186,101 research outputs found
Pharmacoeconomic analysis of adjuvant oral capecitabine vs intravenous 5-FU/LV in Dukes' C colon cancer: the X-ACT trial
No full textOral capecitabine (Xeloda<sup>®</sup>) is an effective drug with favourable safety in adjuvant and metastatic colorectal cancer. Oxaliplatin-based therapy is becoming standard for Dukes' C colon cancer in patients suitable for combination therapy, but is not yet approved by the UK National Institute for Health and Clinical Excellence (NICE) in the adjuvant setting. Adjuvant capecitabine is at least as effective as 5-fluorouracil/leucovorin (5-FU/LV), with significant superiority in relapse-free survival and a trend towards improved disease-free and overall survival. We assessed the cost-effectiveness of adjuvant capecitabine from payer (UK National Health Service (NHS)) and societal perspectives. We used clinical trial data and published sources to estimate incremental direct and societal costs and gains in quality-adjusted life months (QALMs). Acquisition costs were higher for capecitabine than 5-FU/LV, but higher 5-FU/LV administration costs resulted in 57% lower chemotherapy costs for capecitabine. Capecitabine vs 5-FU/LV-associated adverse events required fewer medications and hospitalisations (cost savings £3653). Societal costs, including patient travel/time costs, were reduced by >75% with capecitabine vs 5-FU/LV (cost savings £1318), with lifetime gain in QALMs of 9 months. Medical resource utilisation is significantly decreased with capecitabine vs 5-FU/LV, with cost savings to the NHS and society. Capecitabine is also projected to increase life expectancy vs 5-FU/LV. Cost savings and better outcomes make capecitabine a preferred adjuvant therapy for Dukes' C colon cancer. This pharmacoeconomic analysis strongly supports replacing 5-FU/LV with capecitabine in the adjuvant treatment of colon cancer in the UK
From nominal to true a posteriori probabilities: an exact Bayesian theorem based probabilistic data association approach for iterative MIMO detection and decoding
No full textIt was conventionally regarded that the existing probabilistic data association (PDA) algorithms output the estimated symbol-wise a posteriori probabilities (APPs) as soft information. In this paper, however, we demonstrate that these probabilities are not the true APPs in the rigorous mathematicasense, but a type of nominal APPs, which are unsuitable for the classic architecture of iterative detection and decoding (IDD) aided receivers. To circumvent this predicament, we propose an exact Bayesian theorem based logarithmic domain PDA (EB-Log-PDA) method, whose output has similar characteristics to the true APPs, and hence it is readily applicable to the classic IDD architecture of multiple-input multiple-output (MIMO) systems using the general M-ary modulation. Furthermore, we investigate the impact of the PDA algorithms' inner iteration on the design of PDA-aided IDD receivers. We demonstrate that introducing inner iterations into PDAs, which is common practice in PDA-aided uncoded MIMO systems, would actually degrade the IDD receiver's performance, despite significantly increasing the overall computational complexity of the IDD receiver. Finally, we investigate the relationship between the extrinsic log-likelihood ratio (LLRs) of the proposed EB-Log-PDA and of the approximate Bayesian theorem based logarithmic domain PDA (AB-Log-PDA) reported in our previous work. We also show that the IDD scheme employing the EB-Log-PDA without incorporating any inner PDA iterations has an achievable performance close to that of the optimal maximum a posteriori (MAP) detector based IDD receiver, while imposing a significantly lower computational complexity in the scenarios considered
Voltage calculation on low voltage feeders with distributed generation
No full textIncludes bibliographical references.The increasing levels of greenhouse gas emission and the continued depletion of fossil fuels have been the driving factors for power utilities to utilize renewable energy sources for power generation. In South Africa, a target was set in 2008 to achieve 10000 GWh of renewable generation by 2013, which includes DG on LV feeders. This has seen the increase in small scale generators, close to load centres in low voltage distribution networks such as solar PV panels in residential houses, to supplement the energy needs of consumers. This has sparked much debate over the impacts, as well as benefits, of increasing the amount of generation on these low voltage (LV) feeders. However, the power utility holds the statutory role to preserve and maintain the quality of supply of electricity and must therefore assess any impact of increasing generation on LV distribution systems. This created the need for a planning tool to assess the impact of increasing DG on LV distribution networks. There has been a lot of work carried out by researchers to assess the impact of DG on the power system, using various indicators like frequency, power losses, current, voltage etc. Keeping the voltage of a DG-integrated feeder system within the pre-defined standards has been a major challenge for power