severe anemia with hemoglobin 101°F and other organ involvement, it was observed that 'O' group had an advantage over other the groups. The difference in rosetting ability between red blood cells of different 'ABO' blood groups with a diminished rosetting potential in blood group 'O' red blood cells was due to the differential host susceptibility. 'O' group had an advantage over the other three blood groups. Based on literature and the results of this study, the diminished rosetting potential in blood group 'O' red blood cells is suggested as the basis for the differential host susceptibility.

Advantaged Bidders in Franchise Auctions

OpenAIRE

van den Berg, V.A.C.

2012-01-01

Consider a government that auctions a franchise for, e.g., an airport, telecommunication network, or utility. Consider an 'incumbent bidder' that owns a complement or substitute. With an auction on the transfer (i.e. payment) to the government, the incumbent is advantaged.If the government regulates the market with an auction on the price asked to consumers, it depends who is advantaged. With complements, the incumbent is advantaged: it can set a lower price on the new franchise, as this inc...

Competitive Advantage through Innovation

DEFF Research Database (Denmark)

Brem, Alexander; Maier, Maximilian; Wimschneider, Christine

2016-01-01

Purpose The purpose of this paper is to describe how Nespresso achieved competitive advantage through innovation by changing the rules of the game in its industry. Design/methodology/approach Nespresso was analyzed based on public available secondary data, in combination with related academic...... concepts on innovation and competitive advantage. Findings The company succeeded by the thorough application of a strategy that, through perfect alignment, allowed the company to reach a unique market position. However, as described in the case, it took a relatively long time and the company came close...... as a source for competitive advantage. Research limitations/implications Especially given the current market situation, the case offers different starting points for discussion about innovation and long-term company success. Practical implications Especially before the current market situation, the case...

Arterial Spin Labeling (ASL) fMRI: advantages, theoretical constrains, and experimental challenges in neurosciences.

Science.gov (United States)

Borogovac, Ajna; Asllani, Iris

2012-01-01

Cerebral blood flow (CBF) is a well-established correlate of brain function and therefore an essential parameter for studying the brain at both normal and diseased states. Arterial spin labeling (ASL) is a noninvasive fMRI technique that uses arterial water as an endogenous tracer to measure CBF. ASL provides reliable absolute quantification of CBF with higher spatial and temporal resolution than other techniques. And yet, the routine application of ASL has been somewhat limited. In this review, we start by highlighting theoretical complexities and technical challenges of ASL fMRI for basic and clinical research. While underscoring the main advantages of ASL versus other techniques such as BOLD, we also expound on inherent challenges and confounds in ASL perfusion imaging. In closing, we expound on several exciting developments in the field that we believe will make ASL reach its full potential in neuroscience research.

Mechanistic Basis of Cocrystal Dissolution Advantage.

Science.gov (United States)

Cao, Fengjuan; Amidon, Gordon L; Rodríguez-Hornedo, Naír; Amidon, Gregory E

2018-01-01

Current interest in cocrystal development resides in the advantages that the cocrystal may have in solubility and dissolution compared with the parent drug. This work provides a mechanistic analysis and comparison of the dissolution behavior of carbamazepine (CBZ) and its 2 cocrystals, carbamazepine-saccharin (CBZ-SAC) and carbamazepine-salicylic acid (CBZ-SLC) under the influence of pH and micellar solubilization. A simple mathematical equation is derived based on the mass transport analyses to describe the dissolution advantage of cocrystals. The dissolution advantage is the ratio of the cocrystal flux to drug flux and is defined as the solubility advantage (cocrystal to drug solubility ratio) times the diffusivity advantage (cocrystal to drug diffusivity ratio). In this work, the effective diffusivity of CBZ in the presence of surfactant was determined to be different and less than those of the cocrystals. The higher effective diffusivity of drug from the dissolved cocrystals, the diffusivity advantage, can impart a dissolution advantage to cocrystals with lower solubility than the parent drug while still maintaining thermodynamic stability. Dissolution conditions where cocrystals can display both thermodynamic stability and a dissolution advantage can be obtained from the mass transport models, and this information is useful for both cocrystal selection and formulation development. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

UFT and leucovorin: a review of its clinical development and therapeutic potential in the oral treatment of cancer.

Science.gov (United States)

Hoff, P M; Pazdur, R; Benner, S E; Canetta, R

1998-07-01

UFT is an oral antineoplastic drug combining uracil and tegafur in a 4:1 molar ratio. Tegafur acts as a prodrug of 5-fluorouracil (5-FU), being slowly metabolized by cytochrome P450 to 5-FU. Uracil competitively inhibits the metabolism of 5-FU, resulting in increased plasma and tumor 5-FU concentrations. At equimolar doses, higher peak plasma 5-FU concentrations are achieved with UFT plus oral leucovorin with similar systemic 5-FU exposure compared with low-dose continuous 5-FU infusions. The elimination half-life of 5-FU following UFT administration is approximately 7 h compared with 0.2 h with i.v. 5-FU. In phase II studies of UFT plus oral leucovorin for the treatment of advanced colorectal cancer, response rates ranged from 25 to 42%. UFT plus oral leucovorin is well tolerated, with manageable diarrhea being the only dose-limiting toxicity; the regimen is not associated with significant myelosuppression, mucositis, hand-foot syndrome or alopecia. UFT, with or without leucovorin, has also been evaluated alone or in combination with other cytotoxic agents for the treatment of advanced lung, breast and gastric cancers. UFT has also been evaluated as adjuvant therapy for colorectal, breast, gastric, head and neck, and superficial bladder cancers. UFT plus leucovorin offers patients an entirely oral cancer treatment, and appears to provide potential advantages over bolus 5-FU regimens with regard to toxicity and convenience of administration. These benefits should be advantageous in the adjuvant setting, as well as in advanced disease settings in which palliation is an important consideration. Ongoing clinical trials will further define the role of this promising oral treatment regimen.

Gender Advantage in Single-member Districts: The Mexican Elections of 2012

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Alberto PENADÉS DE LA CRUZ

2014-03-01

Full Text Available Data from Mexican elections in 2012 show that, in single member districts, men obtain electoral advantage over women. This cannot be explained away by the different level of political experience nor by selection bias on the part of parties while nominating candidates in districts of different expected votes. It concludes there is voter bias in favor of male candidates. It is also shown the existence of additional selection bias on the part of parties, and a potential explanation based on gender-neutral seat maximization is discarded. The electoral advantage is weaker when candidates are experienced, which supports the present use of gender quotas.

Compositional Advantage and Strategy

DEFF Research Database (Denmark)

Li, Xin

advantage is redefined as the attractiveness of the composition of the producer’s offering in terms of scope and perceived value/price ratio. I identify five ways or basic compositional strategies to improve the value/price ratio. A firm may have an overall compositional strategy that is composed of some......In this paper, I first critique the composition-based view of Yadong Luo and John Child for understanding how resource-poor firms survive and thrive. To remedy the deficiencies in their perspective, I then propose a dynamic theory of compositional advantage and strategy. Here, the compositional...... or all of the five basic compositional strategies. I argue there are three indispensable key success factors for a composition-based competition, i.e., aspiration (ambition-position asymmetry), attitude (being ALERT), and action (turning asymmetry into advantage). I also discuss the particular relevance...

Toxicology and clinical potential of nanoparticles

Science.gov (United States)

Yildirimer, Lara; Thanh, Nguyen T.K.; Loizidou, Marilena; Seifalian, Alexander M.

2011-01-01

Summary In recent years, nanoparticles (NPs) have increasingly found practical applications in technology, research and medicine. The small particle size coupled to their unique chemical and physical properties is thought to underlie their exploitable biomedical activities. Here, we review current toxicity studies of NPs with clinical potential. Mechanisms of cytotoxicity are discussed and the problem of extrapolating knowledge gained from cell-based studies into a human scenario is highlighted. The so-called ‘proof-of-principle’ approach, whereby ultra-high NP concentrations are used to ensure cytotoxicity, is evaluated on the basis of two considerations; firstly, from a scientific perspective, the concentrations used are in no way related to the actual doses required which, in many instances, discourages further vital investigations. Secondly, these inaccurate results cast doubt on the science of nanomedicine and thus, quite dangerously, encourage unnecessary alarm in the public. In this context, the discrepancies between in vitro and in vivo results are described along with the need for a unifying protocol for reliable and realistic toxicity reports. PMID:23293661

The potential role for a pharmacist in a multidisciplinary general practitioner super clinic.

Science.gov (United States)

Bajorek, Beata; LeMay, Kate; Gunn, Kate; Armour, Carol

2015-01-01

The Australian government's General Practitioner (GP) super clinics programme aims to provide well-integrated, multidisciplinary, patient-centred care for people with chronic disease. However, there is no research into the current role of pharmacists in this setting. To explore the perspectives of GP super clinic staff on current and potential (future) pharmacist-led services provided in this setting. Individual interviews (facilitated using a semi-structured interview guide and thematically analysed) were conducted with purposively sampled staff of a GP super clinic in a semirural location in the state of New South Wales, until theme saturation. Participating staff included (n=9): three GPs, one pharmacist, one nurse, one business manager, and three reception staff. Three themes emerged conveying perspectives on: working relationships between staff; a pharmacist's current role; and potential future roles for a pharmacist. All clinic staff actively engaged the pharmacist in their "team approach". Currently established roles for home medicines reviews (HMRs) and drug information were well supported, but needed to be expanded, for example, with formalised case conferences between GPs, pharmacists, and other staff. New roles needed be explored in auditing medication use, optimising medication records, specialised drug information, dispensing, and prescribing. Although GPs had differing views about opportunities for pharmacists' prescribing in this setting, they saw several benefits to this service, such as reducing the time pressure on GPs to enable more effective consultations. Results suggest a pharmacist's services can potentially be better used within the multidisciplinary super clinic model of care to address current gaps within the semi-rural practice setting. Any future role for the pharmacist could be addressed as part of a formalised, strategic approach to creating an integrated healthcare team, with attention to funding and government legislation.

[Advantages and disadvantages of femtosecond laser assisted LASIK and SMILE].

Science.gov (United States)

Zhang, F J; Sun, M S

2018-01-11

With the development of excimer laser and femtosecond laser equipment, application of diversified and customized surgical decision in modern corneal refractive surgery has been an inevitable trend. However, how to make a personalized decision with an accurate surgical design to achieve better visual quality becomes the main focus in clinical applications. Small-incision lenticule extraction (SMILE) and femtosecond assisted laser in situ keratomileusis (FS-LASIK) have been commonly acknowledged as the mainstream of corneal refractive surgery for ametropia correction nowadays. Both methods have been verified by clinical practice for many years. This article compares and elaborates the different characteristics with advantages and disadvantages of the two methods so as to provide some reasonable treatment options for refractive surgery. (Chin J Ophthalmol, 2018, 54: 7-10) .

Will the next generation of basal insulins offer clinical advantages?

Science.gov (United States)

Garber, A J

2014-06-01

The 21st century has seen the arrival of several insulin analogue products and the refinement of insulin regimens, with widespread advocacy of continuous titration algorithms and earlier initiation of supplementary insulin therapy (predominantly using basal insulins) in type 2 diabetes. Nevertheless, many insulin-treated diabetes patients remain in poor glycaemic control. This might reflect insufficient titration effort or lax adherence, but these issues could in some cases result from concerns about hypoglycaemia. Certainly there is scope for improving the pharmacokinetic/pharmacodynamic (PK/PD) profile of basal insulin, and three new products offer this prospect. Insulin degludec, now in clinical use, and PEGylated insulin lispro, in development, have greatly extended action profiles that result from two very different, but unique, mechanisms. With once-daily dosing, these insulins produce stable PK/PD profiles at steady state, associated with a low incidence of hypoglycaemia. The feasibility of varied daily dose timing has also been confirmed with insulin degludec. High strength formulations of insulin glargine and insulin degludec offer the prospect of a reduced injection number/volume in high dose users, and in the case of glargine, the PK/PD profile might also be favourably modified. This review considers critically the clinical evidence and expectations we should have for these new basal insulins. © 2013 John Wiley & Sons Ltd.

Indications, advantages and limitations of perinatal postmortem imaging in clinical practice

International Nuclear Information System (INIS)

Arthurs, Owen J.; Taylor, Andrew M.; Sebire, Neil J.

2015-01-01

Just as there is a range of paediatric imaging techniques available during life, a similar repertoire is available as part of the foetal and perinatal postmortem examination. In this article, we review the literature regarding the diagnostic utility of postmortem radiography, US, CT and MRI in this clinical setting. There is limited direct evidence on the diagnostic utility of any of these techniques, apart from postmortem MRI, which when combined with other noninvasive investigations, has been shown to be highly sensitive and specific for many foetal postmortem diagnoses. The main disadvantages of postmortem MRI include the longer duration of imaging, the need for appropriate training in the interpretation of normal postmortem changes, and possible non-diagnostic imaging examinations in early gestation fetuses. As less-invasive autopsy becomes increasingly available, the true utility of these techniques will evolve, and clinical guidelines for maximal diagnostic yield can be developed. (orig.)

Indications, advantages and limitations of perinatal postmortem imaging in clinical practice

Energy Technology Data Exchange (ETDEWEB)

Arthurs, Owen J. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Taylor, Andrew M. [Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiorespiratory Division, London (United Kingdom); Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London (United Kingdom); Sebire, Neil J. [University College London, Institute of Child Health, London (United Kingdom); Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Histopathology, London (United Kingdom)

2015-04-01

Just as there is a range of paediatric imaging techniques available during life, a similar repertoire is available as part of the foetal and perinatal postmortem examination. In this article, we review the literature regarding the diagnostic utility of postmortem radiography, US, CT and MRI in this clinical setting. There is limited direct evidence on the diagnostic utility of any of these techniques, apart from postmortem MRI, which when combined with other noninvasive investigations, has been shown to be highly sensitive and specific for many foetal postmortem diagnoses. The main disadvantages of postmortem MRI include the longer duration of imaging, the need for appropriate training in the interpretation of normal postmortem changes, and possible non-diagnostic imaging examinations in early gestation fetuses. As less-invasive autopsy becomes increasingly available, the true utility of these techniques will evolve, and clinical guidelines for maximal diagnostic yield can be developed. (orig.)

Advantages and disadvantages of technologies for HER2 testing in breast cancer specimens.

Science.gov (United States)

Furrer, Daniela; Sanschagrin, François; Jacob, Simon; Diorio, Caroline

2015-11-01

Human epidermal growth factor receptor 2 (HER2) plays a central role as a prognostic and predictive marker in breast cancer specimens. Reliable HER2 evaluation is central to determine the eligibility of patients with breast cancer to targeted anti-HER2 therapies such as trastuzumab and lapatinib. Presently, several methods exist for the determination of HER2 status at different levels (protein, RNA, and DNA level). In this review, we discuss the main advantages and disadvantages of the techniques developed so far for the evaluation of HER2 status in breast cancer specimens. Each technique has its own advantages and disadvantages. It is therefore not surprising that no consensus has been reached so far on which technique is the best for the determination of HER2 status. Currently, emphasis must be put on standardization of procedures, internal and external quality control assessment, and competency evaluation of already existing methods to ensure accurate, reliable, and clinically meaningful test results. Development of new robust and accurate diagnostic assays should also be encouraged. In addition, large clinical trials are warranted to identify the technique that most reliably predicts a positive response to anti-HER2 drugs. Copyright© by the American Society for Clinical Pathology.

Advantages of co-located spent fuel reprocessing, repository and underground reactor facilities

International Nuclear Information System (INIS)

Mahar, James M.; Kunze, Jay F.; Wes Myers, Carl; Loveland, Ryan

2007-01-01

The purpose of this work is to extend the discussion of potential advantages of the underground nuclear park (UNP) concept by making specific concept design and cost estimate comparisons for both present Generation III types of reactors and for some of the modular Gen IV or the GNEP modular concept. For the present Gen III types, we propose co-locating reprocessing and (re)fabrication facilities along with disposal facilities in the underground park. The goal is to determine the site costs and facility construction costs of such a complex which incorporates the advantages of a closed fuel cycle, nuclear waste repository, and ultimate decommissioning activities all within the UNP. Modular power generation units are also well-suited for placement underground and have the added advantage of construction using current and future tunnel boring machine technology. (authors)

Conducting qualitative research within Clinical Trials Units: avoiding potential pitfalls.

Science.gov (United States)

Cooper, Cindy; O'Cathain, Alicia; Hind, Danny; Adamson, Joy; Lawton, Julia; Baird, Wendy

2014-07-01

The value of using qualitative research within or alongside randomised controlled trials (RCTs) is becoming more widely accepted. Qualitative research may be conducted concurrently with pilot or full RCTs to understand the feasibility and acceptability of the interventions being tested, or to improve trial conduct. Clinical Trials Units (CTUs) in the United Kingdom (UK) manage large numbers of RCTs and, increasingly, manage the qualitative research or collaborate with qualitative researchers external to the CTU. CTUs are beginning to explicitly manage the process, for example, through the use of standard operating procedures for designing and implementing qualitative research with trials. We reviewed the experiences of two UK Clinical Research Collaboration (UKCRC) registered CTUs of conducting qualitative research concurrently with RCTs. Drawing on experiences gained from 15 studies, we identify the potential for the qualitative research to undermine the successful completion or scientific integrity of RCTs. We show that potential problems can arise from feedback of interim or final qualitative findings to members of the trial team or beyond, in particular reporting qualitative findings whilst the trial is on-going. The problems include: We make recommendations for improving the management of qualitative research within CTUs. Copyright © 2014. Published by Elsevier Inc.

Revealed Comparative Advantage of Services in Cariforum Countries

Directory of Open Access Journals (Sweden)

Marie Freckleton

2014-09-01

Full Text Available A pesar de la importancia de las exportaciones de servicios a los países del CARIFORUM no hay muchos estudios sobre de la competitividad de las exportaciones. Este artículo examina la ventaja comparativa revelada de las exportaciones de servicios de los países del CARIFORUM. El análisis muestra que la mayoría de los países del CARIFORUM han puesto de manifiesto las ventajas comparativas en el turismo, pero también hay casos de ventaja comparativa revelada en otros servicios como transporte, seguros y servicios empresariales, servicios personales, culturales y recreativos. Los resultados sugieren que existe un potencial de CARIFORUM para diversificar las exportaciones de servicios con el fin de pro-mover el crecimiento económico y reducir la vulnerabilidad. Sin embargo, en la medida en que los países del CARIFORUM pueden tomar ventaja de las oportunidades existentes de acceso al Mercado de los servicios depende de su capacidad de mejorar la capacidad de oferta de servicios y promover la competitividad de los servicios. English: Despite the importance of services ex-ports to CARIFORUM countries there is limited research on the competitiveness of such exports. This article examines the revealed comparative advantage of services exports in CARIFORUM countries. The analysis shows that most CARIFORUM countries have revealed comparative advantage in tourism but there are also cases of revealed comparative advantage in other services including transport, insurance, business services and personal, cultural and recreational services. The results suggest that there is potential for CARIFORUM to diversify exports of services in order to promote economic growth and reduce vulnerability. However, the extent to which CARIFORUM countries can take advantage of existing market access opportunities for services depends on their ability to improve the capacity to supply services and to promote the competitiveness of services.

Immunosuppression by hypoxic cell radiosensitizers: a phenomenon of potential clinical importance

International Nuclear Information System (INIS)

Rockwell, S.; Kapp, D.S.

1982-01-01

The nitroimidazoles metronidazole, misonidazol, and desmethyl misonidazole are currently undergoing clinical trials as possible adjuncts to radiotherapy. Ongoing clinical trials are evaluating the effectiveness of these agents and also documenting the pharmacokinetics and toxicities of radiosensitizing doses of these drugs in man. A variety of toxic effects have been noted in man, including anorexia, nausea and vomiting, peripheral neuropathy, central nervous system symptoms, ototoxicity, allergy, and fear. Laboratory studies have also suggested that these agents have potential to be mutagenic, carcinogenic, and teratogenic. In the editorial presented, the author attempts to draw attention to an additional toxic effect of nitroimidazoles - the inhibition of cell-mediated immune responses

Value-based contracting innovated Medicare advantage healthcare delivery and improved survival.

Science.gov (United States)

Mandal, Aloke K; Tagomori, Gene K; Felix, Randell V; Howell, Scott C

2017-02-01

In Medicare Advantage (MA) with its CMS Hierarchical Condition Categories (CMS-HCC) payment model, CMS reimburses private plans (Medicare Advantage Organizations [MAOs]) with prospective, monthly, health-based or risk-adjusted, capitated payments. The effect of this payment methodology on healthcare delivery remains debatable. How value-based contracting generates cost efficiencies and improves clinical outcomes in MA is studied. A difference in contracting arrangements between an MAO and 2 provider groups facilitated an intervention-control, preintervention-postintervention, difference-in-differences approach among statistically similar, elderly, community-dwelling MA enrollees within one metropolitan statistical area. Starting in 2009, for intervention-group MA enrollees, the MAO and a provider group agreed to full-risk capitation combined with a revenue gainshare. The gainshare was based on increases in the Risk Adjustment Factor (RAF), which modified the CMS-HCC payments. For the control group, the MAO continued to reimburse another provider group through fee-for-service. RAF, utilization, and survival were followed until December 31, 2012. The intervention group's mean RAF increased significantly (P based visits (P based care for these MA enrollees with multiple comorbidities, a 6% survival benefit with a 32.8% lower hazard of death (P Value-based contracting can drive utilization patterns and improve clinical outcomes among chronically ill, elderly MA members.

Constructing regional advantage in branding the cross-border Euroregion Galicia-northern Portugal

NARCIS (Netherlands)

da Silva Oliveira, Eduardo

2015-01-01

This paper employs a constructing regional advantage (CRA) approach in respect of examining the potential of joint branding strategies intended to position and give visibility to cross-border regions. The CRA concept is introduced here to improve understanding about the empirical significance of a

Clinical application of bio ceramics

Energy Technology Data Exchange (ETDEWEB)

Anu, Sharma, E-mail: issaranu@gmail.com; Gayatri, Sharma, E-mail: sharmagayatri@gmail.com [Department of Chemistry, Govt. College of Engineering & Technology, Bikaner, Rajasthan (India)

2016-05-06

Ceramics are the inorganic crystalline material. These are used in various field such as biomedical, electrical, electronics, aerospace, automotive and optical etc. Bio ceramics are the one of the most active areas of research. Bio ceramics are the ceramics which are biocompatible. The unique properties of bio ceramics make them an attractive option for medical applications and offer some potential advantages over other materials. During the past three decades, a number of major advances have been made in the field of bio ceramics. This review focuses on the use of these materials in variety of clinical scenarios.

Clinical application of bio ceramics

International Nuclear Information System (INIS)

Anu, Sharma; Gayatri, Sharma

2016-01-01

Ceramics are the inorganic crystalline material. These are used in various field such as biomedical, electrical, electronics, aerospace, automotive and optical etc. Bio ceramics are the one of the most active areas of research. Bio ceramics are the ceramics which are biocompatible. The unique properties of bio ceramics make them an attractive option for medical applications and offer some potential advantages over other materials. During the past three decades, a number of major advances have been made in the field of bio ceramics. This review focuses on the use of these materials in variety of clinical scenarios.

Advantages and Limitations of Current Imaging Techniques for Characterizing Liposome Morphology

Directory of Open Access Journals (Sweden)

Annie-Louise Robson

2018-02-01

Full Text Available There are currently a number of imaging techniques available for evaluating the morphology of liposomes and other nanoparticles, with each having its own advantages and disadvantages that should be considered when interpreting data. Controlling and validating the morphology of nanoparticles is of key importance for the effective clinical translation of liposomal formulations. There are a number of physical characteristics of liposomes that determine their in vivo behavior, including size, surface characteristics, lamellarity, and homogeneity. Despite the great importance of the morphology of nanoparticles, it is generally not well-characterized and is difficult to control. Appropriate imaging techniques provide important details regarding the morphological characteristics of nanoparticles, and should be used in conjunction with other methods to assess physicochemical parameters. In this review, we will discuss the advantages and limitations of available imaging techniques used to evaluate liposomal formulations.

Motor Third Party Liability Insurance in Russia: Gaining Competitive Advantage

OpenAIRE

Rogozin, Konstantin

2006-01-01

The report identifies which factors of service-based offerings are of utmost importance for customers, considers the areas of MTPL insurance that may contain a potential sources for differentiation, and stresses importance of knowing customer needs and requirements. This report should assist the insurance company to categorise and systematise relevant information so as to develop a product position, which may give a competitive advantage.

Immediately sequential bilateral cataract surgery: advantages and disadvantages.

Science.gov (United States)

Singh, Ranjodh; Dohlman, Thomas H; Sun, Grace

2017-01-01

The number of cataract surgeries performed globally will continue to rise to meet the needs of an aging population. This increased demand will require healthcare systems and providers to find new surgical efficiencies while maintaining excellent surgical outcomes. Immediately sequential bilateral cataract surgery (ISBCS) has been proposed as a solution and is increasingly being performed worldwide. The purpose of this review is to discuss the advantages and disadvantages of ISBCS. When appropriate patient selection occurs and guidelines are followed, ISBCS is comparable with delayed sequential bilateral cataract surgery in long-term patient satisfaction, visual acuity and complication rates. In addition, the risk of bilateral postoperative endophthalmitis and concerns of poorer refractive outcomes have not been supported by the literature. ISBCS is cost-effective for the patient, healthcare payors and society, but current reimbursement models in many countries create significant financial barriers for facilities and surgeons. As demand for cataract surgery rises worldwide, ISBCS will become increasingly important as an alternative to delayed sequential bilateral cataract surgery. Advantages include potentially decreased wait times for surgery, patient convenience and cost savings for healthcare payors. Although they are comparable in visual acuity and complication rates, hurdles that prevent wide adoption include liability concerns as ISBCS is not an established standard of care, economic constraints for facilities and surgeons and inability to fine-tune intraocular lens selection in the second eye. Given these considerations, an open discussion regarding the advantages and disadvantages of ISBCS is important for appropriate patient selection.

Profiles in fibromyalgia: algometry, auditory evoked potentials and clinical characterization of different subtypes.

Science.gov (United States)

Triñanes, Yolanda; González-Villar, Alberto; Gómez-Perretta, Claudio; Carrillo-de-la-Peña, María T

2014-11-01

The heterogeneity found in fibromyalgia (FM) patients has led to the investigation of disease subgroups, mainly based on clinical features. The aim of this study was to test the hypothesis that clinical FM subgroups are associated with different underlying pathophysiological mechanisms. Sixty-three FM patients were classified in type I or type II, according to the Fibromyalgia Impact Questionnaire (FIQ), and in mild/moderate versus severe FM, according to the severity of three cardinal symptoms considered in the American College of Rheumatology (ACR) 2010 criteria (unrefreshed sleep, cognitive problems and fatigue). To validate the subgroups obtained by these two classifications, we calculated the area under the receiver operating characteristic curves for various clinical variables and for two potential biomarkers of FM: Response to experimental pressure pain (algometry) and the amplitude/intensity slopes of the auditory evoked potentials (AEPs) obtained to stimuli of increasing intensity. The variables that best discriminated type I versus type II were those related to depression, while the indices of clinical or experimental pain (threshold or tolerance) did not significantly differ between them. The variables that best discriminated the mild/moderate versus severe subgroups were those related to the algometry. The AEPs did not allow discrimination among the generated subsets. The FIQ-based classification allows the identification of subgroups that differ in psychological distress, while the index based on the ACR 2010 criteria seems to be useful to characterize the severity of FM mainly based on hyperalgesia. The incorporation of potential biomarkers to generate or validate classification criteria is crucial to advance in the knowledge of FM and in the understanding of pathophysiological pathways.

Human iPS Cell-Derived Germ Cells: Current Status and Clinical Potential

Directory of Open Access Journals (Sweden)

Tetsuya Ishii

2014-10-01

Full Text Available Recently, fertile spermatozoa and oocytes were generated from mouse induced pluripotent (iPS cells using a combined in vitro and in vivo induction system. With regard to germ cell induction from human iPS cells, progress has been made particularly in the male germline, demonstrating in vitro generation of haploid, round spermatids. Although iPS-derived germ cells are expected to be developed to yield a form of assisted reproductive technology (ART that can address unmet reproductive needs, genetic and/or epigenetic instabilities abound in iPS cell generation and germ cell induction. In addition, there is still room to improve the induction protocol in the female germline. However, rapid advances in stem cell research are likely to make such obstacles surmountable, potentially translating induced germ cells into the clinical setting in the immediate future. This review examines the current status of the induction of germ cells from human iPS cells and discusses the clinical potential, as well as future directions.

Advantages and disadvantages of ceramic on ceramic total hip arthroplasty: a review.

Science.gov (United States)

Gallo, Jiri; Goodman, Stuart Barry; Lostak, Jiri; Janout, Martin

2012-09-01

Ceramic on ceramic (COC) total hip arthroplasty (THA) was developed to reduce wear debris and accordingly, the occurrence of osteolysis and aseptic loosening especially in younger patients. Based on the excellent tribological behavior of current COC bearings and the relatively low biological activity of ceramic particles, significant improvement in survivorship of these implants is expected. We used manual search to identify all relevant studies reporting clinical data on COC THAs in PubMed. The objective was to determine whether current COC THA offers a better clinical outcome and survivorship than non-COC THA. Studies with early generation ceramic bearings yielded 68% to 84% mean survivorship at 20 years follow-up which is comparable with the survivorship of non-COC THAs. Studies on current ceramic bearings report a 10-year revision-free interval of 92% to 99%. These outcomes are comparable to the survivorship of the best non-COC THAs. However, there are still concerns regarding fracture of sandwich ceramic liners, squeaking, and impingement of the femoral neck on the rim of the ceramic liner leading to chipping, especially in younger and physically active patients. Current COC THA leads to equivalent but not improved survivorship at 10 years follow-up in comparison to the best non-COC THA. Based on this review, we recommend that surgeons weigh the potential advantages and disadvantages of current COC THA in comparison to other bearing surfaces when considering young very active patients who are candidates for THA.

Potential consequences of clinical application of artificial gametes: a systematic review of stakeholder views.

Science.gov (United States)

Hendriks, Saskia; Dondorp, Wybo; de Wert, Guido; Hamer, Geert; Repping, Sjoerd; Dancet, Eline A F

2015-01-01

Recent progress in the formation of artificial gametes, i.e. gametes generated from progenitors or somatic cells, has led to scientific and societal discussion about their use in medically assisted reproduction. In animals, live births have already been achieved using artificial gametes of varying (cell type) sources and biological research seems to be progressing steadily toward clinical application in humans. Artificial gametes could potentially help not only infertile heterosexual couples of reproductive age of which one or both partners lacks functional gametes, but also post-menopausal women and same-sex couples, to conceive a child who will be genetically related to them. But as clinical application of these new technologies may have wider societal consequences, a proactive consideration of the possible impact seems timely and important. This review aims to contribute to this by providing a systematic overview of the potential consequences of clinical application of artificial gametes anticipated by different stakeholders. The electronic database 'Medline/Pubmed' was systematically searched with medical subject heading terms (MesH) for articles published in English between January 1970 and December 2013. Articles were selected based on eligibility and reference lists of eligible studies were hand searched. The reported potential consequences of clinical application of artificial gametes were extracted from the articles and were grouped into categories by content analysis. Per category, we noted which stakeholders referred to which potential consequences, based on author affiliations and, if applicable, study participants. The systematic search yielded 2424 articles, and 84 studies were included after screening. Nine positive consequences, 21 specific consequences requiring consideration and 22 recommendations referring to clinical application of artificial gametes were documented. All positive consequences, consequences requiring consideration and

Environmental structure and competitive scoring advantages in team competitions

Science.gov (United States)

Merritt, Sears; Clauset, Aaron

2013-10-01

In most professional sports, playing field structure is kept neutral so that scoring imbalances may be attributed to differences in team skill. It thus remains unknown what impact environmental heterogeneities can have on scoring dynamics or competitive advantages. Applying a novel generative model of scoring dynamics to roughly 10 million team competitions drawn from an online game, we quantify the relationship between the structure within a competition and its scoring dynamics, while controlling the impact of chance. Despite wide structural variations, we observe a common three-phase pattern in the tempo of events. Tempo and balance are highly predictable from a competition's structural features alone and teams exploit environmental heterogeneities for sustained competitive advantage. Surprisingly, the most balanced competitions are associated with specific environmental heterogeneities, not from equally skilled teams. These results shed new light on the design principles of balanced competition, and illustrate the potential of online game data for investigating social dynamics and competition.

Relative socioeconomic advantage and mood during advanced pregnancy in women in Vietnam

Directory of Open Access Journals (Sweden)

Fisher Jane RW

2007-08-01

Full Text Available Abstract Background Mental health during pregnancy has not been investigated in Vietnam. Antenatal depression is an established risk factor for postpartum mood disturbance and two representative cohort studies have found rates of depression after childbirth in Vietnam two to three times higher than those in high income countries. Aim The aim of this exploratory study was to investigate the prevalence and determinants of depression in a cohort of pregnant Vietnamese women. This was the subsidiary aim of an investigation of sexual beliefs and behaviours in pregnancy in Vietnam. Methods Participants were recruited from antenatal clinics at Hanoi Obstetric Hospital. Inclusion criteria were to be in advanced pregnancy and appear well educated and confident and therefore potentially be willing to discuss sexual matters. Data were collected by individual structured interviews assessing socio-demographic characteristics, reproductive health, quality of intimate relationship and adequacy of support. Emotional wellbeing was assessed by the Vietnamese translation of the Edinburgh Depression Scale (EDS. Results In total 61/74 (82% of women approached to participate were recruited. The mean EDS score of 5.42 ± 3.8, was similar to that of community cohorts in high income countries and only one participant scored above 15. The cohort was relatively socioeconomically advantaged with high rates of post-secondary education, secure salaried employment, reproductive autonomy and ability to afford higher quality antenatal care. Most participants were able to confide in their husbands and their pregnancies were welcome. Worse mood was associated with insecure casual work, crowded living conditions and experiencing critical coercion in the marital relationship. Conclusion There is an apparently low prevalence of symptoms of depression in relatively socioeconomically advantaged pregnant women in Vietnam.

Advantages of Oscillatory Hydraulic Tomography

Science.gov (United States)

Kitanidis, P. K.; Bakhos, T.; Cardiff, M. A.; Barrash, W.

2012-12-01

Characterizing the subsurface is significant for most hydrogeologic studies, such as those involving site remediation and groundwater resource explo¬ration. A variety of hydraulic and geophysical methods have been developed to estimate hydraulic conductivity and specific storage. Hydraulic methods based on the analysis of conventional pumping tests allow the estimation of conductivity and storage without need for approximate petrophysical relations, which is an advantage over most geophysical methods that first estimate other properties and then infer values of hydraulic parameters. However, hydraulic methods have the disadvantage that the head-change signal decays with distance from the pumping well and thus becomes difficult to separate from noise except in close proximity to the source. Oscillatory hydraulic tomography (OHT) is an emerging technology to im¬age the subsurface. This method utilizes the idea of imposing sinusoidally varying pressure or discharge signals at several points, collecting head observations at several other points, and then processing these data in a tomographic fashion to estimate conductivity and storage coefficients. After an overview of the methodology, including a description of the most important potential advantages and challenges associated with this approach, two key promising features of the approach will be discussed. First, the signal at an observation point is orthogonal to and thus can be separated from nuisance inputs like head fluctuation from production wells, evapotranspiration, irrigation, and changes in the level of adjacent streams. Second, although the signal amplitude may be weak, one can extract the phase and amplitude of the os¬cillatory signal by collecting measurements over a longer time, thus compensating for the effect of large distance through longer sampling period.

TH-B-BRC-01: How to Identify and Resolve Potential Clinical Errors

Energy Technology Data Exchange (ETDEWEB)

Das, I. [NYU Langone Medical Center, New York, NY (United States)

2016-06-15

Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient’s treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures. During treatment, there might be errors on machine that needs attention. External reviews of some of the treatment delivery components by independent reviewers, like IROC, can detect errors, but may not be timely. The goal of this session is to help junior clinical physicists identify potential errors as well as the approach of quality assurance to perform a root cause analysis to find and eliminate an error and to continually monitor for errors. A compilation of potential errors will be presented by examples of the thought process required to spot the error and determine the root cause. Examples may include unusual machine operation, erratic electrometer reading, consistent lower electron output, variation in photon output, body parts inadvertently left in beam, unusual treatment plan, poor normalization, hot spots etc. Awareness of the possibility and detection of error in any link of the treatment process chain will help improve the safe and accurate delivery of radiation to patients. Four experts will discuss how to identify errors in four areas of clinical treatment. D. Followill, NIH grant CA 180803.

TH-B-BRC-01: How to Identify and Resolve Potential Clinical Errors

International Nuclear Information System (INIS)

Das, I.

2016-01-01

Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient’s treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures. During treatment, there might be errors on machine that needs attention. External reviews of some of the treatment delivery components by independent reviewers, like IROC, can detect errors, but may not be timely. The goal of this session is to help junior clinical physicists identify potential errors as well as the approach of quality assurance to perform a root cause analysis to find and eliminate an error and to continually monitor for errors. A compilation of potential errors will be presented by examples of the thought process required to spot the error and determine the root cause. Examples may include unusual machine operation, erratic electrometer reading, consistent lower electron output, variation in photon output, body parts inadvertently left in beam, unusual treatment plan, poor normalization, hot spots etc. Awareness of the possibility and detection of error in any link of the treatment process chain will help improve the safe and accurate delivery of radiation to patients. Four experts will discuss how to identify errors in four areas of clinical treatment. D. Followill, NIH grant CA 180803

Structuring the competitive advantage of printing company

OpenAIRE

Kukharuk A. D.

2013-01-01

The nature of the concept of "competitive advantage of the company" if analyzed. The concept of "structuring a competitive advantage" is suggested. The model of structuring of printing company’s competitive advantage based on fundamentals of stakeholder theory is developed.

Prevalence of Potential and Clinically Relevant Statin-Drug Interactions in Frail and Robust Older Inpatients.

Science.gov (United States)

Thai, Michele; Hilmer, Sarah; Pearson, Sallie-Anne; Reeve, Emily; Gnjidic, Danijela

2015-10-01

A significant proportion of older people are prescribed statins and are also exposed to polypharmacy, placing them at increased risk of statin-drug interactions. To describe the prevalence rates of potential and clinically relevant statin-drug interactions in older inpatients according to frailty status. A cross-sectional study of patients aged ≥65 years who were prescribed a statin and were admitted to a teaching hospital between 30 July and 10 October 2014 in Sydney, Australia, was conducted. Data on socio-demographics, comorbidities and medications were collected using a standardized questionnaire. Potential statin-drug interactions were defined if listed in the Australian Medicines Handbook and three international drug information sources: the British National Formulary, Drug Interaction Facts and Drug-Reax(®). Clinically relevant statin-drug interactions were defined as interactions with the highest severity rating in at least two of the three international drug information sources. Frailty was assessed using the Reported Edmonton Frail Scale. A total of 180 participants were recruited (median age 78 years, interquartile range 14), 35.0% frail and 65.0% robust. Potential statin-drug interactions were identified in 10% of participants, 12.7% of frail participants and 8.5% of robust participants. Clinically relevant statin-drug interactions were identified in 7.8% of participants, 9.5% of frail participants and 6.8% of robust participants. Depending on the drug information source used, the prevalence rates of potential and clinically relevant statin-drug interactions ranged between 14.4 and 35.6% and between 14.4 and 20.6%, respectively. In our study of frail and robust older inpatients taking statins, the overall prevalence of potential statin-drug interactions was low and varied significantly according to the drug information source used.

Smart Technology in Lung Disease Clinical Trials.

Science.gov (United States)

Geller, Nancy L; Kim, Dong-Yun; Tian, Xin

2016-01-01

This article describes the use of smart technology by investigators and patients to facilitate lung disease clinical trials and make them less costly and more efficient. By "smart technology" we include various electronic media, such as computer databases, the Internet, and mobile devices. We first describe the use of electronic health records for identifying potential subjects and then discuss electronic informed consent. We give several examples of using the Internet and mobile technology in clinical trials. Interventions have been delivered via the World Wide Web or via mobile devices, and both have been used to collect outcome data. We discuss examples of new electronic devices that recently have been introduced to collect health data. While use of smart technology in clinical trials is an exciting development, comparison with similar interventions applied in a conventional manner is still in its infancy. We discuss advantages and disadvantages of using this omnipresent, powerful tool in clinical trials, as well as directions for future research. Published by Elsevier Inc.

76 FR 56262 - Community Advantage Pilot Program

Science.gov (United States)

2011-09-12

... SMALL BUSINESS ADMINISTRATION [Docket No. SBA 2011-0003] Community Advantage Pilot Program AGENCY: U.S. Small Business Administration (SBA). ACTION: Notice of change to Community Advantage Pilot... Community Advantage Pilot Program. In that notice, SBA modified or waived as appropriate certain regulations...

Nuclear energy. Risk or advantage

International Nuclear Information System (INIS)

Boettiger, Helmut

2011-01-01

Nuclear energy is controversial. But what's all about really in the controversy? It's about more than safty or electricity prices. Nuclear energy is not only a technical or political question, but also a moral, a human. The discussion enter various rational and irrational arguments, beside straightforward arguments various misleading and mendacious exist. The present publication is comprehensively dedicated to the thema of nuclear energy - its pro and contra - and considers its risks and advantages. Thereby the sources of energy, the processes in the nuclear reactor, and the risk potentials (Harrisburg, Chernobyl, Fukushima) are illustratively and reproducibly presented. Extensively the text explains the forms of the radiation, its doses, and the tolerance of it. Also to the theme waste and final disposal an explaining chapter is dedicated and the question for the exit from nuclear energy elucidated. Finally the author appoints with the question ''How considers mankind nuclear energy world-wide'' the international comparison.

[New intensifying screens in clinical radiology. II. Examinations in clinical practice].

Science.gov (United States)

Freyschmidt, J; Saure, D; Hagemann, G

1976-09-01

A clinically applicable procedure for testing new intensifying rare earth screens, as well as the special Siemens' screen is described. The results are related to universal screens. The film-screen combination alpha 4XD (gadolinium oxysulphide with normal, green sensitive film) results in a reduction of radiation dose to half with detail comparable with universal screens. The Siemens' special screen has similar advantages. Screens with a higher intensification factor and reduction of the mAs to one sixth results in loss of detail. This does not necessarily reduce their clinical use if they are used for appropriate purposes. The results of this clinically orientated technique agreed well with physically objective methods using lead grids. The advantages of the new screens are discussed in terms of their practical application.

Potential Clinical and Economic Impact of Switching Branded Medications to Generics

Science.gov (United States)

Straka, Robert J.; Keohane, Denis J.; Liu, Larry Z.

2017-01-01

Switching branded to generic medications has become a common cost-containment measure. Although this is an important objective for health care systems worldwide, the impact of this practice on patient outcomes needs to be carefully considered. We reviewed the literature summarizing the potential clinical and economic consequences of switching from branded to generic medications on patient outcomes. A literature search of peer-reviewed articles published 2003–2013 using key words of “generic switching” or “substitution” was conducted using PubMed, OvidSP, and ScienceDirect. Of 30 articles identified and reviewed, most were related to the diseases of the central nervous system, especially epilepsy. Based on our review, potential impacts of switching fell into 3 broad categories: patient attitudes and adherence, clinical and safety outcomes, and cost and resource utilization. Although in many cases generics may represent an appropriate alternative to branded products, this may not always be the case. Specifically, several studies suggested that switching may negatively impact medication adherence, whereas other studies found that generic switching was associated with poorer clinical outcomes and more adverse events. In some instances, switching accomplished cost savings but did so at increased total cost of care because of increased physician visits or hospitalizations. Although in many cases generics may represent an appropriate alternative, mandatory generic switching may lead to unintended consequences, especially in certain therapeutic areas. Although further study is warranted, based on our review, it may be medically justifiable for physicians and patients to retain the right to request the branded product in certain cases. PMID:26099048

Microfluidic paper-based analytical devices for potential use in quantitative and direct detection of disease biomarkers in clinical analysis.

