Diagnostic value of surgical lung biopsy: comparison with clinical and radiological diagnosis

OBJECTIVE: To determine overall and disease-related accuracy of the clinical/imagiological evaluation for pulmonary infiltrates of unknown aetiology, compared with the pathological result of the surgical lung biopsy (SLB) and to evaluate the need for the latter in this setting. METHODS: We conducted a retrospective review of the experiences of SLB in 366 consecutive patients during the past 5 years. The presumptive diagnosis was based on clinical, imagiological and non-invasive or minimally invasive diagnostic procedures and compared with the gold standard of histological diagnosis by SLB. We considered five major pathological groups: diffuse parenchymal lung disease (DPLD), primitive neoplasms, metastases, infectious disease and other lesions. Patients with previous histological diagnosis were excluded. RESULTS: In 56.0% of patients (n=205) clinical evaluation reached a correct diagnosis, in 42.6% a new diagnosis was established (n=156) by the SLB, which was inconclusive in 1.4% (n=5). The pre-test probability for each disease was 85% for DPLD, 75% for infectious disease, 64% for primitive neoplasms and 60% for metastases. Overall sensitivity, specificity, positive and negative predictive values for the clinical/radiological diagnosis were 70%, 90%, 62% and 92%, respectively. For DPLD: 67%, 90%, 76% and 85%; primitive neoplasms: 47%, 90%, 46% and 90%; metastases: 99%, 79%, 60% and 99%; infectious disease 38%, 98%, 53% and 96%. CONCLUSIONS: Despite a high sensitivity and specificity of the clinical and imagiological diagnosis, the positive predictive value was low, particularly in the malignancy group. SLB should be performed in pulmonary infiltrates of unknown aetiology because the clinical/imagiological assessment missed and/or misdiagnosed an important number of patients.

Extraction of added-value products from biomass using ionic liquids

The main purpose of this thesis is to investigate the potential of ionic liquids (ILs) as a new class of extractive solvents for added-value products from biomass. These include phenolic compounds (vanillin, gallic, syringic and vanillic acids), alkaloids (caffeine) and aminoacids (L-tryptophan). The interest on these natural compounds relies on the wide variety of relevant properties shown by those families and further application in the food, cosmetic and pharmaceutical industries. Aiming at developping more benign and effective extraction/purification techniques than those used, a comprehensive study was conducted using aqueous biphasic systems (ABS) composed of ILs and inorganic/organic salts. In addition, ILs were characterized by a polarity scale, using solvatochromic probes, aiming at providing prior indications on the ILs affinity for particular added-value products. Solid-liquid (S-L) extractions from biomass and using aqueous solution of ILs were also investigated. In particular, and applying and experimental factorial design to optimize the operational conditions, caffeine was extracted from guaraná seeds and spent coffee. With both types of extractions it was found that it is possible to recover the high-value compounds and to recycle the IL and salt solutions. Finally, aiming at exploring the recovery of added-value compounds from biomass using a simpler and more suistainable technique, the solubility of gallic acid, vanillin and caffeine was studied in aqueous solutions of several ILs and common salts. With the gathered results it was possible to demonstrate that ILs act as hydrotropes and that water can be used as an adequate antisolvent. This thesis describes the use of ILs towards the development of more effective and sustainable processes.

Boundary value problems for analytic functions in the class of Cauchy-type integrals with density in

We study the Riemann boundary value problem , for analytic functions in the class of analytic functions represented by the Cauchy-type integrals with density in the spaces with variable exponent. We consider both the case when the coefficient is piecewise continuous and it may be of a more general nature, admitting its oscillation. The explicit formulas for solutions in the variable exponent setting are given. The related singular integral equations in the same setting are also investigated. As an application there is derived some extension of the Szegö-Helson theorem to the case of variable exponents.

