1,954 research outputs found

    A feasibility study of signed consent for the collection of patient identifiable information for a national paediatric clinical audit database

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    Objectives: To investigate the feasibility of obtaining signed consent for submission of patient identifiable data to a national clinical audit database and to identify factors influencing the consent process and its success. Design: Feasibility study. Setting: Seven paediatric intensive care units in England. Participants: Parents/guardians of patients, or patients aged 12-16 years old, approached consecutively over three months for signed consent for submission of patient identifiable data to the national clinical audit database the Paediatric Intensive Care Audit Network (PICANet). Main outcome measures: The numbers and proportions of admissions for which signed consent was given, refused, or not obtained (form not returned or form partially completed but not signed), by age, sex, level of deprivation, ethnicity (South Asian or not), paediatric index of mortality score, length of hospital stay (days in paediatric intensive care). Results: One unit did not start and one did not fully implement the protocol, so analysis excluded these two units. Consent was obtained for 182 of 422 admissions (43%) (range by unit 9% to 84%). Most (101/182; 55%) consents were taken by staff nurses. One refusal (0.2%) was received. Consent rates were significantly better for children who were more severely ill on admission and for hospital stays of six days or more, and significantly poorer for children aged 10-14 years. Long hospital stays and children aged 10-14 years remained significant in a stepwise regression model of the factors that were significant in the univariate model. Conclusion: Systematically obtaining individual signed consent for sharing patient identifiable information with an externally located clinical audit database is difficult. Obtaining such consent is unlikely to be successful unless additional resources are specifically allocated to training, staff time, and administrative support

    Osteogenic Cells Derived From Embryonic Stem Cells Produced Bone Nodules in Three-Dimensional Scaffolds

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    An approach for 3D bone tissue generation from embryonic stem (ES) cells was investigated. The ES cells were induced to differentiate into osteogenic precursors, capable of proliferating and subsequently differentiating into bone-forming cells. The differentiated cells and the seeded scaffolds were characterized using von Kossa and Alizarin Red staining, electron microscopy, and RT-PCR analysis. The results demonstrated that ES-derived bone-forming cells attached to and colonized the biocompatible and biodegradable scaffolds. Furthermore, these cells produced bone nodules when grown for 3ā€“4 weeks in mineralization medium containing ascorbic acid and beta-glycerophosphate both in tissue culture plates and in scaffolds. The differentiated cells also expressed osteospecific markers when grown both in the culture plates and in 3D scaffolds. Osteogenic cells expressed alkaline phosphatase, osteocalcin, and osteopontin, but not an ES cell-specific marker, oct-4. These findings suggest that ES cell can be used for in vitro tissue engineering and cultivation of graftable skeletal structures

    Studying the Optimal Scheduling for Controlling Prostate Cancer under Intermittent Androgen Suppression

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    This retrospective study shows that the majority of patientsā€™ correlations between PSA and Testosterone during the on-treatment period is at least 0.90. Model-based duration calculations to control PSA levels during off-treatment are provided. There are two pairs of models. In one pair, the Generalized Linear Model and Mixed Model are both used to analyze the variability of PSA at the individual patient level by using the variable ā€œPatient IDā€ as a repeated measure. In the second pair, Patient ID is not used as a repeated measure but additional baseline variables are included to analyze the variability of PSA

    Numerical simulation of a new type of cross flow tidal turbine using OpenFOAM - Part II: Investigation of turbine-to-turbine interaction

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    Copyright Ā© 2013 Elsevier. NOTICE: this is the authorā€™s version of a work that was accepted for publication in Renewable Energy. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Renewable Energy, Volume 50 (2013), DOI: 10.1016/j.renene.2012.08.064Prediction of turbine-to-turbine interaction represents a significant challenge in determining the optimized power output from a tidal stream farm, and this is an active research area. This paper presents a detailed work which examines the influence of surrounding turbines on the performance of a base case (isolated turbine). The study was conducted using a new CFD based, Immersed Body Force (IBF) model, which was validated in the first paper, and an open source CFD software package OpenFOAM was used for the simulations. The influence of the surrounding turbines was investigated using randomly chosen initial lateral and longitudinal spacing among the turbines. The initial spacing was then varied to obtain four configurations to examine the relative effect that positioning can have on the performance of the base turbine

    A simple optimal randomized algorithm for sorting on the PDM

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    The Parallel Disks Model (PDM) has been proposed to alleviate the I/O bottleneck that arises in the processing of massive data sets. Sorting has been extensively studied on the PDM model due to the fundamental nature of the problem. Several randomized algorithms are known for sorting. Most of the prior algorithms suffer from undue complications in memory layouts, implementation, or lack of tight analysis. In this paper we present a simple randomized algorithm that sorts in optimal time with high probablity and has all the desirable features for practical implementation

    A Gradualist Approach to Criminality: Early British Socialists, Utopia and Crime

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    The attitudes of early British socialists to criminality are a thoroughly under-researched area of historical scholarship. This paper draws on the utopian ideas of Robert Owen, William Morris, H. G. Wells, Robert Blatchford, Edward Carpenter and Ramsay MacDonald as a vehicle for investigating the attitudes of mainstream fin de siĆØcle British socialists to crime, punishment and penal reform. Placing these figures and their utopias along a spectrum that sees radical ā€˜Arcadianā€™ socialists on the far left, ā€˜technologicalā€™ socialists on the far right, and moderate socialists occupying the middle ground, it presents two principal findings. First it demonstrates how crime was predicted by most of the left to decrease to a minimum level under socialism. ā€˜Arcadiansā€™, ā€˜technologicalā€™ and moderate socialists invoked different methods in this pursuit, but each were in essence grappling with the same broader issue of the relationship of the individual to the state under socialism. Secondly, examining the multifaceted ideological heritage of the British left in relation to their approaches to crime, it is argued that, despite the leftā€™s gradualist philosophy, their own attitudes to criminality actually closely reflected utopian conceptions. Examination of these issues offers an important opportunity to re-evaluate the evolution of British socialist thought
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