Worth Evaluation Research Articles

Stimulant-Drug Therapy for Attention-Deficit Disorder (With or Without Hyperactivity) and Sudden Cardiac Death

Things just get “curiouser and curiouser.” Alice in Wonderland , Lewis Carroll Alice's remark as she visited wonderland is quite applicable to the rapidly changing medical knowledge base. The more we know, the more questions that occur, and this “quest for truth” is daunting. This is a daily element of clinical decision-making in a busy practice, face to face with patients and parents. This is particularly true when addressing the area of drug therapy for attention-deficit disorder with or without hyperactivity [ADD(H)]. Over the past 2 years, there has been a lot of information on this topic. Parents are aware of the emotionally charged aspects of ADD(H) therapy through the rapid access of information from all forms of media. They are raising important questions regarding the safety of use of the stimulant class of drugs for treating ADD(H). The recent concern of sudden cardiac death in patients who are taking these drugs is certainly worth evaluation. What follows is a brief synopsis of the clinically relevant, best evidence-based aspects of this issue. Sudden cardiac death occurs at an estimated rate of 1.3 per 100000 patient-years in the pediatric population.1 It is often assumed under conditions of an unexplained, unexpected death in an otherwise presumed healthy person. … Address correspondence to Matthew Knight, MD, OSFMG Morton Pediatrics, 435 Maxine Dr, Morton, IL 61550. E-mail: meknight50{at}yahoo.com

Feasibility Study for Evaluation of Control Rod Worth in Pressurized Water Reactors using Neutron Count Rate during a Control Rod Drop Testing

Applicability of the modified Neutron Source Multiplication (NSM) method with extraction of the fundamental mode to subcriticality measurement has been proposed. Following the feasibility verification in the previous study based on numerical analyses, its applicability has been proven in a more realistic situation; in a withdrawal sequence of control rod banks during the PWR startup. Subcriticalities with various control rod insertion configurations were estimated based on the modified NSM method. The subcriticality could be evaluated with a good accuracy even with the mockup experiment where any special treatments for accurate measurement were not taken into account and furthermore the insensitivity of measured signals by reactivity changes and their large fluctuations were seen. Based on this fact, we further investigated a feasibility to use neutron count rate data obtained during the control rod drop testing, which is carried out before the reactor physics tests at hot zero power condition. When it is proven that these data could be used for the estimation of each control rod worth, the following reactor physics tests could be performed with the advanced knowledge of each control rod worth and procedures for detailed control rod worth measurement could be simplified or eliminated from the reactor physics tests.

A spatial rehomogenization method in nodal calculations

Infinite medium flux weighted cross-sections used in nodal calculations enable equivalence with the corresponding fine configuration if the following condition is satisfied: the flux shape inside the assembly in the core is close to the infinite medium flux shape (computed in lattice calculations). In presence of big flux gradients this condition is not satisfied and the absence of information about cross-sections distributions inside a node does not permit to predict the reaction rates with the same accuracy attained in ordinary situations. This tendency is amplified in case of high heterogeneous regions where tilting the flux causes big changes in reaction rates. The method presented here uses information coming from the lattice calculations that produced the homogenized cross-sections, in order to predict the right reaction rate even in presence of high tilted flux shapes. This is done in evaluating a variation of the cross-sections equivalent to the variation in reaction rate, but no variation is applied to the discontinuity factors. The accuracy of the method and its limitations are shown in several significant configurations. Its implementation in the Areva NP reactor core simulation system SCIENCE has shown better evaluation of control rod worth in comparisons with experimental results.

Treatment of Renal Failure Associated with Multiple Myeloma and Other Diseases by PACAP‐38

Myeloma kidney injury is caused by the large amount of light chain (LC) of immunoglobulins produced by cancerous plasma cells through stimulation of proinflamatory cytokines like TNF-alpha and IL-6. PACAP-38 suppressed LC-stimulated cytokine production by tubular epithelial cells in vitro and in vivo, and prevented injury of these epithelial cells. The suppressive effect is comparable or greater than dexamethasone (dex). Although dex produces adverse side effects when it is given for a long time period, PACAP-38 is a natural and safe neuropeptide and no adverse effect has been reported when administered to produce significant biological effects. Furthermore, PACAP-38 suppressed growth of myeloma cells in culture and also suppressed production of their growth factor, IL-6, production from the bone marrow stromal cells that was stimulated by adhesion of myeloma cells. These findings render PACAP-38 worth evaluation as a safe and potent renoprotectant in myeloma kidney as well as a new antitumor agent for myeloma cells.

