Improved Road Design for Future Maintenance - Analysis of Road Barrier Repair Costs

The cost of a road construction over its service life is a function of the design, quality of construction, maintenance strategies and maintenance operations. Unfortunately, designers often neglect a very important aspect which is the possibility to perform future maintenance activities. The focus is mainly on other aspects such as investment costs, traffic safety, aesthetic appearance, regional development and environmental effects. This licentiate thesis is a part of a Ph.D. project entitled “Road Design for lower maintenance costs” that aims to examine how the life-cycle costs can be optimized by selection of appropriate geometrical designs for the roads and their components. The result is expected to give a basis for a new method used in the road planning and design process using life-cycle cost analysis with particular emphasis on road maintenance. The project started with a review of literature with the intention to study conditions causing increased needs for road maintenance, the efforts made by the road authorities to satisfy those needs and the improvement potential by consideration of maintenance aspects during planning and design. An investigation was carried out to identify the problems which obstruct due consideration of maintenance aspects during the road planning and design process. This investigation focused mainly on the road planning and design process at the Swedish Road Administration. However, the road planning and design process in Denmark, Finland and Norway were also roughly evaluated to gain a broader knowledge about the research subject. The investigation was carried out in two phases: data collection and data analysis. Data was collected by semi-structured interviews with expert actors involved in planning, design and maintenance and by a review of design-related documents. Data analyses were carried out using a method called “Change Analysis”. This investigation revealed a complex combination of problems which result in inadequate consideration of maintenance aspects. Several urgent needs for changes to eliminate these problems were identified. Another study was carried out to develop a model for calculation of the repair costs for damages of different road barrier types and to analyse how factors such as road type, speed limits, barrier types, barrier placement, type of road section, alignment and seasonal effects affect the barrier damages and the associated repair costs. This study was carried out using a method called the “Case Study Research Method”. Data was collected from 1087 barrier repairs in two regional offices of the Swedish Road Administration, the Central Region and the Western Region. A table was established for both regions containing the repair cost per vehicle kilometre for different combinations of barrier types, road types and speed limits. This table can be used by the designers in the calculation of the life-cycle costs for different road barrier types.

Cost-effectiveness of Transcatheter Mitral Valve Leaflet Repair for the Treatment of Mitral Regurgitation in Heart Failure

Contexte: La régurgitation mitrale (RM) est une maladie valvulaire nécessitant une intervention dans les cas les plus grave. Une réparation percutanée de la valve mitrale avec le dispositif MitraClip est un traitement sécuritaire et efficace pour les patients à haut risque chirurgical. Nous voulons évaluer les résultats cliniques et l'impact économique de cette thérapie par rapport à la gestion médicale des patients en insuffisance cardiaque avec insuffisance mitrale symptomatique. Méthodes: L'étude a été composée de deux phases; une étude d'observation de patients souffrant d'insuffisance cardiaque et de régurgitation mitrale traitée avec une thérapie médicale ou le MitraClip, et un modèle économique. Les résultats de l'étude observationnelle ont été utilisés pour estimer les paramètres du modèle de décision, qui a estimé les coûts et les avantages d'une cohorte hypothétique de patients atteints d'insuffisance cardiaque et insuffisance mitrale sévère traitée avec soit un traitement médical standard ou MitraClip. Résultats: La cohorte de patients traités avec le système MitraClip était appariée par score de propension à une population de patients atteints d'insuffisance cardiaque, et leurs résultats ont été comparés. Avec un suivi moyen de 22 mois, la mortalité était de 21% dans la cohorte MitraClip et de 42% dans la cohorte de gestion médicale (p = 0,007). Le modèle de décision a démontré que MitraClip augmente l'espérance de vie de 1,87 à 3,60 années et des années de vie pondérées par la qualité (QALY) de 1,13 à 2,76 ans. Le coût marginal était 52.500 $ dollars canadiens, correspondant à un rapport coût-efficacité différentiel (RCED) de 32,300.00 $ par QALY gagné. Les résultats étaient sensibles à l'avantage de survie. Conclusion: Dans cette cohorte de patients atteints d'insuffisance cardiaque symptomatique et d insuffisance mitrale significative, la thérapie avec le MitraClip est associée à une survie supérieure et est rentable par rapport au traitement médical.

