First Year Of Introduction Research Articles

РОЗРОБКА ТЕХНОЛОГІЇ ВИРОБНИЦТВА АКТИВОВАНОГО ВУГІЛЛЯ З КОСТРИЦІ ЛЬОНУ ТЕРМОЛІЗНО-ІМПУЛЬСНИМ МЕТОДОМ

Purpose of the study is to develop a technology and research and industrial plant for the production of activated carbon by thermolysis-impulse method from a non-traditional source of raw materials – flax stalks. Research methods. Analysis of the chemical composition of flax fire, as well as the current level of its use; disclosure of the activation process and study of the porous structure of sorbents; selection of the optimal method and modes of activation of carbonaceous materials; consideration of methods of activation and study of the mechanism of this reaction; analysis of modern equipment, design and selection of equipment that is most effective in the conditions of flax plants of Ukraine; determination of energy balance of pulse installation; construction of a mathematical model of the process; drawing up a program for computer determination of regression coefficients and on the basis of performed calculations development of nomograms for graphical determination of technological process parameters; study of the influence of technological factors on the physico-chemical characteristics of the obtained activated carbon using the proposed technology and pulse installation that implements it. The results of the study. As a result of research: - developed technology and research and industrial installation for the production of activated carbon by thermolysis-impulse method from a non-traditional source of raw materials - flax stalks; - the optimal technological modes of the activation process are proposed; - the mathematical model of process is created and the nomograms for definition and the forecast of final characteristics of sorbents on input parameters of a technological mode are developed. The expected economic effect for the first year of introduction of the thermolysis-impulse type installation for processing flax stalks into sorbents reaches UAH 2030765. (in 2020 prices). The payback period of the implemented installation is 2.5 months. Conclusions. Using the research results, developed technology and research and industrial installation, it is possible to activate charcoal from flax stalks by thermolysis-impulse method and select the optimal process parameters within the specified temperature and time limits. The obtained activated carbon is applicable for absorption of relatively large molecules or microsuspensions from liquid media. On the basis of the researched materials of this work it is expedient to recommend the offered industrial technological scheme of process of thermolysis-impulse processing of a flax stalks in sorbents.

Early detection monitoring for non-indigenous fishes; comparison of survey approaches during two species introductions in a Great Lakes port.

Assessing relative performance of different sampling methods used for early detection monitoring (EDM) is a critical step in understanding the likelihood of detecting new non-indigenous species (NIS) in an environment of interest. EDM performance metrics are typically based on the probability of detecting established NIS or rare indigenous species; however, detection probability estimates for these proxies may not accurately reflect survey effectiveness for newly introduced NIS. We used data from three different EDM survey approaches that varied by targeted life-stage (adult-juvenile versus ichthyoplankton), media (physical fish versus environmental DNA), and taxonomic method (morphology-based versus DNA-based taxonomy) to explore relative detection sensitivity for recently introduced white bass (Morone chrysops) and gizzard shad (Dorosoma cepedianum) in the Port of Duluth-Superior, a NIS introduction hot spot within the Laurentian Great Lakes. Detection efficiency, measured by the effort (number of samples) required to achieve 95% probability of detection, differed by EDM approach and species. Also, the relative sensitivity (detection rate) of each survey approach differed by species. For both species, detection in surveys using DNA-based taxonomy was generally as good or better than the adult-juvenile survey using morphology-based taxonomy. While both species appear to have been detected at early stages of invasion, white bass were likely present up to 5 years prior to initial detection, whereas gizzard shad may have been detected in the first year of introduction. We conclude that using complimentary sampling methods can help to balance the strengths and weaknesses of each approach and provide more reliable early detection of new invaders.

QUANTITATIVE CONTENT OF THE MAIN ACTIVE SUBSTANCES IN THE ROOTS OF THE NATURAL AND IN-TRODUCED PLANT SAPOSHNIKOVIA DIVARICATE (TURCZ.) SCHISCHK.