Adding value to performance measurement by using system dynamics and multicriteria analysis

Tese de dout., Filosofia, Department of Management Science, University of Strathclyde, 2004

A value chain analysis of tuna industry in Ghana

Every can of tuna purchased by the consumer has taken a long journey before reaching the supermarket shelves. For each can bought there is a lengthy process from sea to shelf. A large proportion of the tuna cans purchased in the European Union come all the way from West Africa; a developing region with a high dependency on fisheries. Amidst an ever-increasing demand for tuna products the global tuna fisheries are set to continue expanding, apparently one of the last natural resource based industries fit to do so in West Africa. Tuna is the biggest fisheries export and dominates the fisheries sector in Ghana, a country situated in West Africa. This thesis aims to understand how this globally important industrial fisheries functions in terms of procedures, practices, Governance and finance. Socioeconomic influences, in the setting of a developing country, were also examined. For these purposes a Value Chain Analysis was employed. A Value Chain Analysis is a tool commonly used to understand how different companies and organizations participate in a domestic policy environment, which directs conclusion in the global economy. This analysis has the potential to allow researchers to fully understand a commodity chain and hence identify realistic opportunities for consequential improvements. Interviews and questionnaires were employed in-field Ghana along with secondary data collection techniques. It was found that the fisheries functions at the production level under influences from large multinational companies and tends to operate with a certain degree of lawlessness. Governance over the value chain is well defined, however implementation is poor or non-existent. The processors, whom are also dominated by multinationals, exert some control over the producers and their sales, however the high value links which are highlighted occur at the retail stage. Socioeconomic dynamics acting in the chain included the lack of communication between the public and private sector, power imbalances amongst players at production, the role of local businesswomen as actors in the chain and the general characteristics of the workers in the industry. Value addition and upgrading are needed the most in Governance over the chain, especially within Monitoring, Control and Surveillance. The results of the study provide a wealth of material about the components of a cost-heavy fishing industry in a developing country; an industry on which many eyes have recently turned due to illegal fishing activities. It highlights clearly where funding and future focus are needed. This value chain can be used as a guide for those that need to comprehend the financial complexities and real life dynamics of the Ghanaian tuna fishing industry today.

Enhancing Student Learning Experiences in Sport Psychology Modules Using Practical Activities

The University of Worcester states in its most recent strategic plan (2013 – 2018) a set of enduring values that guide and direct the activities of the institution. The first listed, and perhaps the most important value is the striving to be “an outstanding university at which to be a student”. This is further supplemented by values such as “to inspire our students to reach their full potential through excellent, innovative teaching, scholarship and research” (University of Worcester 2013: p.4). One of the many ways in which the institution strives to provide this outstanding educational experience is through regular engagement, both formal and informal, with students at a number of points in each semester. Regular experiences of collating formal and informal feedback has led to the identification of a common theme amongst Higher National Diploma (HND) students in the Institute of Sport and Exercise Sciences (ISES), where they consistently request ‘more practicals’. The ISES modules however are designed to incorporate a high degree of interaction, practical activities and tasks. This is especially important for those studying at HND level as research suggests differences in learning preferences exist when compared to undergraduate students, the former preferring a more tactile style of learning (Peters et al. 2008). Using an introductory Sport Psychology HND module as an example, practical activities and tasks are fully embedded in the taught sessions to enable contextual links to be made between the learning outcomes and their subsequent use. Examples of these include: a. interviewing athletes to produce a performance profile (Butler & Hardy 1992); b. completing psychometric instruments such as the Competitive State Anxiety Inventory-2 (CSAI-2) to measure competitive anxiety in sport (Martens et al. 1990) and demonstrate data collection and construct measurement; c. performing relaxation interventions on the students to demonstrate how specific techniques (in this instance, decreasing somatic anxiety) might work in practice; d. demonstrating how observational learning facilitates skill acquisition by creating experimental conditions that the students participate in, in teaching a new skill. Nevertheless owing to the students' previously stated on-going requests for more practical activities, it became evident that assumptions about what students consider an effective means of experiential or active learning in the context of sport-related disciplines of study needed to be investigated. This is where the opportunity to undertake an action research project arose, this being a practical method commonly employed in pedagogical enquiry to aid reflection on teaching and assessment practice for the purposes of working towards continuous improvement.

Does Cost-Effectiveness Analysis Have a Role in US Managed Care Drug Formularies? An Empirical Study of Utilization, Costs, Outcomes, and Elasticity of Demand of a Value-Based Formulary

Thesis (Ph.D.)--University of Washington, 2015

Is there really a value in entrepreneurship education?

