Core outcome domains for chronic pain clinical trials: IMMPACT recommendations

Objective. To provide recommendations for the core outcome domains that should be considered by investigators conducting clinical trials of the efficacy and effectiveness of treatments for chronic pain. Development of a core set of outcome domains would facilitate comparison and pooling of data, encourage more complete reporting of outcomes, simplify the preparation and review of research proposals and manuscripts, and allow clinicians to make informed decisions regarding the risks and benefits of treatment. Methods. Under the auspices of the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT), 27 specialists from academia. governmental agencies, and the pharmaceutical industry participated in a consensus meeting and identified core outcome domains that should be considered in clinical trials of treatments for chronic pain. Conclusions. There was a consensus that chronic pain clinical trials should assess outcomes representing six core domains: (1) pain, (2) physical functioning, (3) emotional functioning, (4) participant ratings of improvement and satisfaction with treatment, (5) symptoms and adverse events, (6) participant disposition (e.g. adherence to the treatment regimen and reasons for premature withdrawal from the trial). Although consideration should be given to the assessment of each of these domains, there may be exceptions to the general recommendation to include all of these domains in chronic pain trials. When this occurs, the rationale for not including domains should be provided. It is not the intention of these recommendations that assessment of the core domains should be considered a requirement for approval of product applications by regulatory agencies or that a treatment must demonstrate statistically significant effects for all of the relevant core domains to establish evidence of its efficacy. (C) 2003 International Association for the Study of Pain.

Product form approximations for highly linear loss networks with trunk reservation

Admission controls, such as trunk reservation, are often used in loss networks to optimise their performance. Since the numerical evaluation of performance measures is complex, much attention has been given to finding approximation methods. The Erlang Fixed-Point (EFP) approximation, which is based on an independent blocking assumption, has been used for networks both with and without controls. Several more elaborate approximation methods which account for dependencies in blocking behaviour have been developed for the uncontrolled setting. This paper is an exploratory investigation of extensions and synthesis of these methods to systems with controls, in particular, trunk reservation. In order to isolate the dependency factor, we restrict our attention to a highly linear network. We will compare the performance of the resulting approximations against the benchmark of the EFP approximation extended to the trunk reservation setting. By doing this, we seek to gain insight into the critical factors in constructing an effective approximation. (C) 2003 Elsevier Ltd. All rights reserved.

An augmented Lanczos algorithm for the efficient computation of a dot-product of a function of a large sparse symmetric matrix

The Lanczos algorithm is appreciated in many situations due to its speed. and economy of storage. However, the advantage that the Lanczos basis vectors need not be kept is lost when the algorithm is used to compute the action of a matrix function on a vector. Either the basis vectors need to be kept, or the Lanczos process needs to be applied twice. In this study we describe an augmented Lanczos algorithm to compute a dot product relative to a function of a large sparse symmetric matrix, without keeping the basis vectors.

Asymmetric blasting: a rock mass dependent blast design method

Blasting has been the most frequently used method for rock breakage since black powder was first used to fragment rocks, more than two hundred years ago. This paper is an attempt to reassess standard design techniques used in blasting by providing an alternative approach to blast design. The new approach has been termed asymmetric blasting. Based on providing real time rock recognition through the capacity of measurement while drilling (MWD) techniques, asymmetric blasting is an approach to deal with rock properties as they occur in nature, i.e., randomly and asymmetrically spatially distributed. It is well accepted that performance of basic mining operations, such as excavation and crushing rely on a broken rock mass which has been pre conditioned by the blast. By pre-conditioned we mean well fragmented, sufficiently loose and with adequate muckpile profile. These muckpile characteristics affect loading and hauling [1]. The influence of blasting does not end there. Under the Mine to Mill paradigm, blasting has a significant leverage on downstream operations such as crushing and milling. There is a body of evidence that blasting affects mineral liberation [2]. Thus, the importance of blasting has increased from simply fragmenting and loosing the rock mass, to a broader role that encompasses many aspects of mining, which affects the cost of the end product. A new approach is proposed in this paper which facilitates this trend 'to treat non-homogeneous media (rock mass) in a non-homogeneous manner (an asymmetrical pattern) in order to achieve an optimal result (in terms of muckpile size distribution).' It is postulated there are no logical reasons (besides the current lack of means to infer rock mass properties in the blind zones of the bench and onsite precedents) for drilling a regular blast pattern over a rock mass that is inherently heterogeneous. Real and theoretical examples of such a method are presented.