A HPLC-UV method was developed for the quantitative analysis of chromones in the roots of Saposhnikovia divaricata (Turcz.) Schischk. The optimal parameters of chromones extraction (two-fold ultrasonic extraction with a duration of 40 min with 50% ethyl alcohol at a raw material-extractant ratio of 1:10) were selected. The validation analysis showed that the proposed method is characterized by satisfactory metrological parameters. The method was used for the analysis of raw materials of wild, introduced and commercial samples of S. divaricata. In this work, for the first time in the roots of S. divaricata from natural populations of Buryatia, Trans-Baikal Territory, Mongolia and in the introduced samples, the HPLC-UV method was used to determine the quantitative content of the main active substances: prim-O-glucosylcimifugine (0.13–5.22 mg/g), cimifugine (0.01– 1.82 mg/g) and 4’-O-β-D-glucosyl-5-O-methylvisamminol (0.98–3.25 mg/g). The total content of chromones varies depending on the place of collection and the phase of vegetation. The content of chromones in two samples of roots from introduced S. divaricatae, collected in the first year of introduction in different climatic conditions, was established.

Universal use of surgical masks is tolerated and prevents respiratory viral infection in stem cell transplant recipients

Prevention of respiratory viral infection in stem cell transplant patients is important due to its high risk of adverse outcome. This single-centre, mixed methods study, conducted before the severe acute respiratory syndrome coronavirus-2 pandemic, explored the barriers and facilitators to a policy of universal mask use by visitors and healthcare workers, and examined the impact of the first year of introduction of the policy on respiratory viral infection rates compared with preceding years, adjusted for overall incidence. Education around universal mask use was highlighted as being particularly important in policy implementation. A significant decrease in respiratory viral infection was observed following introduction.

THE REPRODUCTIVE PERFORMANCE OF SANTA GERTRUDIS BEEF CATTLE IMPORTED INTO NIGERIA

An analysis of some reproductive perfor­mance traits was carried out for the period 1983 to 1985, in a herd of 168 Santa Gertrudis beef cattle imported from Okla­homa, U.S.A. in 1981 into lkyogen cattle ranch in Nigeria. Three calf crops were obtained during the period. Mean pregnancy rate and calving percentage were 63.24 and 55.72% respectively; with pregnancy rate increasing from 54.23 to 70,41% while calving percentage increased from 48.42 to 61.11% during the period. Mean calf mortality rate of 40.83% was high and increased from 36.34 to 45.15%. Mean adult mortality rate was 5.68% of which 16.99% was recorded in the first year of introduction but this declined sharply to 0O2% in the next two years. Mean weaning rate was 50.08% and this declined from 55.71 to 44.32% during the period under study. Mean birth weight, weaning weight and calving interval were 27.8 t 0.29 kg, 174 ± 4.6kg and 451 days respectively It was concluded that with the exception of weaning weight, the reproductive traits of the imported Santta Gertrudis cattle reported in this study were not superior to those of the predominant indigenous cattle breeds of Nigeria. The implications of these results in the beef cattle industry of Nigeria are discussed.

The first year is the hardest: a comparison of early versus late experience after the introduction of robotic hiatal hernia repair.

While the majority of the literature written concerning minimally invasive hiatal hernia repair involves laparoscopy, little has been written concerning the transition to a robotic technique. We present our experience, with a transparent analysis of data, with regard to the introduction of robotic paraesophageal hernia (PEH) repair by an experienced laparoscopic surgeon. We reviewed our first 30 consecutive patients who underwent robotic PEH over a 2-year period after the introduction of robotic surgery at our institution. Patients were divided into two groups: the early experience group (procedures performed within the first year of introduction of robotic technique, n = 13) and a late experience group (procedures performed in the second year, n = 17). All procedures were performed by a single experienced foregut surgeon. The mean operative time for the early group was significantly greater than for the late group, 184min versus 142min, respectively (p < 0.01). Four patients in the early group required conversion to open, while zero patients in the late group required conversion (p = 0.03). Patient demographics and complications did not differ significantly between the two patient populations. The early robotic hiatal hernia repair experience can be more difficult than expected, even in the hands of an experienced laparoscopic team. We identify several areas of improvement including patient positioning, operating room team training, and technical experience. This data can help other surgeons prepare for the transition to robotic foregut surgery.

A Vaccine Against Cervical Cancer: Context for the Global Public Health Practitioner.