This paper considers whether entrepreneurship education has a value outside of the education institutions in which it takes place. The paper takes an indirect form of enquiry and argues that entrepreneurship education is driven by three factors; the growing emphasis on supply side policy interventions in the economy; the emphasis placed on the agency of management in the growing literature on globalisation and international reforms to public sector organisations. The paper concludes that there is a tension between the activity as descriptive and the activity as promotion and until this tension is resolved it is unlikely that there will be clarity about the value of this form of education.

Theorising and analysing digital labour: from global value chains to modes of production

This paper considers the following question—where do computers, laptops and mobile phones come from and who produced them? Specific cases of digital labour are examined—the extraction of minerals in African mines under slave-like conditions; ICT manufacturing and assemblage in China (Foxconn); software engineering in India; call centre service work; software engineering at Google within Silicon Valley; and the digital labour of internet prosumers/users. Empirical data and empirical studies concerning these cases are systematically analysed and theoretically interpreted. The theoretical interpretations are grounded in Marxist political economy. The term ‘global value chain’ is criticised in favour of a complex and multidimensional understanding of Marx’s ‘mode of production’ for the purposes of conceptualizing digital labour. This kind of labour is transnational and involves various modes of production, relations of production and organisational forms (in the context of the productive forces). There is a complex global division of digital labour that connects and articulates various forms of productive forces, exploitation, modes of production, and variations within the dominant capitalist mode of production.

The significance of Marx's value for strategy theory: competitive advantage and the issue of tautology within the resource-based view of the firm

Marxian thinking following the TSSI (Temporal Single System Interpretation) of Marx is applied to refute the allegation of a tautology in the resource-based view of the firm--paired with providing an explanation of how and why resources create value--, where resources are synonymous with Marx's categories of constant and variable capital. Refuting the allegation naturally leads to the holy grail of resource-based thinking, i.e. the question of what, conceptually, constitutes a firm's competitive advantage within the industry context. The article achieves its objectives by tying the resource-based view into Marx's theory value.

Diagnostic value of H3F3A mutations in giant cell tumour of bone compared to osteoclast-rich mimics

Driver mutations in the two histone 3.3 (H3.3) genes, H3F3A and H3F3B, were recently identified by whole genome sequencing in 95% of chondroblastoma (CB) and by targeted gene sequencing in 92% of giant cell tumour of bone (GCT). Given the high prevalence of these driver mutations, it may be possible to utilise these alterations as diagnostic adjuncts in clinical practice. Here, we explored the spectrum of H3.3 mutations in a wide range and large number of bone tumours (n 5 412) to determine if these alterations could be used to distinguish GCT from other osteoclast-rich tumours such as aneurysmal bone cyst, nonossifying fibroma, giant cell granuloma, and osteoclast-rich malignant bone tumours and others. In addition, we explored the driver landscape of GCT through whole genome, exome and targeted sequencing (14 gene panel). We found that H3.3 mutations, namely mutations of glycine 34 in H3F3A, occur in 96% of GCT. We did not find additional driver mutations in GCT, including mutations in IDH1, IDH2, USP6, TP53. The genomes of GCT exhibited few somatic mutations, akin to the picture seen in CB. Overall our observations suggest that the presence of H3F3A p.Gly34 mutations does not entirely exclude malignancy in osteoclast-rich tumours. However, H3F3A p.Gly34 mutations appear to be an almost essential feature of GCT that will aid pathological evaluation of bone tumours, especially when confronted with small needle core biopsies. In the absence of H3F3A p.Gly34 mutations, a diagnosis of GCT should be made with caution.

Best practice factory for freight transport in Europe: demonstrating how ‘good’ urban freight cases are improving business profit and public sectors benefits

The objective of this study is to better understand why selected urban freight solutions represent innovations that are technically feasible, economically profitable in different contexts, sustainable, transferable, and with tangible beneficial impacts. A total of 15 solutions are evaluated in the fields of Urban Consolidation Centre, clean and electric vehicles, IT solutions, use of urban waterways, and others. Three solutions are analysed more thoroughly, the Cityporto Padova, the Basel Exhibition Centre logistics support system, and the Berlin laboratory area test of the Bentobox. This paper ends with a transversal analysis of the solutions observed, and with methodological conclusions.