The forced adoption of a fast-track appraisal process for a breast cancer treatment in UK

Trastuzumab (Herceptin ®, Roche) is approved in UK for the treatment of the metastatic breast cancer since 2001. As of 2005, concomitantly with the publication of 3 studies that showed it produces a 50% reduction of the recurrence rates of breast cancer, trastuzumab started to be prescribed in the earlt adjuvant treatrnent of this disease. Und June 2006, trastuzumab did not have both: 1) regulatory approval and 2) NICE [National Institute for Health and Clinical Excellence] recommendation for the use in early stages of breast cancer. During the period until June 2006, the trastuzumab use in those patients was not reimbursed and because the cost of trastuzumab is equal with the yearly UK average income, most of patients could not self fund their treatrnent. Before the publication of the final NICE guidance, the new data of trastuzumab in early breast cancer raised enormous patient and professional interest and expectations. A great volume of public and professional pressure was generated to transcend a system by which Primary Care Trusts can reimburse a treatment only after a formal guidance was issued. This paper draw on a case study depicting and analyzing the process by which regulatory approval and NICE recommendations were achieved in a record time and how trastuzumab became a standard treatment on early adjuvant breast cancer. According to the data we gathered in this work we were witnessing one of the fastest processes of adoption of a health care technology since the creation of NICE, in 1999. This study addresses the following research question: How and why does the adoption pattern of trastuzumab differ from the rational decision-making model of the reimbursement process in UK? [Author, p. 4]

To analyse a trace or not? Evaluating the decision-making process in the criminal investigation

In order to broaden our knowledge and understanding of the decision steps in the criminal investigation process, we started by evaluating the decision to analyse a trace and the factors involved in this decision step. This decision step is embedded in the complete criminal investigation process, involving multiple decision and triaging steps. Considering robbery cases occurring in a geographic region during a 2-year-period, we have studied the factors influencing the decision to submit biological traces, directly sampled on the scene of the robbery or on collected objects, for analysis. The factors were categorised into five knowledge dimensions: strategic, immediate, physical, criminal and utility and decision tree analysis was carried out. Factors in each category played a role in the decision to analyse a biological trace. Interestingly, factors involving information available prior to the analysis are of importance, such as the fact that a positive result (a profile suitable for comparison) is already available in the case, or that a suspect has been identified through traditional police work before analysis. One factor that was taken into account, but was not significant, is the matrix of the trace. Hence, the decision to analyse a trace is not influenced by this variable. The decision to analyse a trace first is very complex and many of the tested variables were taken into account. The decisions are often made on a case-by-case basis.

The role of mentoring in facilitating the process of repurposing OER

This paper presents the initial data analysis of a research that is work in progress. It discusses the role of mentoring and peer support in facilitating the process of repurposing open educational resources (OER). It also reports on the lessons so far learned from the analysis of two distinct but related case studies on working with learners to use and disseminate OER.

A Game to Promote Understanding about UCD Methods and Process

The User-centered design (UCD) game is a tool forhuman-computer interaction practitioners to demonstrate the key user-centered design methodsand how they interrelate in the design process in an interactive and participatory manner. The target audiences are departments and institutions unfamiliar with UCD but whose work is related to the definition, creation, and update of a product or service.

Fostering Collaborative Knowledge Building by the Effective Provision of Knowledge about the Discussion Process

Peer-reviewed

Unsaturated Oxazolopiperidone Lactams: an Unexpected Domino-type Double Conjugate Additioncyclization Process

Reactions of 2-acetylindole enolate with unsaturated oxazolopiperidones 3, 4 and 10 unexpectedly gives pentacyclic dilactams 6, 7 and 11, respectively, resulting from a domino-type process involving two successive conjugate additions and a final cyclization.

The experience of identity transformation process for people living with tetraplegia and paraplegia = El proceso de reconstrucción de la identidad de las personas afectadas de una paraplejia o tetraplejia

A spinal cord injury (SCI) is perceived as a source of biographical disruption, not only at a physical level but also in terms of people’s life stories, their motivation and their self-esteem. The aim of this study is to explore the factors that people with spinal cord injuries perceive as contributing to rebuilding their sense of self. Two focus groups were established from the SCIcommunity, one of which was made up of 14 people with paraplegia and the other of 9 people with tetraplegia. In addition, four individual interviews were conducted with the participants. The results of content analysis show that the two most prominent factors in the process of identity renegotiation are the partial transformation of the subject’s identity followed by a coming to terms with that new identity. To rebuild self-worth, the importance of finding a balance between change and continuity was identified. Renegotiation of identity after a spinal cord injury is a complex phenomenon that greatly influences the SCI individual’s quality of life perceptions. Reaching a balance between the changes experienced due to the injury and finding a sense of continuity can be either facilitated or obstructed by the economic, political, legal, architectural, and social context

Process variability-aware proactive reconfiguration technique for mitigating aging effects in nanos scale SRAM lifetime

Postprint (published version)