Road Design for Future Maintenance : Life-cycle Cost Analyses for Road Barriers

The cost of a road construction over its service life is a function of design, quality of construction as well as maintenance strategies and operations. An optimal life-cycle cost for a road requires evaluations of the above mentioned components. Unfortunately, road designers often neglect a very important aspect, namely, the possibility to perform future maintenance activities. Focus is mainly directed towards other aspects such as investment costs, traffic safety, aesthetic appearance, regional development and environmental effects. This doctoral thesis presents the results of a research project aimed to increase consideration of road maintenance aspects in the planning and design process. The following subgoals were established: Identify the obstacles that prevent adequate consideration of future maintenance during the road planning and design process; and Examine optimisation of life-cycle costs as an approach towards increased efficiency during the road planning and design process. The research project started with a literature review aimed at evaluating the extent to which maintenance aspects are considered during road planning and design as an improvement potential for maintenance efficiency. Efforts made by road authorities to increase efficiency, especially maintenance efficiency, were evaluated. The results indicated that all the evaluated efforts had one thing in common, namely ignorance of the interrelationship between geometrical road design and maintenance as an effective tool to increase maintenance efficiency. Focus has mainly been on improving operating practises and maintenance procedures. This fact might also explain why some efforts to increase maintenance efficiency have been less successful. An investigation was conducted to identify the problems and difficulties, which obstruct due consideration of maintainability during the road planning and design process. A method called “Change Analysis” was used to analyse data collected during interviews with experts in road design and maintenance. The study indicated a complex combination of problems which result in inadequate consideration of maintenance aspects when planning and designing roads. The identified problems were classified into six categories: insufficient consulting, insufficient knowledge, regulations and specifications without consideration of maintenance aspects, insufficient planning and design activities, inadequate organisation and demands from other authorities. Several urgent needs for changes to eliminate these problems were identified. One of the problems identified in the above mentioned study as an obstacle for due consideration of maintenance aspects during road design was the absence of a model for calculating life-cycle costs for roads. Because of this lack of knowledge, the research project focused on implementing a new approach for calculating and analysing life-cycle costs for roads with emphasis on the relationship between road design and road maintainability. Road barriers were chosen as an example. The ambition is to develop this approach to cover other road components at a later stage. A study was conducted to quantify repair rates for barriers and associated repair costs as one of the major maintenance costs for road barriers. A method called “Case Study Research Method” was used to analyse the effect of several factors on barrier repairs costs, such as barrier type, road type, posted speed and seasonal effect. The analyses were based on documented data associated with 1625 repairs conducted in four different geographical regions in Sweden during 2006. A model for calculation of average repair costs per vehicle kilometres was created. Significant differences in the barrier repair costs were found between the studied barrier types. In another study, the injuries associated with road barrier collisions and the corresponding influencing factors were analysed. The analyses in this study were based on documented data from actual barrier collisions between 2005 and 2008 in Sweden. The result was used to calculate the cost for injuries associated with barrier collisions as a part of the socio-economic cost for road barriers. The results showed significant differences in the number of injuries associated with collisions with different barrier types. To calculate and analyse life-cycle costs for road barriers a new approach was developed based on a method called “Activity-based Life-cycle Costing”. By modelling uncertainties, the presented approach gives a possibility to identify and analyse factors crucial for optimising life-cycle costs. The study showed a great potential to increase road maintenance efficiency through road design. It also showed that road components with low investment costs might not be the best choice when including maintenance and socio-economic aspects. The difficulties and problems faced during the collection of data for calculating life-cycle costs for road barriers indicated a great need for improving current data collecting and archiving procedures. The research focused on Swedish road planning and design. However, the conclusions can be applied to other Nordic countries, where weather conditions and road design practices are similar. The general methodological approaches used in this research project may be applied also to other studies.

Evaluation of Current Repair Criteria for Longitudinal Barrier with Crash Damage

To protect motorists and avoid tort liability, highway agencies expend considerable resources to repair damaged longitudinal barriers, such as w-beam guardrails. With limited funding available, though, highway agencies are unable to maintain all field-installed systems in the ideal as-built condition. Instead, these agencies focus on repairing only damage that has a detrimental effect on the safety performance of the barrier. The distinction between minor damage and more severe performance-altering damage, however, is not always clear. This paper presents a critical review of current United States (US) and Canadian criteria on whether to repair damaged longitudinal barrier. Barrier repair policies were obtained via comprehensive literature review and a survey of US and Canadian transportation agencies. In an analysis of the maintenance procedures of 40 US States and 8 Canadian transportation agencies, fewer than one-third of highway agencies were found to have quantitative measures to determine when barrier repair is warranted. In addition, no engineering basis for the current US barrier repair guidelines could be found. These findings underscore the importance of the development of quantitative barrier repair guidelines based on a strong technical foundation.

