994 resultados para Trials--Massachusetts--Dukes County--Early works to 1800
Resumo:
The Provisional IRA and its political wing Sinn Féin have attracted by far the greatest scholarly interest of all the players in the Northern Irish conflict. This emphasis is perfectly legitimate, given the centrality of the Provos to so many turning-points in the conflict, from the collapse of Stormont in the early 1970s to the hunger strikes of the following decade and the ceasefires which were followed by the Belfast Agreement. My project, however, looks at political groups that at one time or another challenged the Provos for leadership of the militant, anti-state constituency in Northern Ireland (chiefly based in the Catholic working class). Although never as large or influential as the Provisional republicans, groups such as the Official IRA and the Irish Republican Socialist Party sometimes had a discernible impact on the course of events which is overlooked by most studies, and often pioneered ideas and tactics that were later adopted by the Provos themselves. The idea that republicans should embrace political action and work in broad campaigning alliances was promoted by the IRSP and socialist groups such as People’s Democracy before it was taken up by Gerry Adams and his allies, while the Official IRA supported the principle of a settlement based on democratization of the Northern Irish state, which was later accepted by Sinn Féin in the form of the Belfast Agreement. The goal of my research is to provide a novel perspective on the conflict in Northern Ireland, while engaging with theoretical debates about its character.
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This dissertation carries out a dialogue between Maurice Merleau-Ponty and Nishida Kitarō concerning their theories of artistic expression and faith. Both philosophers go through remarkably similar trajectories in their philosophic projects: In their early works they focus on the motor-perceptual body of the artist, and as they move towards the mature articulation of their ontologies, the concept of faith becomes central. I propose the term “motor-perceptual faith” to bring these seemingly diverse sets of concerns into a conceptual continuity. My study explores this connection, and argues that the artist’s motor-perceptual expressive body, as colourfully and sometimes poetically articulated in their early works, enacts the form of faith developed more abstractly in their later writings. Exploring these relations fosters a mutual expansion of the early by the later works, thus thickening the concept of faith by seeing it as enacted by the artist, while enlarging the concept of artistic expression by understanding it as a practice of motor‐perceptual faith. Framing these philosophers as putting forth a traditionally religious concept as illustrated by way of artistic expression, offers a new articulation of both of their writings, an important conceptual bridge between the two, while challenging un-ambiguous distinctions between art, philosophy and religion, and ultimately philosophy East and West.
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Brazilian composer Heitor Villa-Lobos (1887-1959) began his musical career as a cellist. When he was only twelve years old, it became imperativeupon the sudden and untimely death of his fatherthat the young Villa-Lobos earn money as a cellist to provide financial support for his mother and sisters. Villa-Lobos's intimate relationship with the cello eventually inspired him to compose great music for this instrument. This dissertation explores both the diversity of compositional technique and the evolution of style found in the music for cello written by Villa-Lobos. The project consists of two recorded recital performances and a written document exploring and analyzing those pieces. In the study of the music of Villa-Lobos, it is of great interest to consider the music's traditional European elements in combination (or even juxtaposition) with its imaginative and sometimes wildly innovative Brazilian character. His early works were greatly influenced by European Romantic composers such as Robert Schumann, Frédéric Chopin, and the virtuoso cellist/composer David Popper (whom Villa-Lobos idolized). Later, Villa-Lobos flourished in a newfound compositional independence and moved away from Euro-romanticism and toward the folk music of his Brazilian homeland. It is intriguing to experience this transition through an exploration of his cello compositions. The works examined and performed in this dissertation project are chosen from among the extensive number of Villa-Lobos's cello compositions and are his most important works for cello with piano, cello with another instrument, and cello with orchestra. The chosen works demonstrate the evolving range and combination of characteristic elements found in Villa-Lobos's compositional repertoire.
