1,730 research outputs found
Cost effectiveness analysis of laparoscopic hysterectomy compared with standard hysterectomy: results from a randomised trial
Objective: To assess the cost effectiveness of laparoscopic hysterectomy compared with conventional hysterectomy (abdominal or vaginal). Design: Cost effectiveness analysis based on two parallel trials: laparoscopic (n = 324) compared with vaginal hysterectomy (n = 163); and laparoscopic (n = 573) compared with abdominal hysterectomy (n = 286). Participants: 1346 women requiring a hysterectomy for reasons other than malignancy. Main outcome measure: One year costs estimated from NHS perspective. Health outcomes expressed in terms of QALYs based on women's responses to the EQ-5D at baseline and at three points during up to 52 weeks' follow up. Results: Laparoscopic hysterectomy cost an average of pound401 (471789; E380 437). The, probability that laparoscopic hysterectomy is cost effective was below 50% for a large range of values of willingness to pay for an additional QALY. Laparoscopic hysterectomy cost an average of pound186 (46 893; E37 813). If the NHS is willing to pay pound30 0 00 for an additional QALY, the probability that laparoscopic hysterectomy is cost effective is 56%. Conclusions: Laparoscopic hysterectomy is not cost effective relative to vaginal hysterectomy. Its cost effectiveness relative to the abdominal procedure is finely balanced
Northeastern Forest Experiment Station: Oak Site Index and Biomass Yield in Upland Oak and Cove Hardwood Timber Types in West Virginia
Extending the Ehresmann-Schein-Nambooripad Theorem
We extend the `join-premorphisms' part of the Ehresmann-Schein-Nambooripad
Theorem to the case of two-sided restriction semigroups and inductive
categories, following on from a result of Lawson (1991) for the `morphisms'
part. However, it is so-called `meet-premorphisms' which have proved useful in
recent years in the study of partial actions. We therefore obtain an
Ehresmann-Schein-Nambooripad-type theorem for meet-premorphisms in the case of
two-sided restriction semigroups and inductive categories. As a corollary, we
obtain such a theorem in the inverse case.Comment: 23 pages; final section on Szendrei expansions removed; further
reordering of materia
Six Developmental Trajectories Characterize Children With Autism
The goal of this study was to describe the typical longitudinal developmental trajectories of social and communication functioning in children with autism and to determine the correlates of these trajectories
The eVALuate study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy
OBJECTIVE: To compare the effects of laparoscopic hysterectomy
and abdominal hysterectomy in the abdominal trial, and
laparoscopic hysterectomy and vaginal hysterectomy in the
vaginal trial.
DESIGN: Two parallel, multicentre, randomised trials.
Setting 28 UK centres and two South African centres.
Participants 1380 women were recruited; 1346 had surgery;
937 were followed up at one year.
PRIMARY OUTCOME: outcome Rate of major complications.
RESULTS: In the abdominal trial laparoscopic hysterectomy was
associated with a higher rate of major complications than
abdominal hysterectomy (11.1% v 6.2%, P = 0.02; difference
4.9%, 95% confidence interval 0.9% to 9.1%) and the number
needed to treat to harm was 20. Laparoscopic hysterectomy
also took longer to perform (84 minutes v 50 minutes) but was
less painful (visual analogue scale 3.51 v 3.88, P = 0.01) and
resulted in a shorter stay in hospital after the operation (3 days
v 4 days). Six weeks after the operation, laparoscopic
hysterectomy was associated with less pain and better quality of
life than abdominal hysterectomy (SF-12, body image scale, and
sexual activity questionnaires).
In the vaginal trial we found no evidence of a difference in
major complication rates between laparoscopic hysterectomy
and vaginal hysterectomy (9.8% v 9.5%, P = 0.92; difference
0.3%, − 5.2% to 5.8%), and the number needed to treat to harm
was 333.We found no evidence of other differences between
laparoscopic hysterectomy and vaginal hysterectomy except
that laparoscopic hysterectomy took longer to perform (72
minutes v 39 minutes) and was associated with a higher rate of
detecting unexpected pathology (16.4% v 4.8%, P = < 0.01).
However, this trial was underpowered.