Cost-effectiveness of Transcatheter Mitral Valve Leaflet Repair for the Treatment of Mitral Regurgitation in Heart Failure

Contexte: La régurgitation mitrale (RM) est une maladie valvulaire nécessitant une intervention dans les cas les plus grave. Une réparation percutanée de la valve mitrale avec le dispositif MitraClip est un traitement sécuritaire et efficace pour les patients à haut risque chirurgical. Nous voulons évaluer les résultats cliniques et l'impact économique de cette thérapie par rapport à la gestion médicale des patients en insuffisance cardiaque avec insuffisance mitrale symptomatique. Méthodes: L'étude a été composée de deux phases; une étude d'observation de patients souffrant d'insuffisance cardiaque et de régurgitation mitrale traitée avec une thérapie médicale ou le MitraClip, et un modèle économique. Les résultats de l'étude observationnelle ont été utilisés pour estimer les paramètres du modèle de décision, qui a estimé les coûts et les avantages d'une cohorte hypothétique de patients atteints d'insuffisance cardiaque et insuffisance mitrale sévère traitée avec soit un traitement médical standard ou MitraClip. Résultats: La cohorte de patients traités avec le système MitraClip était appariée par score de propension à une population de patients atteints d'insuffisance cardiaque, et leurs résultats ont été comparés. Avec un suivi moyen de 22 mois, la mortalité était de 21% dans la cohorte MitraClip et de 42% dans la cohorte de gestion médicale (p = 0,007). Le modèle de décision a démontré que MitraClip augmente l'espérance de vie de 1,87 à 3,60 années et des années de vie pondérées par la qualité (QALY) de 1,13 à 2,76 ans. Le coût marginal était 52.500 $ dollars canadiens, correspondant à un rapport coût-efficacité différentiel (RCED) de 32,300.00 $ par QALY gagné. Les résultats étaient sensibles à l'avantage de survie. Conclusion: Dans cette cohorte de patients atteints d'insuffisance cardiaque symptomatique et d insuffisance mitrale significative, la thérapie avec le MitraClip est associée à une survie supérieure et est rentable par rapport au traitement médical.

Cost-effectiveness of surgery in low- and middle-income countries: a systematic review.

BACKGROUND: There is increasing interest in provision of essential surgical care as part of public health policy in low- and middle-income countries (LMIC). Relatively simple interventions have been shown to prevent death and disability. We reviewed the published literature to examine the cost-effectiveness of simple surgical interventions which could be made available at any district hospital, and compared these to standard public health interventions. METHODS: PubMed and EMBASE were searched using single and combinations of the search terms "disability adjusted life year" (DALY), "quality adjusted life year," "cost-effectiveness," and "surgery." Articles were included if they detailed the cost-effectiveness of a surgical intervention of relevance to a LMIC, which could be made available at any district hospital. Suitable articles with both cost and effectiveness data were identified and, where possible, data were extrapolated to enable comparison across studies. RESULTS: Twenty-seven articles met our inclusion criteria, representing 64 LMIC over 16 years of study. Interventions that were found to be cost-effective included cataract surgery (cost/DALY averted range US$5.06-$106.00), elective inguinal hernia repair (cost/DALY averted range US$12.88-$78.18), male circumcision (cost/DALY averted range US$7.38-$319.29), emergency cesarean section (cost/DALY averted range US$18-$3,462.00), and cleft lip and palate repair (cost/DALY averted range US$15.44-$96.04). A small district hospital with basic surgical services was also found to be highly cost-effective (cost/DALY averted 1 US$0.93), as were larger hospitals offering emergency and trauma surgery (cost/DALY averted US$32.78-$223.00). This compares favorably with other standard public health interventions, such as oral rehydration therapy (US$1,062.00), vitamin A supplementation (US$6.00-$12.00), breast feeding promotion (US$930.00), and highly active anti-retroviral therapy for HIV (US$922.00). CONCLUSIONS: Simple surgical interventions that are life-saving and disability-preventing should be considered as part of public health policy in LMIC. We recommend an investment in surgical care and its integration with other public health measures at the district hospital level, rather than investment in single disease strategies.