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The potential of the violoncello as a solo instrument was recognized and supported by cellists such as Luigi Boccherini (1743-1805), Luis Duport (1749-1819), Auguste Franchomme (1808-1884), and Alfredo Piatti (1822-1901). These pioneers composed technically demanding etudes, exercises, and caprices for the cello that were comparable to those already present in the violin literature. Even so, in the late nineteenth century and early twentieth century, considerably fewer substantial works were brought forth for the cello as compared with the violin. Consequently, many cellists such as Luigi Silva (1903-1961), Gregor Piatigorsky (1903-1976), Pierre Fournier (1906-1986), and Janos Starker (b. 1924) selected notable pieces from the violin repertoire and transcribed these for the cello. Some composers themselves actually adapted for the cello their own works originally written for the violin. Johannes Brahms with his Violin Sonata Op. 78, Igor Stravinsky with his Suite Italienne, and Béla Bartók with his First Rhapsody all belong to this category. Adaptations such as these further raised awareness among composers and performers of the possibilities of the cello as an independent and expressive instrument. Thus, many composers from the early 1900s to the present were encouraged to write increasing numbers of more soloistic and demanding works for cello. Herein, I explore the repertoire of cello transcriptions in order to analyze the differences between the original and transcribed versions and the challenges found therein. The performer may attempt to recreate the effect originally intended for the violin or, more daringly, may strive to search for alternate presentations of the music more suitable and expressive of the cello's own character. The project includes two recitals of the following transcribed works presented at the University of Maryland College Park, School of Music: Sonata in A by César Franck, transcribed by Jules Delsart, Variations on a Theme from Rossini by Nicolo Paganini, transcribed by Fournier, Suite Italienne by Igor Stravinsky, transcribed with the help of Piatigorsky, Sonatina Op. 137, No. 1 by Franz Schubert, transcribed by Starker, First Rhapsody by Béla Bartók and Sonata, Op. 108 by Johannes Brahms, transcribed by Hsiao-mei Sun.
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BACKGROUND: Historically, only partial assessments of data quality have been performed in clinical trials, for which the most common method of measuring database error rates has been to compare the case report form (CRF) to database entries and count discrepancies. Importantly, errors arising from medical record abstraction and transcription are rarely evaluated as part of such quality assessments. Electronic Data Capture (EDC) technology has had a further impact, as paper CRFs typically leveraged for quality measurement are not used in EDC processes. METHODS AND PRINCIPAL FINDINGS: The National Institute on Drug Abuse Treatment Clinical Trials Network has developed, implemented, and evaluated methodology for holistically assessing data quality on EDC trials. We characterize the average source-to-database error rate (14.3 errors per 10,000 fields) for the first year of use of the new evaluation method. This error rate was significantly lower than the average of published error rates for source-to-database audits, and was similar to CRF-to-database error rates reported in the published literature. We attribute this largely to an absence of medical record abstraction on the trials we examined, and to an outpatient setting characterized by less acute patient conditions. CONCLUSIONS: Historically, medical record abstraction is the most significant source of error by an order of magnitude, and should be measured and managed during the course of clinical trials. Source-to-database error rates are highly dependent on the amount of structured data collection in the clinical setting and on the complexity of the medical record, dependencies that should be considered when developing data quality benchmarks.