Potential protective action of pituitary adenylate cyclase-activating polypeptide (PACAP38) on in vitro and in vivo models of myeloma kidney injury

AbstractThe most common type of renal injury in multiple myeloma is chronic tubulointerstitial nephropathy associated with casts in tubule lumens, an entity referred to as “myeloma kidney” that often progresses to end-stage kidney diseases. Myeloma kidney is associated with a significant increase in all-cause mortality, yet no effective intervention, except a limited use of steroid, is available. Here, we report that pituitary adenylate cyclase-activating polypeptide with 38 residues (PACAP38) dramatically prevents injury of cultured renal proximal tubule cells caused by myeloma light chains through suppression of proinflammatory cytokines production, by inhibiting p38 MAPK and translocation of NFκB via both PAC1 and VPAC1 receptors. The suppressive effects of PACAP was as effective as dexamethasone in all of their cytokine assays and demonstrated both in vitro and in vivo. Furthermore, PACAP38 inhibits myeloma cell growth directly and may also indirectly by suppressing production of the growth factor, IL-6, from bone marrow stromal cells, that is stimulated by adhesion of myeloma cells. These findings render PACAP38 worth evaluation as a promising candidate for an effective and safe renoprotectant in myeloma kidney, and possibly other nephropathy, and also as a new antitumor agent in multiple myeloma.

Feasibility Study for Evaluation of Control Rod Worth in Pressurized Water Reactors using Neutron Count Rate during a Control Rod Drop Testing

Feasibility Study for Evaluation of Control Rod Worth in Pressurized Water Reactors using Neutron Count Rate during a Control Rod Drop Testing

04/02840 Rural distribution system reliability worth evaluation using individual customer outage cost characteristics: Billinton, R. and Wacker, G. International Journal of Electrical Power& Energy Systems, 2004, 26, (4), 235–240

04/02840 Rural distribution system reliability worth evaluation using individual customer outage cost characteristics: Billinton, R. and Wacker, G. International Journal of Electrical Power& Energy Systems, 2004, 26, (4), 235–240

Chemotherapy for metastatic colorectal cancer: Why not take a break when it works?

3641 Background: Once objective tumor response (OR) or stable disease (SD) has been achieved in patients (Pts) undergoing palliative chemotherapy (CT) for metastatic colorectal cancer (MCRC), we propose a break, allowing the Pts a CT -free period with visit at 6 weeks then a CT every 3 months; in case of PD, CT is given. Patients and methods: This retrospective series included a random selection of our Pts with MCRC who had had at least 1 break in their CT. Results: 62 Pts, age 60.9 +/- 10.8 yrs, received palliative CT for MCRC and had had at least 1 break in their CT. A break was defined as a period when CT could have been but was not given. Periods of palliative care and interruptions due to side effects were not considered breaks. The 1st break took place in a 1st-line (n=61) or 2-line (n=1) protocol in patients who had OR (n=41) or SD (n=20) after a median 4.5 mo (no difference between OR and SD). Median duration of these 1st break was 6 mo. Kaplan-Meier plots showed that 52.5 +/- 6.4%, 30.7 +/- 6% and 20.5 +/- 5.2% of the Pts were still CT -free at 6, 9, and 12 mo. The CT -free period was longer after OR (median > 6 mo) than after SD (4 mo) (p<0.02). After their first break, 57 Pts received a 2nd CT, 35 with the same CT (10 OR, all after initial OR, 14 SD and 8 PD) and 22 with another CT. After this 2nd cycle, 40 Pts took another break (median 5 mo) and 29.5 +/- 7.4% remained CT -free at 6 mo, 13 % at 1 yr. A 3rd cycle was delivered for 32 Pts (median 3 mo) and 13 of them then had another break (median 4 mo); 9 resumed CT (6 mo) and 5 had another break (4 mo). Globally, Pts had CT for a median 8.5 mo (range 3–30) and was CT -free for a median 11 mo (1–75). Median time without CT was 1.3 times median time with CT. On October 10, 2003, 29 Pts had died, 4 were receiving best supportive cares, 14 were CT -free, and 15 were receiving CT. The 1-, 2- and 3-yr survival rates were 95.2 +/- 2.7%, 70.8 +/- 6.5%, and 48 +/- 8% (11 exposed patients). Conclusions: From this retrospective analysis, we conclude that 1) responders can take a break in CT for MCRC, and 2) breaks can be repeated, 3) without compromising survival. The impact of this approach on quality-of-life, healthcare expenditures, and even overall survival is certainly worth evaluation in a large-scale prospective study. No significant financial relationships to disclose.

