Issues in higher education policy : an update on higher education policy issues in 2004 in 11 Western countries

Higher education is a dynamic field. It is, however, also a field where changes don¿t take place overnight. This 2004 update report covers a period of 1.5 years, a period in which some earlier policy initiatives have been implemented and new ones have emerged. It is therefore not surprising to observe that many of the policy issues on the agenda in the previous Update Report (April, 2003) still are a topic of debate today.\ud The main part of the report are the descriptions of the current (2004) higher education debates and policy initiatives for each of the eleven IHEM countries, arranged in four themes educational and research infrastructure, finance, governance and quality. In conclusion, four `overarching¿ policy issues in contemporary European (and Australian) higher education are discussed. These issues are:\ud * The Bologna process and changing degree structures\ud * The changing organisation of research\ud * Financial accountability and responsibility\ud * Interactive governanc

Limited diagnostic yield of non-invasive coronary angiography by 16-slice multi-detector spiral computed tomography in routine patients referred for evaluation of coronary artery disease

Aims Multislice spiral computed tomography (MSCT) is a promising non-invasive method to diagnose coronary artery disease (CAD). As no detailed comparative evaluation in consecutive patients referred for evaluation of CAD has been reported, this prospective study evaluating 2384 coronary segments in 149 consecutive patients was performed. Methods and results The coronary artery tree was analysed in 16 segments both for coronary angiography (CA) and MSCT; a luminal narrowing ≥50% based on visual assessment was considered significant. By MSCT, 77% of 2110 angiographically assessable segments could be evaluated, 94% per patient in proximal and 70% in distal segments (P<0.001). Sensitivity of MSCT to detect significant stenoses was 30% in all, but only 10% in peripheral segments. The main limitations were calcifications in 34% of segments and motion artefacts in 24% of patients. Overall diagnostic sensitivity for the presence of significant CAD was 86% but specificity was only 49%. Conclusion When compared with invasive CA, 16-slice MSCT is of limited diagnostic value for the diagnosis of CAD in consecutive patients. Despite a clinically useful sensitivity for the overall diagnosis of significant CAD, specificity is low. Thus, relevant decisions regarding the need of and suitability for possible revascularization procedures cannot be based on MSCT findings alon

Un estudio comparativo de actuadores Piezoeléctricos y Magnetoestrictivos para estructuras inteligentes

[EN] This paper introduces a comparative analysis of Piezoelectric (PZ) and Magnetostrictive (MS) actuators as components in smart structures. There is an increasing interest in functional structures which are able to adapt to external or internal perturbations, i.e. changes in loading conditions or ageing. Actuator technologies must perform concomitantly as sensors and actuators to be applicable in smart structures. In this paper we will comparatively analyze the possibility of using PZ and MS actuators in smart structures and in so doing their capability to act concomitantly as sensors and of modifying their material characteristics. We will also focus on the analysis of how them can be integrated in structures and on the analysis of the most appropriate structures for each actuator. The operational performance of PZ (Stacks) and MS actuators will be compared and eventually some conclusions will be drawn.[ES] Este artículo presenta un estudio comparativo de actuadores Piezoeléctricos (PZ) y Magnetoestrictivos (MS) como elementos integrantes de estructuras inteligentes. Existe un interés creciente en estructuras activas que puedan adaptarse a perturbaciones tanto internas como externas, por ejemplo, ante cambios en carga estructural o ante su envejecimiento. Para que un actuador forme parte de una estructura inteligente, debe poder actuar también como sensor. Este artículo presenta un estudio comparativo del uso de actuadores PZ y MS en estructuras inteligentes y, como consecuencia, de su habilidad para actuar y medir simultáneamente así cómo para modificar sus características mecánicas. Nos centraremos también en el análisis de como pueden integrase en estructuras y cuales son las más indicadas para cada actuador. Se compararán las características operacionales de los actuadors PZ multicapa y los MS.Peer reviewe

Long-term benefit-risk balance of drug-eluting vs. bare-metal stents in daily practice: does stent diameter matter? Three-year follow-up of BASKET

Aims To assess the long-term benefit-risk ratio of drug-eluting (DES) vs. bare-metal stents (BMS) relative to stent size. Methods and results All 826 consecutive BASKET (BAsel Stent Kosten-Effektivitäts Trial) patients randomized 2:1 to DES vs. BMS were followed after 3 years. Data were analysed separately for patients with small stents (<3.0 mm vessel/<4.0 mm bypass grafts, n = 268) vs. only large stents (≥3.0 mm native vessels, n = 558). Clinical events were related to stent thrombosis. Three-year clinical target-vessel revascularization rates remained borderline reduced after DES [9.9 vs. 13.9% (BMS), P = 0.07], particularly in patients with small stents (10.7 vs. 19.8%, P = 0.03; large stents: 9.5 vs. 11.5%, P = 0.44). Cardiac death/myocardial infarction (MI) rates (12.7 vs. 10.0%, P = 0.30) were similar, however, death/MI beyond 6 months was higher after DES [9.1 vs. 3.8% (BMS), P = 0.009], mainly due to increased late death/MI in patients with large stents (9.7 vs. 3.1%, P = 0.006). The results paralleled findings for stent thrombosis. Conclusion The clinical benefit of DES was maintained at no overall increased risk of death or death/MI up to 3 years. However, death/MI rates were increased in DES vs. BMS patients beyond 6 months, particularly in patients with large stents, paralleling findings for stent thrombosis. Thus, stent size seems to influence the 3-year benefit-risk ratio after DES implantatio

Гидроимпульсный силовой механизм сваебойной машины в условиях обустройства месторождений

