The Egyptian Cardiothoracic Surgeon (ECTS - E-Journal)
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Prognostic factors for progression-free and overall survival in advanced biliary tract cancer
No full textBACKGROUND: Biliary tract cancer is an uncommon cancer with a poor outcome. We assembled data from the National Cancer Research Institute (UK) ABC-02 study and 10 international studies to determine prognostic outcome characteristics for patients with advanced disease.METHODS: Multivariable analyses of the final dataset from the ABC-02 study were carried out. All variables were simultaneously included in a Cox proportional hazards model, and backward elimination was used to produce the final model (using a significance level of 10%), in which the selected variables were associated independently with outcome. This score was validated externally by receiver operating curve (ROC) analysis using the independent international dataset.RESULTS: A total of 410 patients were included from the ABC-02 study and 753 from the international dataset. An overall survival (OS) and progression-free survival (PFS) Cox model was derived from the ABC-02 study. White blood cells, haemoglobin, disease status, bilirubin, neutrophils, gender, and performance status were considered prognostic for survival (all with P < 0.10). Patients with metastatic disease {hazard ratio (HR) 1.56 [95% confidence interval (CI) 1.20-2.02]} and Eastern Cooperative Oncology Group performance status (ECOG PS) 2 had worse survival [HR 2.24 (95% CI 1.53-3.28)]. In a dataset restricted to patients who received cisplatin and gemcitabine with ECOG PS 0 and 1, only haemoglobin, disease status, bilirubin, and neutrophils were associated with PFS and OS. ROC analysis suggested the models generated from the ABC-02 study had a limited prognostic value [6-month PFS: area under the curve (AUC) 62% (95% CI 57-68); 1-year OS: AUC 64% (95% CI 58-69)].CONCLUSION: These data propose a set of prognostic criteria for outcome in advanced biliary tract cancer derived from the ABC-02 study that are validated in an international dataset. Although these findings establish the benchmark for the prognostic evaluation of patients with ABC and confirm the value of longheld clinical observations, the ability of the model to correctly predict prognosis is limited and needs to be improved through identification of additional clinical and molecular markers.</p
The title-page in eighteenth-century grammar books
No full textTheories of paratext have focused primarily on fiction texts, following Gérard Genette’s Paratexts (1997). Recent work in the field of historical sociolinguistics has paid increasing attention to grammar writing, in particular that from the eighteenth century. This study aims to contribute to both areas of research, and to book history in general, by examining the linguistic design of the title-page, one of the richest paratextual elements, in eighteenth-century grammar books, a type of non-fiction text that played a vital role in the education and print culture of that century. The analysis is based on a corpus of title-pages in English grammars, leading to a better understanding of which elements of a book’s title-page, which pedagogical method and which grammar contents were considered essential to present to readers directly. The choice of lexicon will also reveal to what extent a prescriptive tone was overtly presented to readers as a selling point
Techno-economic and business case assessment of low carbon technologies in distributed multi-energy systems
No full textIncreasing focus on energy affordability and environmental impact is drawing interest towards the potential value of low carbon technology (LCT) interventions in buildings and district energy systems. Relevant interventions may include improvements of the insulation levels and installation of low carbon and renewable generation technologies (e.g., combined heat and power, photovoltaics, heat pumps). These LCT interventions for both electricity and heat supply can, in principle, reduce energy costs and CO2 emissions for final energy consumers. This can be achieved by coupling, and possibly optimising, multiple energy vectors from traditionally independent systems (e.g., electricity, heat and gas). However, this transition to distributed multi-energy systems introduces complex physical and commercial interactions between the different energy vectors. Further, these interactions can be fundamentally different at different aggregation levels (e.g., premises, district, and commercial level). This makes the assessment of business cases for LCT interventions in a multi-energy context a grand challenge, and given the potentially disruptive commercial impact of many such novel technologies, such complexity might result in a barrier to their development. In light of this, this paper proposes a techno-economic framework for the assessment of business cases of LCTs, which systematically models the physical and commercial multi-energy flows at the premises, grid connection point, and commercial levels. This is particularly important given the commonly asymmetrical nature of various energy price components, which can have significant effects on the business cases of LCTs and associated actors (e.g., retailers and energy service companies). The proposed framework is demonstrated through a series of case studies that highlight the value of various LCT interventions and of aggregation, in terms of energy, emission and operational cash flow metrics. The relevance and importance of the framework to developing business cases for various energy system actors, including policy makers and regulators, is discussed, with the final aim of facilitating the uptake of low carbon multi-energy technologies.</p
