Using historical lesion volume data in the design of a new phase II clinical trial in acute stroke

Background and Purpose-Clinical research into the treatment of acute stroke is complicated, is costly, and has often been unsuccessful. Developments in imaging technology based on computed tomography and magnetic resonance imaging scans offer opportunities for screening experimental therapies during phase II testing so as to deliver only the most promising interventions to phase III. We discuss the design and the appropriate sample size for phase II studies in stroke based on lesion volume. Methods-Determination of the relation between analyses of lesion volumes and of neurologic outcomes is illustrated using data from placebo trial patients from the Virtual International Stroke Trials Archive. The size of an effect on lesion volume that would lead to a clinically relevant treatment effect in terms of a measure, such as modified Rankin score (mRS), is found. The sample size to detect that magnitude of effect on lesion volume is then calculated. Simulation is used to evaluate different criteria for proceeding from phase II to phase III. Results-The odds ratios for mRS correspond roughly to the square root of odds ratios for lesion volume, implying that for equivalent power specifications, sample sizes based on lesion volumes should be about one fourth of those based on mRS. Relaxation of power requirements, appropriate for phase II, lead to further sample size reductions. For example, a phase III trial comparing a novel treatment with placebo with a total sample size of 1518 patients might be motivated from a phase II trial of 126 patients comparing the same 2 treatment arms. Discussion-Definitive phase III trials in stroke should aim to demonstrate significant effects of treatment on clinical outcomes. However, more direct outcomes such as lesion volume can be useful in phase II for determining whether such phase III trials should be undertaken in the first place. (Stroke. 2009;40:1347-1352.)

The need of sustainable buildings construction in the Kingdom of Bahrain

This thesis is aimed to initiate implementing sustainable building construction in the kingdom of Bahrain, i.e. Building-Integration PhotoVoltaic (BIPV) or Wind Energy (BIWE). It highlights the main constrains that discourage such modern concept in building and construction. Three groups have been questioned using a questionnaire. These are the policy and decision makers, the leading consultants and the contractors. The main constrains of the dissemination of BIVP and BIWE, according to the policy and decision makers, are: lack of knowledge and awareness of the public in sustainable technology, low cost of electricity, low cost of gas and oil and difficulty in applying local environmental taxes. The consultants had attributed the constrains to ignorance of life cycle cost of PV and Wind turbines systems, lack of education and knowledge in sustainable design, political system, shortage of markets importing sustainable technologies and client worries in profitability and pay-back period. The contractors are found to be very enthusiastic and ready to take over any sustainable building project and prefer to have a construction manger to coordinate between the design and contracting team. Design and Build is found the favorable procurement method in Bahrain for conducting BIPV or BIWE projects.

Evidence of systematic approaches to innovation in facilities management

Purpose – This paper seeks to examine the nature of “service innovation” in the facilities management (FM) context. It reviews recent thinking on “service innovation” as distinct from “product innovation”. Applying these contemporary perspectives it describes UK case studies of 11 innovations in different FM organisations. These include both in-house client-based innovations and third-party innovations. Design/methodology/approach – The study described in the paper encompasses 11 different innovations that constitute a mix of process, product and practice innovations. All of the innovations stem from UK-based organisations that were subject to in-depth interviews regarding the identification, screening, commitment of resources and implementation of the selected innovations. Findings – The research suggested that service innovation is highly active in the UK FM sector. However, the process of innovation rarely followed a common formalized path. Generally, the innovations were one-shot commitments at the early stage. None of the innovations studied failed to proceed to full adoption stage. This was either due to the reluctance of participating organisations to volunteer “tested but unsuccessful” innovations or the absence of any trial methods that might have exposed an innovations shortcomings. Research limitations/implications – The selection of innovations was restricted to the UK context. Moreover, the choice of innovations was partly determined by the innovating organisation. This selection process appeared to emphasise “one-shot” high profile technological innovations, typically associated with software. This may have been at the expense of less resource intensive, bottom-up innovations. Practical implications – This paper suggests that there is a role for “research and innovation” teams within larger FM organisations, whether they are client-based or third-party. Central to this philosophy is an approach that is open to the possibility of failure. The innovations studied were risk averse with a firm commitment to proceed at the early stage. Originality/value – This paper introduces new thinking on the subject of “service innovation” to the context of FM. It presents research and development as a planned solution to innovation. This approach will enable service organisations to fully test and exploit service innovations.

Comparison of mechanical properties of tension and opposite wood in Populus

In this paper we focused on the differences of mechanical properties of tension and normal wood of 1-year-old poplar trees, artificially tilted. Elastic and fracture properties have been measured and linked to the anatomy. Tension wood is well known because it prevents good surface finishing and leads to difficulties with sawing. We studied three main mechanical properties: young modulus, energy of cutting and longitudinal residual strain of maturation (with strain gauges) because of their importance in wood technology. Moreover, this work takes place in a larger project of study, the phenomena of axes re-orientation in trees (allowing by the production of reaction wood), where these data are required for biomechanical modelling. The results show that tension wood has a higher young modulus, needs a higher energy to be cut and exhibited a higher level of longitudinal residual strain of maturation than those of normal wood. The results suggest that these differences require deeper analysis of the wood than anatomy: measurement of microfibril orientation in the S2 layer and also the lignin composition in monomeric units.