Science.gov (United States)

Lim, Wei Yin; Goh, Boon Tong; Khor, Sook Mei

2017-08-15

Clinicians, working in the health-care diagnostic systems of developing countries, currently face the challenges of rising costs, increased number of patient visits, and limited resources. A significant trend is using low-cost substrates to develop microfluidic devices for diagnostic purposes. Various fabrication techniques, materials, and detection methods have been explored to develop these devices. Microfluidic paper-based analytical devices (μPADs) have gained attention for sensing multiplex analytes, confirming diagnostic test results, rapid sample analysis, and reducing the volume of samples and analytical reagents. μPADs, which can provide accurate and reliable direct measurement without sample pretreatment, can reduce patient medical burden and yield rapid test results, aiding physicians in choosing appropriate treatment. The objectives of this review are to provide an overview of the strategies used for developing paper-based sensors with enhanced analytical performances and to discuss the current challenges, limitations, advantages, disadvantages, and future prospects of paper-based microfluidic platforms in clinical diagnostics. μPADs, with validated and justified analytical performances, can potentially improve the quality of life by providing inexpensive, rapid, portable, biodegradable, and reliable diagnostics. Copyright © 2017 Elsevier B.V. All rights reserved.

Competitive advantage and corporate communications

OpenAIRE

Mitić Sanja; Ognjanov Galjina

2013-01-01

Strategic importance of corporate communications and its role in the development of competitive advantage has attracted interest of numerous researchers in the fields of organization, management, marketing and public relations. Recent studies particularly emphasise the growing importance of soft factors, such as reputation in the development of competitive advantage. Concept of reputation is strongly connected with stakeholder theory, which stresses the importance of corporate communications ...

[Advantages and disadvantages of direct-to-consumer genetic tests].

Science.gov (United States)

Christiansen, Camilla Worm; Gerdes, Anne-Marie Axø

2017-03-13

Direct-to-consumer genetic tests are sold over the internet to consumers all over the world - including Denmark. No regulation of these tests has been introduced neither in Denmark nor in Europe, even though they have been on the market since 2007. Such tests have several advantages, but indeed also a long list of potential disadvantages, which are most often ignored, and among these is insufficient training of general practitioners in performing the necessary counselling but also the risk of increased expenses to unnecessary follow-up consultations.

Protontherapy versus carbon ion therapy advantages, disadvantages and similarities

CERN Document Server

d’Ávila Nunes, Marcos

2015-01-01

This book presents a comparison analysis of two cancer treatment therapies: carbon ion therapy and protontherapy. It is divided in 5 sections. The first ones gives the reader a brief history of Radiotherapy and types of radiation. In the second section, the techniques and equipments, including new ones in development such as Cyclinac , Laser and DWA, are described. The third section describes biophysical (such as stopping power and LET) and biological (such as RBE and OER) properties, the fundamental experiments and clinical area. The fourth section presents models and the fifth section compares both techniques, showing advantages and disadvantages of each, and their similarities.

Perceived versus Actual Competitive Advantage

OpenAIRE

Langemeier, Michael R.; Yeager, Elizabeth

2014-01-01

This paper examined the relationship between farm characteristics and perceived sources of competitive advantage, and cost-based and revenue-based efficiency indices. Gross farm income and the percentage of labor devoted to crop production were significant and positively correlated with cost and revenue efficiency while the perception of the cowherd being the most important part of the operation was negatively correlated with efficiency. In general, perceived sources of competitive advantage ...

Corporate Finance and Comparative Advantage

OpenAIRE

Peter Egger; Christian Keuschnigg

2009-01-01

Since innovative firms are often financially constrained, access to external funds is important for the expansion of innovative industries. This paper reports four important results. First, comparative advantage is shaped by factor endowments as well as fundamental determinants of corporate finance. In particular, a larger equity ratio of firms and tough governance standards relax finance constraints and create a comparative advantage in innovative industries. Second, factor price equalizatio...

THE RELATIONSHIP BETWEEN ORGANISATIONAL COMPETITIVE ADVANTAGE AND PERFORMANCE MODERATED BY THE AGE AND SIZE OF FIRMS

OpenAIRE

Alimin Ismadi Ismail; Haslinda Abdullah; Jegak Uli; Raduan Che Rose

2010-01-01

It has been argued that achieving a position of competitive advantage is a necessary precursor to a firm's significant performance. This paper will empirically examine the potential moderating variables that could affect the relationship between a firm's competitive advantage and performance, namely the firms' age and size. By examining the relative moderating effects of these variables, this paper delivers valuable information to firms, specifically with regard to strategic management direct...

Potential of Mass Spectrometry in Developing Clinical Laboratory Biomarkers of Nonvolatiles in Exhaled Breath.

Science.gov (United States)

Beck, Olof; Olin, Anna-Carin; Mirgorodskaya, Ekaterina

2016-01-01

Exhaled breath contains nonvolatile substances that are part of aerosol particles of submicrometer size. These particles are formed and exhaled as a result of normal breathing and contain material from distal airways of the respiratory system. Exhaled breath can be used to monitor biomarkers of both endogenous and exogenous origin and constitutes an attractive specimen for medical investigations. This review summarizes the present status regarding potential biomarkers of nonvolatile compounds in exhaled breath. The field of exhaled breath condensate is briefly reviewed, together with more recent work on more selective collection procedures for exhaled particles. The relation of these particles to the surfactant in the terminal parts of the respiratory system is described. The literature on potential endogenous low molecular weight compounds as well as protein biomarkers is reviewed. The possibility to measure exposure to therapeutic and abused drugs is demonstrated. Finally, the potential future role and importance of mass spectrometry is discussed. Nonvolatile compounds exit the lung as aerosol particles that can be sampled easily and selectively. The clinical applications of potential biomarkers in exhaled breath comprise diagnosis of disease, monitoring of disease progress, monitoring of drug therapy, and toxicological investigations. © 2015 American Association for Clinical Chemistry.

Potentiating antibiotics in drug-resistant clinical isolates via stimuli-activated superoxide generation.

Science.gov (United States)

Courtney, Colleen M; Goodman, Samuel M; Nagy, Toni A; Levy, Max; Bhusal, Pallavi; Madinger, Nancy E; Detweiler, Corrella S; Nagpal, Prashant; Chatterjee, Anushree

2017-10-01

The rise of multidrug-resistant (MDR) bacteria is a growing concern to global health and is exacerbated by the lack of new antibiotics. To treat already pervasive MDR infections, new classes of antibiotics or antibiotic adjuvants are needed. Reactive oxygen species (ROS) have been shown to play a role during antibacterial action; however, it is not yet understood whether ROS contribute directly to or are an outcome of bacterial lethality caused by antibiotics. We show that a light-activated nanoparticle, designed to produce tunable flux of specific ROS, superoxide, potentiates the activity of antibiotics in clinical MDR isolates of Escherichia coli , Salmonella enterica , and Klebsiella pneumoniae . Despite the high degree of antibiotic resistance in these isolates, we observed a synergistic interaction between both bactericidal and bacteriostatic antibiotics with varied mechanisms of action and our superoxide-producing nanoparticles in more than 75% of combinations. As a result of this potentiation, the effective antibiotic concentration of the clinical isolates was reduced up to 1000-fold below their respective sensitive/resistant breakpoint. Further, superoxide-generating nanoparticles in combination with ciprofloxacin reduced bacterial load in epithelial cells infected with S. enterica serovar Typhimurium and increased Caenorhabditis elegans survival upon infection with S. enterica serovar Enteriditis, compared to antibiotic alone. This demonstration highlights the ability to engineer superoxide generation to potentiate antibiotic activity and combat highly drug-resistant bacterial pathogens.

Frozen blood products: clinically effective and potentially ideal for remote Australia.

Science.gov (United States)

Holley, A; Marks, D C; Johnson, L; Reade, M C; Badloe, J F; Noorman, F

2013-01-01

The development of effective cryopreservation techniques for both red blood cells and platelets, which maintain ex vivo biological activity, in combination with frozen plasma, provides for a unique blood banking strategy. This technology greatly enhances the storage life of these products. The rationale and potential advantages of using cryopreservation techniques for the provision of blood products to remote and military environments have been effectively demonstrated in several conflicts over the last decade. Current haemostatic resuscitation doctrine for the exsanguinating patient supports the use of red blood cells, platelets and frozen plasma early in the resuscitation. We believe an integrated fresh-frozen blood bank inventory could facilitate provision of blood products, not only in the military setting but also in regional Australia, by overcoming many logistic and geographical challenges. The processes involved in production and point of care thawing are sufficiently well developed and achievable to make this technology a viable option. The potential limitations of cryopreservation and subsequent product thawing need to be considered if such a strategy is to be developed. A substantial body of international experience using cryopreserved products in remote settings has already been accrued. This experience provides a template for the possible creation of an Australian integrated fresh-frozen blood bank inventory that could conceivably enhance the care of patients in both regional Australia and in the military setting.

Application of the MALDI Biotyper to clinical microbiology: progress and potential.

Science.gov (United States)

Kostrzewa, Markus

2018-03-01

The introduction of the MALDI Biotyper in laboratories substantially changed microbiology practice, this has been called a revolution. The system accelerated diagnostic while costs were reduced and accuracy was increased. In just a few years MALDI-TOF MS became the first-line identification tool for microorganisms. Ten years after its introduction, more than 2000 MALDI Biotyper systems are installed in laboratories which are performing routine diagnostic, and the number is still increasing. Areas covered: This article summarises changes in clinical microbiology introduced by the MALDI Biotyper and its effects, as it has been published in peer reviewed articles found in PubMed. Further, the potential of novel developments to increase the value of the system is described. Expert commentary: The MALDI Biotyper has significantly improved clinical microbiology in the area of microorganism identification. Now new developments and applications, e.g. for typing and resistance testing, might further increase its value in clinical microbiology. The systems might get the central diagnostic analyser which is getting integrated into the widely automated microbiology laboratories of the future.

Potential Impact on Clinical Decision Making via a Genome-Wide Expression Profiling: A Case Report

Directory of Open Access Journals (Sweden)

Hyun Kim

2016-11-01

Full Text Available Management of men with prostate cancer is fraught with uncertainty as physicians and patients balance efficacy with potential toxicity and diminished quality of life. Utilization of genomics as a prognostic biomarker has improved the informed decision-making process by enabling more rationale treatment choices. Recently investigations have begun to determine whether genomic information from tumor transcriptome data can be used to impact clinical decision-making beyond prognosis. Here we discuss the potential of genomics to alter management of a patient who presented with high-risk prostate adenocarcinoma. We suggest that this information help selecting patients for advanced imaging, chemotherapies, or clinical trial.

Potential Immune Biomarkers in Diagnosis and Clinical Management for Systemic Lupus Erythematosus

Directory of Open Access Journals (Sweden)

Zecevic Lamija

2018-04-01

Full Text Available Background: There is still no reliable, specific biomarker for precision diagnosis and clinical monitoring of systemic lupus erythematosus. The aim of this study was to investigate the importance of the determination of immunofenotypic profiles (T, B lymphocytes and NK cells and serum cytokine concentrations (IL-17 and IFN-alpha as potential biomarkers for this disease.

A resource based view to small firms' sustainable competitive advantages: A case of Iranian small firms

Directory of Open Access Journals (Sweden)

Ali Reza Babakhan

2012-10-01

Full Text Available During the last decades, the importance of small firms as one of the main economical parts in each country has been proved. Considering to the resources limitation in one hand, and the competitive global market in the other hand, it is very important that firms can obtain sustainable competitive advantages (SCAs to compete with other rivals. This paper, at the first step, tries to explore the potentially SCAs of Qom's small firms by using of Structural Equation Model (SEM. Then, the real current situation of firms in using these competitive advantages has been examined. The results tell that except firms' location, other potentially SCAs do not have acceptable condition.

The Ability to Assimilate Technology as a Source of Competitive Advantage of Financial Companies in Poland

Directory of Open Access Journals (Sweden)

Glabiszewski Waldemar

2016-12-01

Full Text Available This article is empirical in nature and attempts to assess the impact of ability to assimilate newly acquired technologies by financial companies operating in Poland gaining market competitive advantages. The outcome of the research conducted proved the existence of this relationship and found it be strong. This means that the development of these abilities within the absorptive potential of financial companies should trigger a significant increase in the market competitive advantages held by them. The strong impact was identified both in the total of the analyzed personnel and general-organizational components of the assimilation abilities. As regards elementary components of the analyzed potential, the obtained results are definitely more diverse.

UPLC-based metabonomic applications for discovering biomarkers of diseases in clinical chemistry.

Science.gov (United States)

Zhao, Ying-Yong; Cheng, Xian-Long; Vaziri, Nosratola D; Liu, Shuman; Lin, Rui-Chao

2014-10-01

Metabonomics is a powerful and promising analytic tool that allows assessment of global low-molecular-weight metabolites in biological systems. It has a great potential for identifying useful biomarkers for early diagnosis, prognosis and assessment of therapeutic interventions in clinical practice. The aim of this review is to provide a brief summary of the recent advances in UPLC-based metabonomic approach for biomarker discovery in a variety of diseases, and to discuss their significance in clinical chemistry. All the available information on UPLC-based metabonomic applications for discovering biomarkers of diseases were collected via a library and electronic search (using Web of Science, Pubmed, ScienceDirect, Springer, Google Scholar, etc.). Metabonomics has been used in clinical chemistry to identify and evaluate potential biomarkers and therapeutic targets in various diseases affecting the liver (hepatocarcinoma and liver cirrhosis), lung (lung cancer and pneumonia), gastrointestinal tract (colorectal cancer) and urogenital tract (prostate cancer, ovarian cancer and chronic kidney disease), as well as metabolic diseases (diabetes) and neuropsychiatric disorders (Alzheimer's disease and schizophrenia), etc. The information provided highlights the potential value of determination of endogenous low-molecular-weight metabolites and the advantages and potential drawbacks of the application of UPLC-based metabonomics in clinical setting. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Prevention of hepatocellular carcinoma: potential targets, experimental models, and clinical challenges

Science.gov (United States)

Hoshida, Yujin; Fuchs, Bryan C.; Tanabe, Kenneth K.

2013-01-01

Chronic fibrotic liver diseases such as viral hepatitis eventually develop liver cirrhosis, which causes occurrence of hepatocellular carcinoma (HCC). Given the limited therapeutic efficacy in advanced HCC, prevention of HCC development could be an effective strategy for improving patient prognosis. However, there is still no established therapy to meet the goal. Studies have elucidated a wide variety of molecular mechanisms and signaling pathways involved in HCC development. Genetically-engineered or chemically-treated experimental models of cirrhosis and HCC have been developed and shown their potential value in investigating molecular therapeutic targets and diagnostic biomarkers for HCC prevention. In this review, we overview potential targets of prevention and currently available experimental models, and discuss strategies to translate the findings into clinical practice. PMID:22873223

Using integration technology as a strategic advantage.

Science.gov (United States)

Fry, P A

1993-08-01

The underlying premise of the Managed Competition Act previously cited is that through managed competition providers will be forced to lower care costs while increasing the level of positive care outcomes. Because it may also be that tomorrow's hospitals will find a severe rationing of technology, what can they do to prepare? Most of the systems in place today already have built within them all the necessary potential to address this premise and technology requirement with no change, no conversion, no expense for new equipment and software, and no disruption in day-to-day operations, just a little re-engineering. Today, however, these systems are similar to a 20-mule team pulling in different directions: all the power is there, but the wagon remains motionless and totally unable to reach its objective. It takes a skilled wagonmaster to bring them together, to make the mules work as a cohesive unit, to make the power of 20 mules greater than the sum of 20 mules. So it is and will be for the hospital of tomorrow. System integration is no longer a question of whether but of when. Those hospitals that use it today as a strategic advantage will be in a better position tomorrow to use it as a competitive strategic advantage in an environment that will reward low cost and high positive care outcomes and will penalize those that cannot compete. The technology is already here and economically within reach of nearly every hospital, just waiting to be used. The question that must nag all of us who want to make the health care system of America better is, Why not make the when now? Rich Helppie, president of Superior Consultant Company, summarized the solution well: The old ways will not give way to the new overnight. The re-engineering process in healthcare must evolve. Compared to the last 20 years, however, such evolution may appear to be a massive, forthright, complete, comprehensive, drastic and rapid revolution. Survival is the name of the game, and for healthcare

Clinical, Ergonomic, and Economic Outcomes With Multichamber Bags Compared With (Hospital) Pharmacy Compounded Bags and Multibottle Systems: A Systematic Literature Review.

Science.gov (United States)

Alfonso, Jorge Emilio; Berlana, David; Ukleja, Andrew; Boullata, Joseph

2017-09-01

Multichamber bags (MCBs) may offer potential clinical, ergonomic, and economic advantages compared with (hospital) pharmacy compounded bags (COBs) and multibottle systems (MBSs). A systematic literature review was performed to identify and assess the available evidence regarding advantages of MCBs compared with COBs and MBSs. Medline, Embase, the Cochrane Databases, and EconLit were searched for articles reporting clinical, ergonomic, and economic outcomes for MCBs compared with COBs or MBSs. The search was limited to studies conducted in hospitalized patients >2 years of age that were published in English between January 1990 and November 2014. The Population Intervention Comparison Outcomes Study Design (PICOS) framework was used for the analysis. From 1307 unique citations, 74 potentially relevant publications were identified; review of references identified 2 additional publications. Among the 76 publications, 18 published studies met the inclusion criteria. Most were retrospective in design. Ten studies reported clinical outcomes, including 1 prospective randomized trial and multiple retrospective analyses that reported a lower risk of bloodstream infection for MCBs compared with other delivery systems. Sixteen studies reported ergonomic and/or economic outcomes; most reported a potential cost benefit for MCBs, with consistent reports of reduced time and labor compared with other systems. The largest cost benefit was observed in studies evaluating total hospitalization costs. The systematic literature review identified evidence of potential clinical, ergonomic, and economic benefits for MCBs compared with COBs and MBSs; however, methodological factors limited evidence quality. More prospective studies are required to corroborate existing evidence.

The Ability to Assimilate Technology as a Source of Competitive Advantage of Financial Companies in Poland

OpenAIRE

Glabiszewski Waldemar; Zastempowski Maciej

2016-01-01

This article is empirical in nature and attempts to assess the impact of ability to assimilate newly acquired technologies by financial companies operating in Poland gaining market competitive advantages. The outcome of the research conducted proved the existence of this relationship and found it be strong. This means that the development of these abilities within the absorptive potential of financial companies should trigger a significant increase in the market competitive advantages held by...

Compositional Advantage and Strategy

DEFF Research Database (Denmark)

Li, Xin

In this paper, I first critique the composition-based view of Yadong Luo and John Child for understanding how resource-poor firms survive and thrive. To remedy the deficiencies in their perspective, I then propose a dynamic theory of compositional advantage and strategy. Here, the compositional...... advantage is redefined as the attractiveness of the composition of the producer’s offering in terms of scope and perceived value/price ratio. I identify five ways or basic compositional strategies to improve the value/price ratio. A firm may have an overall compositional strategy that is composed of some...... of the present theory to understanding Chinese firms. I conclude with managerial implications and suggestions for future research....

Identification and Pathogenic Potential of Clinical Bacillus and Paenibacillus Isolates.

Directory of Open Access Journals (Sweden)

Francesco Celandroni

Full Text Available The soil-related Bacillus and Paenibacillus species have increasingly been implicated in various human diseases. Nevertheless, their identification still poses problems in the clinical microbiology laboratory and, with the exception of Bacillus anthracis and Bacillus cereus, little is known on their pathogenicity for humans. In this study, we evaluated the use of matrix-assisted laser desorption-ionization time of flight mass spectrometry (MALDI-TOF MS in the identification of clinical isolates of these genera and conducted genotypic and phenotypic analyses to highlight specific virulence properties. Seventy-five clinical isolates were subjected to biochemical and MALDI-TOF MS identification. 16S rDNA sequencing and supplemental tests were used to solve any discrepancies or failures in the identification results. MALDI-TOF MS significantly outperformed classical biochemical testing for correct species identification and no misidentification was obtained. One third of the collected strains belonged to the B. cereus species, but also Bacillus pumilus and Bacillus subtilis were isolated at high rate. Antimicrobial susceptibility testing showed that all the B. cereus, B. licheniformis, B. simplex, B. mycoides, Paenibacillus glucanolyticus and Paenibacillus lautus isolates are resistant to penicillin. The evaluation of toxin/enzyme secretion, toxin-encoding genes, motility, and biofilm formation revealed that B. cereus displays the highest virulence potential. However, although generally considered nonpathogenic, most of the other species were shown to swim, swarm, produce biofilms, and secrete proteases that can have a role in bacterial virulence. In conclusion, MALDI-TOF MS appears useful for fast and accurate identification of Bacillus and Paenibacillus strains whose virulence properties make them of increasing clinical relevance.

The Leading Economic Sectors Building Comparative and Competitive Advantages in Romania's Foreign Trade

Directory of Open Access Journals (Sweden)

Adriana Giurgiu

2008-05-01

Full Text Available For now on, as a member state of the EU, Romania and the Romanian commercial operators should maximize the foreign trade’s opportunities given by the rich portfolio of free trade agreements of the European Union and try to reorient our exports towards countries where the products of which the structure of our Romanian exports is consisted of hold a comparative and competitive advantage, in order to reduce the Romanian long-term trade balance deficit. Therefore, this paper focuses on finding out the leading sectors with high potential to maintain and consolidate the comparative and competitive advantages of the Romania’s foreign trade.

Use of the i2b2 research query tool to conduct a matched case-control clinical research study: advantages, disadvantages and methodological considerations.

Science.gov (United States)

Johnson, Emilie K; Broder-Fingert, Sarabeth; Tanpowpong, Pornthep; Bickel, Jonathan; Lightdale, Jenifer R; Nelson, Caleb P

2014-01-30

A major aim of the i2b2 (informatics for integrating biology and the bedside) clinical data informatics framework aims to create an efficient structure within which patients can be identified for clinical and translational research projects.Our objective was to describe the respective roles of the i2b2 research query tool and the electronic medical record (EMR) in conducting a case-controlled clinical study at our institution. We analyzed the process of using i2b2 and the EMR together to generate a complete research database for a case-control study that sought to examine risk factors for kidney stones among gastrostomy tube (G-tube) fed children. Our final case cohort consisted of 41/177 (23%) of potential cases initially identified by i2b2, who were matched with 80/486 (17%) of potential controls. Cases were 10 times more likely to be excluded for inaccurate coding regarding stones vs. inaccurate coding regarding G-tubes. A majority (67%) of cases were excluded due to not meeting clinical inclusion criteria, whereas a majority of control exclusions (72%) occurred due to inadequate clinical data necessary for study completion. Full dataset assembly required complementary information from i2b2 and the EMR. i2b2 was critical as a query analysis tool for patient identification in our case-control study. Patient identification via procedural coding appeared more accurate compared with diagnosis coding. Completion of our investigation required iterative interplay of i2b2 and the EMR to assemble the study cohort.

Practical advantages of evolutionary computation

Science.gov (United States)

Fogel, David B.

1997-10-01

Evolutionary computation is becoming a common technique for solving difficult, real-world problems in industry, medicine, and defense. This paper reviews some of the practical advantages to using evolutionary algorithms as compared with classic methods of optimization or artificial intelligence. Specific advantages include the flexibility of the procedures, as well as their ability to self-adapt the search for optimum solutions on the fly. As desktop computers increase in speed, the application of evolutionary algorithms will become routine.

Innovation strategies and competitive advantage

OpenAIRE

Gërguri, Shqipe; Rexhepi, Gadaf; Ramadani, Veland

2013-01-01

Companies today operate in a very dynamic, uncertain and competitive environment. They compete in "nicety" that are so small but so important. Companies are trying to achieve competitive advantage in order to help them obtain a better and a stable position in the marketplace. The best way for companies to achieve a competitive advantage is through innovation. This paper addresses the meaning of innovation what does innovation present, types of innovation specifically discussing the right way ...

STRATEGIES FOR ACHIEVING COMPETITIVE ADVANTAGE

OpenAIRE

Jusuf ZEKIRI; Alexandru NEDELEA

2011-01-01

This paper is organized in three parts. A brief overview of the importance of strategies within companies, as well as literature review is presented along with traditional approaches on strategies for achieving competitive advantage, and new approaches for gaining a competitive advantage. The main objective of the paper is to outline and discuss the relevant issues and challenges from a theoretical viewpoint related with the possible strategy formulation of companies in order to achieve a com...

Investigative safety science as a competitive advantage for Pharma.

Science.gov (United States)

Moggs, Jonathan; Moulin, Pierre; Pognan, Francois; Brees, Dominique; Leonard, Michele; Busch, Steve; Cordier, Andre; Heard, David J; Kammüller, Michael; Merz, Michael; Bouchard, Page; Chibout, Salah-Dine

2012-09-01

Following a US National Academy of Sciences report in 2007 entitled "Toxicity Testing of the 21st Century: a Vision and a Strategy," significant advances within translational drug safety sciences promise to revolutionize drug discovery and development. The purpose of this review is to outline why investigative safety science is a competitive advantage for the pharmaceutical industry. The article discusses the essential goals for modern investigative toxicologists including: cross-species target biology; molecular pathways of toxicity; and development of predictive tools, models and biomarkers that allow discovery researchers and clinicians to anticipate safety problems and plan ways to address them, earlier than ever before. Furthermore, the article emphasizes the importance of investigating unanticipated clinical safety signals through a combination of mechanistic preclinical studies and/or molecular characterization of clinical samples from affected organs. The traditional boundaries between pharma industry teams focusing on safety/efficacy and preclinical/clinical development are rapidly disappearing in favor of translational safety science-centric organizations with a vision of bringing more effective medicines forward safely and quickly. Comparative biology and mechanistic toxicology approaches facilitate: i) identifying translational safety biomarkers; ii) identifying new drug targets/indications; and iii) mitigating off-target toxicities. These value-adding safety science contributions will change traditional toxicologists from side-effect identifiers to drug development enablers.

Toward cardiovascular MRI at 7 T: clinical needs, technical solutions and research promises

International Nuclear Information System (INIS)

Niendorf, Thoralf; Sodickson, Daniel K.; Krombach, Gabriele A.; Schulz-Menger, Jeanette

2010-01-01

To consider potential clinical needs, technical solutions and research promises of ultrahigh-field strength cardiovascular MR (CMR). A literature review is given, surveying advantages and disadvantages of CMR at ultrahigh fields (UHF). Key concepts, emerging technologies, practical considerations and applications of UHF CMR are provided. Examples of UHF CMR imaging strategies and their added value are demonstrated, including the numerous unsolved problems. A concluding section explores future directions in UHF CMR. UHF CMR can be regarded as one of the most challenging MRI applications. Image quality achievable at UHF is not always exclusively defined by signal-to-noise considerations. Some of the inherent advantages of UHF MRI are offset by practical challenges. But UHF CMR can boast advantages over its kindred lower field counterparts by trading the traits of high magnetic fields for increased temporal and/or spatial resolution. CMR at ultrahigh-field strengths is a powerful motivator, since speed and signal may be invested to overcome the fundamental constraints that continue to hamper traditional CMR. If practical challenges can be overcome, UHF CMR will help to open the door to new approaches for basic science and clinical research. (orig.)

Innovating information-delivery for potential clinical trials participants. What do patients want from multi-media resources?

Science.gov (United States)

Shneerson, Catherine; Windle, Richard; Cox, Karen

2013-01-01

To discover whether the provision of clinical trials information via a multi-media platform could better meet the needs, preferences and practices of potential cancer trial participants. A mixed qualitative and quantitative questionnaire was delivered to 72 participants from cancer support groups to elicit views on the provision and design features of multimedia resources in delivering clinical trials information. Perceived lack of information is an expressed barrier to clinical trials participation. Multimedia resources were viewed positively as a way to address this barrier by most potential clinical trials participants; in particular by helping to align information to individual needs, promote active engagement with information, and by allowing more control of the learning experience. Whilst text remained the most valued attribute of any resource, other highly rated attributes included the resource being simple to use, easily accessible, having a clear focus, incorporating examples and visual aids, and being interactive. Provision of support for the learning resource was also rated highly. As in other areas, such as education, multimedia resources may enhance the delivery and acceptance of information regarding clinical trials. Better alignment of information may have a positive impact on recruitment and retention into clinical trials. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

When to base clinical policies on observational versus randomized trial data.

Science.gov (United States)

Hornberger, J; Wrone, E

1997-10-15

Physicians must decide when the evidence is sufficient to adopt a new clinical policy. Analysis of large clinical and administrative databases is becoming an important source of evidence for changing clinical policies. Because such analysis cannot control for the effects of all potential confounding variables, physicians risk drawing the wrong conclusion about the cause-and-effect relation between a change in clinical policy and outcomes. Randomized studies offer protection against drawing a conclusion that would lead to adoption of an inferior policy. However, a randomized study may be difficult to justify because of the extra costs of collecting data for a randomized study and concerns that a study will not directly benefit the patients enrolled in the study. This article reviews the advantages and disadvantages of basing clinical policy on analysis of large databases compared with conducting a randomized study. A technique is described and illustrated for accessing the potential costs and benefits of conducting such a study. This type of analysis formed the basis for a physician-managed health care organization deciding to sponsor a randomized study among patients with end-stage renal disease as part of a quality-improvement initiative.

HTGR-steam cycle/cogeneration plant economic potential

International Nuclear Information System (INIS)

1981-05-01

The cogeneration of heat and electricity provides the potential for improved fuel utilization and corresponding reductions in energy costs. In the evaluation of the cogeneration plant product costs, it is advantageous to develop joint-product cost curves for alternative cogeneration plant models. The advantages and incentives for cogeneration are then presented in a form most useful to evaluate the various energy options. The HTGR-Steam Cycle/Cogeneration (SC/C) system is envisioned to have strong cogeneration potential due to its high-quality steam capability, its perceived nuclear siting advantages, and its projected cost advantages relative to coal. The economic information presented is based upon capital costs developed during 1980 and the economic assumptions identified herein

Systematic review of induced pluripotent stem cell technology as a potential clinical therapy for spinal cord injury.

Science.gov (United States)

Kramer, Anne S; Harvey, Alan R; Plant, Giles W; Hodgetts, Stuart I

2013-01-01

Transplantation therapies aimed at repairing neurodegenerative and neuropathological conditions of the central nervous system (CNS) have utilized and tested a variety of cell candidates, each with its own unique set of advantages and disadvantages. The use and popularity of each cell type is guided by a number of factors including the nature of the experimental model, neuroprotection capacity, the ability to promote plasticity and guided axonal growth, and the cells' myelination capability. The promise of stem cells, with their reported ability to give rise to neuronal lineages to replace lost endogenous cells and myelin, integrate into host tissue, restore functional connectivity, and provide trophic support to enhance and direct intrinsic regenerative ability, has been seen as a most encouraging step forward. The advent of the induced pluripotent stem cell (iPSC), which represents the ability to "reprogram" somatic cells into a pluripotent state, hails the arrival of a new cell transplantation candidate for potential clinical application in therapies designed to promote repair and/or regeneration of the CNS. Since the initial development of iPSC technology, these cells have been extensively characterized in vitro and in a number of pathological conditions and were originally reported to be equivalent to embryonic stem cells (ESCs). This review highlights emerging evidence that suggests iPSCs are not necessarily indistinguishable from ESCs and may occupy a different "state" of pluripotency with differences in gene expression, methylation patterns, and genomic aberrations, which may reflect incomplete reprogramming and may therefore impact on the regenerative potential of these donor cells in therapies. It also highlights the limitations of current technologies used to generate these cells. Moreover, we provide a systematic review of the state of play with regard to the use of iPSCs in the treatment of neurodegenerative and neuropathological conditions. The

Using IT-CMF to build Competitive Advantage

OpenAIRE

McLaughlin, Stephen

2012-01-01

Developing a competitive advantage, for any organization, is a key business imperative. Without some form of competitive advantage it is very difficult to compete within today’s highly dynamic market place. In order to develop competitive advantages organizations must focus on identifying and building their core capabilities. As technology’s influence is now pervasive throughout every aspect of organizational life organizations must consider the role their IT based ...

Virtual Collaboration: Advantages and Disadvantages in the Planning and Execution of Operations in the Information Age

National Research Council Canada - National Science Library

Fox, Gregory

2004-01-01

.... In analyzing the specific advantages and disadvantages of one of the systems, virtual collaboration, it becomes clear that commanders and staff at all levels of war are understanding the potential...

THE RELATIONSHIP BETWEEN ORGANISATIONAL COMPETITIVE ADVANTAGE AND PERFORMANCE MODERATED BY THE AGE AND SIZE OF FIRMS

Directory of Open Access Journals (Sweden)

Alimin Ismadi Ismail

2010-07-01

Full Text Available It has been argued that achieving a position of competitive advantage is a necessary precursor to a firm's significant performance. This paper will empirically examine the potential moderating variables that could affect the relationship between a firm's competitive advantage and performance, namely the firms' age and size. By examining the relative moderating effects of these variables, this paper delivers valuable information to firms, specifically with regard to strategic management directed toward performance and attaining a competitive advantage. This research was conducted among 127 manufacturers listed in the 2008 Federation of Malaysian Manufacturers Directory. A cross- sectional study was conducted using a structured questionnaire to obtain responses from the manufacturers. A two-way ANOVA shows that only the age of firms is a significant moderator in the relationship between competitive advantage and performance, and that this relationship is stronger for older firms. The size of firms does not significantly moderate the relationship between competitive advantage and performance. Despite the non-significant moderating effect of firms' size, overall, this study provides empirical support for the Resource-Based View (RBV of Malaysian manufacturers regarding the issue of competitive advantage.

Clinical potential of meningioma genomic insights: a practical review for neurosurgeons.

Science.gov (United States)

Karsy, Michael; Azab, Mohammed A; Abou-Al-Shaar, Hussam; Guan, Jian; Eli, Ilyas; Jensen, Randy L; Ormond, D Ryan

2018-06-01

Meningiomas are among the most common intracranial pathological conditions, accounting for 36% of intracranial lesions treated by neurosurgeons. Although the majority of these lesions are benign, the classical categorization of tumors by histological type or World Health Organization (WHO) grade has not fully captured the potential for meningioma progression and recurrence. Many targeted treatments have failed to generate a long-lasting effect on these tumors. Recently, several seminal studies evaluating the genomics of intracranial meningiomas have rapidly changed the understanding of the disease. The importance of NF2 (neurofibromin 2), TRAF7 (tumor necrosis factor [TNF] receptor-associated factor 7), KLF4 (Kruppel-like factor 4), AKT1, SMO (smoothened), PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha), and POLR2 (RNA polymerase II subunit A) demonstrates that there are at least 6 distinct mutational classes of meningiomas. In addition, 6 methylation classes of meningioma have been appreciated, enabling improved prediction of prognosis compared with traditional WHO grades. Genomic studies have shed light on the nature of recurrent meningioma, distinct intracranial locations and mutational patterns, and a potential embryonic cancer stem cell-like origin. However, despite these exciting findings, the clinical relevance of these findings remains elusive. The authors review the key findings from recent genomic studies in meningiomas, specifically focusing on how these findings relate to clinical insights for the practicing neurosurgeon.

Biocarbon ureterostomy device for urinary diversion. Multicenter clinical trial.

Science.gov (United States)

Chancellor, M; Grossman, H B; Konnak, J; Diokno, A C; Gonzalez, J; Pontes, J E; Huben, R P; King, G W

1989-07-01

The bioCarbon ureterostomy device is a stomal prosthesis for upper tract urinary diversion that has had preliminary successes in animal and human trials in Europe and Peru. Implantation of a pure carbon stomal prosthesis offers the potential advantages of high biocompatibility, lack of encrustation, and elimination of stomal stenosis which is frequently associated with cutaneous ureterostomy. Nine bioCarbon ureterostomy devices were implanted from August, 1984 through July, 1985. Although successful implantation was achieved in 2 patients, the complication rate was high. The bioCarbon ureterostomy device has potential as an alternative form of urinary diversion. However, significant problems need to be remedied before it can be recommended for routine clinical application.

Long-term potentiation and long-term depression: a clinical perspective

Directory of Open Access Journals (Sweden)

Timothy V.P. Bliss

2011-01-01

Full Text Available Long-term potentiation and long-term depression are enduring changes in synaptic strength, induced by specific patterns of synaptic activity, that have received much attention as cellular models of information storage in the central nervous system. Work in a number of brain regions, from the spinal cord to the cerebral cortex, and in many animal species, ranging from invertebrates to humans, has demonstrated a reliable capacity for chemical synapses to undergo lasting changes in efficacy in response to a variety of induction protocols. In addition to their physiological relevance, long-term potentiation and depression may have important clinical applications. A growing insight into the molecular mechanisms underlying these processes, and technological advances in non-invasive manipulation of brain activity, now puts us at the threshold of harnessing long-term potentiation and depression and other forms of synaptic, cellular and circuit plasticity to manipulate synaptic strength in the human nervous system. Drugs may be used to erase or treat pathological synaptic states and non-invasive stimulation devices may be used to artificially induce synaptic plasticity to ameliorate conditions arising from disrupted synaptic drive. These approaches hold promise for the treatment of a variety of neurological conditions, including neuropathic pain, epilepsy, depression, amblyopia, tinnitus and stroke.

A free-floating currency regime during economic crisis: advantage or disadvantage?

OpenAIRE

Lubor Lacina; Petr Toman

2011-01-01

The paper deals with the identification of potential disadvantages associated with the existence of national currencies with the floating exchange rate regime during the current financial and economic crisis in countries postponing their entry into the eurozone. The hypothesis is that the advantages of a floating exchange rate may be outweighed by their disadvantages (high volatility of exchange rates). First part of the paper provides evidence about the development of Czech crown exchange ra...

Quality of clinical supervision and counselor emotional exhaustion: the potential mediating roles of organizational and occupational commitment.

Science.gov (United States)

Knudsen, Hannah K; Roman, Paul M; Abraham, Amanda J

2013-01-01

Counselor emotional exhaustion has negative implications for treatment organizations as well as the health of counselors. Quality clinical supervision is protective against emotional exhaustion, but research on the mediating mechanisms between supervision and exhaustion is limited. Drawing upon data from 934 counselors affiliated with treatment programs in the National Institute on Drug Abuse's Clinical Trials Network (CTN), this study examined commitment to the treatment organization and commitment to the counseling occupation as potential mediators of the relationship between quality clinical supervision and emotional exhaustion. The final ordinary least squares (OLS) regression model, which accounted for the nesting of counselors within treatment organizations, indicated that these two types of commitment were plausible mediators of the association between clinical supervision and exhaustion. Higher quality clinical supervision was strongly correlated with commitment to the treatment organization as well as commitment to the occupation of SUD counseling. These findings suggest that quality clinical supervision has the potential to yield important benefits for counselor well-being by strengthening ties to both their employing organization as well the larger treatment field, but longitudinal research is needed to establish these causal relationships. Copyright © 2013 Elsevier Inc. All rights reserved.

Cross-Over Clinical Trials?

Directory of Open Access Journals (Sweden)

Latif Gachkar

2017-01-01

Full Text Available Abstract Cross-Over Clinical Trials in comparison with Parallel groups clinical trials have some advantages such as control of confounding variables, small sample size, and short time to implement the research project. But this type of research has few essential limitations that discusses in this monogram.

Home advantage in the Winter Olympics (1908-1998).

Science.gov (United States)

Balmer, N J; Nevill, A M; Williams, A M

2001-02-01

We obtained indices of home advantage, based on the medals won by competing nations, for each event held at the Winter Olympics from 1908 to 1998. These indices were designed to assess home advantage while controlling for nation strength, changes in the number of medals on offer and the performance of 'non-hosting' nations. Some evidence of home advantage was found in figure skating, freestyle skiing, ski jumping, alpine skiing and short track speed skating. In contrast, little or no home advantage was observed in ice hockey, Nordic combined, Nordic skiing, bobsled, luge, biathlon or speed skating. When all events were combined, a significant home advantage was observed (P = 0.029), although no significant differences in the extent of home advantage were found between events (P > 0.05). When events were grouped according to whether they were subjectively assessed by judges, significantly greater home advantage was observed in the subjectively assessed events (P = 0.037). This was a reflection of better home performances, suggesting that judges were scoring home competitors disproportionately higher than away competitors. Familiarity with local conditions was shown to have some effect, particularly in alpine skiing, although the bobsled and luge showed little or no advantage over other events. Regression analysis showed that the number of time zones and direction of travel produced no discernible trends or differences in performance.

A clinical perspective of accelerated statistical reconstruction

International Nuclear Information System (INIS)

Hutton, B.F.; Hudson, H.M.; Beekman, F.J.

1997-01-01

Although the potential benefits of maximum likelihood reconstruction have been recognised for many years, the technique has only recently found widespread popularity in clinical practice. Factors which have contributed to the wider acceptance include improved models for the emission process, better understanding of the properties of the algorithm and, not least, the practicality of application with the development of acceleration schemes and the improved speed of computers. The objective in this article is to present a framework for applying maximum likelihood reconstruction for a wide range of clinically based problems. The article draws particularly on the experience of the three authors in applying an acceleration scheme involving use of ordered subsets to a range of applications. The potential advantages of statistical reconstruction techniques include: (a) the ability to better model the emission and detection process, in order to make the reconstruction converge to a quantitative image, (b) the inclusion of a statistical noise model which results in better noise characteristics, and (c) the possibility to incorporate prior knowledge about the distribution being imaged. The great flexibility in adapting the reconstruction for a specific model results in these techniques having wide applicability to problems in clinical nuclear medicine. (orig.). With 8 figs., 1 tab

Constructing Regional advantage

DEFF Research Database (Denmark)

Asheim, Bjørn T.; Boschma, Ron; Cooke, Phil

2011-01-01

This paper presents a regional innovation policy model based on the idea of constructing regional advantage. This policy model brings together concepts like related variety, knowledge bases and policy platforms. Related variety attaches importance to knowledge spillovers across complementary...... economic development within and between regions in action lines appropriate to incorporate the basic principles behind related variety and differentiated knowledge bases....

Do Medicare Advantage Plans Select Enrollees in Higher Margin Clinical Categories?

Science.gov (United States)

Newhouse, Joseph P.; McWilliams, J. Michael; Price, Mary; Huang, Jie; Fireman, Bruce; Hsu, John

2013-01-01

The CMS-HCC risk adjustment system for Medicare Advantage (MA) plans calculates weights, which are effectively relative prices, for beneficiaries with different observable characteristics. To do so it uses the relative amounts spent per beneficiary with those characteristics in Traditional Medicare (TM). For multiple reasons one might expect relative amounts in MA to differ from TM, thereby making some beneficiaries more profitable to treat than others. Much of the difference comes from differences in how TM and MA treat different diseases or diagnoses. Using data on actual medical spending from two MA-HMO plans, we show that the weights calculated from MA costs do indeed differ from those calculated using TM spending. One of the two plans (Plan 1) is more typical of MA-HMO plans in that it contracts with independent community providers, while the other (Plan 2) is vertically integrated with care delivery. We calculate margins, or Average Revenue/Average Cost, for Medicare beneficiaries in the two plans who have one of 48 different combinations of medical conditions. The two plans’ margins for these 48 conditions are correlated (r=0.39, pincentive for selection by HCC. Nonetheless, we find no evidence of overrepresentation of beneficiaries in high margin HCC’s in either plan. Nor, using the margins from Plan 1, the more typical plan, do we find evidence of overrepresentation of high margin HCC’s in Medicare more generally. These results do not permit a conclusion on overall social efficiency, but we note that selection according to margin could be socially efficient. In addition, our findings suggest there are omitted interaction terms in the risk adjustment model that Medicare currently uses. PMID:24308879

Potential cost effectiveness of intravenous tissue plasminogen activator versus streptokinase for acute myocardial infarction.