Optimal Operating Strategy for Distributed Generation Considering Hourly Reliability Worth

This paper presents a method to determine optimal operating strategy for distributed generation (DG) incorporating reliability worth evaluation of a distribution system. The use of DG for peak shaving could reduce the overall system operating cost and its use as standby power could reduce the customer interruption cost. If the DG operating cost is less than the utility power cost at peak time, DG should be employed to reduce the overall system operating cost. However, when customer interruption cost is also an important concern, standby power strategy for DG may be better than peak shaving. The reliability worth and the power cost evaluations are needed to determine whether DG should be operated for peak shaving or as standby power. The hourly reliability worth is incorporated in the strategy proposed in this paper to determine the optimal operating decision for the DG. Using the approach proposed in this paper, the distribution companies could determine the optimal operating strategy for their DG.

Rural distribution system reliability worth evaluation using individual customer outage cost characteristics

Customer interruption costs are a function of both interruption and user characteristics. The specific customer characteristics at a load point in a distribution network can have a significant effect on the estimated customer outage costs at that load point and for the entire feeder. This paper illustrates the effects on outage cost estimates of using generalized sector customer outage cost estimates and actual customer specific outage cost functions. The data used in these analyses are from customer cost surveys conducted in Canada. A small distribution system is used to illustrate the possible variation in interruption cost estimates due to incorporating specific customer characteristics in the evaluation. The results presented clearly show that different customer compositions can result in significantly different feeder interruption cost estimates. The estimated interruption costs can be used in feeder design to create an optimal configuration based on reliability cost/worth analysis.

Comparative case studies for value-based distribution system reliability planning

Abstract This paper will develop a set of reliability worth evaluation models to evaluate the load point reliability worth indices for five different distribution types. The distribution substations, primary distribution systems, and the interaction between them contribute to the load point reliability worth indices. The reliability worth of the distribution systems are evaluated in terms of customer interruption costs, by using the sector customer damage function (SCDF). The most suitable system design is based on comparisons of the total system costs of the candidates under consideration. Four case studies are thoroughly examined in this paper. Also, the impact on customer interruption costs associated with customer type, substation configuration, and feeder configuration are investigated.

Distribution system reliability worth analysis with the customer cost model based on RBF neural network

Reliability worth analysis is an important tool for distribution systems planning and operations. The interruption cost model used in the analysis directly affects the accuracy of the reliability worth evaluation. In this paper, two interruption cost models including an average or aggregated model (AAM), and a probabilistic distribution model (PDM) are proposed by using the radial basis function (RBF) neural network with orthogonal least-squares (OLS) learning method. The residential and industrial interruption costs in AAM and PDM were integrated by the proposed neural network technique. A Monte-Carlo time sequential simulation technique was adopted for worth assessment. The technique is tested by evaluating the reliability worth of a Taipower system for the installation of disconnected switches, lateral fuses, transformers, and alternative supplies. The results show that the two cost models result in very different interruption costs, and PDM may be more realistic in modeling the system.

The analgesic effect of nalbuphine and its long-acting prodrug, nalbuphine pivalate, in rats.

