89,945 research outputs found
S&M - On Waugh Gallery
No full textSpeakers: Karen Poltarek, Loretta Cooper, Ted BrownContents include: On "S&M," a KTRU DJ talks to the On Waugh Gallery owners/employees about the gallery, raising money, upcoming silent auction, large parties, and Saltwater Cats
Waugh, Mabel M, [No Service Number]
No full textThis record was harvested from a previous catalogue system and will be withdrawn in 2025. Information in this record may be superseded or incomplete. Visit this record in UMA's new catalogue at: https://archives.library.unimelb.edu.au/nodes/view/424493Surname: WAUGH. Given Name(s) or Initials: MABEL M. Military Service Number or Last Known Location: [No Registration Number]. Missing, Wounded and Prisoner of War Enquiry Card Index Number: 48574.252363
Item: [2016.0049.56754] "Waugh, Mabel M, [No Service Number]
A rapid and systematic review of the clinical effectiveness and cost-effectiveness of paclitaxel, docetaxel, gemcitabine and vinorelbine in non-small-cell lung cancer
No full textBACKGROUND:
The incidence of lung cancer is declining following a drop in smoking rates, but it is still the leading cause of death from cancer in England and Wales, with about 30,000 deaths a year. Survival rates for lung cancer are poor everywhere, but they appear to be better in the rest of the European Community and the USA than in the UK. Only about 5 per cent of people with lung cancer survive for 5 years, and nearly all of these are cured by surgery after fortuitously early diagnosis. At present, only a small proportion of patients (probably about 5 per cent) with non-small-cell lung cancer are being given chemotherapy. Some centres treat a greater proportion.
OBJECTIVES:
This review examines the clinical effectiveness and cost-effectiveness of four of the newer drugs - vinorelbine, gemcitabine, paclitaxel and docetaxel - used for treating the most common type of lung cancer (non-small-cell lung cancer). The first three drugs are used for first-line treatment, but at present docetaxel is used only after first-line chemotherapy has failed.
METHODS:
This report was based on a systematic literature review and economic modelling, supplemented by cost data. RESULTS - NUMBER AND QUALITY OF STUDIES: A reasonable number of randomised trials were found - three for docetaxel, six for gemcitabine, five for paclitaxel and 13 for vinorelbine. The quality of the trials was variable but good overall. There was a wide range of comparators. Some trials compared chemotherapy with best supportive care (BSC), which involves care that aims to control symptoms, with palliative radiotherapy if needed, but not to prolong life. Others compared the newer drugs against previous drugs or combinations. RESULTS - SUMMARY OF BENEFITS: The gains in duration of survival with the new drugs are modest - a few months - but worthwhile in a condition for which the untreated survival is only about 5 months. There are also gains in quality of life compared with BSC, because on balance the side-effects of some forms of chemotherapy have less effect on quality of life than the effects of uncontrolled spread of cancer. RESULTS - COSTS: The total cost to the NHS of using these new drugs in England and Wales might be about GBP 10 million per annum, but is subject to a number of factors. There would be non-financial constraints on any increase in chemotherapy for the next few years, such as staffing; the number of patients choosing to have the newer forms of chemotherapy is not yet known; and the costs of the drugs may fall, for example, as generic forms appear. RESULTS - COST PER LIFE-YEAR GAINED: The available data did not provide an entirely satisfactory basis for cost-effectiveness calculations. The main problem was the lack of direct comparisons of the new drugs. In order to strengthen the analysis, three different modelling approaches were used: pairwise comparisons using trial data; cost-minimisation analysis, as if all the new regimens were of equal efficacy; and cost-effectiveness analysis pooling the results of several trials with different comparators, giving indirect comparisons of the new drugs by using BSC as the common comparator. A number of different scenarios were explored through extensive sensitivity analysis in each model. Outcomes were expressed in incremental cost per life-year saved or incremental cost, versus BSC. There was insufficient evidence from which to derive cost per quality-adjusted life-year. In first-line treatment, vinorelbine, gemcitabine, and the lower-dose paclitaxel plus cisplatin combinations generally performed well against BSC under a range of different scenarios and especially when given as a maximum of 3 cycles. Incremental cost per life-year gained (LYG) versus BSC varied depending on scenario, but baseline figures based on trial data and protocols were: single-agent vinorelbine, pound 2194 per LYG; vinorelbine plus cisplatin, pound 5206; single-agent gemcitabine, pound 5690; gemcitabine plus cisplatin, pound 10,041; and paclitaxel plus cisplatin, pound 8537. In second-line chemotherapy, docetaxel gave a cost per LYG of pound 17,546, again well within the range usually accepted as cost-effective. However, in routine care, the impact of therapy would be regularly reviewed, and continuation would depend on response, side-effects, patient choice and clinical judgement. Chemotherapy would be stopped in non-responders, making chemotherapy more cost-effective. A 'real-life' scenario in which 60 per cent of patients receive only 1 or 2 cycles of chemotherapy gives much lower costs per LYG, with single-agent gemcitabine, single-agent vinorelbine, and paclitaxel plus platinum appearing to be cost-saving compared with BSC; the incremental cost of gemcitabine plus cisplatin would be pound 2478 per LYG, and of vinorelbine plus cisplatin, pound 2808. At the very least, gains in duration of survival were achieved without diminution of quality of life (at best, they improved quality) and with relatively low incremental cost. Comparisons among the individual drugs should be viewed with caution because they have had to be based on indirect comparisons. RESULTS - LIMITATIONS OF THE ANALYSIS: Each of the three models had limitations. The cost-effectiveness estimates from the pairwise comparisons were based on single studies. The cost-minimisation analysis assumed that the regimens have equal efficacy in practice. The cost-effectiveness analysis had to be based on pooling data from individual trials. The costs of BSC, inpatient stay and outpatient visits were from Scottish data. Median rather than mean data on duration of survival have been used in the analysis, because most of the trials reported only median data. Median survival and number of drug cycles were calculated by averaging across a number of studies, rather than being reliant on one particular study. The costs of the less expensive antiemetics cited in the trials were omitted. The use of more modern and costly antiemetics would have a modest detrimental effect on cost-effectiveness. In the absence of published data, an estimate was made of the cost of side-effects of chemotherapy, in particular hospital admissions, and applied to all the new regimens. In practice, admissions related to side-effects and their respective costs are likely to vary by regimen.