Science.gov (United States)

Goel, V; Naylor, C D

1992-01-01

An economic evaluation of the potential incremental benefits of intravenous tissue plasminogen activator (tPA) versus streptokinase (SK) for treatment of acute myocardial infarction. Cost effectiveness analysis from a third-party payer perspective (Ontario Ministry of Health). ECONOMIC INPUTS: Fully allocated costs for cardiovascular procedures and hospitalization for myocardial infarction were obtained anonymously for four Ontario teaching hospitals and converted to 1988 Canadian dollars. Professional charges were taken from the provincial health insurance fee schedule and drug costs obtained from the manufacturers. CLINICAL INPUTS: The baseline analysis was for nonelderly patients with uncomplicated myocardial infarctions; sensitivity analyses allowed extrapolation to higher risk subgroups. Short and longer term mortality and short term invasive procedure rates were estimated using data from clinical trials. If tPA achieves a 1% short term mortality advantage over SK with no advantages for other survivors, cost per life-year gained can be comparable to other cardiovascular interventions at $58,600. In the absence of immediate survival advantages, but assuming greater left ventricular preservation, the constant annual hazard rate advantage must be about 0.5% per year for competitive cost effectiveness ratios. A full range of projections is presented to help guide the policy decisions that will arise in the wake of the Global Utilization of SK and tPA for Occluded Coronary Arteries (GUSTO) trial. The analysis also illustrates the general importance of considering longer term effects of in-hospital therapies for acute myocardial infarction.

ERDA with an external helium ion micro-beam: Advantages and potential applications

International Nuclear Information System (INIS)

Calligaro, T.; Castaing, J.; Dran, J.-C.; Moignard, B.; Pivin, J.-C.; Prasad, G.V.R.; Salomon, J.; Walter, P.

2001-01-01

Preliminary ERDA experiments at atmospheric pressure have been performed with our external microprobe set-up currently used for the analysis of museum objects by PIXE, RBS and NRA. The objective was to check the feasibility of hydrogen (and deuterium) profiling with an external beam of 3-MeV helium ions. The standard scattering geometry (incident beam at 15 deg. with respect to sample surface and emerging protons or deuterons at 15 deg. in the forward direction) was kept, but the thin foil absorber was replaced by helium gas filling the space between the beam spot and the detector over a distance of about 84 mm. Several standards prepared by ion implantation, with well known H or D depth profiles, were first analysed, which indicated that the analytical capability was as good as under vacuum. A striking feature is the much lower surface peak than under vacuum, a fact that enhances the sensitivity for H analysis near the surface. The same type of measurement was then performed on different materials to show the usefulness of the technique. As a first example, we have checked that the incorporation of H or D into sapphire crystals during mechanical polishing is below the detection limit. Another example is the measurement of the H content in emeralds which can be used as an additional compositional criterion for determining the provenance of emeralds set in museum jewels. The advantages and limitations of our set-up are discussed and several possible applications in the field of cultural heritage are described

Exploring the sequential lineup advantage using WITNESS.

Science.gov (United States)

Goodsell, Charles A; Gronlund, Scott D; Carlson, Curt A

2010-12-01

Advocates claim that the sequential lineup is an improvement over simultaneous lineup procedures, but no formal (quantitatively specified) explanation exists for why it is better. The computational model WITNESS (Clark, Appl Cogn Psychol 17:629-654, 2003) was used to develop theoretical explanations for the sequential lineup advantage. In its current form, WITNESS produced a sequential advantage only by pairing conservative sequential choosing with liberal simultaneous choosing. However, this combination failed to approximate four extant experiments that exhibited large sequential advantages. Two of these experiments became the focus of our efforts because the data were uncontaminated by likely suspect position effects. Decision-based and memory-based modifications to WITNESS approximated the data and produced a sequential advantage. The next step is to evaluate the proposed explanations and modify public policy recommendations accordingly.

Potential clinical and economic effects of homocyst(e)ine lowering.

Science.gov (United States)

Nallamothu, B K; Fendrick, A M; Rubenfire, M; Saint, S; Bandekar, R R; Omenn, G S

Elevated total homocyst(e)ine levels (>/=11 micromol/L) have been identified as a potential risk factor for coronary heart disease. However, the benefits expected from lowering homocyst(e)ine levels with folic acid and vitamin B(12) supplementation have yet to be demonstrated in clinical trials. We constructed a decision analytic model to estimate the clinical benefits and economic costs of 2 homocyst(e)ine-lowering strategies: (1) "treat all"-no screening, daily supplementation with folic acid (400 microg) and vitamin B(12) (cyanocobalamin; 500 microg) for all; (2) "screen and treat"-screening, followed by daily supplementation with folic acid and vitamin B(12) for individuals with elevated homocyst(e)ine levels. Simulated cohorts of 40-year-old men and 50-year-old women in the general population were evaluated. In the base-case analysis, we assumed that lowering elevated levels would reduce excess coronary heart disease risk by 40%; however, this assumption and others were evaluated across a broad range of potential values using sensitivity analysis. Primary outcomes were discounted costs per life-year saved. Although the treat-all strategy was slightly more effective overall, the screen and treat strategy resulted in a much lower cost per life-year saved ($13,600 in men and $27,500 in women) when compared with no intervention. Incremental cost-effectiveness ratios for the treat-all strategy compared with the screen and treat strategy were more than $500,000 per life-year saved in both cohorts. Sensitivity analysis showed that cost-effectiveness ratios for the screen and treat strategy remained less than $50,000 per life-year saved under several unfavorable scenarios, such as when effective homocyst(e)ine lowering was assumed to reduce the relative risk of coronary heart disease-related death by only 11% in men or 23% in women. Homocyst(e)ine lowering with folic acid and vitamin B(12) supplementation could result in substantial clinical benefits at reasonable

Features of formation of competitive advantages: a strategic dimension

OpenAIRE

O.Р. Pashchenko

2015-01-01

The article examines the features of formation of competitive advantages, the depth of theoretical and methodological basis for the formation of competitive advantages at an enterprise. The author has reviewed the approaches to the formation of stable and long-term competitive advantages. The author has also overviewed the requirements which are to be met by competitive advantages of a company and the factors that affect the possibility of competitive advantages. The author develops her ow...

Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

International Nuclear Information System (INIS)

Mendenhall, Nancy P.; Malyapa, Robert S.; Su, Zhong; Yeung, Daniel; Mendenhall, William M.; Li, Zuofeng

2011-01-01

There is a strong rationale for potential benefits from proton therapy (PT) for selected cancers of the head and neck because of the opportunity to improve the therapeutic ratio by improving radiation dose distributions and because of the significant differences in radiation dose distribution achievable with x-ray-based radiation therapy (RT) and PT. Comparisons of dose distributions between x-ray-based and PT plans in selected cases show specific benefits in dose distribution likely to translate into improved clinical outcomes. However, the use of PT in head and neck cancers requires special considerations in the simulation and treatment planning process, and currently available PT technology may not permit realization of the maximum potential benefits of PT. To date, few clinical data are available, but early clinical experiences in sinonasal tumors in particular suggest significant improvements in both disease control and radiation-related toxicity

Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

Energy Technology Data Exchange (ETDEWEB)

Mendenhall, Nancy P.; Malyapa, Robert S.; Su, Zhong; Yeung, Daniel; Mendenhall, William M.; Li, Zuofeng (Univ. of Florida Proton Therapy Inst., Jacksonville, Florida (United States)), e-mail: menden@shands.ufl.edu

2011-08-15

There is a strong rationale for potential benefits from proton therapy (PT) for selected cancers of the head and neck because of the opportunity to improve the therapeutic ratio by improving radiation dose distributions and because of the significant differences in radiation dose distribution achievable with x-ray-based radiation therapy (RT) and PT. Comparisons of dose distributions between x-ray-based and PT plans in selected cases show specific benefits in dose distribution likely to translate into improved clinical outcomes. However, the use of PT in head and neck cancers requires special considerations in the simulation and treatment planning process, and currently available PT technology may not permit realization of the maximum potential benefits of PT. To date, few clinical data are available, but early clinical experiences in sinonasal tumors in particular suggest significant improvements in both disease control and radiation-related toxicity

Ubiquitous Multicriteria Clinic Recommendation System.

Science.gov (United States)

Chen, Toly

2016-05-01

Advancements in information, communication, and sensor technologies have led to new opportunities in medical care and education. Patients in general prefer visiting the nearest clinic, attempt to avoid waiting for treatment, and have unequal preferences for different clinics and doctors. Therefore, to enable patients to compare multiple clinics, this study proposes a ubiquitous multicriteria clinic recommendation system. In this system, patients can send requests through their cell phones to the system server to obtain a clinic recommendation. Once the patient sends this information to the system, the system server first estimates the patient's speed according to the detection results of a global positioning system. It then applies a fuzzy integer nonlinear programming-ordered weighted average approach to assess four criteria and finally recommends a clinic with maximal utility to the patient. The proposed methodology was tested in a field experiment, and the experimental results showed that it is advantageous over two existing methods in elevating the utilities of recommendations. In addition, such an advantage was shown to be statistically significant.

Updates on ultrasound research in implant dentistry: a systematic review of potential clinical indications.

Science.gov (United States)

Bhaskar, Vaishnavi; Chan, Hsun-Liang; MacEachern, Mark; Kripfgans, Oliver D

2018-05-23

Ultrasonography has shown promising diagnostic value in dental implant imaging research; however, exactly how ultrasound was used and at what stage of implant therapy it can be applied has not been systematically evaluated. Therefore, the aim of this review is to investigate potential indications of ultrasound use in the three implant treatment phases, namely planning, intraoperative and postoperative phase. Eligible manuscripts were searched in major databases with a combination of key words related to the use of ultrasound imaging in implant therapy. An initial search yielded 414 articles, after further review, 28 articles were finally included for this systematic review. Ultrasound was found valuable, though at various development stages, for evaluating (1) soft tissues, (2) hard tissues (3) vital structures and (4) implant stability. B-mode, the main function to image anatomical structures of interest, has been evaluated in pre-clinical and clinical studies. Quantitative ultrasound parameters, e.g. sound speed and amplitude, are being developed to evaluate implant-bone stability, mainly in simulation and pre-clinical studies. Ultrasound could be potentially useful in all 3 treatment phases. In the planning phase, ultrasound could evaluate vital structures, tissue biotype, ridge width/density, and cortical bone thickness. During surgery, it can provide feedback by identifying vital structures and bone boundary. At follow-up visits, it could evaluate marginal bone level and implant stability. Understanding the current status of ultrasound imaging research for implant therapy would be extremely beneficial for accelerating translational research and its use in dental clinics.

Assessment of potential advantages of high Tc-superconductors for technical application of superconductivity

International Nuclear Information System (INIS)

Schauer, F.; Juengst, K.P.; Komarek, P.; Maurer, W.

1987-09-01

A first assessment of the technical and economical consequences of liquid nitrogen cooling of new superconductors is given. For the investigation the applications of superconductivity are classified in two categories: First, systems where superconductors are practically indispensable for achieving the system's objectives; second, superconductor applications in competition with highly developed conventional technologies. Further development of those superconducting systems in the first category for which the cost of cryogenic equipment is a smaller fraction of the total system cost (e.g. fusion reactor or MHD generator) will hardly be affected. However, for systems like particle accelerators, research magnets, and NMR spectroscopy and imaging systems, the cryogenic equipment expenditures are significant and LN 2 cooling leads here to a reduction of investment and operating costs, to simplified handling and maintenance, to better reliability and availability, and will thereby improve the acceptance and further spread of these systems. In the second category each application of superconductivity has to be compared with its conventional counterpart, separately. Here, electonic components, power switches, resistive current limiters, and especially the power transmission cables are those applications which look most promising. For magnet applications the main advantageous arguments are less the cost saving aspect but more the higher reliability, simplicity, N 2 -availability, and ease of handling. (orig.) [de

Mesenchymal stem cells: biological characteristics and potential clinical applications

DEFF Research Database (Denmark)

Kassem, Moustapha

2004-01-01

are among the first stem cell types to be introduced in the clinic. Several studies have demonstrated the possible use of MSC in systemic transplantation for systemic diseases, local implantation for local tissue defects, as a vehicle for genes in gene therapy protocols or to generate transplantable tissues...... and organs in tissue engineering protocols. Before their widespread use in therapy, methods allowing the generation of large number of cells without affecting their differentiation potential as well as technologies that overcome immunological rejection (in case allogenic transplantation) must be developed.......Mesenchymal stem cells (MSC) are clonogenic, non-hematpoietic stem cells present in the bone marrow and are able to differentiate into multiple mesoderm-type cell lineages, for example, osteoblasts, chondrocytes, endothelial-cells and also non-mesoderm-type lineages, for example, neuronal...

A clinically feasible method for the detection of potential collision in proton therapy

Energy Technology Data Exchange (ETDEWEB)

Zou Wei; Lin Haibo; Plastaras, John P.; Wang Huanshu; Bui, Viet; Vapiwala, Neha; McDonough, James; Tochner, Zelig; Both, Stefan [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States); Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States) and Department of Mechanical Engineering, Drexel University, Philadelphia, Pennsylvania 19104 (United States); Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States)

2012-11-15

Purpose: Potential collision between the patient/couch and the gantry could delay the start of the treatment and reduce clinical efficiency. The ability to accurately detect possible collisions during the treatment planning phase is desired. Such collision detection should account for the specific proton gantry design, the treatment beam configuration, couch orientation, and the patient specific geometry. In this paper the authors developed an approach to detect possible patient-machine collisions using patient treatment plan data. Methods: The geometry of the machine and the patient was reconstructed relative to the isocenter of the proton treatment room. The surface contour of the gantry was first captured from the proton computer aided design and reconstructed to account for specific gantry rotation, snout position, collimator rotation, and range compensator dimensions based on the patient treatment plan data. The patient body and couch contours were captured from the patient's CT DICOM structure file. They were reconstructed relative to the isocenter taking into account treatment couch rotation. For potential collision that occurs at body portions where no CT images exist, scout images are used to construct the body contour. A software program was developed using a ray casting algorithm that was applied to detect collisions by determining if any of the patient and couch contour points fall into the spatial polygons formed by the proton gantry surfaces. Results: Twenty-four patient plans with or without potential collisions were retrospectively identified and analyzed using the collision detection software. In addition, five collision cases were artificially generated using an anthropomorphic phantom. The program successfully detected the collisions in all cases. The calculation time for each case was within 20 s. The software program was implemented in the authors' clinic to detect patient-gantry or gantry-couch collisions in the treatment planning

The Temporal Limits of Technological Advantage

Science.gov (United States)

2017-06-01

technologically advanced capabilities. “ Technology , in fact, is one of the keys to understanding relations between Hitler’s regime and the German business ...strategy sought to “leverage US advantages in technologies 2 like big data, stealth, advanced manufacturing (e.g. 3-D printing), robotics, and... history has had different parameters and different results, examining historical situations in which a technological advantage has been achieved

COMPETITIVE ADVANTAGE IN THE ENTERPRISE PERFORMANCE

OpenAIRE

PRUNEA Ana Daniela

2014-01-01

Rapid changes in market characteristics and the technological innovations are common and faster challenges, resulting in products, processes and technologies. The competitive advantage is volatile, difficult to obtain and more difficult to maintain and strengthened with consumers who through their individual choices polarization confirms the recognition performance and award competitive advantages, thus causing the competitive ranking of companies present in a particular market. The competiti...

Hematopoietic stem cells from NOD mice exhibit autonomous behavior and a competitive advantage in allogeneic recipients.

Science.gov (United States)

Chilton, Paula M; Rezzoug, Francine; Ratajczak, Mariusz Z; Fugier-Vivier, Isabelle; Ratajczak, Janina; Kucia, Magda; Huang, Yiming; Tanner, Michael K; Ildstad, Suzanne T

2005-03-01

Type 1 diabetes is a systemic autoimmune disease that can be cured by transplantation of hematopoietic stem cells (HSCs) from disease-resistant donors. Nonobese diabetic (NOD) mice have a number of features that distinguish them as bone marrow transplant recipients that must be understood prior to the clinical application of chimerism to induce tolerance. In the present studies, we characterized NOD HSCs, comparing their engraftment characteristics to HSCs from disease-resistant strains. Strikingly, NOD HSCs are significantly enhanced in engraftment potential compared with HSCs from disease-resistant donors. Unlike HSCs from disease-resistant strains, they do not require graft-facilitating cells to engraft in allogeneic recipients. Additionally, they exhibit a competitive advantage when coadministered with increasing numbers of syngeneic HSCs, produce significantly more spleen colony-forming units (CFU-Ss) in vivo in allogeneic recipients, and more granulocyte macrophage-colony-forming units (CFU-GMs) in vitro compared with HSCs from disease-resistant controls. NOD HSCs also exhibit significantly enhanced chemotaxis to a stromal cell-derived factor 1 (SDF-1) gradient and adhere significantly better on primary stroma. This enhanced engraftment potential maps to the insulin-dependent diabetes locus 9 (Idd9) locus, and as such the tumor necrosis factor (TNF) receptor family as well as ski/sno genes may be involved in the mechanism underlying the autonomy of NOD HSCs. These findings may have important implications to understand the evolution of autoimmune disease and impact on potential strategies for cure.

Competitive advantage, what does it really mean?

NARCIS (Netherlands)

dr. Haijing de Haan; Hongjue Yan

2013-01-01

Competitive advantage is probably the most popular business concept today (Mooney, 2007). This article aims to investigate critically the discourse on competitive advantage, as expressed by business literature, by locating its meanings in the public higher education sector. This research reveals

Information technology for competitive advantage: the case of learning and innovation in behavioural healthcare service.

Science.gov (United States)

Hsieh, Chang-tseh; Lin, Binshan

2011-01-01

The utilisation of IS/IT could offer a substantial competitive advantage to healthcare service providers through the realisation of improved clinical, financial, and administrative outcomes. In this study, 42 journal articles were reviewed and summarised with respect to identified benefits and challenges of the development and implementation of electronic medical records, tele-health, and electronic appointment reminders. Results of this study help pave the knowledge foundation for management of the behavioural healthcare to learn how to apply state-of-the-art information technology to offer higher quality, clinically proven effective services at lower costs than those of their competitors.

Sustainability and cleaner production: a study on the implications competitive advantage in business

Directory of Open Access Journals (Sweden)

Jaqueline Guimarães Santos

2015-08-01

Full Text Available This paper discusses the relationship between the adoption of environmental management system in the business and the competitive advantages that can result from this process. Therefore, the effects are discussed the emergence of a model of sustainable development and the role and opportunities of the company that perspective. Being theoretical, the aim of this paper is to discuss the potential contributions that the implementation of cleaner production technology can offer to the enterprise competitive strategy. To elucidate these relationships are discussed concepts relating to the introduction of an environmental management system, which emphasized the use of environmental measures, specifically the inherent Cleaner Production that aim to reduce the environmental impacts of industrial production, eliminating waste and reducing costs. Moreover, the concept of competitive advantage is crafted light of assumptions Porter on profitability from cost reduction and product differentiation. The findings indicate that the introduction of the Cleaner Production to reduce costs and add value to the image of the product, is an instrument of competitiveness that allows the company to differentiate and gain competitive advantage.

Clinical experience with image-guided robotic radiosurgery (the Cyberknife) in the treatment of brain and spinal cord tumors

International Nuclear Information System (INIS)

Chang, S.D.; Murphy, M.; Geis, P.; Martin, D.P.; Hancock, S.L.; Doty, J.R.; Adler, J.R. Jr.

1998-01-01

The Cyberknife is an image-guided ''frameless'' dedicated radiosurgical device. This instrument has several distinct advantages over frame-based systems, including improved patient comfort, increased treatment degrees of freedom, and the potential to target extracranial lesions. Clinical results thus far with respect to the treatment of malignant intracranial tumors has been promising. Additionally, the Cyberknife will likely revolutionize the application of radiosurgery to extracranial sites. A description of the components, treatment planning, and clinical results of the Cyberknife will be reviewed. (author)

4D co-registration of X-ray and MR-mammograms: initial clinical results and potential incremental diagnostic value.

Science.gov (United States)

Dietzel, Matthias; Hopp, Torsten; Ruiter, Nicole V; Kaiser, Clemens G; Kaiser, Werner A; Baltzer, Pascal A

2015-01-01

4D co-registration of X-ray- and MR-mammograms (XM and MM) is a new method of image fusion. The present study aims to evaluate its clinical feasibility, radiological accuracy, and potential clinical value. XM and MM of 25 patients were co-registered. Results were evaluated by a blinded reader. Precision of the 4D co-registration was "very good" (mean-score [ms]=7), and lesions were "easier to delineate" (ms=5). In 88.8%, "relevant additional diagnostic information" was present, accounting for a more "confident diagnosis" in 76% (ms=5). 4D co-registration is feasible, accurate, and of potential clinical value. Copyright © 2015 Elsevier Inc. All rights reserved.

The potential of functional MRI as a biomarker in early Alzheimer’s disease

OpenAIRE

Sperling, Reisa

2011-01-01

Functional magnetic resonance imaging (fMRI) is a relative newcomer in the field of biomarkers for Alzheimer’s disease (AD). fMRI has several potential advantages, particularly for clinical trials, as it is a non-invasive imaging technique that does not require the injection of contrast agent or radiation exposure and thus can be repeated many times during a longitudinal study. fMRI has relatively high spatial and reasonable temporal resolution, and can be acquired in the same session as stru...

[Potential antimicrobial drug interactions in clinical practice: consequences of polypharmacy and multidrug resistance].

Science.gov (United States)

Martínez-Múgica, Cristina

2015-12-01

Polypharmacy is a growing problem nowadays, which can increase the risk of potential drug interactions, and result in a loss of effectiveness. This is particularly relevant to the anti-infective therapy, especially when infection is produced by resistant bacteria, because therapeutic options are limited and interactions can cause treatment failure. All antimicrobial prescriptions were retrospectively reviewed during a week in the Pharmacy Department, in order to detect potential drug-interactions and analysing their clinical significance. A total of 314 antimicrobial prescriptions from 151 patients were checked. There was at least one potential interaction detected in 40% of patients, being more frequent and severe in those infected with multidrug-resistant microorganisms. Drugs most commonly involved were quinolones, azoles, linezolid and vancomycin. Potential drug interactions with antimicrobial agents are a frequent problem that can result in a loss of effectiveness. This is why they should be detected and avoided when possible, in order to optimize antimicrobial therapy, especially in case of multidrug resistant infections.

The Implementation of Knowledge Strategy-Based Entrepreneurial Capacity to Achieve Sustainable Competitive Advantage

Directory of Open Access Journals (Sweden)

Widodo

2013-08-01

Full Text Available This study aims to develop a model of knowledge strategy-based entrepreneurial capacity to achieve sustainable competitive advantage of rurol banking in Central Java province. The sampling method is ‘‘Purposive sampling’’ by considering the characteristics of the population items, namely: operational experience for at least 5 years and representatives of each area of rurol banking in Semarang, Surakarta and Purwokerto. Then, the sample size is 150 of 251 (59.7% of top managers of rurol banking. To analyze the data in this study, it used the Structural Equation Modeling (SEM, of the, AMOS software package. The findings of this study explain that 1. The first step in promoting a sustainable competitive advantage through knowledge sharing is by prioritizing the quality of interaction, willingness and ability. 2. Efforts to improve a sustainable competitive advantage through knowledge exploitation built by knowledge sharing are by prioritizing to actively accept changes and introduction, solve problems together, use and combine new knowledge in operation. 3. Efforts to improve a sustainable competitive advantage through the knowledge exploitation built by risk-taking are by prioritizing a strong tendency for high-risk projects (with the possibility of gaining high-return, a high courage for the actions necessary to achieve the goal, having an aggressive attitude to optimize the possibility of utilizing existing potential opportunities and enjoying the challenge of the risk situation. 4. Efforts to improve a sustainable competitive advantage through knowledge exploitation built by a pro-active are by prioritizing to anticipate problem more quickly than competitors, future oriented, addressed by technology, launching product selectively and systematically search for new ideas. 5. Efforts to improve a sustainable competitive advantage through knowledge exploitation built by the innovativeness are by prioritizing the speed of developing products

Competitive advantage of hotels in Jinhua --Combining Institutional and Resource based Views

OpenAIRE

Wang, Wei

2007-01-01

This research endeavors to address the sustainable competitive advantage issue of Chinese firms from the paradigm combining resource based and institutional views. Both views have been used extensively in the strategy research literature in China, and the integrative perspective has the potential to approach the strategy issues new insight by incorporating the institutional influence on resource. Establishing on extensive RBV, institutional theory literature and especially Oliver(1997)��...

Strategic Positioning for Sustainable Competitive Advantage: An ...

African Journals Online (AJOL)

Organizational learning is increasingly being considered as one of the fundamental sources of competitive advantage within the context of strategic management. However, most literature has not clearly linked organizational learning with sustainable competitive advantage. This paper, therefore, explores and discusses the ...

Diagnostic accuracy of clinical and blood examination for sepsis in potentially infected neonates

Directory of Open Access Journals (Sweden)

Ari Mulyani

2006-10-01

Full Text Available Background Neonatal sepsis remains a diagnostic challenge due to its nonspesific symptoms and signs. Blood culture as the gold standard is still a problem because it takes time, is expensive, and not every health facility is able to perionn. Objective To evaluate the diagnostic accuracy of clinical symptoms, hematologic findings, and C-reactive protein (CRP in neonatal sepsis. Methods Samples were taken from potentially infected neonates admitted to the Matemal-Perinatal Unit of Sardjito Hospital, between December 1st, 2000 and March 31st, 2001 using at least one of the criteria: prematurity, very low birth weight infants, matemal pyrexia during delivery, premature membrane rupture, or thick, cloudy amniotic fluid. Clinical symptoms, total leukocyte, neutrophil, platelet count, CRP, and blood culture as the gold standard were examined. Results Among 99 neonates enrolled, the sensitivity, specificity, positive and negative predictive value of clinical symptoms were 79.3%, 75.7%, 57.5%, and 89.9%, respectively; leukopenia/leukocytosis were 27.6%, 85.7%, 44.4%, and 74.1%; neutropenia! neutrophilia were 41.4%, 71.4%, 37.5%, and 74.6%; thrombocytopenia were 79.3%, 51.8%, 40.4%, and 85.7%; positive CRP were 58.6%,78.6%,53.1%, and 82.1%. Parallel tests increased the sensitivity up to 89.7%. Specificity, positive and negative predictive value, and likelihood ratio were 44.3%, 40%, 91.2%, and 1.6, respectively. Serial tests increased the specificity up to 88.6%. Sensitivity, positive and negative predictive value, and likelihood ratio were 58.6%, 68%, 83.8%, and 5.1, respectively. Conclusion Clinical sepsis, thrombocytopenia, and CRP are sufficiently accurate as diagnostic tests for sepsis in potentially infected neonates. Parallel tests will increase the sensitivity, while serial tests increase the specificity.

ADVANTAGES AND DISADVANTAGES OF THE SONICFILL™ METHOD FOR LATERAL FILLINGS

Directory of Open Access Journals (Sweden)

Nicolae BARANOV

2017-06-01

Full Text Available The aim of the study was to evaluate the advantages and disadvantages of bulk-fill type fillings realized with SONICFill™ over an 18 month interval, on a batch of patients with different ages and occupations. Materials and methods: the study was performed on a batch of 73 patients who addressed the Clinical of OdontologyEndodontics within the Platform of Practical Training (PIP of the Faculty of Dental Medicine of the ”Apollonia” University of Iaşi, between Octomber 1, 2014 - May 1, 2016, subjected to 91 bulk-fill fillings with SonicFill™ on the posterior teeth. Results and discussion: out of the total number of 73 patients, 56 came from the urban environment, and 17 - from the rural medium, the highest ratio being represented by the 21-30 year age group (45%, closely followed by the 31-40 year one (40%. As for gender distribution within the batch, nearly two-thirds are women, the rest being men. The education level influenced patients’ decision – that of accepting a new method of filling application. As to the types of teeth to which restorations were applied, the highest ratio is represented by lower molars (41%, followed by upper molars (23% and mandibular premolars (20%, the lowest number of restorations being applied to maxillary premolars. Out of the total number of 91 bulk-fill restorations, 28 were applied over a base filling while, in 63 restorations, the basic filling was absent. Conclusions: The SonicFill ™ system for bulk-fill posterior restorations has a number of advantages, such as: high photopolymerization depth, significant reduction of setting contraction, better composite adaptation to the cavity walls, long-term predictable clinical results.

Vacuum-assisted drainage in cardiopulmonary bypass: advantages and disadvantages.

Science.gov (United States)

Carvalho Filho, Elio Barreto de; Marson, Fernando Augusto de Lima; Costa, Loredana Nilkenes Gomes da; Antunes, Nilson

2014-01-01

Systematic review of vacuum assisted drainage in cardiopulmonary bypass, demonstrating its advantages and disadvantages, by case reports and evidence about its effects on microcirculation. We conducted a systematic search on the period 1997-2012, in the databases PubMed, Medline, Lilacs and SciELO. Of the 70 selected articles, 26 were included in the review. Although the vacuum assisted drainage has significant potential for complications and requires appropriate technology and professionalism, prevailed in literature reviewed the concept that vacuum assisted drainage contributed in reducing the rate of transfusions, hemodilutions, better operative field, no significant increase in hemolysis, reduced complications surgical, use of lower prime and of smaller diameter cannulas.

Potential clinical impact of laser-accelerated beams in cancer ion therapy

Energy Technology Data Exchange (ETDEWEB)

Obcemea, Ceferino

2016-09-01

In this article, I present three advantages of plasma-accelerated ion beams for cancer therapy. I discuss how: 1. low-emittance and well-collimated beams are advantageous in proximal normal tissue-sparing; 2. highly-peaked quasi-monoenergetic beams are ideal for fast energy selection and switching in Pencil Beam Scanning (PBS) as a treatment delivery; 3. high fluence and ultra-short pulse delivery produce collective excitations in the medium and enhance the stopping power. This in turn produces denser ionization track signatures (spurs, blobs, etc.) in target tumors, higher linear energy transfer, higher Bragg peak, and higher radiobiological effectiveness at the micro-level.

Analysis of yield advantage in mixed cropping

NARCIS (Netherlands)

Ranganathan, R.

1993-01-01

It has long been recognized that mixed cropping can give yield advantages over sole cropping, but methods that can identify such yield benefits are still being developed. This thesis presents a method that combines physiological and economic principles in the evaluation of yield advantage.

Problems and advantages of applying the e-learning model to the teaching of English

OpenAIRE

Shaparenko, А.; Golikova, А.

2013-01-01

In this article we mention some potential and noted problems and advantages of applying the e-learning model to the teaching of English. In the area of foreign language teaching a lot has been done, but there are constant attempts for new solutions. Another option for e-learning is a hybrid course.

Advantages and risks in service standardization

Directory of Open Access Journals (Sweden)

Veres Zoltán

2004-01-01

Full Text Available Comparing the advantages and risks in standardizing services, there can be no clear-cut answer concerning the strategy to be followed. Exploiting advantages in the long run is only worth it for a provider of a service that is able to build up a powerful brand image. However, the more successful a service concept, the stronger the temptation to imitation. The success of imitators will sooner or later bring about multibrand loyalty.

The Strategy and Competitive Advantage of Indoor Sports Industry in Malaysia

OpenAIRE

Tan, Kar Fai

2011-01-01

The sports industry in Malaysia is an industry which is full of potential as it is considered young in this country. The most popular sports in Malaysia are football (soccer) and badminton. Other sports such as squash, cycling, hockey are also quite popular due to our national representative success in the international arena. The purpose of this study is to determine the strategy taken by firms operating in indoor sports industry in Malaysia and to know their competitive advantage. The me...

Comparison of two measurement techniques for clinical wear

DEFF Research Database (Denmark)

Peters, M C; Delong, R; Pintado, M R

1999-01-01

Clinical wear of restorations is generally evaluated by marginal integrity over time. In this study, both a subjective and an objective method for wear assessment are compared, and the relative advantages and disadvantages of each are considered.......Clinical wear of restorations is generally evaluated by marginal integrity over time. In this study, both a subjective and an objective method for wear assessment are compared, and the relative advantages and disadvantages of each are considered....

Constructing a Local Potential Participant Registry to Improve Alzheimer's Disease Clinical Research Recruitment.

Science.gov (United States)

Grill, Joshua D; Hoang, Dan; Gillen, Daniel L; Cox, Chelsea G; Gombosev, Adrijana; Klein, Kirsten; O'Leary, Steve; Witbracht, Megan; Pierce, Aimee

2018-01-01

Potential participant registries are tools to address the challenge of slow recruitment to clinical research. In particular, registries may aid recruitment to secondary prevention clinical trials for Alzheimer's disease (AD), which enroll cognitively normal older individuals meeting specific genetic or biomarker criteria. Evidence of registry effectiveness is sparse, as is guidance on optimal designs or methods of conduct. We report our experiences of developing a novel local potential participant registry that implemented online enrollment and data collection. In the first year of operation, 957 individuals submitted email addresses to the registry, of whom 592 self-reported demographic, family history, and medical data. In addition, registrants provided information related to their interest and willingness to be contacted about studies. Local earned media and community education were the most effective methods of recruitment into the registry. Seventy-six (26%) of 298 registrants contacted about studies in the first year enrolled in those studies. One hundred twenty-nine registrants were invited to enroll in a preclinical AD trial, of whom 25 (18%) screened and 6 were randomized. These results indicate that registries can aid recruitment and provide needed guidance for investigators initiating new local registries.

A study of patient attitudes towards decentralisation of HIV care in an urban clinic in South Africa.

Science.gov (United States)

Mukora, Rachel; Charalambous, Salome; Dahab, Maysoon; Hamilton, Robin; Karstaedt, Alan

2011-08-26

In South Africa, limited human resources are a major constraint to achieving universal antiretroviral therapy (ART) coverage. Many of the public-sector HIV clinics operating within tertiary facilities, that were the first to provide ART in the country, have reached maximum patient capacity. Decentralization or "down-referral" (wherein ART patients deemed stable on therapy are referred to their closest Primary Health Clinics (PHCs) for treatment follow-up) is being used as a possible alternative of ART delivery care. This cross-sectional qualitative study investigates attitudes towards down-referral of ART delivery care among patients currently receiving care in a centralized tertiary HIV clinic. Ten focus group discussions (FGDs) with 76 participants were conducted in early 2008 amongst ART patients initiated and receiving care for more than 3 months in the tertiary HIV clinic study site. Eligible individuals were invited to participate in FGDs involving 6-9 participants, and lasting approximately 1-2 hours. A trained moderator used a discussion topic guide to investigate the main issues of interest including: advantages and disadvantages of down-referral, potential motivating factors and challenges of down-referral, assistance needs from the transferring clinic as well as from PHCs. Advantages include closeness to patients' homes, transport and time savings. However, patients favour a centralized service for the following reasons: less stigma, patients established relationship with the centralized clinic, and availability of ancillary services. Most FGDs felt that for down-referral to occur there needed to be training of nurses in patient-provider communication. Despite acknowledging the down-referral advantages of close proximity and lower transport costs, many participants expressed concerns about lack of trained HIV clinical staff, negative patient interactions with nurses, limited confidentiality and stigma. There was consensus that training of nurses and

Taking advantage of an unerupted third molar: a case report

Directory of Open Access Journals (Sweden)

Igor Figueiredo Pereira

Full Text Available ABSTRACT Introduction: Treatments with dental surgery seek to displace tooth to the correct position within the dental arch. Objective: To report a clinical case that took advantage of an unerupted third molar. Case history: A male patient, 18 years of age, was referred by his dentist to evaluate the third molars. The clinical exam revealed no visible lower third molars. The computed tomography (CT exam showed the presence of a supernumerary tooth in the region of the mandibular ramus, on the left side, and impaction of the third molar, which was causing root resorption on the second molar, thus making it impossible to remain in the buccal cavity. The preferred option, therefore, was to remove both second molar and the supernumerary tooth, in addition to attaching a device to the third molar during surgery for further traction. Results: After 12 months, the third molar reached the proper position. Conclusion: When a mandibular second permanent molar shows an atypical root resorption, an impacted third molar can effectively substitute the tooth by using an appropriate orthodontic-surgical approach.

THE EFFECT OF COMPETITIVE ADVANTAGE AND HUMAN ADVANTAGE ON INDUSTRIAL COMPETITIVE STRATEGY (Case Study: SMIs in Gorontalo Province

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Trifandi Lasalewo

2016-09-01

Full Text Available Small and Medium Industries (SMIs have a strategic role in the Indonesian economy, as they earn 61.9 percent of the foreign exchange which goes to make up the nation’s Gross Domestic Product, and nationally they are able to absorb 97 percent of the workforce. The Global Competitiveness Report also notes that SMIs serve as the business units that affect every nation’s competitiveness. Considering this strategic role, the selection of a competitive strategy for these SMIs is absolutely necessary. Through an in-depth literature review, this study aims to explore what variables influence the competitive strategy of industries, particularly the SMIs. By using a Systematic Literature Review (SLR with a total of 31 main literature (articles, papers and books, this study has found two dominant factors that influence industrial competitive strategy: Competitive advantage and human advantage, which are subsequently developed into six independent variables (construct variables, i.e. cost, delivery, product quality, product variety, know-how and innovativeness, with a total of 44 indicators. The results of measurements of the sample of SMIs in Gorontalo Province, using Structural Equation Modeling, found that both competitive advantage and human advantage jointly influence 40.2 percent of the industrial competitive strategies. These results indicate that competitive strategies, such as creating products with unique features, on-time delivery, flexibility in production, and employee involvement in the innovations, are indispensable to SMIs in order for them to produce quality products and be able to maintain their advantage.

Disadvantages and advantages of transtibial technique for creating the anterior cruciate ligament femoral socket.

Science.gov (United States)

Robin, Brett N; Lubowitz, James H

2014-10-01

Anterior cruciate ligament (ACL) femoral socket techniques have distinct advantages and disadvantages when considering the following techniques: transtibial, anteromedial portal, outside-in, and outside-in retroconstruction. There is no one perfect technique and we have an incomplete understanding of anatomical, biomechanical, isometry, stability, and clinical outcomes. Our primary focus is transtibial technique for creating the ACL femoral socket. Advantages include less invasive, isometric graft placement, stable Lachman exam, and minimal graft impingement with the tunnel and notch. Disadvantages include nonanatomic vertical graft placement that can cause rotational instability and positive pivot shift, interference screw divergence, graft-tunnel length mismatch, femoral socket constraint, posterior cruciate ligament impingement, and a short, oblique tibial tunnel that may undermine the medial plateau in an attempt to achieve anatomic ACL reconstruction. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

TCR-Engineered, Customized, Antitumor T Cells for Cancer Immunotherapy: Advantages and Limitations

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Arvind Chhabra

2011-01-01

Full Text Available The clinical outcome of the traditional adoptive cancer immunotherapy approaches involving the administration of donor-derived immune effectors, expanded ex vivo, has not met expectations. This could be attributed, in part, to the lack of sufficient high-avidity antitumor T-cell precursors in most cancer patients, poor immunogenicity of cancer cells, and the technological limitations to generate a sufficiently large number of tumor antigen-specific T cells. In addition, the host immune regulatory mechanisms and immune homeostasis mechanisms, such as activation-induced cell death (AICD, could further limit the clinical efficacy of the adoptively administered antitumor T cells. Since generation of a sufficiently large number of potent antitumor immune effectors for adoptive administration is critical for the clinical success of this approach, recent advances towards generating customized donor-specific antitumor-effector T cells by engrafting human peripheral blood-derived T cells with a tumor-associated antigen-specific transgenic T-cell receptor (TCR are quite interesting. This manuscript provides a brief overview of the TCR engineering-based cancer immunotherapy approach, its advantages, and the current limitations.

TCR-engineered, customized, antitumor T cells for cancer immunotherapy: advantages and limitations.

Science.gov (United States)

Chhabra, Arvind

2011-01-05

The clinical outcome of the traditional adoptive cancer immunotherapy approaches involving the administration of donor-derived immune effectors, expanded ex vivo, has not met expectations. This could be attributed, in part, to the lack of sufficient high-avidity antitumor T-cell precursors in most cancer patients, poor immunogenicity of cancer cells, and the technological limitations to generate a sufficiently large number of tumor antigen-specific T cells. In addition, the host immune regulatory mechanisms and immune homeostasis mechanisms, such as activation-induced cell death (AICD), could further limit the clinical efficacy of the adoptively administered antitumor T cells. Since generation of a sufficiently large number of potent antitumor immune effectors for adoptive administration is critical for the clinical success of this approach, recent advances towards generating customized donor-specific antitumor-effector T cells by engrafting human peripheral blood-derived T cells with a tumor-associated antigen-specific transgenic T-cell receptor (TCR) are quite interesting. This manuscript provides a brief overview of the TCR engineering-based cancer immunotherapy approach, its advantages, and the current limitations.

The advantages and disadvantages of using high technology in hand rehabilitation.

Science.gov (United States)

Levanon, Yafi

2013-01-01

A brief review of the history of occupational therapy shows that the relationship between health and activity was of great concern to the founders of the Occupational Therapy (OT) field, and continues to be of concern to today's occupational therapists. Today, computers and Virtual Reality (VR) take the place of clay and the weaving loom. The goal of this article is to describe both known and innovative computerized equipment being used in interventions for hand rehabilitation and evaluations, as well as answer the question: 'what are the advantages and disadvantages of using technology in hand rehabilitation?' Our conclusion, based on clinical experience and supported by the literature, appears to emphasize that advanced technology can enrich treatment and help patients who are unable to visit the clinic regularly, to get appropriate treatment. However, advanced technology has not been found to be superior to traditional treatment and cannot replace the occupational therapist. Copyright © 2013 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Is bilingualism losing its advantage? A bibliometric approach.

Science.gov (United States)

Sanchez-Azanza, Victor A; López-Penadés, Raúl; Buil-Legaz, Lucía; Aguilar-Mediavilla, Eva; Adrover-Roig, Daniel

2017-01-01

This study uses several bibliometric indices to explore the temporal course of publication trends regarding the bilingual advantage in executive control over a ten-year window. These indices include the number of published papers, numbers of citations, and the journal impact factor. According to the information available in their abstracts, studies were classified into one of four categories: supporting, ambiguous towards, not mentioning, or challenging the bilingual advantage. Results show that the number of papers challenging the bilingual advantage increased notably in 2014 and 2015. Both the average impact factor and the accumulated citations as of June 2016 were equivalent between categories. However, of the studies published in 2014, those that challenge the bilingual advantage accumulated more citations in June 2016 than those supporting it. Our findings offer evidence-based bibliometric information about the current state of the literature and suggest a change in publication trends regarding the literature on the bilingual advantage.

Features of formation of competitive advantages: a strategic dimension

Directory of Open Access Journals (Sweden)

O.Р. Pashchenko

2015-09-01

Full Text Available The article examines the features of formation of competitive advantages, the depth of theoretical and methodological basis for the formation of competitive advantages at an enterprise. The author has reviewed the approaches to the formation of stable and long-term competitive advantages. The author has also overviewed the requirements which are to be met by competitive advantages of a company and the factors that affect the possibility of competitive advantages. The author develops her own approach to the definition of «competitive enterprise strategy», suggests to understand the concept as the perspective of company development, the way of achieving the goals a company sets for itself guided by its policy, using internal and external competitive advantages. The author implements the model of strategic management of enterprise development based on competitive advantage creating. The suggested model will take into account the maximum possible factors that impact on the development and implementation of strategies. Due to the model risks will also be reduced. The paper determines that the important stage of enterprise development strategic management based on competitive advantage creating is the management of changes and the management of resistance to changes caused by the influence of factors of external and internal environment.

