Low molecular weight heparin significantly reduces embolisation after carotid endarterectomy - a randomised controller trial

Objectives The administration of unfractionated heparin (UFH) prior to carotid clamping during carotid endarterectomy (CEA) transiently increases the platelet aggregation response to arachidonic acid (AA) despite the use of aspirin. We hypothesized that this phenomenon might be reduced by using low molecular weight heparin (LMWH) resulting in fewer emboli in the early post-operative period. Methods 183 aspirinated patients undergoing CEA were randomised to 5000 IU UFH (n = 91) or 2500 IU LMWH (dalteparin, n = 92) prior to carotid clamping. End-points were: transcranial Doppler (TCD) measurement of embolisation, effect on bleeding and platelet aggregation to AA and adenosine 5′-diphosphate (ADP). Results Patients randomised to UFH had twice the odds of experiencing a higher number of emboli in the first 3 h after CEA, than those randomised to LMWH (p = 0.04). This was not associated with increased bleeding (mean time from flow restoration to operation end: 23 min (UFH) vs. 24 min (LMWH), p = 0.18). Platelet aggregation to AA increased significantly following heparinisation, but was unaffected by heparin type (p = 0.90). The platelets of patients randomised to LMWH exhibited significantly lower aggregation to ADP compared to UFH (p < 0.0001). Conclusions Intravenous LMWH is associated with a significant reduction in post-operative embolisation without increased bleeding. The higher rate of embolisation seen with UFH may be mediated by increased platelet aggregation to ADP, rather than to AA.

Implementation of a Bayesian design in a dose-escalation study of an experimental agent in healthy volunteers

Bayesian decision procedures have recently been developed for dose escalation in phase I clinical trials concerning pharmacokinetic responses observed in healthy volunteers. This article describes how that general methodology was extended and evaluated for implementation in a specific phase I trial of a novel compound. At the time of writing, the study is ongoing, and it will be some time before the sponsor will wish to put the results into the public domain. This article is an account of how the study was designed in a way that should prove to be safe, accurate, and efficient whatever the true nature of the compound. The study involves the observation of two pharmacokinetic endpoints relating to the plasma concentration of the compound itself and of a metabolite as well as a safety endpoint relating to the occurrence of adverse events. Construction of the design and its evaluation via simulation are presented.

The competitive dialogue procedure: Advantages, disadvantages, and its implementation into English and Dutch law

Competitive Dialogue (CD) is a new contract award procedure of the European Community (EC). It is set out in Article 29 of the 'Public Sector Directive' 2004/18/EC. Over the last decades, projects were becoming more and more complex, and the existing EC procedures were no longer suitable to procure those projects. The call for a new procedure resulted in CD. This paper describes how the Directive has been implemented into the laws of two member states: the UK and the Netherlands. In order to implement the Directive, both lawmakers have set up a new and distinct piece of legislation. In each case, large parts of the Directive’s content have been repeated ‘word for word’; only minor parts have been reworded and/or restructured. In the next part of the paper, the CD procedure is examined in different respects. First, an overview is given on the different EC contract award procedures (open, restricted, negotiated, CD) and awarding methods (lowest price and Most Economically Advantageous Tender, MEAT). Second, the applicability of CD is described: Among other limitations, CD can only be applied to public contracts for works, supplies, and services, and this scope of application is further restricted by the exclusion of certain contract types. One such exclusion concerns services concessions. This means that PPP contracts which are set up as services concessions cannot be awarded by CD. The last two parts of the paper pertain to the main features of the CD procedure – from ‘contract notice’ to ‘contract award’ – and the advantages and disadvantages of the procedure. One advantage is that the dialogue allows the complexity of the project to be disentangled and clarified. Other advantages are the stimulation of innovation and creativity. These advantages are set against the procedure’s disadvantages, which include high transaction costs and a perceived hindrance of innovation (due to an ambiguity between transparency and fair competition). It is concluded that all advantages and disadvantages are related to one of three elements: communication, competition, and/or structure of the procedure. Further research is needed to find out how these elements are related.

Planning the sustainable eco-city in Taipei: The implementation of green design and green building schemes

Taipei City has put a significant effort toward the implementation of green design and green building schemes towards a sustainable eco-city. Although some of the environmental indicators have not indicated significant progress in environmental improvement, implementing the two schemes has obtained considerable results; therefore, the two schemes are on the right path towards promoting a sustainable eco-city. However, it has to be admitted that the two schemes are a rather “technocratic” set of solutions and eco-centric approach. It is suggested that not only the public sector but also the private sector need to put more effort toward implement the schemes, and the government needs to encourage the private sector to adopt the schemes in practice.