Contribution to active multi-beam reconfigurable antennas for L and S bands

La presente tesis doctoral con título "Contribution to Active Multi-Beam Reconfigurable Antennas for L and S Bands" ha sido desarrollada por el investigador ingeniero de telecomunicación estudiante de doctorado Javier García-Gasco Trujillo en el Grupo de Radiación del Departamento de Señales, Sistemas y Radiocomunicaciones de la ETSI de Telecomunicación de la Universidad Politécnica de Madrid bajo la dirección de los doctores Manuel Sierra Pérez y José Manuel Fernández González. Durante décadas, el desarrollo de antenas de apuntamiento electrónico ha estado limitado al área militar. Su alto coste y su gran complejidad eran los mayores obstáculos que frenaban la introducción de esta tecnología en aplicaciones comerciales de gran escala. La reciente aparición de componentes de estado sólido prácticos, fiables, y de bajo coste ha roto la barrera del coste y ha reducido la complejidad, haciendo que las antenas reconfigurables de apuntamiento electrónico sean una opción viable en un futuro cercano. De esta manera, las antenas phased array podrían llegar a ser la joya de la corona que permitan alcanzar los futuros retos presentes en los sistemas de comunicaciones tanto civiles como militares. Así pues, ahora es el momento de investigar en el desarrollo de antenas de apuntamiento electrónico de bajo coste, donde los nuevos componentes de estado sólido comerciales forman el núcleo duro de la arquitectura. De esta forma, el estudio e implementación de estos arrays de antenas activas de apuntamiento electrónico capaces de controlar la fase y amplitud de las distintas señales implicadas es uno de los grandes retos de nuestro tiempo. Esta tesis se enfrenta a este desafío, proponiendo novedosas redes de apuntamiento electrónico e innovadores módulos de transmisión/recepción (T/R) utilizando componentes de estado sólido de bajo coste, que podrán integrar asequibles antenas activas reconfigurables multihaz en bandas L y S. En la primera parte de la tesis se realiza una descripción del estado del arte de las antenas phased array, incluyendo su base teórica y sus ventajas competitivas. Debido a que las contribuciones obtenidas en la presente tesis han sido realizadas dentro de distintos proyectos de investigación, donde se han manejada antenas de simple/doble polarización circular y simple/doble banda de trabajo, se describen detenidamente los dos proyectos más relevantes de la investigación: el radar de basura espacial de la Agencia Espacial Europea (ESA), Space Situational Awareness (SSA); y la estación base de seguimiento y control de satélites de órbita baja, GEOdesic Dome Array (GEODA). Sin lugar a dudas, los dispositivos desfasadores son uno de los componentes clave en el diseño de antenas phased arrays. Recientemente se ha observado una gran variación en el precio final de estos dispositivos, llegando en ocasiones a límites inasequibles. Así pues, se han propuesto distintas técnicas de conformación de haz alternativas a la utilización de componentes desfasadores comerciales: el desfasador de líneas conmutadas, la red de haz conmutado, y una novedosa red desfasadora divisora/combinadora de potencia. Para mostrar un uso práctico de las mismas, se ha propuesto el uso de las tres alternativas para el caso práctico del subarray de cinco elementos de la celda GEODA-SARAS. Tras dicho estudio se obtiene que la novedosa red desfasadora divisora/combinadora de potencia propuesta es la que mejor relación comportamiento/coste presenta. Para verificar su correcto funcionamiento se construye y mide los dos bloques principales de los que está compuesta la red total, comprobando que en efecto la red responde según lo esperado. La estructura más simple que permite realizar un barrido plano es el array triangular de tres elementos. Se ha realizado el diseño de una nueva red multihaz que es capaz de proporcionar tres haces ortogonales en un ángulo de elevación _0 y un haz adicional en la dirección broadside utilizando el mencionado array triangular de tres elementos como antena. En primer lugar se realizar una breve introducción al estado del arte de las redes clásicas multihaz. Así mismo se comentan innovadores diseños de redes multihaz sin pérdidas. El estudio da paso a las redes disipativas, de tal forma que se analiza su base matemática y se muestran distintas aplicaciones en arrays triangulares de tres elementos. Finalmente, la novedosa red básica propuesta se presenta, mostrando simulaciones y medidas de la misma para el caso prácticoo de GEODA. También se ha diseñado, construido y medido una red compuesta por dos redes básicas complementarias capaz de proporcionar seis haces cuasi-ortogonales en una dirección _0 con dos haces superpuestos en broadside. La red propuesta queda totalmente validada con la fabricación y medida de estos con prototipos. Las cadenas de RF de los módulos T/R de la nueva antena GEODA-SARAS no son algo trivial. Con el fin de mostrar el desarrollo de una cadena compleja con una gran densidad de componentes de estado sólido, se presenta una descripción detallada de los distintos componentes que integran las cadenas de RF tanto en transmisión como en recepción de la nueva antena GEODA-SARAS. Tras presentar las especificaciones de la antena GEODA-SARA y su diagrama de bloques esquemático se describen los dos bloques principales de las cadenas de RF: la celda de cinco elementos, y el módulo de conversión de panel. De la misma manera también se presentará el módulo de calibración integrado dentro de los dos bloques principales. Para comprobar que el funcionamiento esperado de la placa es el adecuado, se realizará un