Gavi, the Vaccine Alliance provides support for vaccine introduction and immunization programs in eligible countries; country eligibility for support from Gavi is chiefly determined by the gross national income (GNI) per capita, which determines the level of co-financing and nature of vaccine program support available.14 Between 2012 and 2016, both Gavi and vaccine manufacturers funded sub-national demonstration projects in countries around the world to better understand how to feasibly and sustainably deliver HPV vaccine to adolescents, a relatively new target age group that does not routinely access health services, especially in low- and middle-income countries. Gavi-eligible countries needed to demonstrate successful vaccination to this new target age group prior to requesting funds for national HPV vaccine introduction. Starting in 2017, Gavi shifted its focus from demonstration programs to national introductions, aiming to scale up early lessons learned and to accelerate progress toward the goal of protecting 40 million girls from cervical cancer by 2020 in Gavi-eligible countries.15 Following WHO recommendations, Gavi enacted policy to support vaccination of multiple age cohorts in the first year of program implementation for Gavi-eligible countries. However, due to current global vaccine shortage, some countries have been advised to target a single age group for the first year of introduction, with the potential to vaccinate multiple age cohorts in the future, as supply allows. Demonstrating experience in delivering the vaccine to adolescents is no longer a prerequisite for support of national implementation in these countries. Following WHO's change in HPV vaccine policy and Gavi's shift in program support, many Gavi-eligible countries are moving rapidly to introduce HPV vaccine into their national immunization programs.

Influence of Climatic Factors on Malaria Epidemic in Gulu District, Northern Uganda: A 10-Year Retrospective Study.

Background Globally, 15 countries, mainly in Sub-Saharan Africa, account for 80% of malaria cases and 78% of malaria related deaths. In Uganda, malaria is endemic and the mortality and morbidity due to malaria cause significant negative impact on the economy. In Gulu district, malaria is the leading killer disease among children <5 years. In 2015, the high intensity of malaria infection in Northern Uganda revealed a possible link between malaria and rainfall. However, available information on the influence of climatic factors on malaria are scarce, conflicting, and highly contextualized and therefore one cannot reference such information to malaria control policy in Northern Uganda, thus the need for this study. Methods and Results During the 10 year's retrospective study period a total of 2,304,537 people suffered from malaria in Gulu district. Malaria infection was generally stable with biannual peaks during the months of June-July and September-October but showed a declining trend after introduction of indoor residual spraying. Analysis of the departure of mean monthly malaria cases from the long-term mean monthly malaria cases revealed biannual seasonal outbreaks before and during the first year of introduction of indoor residual spraying. However, there were two major malaria epidemics in 2015 following discontinuation of indoor residual spraying in the late 2014. Children <5 years of age were disproportionally affected by malaria and accounted for 47.6% of the total malaria cases. Both rainfall (P=0.04) and relative humidity (P=0.003) had significant positive correlations with malaria. Meanwhile, maximum temperature had significant negative correlation with malaria (P=0.02) but minimum temperature had no correlation with malaria (P=0.29). Conclusion Malaria in Gulu disproportionately affects children under 5 years and shows seasonality with a generally stable trend influenced by rainfall and relative humidity. However, indoor residual spraying is a very promising method to achieve a sustained malaria control in this population.

Dengue vaccine supplies under endemic and epidemic conditions in three dengue-endemic countries: Colombia, Thailand, and Vietnam.

Dengue fever has been a major public health concern in Colombia, Thailand, and Vietnam. Unlike other infectious diseases, dengue vaccines had not been available for a long time, causing difficulties to control the disease. However, the first live attenuated, tetravalent dengue vaccine (CYD-TDV) became available in 2016 and has been already licensed in some dengue-endemic countries. Because several second-generation dengue vaccines are also in the pipeline, it is critical to understand the efficient allocation of dengue vaccines considering the geographical variation of the disease. The Climate Risk Factor (CRF) index was created using the climate and non-climate factors in the three countries. A random-coefficient negative binomial model was chosen to validate the relationship between the CRF index and dengue incidence proxy. Given the statistical significance of the CRF index, high risk areas for dengue fever were identified at the 5 km by 5 km resolution and used to estimate vaccination coverage rates and the number of doses required for various types of vaccination scenarios by country. Based upon a three-dose scheme, the estimated number of vaccines required for routine vaccination targeting 9 years old ranged from 1 to 2.6 million doses across the countries during the first year of introduction. A one-off catch-up campaign targeting the age group of 10-17 year olds would require 8 to 18 million additional doses. Routine vaccination (with or without a catch-up campaign) covered 63%, 90%, and 91% of the targeted age group populations in Colombia, Thailand, and Vietnam respectively. Given that many dengue-endemic countries face limited resources and that the costs for mass vaccination campaigns may not be trivial, the findings of this study can guide the decision makers in the three countries regarding the efficient distribution of vaccines by identifying populations at high risk at 5 km by 5 km resolution.

