4,414 research outputs found

    A validated severity score for haemorrhoids as an essential prerequisite for future haemorrhoid trials.

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    BACKGROUND: There is a lack of standardised outcomes for haemorrhoidal disease making comparison between trials difficult. A need for a very well validated severity score is essential to facilitate meta-analysis of comparative studies, enabling evidence-based clinical practice. METHODS: The Hubble trial provides a large cohort of patients with haemorrhoidal disease randomised to rubber band ligation (RBL) or haemorrhoidal artery ligation. The haemorrhoid severity score (HSS) was collected on each patient at baseline, 6 weeks and 1 year after intervention. This allows for the responsiveness of the HSS instrument to be examined and compared with a more specific instrument, the Vaizey incontinence score (also collected). Responsiveness was tested using four methods (effect size, standardised response means (SRM), significance of change, and responsiveness statistic). RESULTS: The four tests of responsiveness demonstrated that the HSS was more responsive to changes in the patient's health status following both of the interventions compared to the Vaizey questionnaire. For example, between baseline and 6 weeks, the RBL intervention effect size scores and SRM calculations indicated a non-significant small amount of change (0.20 and 0.16 respectively). However, using the HSS, the effect size and SRM demonstrated a large magnitude of change (1.12 and 1.01, respectively) which was significant. Similar results were observed at 1 year. Significance of change scores and the index of responsiveness were also higher for the HSS questionnaire than the Vaizey across both treatment modalities. CONCLUSIONS: The HSS is a highly responsive tool for the detection of changes in haemorrhoid symptoms. It should form an essential patient-reported outcome tool for future studies on haemorrhoidal disease

    A Modular Tray Growth System for Barley

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    Determining when a barley plant starts and finishes meiosis is not trivial as when the spikelets undergo meiosis, the spike is not visible as it is still well within the leaf sheath on the developing tiller. This is a general constraint for any experiment involving meiosis, such as cytology, RNA extractions, or abiotic stress treatments aiming to target such a developmental stage. The lack of synchronicity between barley tillers within the same plant exacerbates the difficulty to determine the overall meiotic stage of a plant at a certain time.Given the lack of a nondestructive staging system for predicting the entry into meiosis and the problems of working with large pot plant systems, a modular plant growing is proposed. This system enables the growth of a high number of plants in a small surface, each producing a single tiller. The modular tray system was used to generate a nondestructive prediction tool for meiosis by using external morphological features. As an example, the system is used here for heat treating F1 plants in early meiosis stages to modify recombination.</p

    The Logistic Path from the International Space Station to the Moon and Beyond

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    The period from the loss of the Space Shuttle Columbia in February 2003 to resumption of Space Shuttle flights, planned for May 2005, has presented significant challenges to International Space Station (ISS) maintenance operations. Sharply curtailed upmass capability has forced NASA to revise its support strategy and to undertake maintenance activities that have significantly expanded the envelope of the ISS maintenance concept. This experience has enhanced confidence in the ability to continue to support ISS in the period following the permanent retirement of the Space Shuttle fleet in 2010. Even greater challenges face NASA with the implementation of the Vision for Space Exploration that will introduce extended missions to the Moon beginning in the period of 2015 - 2020 and ultimately see human missions to more distant destinations such as Mars. The experience and capabilities acquired through meeting the maintenance challenges of ISS will serve as the foundation for the maintenance strategy that will be employed in support of these future missions

    Differential Subordinations Involving Generalized Bessel Functions

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    In this paper our aim is to present some subordination and superordination results, by using an operator, which involves the normalized form of the generalized Bessel functions of first kind. These results are obtained by investigating some appropriate classes of admissible functions. We obtain also some sandwich-type results and we point out various known or new special cases of our main results.Comment: 15 pages, accepted in Bulletin of the Malaysian Mathematical Sciences Societ

    Organisation des unternehmensweiten Data Warehousing

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    Stage, grade and morphology of tumours of the colon and rectum recorded in the Oxford Cancer Registry, 1995–2003

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    Data on stage, grade and morphology of 12 761 colorectal cancers registered between 1995 and 2003 by Oxford Cancer Registry are reviewed. Dukes stage is recorded for 81% of colon cancers and for 69% of rectal cancers. Incomplete registry data and changing recording practices may affect future evaluation of bowel cancer screening

    A double-blind placebo-controlled, randomised study comparing gemcitabine and marimastat with gemcitabine and placebo as first line therapy in patients with advanced pancreatic cancer

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    Pancreatic cancer is the fifth most common cause of cancer death in the western world and the prognosis for unresectable disease remains poor. Recent advances in conventional chemotherapy and the development of novel ‘molecular’ treatment strategies with different toxicity profiles warrant investigation as combination treatment strategies. This randomised study in pancreatic cancer compares marimastat (orally administered matrix metalloproteinase inhibitor) in combination with gemcitabine to gemcitabine alone. Two hundred and thirty-nine patients with unresectable pancreatic cancer were randomised to receive gemcitabine (1000 mg m−2) in combination with either marimastat or placebo. The primary end-point was survival. Objective tumour response and duration of response, time to treatment failure and disease progression, quality of life and safety were also assessed. There was no significant difference in survival between gemcitabine and marimastat and gemcitabine and placebo (P=0.95 log-rank test). Median survival times were 165.5 and 164 days and 1-year survival was 18% and 17% respectively. There were no significant differences in overall response rates (11 and 16% respectively), progression-free survival (P=0.68 log-rank test) or time to treatment failure (P=0.70 log-rank test) between the treatment arms. The gemcitabine and marimastat combination was well tolerated with only 2.5% of patients withdrawn due to presumed marimastat toxicity. Grade 3 or 4 musculoskeletal toxicities were reported in only 4% of the marimastat treated patients, although 59% of marimastat treated patients reported some musculoskeletal events. The results of this study provide no evidence to support a combination of marimastat with gemcitabine in patients with advanced pancreatic cancer. The combination of marimastat with gemcitabine was well tolerated. Further studies of marimastat as a maintenance treatment following a response or stable disease on gemcitabine may be justified
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