análisis que tratará entre otros datos: la potencia máxima en la entrada del transmisor (comprobando la saturación de la cadena), señal de recepción mínima y máxima (verificando el rango de sensibilidad requerido), y el factor G/T (cumpliendo la especificación necesaria). Así mismo se mostrará un breve estudio del efecto de la cuantificación de la fase en el conformado de haz de RF. Los estudios muestran que la composición de las cadenas de RF permite el cumplimiento de las especificaciones necesarias. Finalmente la tesis muestra las conclusiones globales del trabajo realizado y las líneas futuras a seguir para continuar con esta línea de investigación. ABSTRACT This PhD thesis named "Contribution to Active Multi-Beam Reconfigurable Antennas for L and S Bands", has been written by the Electrical Engineer MSc. researcher Javier García-Gasco Trujillo in the Grupo de Radiación of the Departamento de Señales, Sistemas y Radiocomunicaciones from the ETSI de Telecomunicación of the Universidad Politécnica de Madrid. For decades, the implementation of electronically steerable phased array antennas was confined to the military area. Their high cost and complexity were the major obstacles to introduce this technology in large scale commercial applications. The recent emergence of new practical, low-cost, and highly reliable solid state devices; breaks the barrier of cost and reduces the complexity, making active phased arrays a viable future option. Thus, phased array antennas could be the crown jewel that allow to meet the future challenges in military and civilian communication systems. Now is time to deploy low-cost phased array antennas, where newly commercial components form the core of the architecture. Therefore, the study and implementation of these novel low-cost and highly efficient solid state phased array blocks capable of controlling signal phase/amplitude accurately is one of the great challenges of our time. This thesis faces this challenge, proposing innovative electronic beam steering networks and transmitter/ receiver (T/R) modules using affordable solid state components, which could integrate fair reconfigurable phased array antennas working in L and S bands. In the first part of the thesis, a description of the state of art of phased array antennas, including their fundamentals and their competitive advantages, is presented. Since thesis contributions have been carried out for different research projects, where antennas with single/double circular polarization and single/double working frequency bands have been examined, frameworks of the two more important projects are detailed: the Space Situational Awareness (SSA) programme from the European Space Agency (ESA), and the GEOdesic Dome Array (GEODA) project from ISDEFE-INSA and the ESA. Undoubtedly, phase shifter devices are one of the key components of phased array antennas. Recent years have witnessed wide fluctuations in commercial phase shifter prices, which sometimes led to unaffordable limit. Several RF steering technique alternatives to the commercial phase shifters are proposed, summarized, and compared: the switched line phase shifter, the switched-beam network, and the novel phase shifter power splitter/combiner network. In order to show a practical use of the three different techniques, the five element GEODA-SARAS subarray is proposed as a real case of study. Finally, a practical study of a newly phase shifter power splitter/combiner network for a subarray of five radiating elements with triangular distribution is shown. Measurements of the two different phase shifter power splitter/combiner prototypes integrating the whole network are also depicted, demonstrating their proper performance. A triangular cell of three radiating elements is the simplest way to obtain a planar scanner. A new multibeam network configuration that provides three orthogonal beams in a desired _0 elevation angle and an extra one in the broadside steering direction for a triangular array of three radiating elements is introduced. Firstly, a short introduction to the state of art of classical multi-beam networks is presented. Lossless network analysis, including original lossless network designs, are also commented. General dissipative network theory as well as applications for array antennas of three radiating elements are depicted. The proposed final basic multi-beam network are simulated, built and measured to the GEODA cell practical case. A combined network that provides six orthogonal beams in a desired _0 elevation angle and a double seventh one in the broadside direction by using two complementary proposed basic networks will be shown. Measurements of the whole system will be also depicted, verifying the expected behavior. GEODA-SARAS T/R module RF chains are not a trivial design. A thorough description of all the components compounding GEODA-SARAS T/R module RF chains is presented. After presenting the general specifications of the GEODA-SARAS antenna and its block diagrams; two main blocks of the RF chains, the five element cell and the panel conversion module, are depicted and analyzed. Calibration module integrated within the two main blocks are also depicted. Signal flow throw the system analyzing critical situations such as maximum transmitted power (testing the chain unsaturation), minimum and maximum receiving signal (verifying sensitivity range), maximum receiver interference signals (assuring a proper reception), and G/T factor (fulfilling the technical specification) are evaluated. Phase quantization error effects are also listed. Finally, the manuscript contains the conclusions drawn of the present research and the future work.