Uptake and timeliness of rotavirus vaccination in Norway: The first year post-introduction

BackgroundTo minimise vaccine-associated risk of intussusception following rotavirus vaccination, Norway adopted very strict age limits for initiating and completing the vaccine series at the time rotavirus vaccination was included in the national immunisation programme, October 2014. Although Norway has a high coverage for routine childhood vaccines, these stringent age limits could negatively affect rotavirus coverage. We documented the status and impact of rotavirus vaccination on other infant vaccines during the first year after its introduction. MethodsWe used individual vaccination data from the national immunisation register to calculate coverage for rotavirus and other vaccines and examine adherence with the recommended schedules. We identified factors associated with completing the full rotavirus series by performing multiple logistic regression analyses. We also evaluated potential changes in uptake and timeliness of other routine vaccines after the introduction of rotavirus vaccine using the Kaplan-Meier method. ResultsThe national coverage for rotavirus vaccine achieved a year after the introduction was 89% for one dose and 82% for two doses, respectively. Among fully rotavirus-vaccinated children, 98% received both doses within the upper age limit and 90% received both doses according to the recommended schedule. The child’s age at the initiation of rotavirus series and being vaccinated with diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (DTaP/IPV/Hib) and pneumococcal vaccines were the strongest predictors of completing the full rotavirus series. No major changes in uptake and timeliness of other paediatric vaccines were observed after introduction of rotavirus vaccine. ConclusionsNorway achieved a high national coverage and excellent adherence with the strict age limits for rotavirus vaccine administration during the first year of introduction, indicating robustness of the national immunisation programme. Rotavirus vaccination did not impact coverage or timeliness of other infant vaccines.

Leveraging Technology to Improve Finances and Care Coordination in a Small Rural Practice [15F

INTRODUCTION: Retaining independence is difficult for OB/GYN practices because of a complex healthcare environment. The purpose of this study is to determine if the implementation of a low-cost electronic practice management system (EHR) improves financial measures and care coordination. METHODS: The OB/GYN practice involved in this study is comprised of 6 physicians and 6 midwives with 150 daily visits. The practice is a member of an Independent Physician Association (IPA) with 180 physicians across 100 practices in rural Georgia. An EHR was utilized for the purposes of this study. The criteria for selection: 1) no upfront costs, 2) care coordination with IPA members, 3) 24/7 patient portal access. athenahealth, a cloud-based EHR, was selected based on the study selection criteria. RESULTS: • Net profit increased 12% in the first year of introduction of implementation • Days in Accounts Receivable decreased by 10.97% • Patient visits increased by 2.93% • No show rate decreased 16.22% overall • Automated, easily accessible quality data gathering demonstrated by improved care coordination with other IPA members. CONCLUSION: This small study demonstrates the use of a low-cost EHR to improve financial outcomes and care coordination for an independent practice in a rural setting. The results of this study merit further investigation to determine how small practices can meet the needs of a 21st century patient population.

An online formative assessment tool to prepare students for summative assessment in physiology

Background. The didactic approach to teaching physiology in our university has traditionally included the delivery of lectures to large groups, illustrating concepts and referencing recommended textbooks. Importantly, at undergraduate level, our assessments demand a level of application of physiological mechanisms to recognised pathophysiological conditions. Objective. To bridge the gap between lectured material and the application of physiological concepts to pathophysiological conditions, we developed a technological tool approach that augments traditional teaching. Methods. Our e-learning initiative, eQuip, is a custom-built e-learning platform specifically created to align question types included in the program to be similar to those used in current assessments. We describe our formative e-learning system and present preliminary results after the first year of introduction, reporting on the performances and perceptions of 2nd-year physiology students. Results. Students who made use of eQuip for at least three of the teaching blocks achieved significantly better results than those who did not use the program (p=0.0032). Questionnaire feedback was positive with regard to the administration processes and usefulness of eQuip. Students reported particularly liking the ease of access to information; however, <60% of them felt that eQuip motivated them to learn. Conclusion. These results are consistent with the literature, which shows that students who made use of an online formative assessment tool performed better in summative assessment tasks. Despite the improved performance of students, the questionnaire results showed that student motives for using online learning tools indicated that they lack self-directed learning skills and seek easy access to information.