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In the late nineteenth century, French composers such as Camille Saint- Saens, Cesar Franck, and Claude Debussy worked to elevate instrumental music in late-Romantic period France, creating symphonies, concertos, and chamber ensembles, including duo sonatas. These composers and followers like, Ernest Chausson and Guillaume Lekeu were all influenced by a particular violinist to whom they dedicated their compositions. The primary violinist who inspired these composers was Eugene Ysaye (1858-1931), a brilliant performer and composer. His freedom of expression motivated many prominent French composers to dedicate major works to him. For example, Debussy dedicated his string quartet to Ysaye, who established the Ysaye Quartet and premiered Debussy's composition. In 1886, Franck completed his sonata for violin and piano which he also dedicated to Ysaye. Fritz Kreisler (1875-1962), one of the most talented violinists of his era, had a relationship withYsaye that was quite special. They respected, supported, and befriended each other. To Ysaye, Kreisler dedicated his Recitativo and Scherzo. To Kreisler, Ysaye dedicated one ofhis celebrated Sonatas for Solo Violin. Pablo de Sarasate (1844-1908) was a magnificent Spanish violinist of the late nineteenth century, and his music and performances influenced many composers, especially Saint-Saens, who included Spanish gypsy fragments in his works. These motifs may found in his Havanaise, Introduction and Rondo Capriccioso and Violin Concerto No.3 which were dedicated to Sarasate. My goal for this dissertation project has been to find and present, in three recitals, works by French composers and also works by the violinists who inspired them. As a violinist, I have endeavored to understand the influence of the various violinists on these French composers and how that knowledge can inform my approach to performing these works. In my first recital, with pianist Soo Young Jung, I performed works by Saint-Saens, Ysaye and Sarasate. With pianist Sun Ha Yoon, I performed works by Ysaye, Debussy, Kreisler and Franck in my second recital. My third recital, again with pianist Sun Ha Yoon, featured works by Ysaye, Chausson, and Lekeu. All recitals were recorded and performed at the University ofMaryland, College Park.
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We investigated the role of visual feedback in adapting to novel visuomotor environments. Participants produced isometric elbow torques to move a cursor towards visual targets. Following trials with no rotation, participants adapted to a 60 degrees rotation of the visual feedback before returning to the non-rotated condition. Participants received continuous visual feedback (CF) of cursor position during task execution or post-trial visual feedback (PF). With training, reductions of the angular deviations of the cursor path occurred to a similar extent and at a similar rate for CF and PF groups. However, upon re-exposure to the non-rotated environment only CF participants exhibited post-training aftereffects, manifested as increased angular deviation of the cursor path, with respect to the pre-rotation trials. These aftereffects occurred despite colour cues permitting identification of the change in environment. The results show that concurrent feedback permits automatic recalibration of the visuomotor mapping while post-trial feedback permits performance improvement via a cognitive strategy. (C) 2008 Elsevier B.V. All rights reserved.
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Background: This is an update of a Cochrane review first published in The Cochrane Library in Issue 3, 2010.
For many patients with head and neck cancer, oral nutrition will not provide adequate nourishment during treatment with radiotherapy or chemoradiotherapy due to the acute toxicity of treatment, obstruction caused by the tumour, or both. The optimal method of enteral feeding for this patient group has yet to be established.
Objectives: To compare the effectiveness of different enteral feeding methods used in the nutritional management of patients with head and neck cancer receiving radiotherapy or chemoradiotherapy using the clinical outcomes, nutritional status, quality of life and rates of complications.
Search methods: Our extensive search included the Cochrane ENT Group Trials Register, CENTRAL, PubMed, EMBASE, CINAHL, AMED and ISI Web of Science. The date of the most recent search was 13 February 2012.
Selection criteria:Randomised controlled trials comparing one method of enteral feeding with another, e.g. nasogastric (NG) or percutaneous endoscopic gastrostomy (PEG) feeding, for adult patients with a diagnosis of head and neck cancer receiving radiotherapy and/or chemoradiotherapy.
Data collection and analysis:Two authors independently assessed trial quality and extracted data using standardised forms. We contacted study authors for additional information.
Main results: One randomised controlled trial met the criteria for inclusion in this review. No further studies were identified when we updated the searches in 2012.
Patients diagnosed with head and neck cancer, being treated with chemoradiotherapy, were randomised to PEG or NG feeding. In total only 33 patients were eligible for analysis as the trial was terminated early due to poor accrual. A high degree of bias was identified in the study.