Issues related to the wearing of fall-arrest harnesses in the construction industry

Work-related falls continues to be one of the leading causes of fatalities in the Australian construction industry, and the failure to use fall protection equipment, such as fall-arrest harnesses and arresting devices, has been found to be a contributing factor. In an attempt to gain an understanding of the issues surrounding the use of fallarrest harness systems by construction workers a study involving semi-structured interviews of 15 male construction workers was carried out at three construction sites. The majority of interviewees commented that there was discomfort in wearing a fall-arrest harness; that there were a number of problems when anchored via an arresting device; and that using a fall-arrest system reduced productivity. Most of the interviewees considered that they needed safety precautions against falls, and they expressed the view that workers’ attitudes towards safety depended critically upon their supervisors’ attitude towards safety. It was also found that workers were not trained in rescue procedures. Interviewees expressed concern that retrieval of a suspended worker may not be carried out in time to prevent the onset of suspension trauma. A number of issues were identified which require further research, such as, investigation into suspension trauma, harness and arresting device design, training provided to workers, and the provision for rescues.

Os fundos de investimento imobiliário listados em bolsa e as variáveis que influenciam seus retornos

Os fundos de investimento imobiliário combinam características tanto do mercado imobiliário, fonte de seus rendimentos, quanto do mercado de capitais, ambiente em que são negociados. O impacto de cada um desses mercados subjacentes no comportamento, desempenho e risco dessa classe de ativos não é, no entanto, ainda claramente definida, sendo um dos grandes temas em análise, tanto na literatura acadêmica, quanto na indústria de fundos internacionais. Em face da significativa expansão dessa alternativa de investimento no mercado brasileiro, no presente estudo foram analisadas as variáveis que influenciam os retornos dos fundos imobiliários brasileiros para uma amostra de fundos listados em Bolsa de Valores de São Paulo, período de 2008-2013. Seguindo a metodologia de Clayton e Mackinnon (2003), os fatores explicativos dos retornos foram decompostos em quatro componentes principais, sendo três fatores de retorno de mercado (mercado de ações, mercado de renda fixa e mercado imobiliário) e risco idiossincrático. De acordo com a estatística descritiva, os fundos imobiliários da amostra apresentaram maior retorno em relação aos demais mercados, exceto em comparação com o mercado imobiliário, porém com menor risco. As análises de correlação, regressão e decomposição da variância indicam que o mercado de ações e o mercado imobiliário direto são, em geral, significativos no modelo, porém explicam apenas cerca de 15% da volatilidade dos retornos dos fundos da amostra. À luz da Moderna Teoria do Portfólio, esses resultados indicam que a inclusão de fundos imobiliários pode ter potencial diversificador numa carteira multi-ativo, seja aumentando o retorno total de uma carteira formada de ações e títulos de renda fixa, sem acréscimo em risco; ou mantendo o retorno dessa carteira, com diminuição da volatilidade, ampliando assim a fronteira eficiente da carteira. Esse efeito questiona o tradicional equilibrium fund de carteiras de investimentos formadas apenas de ações e renda fixa e aponta os fundos imobiliários como uma alternativa de investimento diversificadora, enquanto classe de ativo única. A análise de subamostras por tipologia indica, porém, que o papel diversificador dos fundos imobiliários está atrelado ao tipo de empreendimento que lastreia esse fundo, uma vez que os fatores explicativos e seus impactos nos retornos diferem de uma tipologia para outra. Esse resultado tem importantes implicações no critério de seleção a ser adotado tanto por investidores para seleção de ativos para uma carteira otimizada, como para gestores de fundos imobiliários na formatação e gestão desses produtos. Conclui-se também que os retornos dos fundos, de certo modo, refletem seu caráter híbrido, mas o modelo decomposto em 4 componentes não é suficiente para explicar os retornos dos fundos imobiliários, uma vez que o modelo estendido, demonstrou que outras variáveis, inclusive parâmetros desses próprios mercados, além de variáveis macroeconômicas e as características de cada fundo (eg. market-to-book, tamanho), podem ser responsáveis por explicar considerável parte da variância dos retornos dos FIIs.