The greenhouse advantage of natural gas appliances

International Nuclear Information System (INIS)

Coombe, N.

2000-01-01

The life cycle report prepared recently by Energetics for the AGA, Assessment of Greenhouse Gas Emissions from Natural Gas, demonstrates clearly the greenhouse advantage natural gas has over coal in generating electricity. This study also goes one step further in applying this life cycle approach to the use of space and water heating within the home. The study shows the significant green-house advantage that natural gas appliances have over electric appliances. Findings from other studies also support this claim. The natural gas suppliers are encouraged to take advantage of the marketing opportunity that these studies provide, offering the householders the fuel that will significantly reduce their contribution to greenhouse emission

Ear Advantage for Musical Location and Relative Pitch: Effects of Musical Training and Attention.

Science.gov (United States)

Hutchison, Joanna L; Hubbard, Timothy L; Hubbard, Nicholas A; Rypma, Bart

2017-06-01

Trained musicians have been found to exhibit a right-ear advantage for high tones and a left-ear advantage for low tones. We investigated whether this right/high, left/low pattern of musical processing advantage exists in listeners who had varying levels of musical experience, and whether such a pattern might be modulated by attentional strategy. A dichotic listening paradigm was used in which different melodic sequences were presented to each ear, and listeners attended to (a) the left ear or the right ear or (b) the higher pitched tones or the lower pitched tones. Listeners judged whether tone-to-tone transitions within each melodic sequence moved upward or downward in pitch. Only musically experienced listeners could adequately judge the direction of successive pitch transitions when attending to a specific ear; however, all listeners could judge the direction of successive pitch transitions within a high-tone stream or a low-tone stream. Overall, listeners exhibited greater accuracy when attending to relatively higher pitches, but there was no evidence to support a right/high, left/low bias. Results were consistent with effects of attentional strategy rather than an ear advantage for high or low tones. Implications for a potential performer/audience paradox in listening space are considered.

The light-makeup advantage in facial processing: Evidence from event-related potentials.

Science.gov (United States)

Tagai, Keiko; Shimakura, Hitomi; Isobe, Hiroko; Nittono, Hiroshi

2017-01-01

The effects of makeup on attractiveness have been evaluated using mainly subjective measures. In this study, event-related brain potentials (ERPs) were recorded from a total of 45 Japanese women (n = 23 and n = 22 for Experiment 1 and 2, respectively) to examine the neural processing of faces with no makeup, light makeup, and heavy makeup. To have the participants look at each face carefully, an identity judgement task was used: they were asked to judge whether the two faces presented in succession were of the same person or not. The ERP waveforms in response to the first faces were analyzed. In two experiments with different stimulus probabilities, the amplitudes of N170 and vertex positive potential (VPP) were smaller for faces with light makeup than for faces with heavy makeup or no makeup. The P1 amplitude did not differ between facial types. In a subsequent rating phase, faces with light makeup were rated as more attractive than faces with heavy makeup and no makeup. The results suggest that the processing fluency of faces with light makeup is one of the reasons why light makeup is preferred to heavy makeup and no makeup in daily life.

A competitive trade-off limits the selective advantage of increased antibiotic production.

Science.gov (United States)

Gerardin, Ylaine; Springer, Michael; Kishony, Roy

2016-09-26

In structured environments, antibiotic-producing microorganisms can gain a selective advantage by inhibiting nearby competing species 1 . However, despite their genetic potential 2,3 , natural isolates often make only small amounts of antibiotics, and laboratory evolution can lead to loss rather than enhancement of antibiotic production 4 . Here, we show that, due to competition with antibiotic-resistant cheater cells, increased levels of antibiotic production can actually decrease the selective advantage to producers. Competing fluorescently labelled Escherichia coli colicin producers with non-producing resistant and sensitive strains on solid media, we found that although producer colonies can greatly benefit from the inhibition of nearby sensitive colonies, this benefit is shared with resistant colonies growing in their vicinity. A simple model, which accounts for such local competitive and inhibitory interactions, suggests that the advantage of producers varies non-monotonically with the amount of production. Indeed, experimentally varying the amount of production shows a peak in selection for producers, reflecting a trade-off between benefit gained by inhibiting sensitive competitors and loss due to an increased contribution to resistant cheater colonies. These results help explain the low level of antibiotic production observed for natural species and can help direct laboratory evolution experiments selecting for increased or novel production of antibiotics.

TH-AB-206-02: Nuclear Medicine Theronostics: Wave of the Future; Pre-Clinical and Clinical Opportunities

International Nuclear Information System (INIS)

Delpassand, E.

2016-01-01

In the past few decades, the field of nuclear medicine has made long strides with the continued advancement of related sciences and engineering and the availability of diagnostic and therapeutic radionuclides. Leveraging these advancements while combining the advantages of therapeutic and diagnostic radionuclides into one radiopharmaceutical has also created a new subfield “theranostics” in nuclear medicine that has the potential to further propel the field into the future. This session is composed of two talks; one focused on the physics principles of theranostics from properties of beta and alpha emitting radionuclides to dosimetric models and quantification; while the second describes preclinical and clinical applications of theranostics and discusses the challenges and opportunities of bringing them to the clinic. At the end of the session the listener should be able to identify: The different properties of beta and alpha emitting radionuclides Which radionuclides are selected for which nuclear medicine therapies and why How PET can be used to accurately quantify the uptake of tumor targeting molecules How individualized dosimetry can be performed from the management of thyroid cancer to novel radiolabeled antibody therapies Promising pre-clinical radiopharmaceutical pairs in prostate cancer and melanoma. Promising clinical Theranostics in neuroendocrine cancers. Challenges of bringing Theranostics to the clinic. E. Delpassand, RITA Foundation -Houston; SBIR Grant; CEO and share holder of RadioMedix.

TH-AB-206-02: Nuclear Medicine Theronostics: Wave of the Future; Pre-Clinical and Clinical Opportunities

Energy Technology Data Exchange (ETDEWEB)

Delpassand, E. [Excel Diagnostic & Nuclear Oncology Center, Houston, TX (United States)

2016-06-15

In the past few decades, the field of nuclear medicine has made long strides with the continued advancement of related sciences and engineering and the availability of diagnostic and therapeutic radionuclides. Leveraging these advancements while combining the advantages of therapeutic and diagnostic radionuclides into one radiopharmaceutical has also created a new subfield “theranostics” in nuclear medicine that has the potential to further propel the field into the future. This session is composed of two talks; one focused on the physics principles of theranostics from properties of beta and alpha emitting radionuclides to dosimetric models and quantification; while the second describes preclinical and clinical applications of theranostics and discusses the challenges and opportunities of bringing them to the clinic. At the end of the session the listener should be able to identify: The different properties of beta and alpha emitting radionuclides Which radionuclides are selected for which nuclear medicine therapies and why How PET can be used to accurately quantify the uptake of tumor targeting molecules How individualized dosimetry can be performed from the management of thyroid cancer to novel radiolabeled antibody therapies Promising pre-clinical radiopharmaceutical pairs in prostate cancer and melanoma. Promising clinical Theranostics in neuroendocrine cancers. Challenges of bringing Theranostics to the clinic. E. Delpassand, RITA Foundation -Houston; SBIR Grant; CEO and share holder of RadioMedix.

Home advantage in the Winter Paralympic Games 1976-2014.

Science.gov (United States)

Wilson, Darryl; Ramchandani, Girish

2017-01-01

There is a limited amount of home advantage research concerned with winter sports. There is also a distinct lack of studies that investigate home advantage in the context of para sport events. This paper addresses this gap in the knowledge by examining home advantage in the Winter Paralympic Games. Using a standardised measure of success, we compared the performances of host nations at home with their own performances away from home between 1976 and 2014. Both country level and individual sport level analysis is conducted for this time period. Comparisons are also drawn with the Winter Olympic Games since 1992, the point from which both the Winter Olympic Games and the Winter Paralympic Games have been hosted by the same nations and in the same years. Clear evidence of a home advantage effect in the Winter Paralympic Games was found at country level. When examining individual sports, only alpine skiing and cross country skiing returned a significant home advantage effect. When comparing home advantage in the Winter Paralympic Games with the Winter Olympic Games for the last seven host nations (1992-2014), we found that home advantage was generally more pronounced (although not a statistically significant difference) in the case of the former. The causes of home advantage in the Winter Paralympic Games are unclear and should be investigated further.

Optimal use of MRI in clinical trials, clinical care and clinical registries of patients with rheumatoid arthritis

DEFF Research Database (Denmark)

Østergaard, Mikkel; Møller-Bisgaard, Signe

2014-01-01

the benefits of including MRI in treat-to-target strategies. The benefits of incorporating MRI into clinical registries are not yet known, but may include improved knowledge about the real-life advantages of MRI, as well as opportunities to develop better clinical and laboratory composite measures to monitor......Magnetic resonance imaging (MRI) clearly is more sensitive than clinical examination and conventional radiography (x-ray) for detection of inflammation (synovitis, bone marrow oedema (osteitis) and tenosynovitis) and damage (bone erosion and cartilage loss/joint space narrowing) in patients...... with rheumatoid arthritis (RA). The question is when and how MRI should be used. The present article reviews our knowledge about, and provides suggestions for, the use of MRI in clinical trials, clinical care and clinical registries. In clinical trials, the OMERACT RA MRI scoring system (RAMRIS) is a thoroughly...

Advantages of surface treatment processes by ionic sputtering

International Nuclear Information System (INIS)

Gantois, M.

1976-01-01

The use of high intensity glow-discharge permits to realize a superficial thermochemical treatment. Ions formed by discharge are accelerated against the surfaces to be treated; by effect of ion bombardment, surfaces get heated and a chemical reaction is developed depending on the composition of the ionized gas. The technique presents advantages, as the potential of the active gas might be freely chosen, and as many gases might be used, the decomposition of gases by pyrolysis and a homogeneous treatment (concerning nature of phases and thickness) all over the surface being not necessary. It is possible to develop layers of various nature, looking for those which offer the best properties to solve a technological problem (wear, friction, fatigue toughness, etc.). Some examples of nitruration, carbonitruration are considered [fr

Competitive Advantage in Tourism of Southeast Asian Countries

OpenAIRE

Akarapong Untong

2013-01-01

The competitive advantage in tourism of the countries in Southeast Asia was assessed by using coverage ratio and revealed comparative advantage (RCA). Static and dynamic analyses were applied to the data of tourism services export during 2002-2010. The results show that Cambodia, Laos PDR, Malaysia, Thailand, and Vietnam had competitive advantages, i.e. these countries gain the surpluses more than that of the region’s. Thailand had the highest specialization in Southeast Asia but declining. M...

FACTORS INFLUENCING THE SUSTAINABILITY OF COMPETITIVE ADVANTAGE OF THE EASTERN-EUROPEAN AUTO SECTOR

Directory of Open Access Journals (Sweden)

Lucian-Ovidiu CINADE

2015-04-01

Full Text Available Car-building industry territorial reconfiguration in Europe is the result of several rounds of company delocations from origin countries to emergent countries. Such rounds have been limited by the gradual opening of the national countries, as well as by changes in East European ideology and politics. Hence, about the end of the 90’s, European car-building industry shows considerable disparity, East to West. In the car-building companies’ vision, East-European car-building development potential is basically sustained by both the car low penetration rate, and the low labor cost. On the long term run, gradual valorizing of the East-european trading, with increasing labor costs, may read as a wearing thin of the competitive advantage in car-building industries, as well as problem issues of novel territory attractiveness needing permanent boosting. Country-to-country comparative analysis indicates that competitive advantage of car-building has not gone down in all of the West-European States. Competitive advantage of the West-European car-building industry increases, which can be explained, in part, by adequate strategies, as both labor costs, and cars penetration rate, go up.

A Therapeutic Potential for Marine Skeletal Proteins in Bone Regeneration

Directory of Open Access Journals (Sweden)

Bruce Milthorpe

2013-04-01

Full Text Available A vital ingredient for engineering bone tissue, in the culture dish, is the use of recombinant matrix and growth proteins to help accelerate the growth of cultivated tissues into clinically acceptable quantities. The skeletal organic matrices of calcifying marine invertebrates are an untouched potential source of such growth inducing proteins. They have the advantage of being ready-made and retain the native state of the original protein. Striking evidence shows that skeleton building bone morphogenic protein-2/4 (BMP and transforming growth factor beta (TGF-β exist within various marine invertebrates such as, corals. Best practice mariculture and the latest innovations in long-term marine invertebrate cell cultivation can be implemented to ensure that these proteins are produced sustainably and supplied continuously. This also guarantees that coral reef habitats are not damaged during the collection of specimens. Potential proteins for bone repair, either extracted from the skeleton or derived from cultivated tissues, can be identified, evaluated and retrieved using chromatography, cell assays and proteomic methods. Due to the current evidence for bone matrix protein analogues in marine invertebrates, together with the methods established for their production and retrieval there is a genuine prospect that they can be used to regenerate living bone for potential clinical use.

A Therapeutic Potential for Marine Skeletal Proteins in Bone Regeneration

Science.gov (United States)

Green, David W.; Padula, Matthew P.; Santos, Jerran; Chou, Joshua; Milthorpe, Bruce; Ben-Nissan, Besim

2013-01-01

A vital ingredient for engineering bone tissue, in the culture dish, is the use of recombinant matrix and growth proteins to help accelerate the growth of cultivated tissues into clinically acceptable quantities. The skeletal organic matrices of calcifying marine invertebrates are an untouched potential source of such growth inducing proteins. They have the advantage of being ready-made and retain the native state of the original protein. Striking evidence shows that skeleton building bone morphogenic protein-2/4 (BMP) and transforming growth factor beta (TGF-β) exist within various marine invertebrates such as, corals. Best practice mariculture and the latest innovations in long-term marine invertebrate cell cultivation can be implemented to ensure that these proteins are produced sustainably and supplied continuously. This also guarantees that coral reef habitats are not damaged during the collection of specimens. Potential proteins for bone repair, either extracted from the skeleton or derived from cultivated tissues, can be identified, evaluated and retrieved using chromatography, cell assays and proteomic methods. Due to the current evidence for bone matrix protein analogues in marine invertebrates, together with the methods established for their production and retrieval there is a genuine prospect that they can be used to regenerate living bone for potential clinical use. PMID:23574983

Advantages of magnification radiography

International Nuclear Information System (INIS)

Doi, K.

1976-01-01

Geometric arrangements and exposure conditions used in different magnification techniques are described and the following advantages of radiographic magnification technique are discussed: sharpness effect; noise effect; air gap effect; and visual effect. The magnification technique can be used in various diagnostic procedures as a means of improving the image quality of radiographs

Analisis Dampak Servant Leadership Terhadap Competitive Advantage

OpenAIRE

Oktavia, Pek Nike

2014-01-01

Penelitian ini bertujuan untuk mengetahui apakah terdapat dampak antara Servant Leadership terhadap Competitve Advantage, Employee Empowerment dan Organizational Learning. Variabel Servant Leadership diukur dari lima indikator, yaitu altruistic calling, emotional healing, wisdom, persuasive mapping, dan organizational stewardship. Variabel Competitive Advantage diukur dari lima indikator, yaitu price/cost, quality, delivery dependability, time to market, dan product innovation. Variabel Emplo...

Clinically Relevant Pharmacological Strategies That Reverse MDMA-Induced Brain Hyperthermia Potentiated by Social Interaction.

Science.gov (United States)

Kiyatkin, Eugene A; Ren, Suelynn; Wakabayashi, Ken T; Baumann, Michael H; Shaham, Yavin

2016-01-01

MDMA-induced hyperthermia is highly variable, unpredictable, and greatly potentiated by the social and environmental conditions of recreational drug use. Current strategies to treat pathological MDMA-induced hyperthermia in humans are palliative and marginally effective, and there are no specific pharmacological treatments to counteract this potentially life-threatening condition. Here, we tested the efficacy of mixed adrenoceptor blockers carvedilol and labetalol, and the atypical antipsychotic clozapine, in reversing MDMA-induced brain and body hyperthermia. We injected rats with a moderate non-toxic dose of MDMA (9 mg/kg) during social interaction, and we administered potential treatment drugs after the development of robust hyperthermia (>2.5 °C), thus mimicking the clinical situation of acute MDMA intoxication. Brain temperature was our primary focus, but we also simultaneously recorded temperatures from the deep temporal muscle and skin, allowing us to determine the basic physiological mechanisms of the treatment drug action. Carvedilol was modestly effective in attenuating MDMA-induced hyperthermia by moderately inhibiting skin vasoconstriction, and labetalol was ineffective. In contrast, clozapine induced a marked and immediate reversal of MDMA-induced hyperthermia via inhibition of brain metabolic activation and blockade of skin vasoconstriction. Our findings suggest that clozapine, and related centrally acting drugs, might be highly effective for reversing MDMA-induced brain and body hyperthermia in emergency clinical situations, with possible life-saving results.

Connecting Classroom, Clinic, and Context: Clinical Reasoning Strategies for Clinical Instructors and Academic Faculty.

Science.gov (United States)

Furze, Jennifer; Kenyon, Lisa K; Jensen, Gail M

2015-01-01

Clinical reasoning is an essential skill in pediatric physical therapist (PT) practice. As such, explicit instruction in clinical reasoning should be emphasized in PT education. This article provides academic faculty and clinical instructors with an overview of strategies to develop and expand the clinical reasoning capacity of PT students within the scope of pediatric PT practice. Achieving a balance between deductive reasoning strategies that provide a framework for thinking and inductive reasoning strategies that emphasize patient factors and the context of the clinical situation is an important variable in educational pedagogy. Consideration should be given to implementing various teaching and learning approaches across the curriculum that reflect the developmental level of the student(s). Deductive strategies may be helpful early in the curriculum, whereas inductive strategies are often advantageous after patient interactions; however, exposure to both is necessary to fully develop the learner's clinical reasoning abilities. For more insights from the authors, see Supplemental Digital Content 1, available at http://links.lww.com/PPT/A87.

Competitive advantages of firms in agro-industrial clusters: Study of wine in Brazil and Chile

Directory of Open Access Journals (Sweden)

Mattia Adilene Alvares

2015-01-01

Full Text Available This study aims to explore two cases connected to the wine productive chain, emphasizing the process of competitive advantages creation under the logic of industrial clusters. The analyzed experiences deal with agglomerations of companies, where some are already established, while others are consolidated or under expansion: The Vale dos Vinhedos (Brazil, and Valle de Casablanca (Chile. The comparative study was based on the presence of territorial resources, analyzed in categories, of which we can highlight: denomination of origin (D.O., tourism, economy, political situation and unique value. The analysis of both territories allowed the identification of similarities and potentialities, and the attachment of those with the construction of com- petitive advantages. The results show that the competitiveness of companies established on the Vale dos Vinhedos and Valle de Casablanca is determined by the competitiveness of the territory, meaning that the spaces under analysis perform a fundamental role in the process of creation of competitive advantages of the already installed companies.

Clinical potential of lixisenatide once daily treatment for type 2 diabetes mellitus

DEFF Research Database (Denmark)

Petersen, Andreas Brønden; Christensen, Mikkel

2013-01-01

The glucagon-like peptide (GLP)-1 receptor agonist lixisenatide (Lyxumia(®)) was approved for marketing by the European Medicines Agency in February 2013 and has been evaluated in a clinical study program called GetGoal. Lixisenatide activates the GLP-1 receptor and thereby exercises the range of...... of lixisenatide seems to be in combination with basal insulin. A large multicenter study will determine the future potential of lixisenatide in preventing cardiovascular events and mortality, in patients with type 2 diabetes and recent acute coronary syndrome....

Clinical experience of therapy with cyclotron neutrons at the University of Washington

International Nuclear Information System (INIS)

Parker, R.G.; Gerdes, A.J.; Berry, H.C.; Soronen, M.D.

1975-01-01

Proper clinical evaluation of fast neutron teletherapy of human cancers will be difficult and time-consuming and will require extension over many years. Fast neutron teletherapy may not have significant advantage over modern conventional supervoltage/megavoltage radiation therapy. A negative answer will be acceptable only if based on sound evidence. If fast neutron teletherapy has an advantage over modern conventional radiation therapy, the advantage may be small and tumor- and site-specific. Detection of a small advantage will require study of a large number of patients and this will be possible only in carefully planned cooperative clinical trials. The study of a large number of patients over a long period will require installation of dedicated neutron generators in research-oriented medical centers. Cooperative clinical trials must be preceded by careful definition of target tumors, normal tissue tolerances, reasonable doses and advantageous patterns of application. Any improvement in local tumor control attributed to fast neutron teletherapy might be dissipated by a concurrent increase in treatment-related sequelae. Much related physics and radiobiology remains to be done and must be supported concurrent with the clinical programs

Resolution improvement of brain PET images using prior information from MRI: clinical application on refractory epilepsy

International Nuclear Information System (INIS)

Silva-Rodríguez, Jesus; Tsoumpas, Charalampos; Aguiar, Pablo; Cortes, Julia; Urdaneta, Jesus Lopez

2015-01-01

An important counterpart of clinical Positron Emission Tomography (PET) for early diagnosis of neurological diseases is its low resolution. This is particularly important when evaluating diseases related to small hypometabolisms such as epilepsy. The last years, new hybrid systems combining PET with Magnetic Resonance (MR) has been increasingly used for several different clinical applications. One of the advantages of MR is the production of high spatial resolution images and a potential application of PET-MR imaging is the improvement of PET resolution using MR information. A potential advantage of resolution recovery of PET images is the enhancement of contrast delivering at the same time better detectability of small lesions or hypometabolic areas and more accurate quantification over these areas. Recently, Shidahara et al (2009) proposed a new method using wavelet transforms in order to produce PET images with higher resolution. We optimised Shidahara’s method (SFS-RR) to take into account possible shortcomings on the particular clinical datasets, and applied it to a group of patients diagnosed with refractory epilepsy. FDG-PET and MRI images were acquired sequentially and then co-registered using software tools. A complete evaluation of the PET/MR images was performed before and after the correction, including different parameters related with PET quantification, such as atlas-based metabolism asymmetry coefficients and Statistical Parametric Mapping results comparing to a database of 87 healthy subjects. Furthermore, an experienced physician analyzed the results of non-corrected and corrected images in order to evaluate improvements of detectability on a visual inspection. Clinical outcome was used as a gold standard. SFS-RR demonstrated to have a positive impact on clinical diagnosis of small hypometabolisms. New lesions were detected providing additional clinically relevant information on the visual inspection. SPM sensitivity for the detection of small

Resolution improvement of brain PET images using prior information from MRI: clinical application on refractory epilepsy

Energy Technology Data Exchange (ETDEWEB)

Silva-Rodríguez, Jesus [Instituto de Investigaciones Sanitarias (IDIS), Santiago de Compostela (Spain); Tsoumpas, Charalampos [University of Leeds, Leeds (United Kingdom); Aguiar, Pablo; Cortes, Julia [Nuclear Medicine Department, University Hospital (CHUS), Santiago de Compostela (Spain); Urdaneta, Jesus Lopez [Instituto de Investigaciones Sanitarias (IDIS), Santiago de Compostela (Spain)

2015-05-18

An important counterpart of clinical Positron Emission Tomography (PET) for early diagnosis of neurological diseases is its low resolution. This is particularly important when evaluating diseases related to small hypometabolisms such as epilepsy. The last years, new hybrid systems combining PET with Magnetic Resonance (MR) has been increasingly used for several different clinical applications. One of the advantages of MR is the production of high spatial resolution images and a potential application of PET-MR imaging is the improvement of PET resolution using MR information. A potential advantage of resolution recovery of PET images is the enhancement of contrast delivering at the same time better detectability of small lesions or hypometabolic areas and more accurate quantification over these areas. Recently, Shidahara et al (2009) proposed a new method using wavelet transforms in order to produce PET images with higher resolution. We optimised Shidahara’s method (SFS-RR) to take into account possible shortcomings on the particular clinical datasets, and applied it to a group of patients diagnosed with refractory epilepsy. FDG-PET and MRI images were acquired sequentially and then co-registered using software tools. A complete evaluation of the PET/MR images was performed before and after the correction, including different parameters related with PET quantification, such as atlas-based metabolism asymmetry coefficients and Statistical Parametric Mapping results comparing to a database of 87 healthy subjects. Furthermore, an experienced physician analyzed the results of non-corrected and corrected images in order to evaluate improvements of detectability on a visual inspection. Clinical outcome was used as a gold standard. SFS-RR demonstrated to have a positive impact on clinical diagnosis of small hypometabolisms. New lesions were detected providing additional clinically relevant information on the visual inspection. SPM sensitivity for the detection of small

The clinical trial of TOMOTRON - a new electronic device - and eight months' clinical experience

International Nuclear Information System (INIS)

Kroepelin, T.; Billmann, P.; Wenz, W.; Baumann, H.

1985-01-01

We have been using digital tomography (TOMOTRON) clinically for eight months. Its advantages include savings in both time and dose, good image quality throug increased contrast, and improved magnification and image postprocessing compared with conventional tomography. However, lower image resolution and small image sections are the disadvantages of digital tomography. Weighing these advantages and disadvantages by our experience, the diagnostic accuracy of digital tomography is higher than conventional tomography, particularly in skeletal studies. (author)

An evaluation of the various aspects of the progress in clinical applications of laser driven ionizing radiation

Science.gov (United States)

Hideghéty, K.; Szabó, E. R.; Polanek, R.; Szabó, Z.; Ughy, B.; Brunner, S.; Tőkés, T.

2017-03-01

There has been a vast development of laser-driven particle acceleration (LDPA) using high power lasers. This has initiated by the radiation oncology community to use the dose distribution and biological advantages of proton/heavy ion therapy in cancer treatment with a much greater accessibility than currently possible with cyclotron/synchrotron acceleration. Up to now, preclinical experiments have only been performed at a few LDPA facilities; technical solutions for clinical LDPA have been theoretically developed but there is still a long way to go for the clinical introduction of LDPA. Therefore, to explore the further potential bio-medical advantages of LDPA has pronounced importance. The main characteristics of LDPA are the ultra-high beam intensity, the flexibility in beam size reduction and the potential particle and energy selection whilst conventional accelerators generate single particle, quasi mono-energetic beams. There is a growing number of studies on the potential advantages and applications of Energy Modulated X-ray Radiotherapy, Modulated Electron Radiotherapy and Very High Energy Electron (VHEE) delivery system. Furthermore, the ultra-high space and/or time resolution of super-intense beams are under intensive investigation at synchrotrons (microbeam radiation and very high dose rate (> 40 Gy/s) electron accelerator flash irradiation) with growing evidence of significant improvement of the therapeutic index. Boron Neutron Capture Therapy (BNCT) is an advanced cell targeted binary treatment modality. Because of the high linear energy transfer (LET) of the two particles (7Li and 4He) released by 10BNC reaction, all of the energy is deposited inside the tumour cells, killing them with high probability, while the neighbouring cells are not damaged. The limited availability of appropriate neutron sources, prevent the more extensive exploration of clinical benefit of BNCT. Another boron-based novel binary approach is the 11B-Proton Fusion, which result in

Factors influencing success of cement versus screw-retained implant restorations: a clinical review

Directory of Open Access Journals (Sweden)

Ahmad Manawar

2012-10-01

Full Text Available Aim: As more and more dental practitioners are focusing on implant-supported fixed restorations, some clinicians favor the use of cement retained restorations while others consider screw retained prosthesis to be the best choice. Discussion: In screw-retained restorations, the fastening screw provides a solid joint between the restoration and the implant abutment, while in cement-retained prostheses the restorative screw is eliminated to enhance esthetics, occlusal stability, and passive fit of the restorations. The factors that influence the type of fixation of the prostheses to the implants like passivity of the framework, ease of fabrication, occlusion, esthetics, accessibility, retention and retrievability are discussed in this article with scientific studies demonstrating superior outcomes of one technique over another. Screwretained implant restorations have an advantage of predictable retention, retrievability and lack of potentially retained subgingival cement. However, a few disadvantages exist such as precise placement of the implant for optimal and esthetic location of the screw access hole and obtaining passive fit. On the other hand, cement retained restorations eliminate unesthetic screw access holes, have passive fit of castings, reduced complexity of clinical and lab procedures, enhanced esthetics, reduced cost factors and non disrupted morphology of the occlusal table. Conclusion: This article compares the advantages, potential disadvantages and limitations of screw and cement retained restorations and their specific implications in the most common clinical situation.

BRAF inhibitors and radiotherapy for melanoma brain metastases: potential advantages and disadvantages of combination therapy

Directory of Open Access Journals (Sweden)

Chowdhary M

2016-12-01

Full Text Available Mudit Chowdhary,1,2 Kirtesh R Patel,1 Hasan H Danish,1 David H Lawson,3 Mohammad K Khan1 1Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, 2Department of Radiation Oncology, Rush University Medical Center, Chicago, IL, 3Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA Abstract: Melanoma is an aggressive malignancy that frequently spreads to the brain, resulting in rapid deterioration in both quality and quantity of life. Historically, treatment options for melanoma brain metastases (MBM have predominantly consisted of surgery and radiotherapy. While these options can help provide local control, the majority of patients still develop intracranial progression. Indeed, novel therapeutic options, including molecularly targeted agents and immunotherapy, have improved outcomes and are now changing the role of radiotherapy. Up to 50% of melanomas contain an activating BRAF mutation, resulting in hyperactive cellular proliferation and survival. Drugs that target BRAF have been introduced for the treatment of metastatic melanoma and offer hope in improving disease outcomes; however, many of these trials either excluded or had a limited amount of patients with MBM. Recent studies have revealed that melanoma cell lines become more radiosensitive following BRAF inhibition, thus providing a potential synergistic mechanism when combining BRAF inhibitor (BRAFi and radiotherapy. However, neurotoxicity concerns also exist with this combination. This article reviews the efficacy and limitations of BRAFi therapy for MBM, describes current evidence for combining BRAFis with radiation, discusses the rationale and evidence for combination modalities, and highlights emerging clinical trials specifically investigating this combination in MBM. Keywords: brain metastases, melanoma, radiation, BRAF inhibitors, vemurafenib, dabrafenib

Generating Relational Competitive Advantage from Strategic Technological Partnership

DEFF Research Database (Denmark)

Hu, Yimei; Zhang, Si; Li, Jizhen

2012-01-01

Collaborating with external partners on strategic technological partnerships (STPs) have been popular phenomena for long, which leads new development in existing theories on competitive advantage. Under the relational view, the competitive advantage is jointly generated by alliance firms. Though...... the relational view of competitive advantage has been proposed for more than a decade, few in-depth empirical researches are down within this field, especially case study on R&D strategic alliance from this perspective. Based on these considerations, we investigate an STP between a Danish transnational...... corporation and a Chinese private firm aiming to understand how to generate relational competitive from an STP? Based on the explorative case study, we find that there are three key processes related to relational competitive advantage: partner selection, relational rents generation and relational rents...

Clinically Relevant Anticancer Polymer Paclitaxel Therapeutics

Directory of Open Access Journals (Sweden)

Danbo Yang

2010-12-01

Full Text Available The concept of utilizing polymers in drug delivery has been extensively explored for improving the therapeutic index of small molecule drugs. In general, polymers can be used as polymer-drug conjugates or polymeric micelles. Each unique application mandates its own chemistry and controlled release of active drugs. Each polymer exhibits its own intrinsic issues providing the advantage of flexibility. However, none have as yet been approved by the U.S. Food and Drug Administration. General aspects of polymer and nano-particle therapeutics have been reviewed. Here we focus this review on specific clinically relevant anticancer polymer paclitaxel therapeutics. We emphasize their chemistry and formulation, in vitro activity on some human cancer cell lines, plasma pharmacokinetics and tumor accumulation, in vivo efficacy, and clinical outcomes. Furthermore, we include a short review of our recent developments of a novel poly(L-g-glutamylglutamine-paclitaxel nano-conjugate (PGG-PTX. PGG-PTX has its own unique property of forming nano-particles. It has also been shown to possess a favorable profile of pharmacokinetics and to exhibit efficacious potency. This review might shed light on designing new and better polymer paclitaxel therapeutics for potential anticancer applications in the clinic.

Clinically Relevant Anticancer Polymer Paclitaxel Therapeutics

International Nuclear Information System (INIS)

Yang, Danbo; Yu, Lei; Van, Sang

2010-01-01

The concept of utilizing polymers in drug delivery has been extensively explored for improving the therapeutic index of small molecule drugs. In general, polymers can be used as polymer-drug conjugates or polymeric micelles. Each unique application mandates its own chemistry and controlled release of active drugs. Each polymer exhibits its own intrinsic issues providing the advantage of flexibility. However, none have as yet been approved by the U.S. Food and Drug Administration. General aspects of polymer and nano-particle therapeutics have been reviewed. Here we focus this review on specific clinically relevant anticancer polymer paclitaxel therapeutics. We emphasize their chemistry and formulation, in vitro activity on some human cancer cell lines, plasma pharmacokinetics and tumor accumulation, in vivo efficacy, and clinical outcomes. Furthermore, we include a short review of our recent developments of a novel poly(l-γ-glutamylglutamine)-paclitaxel nano-conjugate (PGG-PTX). PGG-PTX has its own unique property of forming nano-particles. It has also been shown to possess a favorable profile of pharmacokinetics and to exhibit efficacious potency. This review might shed light on designing new and better polymer paclitaxel therapeutics for potential anticancer applications in the clinic

Clinically Relevant Anticancer Polymer Paclitaxel Therapeutics

Energy Technology Data Exchange (ETDEWEB)

Yang, Danbo [Biomedical Engineering and Technology Institute, Institutes for Advanced Interdisciplinary Research, East China Normal University, 3663 North Zhongshan Road, Shanghai, 200062 (China); Yu, Lei, E-mail: yu-lei@gg.nitto.co.jp [Biomedical Engineering and Technology Institute, Institutes for Advanced Interdisciplinary Research, East China Normal University, 3663 North Zhongshan Road, Shanghai, 200062 (China); Biomedical Group, Nitto Denko Technical Corporation, 501 Via Del Monte, Oceanside, CA 92058 (United States); Van, Sang [Biomedical Group, Nitto Denko Technical Corporation, 501 Via Del Monte, Oceanside, CA 92058 (United States)

2010-12-23

The concept of utilizing polymers in drug delivery has been extensively explored for improving the therapeutic index of small molecule drugs. In general, polymers can be used as polymer-drug conjugates or polymeric micelles. Each unique application mandates its own chemistry and controlled release of active drugs. Each polymer exhibits its own intrinsic issues providing the advantage of flexibility. However, none have as yet been approved by the U.S. Food and Drug Administration. General aspects of polymer and nano-particle therapeutics have been reviewed. Here we focus this review on specific clinically relevant anticancer polymer paclitaxel therapeutics. We emphasize their chemistry and formulation, in vitro activity on some human cancer cell lines, plasma pharmacokinetics and tumor accumulation, in vivo efficacy, and clinical outcomes. Furthermore, we include a short review of our recent developments of a novel poly(l-γ-glutamylglutamine)-paclitaxel nano-conjugate (PGG-PTX). PGG-PTX has its own unique property of forming nano-particles. It has also been shown to possess a favorable profile of pharmacokinetics and to exhibit efficacious potency. This review might shed light on designing new and better polymer paclitaxel therapeutics for potential anticancer applications in the clinic.

Real-time three dimensional transesophageal echocardiography: technical aspects and clinical applications

Directory of Open Access Journals (Sweden)

Sergio Mondillo

2010-02-01

Full Text Available Real-time three-dimensional transeso-phageal echocardiography (RT3DTEE is now commonly used in daily clinical practice. The transesophageal, compared to the transthoracic approach, allows the visualization of the whole spectrum of the mitral valve apparatus and the posterior cardiac structures. Moreover, images obtained by RT 3D TEE provide a unique and complete visualization of the mitral valve prosthetic elements. Indeed, the possibility to visualize guidewires and catheters in cardiac chambers and their relationship with cardiac structures during percutaneous transcatheter procedures reduces the time of radiation exposure and simplifies the approach becoming the reference method for monitoring. This review aims to underline the potential clinical applications and the advantages of RT3DTEE compared to other methods.

Measuring and managing radiologist productivity, part 2: beyond the clinical numbers.

Science.gov (United States)

Duszak, Richard; Muroff, Lawrence R

2010-07-01

Radiology practices endeavoring to measure physician productivity, identify and motivate performance outliers, and develop equitable management strategies and policies often encounter numerous challenges. Nonetheless, such efforts are often necessary, in both private and academic settings, for a variety of professional, financial, and personnel reasons. Part 1 of this series detailed metrics for evaluating radiologist productivity and reviewed published benchmarks, focusing on clinical work. This segment expands that discussion to evaluating nonclinical administrative and academic efforts, along with professionalism and quality, outlining advantages and disadvantages of addressing differential productivity, and introducing potential models for practices seeking to motivate physicians on the basis of both their clinical and nonclinical endeavors. Copyright 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The Relational View of Interorganizational Competitive Advantage

DEFF Research Database (Denmark)

Hu, Yimei; Zhang, Si; Li, Jizhen

Collaborating with external partners on R&D and forming strategic partnership for R&D have been popular phenomena for long, which leads new development in existing theories. Though the relational view of competitive advantage has been proposed for more than a decade, few in-depth empirical...... they generate relational rents (interorganizational competitive advantage) from this alliance? Based on this case study, we will propose some implications for the R&D collaboration between Chinese and Scandinavian countries. Also, the case will help us to test and enrich the existing theories...... on interorganizational competitive advantage. At the end of the paper, based on existing theories and the case study result, we will propose our conceptual framework on researching R&D strategic alliance between Scandinavian and Chinese firms....

Routine health insurance data for scientific research: potential and limitations of the Agis Health Database.

Science.gov (United States)

Smeets, Hugo M; de Wit, Niek J; Hoes, Arno W

2011-04-01

Observational studies performed within routine health care databases have the advantage of their large size and, when the aim is to assess the effect of interventions, can offer a completion to randomized controlled trials with usually small samples from experimental situations. Institutional Health Insurance Databases (HIDs) are attractive for research because of their large size, their longitudinal perspective, and their practice-based information. As they are based on financial reimbursement, the information is generally reliable. The database of one of the major insurance companies in the Netherlands, the Agis Health Database (AHD), is described in detail. Whether the AHD data sets meet the specific requirements to conduct several types of clinical studies is discussed according to the classification of the four different types of clinical research; that is, diagnostic, etiologic, prognostic, and intervention research. The potential of the AHD for these various types of research is illustrated using examples of studies recently conducted in the AHD. HIDs such as the AHD offer large potential for several types of clinical research, in particular etiologic and intervention studies, but at present the lack of detailed clinical information is an important limitation. Copyright © 2011 Elsevier Inc. All rights reserved.

Colonic stenting as a bridge to surgery for obstructive colorectal cancer: advantages and disadvantages.

Science.gov (United States)

Haraguchi, Naotsugu; Ikeda, Masataka; Miyake, Masakazu; Yamada, Takuya; Sakakibara, Yuko; Mita, Eiji; Doki, Yuichiro; Mori, Masaki; Sekimoto, Mitsugu

2016-11-01

To clarify the advantages and disadvantages of stenting as a bridge to surgery (BTS) by comparing the clinical features and outcomes of patients who underwent BTS with those of patients who underwent emergency surgery (ES). We assessed technical success, clinical success, surgical procedures, stoma formation, complications, clinicopathological features, and Onodera's prognostic nutritional index (OPNI) in patients who underwent BTS and those who underwent ES. Twenty-six patients underwent stenting, which was successful in 22 (BTS group). The remaining four patients with unsuccessful stenting underwent emergency surgery. A total of 22 patients underwent emergency surgery (ES group). The rates of technical and clinical success were 85.0 and 81.0 %, respectively. The proportion of patients able to be treated by laparoscopic surgery (P = 0.0001) and avoid colostomy (P = 0.0042) was significantly higher in the BTS group. Although the incidence of anastomotic leakage in the two groups was not significantly different, it was significantly reduced by colonoscopic evaluation of obstructive colitis (P = 0.0251). The mean number of harvested lymph nodes (P = 0.0056) and the proportion of D3 lymphadenectomy (P = 0.0241) were significantly greater in the BTS group. Perineural invasion (PNI) was noted in 59.1 and 18.2 % of the BTS group and ES group patients, respectively (P = 0.0053). OPNI and serum albumin decreased significantly after stenting (P = 0.0084). The advantages of stenting as a BTS were that it avoided colostomy and allowed for laparoscopic surgery and lymphadenectomy, whereas its disadvantage lay in the decreased PNI and OPNI levels. A larger study including an analysis of prognosis is warranted.

A diterpenoid taxodone from Metasequoia glyptostroboides with antimycotic potential against clinical isolates of Candida species.

Science.gov (United States)

Bajpai, V K; Park, Y-H; Kang, S C

2015-03-01

The increasing importance of clinical isolates of Candida species and emerging resistance of Candida species to current synthetic antifungal agents have stimulated the search for safer and more effective alternative drugs from natural sources. This study was directed towards exploring the antimycotic potential of a diterpenoid compound taxodone isolated from Metasequoia glyptostroboides against pathogenic isolates of Candida species. Antimycotic efficacy of taxodone was evaluated by disc diffusion assay, determination of minimum inhibitory (MIC) and minimum fungicidal (MFC) concentrations, and cell viability assay. To confirm a partial antimycotic mode of action of taxodone, the efficacy of taxodone was determined by measuring the release of 260 nm absorbing materials from the selected Candida species as compared to control. The taxodone at the concentration of 400 μg/disc displayed potential antimycotic effect against the tested clinical and pathogenic isolates of Candida species as diameters of zones of inhibitions, which were found in the range of 11 ± 0.0 to 12.6 ± 0.5mm. The MIC and MFC values of taxodone against the tested clinical isolates were found in the range of 250 to 1000 and 500 to 2000μ g/mL, respectively. On the other hand, the MIC and MFC values of positive control (amphotericin B) against the tested Candida isolates were found in the range of 62.5 to 250 and 500 to 2000 μg/mL. On the viable counts of the tested fungal isolates, the taxodone exerted significant antimycotic effect. Elaborative study of partial mode of action conducted onto the release of 260nm materials (DNA and RNA) revealed potential detrimental effect of taxodone on the membrane integrity of the tested pathogens at MIC concentration. With respect to the antimycotic effect of taxodone against pathogenic and clinical isolates of Candida species, it might be confirmed that bioactive compound taxodone present in M. glyptostroboides holds therapeutic value of medicinal

Sustainable Competitive Advantages: An Exploratory Study of the Brazilian Cell Phone SectorHttp://Dx.Doi.Org/10.5585/Riae.V9i2.1674

Directory of Open Access Journals (Sweden)

Rodolfo Borges Felipe

2010-11-01

Full Text Available In an environment of rapid changes one should seek definitions of what would be the strategic solutions adopted by organizations to ensure a competitive edge. This article is targeted to identify and verify the longevity of potential competitive advantages in Brazil’s mobile telephone sector through the analysis of the strategic actions taken by its operators between 2000 and 2008. Therefore, a two stage qualitative research with exploratory-descriptive features was adopted and carried out. The first stage saw the development of a theoretical framework based on the theory of competitive advantage. In the second step, the impact of strategic actions with the potential to become a competitive advantage in the four major mobile phone companies in the country was analyzed, and the examination of the sustainability of competitive advantages created from those actions was also undertaken. The study concluded that, although being a highly dynamic and competitive sector, there is evidence of the occurrence of a sustainable competitive advantage in the mobile telephone sector in Brazil.

Clinical proteomics-driven precision medicine for targeted cancer therapy: current overview and future perspectives.