utilities today. In this report, the voltage impact of DG in LV distribution systems is examined and analysed for increasing DG penetration, particularly solar PV panels in residential households. In South Africa, the recommended method for voltage calculation in feeders is the Herman-Beta algorithm, which is used in the design of passive LV feeders. In 2011, Gaunt experimented with modelling DG as negative loads in the HB algorithm to extend the voltage calculation to include the presence of DG on LV feeders. This work identifies and develops a tool(s) to enable power utility planners to analyse the voltage impact of DG on LV feeders. The work in this study adds onto the DG modelling approach, introduced by Gaunt in 2011, to produce an algorithm for voltage calculation in active LV feeders with DG. This involves three major steps. First step involves the thorough testing of the HB algorithm, written in Matlab, for passive LV feeders and validating it against voltage calculation through Monte Carlo Simulation (MCS). The second step involves ammending and extending the HB algorithm for voltage calculation in active LV feeders with DG, testing and validation against voltage calculation through Monte Carlo Simulation (MCS). With the HB algorithm fully tested and validated, the third step involves using the algorithm for voltage analysis of active feeders with increasing DG penetration. The third and final step, analysing the voltage rise constraints of active LV feeders, involves running the HB algorithm, analytical method, in a MCS to create various scenarios on the feeder. Simulations have been performed to assess the voltage impact of increasing DG penetration on LV feeders for various test cases to mimic practical LV feeder conditions. The outcome of this study presented an application tool for the design of active LV feeders, whose output/results are summarized into implications for voltage rise mitigation and providing useful information on the DG hosting capacity of LV feeders. The recommended DG penetration limit for LV feeders in this study has been DG capacity of 30 of the actual ADMD, used to design the passive feeder. It has been shown that after this limit, the feeder should be reinforced to avoid incidents of voltage violations. In addition, the work done in this project has set a foundation upon which a variety of similar studies can be done with active LV feeders such as the effect of solar water heating and the penetration of other DG technologies such as wind
[Report to Chief J. E. Curry, by an unknown author #1]
No full textReport to Chief J. E. Curry, by an unknown author. The report contains a list of officers who gave depositions to the United States Attorney
[Report to Chief J. E. Curry, by an unknown author #2]
No full textReport to Chief J. E. Curry, by an unknown author. The report contains a list of officers who gave depositions to the United States Attorney
IFI and ISI premitigation for block-code-modulated noncoherent UWB impulse radio: A code optimization approach
No full textCodeword matching and signal aggregation (CMSA) is a recently proposed low-complexity noncoherent receiver for block code modulated UWB Impulse Radio (UWB-IR) systems. As the frame/symbol duration is shortened to boost data rate, inter-frame interference (IFI) or inter-symbol interference (ISI) occurs and degrades detection performance of CMSA. In this paper, an effective IFI/ISI pre-mitigation scheme is proposed for CMSA by means of a code optimization approach. By employing a tailored interference model that highlights the codeword properties, the system performance in the presence of moderate IFI/ISI is evaluated and an average collected channel gain (CCG) is introduced as the metric for code optimization. With the primary focus on binary modulation, two IFI/ISI-robust code properties are generalized as Shifted-Orthogonality and Shifted-Repetition. Based on these properties, the optimal code is constructed. It is observed that, when the optimal code occurs, the leaked signal energy or the interference can be partially used to enhance the detection performance of CMSA in the presence of IFI/ISI. Unlike most of the existing IFI/ISI mitigation schemes for noncoherent UWB-IR that focus mainly on signal processing after the nonlinear detector, the optimized code is exploited to aggregate leaked signal energy along with the linear pre-detection operation already involved in CMSA receiver. Both analysis and simulation show that a distinct performance improvement is achieved
The effect of heat stress, dehydration and exercise on global left ventricular function and mechanics in healthy humans
No full textThis thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.This thesis examined the effect of heat stress, dehydration and exercise on global left ventricular (LV) function and LV twist, untwisting and strain (LV mechanics) in healthy individuals. The primary aim was to identify whether the different haemodynamics induced by heat stress, dehydration and exercise would be associated with alterations in systolic and diastolic LV mechanics as assessed by two-dimensional speckle tracking echocardiography.