Estudo da cinética e influência dos métodos de secagem sobre as propriedades físico-químicas de soro de leite

O soro de leite é um subproduto da fabricação do queijo, seja por acidificação ou por processo enzimático. Em condições ideais, a caseína do leite se agrega formando um gel, que posteriormente cortado, induz a separação e liberação do soro. É utilizado de diversas formas em toda a indústria alimentícia, possui rica composição em lactose, sais minerais e proteínas. A desidratação é um dos principais processos utilizados para beneficiamento e transformação do soro. Diante disto, o objetivo deste trabalho foi avaliar a influência dos métodos de secagem: liofilização, leito de espuma (nas temperaturas de 40, 50, 60, 70 e 80ºC) e spray-dryer (nas temperaturas de 55, 60, 65, 70 e 75ºC), sobre as características de umidade, proteína, cor e solubilidade do soro, bem como estudar o seu processo de secagem. O soro foi obtido e desidratado após concentração por osmose reversa, testando 11 tratamentos, em 3 repetições, utilizando um delineamento inteiramente casualizado. Os resultados demonstraram que o modelo matemático que melhor se ajustou foi o modelo de Page, apresentado um coeficiente de determinação ajustado acima de 0,98 e erro padrão da regressão em todas as temperaturas abaixo de 0,04 para o método por leito de espuma. Para o método de liofilização os respectivos valores foram 0,9975 e 0,01612. A partir disso, pode-se elaborar um modelo matemático generalizado, apresentando um coeficiente de determinação igual a 0,9888. No caso do leito de espuma, observou-se que à medida que se aumenta a temperatura do ar de secagem, o tempo de secagem diminui e os valores do coeficiente de difusão efetiva aumentam. Porém, a redução no tempo de secagem entre os intervalos de temperatura, diminui com o aumento da mesma. A energia de ativação para a difusão no processo de secagem do soro foi de 26,650 kJ/mol e para todas as avaliações físico-químicas e tecnológicas, a análise de variância apresentou um valor de F significativo (p<0,05), indicando que há pelo menos um contraste entre as médias dos tratamentos que é significativo.

Integrating environmental and economic life cycle analysis in product development: a material selection case study

Purpose Achieving sustainability by rethinking products, services and strategies is an enormous challenge currently laid upon the economic sector, in which materials selection plays a critical role. In this context, the present work describes an environmental and economic life cycle analysis of a structural product, comparing two possible material alternatives. The product chosen is a storage tank, presently manufactured in stainless steel (SST) or in a glass fibre reinforced polymer composite (CST). The overall goal of the study is to identify environmental and economic strong and weak points related to the life cycle of the two material alternatives. The consequential win-win or trade-off situations will be identified via a Life Cycle Assessment/Life Cycle Costing (LCA/LCC) integrated model. Methods The LCA/LCC integrated model used consists in applying the LCA methodology to the product system, incorporating, in parallel, its results into the LCC study, namely those of the Life Cycle Inventory (LCI) and the Life Cycle Impact Assessment (LCIA). Results In both the SST and CST systems the most significant life cycle phase is the raw materials production, in which the most significant environmental burdens correspond to the Fossil fuels and Respiratory inorganics categories. The LCA/LCC integrated analysis shows that the CST has globally a preferable environmental and economic profile, as its impacts are lower than those of the SST in all life cycle stages. Both the internal and external costs are lower, the former resulting mainly from the composite material being significantly less expensive than stainless steel. This therefore represents a full win-win situation. As a consequence, the study clearly indicates that using a thermoset composite material to manufacture storage tanks is environmentally and economically desirable. However, it was also evident that the environmental performance of the CST could be improved by altering its End-of-Life stage. Conclusions The results of the present work provide enlightening insights into the synergies between the environmental and the economic performance of a structural product made with alternative materials. Further, they provide conclusive evidence to support the integration of environmental and economic life cycle analysis in the product development processes of a manufacturing company, or in some cases even in its procurement practices.