Science.gov (United States)

Zhou, Li; Wang, Kui; Li, Qifu; Nice, Edouard C; Zhang, Haiyuan; Huang, Canhua

2016-01-01

Cancer is a common disease that is a leading cause of death worldwide. Currently, early detection and novel therapeutic strategies are urgently needed for more effective management of cancer. Importantly, protein profiling using clinical proteomic strategies, with spectacular sensitivity and precision, offer excellent promise for the identification of potential biomarkers that would direct the development of targeted therapeutic anticancer drugs for precision medicine. In particular, clinical sample sources, including tumor tissues and body fluids (blood, feces, urine and saliva), have been widely investigated using modern high-throughput mass spectrometry-based proteomic approaches combined with bioinformatic analysis, to pursue the possibilities of precision medicine for targeted cancer therapy. Discussed in this review are the current advantages and limitations of clinical proteomics, the available strategies of clinical proteomics for the management of precision medicine, as well as the challenges and future perspectives of clinical proteomics-driven precision medicine for targeted cancer therapy.

Project safety as a sustainable competitive advantage.

Science.gov (United States)

Rechenthin, David

2004-01-01

To be consistently profitable, a construction company must complete projects in scope, on schedule, and on budget. At the same time, the nature of the often high-risk work performed by construction companies can result in high accident rates. Clients and other stakeholders are placing increasing pressure on companies to decrease those accident rates. Clients routinely demand copies of safety plans and evidence of past results at the "pre-qualification" or "request for proposal" stages of the procurement process. Are high accident rates and the associated costs just a part of business? Companies that deliver on scope, schedule, and budget have a competitive advantage. Is it possible for projects with low accident rates to use it as a competitive advantage? Is the value added by safety just a temporary or parity issue, or does a successful safety program offer significant advantage to the company and the client? This article concludes that in the case of a high-risk industry, such as the construction industry, an organization with a successful safety program can promote safety performance as a sustainable competitive advantage. It is a choice the company can make.

Single incision pediatric endoscopic surgery: advantages of relatively large incision

International Nuclear Information System (INIS)

Yilmaz, E.; Afsarlar, E.; Karaman, I.

2015-01-01

To describe Single Incision Pediatric Endoscopic Surgery (SIPES) performed on children with various diagnoses, emphasizing its advantages. Study Design: An observational case series. Place and Duration of Study: Department of Pediatric Surgery, Dr. Sami Ulus Maternity and Child Health Hospital, Ankara, Turkey, from January 2011 to November 2014. Methodology: A review of patient charts was conducted in which SIPES was preferred as the surgical procedure. Patient demographics, operative details, operative time, clinical outcomes, postoperative pain and cosmesis were analyzed. Results: SIPES was performed on 45 patients (21 girls, 24 boys). Thirty-three appendectomies, 5 varicocelectomies, 3 oophorectomies, 2 ovarian and one paratubal cyst excision, and one fallopian tube excision were performed. All except one procedures were performed through our standard 2cm umbilical vertical or smile incision. In 18 cases, abdominal irrigation/aspiration was easily performed through the existing larger incision, as is done with open surgical technique. None of the patients had early postoperative shoulder/back pain since complete disinflation of CO/sub 2/ could be ensured. All of the patients/parents were satisfied with the cosmesis. Conclusion: SIPES has the advantages of limiting the surgical scar to within the umbilicus and providing easy disinflation of CO/sub 2/, allowing intraabdominal cleaning and extraction of large volume tissue samples through a single large umbilical incision. (author)

Sex Differences in Music: A Female Advantage at Recognizing Familiar Melodies

Science.gov (United States)

Miles, Scott A.; Miranda, Robbin A.; Ullman, Michael T.

2016-01-01

Although sex differences have been observed in various cognitive domains, there has been little work examining sex differences in the cognition of music. We tested the prediction that women would be better than men at recognizing familiar melodies, since memories of specific melodies are likely to be learned (at least in part) by declarative memory, which shows female advantages. Participants were 24 men and 24 women, with half musicians and half non-musicians in each group. The two groups were matched on age, education, and various measures of musical training. Participants were presented with well-known and novel melodies, and were asked to indicate their recognition of familiar melodies as rapidly as possible. The women were significantly faster than the men in responding, with a large effect size. The female advantage held across musicians and non-musicians, and across melodies with and without commonly associated lyrics, as evidenced by an absence of interactions between sex and these factors. Additionally, the results did not seem to be explained by sex differences in response biases, or in basic motor processes as tested in a control task. Though caution is warranted given that this is the first study to examine sex differences in familiar melody recognition, the results are consistent with the hypothesis motivating our prediction, namely that declarative memory underlies knowledge about music (particularly about familiar melodies), and that the female advantage at declarative memory may thus lead to female advantages in music cognition (particularly at familiar melody recognition). Additionally, the findings argue against the view that female advantages at tasks involving verbal (or verbalizable) material are due solely to a sex difference specific to the verbal domain. Further, the results may help explain previously reported cognitive commonalities between music and language: since declarative memory also underlies language, such commonalities may be

Sex Differences in Music: A Female Advantage at Recognizing Familiar Melodies.

Science.gov (United States)

Miles, Scott A; Miranda, Robbin A; Ullman, Michael T

2016-01-01

Although sex differences have been observed in various cognitive domains, there has been little work examining sex differences in the cognition of music. We tested the prediction that women would be better than men at recognizing familiar melodies, since memories of specific melodies are likely to be learned (at least in part) by declarative memory, which shows female advantages. Participants were 24 men and 24 women, with half musicians and half non-musicians in each group. The two groups were matched on age, education, and various measures of musical training. Participants were presented with well-known and novel melodies, and were asked to indicate their recognition of familiar melodies as rapidly as possible. The women were significantly faster than the men in responding, with a large effect size. The female advantage held across musicians and non-musicians, and across melodies with and without commonly associated lyrics, as evidenced by an absence of interactions between sex and these factors. Additionally, the results did not seem to be explained by sex differences in response biases, or in basic motor processes as tested in a control task. Though caution is warranted given that this is the first study to examine sex differences in familiar melody recognition, the results are consistent with the hypothesis motivating our prediction, namely that declarative memory underlies knowledge about music (particularly about familiar melodies), and that the female advantage at declarative memory may thus lead to female advantages in music cognition (particularly at familiar melody recognition). Additionally, the findings argue against the view that female advantages at tasks involving verbal (or verbalizable) material are due solely to a sex difference specific to the verbal domain. Further, the results may help explain previously reported cognitive commonalities between music and language: since declarative memory also underlies language, such commonalities may be

Sex Differences in Music: A Female Advantage at Recognizing Familiar Melodies

Directory of Open Access Journals (Sweden)

Michael T Ullman

2016-03-01

Full Text Available Although sex differences have been observed in various cognitive domains, there has been little work examining sex differences in the cognition of music. We tested the prediction that women would be better than men at recognizing familiar melodies, since memories of specific melodies are likely to be learned (at least in part by declarative memory, which shows female advantages. Participants were 24 men and 24 women, with half musicians and half non-musicians in each group. The two groups were matched on age, education, and various measures of musical training. Participants were presented with well-known and novel melodies, and were asked to indicate their recognition of familiar melodies as rapidly as possible. The women were significantly faster than the men in responding, with a large effect size. The female advantage held across musicians and non-musicians, and across melodies with and without commonly associated lyrics, as evidenced by an absence of interactions between sex and these factors. Additionally, the results did not seem to be explained by sex differences in response biases, or in basic auditory or motor processes as tested in a control task. Though caution is warranted given that this is the first study to examine sex differences in familiar melody recognition, the results are consistent with the hypothesis motivating our prediction, namely that declarative memory underlies knowledge about music (particularly about familiar melodies, and that the female advantage at declarative memory may thus lead to female advantages in music cognition (particularly at familiar melody recognition. Additionally, the findings argue against the view that female advantages at tasks involving verbal (or verbalizable material are due solely to a sex difference specific to the verbal domain. Further, the results may help explain previously-reported cognitive commonalities between music and language: since declarative memory also underlies language

EFFECT OF CSR ON PRODUCT DIFFERENTIATION IN THE PRESENCE OF COST ADVANTAGE

Directory of Open Access Journals (Sweden)

Samar K. Mukhopadhyay

2017-03-01

Full Text Available Corporate social responsibility (CSR, once thought of only a philanthropic activity of a firm, is now treated as a serious business strategy that can contribute to a firm’s profitability. The seemingly altruistic activity helps build the firm’s image with all the stakeholders including its customers so that it has the potential to increase the firm’s profit. This fact is now well established in research literature. Product differentiation is another corporate strategy that is pursued by some companies in order to offer a distinctive product in the market to avoid competition, charge premium price, and increase profit. What is not known is that when two firms compete in a Hotelling type product differentiation line, how much this product differentiation is affected by the extent of the CSR activity of a firm. Our study is conducted in a game-theoretic setting where the CSR firm is competing with a non-CSR firm. The CSR firm maximizes a convex combination of its own profit and a form of social utility function, while the non-CSR firm maximizes its own profit only. The CSR firm is also assumed to have a technological advantage that reduces its production cost. The interaction of the effects of both the extent of CSR and the extent of this production cost advantage is also considered. We also study a scenario of asymmetric information. Our main results include that the degree of product differentiation is reduced when CSR is practiced. On the other hand, product differentiation increases with the production cost advantage. The interaction between the two factors – CSR activity and cost advantage – is also studied.

The light-makeup advantage in facial processing: Evidence from event-related potentials

OpenAIRE

Tagai, Keiko; Shimakura, Hitomi; Isobe, Hiroko; Nittono, Hiroshi

2017-01-01

The effects of makeup on attractiveness have been evaluated using mainly subjective measures. In this study, event-related brain potentials (ERPs) were recorded from a total of 45 Japanese women (n = 23 and n = 22 for Experiment 1 and 2, respectively) to examine the neural processing of faces with no makeup, light makeup, and heavy makeup. To have the participants look at each face carefully, an identity judgement task was used: they were asked to judge whether the two faces presented in succ...

ENTERPRISE IRELAND: Design for Competitive Advantage Conference

OpenAIRE

Dee, Peter

2003-01-01

A stimulating conference bringing together world leading experts on design to address the importance of brand development strategies to achieve competitive advantage. Peter Dee - Strategic Design and Marketing Consultant, specialised in the creation of brand development strategies for Enterprise Ireland’s Design Unit. Peter was responsible for the design and development of the the brand identity for the Enterprise Ireland Design for Competitive Advantage Conference in Dublin.

Maximising the potential of part-time clinical teachers.

Science.gov (United States)

Patston, Philip; Holmes, David; Maalhagh-Fard, Ahmad; Ting, Kang; Ziccardi, Vincent B

2010-12-01

A problem faced by health professions education throughout the world is a lack of full-time clinical teachers. This is particularly serious in dentistry and nursing, but is increasingly also true in medicine. To make up for this shortfall there is a growing reliance on part-time clinical teachers. Part-time clinical teachers are essential for the education of students. However, compared with their full-time counterparts, the part-time teachers are often not adequately prepared for their roles as educators within the context of the clinical curriculum. They might not be trained in the latest educational practices, and may be unprepared for the time needed to excel as teachers and mentors. As part-time teachers take on more responsibility, it is important that they take part in orientation and training sessions to assist them in developing the skills they need to succeed. This will require a significant commitment from the institution as well as the part-time teacher, but is critical for maintaining the academic quality of the clinical training programmes. This also represents an untapped area for research into how to ensure the success of part-time clinical teachers. © Blackwell Publishing Ltd 2010.

Mass Spectrometry for Translational Proteomics: Progress and Clinical Implications

Energy Technology Data Exchange (ETDEWEB)

Baker, Erin Shammel; Liu, Tao; Petyuk, Vladislav A.; Burnum-Johnson, Kristin E.; Ibrahim, Yehia M.; Anderson, Gordon A.; Smith, Richard D.

2012-08-31

Mass spectrometry (MS)-based proteomics measurements have become increasingly utilized in a wide range of biological and biomedical applications, and have significantly enhanced the understanding of the complex and dynamic nature of the proteome and its connections to biology and diseases. While some MS techniques such as those for targeted analysis are increasingly applied with great success, others such as global quantitative analysis (for e.g. biomarker discovery) are more challenging and continue to be developed and refined to provide the desired throughput, sensitivity and/ or specificity. New MS capabilities and proteomics-based pipelines/strategies also keep enhancing for the advancement of clinical proteomics applications such as protein biomarker discovery and validation. Herein, we provide a brief review to summarize the current state of MS-based proteomics with respect to its advantages and present limitations, while highlighting its potential in future clinical applications.

Linear Energy Transfer-Guided Optimization in Intensity Modulated Proton Therapy: Feasibility Study and Clinical Potential

Energy Technology Data Exchange (ETDEWEB)

Giantsoudi, Drosoula, E-mail: dgiantsoudi@partners.org [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Grassberger, Clemens; Craft, David; Niemierko, Andrzej; Trofimov, Alexei; Paganetti, Harald [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States)

2013-09-01

Purpose: To investigate the feasibility and potential clinical benefit of linear energy transfer (LET) guided plan optimization in intensity modulated proton therapy (IMPT). Methods and Materials: A multicriteria optimization (MCO) module was used to generate a series of Pareto-optimal IMPT base plans (BPs), corresponding to defined objectives, for 5 patients with head-and-neck cancer and 2 with pancreatic cancer. A Monte Carlo platform was used to calculate dose and LET distributions for each BP. A custom-designed MCO navigation module allowed the user to interpolate between BPs to produce deliverable Pareto-optimal solutions. Differences among the BPs were evaluated for each patient, based on dose–volume and LET–volume histograms and 3-dimensional distributions. An LET-based relative biological effectiveness (RBE) model was used to evaluate the potential clinical benefit when navigating the space of Pareto-optimal BPs. Results: The mean LET values for the target varied up to 30% among the BPs for the head-and-neck patients and up to 14% for the pancreatic cancer patients. Variations were more prominent in organs at risk (OARs), where mean LET values differed by a factor of up to 2 among the BPs for the same patient. An inverse relation between dose and LET distributions for the OARs was typically observed. Accounting for LET-dependent variable RBE values, a potential improvement on RBE-weighted dose of up to 40%, averaged over several structures under study, was noticed during MCO navigation. Conclusions: We present a novel strategy for optimizing proton therapy to maximize dose-averaged LET in tumor targets while simultaneously minimizing dose-averaged LET in normal tissue structures. MCO BPs show substantial LET variations, leading to potentially significant differences in RBE-weighted doses. Pareto-surface navigation, using both dose and LET distributions for guidance, provides the means for evaluating a large variety of deliverable plans and aids in

Linear Energy Transfer-Guided Optimization in Intensity Modulated Proton Therapy: Feasibility Study and Clinical Potential

International Nuclear Information System (INIS)

Giantsoudi, Drosoula; Grassberger, Clemens; Craft, David; Niemierko, Andrzej; Trofimov, Alexei; Paganetti, Harald

2013-01-01

Purpose: To investigate the feasibility and potential clinical benefit of linear energy transfer (LET) guided plan optimization in intensity modulated proton therapy (IMPT). Methods and Materials: A multicriteria optimization (MCO) module was used to generate a series of Pareto-optimal IMPT base plans (BPs), corresponding to defined objectives, for 5 patients with head-and-neck cancer and 2 with pancreatic cancer. A Monte Carlo platform was used to calculate dose and LET distributions for each BP. A custom-designed MCO navigation module allowed the user to interpolate between BPs to produce deliverable Pareto-optimal solutions. Differences among the BPs were evaluated for each patient, based on dose–volume and LET–volume histograms and 3-dimensional distributions. An LET-based relative biological effectiveness (RBE) model was used to evaluate the potential clinical benefit when navigating the space of Pareto-optimal BPs. Results: The mean LET values for the target varied up to 30% among the BPs for the head-and-neck patients and up to 14% for the pancreatic cancer patients. Variations were more prominent in organs at risk (OARs), where mean LET values differed by a factor of up to 2 among the BPs for the same patient. An inverse relation between dose and LET distributions for the OARs was typically observed. Accounting for LET-dependent variable RBE values, a potential improvement on RBE-weighted dose of up to 40%, averaged over several structures under study, was noticed during MCO navigation. Conclusions: We present a novel strategy for optimizing proton therapy to maximize dose-averaged LET in tumor targets while simultaneously minimizing dose-averaged LET in normal tissue structures. MCO BPs show substantial LET variations, leading to potentially significant differences in RBE-weighted doses. Pareto-surface navigation, using both dose and LET distributions for guidance, provides the means for evaluating a large variety of deliverable plans and aids in

Managerial attitudes, strategic intent, environmental initiatives and competitive advantage

DEFF Research Database (Denmark)

Reyes Rodríguez, Juan Felipe; Ulhøi, John Parm; Madsen, Henning

2013-01-01

To stay at the competitive forefront successful firms have for quite a while addressed environmental issues as part of their strategy. The competitive 'imperative' is however not restricted to large enterprises entirely. This paper reports empirical findings from a series of identical surveys per...... will be provided that allows for making recommendations with regard to possible new strategic directions. Before concluding, key implications for future research, managers and other related decision-makers are briefly addressed....... performed regularly since 1999. The purpose has been to track and analyse the development of the strategic responses of SMEs in Denmark. Furthermore, identification of potential shifts in the influence of motivators and the impact on competitive advantage has also been focused. In so doing, evidence...

Solar thermal upper stage: Economic advantage and development status

Science.gov (United States)

Adams, Alan M.

1995-01-01

A solar thermal upper stage (STUS) is envisioned as a propulsive concept for the future. The STUS will be used for low Earth orbit (LEO) to geostationary-Earth orbit (GEO) transfer and for planetary exploration missions. The STUS offers significant performance gains over conventional chemical propulsion systems. These performance gains translate into a more economical, more efficient method of placing useful payloads in space and maximizing the benefits derived from space activity. This paper will discuss the economical advantages of an STUS compared to conventional chemical propulsion systems, the potential market for an STUS, and the recent activity in the development of an STUS. The results of this assessment combined with the performance gains, will provide a strong justification for the development of an STUS.

Clinical Trials With Large Numbers of Variables: Important Advantages of Canonical Analysis.

Science.gov (United States)

Cleophas, Ton J

2016-01-01

Canonical analysis assesses the combined effects of a set of predictor variables on a set of outcome variables, but it is little used in clinical trials despite the omnipresence of multiple variables. The aim of this study was to assess the performance of canonical analysis as compared with traditional multivariate methods using multivariate analysis of covariance (MANCOVA). As an example, a simulated data file with 12 gene expression levels and 4 drug efficacy scores was used. The correlation coefficient between the 12 predictor and 4 outcome variables was 0.87 (P = 0.0001) meaning that 76% of the variability in the outcome variables was explained by the 12 covariates. Repeated testing after the removal of 5 unimportant predictor and 1 outcome variable produced virtually the same overall result. The MANCOVA identified identical unimportant variables, but it was unable to provide overall statistics. (1) Canonical analysis is remarkable, because it can handle many more variables than traditional multivariate methods such as MANCOVA can. (2) At the same time, it accounts for the relative importance of the separate variables, their interactions and differences in units. (3) Canonical analysis provides overall statistics of the effects of sets of variables, whereas traditional multivariate methods only provide the statistics of the separate variables. (4) Unlike other methods for combining the effects of multiple variables such as factor analysis/partial least squares, canonical analysis is scientifically entirely rigorous. (5) Limitations include that it is less flexible than factor analysis/partial least squares, because only 2 sets of variables are used and because multiple solutions instead of one is offered. We do hope that this article will stimulate clinical investigators to start using this remarkable method.

Insights into the Antimicrobial Properties of Hepcidins: Advantages and Drawbacks as Potential Therapeutic Agents

Directory of Open Access Journals (Sweden)

Lisa Lombardi

2015-04-01

Full Text Available The increasing frequency of multi-drug resistant microorganisms has driven research into alternative therapeutic strategies. In this respect, natural antimicrobial peptides (AMPs hold much promise as candidates for the development of novel antibiotics. However, AMPs have some intrinsic drawbacks, such as partial degradation by host proteases or inhibition by host body fluid composition, potential toxicity, and high production costs. This review focuses on the hepcidins, which are peptides produced by the human liver with a known role in iron homeostasis, as well by numerous other organisms (including fish, reptiles, other mammals, and their potential as antibacterial and antifungal agents. Interestingly, the antimicrobial properties of human hepcidins are enhanced at acidic pH, rendering these peptides appealing for the design of new drugs targeting infections that occur in body areas with acidic physiological pH. This review not only considers current research on the direct killing activity of these peptides, but evaluates the potential application of these molecules as coating agents preventing biofilm formation and critically assesses technical obstacles preventing their therapeutic application.

Clinical usefulness and feasibility of time-frequency analysis of chemosensory event-related potentials.

Science.gov (United States)

Huart, C; Rombaux, Ph; Hummel, T; Mouraux, A

2013-09-01

The clinical usefulness of olfactory event-related brain potentials (OERPs) to assess olfactory function is limited by the relatively low signal-to-noise ratio of the responses identified using conventional time-domain averaging. Recently, it was shown that time-frequency analysis of the obtained EEG signals can markedly improve the signal-to-noise ratio of OERPs in healthy controls, because it enhances both phase-locked and non phase-locked EEG responses. The aim of the present study was to investigate the clinical usefulness of this approach and evaluate its feasibility in a clinical setting. We retrospectively analysed EEG recordings obtained from 45 patients (15 anosmic, 15 hyposmic and 15 normos- mic). The responses to olfactory stimulation were analysed using conventional time-domain analysis and joint time-frequency analysis. The ability of the two methods to discriminate between anosmic, hyposmic and normosmic patients was assessed using a Receiver Operating Characteristic analysis. The discrimination performance of OERPs identified using conventional time-domain averaging was poor. In contrast, the discrimination performance of the EEG response identified in the time-frequency domain was relatively high. Furthermore, we found a significant correlation between the magnitude of this response and the psychophysical olfactory score. Time-frequency analysis of the EEG responses to olfactory stimulation could be used as an effective and reliable diagnostic tool for the objective clinical evaluation of olfactory function in patients.

Analysis of Potential Drug-Drug Interactions and Its Clinical Manifestation of Pediatric Prescription on 2 Pharmacies in Bandung

Directory of Open Access Journals (Sweden)

Melisa I. Barliana

2013-09-01

Full Text Available The potential of Drug-Drug Interactions (DDI in prescription have high incidence around the world, including Indonesia. However, scientific evidence regarding DDI in Indonesia is not available. Therefore, in this study we have conducted survey in 2 pharmacies in Bandung against pediatric prescription given by pediatrician. These prescriptions then analyzed the potential for DDI contained in the prescription and clinical manifestation. The analysis showed that in pharmacy A, there are 33 prescriptions (from a total of 155 prescriptions that have potential DDI, or approximately 21.19% (2 prescriptions have the potential DDI major categories, 23 prescriptions categorized as moderate, and 8 prescriptions as minor. In Pharmacy B, there are 6 prescriptions (from a total of 40 prescriptions or 15% of potential DDI (4 prescriptions categorized as moderate and 2 prescriptions as minor. This result showed that potential DDI happened less than 50% in pediatric prescription from both pharmacies. However, this should get attention because DDI should not happen in a prescription considering its clinical manifestations caused by DDI. Moreover, current pharmaceutical care refers to patient oriented than product oriented. In addition, further study for the pediatric prescription on DDI incidence in large scale need to be investigated.

The role of cannabinoids in prostate cancer: Basic science perspective and potential clinical applications

Directory of Open Access Journals (Sweden)

Juan A Ramos

2012-01-01

Full Text Available Prostate cancer is a global public health problem, and it is the most common cancer in American men and the second cause for cancer-related death. Experimental evidence shows that prostate tissue possesses cannabinoid receptors and their stimulation results in anti-androgenic effects. To review currently relevant findings related to effects of cannabinoid receptors in prostate cancer. PubMed search utilizing the terms "cannabis," "cannabinoids," "prostate cancer," and "cancer pain management," giving preference to most recent publications was done. Articles identified were screened for their relevance to the field of prostate cancer and interest to both urologist and pain specialists. Prostate cancer cells possess increased expression of both cannabinoid 1 and 2 receptors, and stimulation of these results in decrease in cell viability, increased apoptosis, and decreased androgen receptor expression and prostate-specific antigen excretion. It would be of interest to conduct clinical studies utilizing cannabinoids for patients with metastatic prostate cancer, taking advantage not only of its beneficial effects on prostate cancer but also of their analgesic properties for bone metastatic cancer pain.

Hypnosis in the Perioperative Management of Breast Cancer Surgery: Clinical Benefits and Potential Implications

Science.gov (United States)

Roelants, Fabienne; Pospiech, Audrey; Momeni, Mona; Watremez, Christine

2016-01-01

The aim of this review is to summarize data published on the use of perioperative hypnosis in patients undergoing breast cancer surgery (BCS). Indeed, the majority of BCS patients experience stress, anxiety, nausea, vomiting, and pain. Correct management of the perioperative period and surgical removal of the primary tumor are clearly essential but can affect patients on different levels and hence have a negative impact on oncological outcomes. This review examines the effect of clinical hypnosis performed during the perioperative period. Thanks to its specific properties and techniques allowing it to be used as complementary treatment preoperatively, hypnosis has an impact most notably on distress and postoperative pain. During surgery, hypnosis may be applied to limit immunosuppression, while, in the postoperative period, it can reduce pain, anxiety, and fatigue and improve wound healing. Moreover, hypnosis is inexpensive, an important consideration given current financial concerns in healthcare. Of course, large randomized prospective studies are now needed to confirm the observed advantages of hypnosis in the field of oncology. PMID:27635132

Organizational Learning and Sustainable Competitive Advantages (SCA): The Nigerian Experience

OpenAIRE

Omotayo Oyeniyi

2011-01-01

The purpose of this paper is to test for core competencies of organizations in achieving sustainable competitive advantage within the service organizations in a developing economy like Nigeria. The paper specifically deals with the importance of organizational learning on sustainable competitive advantage and how it can be used to achieve sustainable advantage. Despite the wide spread importance attached to building sustainable competitive advantage, the relationship between organizational le...

Clinical and Laboratory Potential Predictors of Blood Culture Positivity in Under Five Children with Clinically Severe Pneumonia - Khartoum -Sudan.

Science.gov (United States)

Salih, Karimeldin Mohamed Ali; El-Samani, El-Fatih; Bilal, Jalal Ali; Eldouch, Widad; Ibrahim, Salah Ahmed

2015-08-01

Blood culture is necessary for appropriate management of clinically severe pneumonia in children under five years of age. However, in limited resource countries it might be unduly costly and waste of valuable time because of the high negative culture rate. This study aims to identify clinical and laboratory parameters that potentially predict a positive blood culture in cases of severe pneumonia. A hospital based study, enrolled 189 cases satisfying the WHO definition of severe pneumonia. Age, gender, clinical history, physical examination, temperature, complete blood count, C-reactive protein, blood culture and Chest X Ray for all the patients were recorded. Forty one patients had positive blood culture giving a prevalence of 21.7%. All variables were used in a dichotomous manner. White Blood Count (WBC) more than 20 000, very high C-reactive protein (C-RP ≥8mg/L) and Temperature more than 40(o)C, had a positive predictive value of 46.1%, 44.3% and 40.0% respectively for a positive culture as well as a Negative Predictive Value of 91.1%, 91.6% and 91.7% respectively. The WBC more than 20 000 and temperature above 40(o)C had a significant association with a positive blood culture. Their adjusted Odds Ratios were 3.9 (95% CI: 1.4-10.90) and 3.1 (95% CI: 1.2-8.4) respectively. This was not the case for C-RP (Odds Ratio=2.2, 95% CI: 0.7-2.2) or positive Chest X Ray (Odds Ratio=1.5, 95% CI: 0.6-3.6). Temperature of more than 40(o)C, Very high C-RP and WBC of more than 20 000 are good indicators of a potential positive blood culture. It is therefore recommended that further research be undertaken to refine these predictors as screening tools before resorting to blood culture. It is also recommended that antibiotic treatment may be initiated on the basis of the high temperature and WBC, while waiting for the culture results.

[Advantage investigation of totally laparoscopic modified Roux-en-Y reconstruction].

Science.gov (United States)

Liu, Tianzhou; Ma, Zhiming; Sun, Pengda; Li, Jinlong; Fang, Xuedong; Tong, Ti; Zhu, Jiaming

2016-01-01

To investigate the clinical advantage of the application of modified Roux-en-Y reconstruction after totally laparoscopic total gastrectomy. Clinical data of 36 patients who underwent totally laparoscopic total gastrectomy with Roux-en-Y reconstruction by one medical team for gastric adenocarcinoma between January 2014 and December 2014 in the Second Hospital of Jilin University were retrospectively analyzed. Patients were divided into classic Roux-en-Y group (CRY, 16 cases) and modified Roux-en-Y group (MRY, 20 cases) according to reconstructive methods. The data concerning the intraoperative and postoperative situation in two groups were compared. Operation was successfully completed in all the cases without conversion to laparotomy. Compared to CRY group, MRY group had shorter mean operative time [(260.9 ± 21.2) min vs. (287.9 ± 19.0) min, P=0.000], shorter mean reconstruction duration [(32.4 ± 9.2] min vs. (45.4 ± 13.2) min, P=0.001] and less intraoperative bleeding [(50.9 ± 23.5) ml vs. (67.0 ± 20.5) ml, P=0.000]. Jejunum mesentery dissection and jejunum resection were not necessary in MRY group. However, there were no significant differences in lymph nodes harvested, time to flatus, hospital stay and postoperative complications between two groups. As compared to classic Roux-en-Y reconstruction, the modified Roux-en-Y reconstruction can simplify the surgical procedures and achieve similar efficacy. It is feasible and safe, and worth further promotion in clinical practice.

Development of clinical study and application on dopaminergic neurotransmitters and neuroreceptor imaging

International Nuclear Information System (INIS)

Wang Rongfu

2000-01-01

In recent years, the neurotransmitter mapping has been rapidly developed from a lot of fundamental researches to the studies of clinical applications. At present, the dopaminergic neurotransmitter and receptor imaging in the central neurotransmitter mapping study are the most active area including dopaminergic receptor, dopaminergic neurotransmitter and dopaminergic transporter imaging, etc,. The nuclear medicine functional imaging technique with positron emission tomography and single photon emission computed tomography possesses potential advantages in the diagnosis and distinguished diagnosis of neuropsychiatric disorders and movement disorders, and in the study of recognition function

Creating corporate advantage.

Science.gov (United States)

Collis, D J; Montgomery, C A

1998-01-01

What differentiates truly great corporate strategies from the merely adequate? How can executives at the corporate level create tangible advantage for their businesses that makes the whole more than the sum of the parts? This article presents a comprehensive framework for value creation in the multibusiness company. It addresses the most fundamental questions of corporate strategy: What businesses should a company be in? How should it coordinate activities across businesses? What role should the corporate office play? How should the corporation measure and control performance? Through detailed case studies of Tyco International, Sharp, the Newell Company, and Saatchi and Saatchi, the authors demonstrate that the answers to all those questions are driven largely by the nature of a company's special resources--its assets, skills, and capabilities. These range along a continuum from the highly specialized at one end to the very general at the other. A corporation's location on the continuum constrains the set of businesses it should compete in and limits its choices about the design of its organization. Applying the framework, the authors point out the common mistakes that result from misaligned corporate strategies. Companies mistakenly enter businesses based on similarities in products rather than the resources that contribute to competitive advantage in each business. Instead of tailoring organizational structures and systems to the needs of a particular strategy, they create plain-vanilla corporate offices and infrastructures. The company examples demonstrate that one size does not fit all. One can find great corporate strategies all along the continuum.

Comparison of student learning in the out-patient clinic and ward round.

Science.gov (United States)

Davis, M H; Dent, J A

1994-05-01

In undergraduate medical education there is a trend away from ward-based teaching towards out-patient and community-based teaching. To study the potential effects of this altered emphasis on student learning, a pilot group of final-year medical students at the University of Dundee was asked to keep individual structured log-books. These contained details of patients seen during their 3-week orthopaedic attachment in both a ward and out-patient setting. A comparison of perceived learning in the two settings showed that students learned more from attending an out-patient clinic than a ward round, but did not make full use of the learning potential of either. The setting did not particularly influence the balance of learning as categorized here but only the ward round supplied experience of surgical complications. The amount of learning taking place in an out-patient clinic was influenced by student ability, measured by examination performance, but not by clinic work-load. The implications of increased use of out-patient clinics and the advantages and disadvantages of the approach employed are discussed. It is concluded that in the situation studied student learning in the outpatient setting is as good as or superior to the ward setting but should not totally replace it.

The Selective Advantage of Synonymous Codon Usage Bias in Salmonella.

Directory of Open Access Journals (Sweden)

Gerrit Brandis

2016-03-01

Full Text Available The genetic code in mRNA is redundant, with 61 sense codons translated into 20 different amino acids. Individual amino acids are encoded by up to six different codons but within codon families some are used more frequently than others. This phenomenon is referred to as synonymous codon usage bias. The genomes of free-living unicellular organisms such as bacteria have an extreme codon usage bias and the degree of bias differs between genes within the same genome. The strong positive correlation between codon usage bias and gene expression levels in many microorganisms is attributed to selection for translational efficiency. However, this putative selective advantage has never been measured in bacteria and theoretical estimates vary widely. By systematically exchanging optimal codons for synonymous codons in the tuf genes we quantified the selective advantage of biased codon usage in highly expressed genes to be in the range 0.2-4.2 x 10-4 per codon per generation. These data quantify for the first time the potential for selection on synonymous codon choice to drive genome-wide sequence evolution in bacteria, and in particular to optimize the sequences of highly expressed genes. This quantification may have predictive applications in the design of synthetic genes and for heterologous gene expression in biotechnology.

PATIENTS WITH SUSPECTED METAL IMPLANT ALLERGY: POTENTIAL CLINICAL PICTURES AND ALLERGOLOGICAL DIAGNOSTIC APPROACH (REVIEW

Directory of Open Access Journals (Sweden)

P. Thomas

2014-01-01

Full Text Available The focus of this review are allergic complications following insertion of metallic orthopedic implants. Such potential allergic reactions encompass eczema, impaired wound and fracture healing, infection-mimicking reactions, effusions, pain and loosening. Nickel, cobalt and chromium seem to be the predominant eliciting allergens. Allergy might be considered prior to planned orthopaedic surgery or in patients with complications following arthroplasty We recommend, that differential diagnoses - in particular infection -should always be excluded in cooperation with surgery collegues. The clinical work up of a patient suspected of suffering from metal implant allergy should include a combined evaluation of medical history, clinical findings, patch testing and histology In vitro testing, namely the lymphocyte transformation test (LTT, can indicate metal sensitization, but needs careful interpretation.

Competitive Intelligence and Social Advantage.

Science.gov (United States)

Davenport, Elisabeth; Cronin, Blaise

1994-01-01

Presents an overview of issues concerning civilian competitive intelligence (CI). Topics discussed include competitive advantage in academic and research environments; public domain information and libraries; covert and overt competitive intelligence; data diversity; use of the Internet; cooperative intelligence; and implications for library and…

Recent Progress in Lab-on-a-Chip Technology and Its Potential Application to Clinical Diagnoses

Directory of Open Access Journals (Sweden)

Nae Yoon Lee

2013-03-01

Full Text Available We present the construction of the lab-on-a-chip (LOC system, a state-of-the-art technology that uses polymer materials (i.e., poly[dimethylsiloxane] for the miniaturization of conventional laboratory apparatuses, and show the potential use of these microfluidic devices in clinical applications. In particular, we introduce the independent unit components of the LOC system and demonstrate how each component can be functionally integrated into one monolithic system for the realization of a LOC system. In specific, we demonstrate microscale polymerase chain reaction with the use of a single heater, a microscale sample injection device with a disposable plastic syringe and a strategy for device assembly under environmentally mild conditions assisted by surface modification techniques. In this way, we endeavor to construct a totally integrated, disposable microfluidic system operated by a single mode, the pressure, which can be applied on-site with enhanced device portability and disposability and with simple and rapid operation for medical and clinical diagnoses, potentially extending its application to urodynamic studies in molecular level.

Improving the Clinical Pharmacologic Assessment of Abuse Potential: Part 1: Regulatory Context and Risk Management.

Science.gov (United States)

Sellers, Edward M

2018-02-01

This article brings to the attention of drug developers the Food and Drug Administration's (FDA's) recent final Guidance to Industry on Assessment of Abuse Potential and provides practical suggestions about compliance with the Guidance. The Guidance areas are reviewed, analyzed, and placed in the context of current scientific knowledge and best practices to mitigate regulatory risk. The Guidance provides substantial new detail on what needs to be done at all stages of drug development for central nervous system-active drugs. However, because many psychopharmacologic agents have unique preclinical and clinical features, the plan for each agent needs to be not only carefully prepared but also reviewed and approved by the FDA. Examples are provided where assumptions about interpretation of the Guidance can delay development. If the expertise and experience needed for assessing abuse potential during drug development do not exist within a company, external preclinical and clinical expert should be involved. Consultation with the FDA is encouraged and important because the specific requirements for each drug will vary.

In Vitro Tumor Models: Advantages, Disadvantages, Variables, and Selecting the Right Platform.

Science.gov (United States)

Katt, Moriah E; Placone, Amanda L; Wong, Andrew D; Xu, Zinnia S; Searson, Peter C

2016-01-01

In vitro tumor models have provided important tools for cancer research and serve as low-cost screening platforms for drug therapies; however, cancer recurrence remains largely unchecked due to metastasis, which is the cause of the majority of cancer-related deaths. The need for an improved understanding of the progression and treatment of cancer has pushed for increased accuracy and physiological relevance of in vitro tumor models. As a result, in vitro tumor models have concurrently increased in complexity and their output parameters further diversified, since these models have progressed beyond simple proliferation, invasion, and cytotoxicity screens and have begun recapitulating critical steps in the metastatic cascade, such as intravasation, extravasation, angiogenesis, matrix remodeling, and tumor cell dormancy. Advances in tumor cell biology, 3D cell culture, tissue engineering, biomaterials, microfabrication, and microfluidics have enabled rapid development of new in vitro tumor models that often incorporate multiple cell types, extracellular matrix materials, and spatial and temporal introduction of soluble factors. Other innovations include the incorporation of perfusable microvessels to simulate the tumor vasculature and model intravasation and extravasation. The drive toward precision medicine has increased interest in adapting in vitro tumor models for patient-specific therapies, clinical management, and assessment of metastatic potential. Here, we review the wide range of current in vitro tumor models and summarize their advantages, disadvantages, and suitability in modeling specific aspects of the metastatic cascade and drug treatment.

Clinical Potential of Hyperbaric Pressure-Treated Whey Protein

Science.gov (United States)

Piccolomini, André F.; Kubow, Stan; Lands, Larry C.

2015-01-01

Whey protein (WP) from cow’s milk is a rich source of essential and branched chain amino acids. Whey protein isolates (WPI) has been demonstrated to support muscle accretion, antioxidant activity, and immune modulation. However, whey is not readily digestible due to its tight conformational structure. Treatment of WPI with hyperbaric pressure results in protein unfolding. This enhances protein digestion, and results in an altered spectrum of released peptides, and greater release of essential and branched chain amino acids. Pressurized whey protein isolates (pWPI), through a series of cell culture, animal models and clinical studies, have been demonstrated to enhance muscle accretion, reduce inflammation, improve immunity, and decrease fatigue. It is also conceivable that pWPI would be more accessible to digestive enzymes, which would allow for a more rapid proteolysis of the proteins and an increased or altered release of small bioactive peptides. The altered profile of peptides released from WP digestion could thus play a role in the modulation of the immune response and tissue glutathione (GSH) concentrations. The research to date presents potentially interesting applications for the development of new functional foods based on hyperbaric treatment of WPI to produce products with more potent nutritional and nutraceutical properties. PMID:27417773

Story of rubidium-82 and advantages for myocardial perfusion PET imaging

Directory of Open Access Journals (Sweden)

Jean-Francois eChatal

2015-09-01

Full Text Available Rubidium-82 has a long story, starting in 1954. After preclinical studies in dogs showing that myocardial uptake of this radionuclide was directly proportional to myocardial blood flow, clinical studies were performed in the 80s leading to an approval in the USA in 1989. From that time thousands of patients have been tested and their results have been reported in 3 meta-analyses. Pooled patient-based sensitivity and specificity were respectively 0.91 and 0.90. By comparison with 99mTc-SPECT, 82Rb-PET had a much better diagnostic accuracy, especially in obese patients with BMI (Body Mass Index ≥30 kg/m2 (85% versus 67% with SPECT and in women with large breasts. A great advantage of 82Rb-PET is its capacity to accurately quantify myocardial blood flow. Quite importantly it has been recently shown that coronary flow reserve is associated with adverse cardiovascular events independently of luminal angiographic severity. Moreover coronary flow reserve is a functional parameter particularly useful in the estimate of microvascular dysfunction such as in diabetes mellitus. Due to the very short half-life of rubidium-82, the effective dose calculated for a rest/stress test is roughly equivalent to the annual natural exposure and even less when stress-only is performed with a low activity compatible with a good image quality with the last generation 3D PET scanners.There is still some debate on the relative advantages of 82Rb-PET with regard to 99mTc-SPECT. For the last ten years, great technological advances substantially improved performances of SPECT with its accuracy getting closer to this of 82Rb/PET. Currently the main advantages of PET are its capacity to accurately quantify myocardial blood flow and to deliver a low radiation exposure.

Assessment by human research ethics committees of potential conflicts of interest arising from pharmaceutical sponsorship of clinical research.

Science.gov (United States)

Newcombe, J P; Kerridge, I H

2007-01-01

Conflicts of interest arising from pharmaceutical industry sponsorship of clinical research have the potential to bias research outcomes and ultimately prejudice patient care. It is unknown how Australian Human Research Ethics Committees (HREC) assess and manage such conflicts of interest. We aimed to gain an understanding of how HREC approach the problem of potential conflicts of interest arising from pharmaceutical sponsorship of clinical research. We conducted a survey of HREC chairpersons in New South Wales. HREC vary widely in their approaches to conflicts of interest, including in their use of National Health and Medical Research Council guidelines, which were often misinterpreted or overlooked. Many committees rely primarily on researchers disclosing potential conflicts of interest, whereas a majority of HREC use disclosure to research participants as the primary tool for preventing and managing conflicts of interest. Almost no HREC place limitations on researcher relationships with pharmaceutical companies. These findings suggest reluctance on the part of HREC to regulate many potential conflicts of interest between researchers and pharmaceutical sponsors, which may arise from uncertainty regarding the meaning or significance of conflicts of interest in research, from ambiguity surrounding the role of HREC in assessing and managing conflicts of interest in research or from misinterpretation or ignorance of current National Health and Medical Research Council guidelines. Further review of policies and practices in this important area may prove beneficial in safeguarding clinical research and patient care while promoting continuing constructive engagement with the pharmaceutical industry.

Comparative Advantage of Maize- and Grass-Silage Based Feedstock for Biogas Production with Respect to Greenhouse Gas Mitigation

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Andreas Meyer-Aurich

2016-06-01

Full Text Available This paper analyses the comparative advantage of using silage maize or grass as feedstock for anaerobic digestion to biogas from a greenhouse gas (GHG mitigation point of view, taking into account site-specific yield potentials, management options, and land-use change effects. GHG emissions due to the production of biogas were calculated using a life-cycle assessment approach for three different site conditions with specific yield potentials and adjusted management options. While for the use of silage maize, GHG emissions per energy unit were the same for different yield potentials, and the emissions varied substantially for different grassland systems. Without land-use change effects, silage maize-based biogas had lower GHG emissions per energy unit compared to grass-based biogas. Taking land-use change into account, results in a comparative advantage of biogas production from grass-based feedstock produced on arable land compared to silage maize-based feedstock. However, under current frame conditions, it is quite unrealistic that grass production systems would be established on arable land at larger scale.