Weight loss was greater for the NG group at six weeks post-treatment than for the PEG group (P = 0.001). At six months post-treatment, however, there was no significant difference in weight loss between the two groups. Anthropometric measurements recorded six weeks post-treatment demonstrated lower triceps skin fold thickness for the NG group compared to the PEG group (P = 0.03). No statistically significant difference was found between the two different enteral feeding techniques in relation to complication rates or patient satisfaction. The duration of PEG feeding was significantly longer than for the NG group (P = 0.0006). In addition, the study calculated the cost of PEG feeding to be 10 times greater than that of NG, though this was not found to be significant. There was no difference in the treatment received by the two groups. However, four PEG fed patients and two NG fed patients required unscheduled treatment breaks of a median of two and six days respectively.
We identified no studies of enteral feeding involving any form of radiologically inserted gastrostomy (RIG) feeding or comparing prophylactic PEG versus PEG for inclusion in the review.
Authors' conclusions: There is not sufficient evidence to determine the optimal method of enteral feeding for patients with head and neck cancer receiving radiotherapy and/or chemoradiotherapy. Further trials of the two methods of enteral feeding, incorporating larger sample sizes, are required.
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Randomised controlled trials are the most effective way to differentiate between the effects of competing interventions. However, head-to-head studies are unlikely to have been conducted for all competing interventions.
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We use new data on the timing of the transition to agriculture, developed by Putterman and Trainor (2006), to test the theory of Diamond (1997) and Olsson and Hibbs (2005) that an earlier transition is reflected in higher incomes today. Our results confirm the theory, even after controlling for institutional quality and other geographical factors. The date of transition is correlated with prehistoric biogeography (the availability of wild grasses and large domesticable animal species). The factors conducive to high per capita incomes today are good institutions, an early transition to agriculture, access to the sea and a low incidence of fatal malaria. Geographical influences have been at work in all of these proximate determinants of per capita income.
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Reproductive performance in the high-yielding dairy cow has severely decreased in the last 40 yr. The aim of this study was to compare the effectiveness of 4 nutritional strategies in improving the reproductive performance of high-yielding dairy cows. It was hypothesized that offering cows a high-starch ration in early lactation would enhance the onset of luteal activity, and that decreasing the severity of negative energy balance in the early postcalving period would improve reproductive parameters. Nutritional regimens aimed at improving fertility were applied to 96 Holstein-Friesian dairy animals. Upon calving, animals were allocated in a balanced manner to one of 4 dietary treatments. Primiparous animals were balanced according to live weight, body condition score and calving date. Multiparous animals were balanced according to parity, previous lactation milk yield, liveweight, body condition score and calving date. Treatment 1 was based on an industry best practice diet (control) to contain 170 g of crude protein/kg of dry matter. Treatment 2 was an individual cow feeding strategy, whereby the energy balance (EB) of individual animals was managed so as to achieve a predetermined target daily EB profile (+/- 10 MJ/d). Treatment 3 was a high-starch/high-fat combination treatment, whereby an insulinogenic (high-starch) diet was offered in early lactation to encourage cyclicity and followed by a lipogenic (low-starch, high-fat) diet to promote embryo development. Treatment 4 was a low-protein diet, containing 140 g of crude protein/kg of dry matter, supplemented with protected methionine at an inclusion level of 40 g per animal per day. The nutritional strategies implemented in this study had no statistically significant effects on cow fertility measures, which included the onset of luteal activity, conception rate, in-calf rate, and the incidence of atypical cycles. The individual cow feeding strategy improved EB in early lactation but had no benefit on conception rate to first insemination. However, conception rate to second insemination, 100-d pregnancy rate (from the commencement of breeding), and overall pregnancy rate tended to be higher in this group. The high-starch/high-fat treatment tended to decrease the proportion of delayed ovulations and increase the proportion of animals cycling by d 50 postcalving. Animals that failed to conceive to first insemination had a significantly longer luteal phase in the first cycle postpartum and a longer inter-ovulatory interval in the second cycle postpartum. With regards to estrous behavior, results indicate that as the size of the sexually active group increased, the intensity of estrus and the expression of mounting or attempting to mount another cow also increased. Furthermore, cows that became pregnant displayed more intense estrous behavior than cows that failed to become pregnant.