The quest for a sustainable product: An environmental study of tyre recyclates

The main objective of the present study is to assess the environmental advantages of substituting aluminium for a polymer composite in the manufacture of a structural product (a frame to be used as a support for solar panels). The composite was made of polypropylene and a recycled tyres’ rubber granulate. Analysis of different composite formulations was performed, to assess the variation of the environmental impact with the percentage of rubber granulate incorporation. The results demonstrate that the decision on which of the two systems (aluminium or composite) has the best life cycle performance is strongly dependent on the End-of Life (EoL) stage of the composite frame. When the EoL is deposition in a landfill, the aluminium frame performs globally better than its composite counterpart. However, when it is incineration with energy recovery or recycling, the composite frame is environmentally preferable. The raw material production stage was found to be responsible for most of the impacts in the two frame systems. In that context, it was shown that various benefits can accrue in several environmental impact categories by recycling rubber tyres and using the resulting materials. This is in a significant part also due to the recycling of the steel in the tyres. The present work illustrates how it is possible to minimize the overall environmental impact of consumer products through the adequate selection of their constitutive materials in the design stage. Additionally it demonstrates how an adequate EoL planning can be an important issue when developing a sustainable product, since it can highly influence its overall life cycle performance.

Improving the environmental performance of bedding products by using life cycle assessment at the design stage

Improvement of the environmental performance of processes and products is a common objective in industry, and has been receiving increased attention in recent years. The main objective of this work is to evaluate the potential environmental impact of two bedding products, a polyurethane foam mattress (PFM) and a pocket spring mattress (PSM). These two types are the most common mattresses used in Europe. A Life Cycle Assessment (LCA) shows that the PFM has a higher environmental impact than the PSM. For both products the main cause of environmental impact is the manufacturing process, respectively the polyurethane foam block moulding process for the PFM, and the pocket spring nucleus process for the PSM. A scenario analysis shows the possibility of reducing the environmental impact of the products’ life cycle using an alternative End-of-Life scenario, resorting to incineration rather than landfill. Two strategies were also studied in order to reduce the environmental impact of the PFM: (1) reutilization of foam that was sent to the waste system management, and (2) a 20% weight reduction of the polyurethane foam. The second strategy has proven to be the most effective.

Reducing fuel consumption through modular vehicle architectures

By identifying energy waste streams in vehicles fuel consumption and introducing the concept of lean driving systems, a technological gap for reducing fuel consumption was identified. This paper proposes a solution to overcome this gap, through a modular vehicle architecture aligned with driving patterns. It does not address detailed technological solutions; instead it models the potential effects in fuel consumption through a modular concept of a vehicle and quantifies their dependence on vehicle design parameters (manifesting as the vehicle mass) and user behavior parameters (driving patterns manifesting as the use of a modular car in lighter and heavier mode, in urban and highway cycles). Modularity has been functionally applied in automotive industry as manufacture and assembly management strategies; here it is thought as a product development strategy for flexibility in use, driven by environmental concerns and enabled by social behaviors. The authors argue this concept is a step forward in combining technological solutions and social behavior, of which eco-driving is a vivid example, and potentially evolutionary to a lean, more sustainable, driving culture.