CONCLUSIONS:
The new drugs for non-small-cell lung cancer extend life by only a few months compared with BSC, but appear to do so without net loss in quality of life and at a cost per LYG that is much lower than for many other NHS activities. Depending on assumptions used, these new drugs range from being cost-effective, as conventionally accepted, to being cost-saving. CONCLUSIONS - IMPLICATIONS OF THE NEWER DRUGS: One of the present constraints on chemotherapy is availability of inpatient beds. The advent of newer and gentler forms of chemotherapy given on an outpatient basis would not only overcome this, but it would allow more patients to be treated. This might apply particularly to older patients. The treatment of more patients would increase workload for oncologists, cancer nurses and pharmacists. The Government has already announced increased expenditure on staff for cancer care. The previously pessimistic attitudes to chemotherapy in non-small-cell lung cancer are changing in the wake of the newer agents, and this shift is likely to increase referral. CONCLUSIONS - NEED FOR FURTHER RESEARCH: Recent advances in chemotherapy are welcome, but their effects remain small for patients with non-small-cell lung cancer. Much more research is needed into better drugs, better combinations, new ways of assessing the likelihood of response and especially direct comparisons between the new regimens. This research would be aided by having a greater proportion of patients involved in trials, but there will be infrastructure implications of increased participation
Modelling and evaluation of pulsed and pulse phase thermography through application of composite and metallic case studies
No full textA transient thermal finite element model has been created of the pulsed thermography (PT) and pulse phase thermography (PPT) experimental procedure. The model has been experimentally validated through the application of four case studies of varying geometries and materials. Materials used include aluminium, carbon fibre reinforced plastic (CFRP) and adhesively bonded joints. The same four case studies have also formed a basis for comparison between three experimental techniques: PT, PPT and the more established ultrasonic (UT) c-scan.Results show PPT to be advantageous over PT due to its deeper probing as it is less influenced by surface features. Whilst UT is able to reveal all the defects in these case studies, the time consuming nature of the process is a significant disadvantage compared to the full field thermography methods.Overall, the model has achieved good correlation for the case studies considered and it was found that the main limiting factor of the PT model accuracy was knowledge of thermal material properties such as conductivity and specific heat. Where these properties were accurately known the model performed very well in comparison with experimental results. PPT modelling performed less well due to the method of processing the PT data which aims to emphasise small differences. Hence inaccuracies in inputted values such as material properties have a much greater influence on the modelled PPT data. The model enables a better understanding of PT and PPT and provides a means of establishing the experimental set-up parameters required for different components, allowing the experimental technique to be appropriately tailored to more complex situations including bonded joints or structures where several materials are present.The paper ends with a section on defect detectability based on thermal diffusivity contrast between the defect and the bulk material. It shows that in aluminium, because of its higher conductivity, greater thermal contrast is achieved for small differences in diffusivity. Regions where the diffusivity ratio between defect and bulk materials was insufficient to provide thermal contrast for defect identification were found. PPT phase data is shown to reduce the extent of such regions increasing the detectability of defects. Effusivity is introduced as a means of determining the thermal contrast between the defect and non-defective areas and hence establishing the defect detectability
The voice of authority : Evelyn Waugh's fiction
No full textA large part of the extant criticism of Evelyn Waugh's fiction is orientated
towards either a biographical or a literary-historical interest: there are
comparatively few detailed surveys of the novels themselves. This study
attempts such a survey, and in particular examines the tension which inheres
in the relationship of Waugh's poised, urbane narrators to the social and
moral chaos they depict. I have been interested in the source and management
of that poise, the testing, as it were to destruction, of a series of
narrative positions. There is a very modern equation to be observed in
Waugh's fiction, between the potentially anarchic mode of fiction and what
Waugh felt to be the actual anarchy of contemporary civilisation. His
novels can with interest be read in terms of a comic exploitation of this
equation, and subsequently, as the writer aged, of his attempts to evade
its logic, to discover a 'voice of authority'. Apparently secure narrative
stances are repeatedly undermined, and a succession of 'realities'
compromised - Tony Last's, William Boot's, John Plant's, Guy Crouchback's.
