505 research outputs found
Combustion of LOX with H2(sub g) under subcritical, critical, and supercritical conditions (Task 1) and experimental observation of dense spray and mixing of impinging jets (Task 2)
The objective was to achieve a better understanding of the combustion processes of liquid oxygen and gaseous hydrogen under broad range of pressure covering subcritical, critical, and supercritical conditions. The scope of the experimental work falls into the following areas: (1) design of the overall experimental setup; (2) modification of an existing windowed high pressure chamber; (3) design of the LOX feeding system; (4) provision of the safety features in the test rig design; (5) LOX cleanliness requirements; (6) cold shock testing; (7) implementation of data acquisition systems; (8) preliminary tests for system checkout; (9) modification of LOX feeding system; and (10) evaporation tests. Progress in each area is discussed
Evaluating case studies of community-oriented integrated care.
This paper summarises a ten-year conversation within London Journal of Primary Care about the nature of community-oriented integrated care (COIC) and how to develop and evaluate it. COIC means integration of efforts for combined disease-treatment and health-enhancement at local, community level. COIC is similar to the World Health Organisation concept of a Community-Based Coordinating Hub - both require a local geographic area where different organisations align their activities for whole system integration and develop local communities for health. COIC is a necessary part of an integrated system for health and care because it enables multiple insights into 'wicked problems', and multiple services to integrate their activities for people with complex conditions, at the same time helping everyone to collaborate for the health of the local population. The conversation concludes seven aspects of COIC that warrant further attention
Powers, inequalities and vulnerabilities
This research addresses the gap that is present in both missiology and family and youth ministry. Missiology does not focus on children and youth specifically, while this is the largest population in the developing world. On the other hand, family and youth ministry has a more pastoral than missional approach, not always taking cognisance of contexts like globalisation. Thus, the purpose of the book is to address the sometimes unintended and unnoticed influence of globalisation on the mission of the church, with a specific focus on children, youth and family. For this purpose, the International Association for Mission Studies study group for children, youth and families coming from different parts of the world decided to describe the powers, inequalities and vulnerabilities of children, youth and families in a globalised world from their specific contexts. Although the most prominent research methodology was critical literature studies, methods like autoethnographic, and empirical methods were also used. No decisions were made on a specific method of research for this publication. This publication can be viewed as an interdisciplinary and intra-disciplinary, because it deals with social sciences, anthropology, psychology, missiology, systematic theology and practical theology
Human-in-the-Loop Schema Induction
Schema induction builds a graph representation explaining how events unfold
in a scenario. Existing approaches have been based on information retrieval
(IR) and information extraction(IE), often with limited human curation. We
demonstrate a human-in-the-loop schema induction system powered by GPT-3. We
first describe the different modules of our system, including prompting to
generate schematic elements, manual edit of those elements, and conversion of
those into a schema graph. By qualitatively comparing our system to previous
ones, we show that our system not only transfers to new domains more easily
than previous approaches, but also reduces efforts of human curation thanks to
our interactive interface.Comment: 10 pages, ACL2023 demo trac
Treatment of Canine Osseous Tumors with Photodynamic Therapy: A Pilot Study
Photodynamic therapy uses nonthermal coherent light delivered via fiber optic cable to locally activate a photosensitive chemotherapeutic agent that ablates tumor tissue. Owing to the limitations of light penetration, it is unknown whether photodynamic therapy can treat large osseous tumors. We determined whether photodynamic therapy can induce necrosis in large osseous tumors, and if so, to quantify the volume of treated tissue. In a pilot study we treated seven dogs with spontaneous osteosarcomas of the distal radius. Tumors were imaged with MRI before and 48 hours after treatment, and the volumes of hypointense regions were compared. The treated limbs were amputated immediately after imaging at 48 hours and sectioned corresponding to the MR axial images. We identified tumor necrosis histologically; the regions of necrosis corresponded anatomically to hypointense tissue on MRI. The mean volume of necrotic tissue seen on MRI after photodynamic therapy was 21,305 mm3 compared with a pretreatment volume of 6108 mm3. These pilot data suggest photodynamic therapy penetrates relatively large canine osseous tumors and may be a useful adjunct for treatment of bone tumors
Cost-Effectiveness of Haemorrhoidal Artery Ligation versus Rubber Band Ligation for the Treatment of Grade II–III Haemorrhoids: Analysis Using Evidence from the HubBLe Trial
Aim Haemorrhoids are a common condition, with nearly
30,000 procedures carried out in England in 2014/15, and
result in a significant quality-of-life burden to patients and
a financial burden to the healthcare system. This study
examined the cost effectiveness of haemorrhoidal artery
ligation (HAL) compared with rubber band ligation (RBL)
in the treatment of grade II–III haemorrhoids.