Laparoscopic ventral hernia repair is safe and cost effective

BACKGROUND: Ventral hernia repair is increasingly performed by laparoscopic means since the introduction of dual-layer meshes. This study aimed to compare the early complications and cost effectiveness of open hernia repair with those associated with laparoscopic repair. METHODS: Open ventral hernia repair was performed for 92 consecutive patients using a Vypro mesh, followed by laparoscopic repair for 49 consecutive patients using a Parietene composite mesh. RESULTS: The rate of surgical-site infections was significantly higher with open ventral hernia repair (13 vs 1; p = 0.03). The median length of hospital stay was significantly shorter with laparoscopic surgery (7 vs 6 days; p = 0.02). For laparoscopic repair, the direct operative costs were higher (2,314 vs 2,853 euros; p = 0.03), and the overall hospital costs were lower (9,787 vs 7,654 euros; p = 0.02). CONCLUSIONS: Laparoscopic ventral hernia repair leads to fewer surgical-site infections and a shorter hospital stay than open repair. Despite increased operative costs, overall hospital costs are lowered by laparoscopic ventral hernia repair.

Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost

Objective: To compare tension-free open mesh hernioplasty under local anaesthetic with transabdominal preperitoneal laparoscopic hernia repair under general anaesthetic.

Costs, quality of life and cost-effectiveness of open and arthroscopic repair for rotator cuff tears : economic evaluation alongside the UKUFF trial

FUNDING & ACKNOWLEDGEMENTS This project was funded by the NIHR Health Technology Assessment programme (project number 05/47/02) and is published in full in Health Technology Assessment; Vol. 19, No. 80. Further information available at: http://www.nets.nihr.ac.uk/projects/hta/054702 This paper presents independent research commissioned by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, MRC, CCF, NETSCC, the HTA programme or the Department of Health. Due to the confidential nature of the trial data supporting this publication not all of the data can be made accessible to other researchers. Please contact the UKUFF study principal investigator Andrew Carr (andrew.carr@ndorms.ox.ac.uk) for more information. The authors wish to thank the UKUFF trial collaborators for their contribution in managing the conduct of the trial, and for their comments on the interim economic results: Marion Campbell and Hannah Bruhn (Centre for Healthcare Randomised Trials, HSRU, University of Aberdeen), Jonathan Rees MD and David Beard (NDORMS, University of Oxford; NIHR Oxford Biomedical Research Centre), Jane Moser (NDORMS, University of Oxford), Raymond Fitzpatrick and Jill Dawson (NDPH, University of Oxford).

