The cost-effectiveness of total laparoscopic hysterectomy compared to total abdominal hysterectomy for the treatment of early stage endometrial cancer

Objective To summarise how costs and health benefits will change with the adoption of total laparoscopic hysterectomy compared to total abdominal hysterectomy for the treatment of early stage endometrial cancer. Design Cost-effectiveness modelling using the information from a randomised controlled trial. Participants Two hypothetical modelled cohorts of 1000 individuals undergoing total laparoscopic hysterectomy and total abdominal hysterectomy. Outcome measures Surgery costs; hospital bed days used; total healthcare costs; quality-adjusted life years; and net monetary benefits. Results For 1000 individuals receiving total laparoscopic hysterectomy surgery, the costs were $509 575 higher, 3548 hospital fewer bed days were used and total health services costs were reduced by $3 746 221. There were 39.13 more quality-adjusted life years for a 5 year period following surgery. Conclusions The adoption of total laparoscopic hysterectomy is almost certainly a good decision for health services policy makers. There is 100% probability that it will be cost saving to health services, a 86.8% probability that it will increase health benefits and a 99.5% chance that it returns net monetary benefits greater than zero.

Analysis of albumin-associated peptides and proteins from ovarian cancer patients

Albumin binds low–molecular-weight molecules, including proteins and peptides, which then acquire its longer half-life, thereby protecting the bound species from kidney clearance. We developed an experimental method to isolate albumin in its native state and to then identify [mass spectrometry (MS) sequencing] the corresponding bound low–molecular-weight molecules. We used this method to analyze pooled sera from a human disease study set (high-risk persons without cancer, n= 40; stage I ovarian cancer, n = 30; stage III ovarian cancer, n = 40) to demonstrate the feasibility of this approach as a discovery method. Methods Albumin was isolated by solid-phase affinity capture under native binding and washing conditions. Captured albumin-associated proteins and peptides were separated by gel electrophoresis and subjected to iterative MS sequencing by microcapillary reversed-phase tandem MS. Selected albumin-bound protein fragments were confirmed in human sera by Western blotting and immunocompetition. Results In total, 1208 individual protein sequences were predicted from all 3 pools. The predicted sequences were largely fragments derived from proteins with diverse biological functions. More than one third of these fragments were identified by multiple peptide sequences, and more than one half of the identified species were in vivo cleavage products of parent proteins. An estimated 700 serum peptides or proteins were predicted that had not been reported in previous serum databases. Several proteolytic fragments of larger molecules that may be cancer-related were confirmed immunologically in blood by Western blotting and peptide immunocompetition. BRCA2, a 390-kDa low-abundance nuclear protein linked to cancer susceptibility, was represented in sera as a series of specific fragments bound to albumin. Conclusion Carrier-protein harvesting provides a rich source of candidate peptides and proteins with potential diverse tissue and cellular origins that may reflect important disease-related information.

Third harmonic generation of the surface wave in the semiconductor-metal slowing-down structure

A nonlinear process is considered of the surface wave third harmonics generation in a slowing-down semiconductor-metal structure. The process is conditioned by non-parabolicity of the charge carrier dispersion law. It is shown that in narrow-gap semiconducting materials it is necessary to account for the process together with the surface wave second harmonics generation conditioned by nonlinearity of quasi-hydrodynamics and the Maxwell equations. The conclusion is made that the third harmonies amplitude in narrow-gap semiconductors may exceed substantially the signal amplitude at the 3w frequency in a gas plasma and be of the same order with the surface waves second harmonies amplitude.

Multi-stage collapse events in the South Soufrière Hills, Montserrat as recorded in marine sediment cores

We present new evidence for sector collapses of the South Soufrière Hills (SSH) edifice, Montserrat during the mid-Pleistocene. High-resolution geophysical data provide evidence for sector collapse, producing an approximately 1 km3 submarine collapse deposit to the south of SSH. Sedimentological and geochemical analyses of submarine deposits sampled by sediment cores suggest that they were formed by large multi-stage flank failures of the subaerial SSH edifice into the sea. This work identifies two distinct geochemical suites within the SSH succession on the basis of trace-element and Pb-isotope compositions. Volcaniclastic turbidites in the cores preserve these chemically heterogeneous rock suites. However, the subaerial chemostratigraphy is reversed within the submarine sediment cores. Sedimentological analysis suggests that the edifice failures produced high-concentration turbidites and that the collapses occurred in multiple stages, with an interval of at least 2 ka between the first and second failure. Detailed field and petrographical observations, coupled with SEM image analysis, shows that the SSH volcanic products preserve a complex record of magmatic activity. This activity consisted of episodic explosive eruptions of andesitic pumice, probably triggered by mafic magmatic pulses and followed by eruptions of poorly vesiculated basaltic scoria, and basaltic lava flows.