Theoretical aspects of competitive advantage and competition

OpenAIRE

Hudakova, Ivana

2009-01-01

The concept of competitive advantage is well-known for many of us and a number of literary resources focused on entrepreneurship and functioning of economies deal with it, either directly or indirectly. The understanding of the term competitive advantage though sometimes varies. One can only perceive it when looking at it as a whole, a live organism that is constantly developing in a complex dynamic entrepreneurial environment, the individual parts of which do not function when separated from...

Measuring and managing radiologist productivity, part 1: clinical metrics and benchmarks.

Science.gov (United States)

Duszak, Richard; Muroff, Lawrence R

2010-06-01

Physician productivity disparities are not uncommonly debated within radiology groups, sometimes in a contentious manner. Attempts to measure productivity, identify and motivate outliers, and develop equitable management policies can present challenges to private and academic practices alike but are often necessary for a variety of professional, financial, and personnel reasons. This is the first of a two-part series that will detail metrics for evaluating radiologist productivity and review published benchmarks, focusing primarily on clinical work. Issues and limitations that may prevent successful implementation of measurement systems are explored. Part 2 will expand that discussion to evaluating nonclinical administrative and academic activities, outlining advantages and disadvantages of addressing differential productivity, and introducing potential models for practices seeking to motivate physicians on the basis of both clinical and nonclinical work.

Neural correlates of the in-group memory advantage on the encoding and recognition of faces.

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Grit Herzmann

Full Text Available People have a memory advantage for faces that belong to the same group, for example, that attend the same university or have the same personality type. Faces from such in-group members are assumed to receive more attention during memory encoding and are therefore recognized more accurately. Here we use event-related potentials related to memory encoding and retrieval to investigate the neural correlates of the in-group memory advantage. Using the minimal group procedure, subjects were classified based on a bogus personality test as belonging to one of two personality types. While the electroencephalogram was recorded, subjects studied and recognized faces supposedly belonging to the subject's own and the other personality type. Subjects recognized in-group faces more accurately than out-group faces but the effect size was small. Using the individual behavioral in-group memory advantage in multivariate analyses of covariance, we determined neural correlates of the in-group advantage. During memory encoding (300 to 1000 ms after stimulus onset, subjects with a high in-group memory advantage elicited more positive amplitudes for subsequently remembered in-group than out-group faces, showing that in-group faces received more attention and elicited more neural activity during initial encoding. Early during memory retrieval (300 to 500 ms, frontal brain areas were more activated for remembered in-group faces indicating an early detection of group membership. Surprisingly, the parietal old/new effect (600 to 900 ms thought to indicate recollection processes differed between in-group and out-group faces independent from the behavioral in-group memory advantage. This finding suggests that group membership affects memory retrieval independent of memory performance. Comparisons with a previous study on the other-race effect, another memory phenomenon influenced by social classification of faces, suggested that the in-group memory advantage is dominated by

IMPACT OF FARM SIZE AND TYPE ON COMPETITIVE ADVANTAGE

OpenAIRE

Morgan, Jeffery D.; Langemeier, Michael R.

2003-01-01

This study examined sustained competitive advantage for a sample of Kansas farms. Whole-farm data for 224 farms with continuous data from 1982-2001 were used. Overall efficiency was computed for each farm and year. Sixty farms exhibited a sustained competitive advantage. Seventy-six farms exhibited a sustained competitive disadvantage. Farms with a competitive advantage were relatively larger, received more of their gross farm income from dairy and swine production, had significantly lower ex...

THE CONCEPT OF COMPETITIVE ADVANTAGES. LOGIC, SOURCES AND DURABILITY

OpenAIRE

Cegliński, Paweł

2017-01-01

Purpose: The main purpose of this article is to present theoretical assumptions of the concept of competitive advantages and main problems connected with the same. Most of all, the article outlines issues, which are presently discussed in the field of management sciences, including sources of competitive advantages, causal ambiguity and character of durability of competitive advantages in the contemporary turbulent business environment. In the author’s opinion, the issues have a great signifi...

COMPETITIVE ADVANTAGES THROUGH THE IMPLEMENTATION OF INTERNATIONAL ENERGY MANAGEMENT STANDARDS

Directory of Open Access Journals (Sweden)

PALIEKHOVA L. L.

2016-03-01

Full Text Available Purpose. The purpose of the presented research is to explore the potential of international energy management standards to increase competitiveness of industrial enterprises under conditions of Ukrainian transitional economy. The study had the following objectives: to trace the evolution of fundamental energy efficiency standards; to discuss experience in their use in various countries; to identify factors that are key to achieving competitive advantage under the implementation ISO 50001. Methodology. This article presents a historical overview of the standardisation of principles and approaches for the purpose of the energy-efficient management. The research was carried out by studying the international documents, voluntary standards and national practices in the field of energy efficiency. Conclusions. The study examines the experiences of different countries in the field of energy management systems. The authors conducted a comparative analysis of the ISO 50001 with the other basic standards for the organisation of management. The system approach enables to identify the main factors and their impact on capacity to achieve competitive advantages, which are possible to obtain after certification to ISO 50001. Originality. The study reviewed and analysed the energy management penetration within its dynamics at time and country level. After analysing the statistical data and the results of the interviews, the authors identified 20 key factors affecting the competitiveness of enterprises that are certified to ISO 50001. All of these factors were divided into four groups, two groups represent external environment – opportunities and threats, and two groups – internal capacity – strengths and weaknesses of enterprises. Practical value. The proposed system of factors may be useful for the planning of actions towards strengthening the capacity of energy management systems in the context of the formation competitive advantages on the industrial

Principles of three-dimensional printing and clinical applications within the abdomen and pelvis.

Science.gov (United States)

Bastawrous, Sarah; Wake, Nicole; Levin, Dmitry; Ripley, Beth

2018-04-04

Improvements in technology and reduction in costs have led to widespread interest in three-dimensional (3D) printing. 3D-printed anatomical models contribute to personalized medicine, surgical planning, and education across medical specialties, and these models are rapidly changing the landscape of clinical practice. A physical object that can be held in one's hands allows for significant advantages over standard two-dimensional (2D) or even 3D computer-based virtual models. Radiologists have the potential to play a significant role as consultants and educators across all specialties by providing 3D-printed models that enhance clinical care. This article reviews the basics of 3D printing, including how models are created from imaging data, clinical applications of 3D printing within the abdomen and pelvis, implications for education and training, limitations, and future directions.

Nuclear medical approaches to clinical research

International Nuclear Information System (INIS)

Otte, Andreas; Nguyen, Tristan

2009-01-01

In the frame of the master course Clinical research management at the scientific college Lahr in cooperation with the Albert-Ludwigs-University Freiburg three contributions are presented: Functional imaging - supported clinical studies in the sleep research. A comparison of NMR imaging versus SPECT and PET (advantages and disadvantages). Clinical studies with ionizing radiation and the radiation fear of the public. The new radioimmunotherapeutic agent Zevalin and the challenges at the market.

A Kantian argument against comparatively advantageous genetic modification.

Science.gov (United States)

Jensen, David

2011-08-01

The genetic modification of children is becoming a more likely possibility given our rapid progress in medical technologies. I argue, from a broadly Kantian point of view, that at least one kind of such modification-modification by a parent for the sake of a child's comparative advantage-is not rationally justified. To argue this, I first characterize a necessary condition on reasons and rational justification: what is a reason for an agent to do an action in one set of circumstances must be a reason for any in those circumstances to do the action. I then show that comparatively advantageous genetic modification violates this principle since a child's "getting ahead" through genetic modification cannot be rationally justified unless other children also could receive the modification, thus rendering the advantage useless. Finally, I consider the major objection to this it seems to disallow all cases of a parent's helping a child get ahead, something that parents normally engage in with their children. I argue that typical practices of developing a comparative advantage in a child, as well as practices of societal competition in general, do not conflict because they involve circumstances that mitigate the universal character of reasons. Many ordinary cases of competitive advantage that we think of as unjust, in fact, can be explained by my argument.

Advantages of liquid fluoride thorium reactor in comparison with light water reactor

Energy Technology Data Exchange (ETDEWEB)

Bahri, Che Nor Aniza Che Zainul, E-mail: anizazainul@gmail.com; Majid, Amran Ab.; Al-Areqi, Wadeeah M. [Nuclear Science Program, School of Applied Physics, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor (Malaysia)

2015-04-29

Liquid Fluoride Thorium Reactor (LFTR) is an innovative design for the thermal breeder reactor that has important potential benefits over the traditional reactor design. LFTR is fluoride based liquid fuel, that use the thorium dissolved in salt mixture of lithium fluoride and beryllium fluoride. Therefore, LFTR technology is fundamentally different from the solid fuel technology currently in use. Although the traditional nuclear reactor technology has been proven, it has perceptual problems with safety and nuclear waste products. The aim of this paper is to discuss the potential advantages of LFTR in three aspects such as safety, fuel efficiency and nuclear waste as an alternative energy generator in the future. Comparisons between LFTR and Light Water Reactor (LWR), on general principles of fuel cycle, resource availability, radiotoxicity and nuclear weapon proliferation shall be elaborated.

Potential of robots as next-generation technology for clinical assessment of neurological disorders and upper-limb therapy.

Science.gov (United States)

Scott, Stephen H; Dukelow, Sean P

2011-01-01

Robotic technologies have profoundly affected the identification of fundamental properties of brain function. This success is attributable to robots being able to control the position of or forces applied to limbs, and their inherent ability to easily, objectively, and reliably quantify sensorimotor behavior. Our general hypothesis is that these same attributes make robotic technologies ideal for clinically assessing sensory, motor, and cognitive impairments in stroke and other neurological disorders. Further, they provide opportunities for novel therapeutic strategies. The present opinionated review describes how robotic technologies combined with virtual/augmented reality systems can support a broad range of behavioral tasks to objectively quantify brain function. This information could potentially be used to provide more accurate diagnostic and prognostic information than is available from current clinical assessment techniques. The review also highlights the potential benefits of robots to provide upper-limb therapy. Although the capital cost of these technologies is substantial, it pales in comparison with the potential cost reductions to the overall healthcare system that improved assessment and therapeutic interventions offer.

Can the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) be used to accurately report clinic total reproductive potential (TRP)?

Science.gov (United States)

Stern, Judy E; Hickman, Timothy N; Kinzer, Donna; Penzias, Alan S; Ball, G David; Gibbons, William E

2012-04-01

To assess whether total reproductive potential (TRP), the chance of a live birth from each fresh cycle (fresh cycle plus frozen transfers), could be calculated from the national Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) database and whether information not available in SART CORS resulted in significant changes to the TRP calculation. Retrospective study using SART CORS and clinic data. Three assisted reproductive technology clinics. Women undergoing ART. None. Two- and three-year TRPs for 2005 and 2006 were calculated according to patient age at cycle start by linking fresh to frozen cycles up to first live birth. Clinic records were used to adjust for (remove) frozen cycles that used more than one fresh cycle as a source of embryos and for any embryos donated to other patients or research or shipped to another facility before a live birth. TRP was higher than fresh per-cycle rates for most ages at all clinics, although accuracy was compromised when there were fewer than 20 cycles per category. Two- and 3-year TRPs differed in only 2 of 24 calculations. Adjusted TRPs differed less than three percentage points from unadjusted TRPs when volume was sufficient. Clinic TRP can be calculated from SART CORS. Data suggest that calculations of clinic TRP from the national dataset would be meaningful. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Symbol labelling improves advantageous decision-making on the Iowa Gambling Task in people with intellectual disabilities.

Science.gov (United States)

Dymond, Simon; Bailey, Rebecca; Willner, Paul; Parry, Rhonwen

2010-01-01

Individuals with intellectual and developmental disabilities often have difficulties foregoing short-term loss for long-term gain. The Iowa Gambling Task (IGT) has been extensively adopted as a laboratory measure of this ability. In the present study, we undertook the first investigation with people with intellectual disabilities using a two-choice child version of the IGT, with measures of intellectual and executive functioning. Compared to a group of matched controls, people with intellectual disabilities performed advantageously and showed high levels of subjective awareness about the relative goodness and badness of the decks. A symbol labelling intervention, in which participants were taught to label the good and bad decks at regular intervals significantly improved advantageous decision-making to levels approximating that of controls. Factor analysis of executive functioning scores identified working memory and mental flexibility (response initiation and set shifting), with a near-significant inverse correlation between the extent to which the intervention was required and mental flexibility. These findings show, for the first time, that people with intellectual disabilities are capable of performing advantageously on the IGT and add to the growing clinical literature on decision-making. Copyright 2009 Elsevier Ltd. All rights reserved.

Can emergency medicine research benefit from adaptive design clinical trials?

Science.gov (United States)

Flight, Laura; Julious, Steven A; Goodacre, Steve

2017-04-01

Adaptive design clinical trials use preplanned interim analyses to determine whether studies should be stopped or modified before recruitment is complete. Emergency medicine trials are well suited to these designs as many have a short time to primary outcome relative to the length of recruitment. We hypothesised that the majority of published emergency medicine trials have the potential to use a simple adaptive trial design. We reviewed clinical trials published in three emergency medicine journals between January 2003 and December 2013. We determined the proportion that used an adaptive design as well as the proportion that could have used a simple adaptive design based on the time to primary outcome and length of recruitment. Only 19 of 188 trials included in the review were considered to have used an adaptive trial design. A total of 154/165 trials that were fixed in design had the potential to use an adaptive design. Currently, there seems to be limited uptake in the use of adaptive trial designs in emergency medicine despite their potential benefits to save time and resources. Failing to take advantage of adaptive designs could be costly to patients and research. It is recommended that where practical and logistical considerations allow, adaptive designs should be used for all emergency medicine clinical trials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Implement the medical group revenue function. Create competitive advantage.

Science.gov (United States)

Colucci, C

1998-01-01

This article shows medical groups how they can employ new financial management and information technology techniques to safeguard their revenue and income streams. These managerial techniques stem from the application of the medical group revenue function, which is defined herein. This article also describes how the medical group revenue function can be used to create value by employing a database and a decision support system. Finally, the article describes how the decision support system can be used to create competitive advantage. Through the wise use of internally generated information, medical groups can negotiate better contract terms, improve their operations, cut their costs, embark on capital investment programs and improve market share. As medical groups gain market power by improving in these areas, they will be more attractive to potential strategic allies, payers and investment bankers.

Pancreatic islet transplantation. Experimental and clinical aspects

DEFF Research Database (Denmark)

Yderstræde, Knud Bonnet

1987-01-01

interest has been shown in transplantation of isolated islets either directly, introduced intraportally, intramuscularly, inter alia, or encapsulated in artificial devices providing an immuno-isolation. Clinical application has revealed promising results concerning the immunological aspects. However......, quantitative assessment points to a difficulty in achieving satisfactory amounts of islets to attain normoglycaemia. Work with fetal pancreata has shown these to possess a growth potential in vitro thus, possibly, aiding the quantification of islets in transplantation models. In the field of pancreatic islet...... transplantation, future models include microencapsulation and hybrid artificial devices, both of which provide immuno-isolation - thus the ability of allo- as well as xeno-transplantation. The obvious advantage of immuno-isolated islet transplant, as opposed to segmentally engrafted pancreas, is stressed...

A scoping review of the potential for chart stimulated recall as a clinical research method.

Science.gov (United States)

Sinnott, Carol; Kelly, Martina A; Bradley, Colin P

2017-08-22

Chart-stimulated recall (CSR) is a case-based interviewing technique, which is used in the assessment of clinical decision-making in medical education and professional certification. Increasingly, clinical decision-making is a concern for clinical research in primary care. In this study, we review the prior application and utility of CSR as a technique for research interviews in primary care. Following Arksey & O'Malley's method for scoping reviews, we searched seven databases, grey literature, reference lists, and contacted experts in the field. We excluded studies on medical education or competence assessment. Retrieved citations were screened by one reviewer and full texts were ordered for all potentially relevant abstracts. Two researchers independently reviewed full texts and performed data extraction and quality appraisal if inclusion criteria were met. Data were collated and summarised using a published framework on the reporting of qualitative interview techniques, which was chosen a priori. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines informed the review report. From an initial list of 789 citations, eight studies using CSR in research interviews were included in the review: six from North America, one from the Netherlands, and one from Ireland. The most common purpose of included studies was to examine the influence of guidelines on physicians' decisions. The number of interviewees ranged from seven to twenty nine, while the number of charts discussed per interview ranged from one to twelve. CSR gave insights into physicians' reasoning for actions taken or not taken; the unrecorded social and clinical influences on decisions; and discrepancies between physicians' real and perceived practice. Ethical concerns and the training and influence of the researcher were poorly discussed in most of the studies. Potential pitfalls included the risk of recall, selection and observation biases. Despite the proven validity

Cognitive strategies take advantage of the cooperative potential of heterogeneous networks

International Nuclear Information System (INIS)

Vukov, Jeromos; Santos, Francisco C; Pacheco, Jorge M

2012-01-01

Understanding the emergence and maintenance of cooperation is one of the most challenging topics of our time. Evolutionary game theory offers a very flexible framework within which to address this challenge. Here we use the prisoner's dilemma game to investigate the performance of individuals who are capable of adopting reactive strategies in communities structurally organized by means of Barabási-Albert scale-free networks. We find that basic cognitive abilities, such as the capability to distinguish their partners and act according to their previous actions, enable cooperation to thrive. This result is particularly significant whenever fear is the leading social tension, as this fosters retaliation, thus enforcing and sustaining cooperation. Being able to simultaneously reward fellow cooperators and punish defectors proves instrumental in achieving cooperation and the welfare of the community. As a result, central individuals can successfully lead the community and turn defective players into cooperative ones. Finally, even when participation costs—known to be detrimental to cooperation in scale-free networks—are explicitly included, we find that basic cognitive abilities have enough potential to help cooperation to prevail. (paper)

Tattoos: could they be used to advantage as a medical alert in oral and maxillofacial surgery?

Science.gov (United States)

Colbert, S D; Brennan, P A

2017-04-01

Many publications have addressed the medical complications of tattoos, but to our knowledge there are no reports of their use to alert people in our field of potentially dangerous conditions. We present a new way to inform oral and maxillofacial colleagues about patients with a history of malignant hyperthermia (or any other life-threatening medical problem) and discuss the potential advantages and disadvantages of medical alert tattoos. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Internal microdosimetry of inhaled radon progeny in bronchial airways: advantages and limitations

International Nuclear Information System (INIS)

Hofmann, Werner; Fakir, Hatim; Pihet, Pascal

2007-01-01

The objective of the present study was to identify advantages and limitations of the application of microdosimetric concepts for inhaled radon progeny activities in the lungs. The methods employed for this analysis were a recently developed Monte- Carlo microdosimetry code for the calculation of energy deposition in bronchial target cells and the Probability Per Unit Track Length (PPUTL) model, which relates these microdosimetric parameters to cellular radiation effects. The major advantages of internal microdosimetry of radon progeny in bronchial airways are: (i) quantitative characterisation of non-uniform dose distributions and identification of target sites with enhanced carcinogenic potential, (ii) quantification of low doses of alpha particles by the number of cells hit and the dose received by those cells, (iii) illustration of the random variations of cellular doses by specific energy distributions and (iv) establishment of a direct link to cellular radiobiological effects. At present, a major limitation of microdosimetry is the extrapolation of the response of individual cells to the resulting tissue response, which is still not fully explored. (authors)

Energy Advantages for Green Schools

Science.gov (United States)

Griffin, J. Tim

2012-01-01

Because of many advantages associated with central utility systems, school campuses, from large universities to elementary schools, have used district energy for decades. District energy facilities enable thermal and electric utilities to be generated with greater efficiency and higher system reliability, while requiring fewer maintenance and…

Competitive Advantage and its Sources in an Evolving Market

Science.gov (United States)

Zaridis, Apostolos D.

2009-08-01

In a continuously altered and evolving Market, as is the food manufacturing market, the main and long-lasting objective of firm that is the maximization of its wealth and consequently the continuous remaining in profit regions, appears that it is possible to be achieved via the obtainment and maintenance of diachronically long-term competitive advantage, which it will render the firm unique or leader force in a inexorable competition that is continuously extended in a globalized market. Various definitions and different regards are developed in regard to the competitive advantage and the way with which a firm it is possible, acquiring it, to star in the market in which it is activated. As result of sustainable competitive advantage in a firm comes the above the average performance. Abundance of resources and competences that are proposed as sources of competitive advantage in the resource-based view literature exists, while they are added continuously new based on empiric studies. In any case, it appears to suffer hierarchy of sources of competitive advantage, with regard to sustainability of these.

[Clinical treatment adherence of health care workers and students exposed to potentially infectious biological material].

Science.gov (United States)

Almeida, Maria Cristina Mendes de; Canini, Silvia Rita Marin da Silva; Reis, Renata Karina; Toffano, Silmara Elaine Malaguti; Pereira, Fernanda Maria Vieira; Gir, Elucir

2015-04-01

To assess adherence to clinical appointments by health care workers (HCW) and students who suffered accidents with potentially infectious biological material. A retrospective cross-sectional study that assessed clinical records of accidents involving biological material between 2005 and 2010 in a specialized unit. A total of 461 individuals exposed to biological material were treated, of which 389 (84.4%) were HCWs and 72 (15.6%) students. Of the 461 exposed individuals, 307 (66.6%) attended a follow-up appointment. Individuals who had suffered an accident with a known source patient were 29 times more likely to show up to their scheduled follow-up appointments (OR: 29.98; CI95%: 16.09-55.83). The predictor in both univariate and multivariate analyses for adherence to clinical follow-up appointment was having a known source patient with nonreactive serology for the human immunodeficiency virus and/or hepatitis B and C.

Human Induced Pluripotent Stem Cells from Basic Research to Potential Clinical Applications in Cancer

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Teresa de Souza Fernandez

2013-01-01

Full Text Available The human induced pluripotent stem cells (hiPSCs are derived from a direct reprogramming of human somatic cells to a pluripotent stage through ectopic expression of specific transcription factors. These cells have two important properties, which are the self-renewal capacity and the ability to differentiate into any cell type of the human body. So, the discovery of hiPSCs opens new opportunities in biomedical sciences, since these cells may be useful for understanding the mechanisms of diseases in the production of new diseases models, in drug development/drug toxicity tests, gene therapies, and cell replacement therapies. However, the hiPSCs technology has limitations including the potential for the development of genetic and epigenetic abnormalities leading to tumorigenicity. Nowadays, basic research in the hiPSCs field has made progress in the application of new strategies with the aim to enable an efficient production of high-quality of hiPSCs for safety and efficacy, necessary to the future application for clinical practice. In this review, we show the recent advances in hiPSCs’ basic research and some potential clinical applications focusing on cancer. We also present the importance of the use of statistical methods to evaluate the possible validation for the hiPSCs for future therapeutic use toward personalized cell therapies.

Knowledge And Knowledge Management As A Competitive Advantage

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Diana Bratić

2009-01-01

Full Text Available In the modern business environment with high turbulence and complexity, an organization’s force to create and sustain competitive advantage lies in what it knows not what it owns. Establishment of a knowledge management in organization will ensure sustainable competitive advantage because the intellectual capital has become the primary bases of core competencies and the key to superior performance. The transition from industrial to knowledge society, effective use of knowledge is one of the deciding factors in the struggle for competitiveness because it will ensure the rationality, efficiency and flexibility in operations, and only through the realization of those graphics company can gain a competitive advantage on the market.

Epicardial fat and atrial fibrillation: current evidence, potential mechanisms, clinical implications, and future directions.

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Wong, Christopher X; Ganesan, Anand N; Selvanayagam, Joseph B

2017-05-01

Obesity is increasingly recognized as a major modifiable determinant of atrial fibrillation (AF). Although body mass index and other clinical measures are useful indications of general adiposity, much recent interest has focused on epicardial fat, a distinct adipose tissue depot that can be readily assessed using non-invasive imaging techniques. A growing body of data from epidemiological and clinical studies has demonstrated that epicardial fat is consistently associated with the presence, severity, and recurrence of AF across a range of clinical settings. Evidence from basic science and translational studies has also suggested that arrhythmogenic mechanisms may involve adipocyte infiltration, pro-fibrotic, and pro-inflammatory paracrine effects, oxidative stress, and other pathways. Despite these advances, however, significant uncertainty exists and many questions remain unanswered. In this article, we review our present understanding of epicardial fat, including its classification and quantification, existing evidence implicating its role in AF, potential mechanisms, implications for clinicians, and future directions for research. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Decision support and data warehousing tools boost competitive advantage.

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Waldo, B H

1998-01-01

The ability to communicate across the care continuum is fast becoming an integral component of the successful health enterprise. As integrated delivery systems are formed and patient care delivery is restructured, health care professionals must be able to distribute, access, and evaluate information across departments and care settings. The Aberdeen Group, a computer and communications research and consulting organization, believes that "the single biggest challenge for next-generation health care providers is to improve on how they consolidate and manage information across the continuum of care. This involves building a strategic warehouse of clinical and financial information that can be shared and leveraged by health care professionals, regardless of the location or type of care setting" (Aberdeen Group, Inc., 1997). The value and importance of data and systems integration are growing. Organizations that create a strategy and implement DSS tools to provide decision-makers with the critical information they need to face the competition and maintain quality and costs will have the advantage.

Commit to Building on New England's "Employability" Advantage!

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Gittell, Ross

2017-01-01

Higher education has provided New England with an economic advantage, as the region without strong natural resource advantages has relied on its higher education institutions (HEIs) and brainpower. A higher education-based economic advantage has enabled the region to develop strong well-paying technology and knowledge-based industries tied to New…

Evolving role of hadron irradiation: Potential and risks of hadrons heavier than protons

International Nuclear Information System (INIS)

Levy, Richard P.

2007-01-01

Proton irradiation has been developed to achieve the clinical benefit of improved 3D-dose distribution, with biological properties similar to X-rays. Neutron irradiation, though much less 3D-conformal than proton treatment, has been developed to take advantage of increased relative biologic effectiveness (RBE). Irradiation with hadrons heavier than protons (e.g. carbon and neon ions) exhibits the unique combination of improved 3D-dose distribution and increased RBE. The synchrotron technology is rapidly developing to improve the efficiency of delivering these heavier hadrons clinically, but important issues remain regarding optimization of dose and fractionation parameters in the treatment of various histopathologies located in different portions of the anatomy. Many laboratory animal and in vitro cellular studies, and some clinical studies, have been performed to enable better understanding of how to adjust dose-fractionation selection to improve the therapeutic ratio of tumor-cell kill to normal-tissue injury. This paper highlights the enhanced therapeutic potential and associated risks of treatment with these heavier hadrons

Perceived Cost Advantages and Disadvantages of Purchasing HIV Self-Testing Kits among Urban Tanzanian Men: An Inductive Content Analysis.

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Jennings, Larissa; Conserve, Donaldson F; Merrill, Jamison; Kajula, Lusajo; Iwelunmor, Juliet; Linnemayr, Sebastian; Maman, Suzanne

2017-08-01

Impoverished men have lower rates of facility-based HIV counseling and testing and higher unknown HIV-positive status than women. Economic theory suggests that individuals will obtain an HIV test if anticipated benefits are greater than anticipated costs. Yet, few studies have investigated the range of financial preferences of HIV self-testing (HIVST) among poor men who decline testing or do not test regularly. Twenty-three interviews were conducted to qualitatively assess perceived costs saved and costs incurred from use of HIVST kits in infrequently- or never-tested Tanzanian men. All men were shown an HIVST kit and video. They were then asked about the costs associated with provider-led HIV testing, financial benefits and concerns of HIVST and willingness to pay for HIVST. Data were transcribed, coded and analyzed using inductive content analyses. We then grouped codes into perceived cost advantages and disadvantages and tabulated the range of prices men were willing to pay for a self-test kit. Perceived cost advantages of HIVST were avoidance of spending money to test in facilities, omission of follow-up fees, affordability relative to private clinics, and increased time for earning income and other activities. Men also discussed the imbalance of the financial benefit of accessing free, public HIV testing with the resources spent for transport, purchasing meals away from home and long wait lines. Perceived cost disadvantages of HIVST were prohibitive kit costs, required prior savings to purchase kits, expenditures relating to death and preferences for free provider-performed testing. Men were also concerned about the psychological costs of inaccurate results. HIVST willingness to pay varied among men. Men's decisions to self-test for HIV takes into account expected financial gains and losses. Demand generation for HIVST among men should consider use of low fees or free HIVST, while emphasizing potential savings from reduced travel, clinical costs, or time way

Beat-to-beat variability of cardiac action potential duration: underlying mechanism and clinical implications.

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Nánási, Péter P; Magyar, János; Varró, András; Ördög, Balázs

2017-10-01

Beat-to-beat variability of cardiac action potential duration (short-term variability, SV) is a common feature of various cardiac preparations, including the human heart. Although it is believed to be one of the best arrhythmia predictors, the underlying mechanisms are not fully understood at present. The magnitude of SV is basically determined by the intensity of cell-to-cell coupling in multicellular preparations and by the duration of the action potential (APD). To compensate for the APD-dependent nature of SV, the concept of relative SV (RSV) has been introduced by normalizing the changes of SV to the concomitant changes in APD. RSV is reduced by I Ca , I Kr , and I Ks while increased by I Na , suggesting that ion currents involved in the negative feedback regulation of APD tend to keep RSV at a low level. RSV is also influenced by intracellular calcium concentration and tissue redox potential. The clinical implications of APD variability is discussed in detail.

Advanced MR methods at ultra-high field (7 Tesla) for clinical musculoskeletal applications

Energy Technology Data Exchange (ETDEWEB)

Trattnig, Siegfried [Medical University of Vienna/Vienna General Hospital, MR Centre - High Field MR, Department of Radiology, Vienna (Austria); Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Austrian Cluster for Tissue Regeneration, Vienna (Austria); Zbyn, Stefan; Schmitt, Benjamin; Friedrich, Klaus; Bogner, Wolfgang [Medical University of Vienna/Vienna General Hospital, MR Centre - High Field MR, Department of Radiology, Vienna (Austria); Juras, Vladimir; Szomolanyi, Pavol [Medical University of Vienna/Vienna General Hospital, MR Centre - High Field MR, Department of Radiology, Vienna (Austria); Slovak Academy of Sciences, Department of Imaging Methods, Institute of Measurement Science, Bratislava (Slovakia)

2012-11-15

This article provides an overview of the initial clinical results of musculoskeletal studies performed at 7 Tesla, with special focus on sodium imaging, new techniques such as chemical exchange saturation transfer (CEST) and T2* imaging, and multinuclear MR spectroscopy. Sodium imaging was clinically used at 7 T in the evaluation of patients after cartilage repair procedures because it enables the GAG content to be monitored over time. Sodium imaging and T2* mapping allow insights into the ultra-structural composition of the Achilles tendon and help detect early disease. Chemical exchange saturation transfer was, for the first time, successfully applied in the clinical set-up at 7 T in patients after cartilage repair surgery. The potential of phosphorus MR spectroscopy in muscle was demonstrated in a comparison study between 3 and 7 T, with higher spectral resolution and significantly shorter data acquisition times at 7 T. These initial clinical studies demonstrate the potential of ultra-high field MR at 7 T, with the advantage of significantly improved sensitivity for other nuclei, such as {sup 23}Na (sodium) and {sup 31}P (phosphorus). The application of non-proton imaging and spectroscopy provides new insights into normal and abnormal physiology of musculoskeletal tissues, particularly cartilage, tendons, and muscles. (orig.)

THE RELATIONSHIP BETWEEN ORGANISATIONAL RESOURCES, CAPABILITIES, SYSTEMS AND COMPETITIVE ADVANTAGE

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Raduan Che Rose

2012-01-01

Full Text Available The main objective that business organisations in particular should strive to attain is achieving a competitive advantage position relative to their competitors.. This research empirically examined the importance of and emphasis placed on organisational resources, capabilities and systems in their relationships with competitive advantage. The overall findings indicated significant, positive effects of organisational resources, capabilities and systems collectively on competitive advantage, providing support and corroboration to the resource-based view (RBV. The total variance in competitive advantage accounted for by the multiple linear regression (MLR model was 56.2%. In short, the findings from this study have not only contributed to the literature on the issue of the relationship between organisational resources, capabilities, systems and competitive advantage, but also provided vital information to both practitioners and policy makers on the subject matter.

Prevalence and Citation Advantage of Gold Open Access in the Subject Areas of the Scopus Database

Science.gov (United States)

Dorta-González, Pablo; Santana-Jiménez, Yolanda

2018-01-01

The potential benefit of open access (OA) in relation to citation impact has been discussed in the literature in depth. The methodology used to test the OA citation advantage includes comparing OA vs. non-OA journal impact factors and citations of OA vs. non-OA articles published in the same non-OA journals. However, one problem with many studies…

Mechanism of Action and Clinical Potential of Fingolimod for the Treatment of Stroke

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Wentao Li

2016-08-01

Full Text Available Fingolimod (FTY720 is an orally bio-available immunomodulatory drug currently approved by the FDA for the treatment of multiple sclerosis. Currently, there is a significant interest in the potential benefits of FTY720 on stroke outcomes. FTY720 and the sphingolipid signaling pathway it modulates has a ubiquitous presence in the central nervous system and both rodent models and pilot clinical trials seem to indicate that the drug may improve overall functional recovery in different stroke subtypes. Although the precise mechanisms behind these beneficial effects are yet unclear, there is evidence that FTY720 has a role in regulating cerebrovascular responses, blood brain barrier permeability, and cell survival in the event of cerebrovascular insult. In this article, we critically review the data obtained from the latest laboratory findings and clinical trials involving both ischemic and hemorrhagic stroke, and attempt to form a cohesive picture of FTY720’s mechanisms of action in stroke

Advantage of resonant power conversion in aerospace applications

Science.gov (United States)

Hansen, I. G.

1983-01-01

An ultrasonic, sinusoidal aerospace power distribution system is shown to have many advantages over other candidate power systems. These advantages include light weight, ease of fault clearing, versatility in handling many loads including motors, and the capability of production within the limits of present technology. References are cited that demonstrate the state of resonant converter technology and support these conclusions.

Framing the research agenda for sickle cell trait: building on the current understanding of clinical events and their potential implications.

Science.gov (United States)

Goldsmith, Jonathan C; Bonham, Vence L; Joiner, Clinton H; Kato, Gregory J; Noonan, Allan S; Steinberg, Martin H

2012-03-01

Sickle Cell Trait (HbAS), the heterozygous state for the sickle hemoglobin beta globin gene is carried by as many as 100 million individuals including up to 25% of the population in some regions of the world (World Health Organization, Provisional agenda item 4.8, EB117/34 (22 December 2005) or World Health Organization, Provisional agenda item 11.4 (24 April 2006)). Persons with HbAS have some resistance to falciparum malaria infection in early childhood (Piel FB, Patil AP, Howes RE, et al., Nat Commun 2010;1104:1-7 and Aidoo M, Terlouw DJ, Kolczak M, et al., Lancet 2002;359:1311-1312) and as a result individuals with HbAS living in malarial endemic regions of Africa have a survival advantage over individuals with HbAA. Reports from the US emphasize possible health risks for individuals with HbAS including increased incidence of renal failure and malignancy, thromboembolic disorders, splenic infarction as a high altitude complication, and exercise-related sudden death. The National Heart, Lung, and Blood Institute, National Institutes of Health convened a workshop in Bethesda, Maryland on June 3-4, 2010, Framing the Research Agenda for Sickle Cell Trait, to review the clinical manifestations of HbAS, discuss the exercise-related sudden death reports in HbAS, and examine the public health, societal, and ethical implications of policies regarding HbAS. The goal of the workshop was to identify potential research questions to address knowledge gaps.

COMPETITIVE ADVANTAGES ENTERPRISES IN KOOPERATION RELATIONS

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O. Mikitiuk

2013-09-01

Full Text Available Formation of new approaches to the definition of competitive advantage requires different ways to implement them according to market conditions. These paths can be cooperative relations entities that are implemented in the competitive advantage of enterprises in the new stage of development of a competitive society. The result of the interaction of small businesses with industrial and economic structures is the formation and development of such forms of cooperation entities as subcontracting, franchising, leasing, venture finance. The content of these forms is to integrate (interlacing of the functional areas of business including production of functional form is subcontracting relationships, forms of supply – franchising, industrial and financial shape – leasing as a form of innovative functional integration relations is venture financing.

Clinical application of digital radiography

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Abe, Hiroyuki; Nagasaka, Hideo; Himi, Kazuhisa [Nihon Univ., Tokyo. School of Medicine

1983-04-01

Utility of digital subtraction angiography (DSA) by fluorography was advocated with demonstrable clinical cases. DSA is drawing attention for use at the outpatient clinic because it is relatively noninvasive, involves less risk than that by catheterization, and can be performed by intravenous injection. It also has a number of advantages such as instantaneous imaging and possible imaging of multiple sites by the same procedure. It still be extensively used in clinical practice not only as a screening method, but also as a functional imaging one.

ELECTRONIC BANKING ADVANTAGES FOR FINANCIAL SERVICES DELIVERY

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Paun Dragos

2010-12-01

Full Text Available E-banking is a fully automatic service for traditionally banking customers products based on information technology platforms. E-banking services provide customer access to accounts, the ability to move their money between different accounts or making payments via e-channels. The advantages generated by this services have determined an accelerate developing of this industry over the entire world. This paper examines some of the advantages of electronic banking products together with the characteristic management issues generated by the implementation of this new channel for financial services delivery.

Flat detectors and their clinical applications

International Nuclear Information System (INIS)

Spahn, Martin

2005-01-01

Diagnostic and interventional flat detector X-ray systems are penetrating the market in all application segments. First introduced in radiography and mammography, they have conquered cardiac and general angiography and are getting increasing attention in fluoroscopy. Two flat detector technologies prevail. The dominating method is based on an indirect X-ray conversion process, using cesium iodide scintillators. It offers considerable advantages in radiography, angiography and fluoroscopy. The other method employs a direct converter such as selenium which is particularly suitable for mammography. Both flat detector technologies are based on amorphous silicon active pixel matrices. Flat detectors facilitate the clinical workflow in radiographic rooms, foster improved image quality and provide the potential to reduce dose. This added value is based on their large dynamic range, their high sensitivity to X-rays and the instant availability of the image. Advanced image processing is instrumental in these improvements and expand the range of conventional diagnostic methods. In angiography and fluoroscopy the transition from image intensifiers to flat detectors is facilitated by ample advantages they offer, such as distortion-free images, excellent coarse contrast, large dynamic range and high X-ray sensitivity. These characteristics and their compatibility with strong magnetic fields are the basis for improved diagnostic methods and innovative interventional applications. (orig.)

Plant circadian clocks increase photosynthesis, growth, survival, and competitive advantage.

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Dodd, Antony N; Salathia, Neeraj; Hall, Anthony; Kévei, Eva; Tóth, Réka; Nagy, Ferenc; Hibberd, Julian M; Millar, Andrew J; Webb, Alex A R

2005-07-22

Circadian clocks are believed to confer an advantage to plants, but the nature of that advantage has been unknown. We show that a substantial photosynthetic advantage is conferred by correct matching of the circadian clock period with that of the external light-dark cycle. In wild type and in long- and short-circadian period mutants of Arabidopsis thaliana, plants with a clock period matched to the environment contain more chlorophyll, fix more carbon, grow faster, and survive better than plants with circadian periods differing from their environment. This explains why plants gain advantage from circadian control.

Trust, Commitment and Competitive Advantage in SMEs Export Performance

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Md Daud Ismail

2017-04-01

Full Text Available The entry of small businesses into international markets has intensified. However, despite the growing presence of small businesses in international markets, studies into their international behavior, particularly regarding the effect of international relationships on international outcomes, remain limited. This study investigates the cross-border relationships of Small and Medium Enterprises (SMEs by examining the effects of the dimensions of the key relationship on the competitive advantage and performance of SMEs in export markets. These dimensions include trust and commitment. Results indicate that trust is significantly related to commitment and export performance. Commitment is positively related to competitive advantage but not to export performance. Trust affects competitive advantage through commitment. The effect of commitment on export performance is mediated by competitive advantage. The methodology and results are presented. The conclusion, implications, and limitations of this study are also discussed.

Clinical treatment adherence of health care workers and students exposed to potentially infectious biological material

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Maria Cristina Mendes de Almeida

2015-04-01

Full Text Available OBJECTIVE To assess adherence to clinical appointments by health care workers (HCW and students who suffered accidents with potentially infectious biological material. METHOD A retrospective cross-sectional study that assessed clinical records of accidents involving biological material between 2005 and 2010 in a specialized unit. RESULTS A total of 461 individuals exposed to biological material were treated, of which 389 (84.4% were HCWs and 72 (15.6% students. Of the 461 exposed individuals, 307 (66.6% attended a follow-up appointment. Individuals who had suffered an accident with a known source patient were 29 times more likely to show up to their scheduled follow-up appointments (OR: 29.98; CI95%: 16.09-55.83. CONCLUSION The predictor in both univariate and multivariate analyses for adherence to clinical follow-up appointment was having a known source patient with nonreactive serology for the human immunodeficiency virus and/or hepatitis B and C.

Computer-assisted technologies used in oral rehabilitation and the clinical documentation of alleged advantages - a systematic review.

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Jokstad, A

2017-04-01

The objective of this systematic review is to identify current computer-assisted technologies used for managing patients with a need to re-establish craniofacial appearance, subjective discomfort and stomatognathic function, and the extent of their clinical documentation. Electronic search strategies were used for locating clinical studies in MEDLINE through PubMed and in the Cochrane library, and in the grey literature through searches on Google Scholar. The searches for commercial digital products for use in oral rehabilitation resulted in identifying 225 products per November 2016, used for patient diagnostics, communication and therapy purposes, and for other computer-assisted applications in context with oral rehabilitation. About one-third of these products were described in about 350 papers reporting from clinical human studies. The great majority of digital products for use in oral rehabilitation has no clinical documentation at all, while the products from a distinct minority of manufacturers have frequently appeared in more or less scientific reports. Moore's law apply also to digital dentistry, which predicts that the capacity of microprocessors will continue to become faster and with lower cost per performance unit, and innovative software programs will harness these improvements in performance. The net effect is the noticeable short product life cycle of digital products developed for use in oral rehabilitation and often lack of supportive clinical documentation. Nonetheless, clinicians must request clinically meaningful information about new digital products to assess net benefits for the patients or the dental professionals and not accept only technological verbiage as a basis for product purchases. © 2017 John Wiley & Sons Ltd.

Indonesian Comparative Advantage Entering the ASEAN Economic Community

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Riandi .

2017-03-01

Full Text Available The purpose of this study is to examine the comparative advantage of Indonesian commodities in order to enter the ASEAN Economic Community (AEC. This study uses the export data during the period of 2003-2013 among five ASEAN countries participating in the AEC, including Indonesia, Malaysia, The Philippines, Singapore, and Thailand. All data obtained from the UN Comtrade database following the Harmonized System (HS at the two-digit classification level. This study applies dynamic revealed comparative advantage (DRCA index developed by Edwards and Schoer (2001 which is the development of revealed comparative advantage (RCA index by Balassa (1965. The results show that Indonesia is ready to enter the AEC. From this research, there are several Indonesian main commodities which have comparative advantage in ASEAN, including fish, crustaceans, molluscs, aquatic invertebrates ones (HS-03, edible fruit, nuts, peel of citrus fruit, melons (HS-08, oil seed, oleagic fruits, grain, seed, fruit, etc, nes (HS-12, lac, gums, resins, vegetable saps and extracts nes (HS-13, rubber and articles thereof (HS-40, paper & paperboard, articles of pulp, paper and board (HS-48, special woven or tufted fabric, lace, tapestry etc (HS-58, articles apparel, accessories, not knit or crochet (HS-62, and vehicles other than railway, tramway (HS-87. Those commodities are in line with Indonesian government export's strategy direction which mainly focuses on several sectors, including fishery, vegetable products, rubber, wood and wood products, textiles, and transportation. Therefore, Indonesian government should focus to improve those commodities in AEC. Keywords: Indonesian Comparative Advantage, Main Export Commodities, Export Strategy Direction, ASEAN Economic Community

New intensifying screens in clinical radiology. Pt. 2

International Nuclear Information System (INIS)

Freyschmidt, J.; Saure, D.; Hagemann, G.