Method This analyses used data from the HubBLe study, a
multicentre, open-label, parallel group, randomised controlled
trial conducted in 17 acute UK hospitals between
September 2012 and August 2015. A full economic evaluation,
including long-term cost effectiveness, was conducted
from the UK National Health Service (NHS)
perspective. Main outcomes included healthcare costs,
quality-adjusted life-years (QALYs) and recurrence. Costeffectiveness
results were presented in terms of incremental
cost per QALY gained and cost per recurrence
avoided. Extrapolation analysis for 3 years beyond the trial
follow-up, two subgroup analyses (by grade of haemorrhoids
and recurrence following RBL at baseline), and
various sensitivity analyses were undertaken.
Results In the primary base-case within-trial analysis, the
incremental total mean cost per patient for HAL compared
with RBL was £1027 (95% confidence interval [CI] £782–
£1272, p\0.001). The incremental QALYs were 0.01
QALYs (95% CI -0.02 to 0.04, p = 0.49). This generated
an incremental cost-effectiveness ratio (ICER) of £104,427
per QALY. In the extrapolation analysis, the estimated
probabilistic ICER was £21,798 per QALY. Results from
all subgroup and sensitivity analyses did not materially
change the base-case result.
Conclusions Under all assessed scenarios, the HAL procedure
was not cost effective compared with RBL for the
treatment of grade II-III haemorrhoids at a cost-effectiveness
threshold of £20,000 per QALY; therefore
Genetic Variation in Soluble Epoxide Hydrolase (EPHX2) Is Associated With Forearm Vasodilator Responses in Humans
Cytochrome P450-derived epoxyeicosatrienoic acids are potent vasodilators in preclinical models and are hydrolyzed by soluble epoxide hydrolase (EPHX2). Associations between the EPHX2 Lys55Arg and Arg287Gln polymorphisms and cardiovascular disease risk have been reported; however, their impact on vascular function in humans has not been investigated. In 265 volunteers (198 white, 67 black American), forearm blood flow was measured by strain-gauge venous occlusion plethysmography at baseline and in response to bradykinin, methacholine and sodium nitroprusside. Forearm vascular resistance was calculated as mean arterial pressure/forearm blood flow. In white Americans, Lys55Arg genotype was associated with vasodilator response to bradykinin, such that forearm blood flow was significantly lower (P=0.043) and forearm vascular resistance was significantly higher (P=0.013) in Arg55 variant allele carriers compared to wild-type individuals. Significant associations were also observed with methacholine and sodium nitroprusside. In contrast, no relationship was observed in black Americans. In black Americans, Arg287Gln genotype was associated with vasodilator response to bradykinin. Although the difference in forearm blood flow did not reach statistical significance (P=0.058), forearm vascular resistance was significantly lower (P=0.037) in Gln287 variant allele carriers compared to wild-type individuals. Significant associations were also observed with methacholine and sodium nitroprusside. In white Americans, Gln287 variant allele carriers did not exhibit significantly higher forearm blood flow (P=0.128) or lower forearm vascular resistance (P=0.080). Genetic variation in EPHX2 is associated with forearm vasodilator responses in a bradykinin receptor- and endothelium-independent manner, suggesting an important role for soluble epoxide hydrolase in the regulation of vascular function in humans
Powers, inequalities and vulnerabilities
This research addresses the gap that is present in both missiology and family and youth ministry. Missiology does not focus on children and youth specifically, while this is the largest population in the developing world. On the other hand, family and youth ministry has a more pastoral than missional approach, not always taking cognisance of contexts like globalisation. Thus, the purpose of the book is to address the sometimes unintended and unnoticed influence of globalisation on the mission of the church, with a specific focus on children, youth and family. For this purpose, the International Association for Mission Studies study group for children, youth and families coming from different parts of the world decided to describe the powers, inequalities and vulnerabilities of children, youth and families in a globalised world from their specific contexts. Although the most prominent research methodology was critical literature studies, methods like autoethnographic, and empirical methods were also used. No decisions were made on a specific method of research for this publication. This publication can be viewed as an interdisciplinary and intra-disciplinary, because it deals with social sciences, anthropology, psychology, missiology, systematic theology and practical theology
