500 research outputs found

    An Integrated Circuit for Signal Processing of the AMS RICH Photmultipliers Tubes

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    An analog integrated circuit has been designed, in a BiCMOS 0.8 micron technology, for the feasability study of the signal processing of the AMS RICH photomultiplier tubes. This low power, three channel gated integrator includes its own gate and no external analog delay is requiered. It processes PMT pulses over a dynamic range of more than 100. A logic output that indicates whether the analog charge has to be considered is provided. This gated integrator is used with a compact DSP based acquisition system in a 132 channels RICH prototype. The charge calibration of each channel is carried out using a LED. The pedestal measurement is performed on activation of a dedicated input. The noise contribution study of the input RC network and amplifiers is presented.Comment: IEEE symp. on Nucl. Sci. and Med. Imaging, Toront

    Specialist versus primary care prostate cancer follow-up:A process evaluation of a randomized controlled trial

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    Background: A randomized controlled trial (RCT) is currently comparing the effectiveness of specialist- versus primary care-based prostate cancer follow-up. This process evaluation assesses the reach and identified constructs for the implementation of primary care-based follow-up. Methods: A mixed-methods approach is used to assess the reach and the implementation through the Consolidated Framework for Implementation Research. We use quantitative data to evaluate the reach of the RCT and qualitative data (interviews) to indicate the perspectives of patients (n = 15), general practitioners (GPs) (n = 10), and specialists (n = 8). Thematic analysis is used to analyze the interview transcripts. Results: In total, we reached 402 (67%) patients from 12 hospitals and randomized them to specialist- (n = 201) or to primary care-based (n = 201) follow-up. From the interviews, we identify several advantages of primary care- versus specialist-based follow-up: it is closer to home, more accessible, and the relationship is more personal. Nevertheless, participants also identified challenges: guidelines should be implemented, communication and collaboration between primary and secondary care should be improved, quality indicators should be collected, and GPs should be compensated. Conclusion: Within an RCT context, 402 (67%) patients and their GPs were willing to receive/provide primary care-based follow-up. If the RCT shows that primary care is equally as effective as specialist-based follow-up, the challenges identified in this study need to be addressed to enable a smooth transition of prostate cancer follow-up to primary care. Netherlands Trial Registry, Trial NL7068 (NTR7266)

    The future of the CDM: same same, but differentiated?

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    Policy-makers and scientists have raised concerns about the functioning of the Clean Development Mechanism (CDM), in particular regarding its low contribution to sustainable development, unbalanced regional and sectoral distribution of projects, and its limited contribution to global emission reductions. Differentiation between countries or project types has been proposed as a possible way forward to address these problems. An overview is provided of the different ways in which CDM differentiation could be implemented. The implications for the actors involved in the CDM are analysed, along with a quantitative assessment of the impacts on the carbon market, using bottom-up marginal abatement cost curves. The discounting of CDM credits, quota systems, or differentiated eligibility of countries could help to address several of the concerns raised. Preferential treatment may also make a limited contribution to achieving the aims of CDM differentiation by increasing opportunities for under-represented host countries. The impact on the carbon market appears to be limited for most options

    Oral esketamine for treatment-resistant depression:rationale and design of a randomized controlled trial

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    BACKGROUND: There is an urgent need to develop additional treatment strategies for patients with treatment-resistant depression (TRD). The rapid but short-lived antidepressant effects of intravenous (IV) ketamine as a racemic mixture have been shown repeatedly in this population, but there is still a paucity of data on the efficacy and safety of (a) different routes of administration, and (b) ketamine's enantiomers esketamine and arketamine. Given practical advantages of oral over IV administration and pharmacodynamic arguments for better antidepressant efficacy of esketamine over arketamine, we designed a study to investigate repeated administration of oral esketamine in patients with TRD. METHODS: This study features a triple-blind randomized placebo-controlled trial (RCT) comparing daily oral esketamine versus placebo as add-on to regular antidepressant medications for a period of 6 weeks, succeeded by a follow-up of 4 weeks. The methods support examination of the efficacy, safety, tolerability, mechanisms of action, and economic impact of oral esketamine in patients with TRD. DISCUSSION: This is the first RCT investigating repeated oral esketamine administration in patients with TRD. If shown to be effective and tolerated, oral esketamine administration poses important advantages over IV administration. TRIAL REGISTRATION: Dutch Trial Register, NTR6161. Registered 21 October 2016

    Modelling societal transitions with agent transformation

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    Transition models explain long-term and large-scale processes fundamentally changing the structure of a societal system. Our concern is that most transition models are too static. Although they capture a move of focus from static equilibria to transitions between dynamic equilibria, they are still rooted in an "equilibriumist" approach. Improvement is possible with agent-based models that give attention to endogenous system processes called "transformation processes". These models can render far more dynamic pictures of societal systems in transition, and are no longer remote from descriptions in the emerging transition literature
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