Oral History as an Autobiographical Practice
No full textOral history has changed its focus since the 1970s. It is still an important method of recovering neglected histories, but whereas once oral historians aspired to collect objective data from eye witnesses, practitioners now increasingly regard the methodology as an autobiographical practice centred on the subjectivity of the narrator. As the representative sample loosened its grip, the need to understand how subjectivity is constituted in an interview became more urgent. Oral history demanded revision of the historical agenda in the 1970s; the changes in its orientation challenge how history itself is conceptualized. This article explores some of the implications of the shift, drawing on two projects on Britain in the Second World War for illustration
Flyover Noise Measurements and Predictions of Commercial Airplanes
No full textA series of flyover noise measurements has been taken to gather data for noise prediction, analysis, and computer program validation. A selected database of measurements is presented for the Airbus A320-200, the Boeing B737-800, and the ATR72 (turboprop). The experimental setup, the microphone positions, the effect of background noise, and the atmospheric effects are presented. It is shown that landing measurements are generally coherent with one another, with consistent peaks in noise levels and uniform noise levels ±5 s from the overhead position. In contrast, at takeoff, there are considerable variations in peak noise level, which are attributed to different takeoff procedures and gross weights. Comparisons with noise predicted using ray tracing are shown. These comparisons indicate that it is possible to predict with some accuracy the noise peaks, the rise and fall of overall sound level, and the integral noise metrics (effective perceived noise level and LAmax)
The effective oxidation state of a peatland
No full textThe oxidative ratio (OR) of the organic matter of the terrestrial biosphere is a key parameter in the understanding of the magnitude of the carbon sink represented both by the terrestrial biosphere and by the global oceans. However, no study has considered the oxidation state of all the organic pools and fluxes within one environment. In this study all organic matter pathways (dissolved organic matter, particulate organic matter, CO2, and CH4) were measured within an upland peat ecosystem in northern England. The study showed the following: (1) The peat soil of ecosystem was accumulating oxygen at a rate of between16 and 73 t O km2yr1; (2) Although there was no significant variation in oxidation state in the peat profile, there was a significant increase in degree of unsaturation with depth; (3) The dissolved organic matter leaving the ecosystem was significantly more oxidized than the other carbon pools analyzed while the particulate organic matter was not significantly different from the peat soil profile; and (4) Assuming that al lcarbon flux from the site was as CO2, the OR of the ecosystem was 1.07; when the nature and speciation of the release pathways were considered, the ecosystem OR was 1.04. At the global scale, correcting for the speciation of carbon fluxes means that the annual global fluxes of carbon to land = 1.49 ± 0.003 Gt C/yr and to the oceans = 2.01 ± 0.004 Gt C/yr
The New International Division of Labour:Global Transformation and Uneven Development
No full textThis book revisits the debate over the new international division of labour (NIDL) that dominated discussions in international political economy and development studies until the early 1990s. It submits that a revised NIDL thesis can shed light on the specificities of capitalist development in various parts of the world today. Taken together, the contributions amount to a novel value-theoretical approach to understanding the NIDL. This rests upon the distinction between the global economic content that determines the constitution and dynamics of the NIDL and the evolving national political forms that mediate its development. More specifically, the authors argue that uneven development is an expression of the underlying essential unity of the production of relative surplus-value on a world scale. They substantiate and illustrate this argument through several international case studies, including Argentina, Brazil, Ecuador, Ireland, South Korea, Spain and Venezuela