Clinical impacts of mammalian target of rapamycin expression in human colorectal cancers

This study investigated the clinicopathologic roles of mammalian target of rapamycin (mTOR) expression and its relationship to carcinogenesis and tumor progression in a colorectal adenoma-adenocarcinoma model. Two colon cancer cell lines with different pathologic stages (SW480 and SW48) and 1 normal colonic epithelial cell line (FHC) were used, in addition to 119 colorectal adenocarcinomas and 32 adenomas. mTOR expression profiles at messenger RNA (mRNA) and protein levels were investigated in the cells and tissues using real-time quantification polymerase chain reaction and immunohistochemistry. The findings were correlated with the clinicopathologic features of the tumors. The colon cell line from stage III cancer (SW48) showed higher expression of mTOR mRNA than that from stage II cancer (SW480). At the tissue level, mTOR showed higher mRNA and protein expression in colorectal carcinoma than in adenoma. The mRNA and protein expression was correlated with each other in approximately one-third of the carcinomas and adenomas. High levels of mTOR mRNA expression were noted more in carcinoma or adenoma arising from the distal portion of the large intestine (P = .025 and .019, respectively). Within the colorectal cancer population, a high level of expression of mTOR mRNA was related to the presence of lymph node metastases (P = .031), advanced pathologic stage (P = .05), and presence of persistent disease or tumor recurrence (P = .035). To conclude, the study has indicated that mTOR is likely to be involved in the development and progression of colorectal cancer and is linked to cancer initiation, invasiveness, and progression.

Impact of child labor on academic performance : evidence from the program "Edúcame Primero Colombia"

In this study, the effects of different variables of child labor on academic performance are investigated. To this end, 3302 children participating in the child labor eradication program “Edúcame Primero Colombia” were interviewed. The interview format used for the children's enrollment into the program was a template from which socioeconomic conditions, academic performance, and child labor variables were evaluated. The academic performance factor was determined using the Analytic Hierarchy Process (AHP). The data were analyzed through a logistic regression model that took into account children who engaged in a type of labor (n = 921). The results showed that labor conditions, the number of weekly hours dedicated to work, and the presence of work scheduled in the morning negatively affected the academic performance of child laborers. These results show that the relationship between child labor and academic performance is based on the conflict between these two activities. These results do not indicate a linear and simple relationship associated with the recognition of the presence or absence of child labor. This study has implications for the formulation of policies, programs, and interventions for preventing, eradicating, and attenuating the negative effects of child labor on the social and educational development of children.

Mediated politics in Australia : towards a qualitative evaluation

The debate about the democratic significance of these trends—a more aggressively inquisitorial media environment, greater public participation in political communication, a more accessible and transparent (at least in appearance) political class—continues, not least in Australia. This essay was written in the first half of 2013, a time of extreme political volatility in Australia, and in the run-up to a general election following three years of minority Labor government. By that stage in the political cycle, Prime Minister Julia Gillard had survived not one but two attempts at leadership “spills”, ministers had resigned or been sacked for disloyalty to the leader, major policy initiatives had been dumped, reversed or quietly dropped, and a Coalition opposition was confidently looking forward to a landslide majority in the election of September that year. Labor’s internal party turmoil, rather than the Coalition’s policy prospectus (which remained sketchy and vague right up to the eve of the election), were widely assumed to be the cause of the former’s poor standing in the opinion polls.

Proceedings of the Third International Workshop on Theory and Applications of Process Visualization

This is the third TAProViz workshop being run at BPM. The intention this year is to consolidate on the results of the previous successful workshops by further developing this important topic, identifying the key research topics of interest to the BPM visualization community. We note this year the continuing interest in the visualisation of process mining data and resultant process models. More info at: http://wst.univie.ac.at/topics/taproviz14/

Bluebird AR

"What is Bluebird AR? Bluebird AR was the ABC's alternate reality drama set around the leak of Bluebird, a clandestine geoengineering initiative created by eco-billionaire Harrison Wyld. Proposing a fictional scenario set against a backdrop of real world possibilities, Bluebird AR took some of the conventions of the well-established alternate reality game (ARG) genre and pulled them into the relatively new area of online drama, to create a hybrid entertainment form best described as 'participatory drama'. With Bluebird AR's interactive narrative centred on the experimental science of geoengineering, the deliberate manipulation of the Earth's atmosphere to counteract global warming, the events and characters in the Bluebird story were entirely fictional but fused with reality online. Inhabiting a mixture of third party social media spaces and websites created by the ABC, the story incorporated real online articles, scientific journals, media and debate around geoengineering. In an Australian first, ABC Innovation launched Bluebird AR on 27 April 2010, with a 6 week live phase. Audience members were invited to play collectively to help 'unlock the drama' and push forward the emerging narrative, or passively watch the story unfold in real-time across the internet. Bluebird AR subverted ARG conventions with the high quality of its production and assets, and raised the stakes for online drama with its level of audience participation." © 2014 ABC "Introduction One of the most exciting creative challenges of producing Bluebird AR was formulating the broad array of visual styles and treatments required for the project's diverse range of content. Many assets also needed to translate well not only online but across other media, including television and print. With the project's producers keen to create a visually rich narrative with high production values from the outset, inspiration for the production design for various aspects of the Bluebird story began in the earliest pitching phase in September 2008. Particular visual treatments and styles for Bluebird's characters, their web spaces and real world possessions were formulated concurrently with the creation of their profiles. Ideas around how various clues and gameplay spaces might look and feel were also explored at this early stage. Bluebird AR's small but tight creative team produced 7 website designs and brands, motion graphics for title sequences and logo animations, rotoscope animation, 3D compositing and animation, 3D wireframes and schematics, countless Photoshop composites, and a vast array of character assets for the DC (including Kyle's Bluebird Labs security pass and resignation letter, Kruger's American and Russia passports and birth certificate, Harrison's divorce papers, and more)…" © 2014 ABC

