The ZEST Trial - A double-blind, placebo-controlled trial of Zoloft's Effects on Symptoms and survival Time in Advanced Cancer

The objective of the ZEST trial is to determine the effects of zoloft on depression and survival time in patients with advanced cancer

Accurate localization of life threatening colonic hemorrhage during nuclear medicine bleeding scan as an aid to selective angiography

<p>Abstract</p> <p>Purpose</p> <p>To describe a new technique to help localize life threatening colorectal bleeding during nuclear medicine bleeding scan to aid in selective angiography.</p> <p>Methods</p> <p>During the gastrointestinal bleeding scan, a simple metallic marker (paper clip) was used to localize the bleeding site on the patient body. Angiography was then performed within 2 hours. The marker was then used to guide superselective angiography and embolization.</p> <p>Results</p> <p>5 cases of patients with colorectal bleeding were performed using this technique with cessation of bleeding in 4/5 initial attempts. 1 patient required a repeat angiogram that did demonstrate the bleeding on the second attempt allowing superselective angiography and embolization that resulted in cessation of bleeding. This patient with a rectal bleed required selection of additional vessels guided by the marker on the second attempt.</p> <p>Conclusion</p> <p>The dilemma of positive scintigraphic evidence of colonic bleeding with negative arteriography can be resolved with the use of a metal marker during the scintigram to guide superselective angiography. Although in our small series of patients this technique appears to be simple and effective, further clinical investigation is warranted with a larger patient population. This technique may offer a role in therapy in coordination with the colorectal surgeon for the high risk patient in an otherwise life threatening situation.</p

Effect of Nb on β→α″ martensitic phase transformation and characterization of new biomedical Ti-xNb-3Fe-9Zr alloys

A new generation of Ti-xNb-3Fe-9Zr (x=15, 20, 25, 30, 35 wt %) alloys have been designed using various theoretical approaches including DV-xα cluster, molybdenum equivalency, and electron to atom ratio. Afterward, designed alloys are fabricated using cold crucible levitation melting technique. The microstructure and mechanical performances of newly designed alloys are characterized in this work using scanning electron microscope and universal testing machine, respectively. Each alloy demonstrates monolithic β phase except Ti-35Nb-3Fe-9Zr alloy which display dual α″+β phases. Typically, niobium acts as an isomorphous beta stabilizer. However, in this work, formation of martensitic α″ phases occurs at 35 wt % of niobium among the series of newly designed alloys. Furthermore, none of the alloys fail till the maximum load capacity of machine, i.e., 100 KN except Ti-35Nb-3Fe-9Zr alloy. Moreover, the Vickers hardness test is carried out on Ti-xNb-3Fe-9Zr alloys which demonstrate slip bands around the indentation for each alloy. Notably, the deformation bands and cracks around the indentations of each alloy have been observed using optical microscopy; Ti-35Nb-3Fe-9Zr demonstrates some cracks along with slip bands around its indentation. The Ti-25Nb-3Fe-9Zr alloy shows the highest yield strength of 1043±20 MPa, large plasticity of 32±0.5%, and adequate hardness of 152±3.90 Hv among the investigated alloys. The Ti-25Nb-3Fe-9Zr alloy demonstrates good blend of strength and malleability. Therefore, Ti-25Nb-3Fe-9Zr can be used effectively for the biomedical applications

Understanding and managing project complexity

This research focuses on project complexity with the aim to better understand it and to highlight the factors that affect/contribute to it. In addition, this research also highlights key project management practices and project critical success factors considered important to manage project complexity/complex projects. The two main motivating factors behind this research were, the lack of understanding of complex projects and the lack of relevance of project management theory to practice, which have been highlighted by many researchers. Since projects in different sectors are increasingly being characterised as complex, this entails a better project management knowledge base focusing on the dynamic, social and complex contexts of projects, so that the interrelationships, interdependencies and uncertainties between different project interfaces can be understood and managed properly. In order to understand this 'project actuality', it was necessary to obtain the views from practitioners working in these project settings and managing project dynamics and intricacies. To establish this pragmatic view, a series of interviews and questionnaire surveys was carried out and all efforts were made to select the participants working on complex projects with complex products falling under the Complex Product Systems (CoPS) category which was the case in the 2nd phase interviews and questionnaire, whereas in the 1st phase practitioners with industrial experience and also involved and/or in the process of getting academic qualification in project management were preferred. The first phase helped in establishing the theoretical and pragmatic perspective and the 2nd phase in refining and validating the findings. The questions were inline with the research focus mentioned earlier.The main findings of the research show that the perception of project complexity and its contributing factors were very much influenced by the project context, i.e. from organization level to work discipline level. No difference in the practitioners' perception of project complexity and its contributing factors was observed among the practitioners based in a similar organization and project setting. Novelty was found to be one of the key project complexity characteristics related to three project elements-people, product and process. In terms of key project management practices and skills considered important in managing project complexity, soft skills were reported useful by majority of the participants. The key processes found useful were either the ones which focused on people or others which helped to manage changes/deviations in projects. Influence and relationship, delegation, flexibility and trust were the main project critical success factors which emerged out of this research for complex projects.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

High-fidelity validation with smart grid modelling complexity : considerations on emerging solutions