E-governments' role activation in arab countries

This paper discusses the activating role of e-Governments in the Arab countries, by seeking new rules and innovative ways to provide services to the public sector. It starts from the analysis of different stages and dimensions of e-government through better understanding of the phenomenon and investment of opportunities in Information Technology in order to develop the role of governments and departments of public affairs particularly in Arab countries. In the developing countries most of the Arab governments may be doing their best to deliver the best services they can offer but with low level of efficiency and high cost. This raised many questions about productivity and performance of government agencies; the problem of low productivity and poor performance in the government sector that affected individuals and administrative units. This paper aims to analyze the different stages, concepts and dimensions of e-government and to understand the opportunities that information technology offers, especially in Arab countries in order to develop the government role as well as public affairs administration system.

Ocean data dissemination: new challenges for data integration

In the decade since OceanObs `99, great advances have been made in the field of ocean data dissemination. The use of Internet technologies has transformed the landscape: users can now find, evaluate and access data rapidly and securely using only a web browser. This paper describes the current state of the art in dissemination methods for ocean data, focussing particularly on ocean observations from in situ and remote sensing platforms. We discuss current efforts being made to improve the consistency of delivered data and to increase the potential for automated integration of diverse datasets. An important recent development is the adoption of open standards from the Geographic Information Systems community; we discuss the current impact of these new technologies and their future potential. We conclude that new approaches will indeed be necessary to exchange data more effectively and forge links between communities, but these approaches must be evaluated critically through practical tests, and existing ocean data exchange technologies must be used to their best advantage. Investment in key technology components, cross-community pilot projects and the enhancement of end-user software tools will be required in order to assess and demonstrate the value of any new technology.

Real estate investment in global financial centers: risk, return and contagion

Global financial activity is heavily concentrated in a small number of world cities –international financial centers. The office markets in those cities receive significant flows of investment capital. The growing specialization of activity in IFCs and innovations in real estate investment vehicles lock developer, occupier, investment, and finance markets together, creating common patterns of movement and transmitting shocks from one office market throughout the system. International real estate investment strategies that fail to recognize this common source of volatility and risk may fail to deliver the diversification benefits sought.

Letterforms for handwriting and reading: print script and sanserifs in early twentieth-century England

This essay is about letterforms and typography in reading books for young children and how they were influenced by the teaching of handwriting in the early decades of the twentieth century. I examine the contributions made by infant teachers to typography and book design and draw particular attention to the print script movement and the gradual introduction of sanserif typefaces in reading books. I suggest that the use of sanserifs in reading books for young children is one of their first appearances for continuous text. Although the influence of print script on the teaching of handwriting may have had some undesirable effects, I suggest that it indirectly contributed to some innovations in book design.

Detection of faults in a high speed packaging machine using a multilayer perceptron (MLP)

In high speed manufacturing systems, continuous operation is desirable, with minimal disruption for repairs and service. An intelligent diagnostic monitoring system, designed to detect developing faults before catastrophic failure, or prior to undesirable reduction in output quality, is a good means of achieving this. Artificial neural networks have already been found to be of value in fault diagnosis of machinery. The aim here is to provide a system capable of detecting a number of faults, in order that maintenance can be scheduled in advance of sudden failure, and to reduce the necessity to replace parts at intervals based on mean time between failures. Instead, parts will need to be replaced only when necessary. Analysis of control information in the form of position error data from two servomotors is described.

Considering user attitude and behavior in persuasive systems design: the 3D-RAB model

As in any technology systems, analysis and design issues are among the fundamental challenges in persuasive technology. Currently, the Persuasive Systems Development (PSD) framework is considered to be the most comprehensive framework for designing and evaluation of persuasive systems. However, the framework is limited in terms of providing detailed information which can lead to selection of appropriate techniques depending on the variable nature of users or use over time. In light of this, we propose a model which is intended for analysing and implementing behavioural change in persuasive technology called the 3D-RAB model. The 3D-RAB model represents the three dimensional relationships between attitude towards behaviour, attitude towards change or maintaining a change, and current behaviour, and distinguishes variable levels in a user’s cognitive state. As such it provides a framework which could be used to select appropriate techniques for persuasive technology.

Auditing technology uses within a global voluntary organisation

WAGGGS, the World Association of Girl Guides and Girl Scouts, is the umbrella organization for Member Organizations from 145 countries around the world. As such one of its remits is to provide programmes that promote leadership development and opportunities for girls and young women to advocate on issues they care about. One of the ways WAGGGS is exploring to do this more widely and efficiently is through the use of digital technologies. This paper presents the results of an audit undertaken of the technologies already used by potential participants in online communities and courses and investigates the challenges faced in using technology to facilitate learning, within this context.