A comparison of treatment options for management of end stage kidney disease in elderly patients : a systematic review

Background Chronic kidney disease is a global public health problem of increasing prevalence. There are five stages of kidney disease, with Stage 5 indicating end stage kidney disease (ESKD) requiring dialysis or death will eventually occur. Over the last two decades there have been increasing numbers of people commencing dialysis. A majority of this increase has occurred in the population of people who are 65 years and over. With the older population it is difficult to determine at times whether dialysis will provide any benefit over non-dialysis management. The poor prognosis for the population over 65 years raises issues around management of ESKD in this population. It is therefore important to review any research that has been undertaken in this area which compares outcomes of the older ESKD population who have commenced dialysis with those who have received non-dialysis management. Objective The primary objective was to assess the effect of dialysis compared with non-dialysis management for the population of 65 years and over with ESKD. Inclusion criteria Types of participants This review considered studies that included participants who were 65 years and older. These participants needed to have been diagnosed with ESKD for greater than three months and also be either receiving renal replacement therapy (RRT) (hemodialysis [HD] or peritoneal dialysis [PD]) or non-dialysis management. The settings for the studies included the home, self-care centre, satellite centre, hospital, hospice or nursing home. Types of intervention(s)/phenomena of interest This review considered studies where the intervention was RRT (HD or PD) for the participants with ESKD. There was no restriction on frequency of RRT or length of time the participant received RRT. The comparator was participants who were not undergoing RRT. Types of studies This review considered both experimental and epidemiological study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, before and after studies, prospective and retrospective cohort studies, case control studies and analytical cross sectional studies. This review also considered descriptive epidemiological study designs including case series, individual case reports and descriptive cross sectional studies for inclusion. This review included any of the following primary and secondary outcome measures: •Primary outcome – survival measures •Secondary outcomes – functional performance score (e.g. Karnofsky Performance score) •Symptoms and severity of end stage kidney disease •Hospital admissions •Health related quality of life (e.g. KDQOL, SF36 and HRQOL) •Comorbidities (e.g. Charlson Comorbidity index).

Self-management programs in stage 1-4 chronic kidney disease : a literature review.

Background Chronic kidney disease (CKD) is a complex health problem, which requires individuals to invest considerable time and energy in managing their health and adhering to multifaceted treatment regimens. Objectives To review studies delivering self-management interventions to people with CKD (Stages 1–4) and assess whether these interventions improve patient outcomes. Design: Systematic review. Methods Nine electronic databases (MedLine, CINAHL, EMBASE, ProQuest Health & Medical Complete, ProQuest Nursing & Allied Health, The Cochrane Library, The Joanna Briggs Institute EBP Database, Web of Science and PsycINFO) were searched using relevant terms for papers published between January 2003 and February 2013. Results The search strategy identified 2,051 papers, of which 34 were retrieved in full with only 5 studies involving 274 patients meeting the inclusion criteria. Three studies were randomised controlled trials, a variety of methods were used to measure outcomes, and four studies included a nurse on the self-management intervention team. There was little consistency in the delivery, intensity, duration and format of the self-management programmes. There is some evidence that knowledge- and health-related quality of life improved. Generally, small effects were observed for levels of adherence and progression of CKD according to physiologic measures. Conclusion The effectiveness of self-management programmes in CKD (Stages 1–4) cannot be conclusively ascertained, and further research is required. It is desirable that individuals with CKD are supported to effectively self-manage day-to-day aspects of their health.

A two-stage item recommendation method using probabilistic ranking with reconstructed tensor model

In a tag-based recommender system, the multi-dimensional correlation should be modeled effectively for finding quality recommendations. Recently, few researchers have used tensor models in recommendation to represent and analyze latent relationships inherent in multi-dimensions data. A common approach is to build the tensor model, decompose it and, then, directly use the reconstructed tensor to generate the recommendation based on the maximum values of tensor elements. In order to improve the accuracy and scalability, we propose an implementation of the -mode block-striped (matrix) product for scalable tensor reconstruction and probabilistically ranking the candidate items generated from the reconstructed tensor. With testing on real-world datasets, we demonstrate that the proposed method outperforms the benchmarking methods in terms of recommendation accuracy and scalability.