AbstractObjectivesThis study sought to evaluate whether objective assessment of the myocardial functional reserve, using strain rate imaging (SRI), allows accurate detection of viable myocardium.BackgroundStrain rate imaging is a new echocardiographic modality that allows quantitative assessment of segmental myocardial contractility.MethodsIn 37 patients (age 58 ± 9 years) with ischemic left ventricular dysfunction, myocardial viability was assessed using low-dose (10 μg/kg body weight per min) two-dimensional dobutamine stress echocardiography (DSE), tissue Doppler imaging, SRI and 18F-fluorodeoxyglucose (18FDG) positron emission tomography (PET). The peak systolic tissue Doppler velocity and peak systolic myocardial strain rate were determined at baseline and during low-dose dobutamine stress from the apical views.ResultsA total of 192 segments with dyssynergy at rest were classified by 18FDG PET as viable in 94 and nonviable in 98. An increase of peak systolic strain rate from rest to dobutamine stimulation by more than −0.23 1/s allowed accurate discrimination of viable from nonviable myocardium, as determined by 18FDG PET with a sensitivity of 83% and a specificity of 84%. Receiver operating characteristic (ROC) curve analysis showed an area under the curve for prediction of nonviable myocardium, as determined by 18FDG PET using SRI, of 0.89 (95% confidence interval [CI] 0.88 to 0.90), whereas the area under the ROC curve using tissue Doppler imaging was 0.63 (95% CI 0.61 to 0.65).ConclusionsThe increase in the peak systolic strain rate during low-dose dobutamine stimulation allows accurate discrimination between different myocardial viability states. Strain rate imaging is superior to two-dimensional DSE and tissue Doppler imaging for the assessment of myocardial viability

Risks and benefits of optimised medical and revascularisation therapy in elderly patients with angina - on-treatment analysis of the TIME trial

Aim To assess treatment effects of optimised medical therapy and PCI or CABG surgery on one-year outcome in patients ⩾75 years old with chronic angina. Methods and Results On-treatment analysis of the TIME data: all re-vascularised patients (REVASC \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} $n=174$ \end{document}: 112 randomised to revascularisation and 62 to drugs with late revascularisation) were compared to all patients on continued drug therapy (MED \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} $n=127$ \end{document}: 86 randomised to drugs and 41 to revascularisation only). Baseline characteristics of both groups were similar (age 80±4 years). Risk of death at one year (adjusted hazard ratio (HR)=1.31; 95%-CI: 0.58-2.99; \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} $P=0.52$ \end{document}) and of death/infarction (adjusted hazard ratio=1.77; 95%-CI 0.91-3.41; \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} $P=0.09$ \end{document}) were comparable between REVASC and MED patients. Furthermore, the risk of death within 30 days was even slightly lower among REVASC patients (unadjusted hazard ratio=0.73; 95%-CI: 0.21-2.53; \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} $P=0.98)$ \end{document}. Overall, REVASC patients had greater improvements in symptoms and well-being than MED patients \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} $(P{<}0.01)$ \end{document}. Surgical patients had similar mortality rates as angioplasty patients, but they also had greater symptomatic improvements \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} $(P{<}0.01)$ \end{document}. Conclusion Treated medically, elderly patients with chronic angina have a similarly high 30-day and one-year mortality as patients of the same age being re-vascularised; however, they can expect lower improvements in symptoms and well bein

Routine implementation costs of larviciding with Bacillus thuringiensis israelensis against malaria vectors in a district in rural Burkina Faso

Background: The key tools in malaria control are early diagnosis and treatment of cases as well as vector control. Current strategies for malaria vector control in sub-Saharan Africa are largely based on long-lasting insecticide-treated nets (LLINs) and to a much smaller extent on indoor residual spraying (IRS). An additional tool in the fight against malaria vectors, larval source management (LSM), has not been used in sub-Saharan Africa on a wider scale since the abandonment of environmental spraying of DDT. Increasing concerns about limitations of LLINs and IRS and encouraging results from large larvicide-based LSM trials make a strong case for using biological larviciding as a complementary tool to existing control measures. Arguments that are often quoted against such a combined approach are the alleged high implementation costs of LSM. This study makes the first step to test this argument. The implementation costs of larval source management based on Bacillus thuringiensis israelensis (Bti) (strain AM65-52) spraying under different implementation scenarios were analysed in a rural health district in Burkina Faso. Methods: The analysis draws on detailed cost data gathered during a large-scale LSM intervention between 2013 and 2015. All 127 villages in the study setup were assigned to two treatment arms and one control group. Treatment either implied exhaustive spraying of all available water collections or targeted spraying of the 50 % most productive larval sources via remote-sensing derived and entomologically validated risk maps. Based on the cost reports from both intervention arms, the per capita programme costs were calculated under the assumption of covering the whole district with either intervention scenario. Cost calculations have been generalized by providing an adaptable cost formula. In addition, this study assesses the sensitivity of per capita programme costs with respect to changes in the underlying cost components. Results: The average annual per capita costs of exhaustive larviciding with Bti during the main malaria transmission period (June–October) in the Nouna health district were calculated to be US$1.05. When targeted spraying of the 50$ 0.77. Additionally, a high sensitivity of per capita programme costs against changes in total surface of potential larval sources and the number of spraying repetitions was found. Discussion: The per capita costs for larval source management interventions with Bti are roughly a third of the annual per capita expenditures for anti-malarial drugs and those for LLINs in Burkina Faso which are US$ 3.80 and 3.00, respectively. The average LSM costs compare to those of IRS and LLINs for sub-Saharan Africa. The authors argue that in such a setting LSM based on Bti spraying is within the range of affordable anti-malarial strategies and, consequently, should deserve more attention in practice. Future research includes a cost-benefit calculation, based on entomological and epidemiological data collected during the research project