It is this awareness and exploitation of the reflexive quality of fiction,
and its use in disclosing the nature of his age which lends Waugh's writing
its real and enduring interest.
I seek to draw out this awareness through detailed examination of the
different novels' precise narrative stance, the source of their 'voice',
and have been largely content to let stand other commentators' descriptions
of Waugh's broader thesis. My method involves close attention to Waugh's
language, from the conviction that nuances of tone and the development of
marginal allusions and metaphors are the keys to many of his characteristic
effects
Dr. Glendon Swarthout
No full textHosted by Roger M. Busfield, MSU Assistant Professor of Speech and Theater, Meet the Author is designed to introduce a general audience to a contemporary author and their work through in-depth interviews. This episode features a conversation between Dr. Glendon Swarthout, prolific author and English professor at MSU, and assistant professors Sam S. Baskett and Theodore B. Strandness
Simulation of thermal plant optimization and hydraulic aspects of thermal distribution loops for large campuses
No full textFollowing an introduction, the author describes Texas A&M University and its utilities system. After that, the author presents how to construct simulation models for chilled water and heating hot water distribution systems. The simulation model was used in a $2.3 million Ross Street chilled water pipe replacement project at Texas A&M University. A second project conducted at the University of Texas at San Antonio was used as an example to demonstrate how to identify and design an optimal distribution system by using a simulation model. The author found that the minor losses of these closed loop thermal distribution systems are significantly higher than potable water distribution systems. In the second part of the report, the author presents the latest development of software called the Plant Optimization Program, which can simulate cogeneration plant operation, estimate its operation cost and provide optimized operation suggestions. The author also developed detailed simulation models for a gas turbine and heat recovery steam generator and identified significant potential savings. Finally, the author also used a steam turbine as an example to present a multi-regression method on constructing simulation models by using basic statistics and optimization algorithms. This report presents a survey of the author??s working experience at the Energy Systems Laboratory (ESL) at Texas A&M University during the period of January 2002 through March 2004. The purpose of the above work was to allow the author to become familiar with the practice of engineering. The result is that the author knows how to complete a project from start to finish and understands how both technical and nontechnical aspects of a project need to be considered in order to ensure a quality deliverable and bring a project to successful completion. This report concludes that the objectives of the internship were successfully accomplished and that the requirements for the degree of Degree of Engineering have been satisfied
C3H7NO2S effect on concrete steel-rebar corrosion in 0.5 M H2SO4 simulating industrial/microbial environment
No full textThis paper investigates C3H7NO2S (Cysteine) effect on the inhibition of reinforcing steel corrosion in concrete immersed in 0.5 M H2SO4, for simulating industrial/microbial environment. Different C3H7NO2S concentrations were admixed, in duplicates, in steel-reinforced concrete samples that were partially immersed in the acidic sulphate environment. Electrochemical monitoring techniques of open circuit potential, as per ASTM C876-91 R99, and corrosion rate, by linear polarization resistance, were then employed for studying anticorrosion effect in steel-reinforced concrete samples by the organic hydrocarbon admixture. Analyses of electrochemical test-data followed ASTM G16-95 R04 prescriptions including probability distribution modeling with significant testing by Kolmogorov-Smirnov and student's t-tests statistics. Results established that all datasets of corrosion potential distributed like the Normal, the Gumbel and the Weibull distributions but that only the Weibull model described all the corrosion rate datasets in the study, as per the Kolmogorov-Smirnov test-statistics. Results of the student's t-test showed that differences of corrosion test-data between duplicated samples with the same C3H7NO2S concentrations were not statistically significant. These results indicated that 0.06878 M C3H7NO2S exhibited optimal inhibition efficiency η = 90.52±1.29% on reinforcing steel corrosion in the concrete samples immersed in 0.5 M H2SO4, simulating industrial/microbial service-environment
A method for estimating the extent of denitrification of Arctic polar vortex air from tracer-tracer scatter plots
No full textA method for estimating the extent of denitrification of Arctic polar vortex air is proposed. Previous estimates of denitrification using tracer-tracer scatter plots have not allowed for mixing-induced changes in tracer-tracer relationships in a sufficiently general way. This difficulty is overcome by constructing an artificial "reference tracer'' from a linear combination of other long-lived tracers. The reference tracer is designed so that, as far as possible, it has a linear canonical relationship with NOy in midlatitudes. A linear relationship is unaffected by mixing, so denitrification is apparent as deviations of vortex measurements from the linear midlatitude relationship. The method is first demonstrated using data from a chemical transport model in which no denitrification processes are present. It is then applied to balloon, aircraft and shuttle-borne measurements made before and during the breakdown of the Arctic vortex in 1992-1993 and 1996-1997. In each case the method indicates that little or no denitrification had occurred in any of the vortex air encountered. When the method is applied to the southern hemisphere vortex in 1994, by contrast, denitrified air is clearly seen to be present around 19-23 km in the vortex
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