Oncologic Home-Hospitalization Delivers a High-Quality and Patient-Centered Alternative to Standard Ambulatory Care: Results of a Randomized-Controlled Equivalence Trial

PURPOSE- Given the increasing burden of cancer on patients, health care providers, and payers, the shift of certain outpatient procedures to the patients' homes (further indicated as oncologic home-hospitalization [OHH]) might be a high-quality, patient-centered, and cost-effective alternative to standard ambulatory cancer care (SOC). METHODS- A randomized-controlled trial was conducted to evaluate the quality of a locally implemented model for OHH (n = 74) compared with SOC (n = 74). The model for OHH consisted of home administration of certain subcutaneous cancer drugs (full OHH) and home nursing assessments before ambulatory systemic cancer therapy (partial OHH). Quality was evaluated based on patient-reported quality of life (QoL) and related end points; service use and cost data; safety data; patient-reported satisfaction and preferences; and model efficiency. An equivalence design was used for primary end point analysis. Participants were followed during 12 weeks of systemic cancer treatment. RESULTS- This trial demonstrated equivalence of both models (OHH v SOC) in terms of patient-reported QoL (95% CI not exceeding the equivalence margin of 10%). Full OHH resulted in significantly less hospital visits (mean of 5.6 ± 3.0 v 13.2 ± 4.6; P = .011). Partial OHH reduced waiting times for therapy administration at the day care unit with 45% per visit (2 hours 36 minutes ± 1 hour 4 minutes v 4 hours ± 1 hour 4 minutes; P < .001). No safety issues were detected. Of the intervention group, 88% reported to be highly satisfied with the OHH model, and 77% reported a positive impact on their QoL. At study end, 60% of both study arms preferred OHH above SOC. CONCLUSION- The shift of particular procedures from the outpatient clinic to the patients' homes offers a high-quality and patient-centered alternative for a large proportion of patients with cancer. Further research is needed to evaluate potential cost-efficiency

Performance of LHC Main Dipoles for Beam Operation

At present about 90% of the main dipoles for the LHC have been manufactured and one of the three cold mass assemblers has already completed the production. 85% of the 1232 dipoles needed for the tunnel have been tested and accepted. In this paper we mainly deal with the performance results: the quench behaviour, the magnetic field quality, the electrical integrity quality and the geometry features will be summarized

Fiducialisation tools : old techniques

Equipement de fiducialisation , historiqu

Considerations on a Partial Energy Upgrade of the LHC

In the frame of the HL-LHC project, a few accelerator dipole and quadrupole magnets of higher critical field and/or larger aperture are being produced. The new inner triplet quadrupoles and dispersion-suppressor dipoles are made from Nb$_{3}$Sn superconductor, which supports a higher field than the classical Nb-Ti magnets used for the LHC. For the longer term future, it has been proposed to replace a fraction of the Nb-Ti arc magnets in the LHC arcs with Nb$_{3}$Sn magnets of higher field (e.g. 11 T), in order to boost the beam energy. Here we examine several options: the replacement of every third dipole by a stronger one, the substitution of the present Nb-Ti quadrupole by Nb$_{3}$Sn combined-function magnets, the excitation of the horizontal orbit correctors, and pushing all the dipole magnets to their ultimate field. We discuss challenges and constraints, including issues related to mechanical aperture, powering, or other hardware limitations, and we estimate the potential energy reach for each of the options

Considerations on a Partial Energy Upgrade of the LHC

In the frame of the HL-LHC project, a few accelerator dipole and quadrupole magnets of higher critical field and/or larger aperture are being produced. The new inner triplet quadrupoles and dispersion-suppressor dipoles are made from Nb$_{3}$Sn superconductor, which supports a higher field than the classical Nb-Ti magnets used for the LHC. For the longer term future, it has been proposed to replace a fraction of the Nb-Ti arc magnets in the LHC arcs with Nb$_{3}$Sn magnets of higher field (e.g. 11 T), in order to boost the beam energy. Here we examine several options: the replacement of every third dipole by a stronger one, the substitution of the present Nb-Ti quadrupole by Nb$_{3}$Sn combined-function magnets, the excitation of the horizontal orbit correctors, and pushing all the dipole magnets to their ultimate field. We discuss challenges and constraints, including issues related to mechanical aperture, powering, or other hardware limitations, and we estimate the potential energy reach for each of the options