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Late age-related maculopathy (ARM) is responsible for the majority of blind registrations in the Western world among persons over 50 years of age. It has devastating effects on quality of life and independence and is becoming a major public health concern. Current treatment options are limited and most aim to slow progression rather than restore vision; therefore, early detection to identify those patients most suitable for these interventions is essential. In this work, we review the literature encompassing the investigation of visual function in ARM in order to highlight those visual function parameters which are affected very early in the disease process. We pay particular attention to measures of acuity, contrast sensitivity (CS), cone function, electrophysiology, visual adaptation, central visual field sensitivity and metamorphopsia. We also consider the impact of bilateral late ARM on visual function as well as the relationship between measures of vision function and self-reported visual functioning. Much interest has centred on the identification of functional changes which may predict progression to neovascular disease; therefore, we outline the longitudinal studies, which to date have reported dark-adaptation time, short-wavelength cone sensitivity, colour-match area effect, dark-adapted foveal sensitivity, foveal flicker sensitivity, slow recovery from glare and slower foveal electroretinogram implicit time as functional risk factors for the development of neovascular disease. Despite progress in this area, we emphasise the need for longitudinal studies designed in light of developments in disease classification and retinal imaging, which would ensure the correct classification of cases and controls, and provide increased understanding of the natural course and progression of the disease and further elucidate the structure-function relationships in this devastating disorder.
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Stress systems may be altered in the long term in preterm infants for multiple reasons, including early exposure to procedural pain in neonatal intensive care. This question has received little attention beyond hospital discharge. Stress responses (cortisol) to visual novelty in preterm infants who were born at extremely low gestational age (ELGA; <or =28 weeks), very low gestational age (VLGA; 29-32 weeks), and term were compared at 8 months of age corrected for prematurity (corrected chronological age [CCA]). In addition, among the preterm infants, we evaluated whether cortisol levels at 8 months were related to neonatal exposure to procedural pain and morphine in the neonatal intensive care unit.
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This chapter sets out to explain the factors behind Ireland's exceptional period of economic growth from the early 1990s to the mid 2000s. It suggests that an unbending commitment to economic openness and an on-going effort to establish quality domestic institutions were the main drivers of the so-called ‘Celtic tiger’ phenomenon. The commitment to economic openness manifested itself in the relentless search for inward investment and a willingness to accept deep forms of European integration. Building domestic institutional capabilities involved adopting new-classical macroeconomic policies, creating a robust system of social partnership and reforming the educational system. The two factors positively interacted with each other to create dynamic effects.
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Background: Molecular characteristics of cancer vary between individuals. In future, most trials will require assessment of biomarkers to allocate patients into enriched populations in which targeted therapies are more likely to be effective. The MRC FOCUS3 trial is a feasibility study to assess key elements in the planning of such studies.
Patients and methods: Patients with advanced colorectal cancer were registered from 24 centres between February 2010 and April 2011. With their consent, patients' tumour samples were analysed for KRAS/BRAF oncogene mutation status and topoisomerase 1 (topo-1) immunohistochemistry. Patients were then classified into one of four molecular strata; within each strata patients were randomised to one of two hypothesis-driven experimental therapies or a common control arm (FOLFIRI chemotherapy). A 4-stage suite of patient information sheets (PISs) was developed to avoid patient overload.
Results: A total of 332 patients were registered, 244 randomised. Among randomised patients, biomarker results were provided within 10 working days (w.d.) in 71%, 15 w.d. in 91% and 20 w.d. in 99%. DNA mutation analysis was 100% concordant between two laboratories. Over 90% of participants reported excellent understanding of all aspects of the trial. In this randomised phase II setting, omission of irinotecan in the low topo-1 group was associated with increased response rate and addition of cetuximab in the KRAS, BRAF wild-type cohort was associated with longer progression-free survival.
Conclusions: Patient samples can be collected and analysed within workable time frames and with reproducible mutation results. Complex multi-arm designs are acceptable to patients with good PIS. Randomisation within each cohort provides outcome data that can inform clinical practice.