Implementation of a patient blood management monitoring and feedback program significantly reduces transfusions and costs.

Patient blood management (PBM) measures have been shown to be effective in reducing transfusions while maintaining patient outcome. The issuance of transfusion guidelines is seen as being key to the success of PBM programs. As the introduction of guidelines alone did not visibly reduce transfusions in our center, a monitoring and feedback program was established. The aim of our study was to show the effectiveness of such measures in reducing transfusions and cost. We designed a prospective, interventional cohort study with a 3-year time frame (January 1, 2012 to December 31, 2014). In total, 101,794 patients aged 18 years or older were included. The PBM monitoring and feedback program was introduced on January 1, 2014, with the subsequent issuance of quarterly reporting. Within the first year of introduction, transfusion of all allogeneic blood products per 1000 patients was reduced by 27% (red blood cell units, -24%; platelet units, -25%; and fresh-frozen plasma units, -37%; all p < 0.001) leading to direct allogeneic blood product related savings of more than 2 million USD. The number of blood products transfused per case was significantly reduced from 9 ± 19 to 7 ± 14 (p < 0.001). With an odds ratio of 0.86 (95% confidence interval, 0.82-0.91), the introduction of our PBM monitoring and feedback program was a significant independent factor in the reduction of transfusion probability (p < 0.001). Our PBM monitoring and feedback program was highly efficacious in reducing the transfusion of allogeneic blood products and transfusion-related costs.

Apparent Red Clover Nitrogen Credit to Corn: Evaluating Cover Crop Introduction

Corn (Zea mays L.) production systems can benefit from introducing a leguminous winter cover crop into the rotation, especially with regard to increased N availability (i.e., legume N credit); however, it is not known if the full agronomic benefit is realized in the first year of cover crop introduction or if the benefit is cumulative with time. The objective of this study was to determine the apparent red clover (Trifolium pratense L.) N credit to corn in a conventional system where red clover was introduced for the first time compared with three agricultural systems that had a 14‐yr history of using cover crops. The apparent red clover N credit was calculated by the difference in unfertilized corn N accumulation between cover and no‐cover split‐split plots. These data suggest that corn growers can realize the full benefits of a red clover cover crop in the first year of introduction.

Bt-Cotton in India: The Technology Wins as the Controversy Wanes India Approves Bt-Cotton – The First Agribiotech Product

Bt-cotton developed by Mahyco (Maharashtra Hybrid Seed Company) containing the Bollgard Bt gene, cry 1Ac, licensed from Monsanto, was approved by Government of India for commercial cultivation in March 2002. This approval was preceded by a large number of laboratory studies and about 500 field trials carried out during 1996-2001 to demonstrate the safety and benefits of Bt-cotton as per regulatory requirements. The area planted with Bt-cotton in 2002, the first year of introduction, was 29,415 ha (72,685 acres). It increased to 86,240 ha in 2003 and to 530,800 ha in 2004. A nationwide survey carried out in 2003 indicated that the Bt-cotton growers in India were able to obtain , on an average, a yield increase by about 29% due to effective control of bollworms, a reduction in chemical sprays by 60% and an increase in net profit by 78% as compared to their non-Bt counterparts. The indications are that the demand for Bt-cotton will grow significantly in the coming years. Realizing its potential, 19 other seed companies have already joined Mahyco-Monsanto as their sub-licensees for Bt-cotton. The details of the development of Bt-cotton, safety studies, field performance, opposition it faced, problem of illegal Bt-cotton and the prospects of this technology in India are outlined in this article.

Strategic reorganisation – impact on antenatal screening service for first trimester combined test in down's syndrome

IntroductionThe UK National Screening Committee (NSC) recommended the first trimester combined test as a screening tool for Down' syndrome in 2007. While the test was available in private healthcare, implementation...

Does customer engagement with internet based services influence adoption of other new products?

AbstractThe impact of the Internet on how and when individuals decide to adopt new products and services remains a critical yet under examined topic. This research examines the linkage between Internet use and the new product diffusion process through the examination of a very large, detailed, Internet usage dataset. Our 12‐month longitudinal analysis of 34,731 customers' Internet related behaviours indicates that the introduction of Internet based services is positively correlated with expedited adoption behaviour. Customers that utilized a company's Internet related service innovations were over twice as likely to adopt the company's new product offering during the first year of introduction. We conclude by discussing the implications and need for additional research. Copyright © 2010 ASAC. Published by John Wiley &amp; Sons, Ltd.