1976-01-01

A clinically applicable procedure for testing new intensifying rare earth screens, as well as the special Siemens' screen is described. The results are related to universal screeens. The film-screen combination α 4XD (gadolinium oxysulphide with normal, green sensitive film) results in a reduction of radiation dose to half with detail comparable with universal screens. The Siemens' special screen has similar advantages. Screens with a higher intensification factor and reduction of the mAs to one sixth results in loss of detail. This does not necessarily reduce their clinical use if they are used for appropriate purposes. The results of this clinically orientated technique agreed well with physically objective methods using lead grids. The advantages of the new screens are discussed in terms of their practical application. (orig.) [de

Hidden Advantages and Disadvantages of Social Class.

Science.gov (United States)

Goudeau, Sébastien; Croizet, Jean-Claude

2017-02-01

Three studies conducted among fifth and sixth graders examined how school contexts disrupt the achievement of working-class students by staging unfair comparison with their advantaged middle-class peers. In regular classrooms, differences in performance among students are usually showcased in a way that does not acknowledge the advantage (i.e., higher cultural capital) experienced by middle-class students, whose upbringing affords them more familiarity with the academic culture than their working-class peers have. Results of Study 1 revealed that rendering differences in performance visible in the classroom by having students raise their hands was enough to undermine the achievement of working-class students. In Studies 2 and 3, we manipulated students' familiarity with an arbitrary standard as a proxy for social class. Our results suggest that classroom settings that make differences in performance visible undermine the achievement of the students who are less familiar with academic culture. In Study 3, we showed that being aware of the advantage in familiarity with a task restores the performance of the students who have less familiarity with the task.

Potential Strategies to Address the Major Clinical Barriers Facing Stem Cell Regenerative Therapy for Cardiovascular Disease: A Review.

Science.gov (United States)

Nguyen, Patricia K; Neofytou, Evgenios; Rhee, June-Wha; Wu, Joseph C

2016-11-01

Although progress continues to be made in the field of stem cell regenerative medicine for the treatment of cardiovascular disease, significant barriers to clinical implementation still exist. To summarize the current barriers to the clinical implementation of stem cell therapy in patients with cardiovascular disease and to discuss potential strategies to overcome them. Information for this review was obtained through a search of PubMed and the Cochrane database for English-language studies published between January 1, 2000, and July 25, 2016. Ten randomized clinical trials and 8 systematic reviews were included. One of the major clinical barriers facing the routine implementation of stem cell therapy in patients with cardiovascular disease is the limited and inconsistent benefit observed thus far. Reasons for this finding are unclear but may be owing to poor cell retention and survival, as suggested by numerous preclinical studies and a small number of human studies incorporating imaging to determine cell fate. Additional studies in humans using imaging to determine cell fate are needed to understand how these factors contribute to the limited efficacy of stem cell therapy. Treatment strategies to address poor cell retention and survival are under investigation and include the following: coadministration of immunosuppressive and prosurvival agents, delivery of cardioprotective factors packaged in exosomes rather than the cells themselves, and use of tissue-engineering strategies to provide structural support for cells. If larger grafts are achieved using these strategies, it will be imperative to carefully monitor for the potential risks of tumorigenicity, immunogenicity, and arrhythmogenicity. Despite important achievements to date, stem cell therapy is not yet ready for routine clinical implementation. Significant research is still needed to address the clinical barriers outlined herein before the next wave of large clinical trials is under way.

Advantages in imaging results with titanium aneurysm clips (TiAl6V4)

International Nuclear Information System (INIS)

Piepgras, A.; Gueckel, F.; Weik, T.; Schmiedek, P.

1995-01-01

Aneurysm clips made of a titanium alloy (TiAl6V4) were used in clinical practice for the first time. The design of the clips is identical to the routinely used Yasargil series. In 30 patients, 38 symptomatic and asymptomatic aneurysms were fixed with 45 clips. Metallurgical advantages of the new alloy are better biocompatibility, less magnetic susceptibility, and lower X-ray density. The postoperative imaging results are superior to the conventionally used alloys with respect to artifact reduction in computed tomography, angiography, and magnetic resonance imaging. With a follow-up period of 7 months, a statement on biocompatibility cannot yet be given. (orig.) [de

Clinical practice guidelines in patient management

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Santosh Kumar

2001-01-01

Full Text Available Efforts have always been made to evolve certain prin-ciples to reduce the variability in the management of patients and make medical care more appropriate. These efforts have become almost a movement since 1980s as evidenced in the development of clinical practice guide-lines in all medical disciplines. This article describes the need for clinical practice guidelines and their de-velopment methods and qualities. Advantages and limi-tations of clinical practice guidelines are enumerated. The salient features of various available clinical prac-tice guidelines in urology are also described.

The potential advantages of microstructure modeling of titanium to the aerospace industry

International Nuclear Information System (INIS)

Boyer, R.R.; Furrer, D.U.

2004-01-01

A multi-organization team across the entire titanium aerospace supply chain has been established to develop and implement modeling tools for the reduction of manufacturing lead-time and cost. This Air Force sponsored Metals Affordability Initiative (MAI) program is developing model tools capable of predicting the microstructure and mechanical properties of titanium alloys. The developed tools are intended to enable predicting the microstructure and texture evolution through wrought processing and heat treatment of ingot metallurgy titanium components, with a stronger emphasis on the latter stages of the processing. It will also take into account chemistry, including the composition of the individual phases during processing. Beta phase and primary alpha phase grain growth at temperature and during cooling along with morphological aspects will be taken into consideration.The success of this modeling effort could have a significant impact on the industry in terms of reducing cost and lead times of wrought products -- while this study is directed at forgings, there is no reason it would not be applicable to other product forms. Initial applications of these tools include the potential to reduce and in some cases eliminate certification testing presently done on forged or other components. There is also the potential for making a disposition on components with a metallurgical discrepancy without cutting up (sacrificing) a part(s), through the use of predictive tools. For parts where the property requirements are difficult to meet, these modeling tools could also enable one to determine the more critical parameters and concentrate efforts on controlling them, providing a more consistent product.In the longer term, titanium modeling tools could result in reduction of the lead time and cost of developing a new heat treatment or alloy to meet specific application requirements -- the models could be used to predict the proper aim chemistry, optimized chemistry limits, and

Contextual Advantage for State Discrimination

Science.gov (United States)

Schmid, David; Spekkens, Robert W.

2018-02-01

Finding quantitative aspects of quantum phenomena which cannot be explained by any classical model has foundational importance for understanding the boundary between classical and quantum theory. It also has practical significance for identifying information processing tasks for which those phenomena provide a quantum advantage. Using the framework of generalized noncontextuality as our notion of classicality, we find one such nonclassical feature within the phenomenology of quantum minimum-error state discrimination. Namely, we identify quantitative limits on the success probability for minimum-error state discrimination in any experiment described by a noncontextual ontological model. These constraints constitute noncontextuality inequalities that are violated by quantum theory, and this violation implies a quantum advantage for state discrimination relative to noncontextual models. Furthermore, our noncontextuality inequalities are robust to noise and are operationally formulated, so that any experimental violation of the inequalities is a witness of contextuality, independently of the validity of quantum theory. Along the way, we introduce new methods for analyzing noncontextuality scenarios and demonstrate a tight connection between our minimum-error state discrimination scenario and a Bell scenario.

Contextual Advantage for State Discrimination

Directory of Open Access Journals (Sweden)

David Schmid

2018-02-01

Full Text Available Finding quantitative aspects of quantum phenomena which cannot be explained by any classical model has foundational importance for understanding the boundary between classical and quantum theory. It also has practical significance for identifying information processing tasks for which those phenomena provide a quantum advantage. Using the framework of generalized noncontextuality as our notion of classicality, we find one such nonclassical feature within the phenomenology of quantum minimum-error state discrimination. Namely, we identify quantitative limits on the success probability for minimum-error state discrimination in any experiment described by a noncontextual ontological model. These constraints constitute noncontextuality inequalities that are violated by quantum theory, and this violation implies a quantum advantage for state discrimination relative to noncontextual models. Furthermore, our noncontextuality inequalities are robust to noise and are operationally formulated, so that any experimental violation of the inequalities is a witness of contextuality, independently of the validity of quantum theory. Along the way, we introduce new methods for analyzing noncontextuality scenarios and demonstrate a tight connection between our minimum-error state discrimination scenario and a Bell scenario.

Cognitive advantage in bilingualism: an example of publication bias?

Science.gov (United States)

de Bruin, Angela; Treccani, Barbara; Della Sala, Sergio

2015-01-01

It is a widely held belief that bilinguals have an advantage over monolinguals in executive-control tasks, but is this what all studies actually demonstrate? The idea of a bilingual advantage may result from a publication bias favoring studies with positive results over studies with null or negative effects. To test this hypothesis, we looked at conference abstracts from 1999 to 2012 on the topic of bilingualism and executive control. We then determined which of the studies they reported were subsequently published. Studies with results fully supporting the bilingual-advantage theory were most likely to be published, followed by studies with mixed results. Studies challenging the bilingual advantage were published the least. This discrepancy was not due to differences in sample size, tests used, or statistical power. A test for funnel-plot asymmetry provided further evidence for the existence of a publication bias. © The Author(s) 2014.

Potentially three distinct roles for hypoxic cell sensitizers in the clinic

International Nuclear Information System (INIS)

Chapman, J.D.; Raleigh, J.A.; Pedersen, J.E.; Ngan, J.; Shum, F.Y.

1979-01-01

Nitroaromatic drugs have been applied to radiation therapy on the basis of their effectiveness to enhance radiation damages selectively in hypoxic mammalian cells at nontoxic concentration. Such sensitizers could improve the rate of local tumor control by conventional radiotherapy in such cases that the resistance due to hypoxia in a limiting factor. The selective cytotoxicity of the drug to hypoxic cells is the second distinct action. A third potential role for nitroaromatic drugs could involve their use for the diagnosis of the number and location of hypoxic cells within tumors. The gain in therapeutic ratio by a factor from 5 to 10 is necessary before the full clinical impact of hypoxic cell radiosensitizers can be evaluated. The drugs selected for the use as clinical radiosensitizers were originally developed as the antibacterial agents with selective activity against anaerobes. The hypoxic cells in tumors are usually resistant to chemotherapy as well as resistant to radiation, and this specific drug action of sensitizers combined with that of an agent effective against oxygenated and cycling cells could possibly produce improved tumor cures. Electron-affinitive chemicals become selectively bound to the macromolecules of hypoxic mammalian cells by radiation-induced chemical reaction. This technique was used to identify by autoradiographic procedures the location of the radioactive nitrofurazone bound to hypoxic cells within multicellular spheroids. (Yamashita, S.)

Controversies surrounding the clinical potential of cinnamon for the management of diabetes.

Science.gov (United States)

Rafehi, H; Ververis, K; Karagiannis, T C

2012-06-01

Obesity levels have increased significantly in the past five decades and are predicted to continue rising, resulting in important health implications. In particular, this has translated to an increase in the occurrence of type II diabetes mellitus (T2D). To alleviate associated problems, certain nutraceuticals have been considered as potential adjuncts or alternatives to conventional prescription drugs. Cinnamon, a commonly consumed spice originating from South East Asia, is currently being investigated as a potential preventative supplement and treatment for insulin resistance, metabolic syndrome and T2D. Extensive in vitro evidence has shown that cinnamon may improve insulin resistance by preventing and reversing impairments in insulin signalling in skeletal muscle. In adipose tissue, it has been shown that cinnamon increases the expression of peroxisome proliferator-activated receptors including, PPARγ. This is comparable to the action of commonly used thiazolinediones, which are PPAR agonists. Studies have also shown that cinnamon has potent anti-inflammatory properties. However, numerous human clinical trials with cinnamon have been conducted with varying findings. While some studies have showed no beneficial effect, others have indicated improvements in cholesterol levels, systolic blood pressure, insulin sensitivity and postprandial glucose levels with cinnamon. However, the only measurement consistently improved by cinnamon consumption is fasting glucose levels. While it is still premature to suggest the use of cinnamon supplementation based on the evidence, further investigation into mechanisms of action is warranted. Apart from further characterization of genetic and epigenetic changes in model systems, systematic large-scale clinical trials are required. In this study, we discuss the mechanisms of action of cinnamon in the context of T2D and we highlight some of the associated controversies. © 2011 Blackwell Publishing Ltd.

Adaptive memory: the survival-processing memory advantage is not due to negativity or mortality salience.

Science.gov (United States)

Bell, Raoul; Röer, Jan P; Buchner, Axel

2013-05-01

Recent research has highlighted the adaptive function of memory by showing that imagining being stranded in the grasslands without any survival material and rating words according to their survival value in this situation leads to exceptionally good memory for these words. Studies examining the role of emotions in causing the survival-processing memory advantage have been inconclusive, but some studies have suggested that the effect might be due to negativity or mortality salience. In Experiments 1 and 2, we compared the survival scenario to a control scenario that implied imagining a hopeless situation (floating in outer space with dwindling oxygen supplies) in which only suicide can avoid the agony of choking to death. Although this scenario was perceived as being more negative than the survival scenario, the survival-processing memory advantage persisted. In Experiment 3, thinking about the relevance of words for survival led to better memory for these words than did thinking about the relevance of words for death. This survival advantage was found for concrete, but not for abstract, words. The latter finding is consistent with the assumption that the survival instructions encourage participants to think about many different potential uses of items to aid survival, which may be a particularly efficient form of elaborate encoding. Together, the results suggest that thinking about death is much less effective in promoting recall than is thinking about survival. Therefore, the survival-processing memory advantage cannot be satisfactorily explained by negativity or mortality salience.

[Internet research methods: advantages and challenges].

Science.gov (United States)

Liu, Yi; Tien, Yueh-Hsuan

2009-12-01

Compared to traditional research methods, using the Internet to conduct research offers a number of advantages to the researcher, which include increased access to sensitive issues and vulnerable / hidden populations; decreased data entry time requirements; and enhanced data accuracy. However, Internet research also presents certain challenges to the researcher. In this article, the advantages and challenges of Internet research methods are discussed in four principle issue areas: (a) recruitment, (b) data quality, (c) practicality, and (d) ethics. Nursing researchers can overcome problems related to sampling bias and data truthfulness using creative methods; resolve technical problems through collaboration with other disciplines; and protect participant's privacy, confidentiality and data security by maintaining a high level of vigilance. Once such issues have been satisfactorily addressed, the Internet should open a new window for Taiwan nursing research.

Is it time to introduce repetitive transcranial magnetic stimulation into standard clinical practice for the treatment of depressive disorders?

Science.gov (United States)

Fitzgerald, Paul

2003-02-01

To examine issues relating to the potential introduction of repetitive transcranial magnetic stimulation (rTMS) into clinical practice as a treatment for depression. A review of the outcomes literature accompanied by an analysis of issues relating to the potential advantages and pitfalls of the introduction of rTMS as a treatment strategy. Evidence is progressively accumulating that rTMS has antidepressant properties that are clinically relevant. These effects are biologically plausible and supported by basic research. Patients with therapy-resistant depression have few treatment alternatives and experience significant suffering, thus justifying the early introduction of a new treatment such as rTMS for this patient group. However, this must be balanced by a need to foster considerable further research and not to raise expectations unreasonably. It is timely for rTMS to be made more available to patients with treatment-resistant mood disorders. This need not be limited to clinical research trials but should only occur in medical settings where continual evaluation and research is conducted.

Application of Knowledge in Advergaming as a Possible Source of Competitive Advantage

Directory of Open Access Journals (Sweden)

Mráček Pavel

2011-09-01

Full Text Available The article focuses on the question of the utilization of knowledge in advergaming (an original tool of the marketing communication as a possible source of competitive advantage. Related terms are briefly described and the research was conducted within a group of young people in the Czech Republic. The research confirms that, just advergaming might have the potential for acquiring “consumers of the advertising message” and, consequently, the possible broadening of the knowledge of the company. The output then becomes the scheme for displaying the links and the utilization of the knowledge in the advergame itself.

Problems of fluorescent imaging and its solution using nanofluorophores. Part I: Advantages of fluorescent nanoparticles over conventional organic fluorophores

International Nuclear Information System (INIS)

Zhelev, Z.; Hadjidekov, G.; Zlateva, G.; Spasov, L.; Bakalova, R.

2011-01-01

The application of fluorescence in deep-tissue imaging is rapidly expanding in fast several years. The progress in fluorescent molecular probes and fluorescent imaging techniques gives an opportunity to detect single cells and even molecules in live organisms. The highly sensitive and high-speed fluorescent molecular sensors and detection devices allow the application of fluorescence in functional imaging. With development of novel bright fluorophores based on nano-technologies and fluorescence scanners with high spatial and temporal resolution, the fluorescent imaging has a potential to become an alternative of the other non-invasive imaging techniques as magnetic resonance imaging, positron-emission tomography, X-ray, computing tomography. This review outlines the current status and future trends of fluorescent nanoparticles - quantum dots (QDs), as a new generation of fluorophores in experimental and pre-clinical fluorescent imaging diagnostic. Part 1 focuses on the advantages of quantum dots over conventional organic fluorophores and defines the major requirements to the 'perfect' fluorophore for fluorescent deep-tissue imaging diagnostic. The analysis is based on the limitations of fluorescent imaging in vivo and overcome by using quantum dots

The second leg home advantage: evidence from European football cup competitions.

Science.gov (United States)

Page, Lionel; Page, Katie

2007-12-01

The home advantage is a widely acknowledged sporting phenomenon, especially in association football. Here, we examine the second leg home advantage, an effect that is discussed in the public domain but which has received very little scientific attention. The second leg home advantage effect occurs when on average teams are more likely to win a two-stage knock-out competition when they play at home in the second leg. That is, both teams have a home advantage but this advantage is significantly greater for the team that plays at home second. Examining data from three different European Cup football competitions spanning 51 years, we show that the second leg home advantage is a real phenomenon. The second leg home team has more than a 50% probability to qualify for the next round in the competition even after controlling for extra time and team ability as possible alternative explanations. The second leg home advantage appears, however, to have decreased significantly over the past decade. Possible reasons for its existence and subsequent decline are presented.

AquAdvantage Salmon Genetically modified organism

OpenAIRE

Núñez Saurí, Ester; Universitat Autònoma de Barcelona. Facultat de Veterinària

2014-01-01

Póster AquAdvantage Salmon is a genetically modified organism developed by AquBounty Technologies. The objective of this transgenic organism is to increase the growth rate to obtain the same of conventional salmon faster.

Home advantage in speed skating : Evidence from individual data

NARCIS (Netherlands)

Koning, RH

Home advantage is a well-documented phenomenon in many sports. Home advantage has been shown to exist for team sports (soccer, hockey, football, baseball, basketball) and for countries organizing sports tournaments like the Olympics and World Cup Soccer. There is also some evidence for home

The theoretical advantage of affinity membrane-based immunoadsorption therapy of hypercholesterolemia

International Nuclear Information System (INIS)

Green, P.; Odell, R.; Schindhelm, K.

1996-01-01

Full text: Therapy of hypercholesterolemia using immunoadsorption of Low Density Lipoprotein (LDL) to a gel substrate is a current clinical technique (Bosch T., Biomat., Art. Cells and Immob. Biotech, 20: 1165- 1169, 1992). Recently, Affinity Membranes have been proposed as an alternate substrate for immunoadsorption (Brandt S and others, Bio Technology, 6:779-782, 1988). Potentially, the overall rate of adsorption to a membrane may be faster than to a gel because of the different geometry (ibid). This implies that for the same conditions, a membrane-based device will have a higher Number of Transfer Units, more efficient adsorption and a smaller device size than a gel. To test this hypothesis, we calculated two key theoretical design parameters: Separation Factor, R, and the Number of Transfer Units, N, for a functioning clinical-scale affinity membrane device: R=K d /K d +C 0 . Kd: Equilibrium Dissociation Constant (M) and Co: Feed Concentration (M) N=k a Q max V m /F. ka: Intrinsic reaction rate constant (M -1 min -1 ), Qmax: Substrate capacity (M), Vm: Membrane volume (m1) and F: Flow Rate (m1 min -1 ). We assumed 1 hr treatment time during which 1 plasma volume (3L) is treated, hence F=50 (m1 min -1 ). If we assume 2/3 of LDL is removed from an initial level of 3 g/L, we can calculate an average feed concentration Co = 2 g / L. There is some data available in the literature for typical values of Kd (10 -8 M) and ka ( 10 3 M -1 s -1 to 3 x 10 5 M -1 s -1 ) (Olsen WC and others, Molec. Immun: 26: 129-136, 1989). Since the intrinsic reaction kinetics may vary from very slow (10 3 M) to very fast (3 x 10 5 M), the Number of Transfer Units, N may vary from small (2) to large (650). Hence for a membrane device, we must select the antibody with the fastest reaction, ka, and highest capacity (Qmax) otherwise, there may be no advantage in a membrane-based device over a gel-based device

CREATING A CORPORATE ENTREPRENEURSHIP STRATEGY FOR COMPETITIVE ADVANTAGE

OpenAIRE

ENGİNOĞLU, Didem; ARIKAN, Cenk Laçin

2016-01-01

Current competitive environment is rapidly changing. In today’s business environment, organizations are having an increasingly difficult time in creating competitive advantages. The main reason for this is the ease in contemporary business life for organizations to reach the same or very similar resources. Firms need innovation to create and sustain success and effectiveness. In such a highly competitive business life, the importance of creating competitive advantages for organizations based ...

Modern Paradigm of Ensuring Competitive Advantages of an Enterprise

Directory of Open Access Journals (Sweden)

Klymchuk Alyona O.

2014-01-01

Full Text Available The article considers evolution of development of the paradigm of ensuring competitive advantages of an enterprise. Foreign and domestic scientists focus on individual directions of development of competitive advantages and pay insufficient attention to new management concepts – development of the information society, knowledge economy and dynamism of integration processes. The goal of the study is formation of the modern paradigm of ensuring competitive advantages of an enterprise with consideration of tendencies of development of the knowledge economy, information society and integration processes. Enterprise competitiveness is a synergetic characteristic, which reflects enterprise capability of dynamic response to changes of the market situation with the aim of keeping predominance over other economic subjects. Management of the future, on the basis of the management 2.0 concept, should take into account interests not only of top management and shareholders but also employees, local communities and territories and meet requirements of the society in general, individual groups of consumers and tendencies of development of managerial and information technologies. The paradigm of the modern theory of ensuring competitive advantages should include models of keeping competitive advantages in the existing markets and models of development of future markets; strategy of development of enterprise competitiveness, human capital development and efficient enterprise management.

Basics concepts and clinical applications of oxygen-enhanced MR imaging

International Nuclear Information System (INIS)

Ohno, Yoshiharu; Hatabu, Hiroto

2007-01-01

Oxygen-enhanced MR imaging is a new technique, and its physiological significance has not yet been fully elucidated. This review article covers (1) the theory of oxygen enhancement and its relationship with respiratory physiology; (2) design for oxygen-enhanced MR imaging sequencing; (3) a basic study of oxygen-enhanced MR imaging in animal models and humans; (4) a clinical study of oxygen-enhanced MR imaging; and (5) a comparison of advantages and disadvantages of this technique with those of hyperpolarized noble gas MR ventilation imaging. Oxygen-enhanced MR imaging provides not only the ventilation-related, but also respiration-related information. Oxygen-enhanced MR imaging has the potential to replace nuclear medicine studies for the identification of regional pulmonary function, and many investigators are now attempting to adapt this technique for routine clinical studies. We believe that further basic studies as well as clinical applications of this new technique will define the real significance of oxygen-enhanced MR imaging for the future of pulmonary functional imaging and its usefulness for diagnostic radiology and pulmonary medicine

Tanzania's Revealed Comparative Advantage and Structural ...

African Journals Online (AJOL)

example, the contribution from vegetable products fell by 7%, and that from textiles .... 43 -‐ Furskins and artificial fur, manufactures thereof ... example, while Tanzania has comparative advantage in raw hides and skins (see Figure 6), it.

Blood Transfusion In Surgical Children: The Advantages And Hazards

African Journals Online (AJOL)

The increasing opposition to blood transfusion makes the management of surgical children who require blood very challenging. This retrospective study reviews records of blood transfusion so as to determine the advantages and hazards in surgical children. The advantages and hazards of blood transfusion in surgical ...

Home advantage in speed skating : evidence from individual data

NARCIS (Netherlands)

Koning, Ruud H.

2003-01-01

Home advantage is a well documented phenomena in many types of sports. Home advantage has been shown to exist for team sports (soccer, hockey, football, baseball, basketball) and for countries organizing sports tournaments like the Olympics and World Cup Soccer. There is also some evidence for home

The Real Transformation: Building and Maintaining Long-Term Competitive Advantage

Science.gov (United States)

2003-01-01

TERM COMPETITIVE ADVANTAGE LTC EDWARD C. CARDON, USA A TRANFORMATION PAPER FOR THE CHAIRMAN OF THE JOINT CHIEFS OF STAFF SEMINAR...SUBTITLE The Real Transformation: Building and Maintaining Long-Term Competitive Advantage 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT...long-term military competitive advantage in comparison to the rest of the world.4 This approach suggests a model that places competition as the

The Home-based Advantages and a Hierarchy of Location Advantages: Foreign and British-owned Firms in the London Wholesale Insurance Market

OpenAIRE

Lilach Nachum

2003-01-01

This study seeks to explain why, in some cases, locationally advantageous countries attract foreign firms, who develop dominant competitive positions in the market, rather than facilitate the development of internationally competitive national firms, as theory suggests. Comparative analyses of samples of foreign and British-owned insurance firms in the London wholesale insurance market are used to establish a hierarchy of location advantages in terms of their competitive importance. It is sho...

Opportunities for Cancer-relevant Innovative Technologies with Transformative Potential | Office of Cancer Clinical Proteomics Research

Science.gov (United States)

The National Cancer Institute (NCI) is seeking input from the community on identifying priorities with regards to supporting innovative technology development for cancer-relevant research. While the NCI provides support for technology development through a variety of mechanisms, it is important to understand whether or not these are sufficient for catalyzing and supporting the development of tools with significant potential for advancing important fields of cancer research or clinical care.

Economic potential of inertial fusion

International Nuclear Information System (INIS)

Nuckolls, J.H.

1984-04-01

Beyond the achievement of scientific feasibility, the key question for fusion energy is: does it have the economic potential to be significantly cheaper than fission and coal energy. If fusion has this high economic potential then there are compelling commercial and geopolitical incentives to accelerate the pace of the fusion program in the near term, and to install a global fusion energy system in the long term. Without this high economic potential, fusion's success depends on the failure of all alternatives, and there is no real incentive to accelerate the program. If my conjectures on the economic potential of inertial fusion are approximately correct, then inertial fusion energy's ultimate costs may be only half to two-thirds those of advanced fission and coal energy systems. Relative cost escalation is not assumed and could increase this advantage. Both magnetic and inertial approaches to fusion potentially have a two-fold economic advantage which derives from two fundamental properties: negligible fuel costs and high quality energy which makes possible more efficient generation of electricity. The wining approach to fusion may excel in three areas: electrical generating efficiency, minimum material costs, and adaptability to manufacture in automated factories. The winning approach must also rate highly in environmental potential, safety, availability factor, lifetime, small 0 and M costs, and no possibility of utility-disabling accidents

An investigation of home advantage in the Summer Paralympic Games.

Science.gov (United States)

Wilson, Darryl; Ramchandani, Girish

2017-01-01

There is a paucity of home advantage research set in the context of para-sport events. It is this gap in the knowledge that this paper addresses by investigating the prevalence and size of home advantage in the Summer Paralympic Games. Using a standardised measure of success, we compared the performances of nations when competing at home with their own performances away from home in the competition between 1960 and 2016. Both country-level and individual sport-level analyses were conducted for this time frame. A Wilcoxon signed rank test was used to determine whether there was a genuine difference in nations' performance under host and non-host conditions. Spearman's rank-order correlation was run to assess the relationship between nation quality and home advantage. Strong evidence of a home advantage effect in the Summer Paralympic Games was found at country level ( p   0.10). While our results confirm that home advantage is prevalent in the Summer Paralympic Games at an overall country level and within specific sports, they do not explain fully why such an effect does exist. Future studies should investigate the causes of home advantage in the competition and also draw comparisons with the Summer Olympic Games to explore any differences between para-sport events and able-bodied events.

Undermatched? School-Based Linguistic Status, College Going, and the Immigrant Advantage

Science.gov (United States)

Callahan, Rebecca M.; Humphries, Melissa H.

2016-01-01

Considerable research investigates the immigrant advantage--the academic benefit first- and second-generation students experience relative to native-born peers. However, little work examines how school-based linguistic status may influence this advantage. Contradictory patterns exist: Research identifies both an immigrant advantage and a language…

Stimulus-dependent effects on right ear advantage in schizophrenia

Directory of Open Access Journals (Sweden)

Smucny J

2012-09-01

Full Text Available Jason Smucny,1,3 Korey Wylie,3 Jason Tregellas1–31Neuroscience Program, University of Colorado Anschutz Medical Campus, 2Research Science, Denver VA Medical, Center, 3Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USABackground: When presented with different sounds in each ear (dichotic listening, healthy subjects typically show a preference for stimuli heard in the right ear, an effect termed "right ear advantage". Previous studies examining right ear advantage in schizophrenia have been inconsistent, showing either decreased or increased advantage relative to comparison subjects. Given evidence for enhanced semantic processing in schizophrenia, some of this inconsistency may be due to the type of stimuli presented (words or syllables. The present study examined right ear advantage in patients and controls using both words and syllables as stimuli.Methods: Right ear advantage was compared between 20 patients with schizophrenia and 17 healthy controls. Two versions of the task were used, ie, a consonant-vowel pairing task and a fused rhymed words task.Results: A significant group × task interaction was observed. Relative to healthy controls, patients showed a greater difference on the syllable-based task compared with the word-based task. The number of distractors marked during the syllable-based task was inversely correlated with score on the Global Assessment of Function Scale.Conclusion: The findings are consistent with a left hemisphere dysfunction in schizophrenia, but also suggest that differences may be stimulus-specific, with a relative sparing of the deficit in the context of word stimuli. Performance may be related to measures of social, occupational, and psychological function.Keywords: schizophrenia, right ear advantage, dichotic, distraction

The flare-up phenomenon in endodontics: a clinical perspective and review.

Science.gov (United States)

Matusow, R J

1988-06-01

The acute endodontic cellulitis exacerbation, which can be potentially fatal, is a definitive entity in endodontic flare-ups. Aerobic microbes, particularly streptococci, are the predominant causative microbes isolated. There was a noticeable absence of obligate anaerobes. This is significant for the selection of an antibiotic for therapy. Treatment parameters were presented. An endodontic cellulitis exacerbation is most unlikely with obligate anaerobes. An endodontic flare-up perspective was attempted with some clinical parameters. The proponents of routine one-visit endodontic treatment with prophylactic drugs to prevent cellulitis exacerbations do not appear to offer any advantage to the more traditional approaches to endodontic treatment of the patient, which may be more beneficial.

Seeking the competitive advantage: it's more than cost reduction.

Science.gov (United States)

South, S F

1999-01-01

Most organizations focus considerable time and energy on reducing operating costs as a way to attain marketplace advantage. This strategy was not inappropriate in the past. To be competitive in the future, however, focus must be placed on other issues, not just cost reduction. The near future will be dominated by service industries, knowledge management, and virtual partnerships, with production optimization and flexibility, innovation, and strong partnerships defining those organizations that attain competitive advantage. Competitive advantage will reside in clarifying the vision and strategic plan, reviewing and redesigning work processes to optimize resources and value-added work, and creating change-ready environments and empowered workforces.

THE TAX ADVANTAGES OF INCOME TAX PAYERS

Directory of Open Access Journals (Sweden)

SUCIU GHEORGHE

2015-04-01

Full Text Available The paper analyzes the cost of financing through financial and operational leasing due to the deductibility of depreciation and interest. The shareholders of any company aim to obtain profit and to increase their ownership equity. In order for this to happen, the company must have profit, for which a corporate tax must be paid. A good management translates into choosing the most advantageous means of financing, which will lead to paying a lower corporate tax. Leasing and the non-taxation of reinvested profits are two means through which companies can obtain significant fiscal advantages, by increasing the deductible expenses, or by paying lower taxes.

Advantages of Intelligent SDH/SONET Networks

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. Advantages of Intelligent SDH/SONET Networks. GMPLS simplifies network management, thus reducing operating expenses (“staff”) and minimizing errors. Same benefits as computerization of banking, accounts, etc. Auto-discovery simplifies equipment installation ...

Emerging treatments for advanced pancreatic cancer: clinical potential of albumin-bound paclitaxel

Directory of Open Access Journals (Sweden)

Fontana E

2014-06-01

Full Text Available Elisa Fontana, Francesco Sclafani, David Cunningham Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey, UK Abstract: The management of pancreatic cancer has historically represented a major challenge for oncologists. The inherent aggressiveness of this tumor and the fibrotic features of the surrounding stromal tissue have significantly limited the impact of standard chemotherapy. Moreover, the paucity of available tumor tissue has hampered a better understanding of the biology of this disease as well as the development of new treatment strategies. Recently, the therapeutic landscape of metastatic pancreatic cancer has been enriched by two new combination regimens (FOLFIRINOX and gemcitabine-nab-paclitaxel which have been demonstrated to improve the outcome in patients with good performance status. Moreover, the peritumoral stroma has been increasingly recognized as a potential therapeutic target for this disease, and several new agents targeting stromal components are currently under investigation. In this paper, we review the current treatment options for advanced pancreatic cancer, highlight the role of the peritumoral stroma, and discuss the clinical potential of nab-paclitaxel and antistromal treatment strategies. Keywords: pancreatic cancer, nab-paclitaxel, stroma, SPARC

Implementation of marketing strategy: Factor of competitive advantage

OpenAIRE

Krstić Ivan; Becić Sonja

2011-01-01

Primary objective of the company is to reach the business success. Competitors have the same objective. Only the companies that really meet the consumer's needs and demands survive in the competitive struggle. The company who succeeds in it, has the possibility to achieve the competitive advantage as well. The company has to have the adequate marketing strategy in order to fulfill the marketing objectives and achieve the competitive advantage. The marketing strategy should be flexible and pro...

Comparison of the Developmental Potential and Clinical Results of In Vivo Matured Oocytes Cryopreserved with Different Vitrification Media

Directory of Open Access Journals (Sweden)

Mei Li

2015-01-01

Full Text Available Background: Oocyte vitrification is widely used throughout the world, but its clinical efficacy is inconsistent and depends on the vitrification media. This study compared the developmental potential and clinical results of in vivo matured oocytes cryopreserved with different vitrification media. Methods: This retrospective study involved vitrified-warmed oocytes at one in vitro fertilization laboratory. Vitrification media kits comprised the MC kit (ethylene glycol [EG] plus 1,2-propanediol [PROH], the KT kit (EG plus dimethyl sulphoxide [DMSO], and the Modified kit (EG plus DMSO and PROH kit. Rates of oocyte survival and subsequent developmental potential were recorded and analyzed. The t-test and the Chi-square test were used to evaluate each method′s efficacy. Results: Oocyte survival rate was significantly higher for the Modified kit (92.0% than for the MC kit (88.2% (P 0.05. The high-quality embryo rate per warmed oocyte was significantly higher (23.4% in the Modified kit group than in the other groups (P 0.05. Conclusions: Modified vitrification media are efficient for oocyte vitrification and, with further verification, may be able to replace commercially available media in future clinical applications.

Rational use of intensity-modulated radiation therapy: the importance of clinical outcome.

Science.gov (United States)

De Neve, Wilfried; De Gersem, Werner; Madani, Indira

2012-01-01

During the last 2 decades, intensity-modulated radiation therapy (IMRT) became a standard technique despite its drawbacks of volume delineation, planning, robustness of delivery, challenging quality assurance, and cost as compared with non-IMRT. The theoretic advantages of IMRT dose distributions are generally accepted, but the clinical advantages remain debatable because of the lack of clinical assessment of the effort that is required to overshadow the disadvantages. Rational IMRT use requires a positive advantage/drawback balance. Only 5 randomized clinical trials (RCTs), 3 in the breast and 2 in the head and neck, which compare IMRT with non-IMRT (2-dimensional technique in four fifths of the trials), have been published (as of March 2011), and all had toxicity as the primary endpoint. More than 50 clinical trials compared results of IMRT-treated patients with a non-IMRT group, mostly historical controls. RCTs systematically showed a lower toxicity in IMRT-treated patients, and the non-RCTs confirmed these findings. Toxicity reduction, counterbalancing the drawbacks of IMRT, was convincing for breast and head and neck IMRT. For other tumor sites, the arguments favoring IMRT are weaker because of the inability to control bias outside the randomized setting. For anticancer efficacy endpoints, like survival, disease-specific survival, or locoregional control, the balance between advantages and drawbacks is fraught with uncertainties because of the absence of robust clinical data. Copyright © 2012 Elsevier Inc. All rights reserved.

A longitudinal study of memory advantages in bilinguals.

Directory of Open Access Journals (Sweden)

Jessica K Ljungberg

Full Text Available Typically, studies of cognitive advantages in bilinguals have been conducted previously by using executive and inhibitory tasks (e.g. Simon task and applying cross-sectional designs. This study longitudinally investigated bilingual advantages on episodic memory recall, verbal letter and categorical fluency during the trajectory of life. Monolingual and bilingual participants (n=178 between 35-70 years at baseline were drawn from the Betula Prospective Cohort Study of aging, memory, and health. Results showed that bilinguals outperformed monolinguals at the first testing session and across time both in episodic memory recall and in letter fluency. No interaction with age was found indicating that the rate of change across ages was similar for bilinguals and monolinguals. As predicted and in line with studies applying cross-sectional designs, no advantages associated with bilingualism were found in the categorical fluency task. The results are discussed in the light of successful aging.

Electrophysiological explorations of the bilingual advantage: evidence from a Stroop task.

Science.gov (United States)

Coderre, Emily L; van Heuven, Walter J B

2014-01-01

Bilinguals have been shown to exhibit a performance advantage on executive control tasks, outperforming their monolingual counterparts. Although a wealth of research has investigated this 'bilingual advantage' behaviourally, electrophysiological correlates are lacking. Using EEG with a Stroop task that manipulated the stimulus onset asynchrony (SOA) of word and colour presentation, the current study addressed two facets of the bilingual advantage. The possibility that bilinguals experience superior conflict processing relative to monolinguals (a 'conflict-specific advantage') was investigated by comparing behavioural interference effects as well as the amplitude of the Ninc, a conflict-related ERP component occurring from approximately 300-500 ms after the onset of conflict. In contrast, the hypothesis that bilinguals experience domain-general, conflict-independent enhancements in executive processing (a 'non-conflict-specific advantage') was evaluated by comparing the control condition (symbol strings) between groups. There was some significant, but inconsistent, evidence for a conflict-specific bilingual advantage. In contrast, strong evidence emerged for a non-conflict-specific advantage, with bilinguals demonstrating faster RTs and reduced ERP amplitudes on control trials compared to monolinguals. Importantly, when the control stimulus was presented before the colour, ERPs to control trials revealed group differences before the onset of conflict, suggesting differences in the ability to ignore or suppress distracting irrelevant information. This indicates that bilinguals experience superior executive processing even in the absence of conflict and semantic salience, and suggests that the advantage extends to more efficient proactive management of the environment.

Electrophysiological explorations of the bilingual advantage: evidence from a Stroop task.

Directory of Open Access Journals (Sweden)

Emily L Coderre

Full Text Available Bilinguals have been shown to exhibit a performance advantage on executive control tasks, outperforming their monolingual counterparts. Although a wealth of research has investigated this 'bilingual advantage' behaviourally, electrophysiological correlates are lacking. Using EEG with a Stroop task that manipulated the stimulus onset asynchrony (SOA of word and colour presentation, the current study addressed two facets of the bilingual advantage. The possibility that bilinguals experience superior conflict processing relative to monolinguals (a 'conflict-specific advantage' was investigated by comparing behavioural interference effects as well as the amplitude of the Ninc, a conflict-related ERP component occurring from approximately 300-500 ms after the onset of conflict. In contrast, the hypothesis that bilinguals experience domain-general, conflict-independent enhancements in executive processing (a 'non-conflict-specific advantage' was evaluated by comparing the control condition (symbol strings between groups. There was some significant, but inconsistent, evidence for a conflict-specific bilingual advantage. In contrast, strong evidence emerged for a non-conflict-specific advantage, with bilinguals demonstrating faster RTs and reduced ERP amplitudes on control trials compared to monolinguals. Importantly, when the control stimulus was presented before the colour, ERPs to control trials revealed group differences before the onset of conflict, suggesting differences in the ability to ignore or suppress distracting irrelevant information. This indicates that bilinguals experience superior executive processing even in the absence of conflict and semantic salience, and suggests that the advantage extends to more efficient proactive management of the environment.

Islamic Banking in Nigeria: Perception of its Relative Advantage by ...

African Journals Online (AJOL)

Islamic Banking in Nigeria: Perception of its Relative Advantage by Consumer Segments in Anambra State. ... perceived relative advantage of Islamic banking concept by those consumer groups in. Awka ... AJOL African Journals Online.

Interest alignment and competitive advantage

OpenAIRE

Gottschalg, Oliver; Zollo, Mauricio

2006-01-01

This paper articulates a theory of the conditions under which the alignment between individual and collective interests generates sustainable competitive advantage. The theory is based on the influence of tacitness, context-specificity and casual ambiguity in the determinants of different types of motivation (extrinsic, normative intrinsic and hedonic intrinsic), under varying conditions of environmental dynamism. The analysis indicates the need to consider mitivational processes as a complem...

Profile of bosutinib and its clinical potential in the treatment of chronic myeloid leukemia

Directory of Open Access Journals (Sweden)

Keller-von Amsberg G

2013-03-01

Full Text Available Gunhild Keller-von Amsberg,1 Steffen Koschmieder21Department of Hematology and Oncology, University Cancer Center Hamburg, University Hospital Hamburg Eppendorf, 2Department of Medicine (Hematology, Oncology, and Stem Cell Transplantation, University Medical Center of Aachen and RWTH Aachen University, Aachen, GermanyAbstract: Bosutinib (SKI-606 is an orally available, once-daily, dual Src and Abl kinase inhibitor with promising clinical potential in first-, second-, and third-line treatment of chronic myeloid leukemia (CML. Bosutinib effectively inhibits wild-type BCR-ABL and most imatinib-resistant BCR-ABL mutations except for V299L and T315I. Low hematologic toxicity is a remarkable characteristic of this novel second-generation tyrosine kinase inhibitor, and this has been ascribed to its minimal activity against the platelet-derived growth factor receptor and KIT. Low-grade, typically self-limiting diarrhea, which usually appears within the first few weeks after treatment initiation, represents the predominant toxicity of bosutinib. Other treatment-associated adverse events are mostly mild to moderate. Bosutinib has been approved by the US Food and Drug Administration for the treatment of chronic, accelerated, or blast phase Philadelphia chromosome-positive CML in adult patients with resistance or intolerance to prior therapy. This review summarizes the main properties of bosutinib and the currently available data on its clinical potential in the treatment of CML.Keywords: bosutinib, chronic myeloid leukemia, BCR-ABL, Src/Abl kinase inhibitor, point mutation, imatinib resistance

The potential of polymeric micelles in the context of glioblastoma therapy

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Ramin eMorshed

2013-12-01

Full Text Available Glioblastoma multiforme (GBM, a type of malignant glioma, is the most common form of brain cancer found in adults. The current standard of care for GBM involves adjuvant temozolomide-based chemotherapy in conjunction with radiotherapy, yet patients still suffer from poor outcomes with a median survival of 14.6 months. Many novel therapeutic agents that are toxic to GBM cells in vitro cannot sufficiently accumulate at the site of an intracranial tumor after systemic administration. Thus, new delivery strategies must be developed to allow for adequate intratumoral accumulation of such therapeutic agents. Polymeric micelles offer the potential to improve delivery to brain tumors as they have demonstrated the capacity to be effective carriers of chemotherapy drugs, genes, and proteins in various preclinical GBM studies. In addition to this, targeting moieties and trigger-dependent release mechanisms incorporated into the design of these particles can promote more specific delivery of a therapeutic agent to a tumor site. Despite these advantages however, there are currently no micelle formulations targeting brain cancer in clinical trials. Here, we highlight key aspects of the design of polymeric micelles as therapeutic delivery systems with a review of their clinical applications in several non-brain tumor cancer types. We also discuss their potential to serve as nanocarriers targeting GBM, the major barriers preventing their clinical implementation in this disease context, as well as current approaches to overcome these limitations.