Nalbuphine is an opioid-analgesic with agonist-antagonist properties. Recently, we have synthesized a nalbuphine prodrug, nalbuphine pivalate. The aim of the present study was to evaluate the analgesic effect and the analgesic duration of this prodrug. Forty-eight male Sprague-Dawley rats (4 groups, n = 12 in each group) were used. Rats in group 1 received nalbuphine HCl 25 mumol/kg (in saline) intramuscular injection; rats in group 2 received nalbuphine pivalate 25 mumol/kg (in sesame oil) intramuscular injection, whereas those in groups 3 and 4 received saline and sesame oil respectively. The analgesic effects of testing agents were evaluated using the cold ethanol tail-flick test (-30 degrees C). Both nalbuphine HCl and nalbuphine pivalate demonstrated significant analgesic effects. The analgesic duration of nalbuphine HCl was 2 h while that of nalbuphine pivalate was 30 h. Nalbuphine pivalate has a very long duration of analgesic action. This fascinating finding is worth further evaluation.

THE DEVELOPMENT AND EXPERIMENTAL TESTING OF A FUZZY CONTROL SYSTEM FOR BATCH DISTILLATION

The present work describes the development and implementation of fuzzy control algorithms in order to control on-line the overhead product composition of a batch distillation column. Firstly, the influence of design parameters was evaluated through computational simulations and then the algorithms were experimentally tested by monitoring a pilot column. Binary mixtures of n-hexane/n-heptane were distilled. Temperature measurements and vapor-liquid equilibrium data are the basis for the inference of overhead and bottom compositions. Two different operational strategies were used for the experimental runs: constant overhead product composition and previously determined set-point trajectory. Using the first strategy, the performance of the fuzzy controllers is compared to the performance of conventional feedback digital controllers. Experimental results show that fuzzy control presents a better performance than the conventional digital feedback control and also that fuzzy controllers were able to deal successfully with variable set-point strategy, albeit using constant design parameter values. Under conventional control, the average reflux rate implemented was higher than the average reflux rate implemented with fuzzy algorithms. Consequently, the process becomes less time- and energy-consuming under fuzzy control. Since fuzzy methodology is a promising new way of looking at process control problems and their solutions, the results of this work could provide control system designers with a better evaluation of the potential worth of fuzzy control.

Another search for the hot cognitions: Appraisal, irrational beliefs, attributions, and their relation to emotion

One study examined the hypothesized status of appraisal and irrational beliefs relative to attributions, as proximal antecedents of emotion. In our study, which looked at 4 pairs of functional and dysfunctional negative emotions (i.e., concern/anxiety, sadness/depression, remorse/guilt, annoyance/anger), undergraduates (N = 120) reported on their attributions, appraisal, irrational beliefs, and emotions during past encounters associated with various negative events. Congruent with both Smith and Lazarus' (1993) appraisal theory and Ellis' (1994) cognitive theory of emotion, the results of this study indicate that the emotions (both functional and dysfunctional negative emotions) were more directly associated with appraisal and with irrational beliefs (dysfunctional negative emotions only) than they were with attributions. Also, irrational beliefs were strongly associated with appraisal; while demandingness (DEM) was associated more with primary appraisal, awfulizing/catastrophizing, low frustration tolerance, and global evaluation of human worth (including self-downing) were associated more with secondary appraisal. Dysfunctional emotions seem to involve primary appraisal associated with DEM while functional emotions involve primary appraisal associated with preferences. These findings lend to support the status of appraisal and irrational beliefs as the proximal cognitive antecedents of emotion and the status of irrational beliefs as a differencing factor between functional and dysfunctional emotions.

Sidetrack and Recompletion Risks in Oil Fields. V. Sidetrack Uncertainties and Parameter Sensitivities

Models of total estimated reserves, of future selling price per barrel of oil, and of the chances that undertaking a sidetrack will not kill a producing well, and that the sidetrack will also be successful, all provide parameter values that are used to estimate the worth of undertaking the sidetrack. However, such parameter values are themselves uncertain and therefore contribute uncertainty to the sidetrack worth. To decide to undertake a sidetrack requires that some idea is to hand of the sensitivity of the assessed worth to parameter variations, so that one knows where to place effort to minimize the uncertainty of the estimated worth. In this paper we show how models of such effects can be incorporated into the evaluation of sidetrack worth and its sensitivity to parameter uncertainties. In addition we show how the relative contributions of ranges and distribution types of the uncertainties can be evaluated. In this way one knows precisely where to focus efforts to improve matters prior to undertaking the sidetrack, and one also determines the range of likely outcomes with some statistical sharpness should one decide for or against undertaking the sidetrack. Several simple numerical illustrations are given to demonstrate the influence of different choices of parameter models on the assessment of the best worth and its uncertainty for a sidetrack situation.