GIS analysis of the spread and population density ofDiabrotica virgifera virgiferaLeConte and its impact on agricultural practice in Slovenia during the period from 2003 to 2007

The western corn rootworm (WCR, Diabrotica virgifera virgifera LeConte) is one of the most important maize pests, and was introduced to Slovenia in 2003 by natural spread from both the East and West. In Slovenia, as in other European countries, different patterns of spread and population growth of the WCR have been observed in maize growing areas, depending on the density of maize fields in the area and the frequency of maize in the crop rotation. In this study, the spread, population growth and impact on agriculture practice of the WCR have been analysed using GIS tools. In the period from 2003 to 2007, the spread and population growth were observed to be different between western and eastern Slovenia due to differences in population pressure from neighbouring areas and the portion of maize in the area. In the West, the distribution and prevalence of WCR has remained approximately unchanged since the first year of introduction, while in the East, both spread and population growth have become more progressive. However, both parameters showed only moderate progress up to 2006, while in 2007, conditions became more favourable for WCR development and spread. Spread was influenced significantly, although there were only 45 captured imagos per positive PAL pheromone trap per year after 4 years of presence, on average. Moderate growth of the WCR population was a consequence of the implementation of area-wide containment measures in a delimited area, which resulted in a considerable decrease of monoculture maize growth. This altered pattern of agricultural practice was confirmed with GIS analysis in areas that were demarcated in 2004 and 2005. In the maize growing area in the East, the portion of area under monocultural maize cultivation decreased from 28% to 5% in demarcated areas of WCR from 2004 and 2005, and decreased from 18% to 2% in 2007. In the area demarcated in 2004 in the West, the portion of monocultural maize is decreased in 2007 to only 3%, compared with 34% in 2003. Obviously Slovenian farmers have followed the legislation to a great extent and adopted crop rotation as the main WCR control measure. Implementation of area-wide containment measures from the first year of WCR infestation resulted in slower population growth and expansion.

Compliance of Companies with Corporate Governance Codes: Case Study on Listed Belgian

Listed and large companies become increasingly subject to internal and external pressure to comply with ethical and social standards. This article focuses on one aspect of this matter, namely the corporate governance issue. Within the framework of recent corporate scandals, this paper investigates whether and to which extent Belgian publicly listed SMEs comply with the Belgian Code on Corporate Governance after its first year of introduction, which has been constituted in the framework of the European Action Plan on Corporate Governance.In a sample of 78 Belgian listed SMEs, the compliance with the Code is analysed. After its first year of introduction, companies comply with on average 70% of the Code’s provisions. The most problematic topics in terms of disclosure of information seem to relate to (individual) remuneration, private information and content of shareholders’ meetings.

Evaluation of mitoxantrone for the treatment of multiple sclerosis

Mitoxantrone (Novantrone®), an antineoplastic agent, has been approved for treating patients with secondary progressive multiple sclerosis (MS). Mitoxantrone, which is usually categorised as an immunosuppressant drug, is now also considered to be a specific immunomodulator. Autoimmune mechanism of pathogenesis of MS is the basis of immunosuppressive therapeutic approaches to MS whereas immunoregulatory abnormalities including defective IFN-α production provide the rationale for immunomodulating therapies. Clinical trials have shown that mitoxantrone had a statistically significant impact on reduction of relapse rate and delay in disability progression in these patients. Advantages of mitoxantrone as therapy for MS are: (1) considerable information is available about its pharmacokinetics, metabolism and toxicology from previous use in oncology; (2) it requires administration only once in three months which is not only convenient for the patient but also cost-effective; (3) mitoxantrone is one of the two drugs to be approved for secondary progressive MS (the other is IFN-β1) which offers an advantage over IFN-β1a preparations and glatiramer acetate which are indicated only for relapsing remitting MS. However, the duration of therapy is usually limited to two to three years because the maximum cumulative dose recommended is 120 mg/m2 due to concern for possible cardiotoxicity. Potential market value of the mitoxantrone, based on the cost of treatment per patient and the number of patients likely to be treated in the first year of introduction, is US$210 million.