Changes in quantum efficiency of Photosystem II of symbiotic dinoflagellates of corals after heat stress, and of bleached corals sampled after the 1998 Great Barrier Reef mass bleaching event Ross J. Jones , Selina Ward, Affendi Yang Amri and Ove Hoegh-Guldberg

Pulse-amplitude-modulation chlorophyll fluorometry was used to examine changes in dark-adapted F-v/F-m of endosymbiotic dinoflagellate microalgae within the tissues of the temperate coral Plesiastrea versipora exposed to elevated seawater temperature. The F-v/F-m was markedly reduced following exposure of corals to 28 degrees C for 48 h. When corals were returned to ambient (24 degrees C) conditions, F-v/F-m increased in an initial rapid and then secondary slower phase. Tissue discolouration (coral bleaching), caused by a significant decrease in the density of algae, was observed during the first 2-3 days of the recovery period. After 14 days, F-v/F-m was still significantly lower than in control corals. The recovery of F-v/F-m is discussed in terms of repair processes within the symbiotic algae, division of healthy algae and also the selective removal of photo-damaged dinoflagellates. Under field conditions, bleached corals sampled at Heron Island Reef during a bleaching event had significantly lower F-v/F-m than non-bleached colonies; four months after the bleaching event, there were no differences in F-v/F-m or algal density in corals marked as having bleached or having shown no signs of colour loss. The results of this laboratory and field study are consistent with the hypothesis that an impairment of photosynthesis occurs during heat-stress, and is the underlying cause of coral bleaching.

Bone defect repair on the alveolar wall of the maxillary sinus using collagen membranes and temporal fascia. An experimental study in monkeys

Few studies has been done using guided bone regeneration in maxillary sinus defects. Aim: To assess the bone repair process in surgical defects on the alveolar wall of the monkey maxillary sinus, which communicates with the sinus cavity, by using collagen membranes: Gen-derm - Genius Baumer, Pro-tape - Proline and autologous temporal fascia. Materials and Methods: In this prospective and experimental study, orosinusal communications were performed in four tufted capuchin monkeys (Cebus apella) and histologic analysis was carried out 180 days after. Results: In the defects without a cover (control), bone proliferation predominated in two animals and fibrous connective tissue predominated in the other two. In defects repaired with a temporal fascia flap, fibrous connective tissue predominated in three animals and bone proliferation predominated in one. In the defects repaired with Gen-derm or Pro-tape collagen membranes there was complete bone proliferation in three animals and fibrous connective tissue in one. Conclusions: Surgical defect can be repaired with both bone tissue and fibrous connective tissue in all study groups; collagen membranes was more beneficial in the bone repair process than temporal fascia or absence of a barrier.

Macrophages, myofibroblasts and neointimal hyperplasia after coronary artery injury and repair

Macrophages participate in the restenosis process through the release of cytokines, metalloproteinases and growth factors. Studies of peritoneal granulation tissue suggest that macrophages may be precursors of myofibroblasts. This study examined the contribution of monocyte/macrophage lineage cells to neointimal cellular mass in a porcine model of thermal vascular injury. Thermal coronary artery injury caused medial smooth muscle cell necrosis and transformation of the media into an extracellular matrix barrier. The neointimal hyperplasia that developed over the injury sites was evaluated by light microscopy, electron microscopy and immunohistochemistry. At day 3, blood monocytes were adhered to the vessel wall and infiltrated the fibrotic media. At day 14, 42 +/- 3.9% of neointimal cells had a monocytic nuclear morphology and expressed macrophage-specific antigen SWC3 (identified by monoclonal antibody DH59B). Moreover, 9.2+/-1.8% of neointimal cells co-expressed SWC3 and alpha-smooth muscle actin and had ultrastructural characteristics intermediate between macrophages and myofibroblasts. At day 28, 10.5 +/- 3.5%, of cells expressed SWC3 and 5.2+/-1.8% of cells co-expressed SWC3 and alpha-smooth muscle actin. This study indicates that hematopoietic cells of monocyte/macrophage lineage abundantly populate the neointima in the process of lesion formation and may be precursors of neointimal myofibroblasts after thermal vascular injury. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.

Repair-replace strategies for two-dimensional warranty policies

For repairable items sold with free replacement warranty, the actions available to the manufacturer to rectify failures under warranty are to (1) repair the failed item or (2) replace it with a new one. A proper repair-replace strategy can reduce the expected cost of servicing the warranty. In this paper, we study repair-replace strategies for items sold with a two-dimensional free replacement warranty. (C) 2003 Elsevier Ltd. All rights reserved.

Improving contact center cost efficiency and customer experience in a retail company

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics