Productivity Analysis of German Electricity Distribution Utilities

The paper is the first productivity analysis of a large number of German electricity distributors to date. In it, we address both traditional issues of electricity sector benchmarking, such as the role of scale effects and optimal utility size, as well as new evidence specific to the situation in Germany. Regarding the latter, we consider the potential effects of three structural variables: consumer density, grid composition (cable versus aerial lines), and differences between East and West German distribution companies. Our empirical section thus follows the structural criteria set out by the German association agreements (?Verbändevereinbarung Strom VV II+?). The data covers 380 (out of 553) German electricity distribution utilities

Infrastrukturausbau in Europa - mehr Investitionen und höhere Effizienz durch bessere Regulierung?: Ergebnisse einer internationalen Konferenz des DIW Berlin

Angesichts eines langfristigen Infrastrukturdefizits in Europa sowie kurzfristig spektakulärer Infrastrukturausfälle (wie des Stromausfalls in Italien am 28. September 2003) stellt sich sowohl auf europäischer als auch auf deutscher Ebene die Frage nach den richtigen wirtschaftspolitischen Antworten. Dies gilt insbesondere für strategische Infrastruktursektoren, die in den 90er Jahren liberalisiert wurden, etwa für die Verkehrswirtschaft sowie die Elektrizitäts- und Gaswirtschaft. Mit diesen Themen beschäftigte sich ein internationaler Workshop, den das DIW Berlin in Kooperation mit dem Fachgebiet Wirtschafts- und Infrastrukturpolitik der Technischen Universität Berlin im Oktober 2003 veranstaltete. Zentrales Ergebnis war, dass Investitionen in liberalisierten Infrastrukturmärkten einer marktorientierten Regulierung bedürfen, die feste Rahmenbedingungen für Investoren schafft, ohne dem Endverbraucher überhöhte Preise aufzuerlegen. Die richtigen Rahmenbedingungen für Investitionen sind wichtiger als von staatlicher Hand zur Verfügung gestellte finanzielle Mittel. Insofern ist das gerade von der Europäischen Kommission verabschiedete Konzept transeuropäischer Infrastrukturprogramme ("van-Miert-Plan") kritisch zu beurteilen, in denen erhebliche Mittel (insgesamt etwa 600 Mrd. Euro) an nur relativ wenige Projekte gebunden werden sollen. Deutschland nimmt bei der Infrastrukturregulierung im europäischen Vergleich einen der hinteren Plätze ein. Hier ist der Aufbau einer Regulierungsbehörde für Netzwerkindustrien ein Schritt in die richtige Richtung. Dies sollte aber nicht zu einer ausufernden staatlichen Einflussnahme führen

Constraints on the Formation of the Galactic Bulge from Na, Al, and Heavy Element Abundances in Plaut's Field

We report chemical abundances of Na, Al, Zr, La, Nd, and Eu for 39 red giant branch (RGB) stars and 23 potential inner disk red clump stars located in Plaut-s low extinction window. We also measure lithium for a super Li-rich RGB star. The abundances were determined by spectrum synthesis of high resolution (R~25,000), high signal-to-noise (S/N~50-100 pixel-1) spectra obtained with the Blanco 4m telescope and Hydra multifiber spectrograph. For the bulge RGB stars, we find a general increase in the [Na/Fe] and [Na/Al] ratios with increasing metallicity, and a similar decrease in [La/Fe] and [Nd/Fe]. Additionally, the [Al/Fe] and [Eu/Fe] abundance trends almost identically follow those of the {\alpha}-elements, and the [Zr/Fe] ratios exhibit relatively little change with [Fe/H]. The consistently low [La/Eu] ratios of the RGB stars indicate that at least a majority of bulge stars formed rapidly (<1 Gyr) and before the main s-process could become a significant pollution source. In contrast, we find that the potential inner disk clump stars exhibit abundance patterns more similar to those of the thin and thick disks. Comparisons between the abundance trends at different bulge locations suggest that the inner and outer bulge formed on similar timescales. However, we find evidence of some abundance differences between the most metal-poor and metal-rich stars in various bulge fields. The data also indicate that the halo may have had a more significant impact on the outer bulge initial composition than the inner bulge composition. The [Na/Fe] and to a lesser extent [La/Fe] abundances further indicate that the metal-poor bulge, at least at ~1 kpc from the Galactic center, and thick disk may not share an identical chemistry.Comment: Accepted for publication in ApJ; 66 pages, 17 figures, 3 tables; prior to publication, data tables in electronic form will be made available upon reques