The continued integration of increased volumes of distributed energy resources and flexibility services into power networks across the world is introducing increasing complexity into system operations. With the growing number and dimensions of complexity, modelling of smart grids for simulation is becoming more demanding. In particular, achieving high-fidelity validation of such complex cyber-physical systems is growing in importance and in scale of challenge. Coordinated real-time simulation across multiple platforms, termed geographically distributed simulations (GDS), paves a new pathway for high-fidelity validation of large-scale smart grids. Furthermore, the integration of cloud solutions enables efficient initialization of simulations and ensures secure data communications among GDS participants. This paper provides a comprehensive overview of different types of real-time simulation concepts and explains how they can best be utilized to realize GDS with enhanced computational capability. Subsequently, this paper summarizes the applicability of GDS, specifically emphasizing on cloud-based GDS, to facilitate high-fidelity validation of complex smart grids

Predictors and outcome of tetanus in newborns in slum areas of Karachi city: A case control study

Background: Tetanus in newborns, is an under-reported public health problem and a major cause of mortality in developing countries. This study aimed to determine the predictors and outcome of tetanus in newborn infants in the slums of Bin-Qasim town, Karachi, Pakistan.Methods: We conducted a case-control study at primary health care centers of slums of Bin-Qasim town, area located adjacent to Bin Qasim seaport in Karachi, from January 2003 to December 2013. Cases were infants aged ≤30 days with tetanus, as defined by the World Health Organization. Controls were newborn infants aged ≤30 days without Tetanus, who were referred for a checkup or minor illnesses. The case to control ratio was 1:2.Results: We analyzed 26 cases and 52 controls. The case fatality was 70.8%. We identified four independent predictors of Tetanus in newborns: maternal education (only religious education with no formal education OR 51.95; 95% CI 3.69-731), maternal non-vaccination (OR 24.55; 95% CI 1.01-131.77), lack of a skilled birth attendant (OR 44.00; 95% CI 2.30-840.99), and delivery at home (OR 11.54; 95% CI 1.01-131.77).Conclusions: We identified several potentially modifiable socio-demographic risk factors for Tetanus in newborns, including maternal education and immunization status, birth site, and lack of a skilled birth attendant. Prioritization of these risk factors could be useful for planning preventive and cost-effective measures

Exploring knowledge and practices regarding menstrual hygiene management among Bihari women in the Geneva Camp in Bangladesh

Background: Research into menstrual hygiene management (MHM) has been mainly based on menstruation-related knowledge and practices of women and girls in the mainstream Bangladeshi society; socially disadvantaged groups, such as the Bihari refugee women, have largely been ignored. Purpose: This study aims to assess knowledge and practices about MHM among Bihari women in the Mohammadpur Geneva Camp in Dhaka, Bangladesh. Methods: In 2017, a cross-sectional survey was conducted among Bihari women and girls by the trained interviewers using a structured questionnaire. The purposive sampling was applied to select 160 Bihari women aged between 15 and 49. Data were entered, cleaned, and analysed using SPSS software. Both univariate and bivariate analyses were undertaken to examine knowledge and MHM-related practices with a significance level of p<0.01. Results: Overall, most women (59.4%) had low knowledge about menstruation. More than one-quarter (27.0%) used disposable sanitary napkins. The Bihari women who did not use sanitary pads (73%) reported that they used old disposable clothes (59.83%), reusable cloths (25.64%), cotton (9.40%), or toilet tissue paper (4.27%). Around two-thirds of the women (68.0%) performed special baths and 36.9% followed socio-cultural taboos during menstruation. The bivariate analyses revealed that higher menstruation knowledge was associated with higher use of disposable sanitary napkins (low knowledge: 18.9%, high knowledge: 38.5%; p<0.01). Conclusions: The findings suggest that it is imperative for Bihari women to have adequate and appropriate menstruation knowledge so that they can maintain good menstrual hygiene practices. The findings highlight challenges experienced by the refugee women in maintaining MHM and can be used to improve women’s reproductive health and well-being and reduce the risk of reproductive tract infections (RTI) among socially disadvantaged women

Functionalized Multi-Walled Carbon Nanotube-Reinforced Epoxy-Composites: Electrical And Mechanical Characterization

Carbon nanotubes (CNTs) got great attention because of their interesting physical and mechanical properties. Due to these interesting properties observed at the nanoscale have motivated scientific community to utilize CNTs as reinforcement in composite materials. In the present study, different CNTs and epoxy nano-composites with different wt% (1, 2, 3, and 4%) of f-MWCNTs were prepared and their surface morphology and orientation has been investigated in detail. Further, the surface investigation, electrical and mechanical tests were carried out on CNTs-filled and unfilled epoxy at maximum sonication time 30 minute to identify the loading effect on the properties of the materials. Experimental results depicts well dispersion of f-MWCNTs, significant improvement that the resistivity of pure epoxy decreased from 108 .m to average value 103 .m with 1, 2, 3, and 4wt% f-MWCNTs. The 4.5wt% CNTs/epoxy was attributed to poor dispersion of f-MWCNTs in the nanocomposte. The hardness of nanocomposite loading 1, 2, 3, 4wt% of CNTs, increased 20.7%, 23.02%, 25.62%, 29.09% respectively as compared to pure epoxy. We believe that our strategy for obtaining CNT–reinforced epoxy nanocomposites is a very promising technology and will open a new doors in fields of aviation, aerospace, marine and sporting goods