Radial distribution system reliability worth evaluation utilizing the Monte Carlo simulation technique

Conventional reliability worth evaluation using analytical methods can only provide the expected or average values of the worth indices. The actual shape of the statistical distributions associated with these indices are generally not considered. This paper describes a Monte Carlo simulation approach to a complex radial distribution system reliability worth evaluation. The results of a series of simulations studying the impacts of various probability distributions for restoration times on load point expected cost, interrupted energy assessment rate and their probability distributions are presented. Furthermore, different radial system operating philosophies are incorporated in the analysis and their impacts are analyzed.

Development of an Undergraduate Module in Evidence-based Physiotherapy Practice

Method Students were divided into four groups of ten with an academic and a clinical facilitator. The aim for each group was to develop evidence-based guidelines in one of four subject areas. These were therapeutic exercise in the management of osteo-arthritic (OA) knees, physiotherapy management of vestibular dysfunction, ultrasound in the management of tennis elbow, and parameters for electrical muscle stimulation. Following the first week of formal lectures the groups met with the facilitators once per week during a five-week period. The specialist subject librarians enabled the students to undertake advanced literature searches using on-line facilities. The module was assessed in two ways: a group submission of a clinical guideline worth 40% of the mark and an individual submission of 2000 words which demonstrated reflection and critical evaluation of the process worth 60% of the mark. Marking guidelines were developed utilising existing methods for assessing clinical guidelines (Cluzeau et al, 1997).

186/188Re] rhenium-ethylene dicysteine (Re-Ec): preparation and evaluation for possible use in endovascular brachytherapy

188ReO 4 −, 188Re-MAG 3, and 188Re-DTPA are currently under investigation as radiation sources in liquid-filled balloons for prevention of restenosis following coronary angioplasty. Because 99mTc-labeled ethylene dicysteine (EC) is a well-established agent for renal tubular function imaging, the use of [ 188Re] rhenium-labeled EC as a potential agent for prevention of restenosis after angioplasty is worth evaluation. In this article, the preparation and pharmacological behavior of [ 188/186Re]Re complex of EC are reported. The yield of the Re complex was optimized by varying the parameters of complexation. The complex prepared under the optimized conditions was found to be stable over a period of 7 days when stored at pH 2 and at 4°C. The pharmacological behavior of [ 188/186Re]Re-EC confirms its similarity to 188Re-MAG 3 and its superiority over 188ReO 4 − for use in endovascular brachytherapy.

Extending health considerations in subtransmission systems to include reliability worth

The basic concepts associated with quantitative reliability assessment of electric power systems are reasonably well established, and well accepted within the power industry. The evaluation of the costs and benefits of competing investments is now becoming a standard practice in power-system planning. To justify the use of new facilities and system modification specific reference to reliability has normally been included, and one approach that has received considerable attention is the evaluation of the societal worth (benefit) of system reliability, or conversely the costs incurred by consumers due to power supply interruptions. To make a consistent appraisal of economics and reliability, it is necessary to compare investment cost needed to attain a specified level of reliability with the reliability worth or benefits derived by the society at that level of system reliability. The well-being framework is extended to include the societal worth of electric service reliability in subtransmission systems. System well-being is defined in terms of three system states: (i) healthy, (ii) marginal and (iii) at risk, thus combining the deterministic and probabilistic approaches into a single framework. The determination of reliability worth indices of expected energy not supplied (EENS), expected cost of interruptions (ECOST) and interrupted energy assessment rate (IEAR) are discussed, for both the healthy and at risk states in the well-being framework. The concepts associated with extending the well-being framework to include reliability worth parameters are illustrated by application to a small reliability test system designated RBTS.