CONCLUSIONS: Laparoscopic hysterectomy was associated with a
significantly higher rate of major complications than abdominal
hysterectomy. It also took longer to perform but was associated
with less pain, quicker recovery, and better short term quality of
life. The trial comparing vaginal hysterectomy with laparoscopic
hysterectomy was underpowered and is inconclusive on the rate
of major complications; however, vaginal hysterectomy took less
time
The influence of risk factors associated with captive rearing on post-release survival in translocated cirl buntings Emberiza cirlus in the UK
Population decline resulting from agricultural intensification led to contraction of the range of the cirl bunting Emberiza cirlus in the UK to a small area of south Devon. As part of the UK Biodiversity Action Plan for the species, a project to re-establish a population in suitable habitat in Cornwall was undertaken during 2006–2011, in which chicks were removed from the nest in Devon, hand-reared and then delayed-released. The survival of the birds to four time points in the year after release was analysed in relation to the effect of rearing factors, using a multivariable logistic regression model. Individuals with higher body weight at capture were more likely to survive to 1 January and 1 May in the year following release, and individuals released in June and July were more likely to survive than those released in August. Individuals released in 2006 and 2011 had a higher survival rate than those released during 2007–2010. Timing of capture, time spent at each stage in captivity, medication and the detection of parasites in the brood had no significant effect. Immunosuppressive disease, weather factors and predator activity may have led to some of the observed differences in survival. This analysis provides evidence with which to plan future translocation projects for cirl buntings and other passerine birds
Eyelid eversion for visualisation of the upper eyelid lamellae: An anatomical cadaver study
Oculoplastics Paper SessionControversy persists in surgical eyelid anatomy despite the routine use of microanatomical examination in modern eyelid research. The aim of our study was to facilitate visualisation of upper eyelid anatomy by optimising the orientation of cadaveric specimens. We studied the anatomy of everted eyelids, providing an excellent histological view of the posterior approach to the eyelid commonly used in surgery. Non-traumatic separation of the eyelid lamellae provides a new view of the eyelid's lamellar nature. Further application of this model may enhance understanding of the multilayered aspect of the levator aponeurosis. The technique may improve intraoperative understanding of critical eyelid anatomy and promote safer and more effective eyelid surgery.published_or_final_versionThe 26th Asia Pacific Academy of Ophthalmology Congress (APAO 2011), Sydney, Australia, 20-24 March 2011. In British Journal of Ophthalmology, 2011, v. 95 n. 10, p. 1376-137
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Caustic Recycle from Hanford Tank Waste Using Large Area NaSICON Structures (LANS)
This report presents the results of a 5-day test of an electrochemical bench-scale apparatus using a proprietary (NAS-GY) material formulation of a (Na) Super Ion Conductor (NaSICON) membrane in a Large Area NaSICON Structures (LANS) configuration. The primary objectives of this work were to assess system performance, membrane seal integrity, and material degradation while removing Na from Group 5 and 6 tank waste from the Hanford Site
The importance of soil and vegetation characteristics for establishing ground nesting bee aggregations
Most bee species are ground-nesters, yet knowledge on the nesting behaviour of this diverse group remains sparse. Evidence on the effectiveness of ground-nesting bee species as crop pollinators is growing, but there is limited information on their nesting habits and preferences and how to manage habitats to enhance populations on farms. In this study, artificially prepared plots of bare soil were constructed with the aim to attract ground-nesting bees to nest in a commercial orchard in Kent, UK. Nine soil parameters were measured to determine their preferred soil properties: hydraulic conductivity, soil compaction, soil moisture, soil temperature, soil stoniness, soil organic matter, soil root biomass, soil texture and vegetation cover. Eighteen non-parasitic ground-nesting bee species (7 Andrena, 9 Lasioglossum, 1 Halictus and 1 Colletes spp.) were recorded in the study plots. Soil stoniness and soil temperature at 10cm depth were positively correlated, and vegetation cover and hydraulic conductivity were negatively correlated with the number of ground-nesting bees on the plots. We show that artificially created habitats can be exploited for nesting by several ground-nesting bee species. This study’s findings can inform management practices to enhance ground-nesting bee populations in agricultural and urban areas
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