Study one showed that enhanced systolic and diastolic LV mechanics during progressively increasing heat stress at rest likely compensate in part for a lower venous return, resulting in a maintained stroke volume (SV). In contrast, heat stress during knee-extensor exercise did not significantly increase LV twist, suggesting that exercise attenuates the increase in LV mechanics seen during passive heat stress. Study two revealed that dehydration enhances systolic LV mechanics whilst diastolic mechanics remain unaltered at rest, despite pronounced reductions in preload. The maintenance of systolic and diastolic LV mechanics with dehydration during knee-extensor exercise further suggests that the large decline in SV with dehydration and hyperthermia is caused by peripheral cardiovascular factors and not impaired LV mechanics. During both, heat stress and dehydration, enhanced systolic mechanics were achieved solely by increases in basal rotation. In contrast, the third study demonstrated that when individuals are normothermic and euhydrated, systolic and diastolic basal and apical mechanics increase significantly during incremental exercise to approximately 50% peak power. The subsequent plateau suggests that LV mechanics reach their peak at sub-maximal exercise intensities. Together, the present findings emphasise the importance of acute adjustments in both, basal and apical LV mechanics, during periods of increased cardiovascular demand
Effects of steady state free precession parameters on cardiac mass, function, and volumes.
No full textPURPOSE: We aimed to investigate comparability of LV volumes, function, and mass acquired with three steady-state free precession (SSFP) pulse sequences, simulating typical vendor and protocol specific differences in data acquisition. METHODS: Twenty-one healthy subjects (11 male and 10 female; age range 23-49) underwent cardiac magnetic resonance (CMR) imaging at 1.5 Tesla (T). A complete stack of short-axis views covering the entire left ventricle (LV) were acquired for each of the three SSFP sequences, differing in the interslice gap and slice thickness (7 mm with no gap (7/0 mm); 7 mm with a 3 mm gap (7/3 mm) and 6 mm with a 4 mm gap (6/4 mm)) with slight variations in acquisition parameters. For each sequence, the LV volumes, function, and mass were determined. Intra- and inter-observer variability and inter-study reproducibility were assessed for all protocols. RESULTS: All LV volumes, function and mass parameters were similar for the three SSFP sequences (P > 0.05 for all). The LV ejection fraction for the 7/3 mm sequence was 67.2 +/- 6.0, 67.4 +/- 5.3 for the 7/0 mm sequence, and the 6/4 mm sequence was 69.2 +/- 5.7. The LV mass ranged from 119.8 +/- 32.4 for the 7/3 mm sequence to 122.2 +/- 34.0 for the 7/0 mm sequence. Variabilities were low with no difference in variability between the sequences. CONCLUSION: The three SSFP pulse sequence techniques resulted in similar LV volume, function, and mass measurements with no difference in observer and interstudy variabilities. This may allow application and transfer of LV volume studies and databases based on different imaging parameters, at different CMR sites, with a given post-processing method. Future multi-centre studies may now be in a position to consider multi-vendor study designs for LV volume studies
Murder on the mountain: author talk with Peter J. Wosh
No full textAuthor talk by Peter J. Wosh on May 5th, 2022, on his book, "Murder on the Mountain: crime, passion, and punishment in gilded age New Jersey.
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