Rationale and design of decision: a double-blind, randomized, placebo-controlled phase III trial evaluating the efficacy and safety of sorafenib in patients with locally advanced or metastatic radioactive iodine (RAI)-refractory, differentiated thyroid cancer

<p>Abstract</p> <p>Background</p> <p>The incidence of thyroid cancer and the number of patients who die from this disease are increasing globally. Differentiated thyroid cancer (DTC) is the histologic subtype present in most patients and is primarily responsible for the increased overall incidence of thyroid cancer. Sorafenib is a multikinase inhibitor that targets several molecular signals believed to be involved in the pathogenesis of thyroid cancer, including those implicated in DTC. In phase II studies of patients with DTC, sorafenib treatment has yielded a median progression-free survival (PFS) of 58 to 84 weeks and disease control rates of 59% to 100%. The DECISION trial was designed to assess the ability of sorafenib to improve PFS in patients with locally advanced or metastatic, radioactive iodine (RAI)-refractory DTC.</p> <p>Methods/design</p> <p>DECISION is a multicenter, double-blind, randomized, placebo-controlled phase III study in patients with locally advanced/metastatic RAI<b>-</b>refractory DTC. Study treatment will continue until radiographically documented disease progression, unacceptable toxicity, noncompliance, or withdrawal of consent. Efficacy will be evaluated every 56 days (2 cycles), whereas safety will be evaluated every 28 days (1 cycle) for the first 8 months and every 56 days thereafter. Following disease progression, patients may continue or start sorafenib, depending on whether they were randomized to receive sorafenib or placebo, at investigator discretion. Patients originally randomized to receive sorafenib will be followed up every 3 months for overall survival (OS); patients originally randomized to receive placebo will be followed up every month for 8 months after cross-over to sorafenib. The duration of the trial is expected to be 30 months from the time the first patient is randomized until the planned number of PFS events is attained. The primary endpoint is PFS; secondary endpoints include OS, time to disease progression, disease control rate, response rate, duration of response, safety, and pharmacokinetic analysis.</p> <p>Discussion</p> <p>The DECISION study has been designed to test whether sorafenib improves PFS in patients with locally advanced or metastatic RAI-refractory DTC.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov Identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00984282">NCT00984282</a>; EudraCT: 2009-012007-25.</p

Effect of crossover from placebo to darolutamide on overall survival in men with non-metastatic prostate cancer : sensitivity analyses from the randomised phase 3 ARAMIS study

Background: In the phase 3 ARAMIS study (NCT02200614), darolutamide significantly improved metastasis-free survival in patients with non-metastatic castration-resistant prostate cancer (nmCRPC). Following the primary analysis, the study was unblinded, and placebo recipients were permitted to cross over to open-label darolutamide. Despite crossover, darolutamide significantly improved overall survival (OS). We conducted sensitivity analyses to estimate the effect of placebo–darolutamide crossover on OS. Methods: Patients with nmCRPC were randomised to oral darolutamide 600 mg twice daily (n = 955) or placebo (n = 554). Prespecified (rank-preserving structural failure time [RPSFT] and iterative parameter estimation [IPE]) and post hoc (OS-adjusted censoring and inverse probability of censoring weighting [IPCW], with weightings for baseline testosterone and prostate-specific antigen) sensitivity analyses were conducted. Results: After unblinding, 170 of 554 placebo recipients (30.7%) crossed over to darolutamide. At the final OS intention-to-treat analysis (median 11.2 months after unblinding), darolutamide significantly improved OS by 31% versus placebo (hazard ratio [HR] 0.69, 95% confidence interval [CI] 0.53–0.88; P = 0.003). The benefit increased in the analyses adjusting for crossover is as follows: RPSFT HR 0.68, 95% CI 0.51–0.90; P = 0.007; IPE HR 0.66, 95% CI 0.51–0.84; P < 0.001; OS-adjusted censoring HR 0.59, 95% CI 0.45–0.76; IPCW HR 0.63, 95% CI 0.48–0.81. The favourable safety profile of darolutamide was maintained, including in crossover patients. Conclusions: After adjusting for crossover, darolutamide reduced the risk of death by up to 41% in patients with nmCRPC. The effect of darolutamide on OS may have been underestimated in the original intention-to-treat analysis.Peer reviewe