A new cognitive evaluation battery for Down syndrome and its relevance for clinical trials

Directory of Open Access Journals (Sweden)

Susana ede Sola

2015-06-01

Full Text Available The recent prospect of pharmaceutical interventions for cognitive impairment of Down syndrome(DS has boosted a number of clinical trials in this population. However, running the trials has raised some methodological challenges and questioned the prevailing methodology used to evaluate cognitive functioning of DS individuals. This is usually achieved by comparing DS individuals to matched healthy controls of the same mental age. We propose a new tool, the TESDAD Battery that uses comparison with age-matched typically developed adults. This is an advantageous method for probing the clinical efficacy of DS therapies, allowing the interpretation and prediction of functional outcomes in clinical trials. In our DS population the TESDAD battery permitted a quantitative assessment of cognitive defects, which indicated language dysfunction and deficits in executive function, as the most important contributors to other cognitive and adaptive behavior outcomes as predictors of functional change in DS. Concretely, auditory comprehension and functional academics showed the highest potential as end-point measures of therapeutic intervention for clinical trials: the former as a cognitive key target for therapeutic intervention, and the latter as a primary functional outcome measure of clinical efficacy. Our results also emphasize the need to explore the modulating effects of IQ, gender and age on cognitive enhancing treatments. Noticeably, women performed significantly better than men of the same age and IQ in most cognitive tests, with the most consistent differences occurring in memory and executive functioning and negative trends rarely emerged on quality of life linked to the effect of age after adjusting for IQ and gender. In sum, the TESDAD battery is a useful neurocognitive tool for probing the clinical efficacy of experimental therapies in interventional studies in the DS population suggesting that age-matched controls are advantageous for determining

Rat models of spinal cord injury: from pathology to potential therapies

Science.gov (United States)

2016-01-01

ABSTRACT A long-standing goal of spinal cord injury research is to develop effective spinal cord repair strategies for the clinic. Rat models of spinal cord injury provide an important mammalian model in which to evaluate treatment strategies and to understand the pathological basis of spinal cord injuries. These models have facilitated the development of robust tests for assessing the recovery of locomotor and sensory functions. Rat models have also allowed us to understand how neuronal circuitry changes following spinal cord injury and how recovery could be promoted by enhancing spontaneous regenerative mechanisms and by counteracting intrinsic inhibitory factors. Rat studies have also revealed possible routes to rescuing circuitry and cells in the acute stage of injury. Spatiotemporal and functional studies in these models highlight the therapeutic potential of manipulating inflammation, scarring and myelination. In addition, potential replacement therapies for spinal cord injury, including grafts and bridges, stem primarily from rat studies. Here, we discuss advantages and disadvantages of rat experimental spinal cord injury models and summarize knowledge gained from these models. We also discuss how an emerging understanding of different forms of injury, their pathology and degree of recovery has inspired numerous treatment strategies, some of which have led to clinical trials. PMID:27736748

Potential facilitators and barriers to adopting standard treatment guidelines in clinical practice.

Science.gov (United States)

Sharma, Sangeeta; Pandit, Ajay; Tabassum, Fauzia

2017-04-18

Purpose The purpose of this paper is to assess medicines information sources accessed by clinicians, if sources differed in theory and practice and to find out the barriers and facilitators to effective guideline adoption. Design/methodology/approach In all, 183 doctors were surveyed. Barriers and facilitators were classified as: communication; potential adopters; innovation; organization characteristics and environmental/social/economic context. Findings Most of the clinicians accessed multiple information sources including standard treatment guidelines, but also consulted seniors/colleagues in practice. The top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in the following areas: concerns about flexibility offered by the guideline; denying patients' individuality; professional autonomy; insights into gaps in current practice and evidence-based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance companies) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as the barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications Guideline adoption in clinical practice is partly within doctors' control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality

Canadian competitive advantage

International Nuclear Information System (INIS)

Wills, J.

1997-01-01

The evolution of the Canadian petrochemical industry was outlined, emphasizing the proximity to feedstocks as the principal advantage enjoyed by the industry over its international competitors. Annual sales statistics for 1995 were provided. Key players in the Canadian petrochemical industry (Nova, Dow, DuPont, Methanex, Esso, Union Carbide, Shell and Celanese), their share of the market and key products were noted. Manufacturing facilities are located primarily in Alberta, southern Ontario and Quebec. The feedstock supply infrastructure, historical and alternative ethane pricing in Canada and the US, the North American market for petrochemicals, the competitiveness of the industry, tax competitiveness among Canadian provinces and the US, the Canada - US unit labour cost ratio, ethylene facility construction costs in Canada relative to the US Gulf Coast, and projected 1997 financial requirements were reviewed. 19 figs

Advantages of genome sequencing by long-read sequencer using SMRT technology in medical area.

Science.gov (United States)

Nakano, Kazuma; Shiroma, Akino; Shimoji, Makiko; Tamotsu, Hinako; Ashimine, Noriko; Ohki, Shun; Shinzato, Misuzu; Minami, Maiko; Nakanishi, Tetsuhiro; Teruya, Kuniko; Satou, Kazuhito; Hirano, Takashi

2017-07-01

PacBio RS II is the first commercialized third-generation DNA sequencer able to sequence a single molecule DNA in real-time without amplification. PacBio RS II's sequencing technology is novel and unique, enabling the direct observation of DNA synthesis by DNA polymerase. PacBio RS II confers four major advantages compared to other sequencing technologies: long read lengths, high consensus accuracy, a low degree of bias, and simultaneous capability of epigenetic characterization. These advantages surmount the obstacle of sequencing genomic regions such as high/low G+C, tandem repeat, and interspersed repeat regions. Moreover, PacBio RS II is ideal for whole genome sequencing, targeted sequencing, complex population analysis, RNA sequencing, and epigenetics characterization. With PacBio RS II, we have sequenced and analyzed the genomes of many species, from viruses to humans. Herein, we summarize and review some of our key genome sequencing projects, including full-length viral sequencing, complete bacterial genome and almost-complete plant genome assemblies, and long amplicon sequencing of a disease-associated gene region. We believe that PacBio RS II is not only an effective tool for use in the basic biological sciences but also in the medical/clinical setting.

Relation between competence and competitive advantages of the firm

OpenAIRE

Lavrova, Natalia

2014-01-01

Research paper was considered an aspect of competence as source of uniqueness organization and its competition advantages. It emphasizes the importance internal factors for get success of business. The article is divided into two parts: theoretical framework and case study, which suggests as the competence of the influence on the competitive advantages of firms in theory and practice.

The half-truth of first-mover advantage.

Science.gov (United States)

Suarez, Fernando; Lanzolla, Gianvito

2005-04-01

Many executives take for granted that the first company in a new product category gets an unbeatable head start and reaps long-lasting benefits. But that doesn't always happen. The authors of this article discovered that much depends on the pace at which the category's technology is changing and the speed at which the market is evolving. By analyzing these two factors, companies can improve their odds of succeeding as first movers with the resources they possess. Gradual evolution in both the technology and the market provides a first mover with the best conditions for creating a dominant position that is long lasting (Hoover in the vacuum cleaner industry is a good example). In such calm waters, a company can defend its advantages even without exceptional skills or extensive financial resources. When the market is changing rapidly and the product isn't, a first entrant with extensive resources can obtain a long-lasting advantage (as Sony did with its Walkman personal stereo); a company with only limited resources probably must settle for a short-term benefit. When the market is static but the product is changing constantly, first-mover advantages of either kind--durable or short-lived--are unlikely. Only companies with very deep pockets can survive (think of Sony and the digital cameras it pioneered). Rapid churn in both the technology and the market creates the worst conditions. But if companies have an acute sense of when to exit-as Netscape demonstrated when it agreed to be acquired by AOL-a worthwhile short-term gain is possible. Before venturing into a newly forming market, you need to analyze the environment, assess your resources, then determine which type offirst-mover advantage is most achievable. Once you've gone into the water, you have no choice but to swim.

Fuel cell mining vehicles: design, performance and advantages

International Nuclear Information System (INIS)

Betournay, M.C.; Miller, A.R.; Barnes, D.L.

2003-01-01

The potential for using fuel cell technology in underground mining equipment was discussed with reference to the risks associated with the operation of hydrogen vehicles, hydrogen production and hydrogen delivery systems. This paper presented some of the initiatives for mine locomotives and fuel cell stacks for underground environments. In particular, it presents the test results of the first applied industrial fuel cell vehicle in the world, a mining and tunneling locomotive. This study was part of an international initiative managed by the Fuel Cell Propulsion Institute which consists of several mining companies, mining equipment manufacturers, and fuel cell technology developers. Some of the obvious benefits of fuel cells for underground mining operations include no exhaust gases, lower electrical costs, significantly reduced maintenance, and lower ventilation costs. Another advantage is that the technology can be readily automated and computer-based for tele-remote operations. This study also quantified the cost and operational benefits associated with fuel cell vehicles compared to diesel vehicles. It is expected that higher vehicle productivity could render fuel cell underground vehicles cost-competitive. 6 refs., 1 tab

Mission and System Advantages of Iodine Hall Thrusters

Science.gov (United States)

Dankanich, John W.; Szabo, James; Pote, Bruce; Oleson, Steve; Kamhawi, Hani

2014-01-01

The exploration of alternative propellants for Hall thrusters continues to be of interest to the community. Investments have been made and continue for the maturation of iodine based Hall thrusters. Iodine testing has shown comparable performance to xenon. However, iodine has a higher storage density and resulting higher ?V capability for volume constrained systems. Iodine's vapor pressure is low enough to permit low-pressure storage, but high enough to minimize potential adverse spacecraft-thruster interactions. The low vapor pressure also means that iodine does not condense inside the thruster at ordinary operating temperatures. Iodine is safe, it stores at sub-atmospheric pressure, and can be stored unregulated for years on end; whether on the ground or on orbit. Iodine fills a niche for both low power (10kW) electric propulsion regimes. A range of missions have been evaluated for direct comparison of Iodine and Xenon options. The results show advantages of iodine Hall systems for both small and microsatellite application and for very large exploration class missions.

Exploration of the Super H-mode regime on DIII-D and potential advantages for burning plasma devices

Energy Technology Data Exchange (ETDEWEB)

Solomon, W. M., E-mail: solomon@fusion.gat.com; Bortolon, A.; Grierson, B. A.; Nazikian, R.; Poli, F. [Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08543 (United States); Snyder, P. B.; Burrell, K. H.; Garofalo, A. M.; Groebner, R. J.; Leonard, A. W.; Meneghini, O.; Osborne, T. H.; Petty, C. C. [General Atomics, P.O. Box 85608, San Diego, California 92186-5608 (United States); Loarte, A. [ITER Organization, Route de Vinon-sur-Verdon - CS 90 046, 13067 St Paul Lez Durance Cedex (France)

2016-05-15

A new high pedestal regime (“Super H-mode”) has been predicted and accessed on DIII-D. Super H-mode was first achieved on DIII-D using a quiescent H-mode edge, enabling a smooth trajectory through pedestal parameter space. By exploiting Super H-mode, it has been possible to access high pedestal pressures at high normalized densities. While elimination of Edge localized modes (ELMs) is beneficial for Super H-mode, it may not be a requirement, as recent experiments have maintained high pedestals with ELMs triggered by lithium granule injection. Simulations using TGLF for core transport and the EPED model for the pedestal find that ITER can benefit from the improved performance associated with Super H-mode, with increased values of fusion power and gain possible. Similar studies demonstrate that the Super H-mode pedestal can be advantageous for a steady-state power plant, by providing a path to increasing the bootstrap current while simultaneously reducing the demands on the core physics performance.

Polyhexamethylene guanidine hydrochloride shows bactericidal advantages over chlorhexidine digluconate against ESKAPE bacteria.

Science.gov (United States)

Zhou, Zhongxin; Wei, Dafu; Lu, Yanhua

2015-01-01

More information regarding the bactericidal properties of polyhexamethylene guanidine hydrochloride (PHMG) against clinically important antibiotic-resistant ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) pathogens needs to be provided for its uses in infection control. The bactericidal properties of PHMG and chlorhexidine digluconate (CHG) were compared based on their minimum inhibitory concentrations (MICs), minimum bactericidal concentrations, and time-course-killing curves against clinically important antibiotic-susceptible and antibiotic-resistant ESKAPE pathogens. Results showed that PHMG exhibited significantly higher bactericidal activities against methicillin-resistant Staphylococcus aureus, carbapenem-resistant Klebsiella pneumoniae, and ceftazidime-resistant Enterobacter spp. than CHG. A slight bactericidal advantage over CHG was obtained against vancomycin-resistant Enterococcus faecium, ciprofloxacin- and levofloxacin-resistant Acinetobacter spp., and multidrug-resistant Pseudomonas aeruginosa. In previous reports, PHMG had higher antimicrobial activity against almost all tested Gram-negative bacteria and several Gram-positive bacteria than CHG using MIC test. These studies support the further development of covalently bound PHMG in sterile-surface materials and the incorporation of PHMG in novel disinfectant formulas. © 2014 International Union of Biochemistry and Molecular Biology, Inc.

Thermodynamic advantages of nuclear desalination through reverse osmosis

International Nuclear Information System (INIS)

Bhattacharyya, K.P.; Prabhakar, S.; Tewari, P.K.

2009-01-01

Seawater Reverse Osmosis (SWRO) integrated with nuclear power station has significant thermodynamic advantages since it can utilize the waste heat available in the condenser cooling circuit and electrical power from the nuclear power plant with provision for using grid power in case of exigencies and shared infrastructure. Coupling of RO plants to the reactor is simple and straightforward and power loss due to RO unit, resulting in the loss of load, does not impact reactor turbine. Product water contamination probability is also very less since it has in-built mechanical barrier. Preheat reverse osmosis desalination has many thermodynamic advantages and studies have indicated improved performance characteristics thereby leading to savings in operational cost. The significant advantages include the operational flexibility of the desalination systems even while power plant is non-operational and non-requirement of safety systems for resource utilization. This paper brings out a comprehensive assessment of reverse osmosis process as a stand-alone nuclear desalination system. (author)

Demonstration of quantum advantage in machine learning

Science.gov (United States)

Ristè, Diego; da Silva, Marcus P.; Ryan, Colm A.; Cross, Andrew W.; Córcoles, Antonio D.; Smolin, John A.; Gambetta, Jay M.; Chow, Jerry M.; Johnson, Blake R.

2017-04-01

The main promise of quantum computing is to efficiently solve certain problems that are prohibitively expensive for a classical computer. Most problems with a proven quantum advantage involve the repeated use of a black box, or oracle, whose structure encodes the solution. One measure of the algorithmic performance is the query complexity, i.e., the scaling of the number of oracle calls needed to find the solution with a given probability. Few-qubit demonstrations of quantum algorithms, such as Deutsch-Jozsa and Grover, have been implemented across diverse physical systems such as nuclear magnetic resonance, trapped ions, optical systems, and superconducting circuits. However, at the small scale, these problems can already be solved classically with a few oracle queries, limiting the obtained advantage. Here we solve an oracle-based problem, known as learning parity with noise, on a five-qubit superconducting processor. Executing classical and quantum algorithms using the same oracle, we observe a large gap in query count in favor of quantum processing. We find that this gap grows by orders of magnitude as a function of the error rates and the problem size. This result demonstrates that, while complex fault-tolerant architectures will be required for universal quantum computing, a significant quantum advantage already emerges in existing noisy systems.

Traditional and innovative experimental and clinical trial designs and their advantages and pitfalls.

Science.gov (United States)

Weimer, Katja; Enck, Paul

2014-01-01

Many study designs and design variants have been developed in the past to either overcome or enhance drug-placebo differences in clinical trials or to identify and characterize placebo responders in experimental studies. They share many commonalities as well as differences that are discussed here: the role of deception and ethical restrictions, habituation effects and the control of the natural course of disease, assay sensitivity testing and effective blinding, acceptability and motivation of patients and volunteers, and the development of individualized medicine. These are fostered by two opposite strategies: utilizing the beneficial aspects of the placebo response-and avoiding its negative counterpart, the nocebo effect-in medical routine for the benefit of patients, and minimizing-by controlling-the negative aspects of the placebo effect during drug development.

Molecular methods for pathogen and microbial community detection and characterization: current and potential application in diagnostic microbiology.

Science.gov (United States)

Sibley, Christopher D; Peirano, Gisele; Church, Deirdre L

2012-04-01

Clinical microbiology laboratories worldwide have historically relied on phenotypic methods (i.e., culture and biochemical tests) for detection, identification and characterization of virulence traits (e.g., antibiotic resistance genes, toxins) of human pathogens. However, limitations to implementation of molecular methods for human infectious diseases testing are being rapidly overcome allowing for the clinical evaluation and implementation of diverse technologies with expanding diagnostic capabilities. The advantages and limitation of molecular techniques including real-time polymerase chain reaction, partial or whole genome sequencing, molecular typing, microarrays, broad-range PCR and multiplexing will be discussed. Finally, terminal restriction fragment length polymorphism (T-RFLP) and deep sequencing are introduced as technologies at the clinical interface with the potential to dramatically enhance our ability to diagnose infectious diseases and better define the epidemiology and microbial ecology of a wide range of complex infections. Copyright © 2012 Elsevier B.V. All rights reserved.

Transitioning from video-assisted thoracic surgical lobectomy to robotics for lung cancer: are there outcomes advantages?

Science.gov (United States)

Lee, Benjamin E; Korst, Robert J; Kletsman, Elaine; Rutledge, John R

2014-02-01

To determine if there are advantages to transitioning to robotics by a surgeon who is already proficient in performing video-assisted thoracic surgical (VATS) lobectomy. A single surgeon proficient in VATS lobectomy initiated a robotic lobectomy program, and a retrospective review was conducted of his patients undergoing minimally invasive lobectomy (robotics or VATS) for lung cancer between 2011 and 2012. Data collected included patient/tumor characteristics, morbidity, mortality, operative times, and length of hospital stay. Over a 24-month period, a total of 69 patients underwent minimally invasive lobectomy (35 robotic, 34 VATS). Patients in each group were similar in age and clinical stage. Robotic upper lobectomy operative times were longer than VATS (172 vs 134 minutes; P = .001), with no significant difference in lower lobectomies noted (140 vs 123 minutes; P = .1). Median length of stay was 3 days in both groups, and the median number of lymph nodes harvested was 18 (robotic) versus 16 (VATS; P = .42). Morbidity and mortality for robotic versus VATS were 11% versus 18% (P = .46) and 0% versus 3% (P = .49), respectively. There does not seem to be a significant advantage for an established VATS lobectomy surgeon to transition to robotics based on clinical outcomes. The learning curve for robotic upper lobectomies seems to be more significant than that for lower lobectomies. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Using generalizability theory to develop clinical assessment protocols.

Science.gov (United States)

Preuss, Richard A

2013-04-01

Clinical assessment protocols must produce data that are reliable, with a clinically attainable minimal detectable change (MDC). In a reliability study, generalizability theory has 2 advantages over classical test theory. These advantages provide information that allows assessment protocols to be adjusted to match individual patient profiles. First, generalizability theory allows the user to simultaneously consider multiple sources of measurement error variance (facets). Second, it allows the user to generalize the findings of the main study across the different study facets and to recalculate the reliability and MDC based on different combinations of facet conditions. In doing so, clinical assessment protocols can be chosen based on minimizing the number of measures that must be taken to achieve a realistic MDC, using repeated measures to minimize the MDC, or simply based on the combination that best allows the clinician to monitor an individual patient's progress over a specified period of time.

On the measurement of comparative advantage

NARCIS (Netherlands)

Hoen, A.R.; Oosterhaven, J.

This paper shows-that the standard measure of revealed comparative advantage (RCA), ranging from 0 to infinity, has problematic properties. Due to its multiplicative specification, it has a moving mean larger than its expected value of 1, while its distribution strongly depends on the number of

On the measurement of comparative advantage

NARCIS (Netherlands)

Hoen, Alex R.

2001-01-01

This article shows that the distribution of the standard measure of revealed comparative advantage (RCA), which runs from 0 to 8, has problematic properties. Due to its multiplicative specification, it has a moving mean without a useful interpretation, while its distribution depends on the number of

Competitive advantage for differentiation of Pereira International Free Trade Zone

Directory of Open Access Journals (Sweden)

Paola Andrea Echeverri Gutiérrez

2014-01-01

Full Text Available The best way to know if a company is at the heart of success is by determining its competitive advantage. For Pereira International Free Trade Zone, foreign trade platform and recent project implementation, it is important to identify its competitive advantage, so it can develop strategies for entering and staying in the market. In this research, an analysis of the five forces industry free zones was performed, the value chain of the Pereira International Free Trade Zone was defined, finally the factors that influence their competitive advantage was determined.

In vitro, in vivo, and clinical studies of tedizolid to assess the potential for peripheral or central monoamine oxidase interactions.

Science.gov (United States)

Flanagan, S; Bartizal, K; Minassian, S L; Fang, E; Prokocimer, P

2013-07-01

Tedizolid phosphate is a novel oxazolidinone prodrug whose active moiety, tedizolid, has improved potency against Gram-positive pathogens and pharmacokinetics, allowing once-daily administration. Given linezolid warnings for drug-drug and drug-food interactions mediated by monoamine oxidase (MAO) inhibition, including sporadic serotonergic toxicity, these studies evaluated tedizolid for potential MAO interactions. In vitro, tedizolid and linezolid were reversible inhibitors of human MAO-A and MAO-B; the 50% inhibitory concentration (IC50) for tedizolid was 8.7 μM for MAO-A and 5.7 μM for MAO-B and 46.0 and 2.1 μM, respectively, with linezolid. Tedizolid phosphate was negative in the mouse head twitch model of serotonergic activity. Two randomized placebo-controlled crossover clinical studies assessed the potential of 200 mg/day tedizolid phosphate (at steady state) to enhance pressor responses to coadministered oral tyramine or pseudoephedrine. Sensitivity to tyramine was determined by comparing the concentration of tyramine required to elicit a ≥ 30-mmHg increase in systolic blood pressure (TYR30) when administered with placebo versus tedizolid phosphate. The geometric mean tyramine sensitivity ratio (placebo TYR30/tedizolid phosphate TYR30) was 1.33; a ratio of ≥ 2 is considered clinically relevant. In the pseudoephedrine study, mean maximum systolic blood pressure was not significantly different when pseudoephedrine was coadministered with tedizolid phosphate versus placebo. In summary, tedizolid is a weak, reversible inhibitor of MAO-A and MAO-B in vitro. Provocative testing in humans and animal models failed to uncover significant signals that would suggest potential for hypertensive or serotonergic adverse consequences at the therapeutic dose of tedizolid phosphate. Clinical studies are registered at www.clinicaltrials.gov as NCT01539473 (tyramine interaction study conducted at Covance Clinical Research Center, Evansville, IN) and NCT01577459

Changing Patterns of Publication Productivity: Accumulative Advantage or Institutional Isomorphism?

Science.gov (United States)

Dey, Eric L.; Milem, Jeffrey F.; Berger, Joseph B.

1997-01-01

Investigates two competing perspectives, accumulated advantage and institutional isomorphism, on the relationship between publication productivity and institutional hierarchy. Accumulated advantage refers to the continuing attraction of students, faculty, and research dollars to prestige universities. Institutional isomorphism denotes the tendency…

Robotic surgery for lung resections—total port approach: advantages and disadvantages

Science.gov (United States)

Ramadan, Omar I.; Cerfolio, Robert J.

2017-01-01

Minimally invasive thoracic surgery, when compared with open thoracotomy, has been shown to have improved perioperative outcomes as well as comparable long-term survival. Robotic surgery represents a powerful advancement of minimally invasive surgery, with vastly improved visualization and instrument maneuverability, and is increasingly popular for thoracic surgery. However, there remains debate over the best robotic approaches for lung resection, with several different techniques evidenced and described in the literature. We delineate our method for total port approach with four robotic arms and discuss how its advantages outweigh its disadvantages. We conclude that it is preferred to other robotic approaches, such as the robotic assisted approach, due to its enhanced visualization, improved instrument range of motion, and reduced potential for injury. PMID:29078585

Robotic surgery for lung resections-total port approach: advantages and disadvantages.

Science.gov (United States)

Ramadan, Omar I; Wei, Benjamin; Cerfolio, Robert J

2017-01-01

Minimally invasive thoracic surgery, when compared with open thoracotomy, has been shown to have improved perioperative outcomes as well as comparable long-term survival. Robotic surgery represents a powerful advancement of minimally invasive surgery, with vastly improved visualization and instrument maneuverability, and is increasingly popular for thoracic surgery. However, there remains debate over the best robotic approaches for lung resection, with several different techniques evidenced and described in the literature. We delineate our method for total port approach with four robotic arms and discuss how its advantages outweigh its disadvantages. We conclude that it is preferred to other robotic approaches, such as the robotic assisted approach, due to its enhanced visualization, improved instrument range of motion, and reduced potential for injury.

THE COMPETITIVE ADVANTAGE OF ROMANIA IN THE CONTEXT OF ECONOMIC RECOVERY

Directory of Open Access Journals (Sweden)

Filip Radu Ion

2010-07-01

Full Text Available The economic crisis has given the opportunity for the world to reconsider the use of resources, so the subject of competitive advantage has became actual. There are several relevant papers on national competitiveness, but we consider that there are still important issues to discuss in order to identify the economic sectors in Romania that have the potential to create successful products for the global market. The paper applies modern competitivity models on the features of our country, and concludes about the best use of our resources, in terms of increased productivity and optimal results. The goal is to encourage exporters to extend on several international markets and multinational companies to invest in developing new businesses in Romania.

Quantum communication complexity advantage implies violation of a Bell inequality

NARCIS (Netherlands)

H. Buhrman (Harry); L. Czekaj (Lłukasz); A. Grudka (Andrzej); M. Horodecki (Michalł); P. Horodecki (Pawelł); M. Markiewicz (Marcin); F. Speelman (Florian); S. Strelchuk (Sergii)

2015-01-01

htmlabstractWe obtain a general connection between a quantum advantage in communication complexity and non-locality. We show that given any protocol offering a (sufficiently large) quantum advantage in communication complexity, there exists a way of obtaining measurement statistics which violate

Nanotechnology and glaucoma: a review of the potential implications of glaucoma nanomedicine.

Science.gov (United States)

Kim, Nathaniel J; Harris, Alon; Gerber, Austin; Tobe, Leslie Abrams; Amireskandari, Annahita; Huck, Andrew; Siesky, Brent

2014-04-01

The purpose of this review is to discuss the evolution of nanotechnology and its potential diagnostic and therapeutic applications in the field of ophthalmology, particularly as it pertains to glaucoma. We reviewed literature using MEDLINE and PubMed databases with the following search terms: glaucoma, nanotechnology, nanomedicine, nanoparticles, ophthalmology and liposomes. We also reviewed pertinent references from articles found in this search. A brief history of nanotechnology and nanomedicine will be covered, followed by a discussion of the advantages and concerns of using this technology in the field of glaucoma. We will look at various studies concerning the development of nanomedicine, its potential applications in ocular drug delivery, diagnostic and imaging modalities and, surgical techniques. In particular, the challenges of assuring safety and efficacy of nanomedicine will be examined. We conclude that nanotechnology offers a novel approach to expanding diagnostic, imaging and surgical modalities in glaucoma and may contribute to the knowledge of disease pathogenesis at a molecular level. However, more research is needed to better elucidate the mechanism of cellular entry, the potential for nanoparticle cytotoxicity and the assurance of clinical efficacy.

Social media in clinical trials.

Science.gov (United States)

Thompson, Michael A

2014-01-01

Social media has potential in clinical trials for pointing out trial issues, addressing barriers, educating, and engaging multiple groups involved in cancer clinical research. Social media is being used in clinical trials to highlight issues such as poor accrual and barriers; educate potential participants and physicians about clinical trial options; and is a potential indirect or direct method to improve accrual. We are moving from a passive "push" of information to patients to a "pull" of patients requesting information. Patients and advocates are often driving an otherwise reluctant health care system into communication. Online patient communities are creating new information repositories. Potential clinical trial participants are using the Twittersphere and other sources to learn about potential clinical trial options. We are seeing more organized patient-centric and patient-engaged forums with the potential to crowd source to improve clinical trial accrual and design. This is an evolving process that will meet many individual, institutional, and regulatory obstacles as we move forward in a changed research landscape.

Lineup composition, suspect position, and the sequential lineup advantage.

Science.gov (United States)

Carlson, Curt A; Gronlund, Scott D; Clark, Steven E

2008-06-01

N. M. Steblay, J. Dysart, S. Fulero, and R. C. L. Lindsay (2001) argued that sequential lineups reduce the likelihood of mistaken eyewitness identification. Experiment 1 replicated the design of R. C. L. Lindsay and G. L. Wells (1985), the first study to show the sequential lineup advantage. However, the innocent suspect was chosen at a lower rate in the simultaneous lineup, and no sequential lineup advantage was found. This led the authors to hypothesize that protection from a sequential lineup might emerge only when an innocent suspect stands out from the other lineup members. In Experiment 2, participants viewed a simultaneous or sequential lineup with either the guilty suspect or 1 of 3 innocent suspects. Lineup fairness was varied to influence the degree to which a suspect stood out. A sequential lineup advantage was found only for the unfair lineups. Additional analyses of suspect position in the sequential lineups showed an increase in the diagnosticity of suspect identifications as the suspect was placed later in the sequential lineup. These results suggest that the sequential lineup advantage is dependent on lineup composition and suspect position. (c) 2008 APA, all rights reserved

Building Information Model: advantages, tools and adoption efficiency

Science.gov (United States)

Abakumov, R. G.; Naumov, A. E.

2018-03-01

The paper expands definition and essence of Building Information Modeling. It describes content and effects from application of Information Modeling at different stages of a real property item. Analysis of long-term and short-term advantages is given. The authors included an analytical review of Revit software package in comparison with Autodesk with respect to: features, advantages and disadvantages, cost and pay cutoff. A prognostic calculation is given for efficiency of adoption of the Building Information Modeling technology, with examples of its successful adoption in Russia and worldwide.

The textile and clothing industry in the Danube region countries: Comparative advantages

Directory of Open Access Journals (Sweden)

Ignjatijević Svetlana

2016-01-01

Full Text Available The subject of this study is the analysis of comparative advantages of international export in the TC (textile and clothing industry of the Danube region countries with a special focus on Serbia. The aim of this study is to analyze the comparative advantage and suggest possible economic and legal measures to strengthen export. This study observed export per capita and participation of TC industry export, and measured the comparative advantage and specialization of the Danube region countries in the period between 2005 and 2013. In the course of research, we used the Balassa (RCA and Lafay (LFI indexes of comparative advantage, and the GL index and RUV index of horizontal and vertical specialization in intra-industry exchange. The research has revealed positive comparative advantage in the export of the textile industry in the Czech Republic, Germany and Slovenia. In the clothing industry export, positive comparative advantage was revealed in the cases of: Bulgaria, Hungary, Moldova, Romania, Slovakia and Serbia. The research has shown a positive comparative advantage of the TC industry sector in Serbia. The results of our research into the TC industry reveal the existence of correlation between comparative advantage and intra-industry specialization in international trade.

Implementing Clinical Research Using Factorial Designs: A Primer.

Science.gov (United States)

Baker, Timothy B; Smith, Stevens S; Bolt, Daniel M; Loh, Wei-Yin; Mermelstein, Robin; Fiore, Michael C; Piper, Megan E; Collins, Linda M

2017-07-01

Factorial experiments have rarely been used in the development or evaluation of clinical interventions. However, factorial designs offer advantages over randomized controlled trial designs, the latter being much more frequently used in such research. Factorial designs are highly efficient (permitting evaluation of multiple intervention components with good statistical power) and present the opportunity to detect interactions amongst intervention components. Such advantages have led methodologists to advocate for the greater use of factorial designs in research on clinical interventions (Collins, Dziak, & Li, 2009). However, researchers considering the use of such designs in clinical research face a series of choices that have consequential implications for the interpretability and value of the experimental results. These choices include: whether to use a factorial design, selection of the number and type of factors to include, how to address the compatibility of the different factors included, whether and how to avoid confounds between the type and number of interventions a participant receives, and how to interpret interactions. The use of factorial designs in clinical intervention research poses choices that differ from those typically considered in randomized clinical trial designs. However, the great information yield of the former encourages clinical researchers' increased and careful execution of such designs. Copyright © 2017. Published by Elsevier Ltd.

THE COMPETITIVE ADVANTAGE OF NATIONS AND THE PARTICULARITIES OF ROMANIAN COMPANIES

Directory of Open Access Journals (Sweden)

Alina HAGIU

2013-12-01

Full Text Available The theory of competitive advantage of Michael Porter stated that national competitive advantage is a reflection of a "diamond" which is running properly and efficiently. But if a developing country like Romania does not have the right conditions for effective functioning of the "diamond", what happens? This is the question to which we try to give an answer within this paper. In this respect, the paper aims to analyze the theory of competitive advantage of Michael Porter, followed by an identification of the advantages and criticisms of this theory over time. Finally we make a customization of this theory in the context of the competitive environment in Romania.

The Source of Competitive Advantage and Entrepreneurial Judgment in the RBV

DEFF Research Database (Denmark)

Ishikawa, Ibuki

The purpose of this paper is to identify the source of competitive advantage in the resource based view of strategic management literature. In particular, it is argued that the source of competitive advantage is rooted in entrepreneur judgment. In this argument, this paper consists largely of three...... on Lachmann (1947,1956), Mises (1946) and Knight (1921) to improve the RBV framework; thirdly, to apply the Austrian perspective to the RBV and demonstrate that the source of competitive advantage is derived from entrepreneurial judgment per se, not the resource per se, and to discuss some possible future...... the source of competitive advantage.Jel Code: B25, D21, D81, M13...

Induced pluripotent stem cells for the treatment of stroke: the potential and the pitfalls.

Science.gov (United States)

Yu, Fenggang; Li, Yingying; Morshead, Cindi M

2013-09-01

The extraordinary discovery of induced pluripotent stem cells (iPSCs) has led to the very real possibility that patient-specific cell therapy can be realized. The potential to develop cell replacement therapies outside the ethical and legal limitations, has initiated a new era of hope for regenerative strategies to treat human neurological disease including stroke. In this article, we will review and compare the current approaches to derive iPSCs from different somatic cells, and the induction into neuronal phenotypes, considering the advantages and disadvantages to the methodologies of derivation. We will highlight the work relating to the use of iPSC-based therapies in models of stroke and their potential use in clinical trials. Finally, we will consider future directions and areas of exploration which may promote the realization of iPSC-based cell replacement strategies for the treatment of stroke.

Advantages and limits of hemorrhoidal dearterialization in the treatment of symptomatic hemorrhoids.

Science.gov (United States)

Giamundo, Paolo

2016-01-27

In the last two decades, hemorrhoidal dearterialization has become universally accepted as a treatment option for symptomatic hemorrhoids. The rationale for this procedure is based on the assumption that arterial blood overflow is mainly responsible for dilatation of the hemorrhoidal plexus due to the absence of capillary interposition between the arterial and venous systems within the anal canal. Dearterialization, with either suture ligation (Doppler-guided hemorrhoid artery ligation/transanal hemorrhoidal dearterialization) or laser (hemorrhoidal laser procedure), may be successfully performed alone or with mucopexy. Although the added value of Doppler-guidance in association with dearterialization has recently been challenged, this imaging method still plays an important role in localizing hemorrhoidal arteries and, therefore, minimizing the effect of anatomic variation among patients. However, it is important to employ the correct Doppler transducer. Some Doppler transducers may not easily detect superficial arteries due to inadequate frequency settings. All techniques of dearterialization have the advantage of preserving the anatomy and physiology of the anal canal, when compared to other surgical treatments for hemorrhoids. This advantage cannot be underestimated as impaired anal function, including fecal incontinence and other defecation disorders, may occur following surgical treatment for hemorrhoids. Furthermore, this potentially devastating problem can occur in patients of all ages, including younger patients.

Customerizing the clinical laboratory. Repositioning for enhanced service and a competitive advantage.

Science.gov (United States)

Schuler, R S

1989-01-01

The call for excellence has never been louder, especially in the health-care industry. This call typically means increased service, i.e., faster, more accurate and, of course, friendlier service--all easier said than done, but qualities that make enhanced customer service so powerful. The excellent companies are learning that because it is so difficult to customerize, few competitors do so. Therefore, by devoting the time and effort necessary for customerization, they can move ahead of their competitors. But surpassing competitors by excellent service can be done inside of companies as well as outside. All units and departments have customers. The key to customerization inside is finding out what your customers want and behaving accordingly. The results go beyond enhanced customer satisfaction. They also include enhanced energy levels, reduced turnover, increased pride, and greater creativity for the newly customerized department. All it takes is an understanding of and dedication to customerization. Repositioning the existing department is critical to the success of any attempt to customerize. This article thoroughly describes customerization and the entire process of repositioning the clinical laboratory. One will not occur without the other.

Introducing the religio-centric positional advantage to Indonesian small businesses

Directory of Open Access Journals (Sweden)

Hendar Hendar

2017-03-01

Full Text Available With a focus on small religion-based businesses in Indonesia, this research examines whether marketing innovativeness, customers responsiveness and competitors′ responsiveness can improve marketing performance. A conceptual model on the correlation of these three variables with religio-centric positional advantage and marketing performance is examined by using structural equation model. For this purpose 335 small businesses of Islamic Fashion had been studied using purposive sampling from 11 regencies/cities in Central Java (Indonesia. The results showed that (1 small companies in these market segments based on religion is likely to have better marketing performance when they have the Religio-centric positional advantage, (2 The increase in marketing innovativeness, CuR and CoR is required to improve and maintain religio-centric positional advantage, and (3 religio-centric positional advantage is definitely a mediator in the correlation of marketing innovativeness, customer responsiveness and competitors responsiveness with marketing performance.

Principles and advantages of robotics in urologic surgery.

Science.gov (United States)

Renda, Antonio; Vallancien, Guy

2003-04-01

Although the available minimally invasive surgical techniques (ie, laparoscopy) have clear advantages, these procedures continue to cause problems for patients. Surgical tools are limited by set axes of movement, restricting the degree of freedom available to the surgeon. In addition, depth perception is lost with the use of two-dimensional viewing systems. As surgeons view a "virtual" target on a television screen, they are hampered by decreased sensory input and a concurrent loss of dexterity. The development of robotic assistance systems in recent years could be the key to overcoming these difficulties. Using robotic systems, surgeons can experience a more natural and ergonomic surgical "feel." Surgical assistance, dexterity and precision enhancement, systems networking, and image-guided therapy are among the benefits offered by surgical robots. In return, the surgeon gains a shorter learning curve, reduced fatigue, and the opportunity to perform complex procedures that would be difficult using conventional laparoscopy. With the development of image-guided technology, robotic systems will become useful tools for surgical training and simulation. Remote surgery is not a routine procedure, but several teams are working on this and experiencing good results. However, economic concerns are the major drawbacks of these systems; before remote surgery becomes routinely feasible, the clinical benefits must be balanced with high investment and running costs.

Advertising Dynamics and Competitive Advantage

OpenAIRE

Ulrich Doraszelski; Sarit Markovich

2004-01-01

Can advertising lead to a sustainable competitive advantage? To answer this question, we propose a dynamic model of advertising competition where firms repeatedly advertise, compete in the product market, and make entry as well as exit decisions. Within this dynamic framework, we study two different models of advertising: In the first model, advertising influences the goodwill consumers extend towards a firm ("goodwill advertising"), whereas in the second model it influences the share of cons...

Clinical medical librarian: the last unicorn?

OpenAIRE

Demas, J M; Ludwig, L T

1991-01-01

In the information age of the 1990s, the clinical medical librarian (CML) concept, like many other personalized library services, is often criticized as being too labor-intensive and expensive; others praise its advantages. To determine the attitudes of medical school library directors and clinical department heads toward implementation and feasibility of a CML program, forty randomly selected medical schools were surveyed. A double-blind procedure was used to sample department heads in inter...

Clinical investigations of the therapeutic potential of ayahuasca: rationale and regulatory challenges.

Science.gov (United States)

McKenna, Dennis J

2004-05-01

Ayahuasca is a hallucinogenic beverage that is prominent in the ethnomedicine and shamanism of indigenous Amazonian tribes. Its unique pharmacology depends on the oral activity of the hallucinogen, N,N-dimethyltryptamine (DMT), which results from inhibition of monoamine oxidase (MAO) by beta-carboline alkaloids. MAO is the enzyme that normally degrades DMT in the liver and gut. Ayahuasca has long been integrated into mestizo folk medicine in the northwest Amazon. In Brazil, it is used as a sacrament by several syncretic churches. Some of these organizations have incorporated in the United States. The recreational and religious use of ayahuasca in the United States, as well as "ayahuasca tourism" in the Amazon, is increasing. The current legal status of ayahuasca or its source plants in the United States is unclear, although DMT is a Schedule I controlled substance. One ayahuasca church has received favorable rulings in 2 federal courts in response to its petition to the Department of Justice for the right to use ayahuasca under the Religious Freedom Restoration Act. A biomedical study of one of the churches, the Uñiao do Vegetal (UDV), indicated that ayahuasca may have therapeutic applications for the treatment of alcoholism, substance abuse, and possibly other disorders. Clinical studies conducted in Spain have demonstrated that ayahuasca can be used safely in normal healthy adults, but have done little to clarify its potential therapeutic uses. Because of ayahuasca's ill-defined legal status and variable botanical and chemical composition, clinical investigations in the United States, ideally under an approved Investigational New Drug (IND) protocol, are complicated by both regulatory and methodological issues. This article provides an overview of ayahuasca and discusses some of the challenges that must be overcome before it can be clinically investigated in the United States.

Multiplex Sequence Analysis Demonstrates the Competitive Growth Advantage of the A-to-G Mutants of Clarithromycin-Resistant Helicobacter pylori

OpenAIRE

Wang, Ge; Rahman, M. Sayeedur; Humayun, M. Zafri; Taylor, Diane E.

1999-01-01

Clarithromycin resistance in Helicobacter pylori is due to point mutation within the 23S rRNA. We examined the growth rates of different types of site-directed mutants and demonstrated quantitatively the competitive growth advantage of A-to-G mutants over other types of mutants by a multiplex sequencing assay. The results provide a rational explanation of why A-to-G mutants are predominantly observed among clarithromycin-resistant clinical isolates.

Multiplex sequence analysis demonstrates the competitive growth advantage of the A-to-G mutants of clarithromycin-resistant Helicobacter pylori.

Science.gov (United States)