The role of the Hellenic food safety authority in Greece: implementation strategies

During the last 15 years, a series of food scares and crises (BSE, dioxin. foot and mouth disease) have seriously under-mined public confidence in food producers and operators and their capacity to produce safe food. As a result, food safety has become a top priority of the European legislative authorities and systems of national food control have been tightened up and have included the establishment of the European Food Safety Authority. In Greece a law creating the Hellenic Food Safety Authority has been approved. The main objectives of this Authority are to promote the food security to consumers and inform them of any changes or any development in the food and health sector. The paper reviews the general structure of the current food control system in Greece. It describes the structure and the mission of the Hellenic Food Safety Authority and explains the strategy to carry out inspections and the analysis of the preliminary results of such inspections. Details are also given of the personnel training and certification and accreditation standards to be met by the Authority by the end of 2004. (c) 2005 Elsevier Ltd. All rights reserved.

An analysis of real time implementation of Fourier transform-based frequency recognition algorithms

Frequency recognition is an important task in many engineering fields such as audio signal processing and telecommunications engineering, for example in applications like Dual-Tone Multi-Frequency (DTMF) detection or the recognition of the carrier frequency of a Global Positioning, System (GPS) signal. This paper will present results of investigations on several common Fourier Transform-based frequency recognition algorithms implemented in real time on a Texas Instruments (TI) TMS320C6713 Digital Signal Processor (DSP) core. In addition, suitable metrics are going to be evaluated in order to ascertain which of these selected algorithms is appropriate for audio signal processing(1).

A new organization for a perceptron-based branch predictor and its FPGA implementation

An unaltered rearrangement of the original computation of a neural based predictor at the algorithmic level is introduced as a new organization. Its FPGA implementation generates circuits that are 1.7 faster than a direct implementation of the original algorithm. This faster clock rate allows to implement predictors with longer history lengths using the nearly the same hardware budget.

An efficient low power FFT implementation for multiband full-rate ultra-wideband (UWB) receivers

This paper discusses the design, implementation and synthesis of an FFT module that has been specifically optimized for use in the OFDM based Multiband UWB system, although the work is generally applicable to many other OFDM based receiver systems. Previous work has detailed the requirements for the receiver FFT module within the Multiband UWB ODFM based system and this paper draws on those requirements coupled with modern digital architecture principles and low power design criteria to converge on our optimized solution. The FFT design obtained in this paper is also applicable for implementation of the transmitter IFFT module therefore only needing one FFT module for half-duplex operation. The results from this paper enable the baseband designers of the 200Mbit/sec variant of Multiband UWB systems (and indeed other OFDM based receivers) using System-on-Chip (SoC), FPGA and ASIC technology to create cost effective and low power solutions biased toward the competitive consumer electronics market.

Linear predicted two-pass hexagonal algorithm with parallel implementation for motion estimation

This paper presents a paralleled Two-Pass Hexagonal (TPA) algorithm constituted by Linear Hashtable Motion Estimation Algorithm (LHMEA) and Hexagonal Search (HEXBS) for motion estimation. In the TPA., Motion Vectors (MV) are generated from the first-pass LHMEA and are used as predictors for second-pass HEXBS motion estimation, which only searches a small number of Macroblocks (MBs). We introduced hashtable into video processing and completed parallel implementation. We propose and evaluate parallel implementations of the LHMEA of TPA on clusters of workstations for real time video compression. It discusses how parallel video coding on load balanced multiprocessor systems can help, especially on motion estimation. The effect of load balancing for improved performance is discussed. The performance or the algorithm is evaluated by using standard video sequences and the results are compared to current algorithms.

Two-pass hexagonal algorithm with parallel implementation for video coding

This paper presents a paralleled Two-Pass Hexagonal (TPA) algorithm constituted by Linear Hashtable Motion Estimation Algorithm (LHMEA) and Hexagonal Search (HEXBS) for motion estimation. In the TPA, Motion Vectors (MV) are generated from the first-pass LHMEA and are used as predictors for second-pass HEXBS motion estimation, which only searches a small number of Macroblocks (MBs). We introduced hashtable into video processing and completed parallel implementation. We propose and evaluate parallel implementations of the LHMEA of TPA on clusters of workstations for real time video compression. It discusses how parallel video coding on load balanced multiprocessor systems can help, especially on motion estimation. The effect of load balancing for improved performance is discussed. The performance of the algorithm is evaluated by using standard video sequences and the results are compared to current algorithms.