The Development and Validation of a Novice Nurse Decision-Making Skills Education Curriculum

Novice nurses (NNs) are entering critical care environments with limited knowledge, skills, and decision-making expertise. They are expected to care for complex patients in a dynamic healthcare setting. The research question for this project examined whether NNs improve their knowledge and skills by participating in a nursing decision-making skills curriculum. The purpose of the project was to develop and validate a nursing decision-making skills education curriculum working in an intermediate critical care unit. Taba\u27s instructional theoretical model was used to guide the new curriculum development along with current evidence based practice found in the current literature. Scaffolding approach theory encouraged the use of more knowledgeable peers or educators to assist NN with skill acquisition. Project participants consisted of 5 local learning specialists in critical-care nursing with a minimum of a bachelor\u27s of science degree in nursing as well as national certifications. Upon curriculum review completion, each of the 5 specialists were asked to complete a 5-point Likert scale survey to evaluate the content of the newly developed curriculum. Descriptive analysis was completed on the survey data. Three of the 5 learning specialists agreed and 2 strongly agreed that the program met its stated objectives. Three of the learning specialists strongly agreed and 2 agreed that the course content was relevant to NNs\u27 day-to-day roles and that the material and resources facilitated the development of decision-making skills. Adjunct NN education may promote positive social change by providing an effective strategy for improving decision-making skills among NNs, potentially leading to improved patient outcomes in a healthier community with a skilled healthcare workforce

Moving in the anthropocene: global reductions in terrestrial mammalian movements

Animal movement is fundamental for ecosystem functioning and species survival, yet the effects of the anthropogenic footprint on animal movements have not been estimated across species. Using a unique GPS-tracking database of 803 individuals across 57 species, we found that movements of mammals in areas with a comparatively high human footprint were on average one-half to one-third the extent of their movements in areas with a low human footprint. We attribute this reduction to behavioral changes of individual animals and to the exclusion of species with long-range movements from areas with higher human impact. Global loss of vagility alters a key ecological trait of animals that affects not only population persistence but also ecosystem processes such as predator-prey interactions, nutrient cycling, and disease transmission

Hippocampal pyramidal cells: the reemergence of cortical lamination

The increasing resolution of tract-tracing studies has led to the definition of segments along the transverse axis of the hippocampal pyramidal cell layer, which may represent functionally defined elements. This review will summarize evidence for a morphological and functional differentiation of pyramidal cells along the radial (deep to superficial) axis of the cell layer. In many species, deep and superficial sublayers can be identified histologically throughout large parts of the septotemporal extent of the hippocampus. Neurons in these sublayers are generated during different periods of development. During development, deep and superficial cells express genes (Sox5, SatB2) that also specify the phenotypes of superficial and deep cells in the neocortex. Deep and superficial cells differ neurochemically (e.g. calbindin and zinc) and in their adult gene expression patterns. These markers also distinguish sublayers in the septal hippocampus, where they are not readily apparent histologically in rat or mouse. Deep and superficial pyramidal cells differ in septal, striatal, and neocortical efferent connections. Distributions of deep and superficial pyramidal cell dendrites and studies in reeler or sparsely GFP-expressing mice indicate that this also applies to afferent pathways. Histological, neurochemical, and connective differences between deep and superficial neurons may correlate with (patho-) physiological phenomena specific to pyramidal cells at different radial locations. We feel that an appreciation of radial subdivisions in the pyramidal cell layer reminiscent of lamination in other cortical areas may be critical in the interpretation of studies of hippocampal anatomy and function