Process intensification: From optimised flow patterns to microprocess technology

This thesis is focused on process intensification. Several significant problems and applications of this theme are covered. Process intensification is nowadays one of the most popular trends in chemical engineering and attempts have been made to develop a general, systematic methodology for intensification. This seems, however, to be very difficult, because intensified processes are often based on creativity and novel ideas. Monolith reactors and microreactors are successful examples of process intensification. They are usually multichannel devices in which a proper feed technique is important for creating even fluid distribution into the channels. Two different feed techniques were tested for monoliths. In the first technique a shower method was implemented by means of perforated plates. The second technique was a dispersion method using static mixers. Both techniques offered stable operation and uniform fluid distribution. The dispersion method enabled a wider operational range in terms of liquid superficial velocity. Using dispersion method, a volumetric gas-liquid mass transfer coefficient of 2 s-1 was reached. Flow patterns play a significant role in terms of the mixing performance of micromixers. Although the geometry of a T-mixer is simple, channel configurations and dimensions had a clear effect on mixing efficiency. The flow in the microchannel was laminar, but the formation of vortices promoted mixing in micro T-mixers. The generation of vortices was dependent on the channel dimensions, configurations and flow rate. Microreactors offer a high ratio of surface area to volume. Surface forces and interactions between fluids and surfaces are, therefore, often dominant factors. In certain cases, the interactions can be effectively utilised. Different wetting properties of solid materials (PTFE and stainless steel) were applied in the separation of immiscible liquid phases. A micro-scale plate coalescer with hydrophilic and hydrophobic surfaces was used for the continuous separation of organic and aqueous phases. Complete phase separation occurred in less than 20 seconds, whereas the separation time by settling exceeded 30 min. Fluid flows can be also intensified in suitable conditions. By adding certain additives into turbulent fluid flow, it was possible to reduce friction (drag) by 40 %. Drag reduction decreases frictional pressure drop in pipelines which leads to remarkable energy savings and decreases the size or number of pumping facilities required, e.g., in oil transport pipes. Process intensification enables operation often under more optimal conditions. The consequent cost savings from reduced use of raw materials and reduced waste lead to greater economic benefits in processing.

Approximation to the theory of affinities to manage the problems of the groupping process

New economic and enterprise needs have increased the interest and utility of the methods of the grouping process based on the theory of uncertainty. A fuzzy grouping (clustering) process is a key phase of knowledge acquisition and reduction complexity regarding different groups of objects. Here, we considered some elements of the theory of affinities and uncertain pretopology that form a significant support tool for a fuzzy clustering process. A Galois lattice is introduced in order to provide a clearer vision of the results. We made an homogeneous grouping process of the economic regions of Russian Federation and Ukraine. The obtained results gave us a large panorama of a regional economic situation of two countries as well as the key guidelines for the decision-making. The mathematical method is very sensible to any changes the regional economy can have. We gave an alternative method of the grouping process under uncertainty.

Development of tender information process by business intelligence in a global company unit

The purpose of this Thesis was to study what is the present situation of Business Intelligence of the company unit. This means how efficiently unit uses possibilities of modern information management systems. The aim was to resolve how operative informa-tion management of unit’s tender process could be improved by modern information technology applications. This makes it possible that tender processes could be faster and more efficiency. At the beginning it was essential to acquaint oneself with written literature of Business Intelligence. Based on Business Intelligence theory is was relatively easy but challenging to search and discern how tender business could be improved by methods of Busi-ness Intelligence. The empirical phase of this study was executed as qualitative research method. This phase includes theme and natural interviews on the company. Problems and challenges of tender process were clarified in a part an empirical phase. Group of challenges were founded when studying information management of company unit. Based on theory and interviews, group of improvements were listed which company could possible do in the future when developing its operative processes.

Macroautophagic process was differentially modulated by long-term moderate exercise in rat brain and peripheral tissues

The autophagic process is a lysosomal degradation pathway, which is activated during stress conditions, such as starvation or exercise. Regular exercise has beneficial effects on human health, including neuroprotection. However, the cellular mechanisms underlying these effects are incompletely understood. Endurance and a single bout of exercise induce autophagy not only in brain but also in peripheral tissues. However, little is known whether autophagy could be modulated in brain and peripheral tissues by long-term moderate exercise. Here, we examined the effects on macroautophagy process of long-term moderate treadmill training (36 weeks) in adult rats both in brain (hippocampus and cerebral cortex) and peripheral tissues (skeletal muscle, liver and heart). We assessed mTOR activation and the autophagic proteins Beclin 1, p62, LC3B (LC3B-II/LC3B-I ratio) and the lysosomal protein LAMP1, as well as the ubiquitinated proteins. Our results showed in the cortex of exercised rats an inactivation of mTOR, greater autophagy flux (increased LC3-II/LC3-I ratio and reduced p62) besides increased LAMP1. Related with these effects a reduction in the ubiquitinated proteins was observed. No significant changes in the autophagic pathway were found either in hippocampus or in skeletal and cardiac muscle by exercise. Only in the liver of exercised rats mTOR phosphorylation and p62 levels increased, which could be related with beneficial metabolic effects in this organ induced by exercise. Thus, our findings suggest that long-term moderate exercise induces autophagy specifically in the cortex