Comparison of stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease (eTHoS): a pragmatic, multicentre, randomised controlled trial
Background Two commonly performed surgical interventions are available for severe (grade II–IV) haemorrhoids;
traditional excisional surgery and stapled haemorrhoidopexy. Uncertainty exists as to which is most eff ective. The
eTHoS trial was designed to establish the clinical effectiveness and cost-eff ectiveness of stapled haemorrhoidopexy
compared with traditional excisional surgery.
Methods The eTHoS trial was a large, open-label, multicentre, parallel-group, pragmatic randomised controlled trial
done in adult participants (aged 18 years or older) referred to hospital for surgical treatment for grade II–IV
haemorrhoids. Participants were randomly assigned (1:1) to receive either traditional excisional surgery or stapled
haemorrhoidopexy. Randomisation was minimised according to baseline EuroQol 5 dimensions 3 level
score (EQ-5D-3L), haemorrhoid grade, sex, and centre with an automated system to stapled haemorrhoidopexy or
traditional excisional surgery. The primary outcome was area under the quality of life curve (AUC) measured with the
EQ-5D-3L descriptive system over 24 months, assessed according to the randomised groups. The primary outcome
measure was analysed using linear regression with adjustment for the minimisation variables. This trial is registered
with the ISRCTN registry, number ISRCTN80061723.
Findings Between Jan 13, 2011, and Aug 1, 2014, 777 patients were randomised (389 to receive stapled haemorrhoidopexy
and 388 to receive traditional excisional surgery). Stapled haemorrhoidopexy was less painful than traditional
excisional surgery in the short term and surgical complication rates were similar between groups. The
EQ-5D-3L AUC score was higher in the traditional excisional surgery group than the stapled haemorrhoidopexy
group over 24 months; mean diff erence –0·073 (95% CI –0·140 to –0·006; p=0·0342). EQ-5D-3L was higher for
stapled haemorrhoidopexy in the fi rst 6 weeks after surgery, the traditional excisional surgery group had signifi cantly
better quality of life scores than the stapled haemorrhoidopexy group. 24 (7%) of 338 participants who received
stapled haemorrhoidopexy and 33 (9%) of 352 participants who received traditional excisional surgery had serious
adverse events.
Interpretation As part of a tailored management plan for haemorrhoids, traditional excisional surgery should be
considered over stapled haemorrhoidopexy as the surgical treatment of choice
Experiences of wearing support garments by people living with a urostomy
BACKGROUND:support garments are commonly worn by people with a urostomy but there are no published data about their experiences of doing so. AIMS:to identify the views of people living with a urostomy on the role of support garments. METHODS:a cross-sectional survey of the stoma population's experiences of support garments was conducted in 2018. Recruitment was by social media. The free-text responses provided by a sub-sample of 58 people out of 103 respondents with a urostomy, were analysed. FINDINGS:thematic analysis revealed four themes: physical self-management; psychosocial self-management; lifestyle; and healthcare advice and support. There were mixed feelings about the value of support garments. Many cited a sense of reassurance and confidence and being able to be more sociable and active; others reported discomfort and uncertainty about their value. CONCLUSION:these findings add new understanding of experiences of support garments and provide novel theoretical insights about life with a urostomy
- …