Purpose
This paper presents a regionally downscaled economic model developed to assess the impacts of the management of dredged sediments on Gross Domestic Product (GDP) and jobs created; the model ...is validated and applied using real project data from sediment management projects in Ireland and Scotland. The model provides significant insight into and allows impact analysis for the economic aspect of sediment management projects with the potential to facilitate and inform stakeholders across the sediment management sector.
Methods
The economic model facilitates regional analysis of the impacts of sediment management projects on GDP and job creation for direct, indirect and induced effects. Methods for estimating the economic induced impacts are based on industry-specific type I and type II economic multipliers and coefficients, derived for the EU Interreg SURICATES partner countries (Ireland, Scotland, France and the Netherlands) using symmetric input–output tables and application of the open Leontief model and based on available economic data for the identified countries.
The model is applied to sediment management projects in Ireland (a harbour development project at Castletownbere) and in Scotland (a bioremediation project at Falkirk). Model results are compared to project data for direct contribution to GDP and direct jobs created, and the model also estimates the indirect and induced economic project impacts. The model has been applied to undertake sensitivity analyses and compare different sediment management options.
Results
Model results provide a satisfactory comparison to real project data for direct cost and jobs created. Indirect economic benefits for GDP and employment created were estimated from 47 to 53% of direct impacts
.
The model has been applied to undertake sensitivity analyses and assess a range of different site-specific sediment management options with indirect economic impacts ranging from 42 to 53% of direct impacts.
Conclusions
The economic model results are compared to real project economic data, the validation exercise proving satisfactory with promising results. Sensitivity analyses and site-specific sediment management options have been assessed. The positive economic impacts of the Castletownbere Harbour project in particular are evident. These results highlight the potentially different economic impacts of the implementation of different sediment management options and in different regions and countries.
The model allows the quantification of the economic benefits of sediment management projects. The model provides significant insight into and allows impact analysis for the economic aspect of sediment management projects and has the potential to facilitate and inform stakeholders and decision-makers across the sector.
Stimulated Raman backscattering (SRS) has many unwanted effects in megajoule-scale inertially confined fusion (ICF) plasmas. Moreover, attempts to harness SRS to amplify short laser pulses through ...backward Raman amplification have achieved limited success. In high-temperature fusion plasmas, SRS usually occurs in a kinetic regime where the nonlinear response of the Langmuir wave to the laser drive and its host of complicating factors make it difficult to predict the degree of amplification that can be achieved under given experimental conditions. Here we present experimental evidence of reduced Landau damping with increasing Langmuir wave amplitude and determine its effects on Raman amplification. The threshold for trapping effects to influence the amplification is shown to be very low. Above threshold, the complex SRS dynamics results in increased amplification factors, which partly explains previous ICF experiments. These insights could aid the development of more efficient backward Raman amplification schemes in this regime.
Semantic priming in the lexical decision task has been shown to increase when the proportion of related-prime trials is increased. This finding typically is taken as evidence for a conscious, ...strategic use of primes. Three experiments are reported in which masked semantic primes displayed for only 45 msec were tested in high- versus low-relatedness proportion conditions. Relatedness proportion was increased either by using a high proportion of semantically related primes or a large set of repetition-primed filler trials. Semantic priming was consistently enhanced relative to a low-relatedness proportion condition. These relatedness proportion effects were not due to conscious, strategic use of primes: Exclusion of prime-aware subjects did not attenuate the effects, and better performance in a prime classification task was not associated with larger semantic priming effects. These results are interpreted within a retrospective account of semantic priming in which recruitment of a prime event is modulated by prime validity.
Objective: ischaemic lower-extremity ulcers in the diabetic population are a source of major concern because of the associated high risk of limb-threatening complications. The aim of this study was ...to evaluate the role of hyperbaric oxygen in the management of these ulcers. Method: eighteen diabetic patients with ischaemic, non-healing lower-extremity ulcers were recruited in a double-blind study. Patients were randomly assigned either to receive 100% oxygen (treatment group) or air (control group), at 2.4 atmospheres of absolute pressure for 90 min daily (total of 30 treatments). Results: healing with complete epithelialisation was achieved in five out of eight ulcers in the treatment group compared to one out of eight ulcers in the control group. The median decrease of the wound areas in the treatment group was 100% and in the control group was 52% (p = 0.027). Cost-effectiveness analysis has shown that despite the extra cost involved in using hyperbaric oxygen, there was a potential saving in the total cost of treatment for each patient during the study. Conclusion: hyperbaric oxygen enhanced the healing of ischaemic, non-healing diabetic leg ulcers and may be used as a valuable adjunct to conventional therapy when reconstructive surgery is not possible.
Eur J Vasc Endovasc Surg 25, 513-518 (2003)
We report for the first time severe acute pancreatitis in a child treated for phenylketonuria (PKU) discovered on neonatal screening. This 2-year-old boy was first hospitalized for bilious vomiting ...and moderate back pain. Laboratory values included a lipase level of 1.142 U/L, a phenylalanine level of 10mg/dL, and computed tomography revealed Balthazar grade E pancreatitis. Continuous enteral feeding was started on the 3rd day after admission. We observed clinical and biological improvement. Etiologic investigations for pancreatitis returned negative. Despite the severity of the pancreatitis, we did not observe decompensation of the metabolic disease. Specific nutritional management was necessary.
Natural killer cells are the first lymphocyte subset to reconstitute, and play a major role in early immunity after allogeneic hematopoietic stem cell transplantation. Cells expressing the activating ...receptor NKG2C seem crucial in the resolution of cytomegalovirus episodes, even in the absence of T cells. We prospectively investigated natural killer-cell reconstitution in a cohort of 439 adult recipients who underwent non-T-cell-depleted allogeneic hematopoietic stem cell transplantation between 2005 and 2012. Freshly collected blood samples were analyzed 3, 6, 12 and 24 months after transplantation. Data were studied with respect to conditioning regimen, source of stem cells, underlying disease, occurrence of graft-versus-host disease, and profiles of cytomegalovirus reactivation. In multivariate analysis we found that the absolute numbers of CD56(bright) natural killer cells at month 3 were significantly higher after myeloablative conditioning than after reduced intensity conditioning. Acute graft-versus-host disease impaired reconstitution of total and CD56(dim) natural killer cells at month 3. In contrast, high natural killer cell count at month 3 was associated with a lower incidence of chronic graft-versus-host disease, independently of a previous episode of acute graft-versus-host disease and stem cell source. NKG2C(+)CD56(dim) and total natural killer cell counts at month 3 were lower in patients with reactivation of cytomegalovirus between month 0 and month 3, but expanded greatly afterwards. These cells were also less numerous in patients who experienced later cytomegalovirus reactivation between month 3 and month 6. Our results advocate a direct role of NKG2C-expressing natural killer cells in the early control of cytomegalovirus reactivation after allogeneic hematopoietic stem cell transplantation.
To determine the comparative effectiveness and cost-effectiveness of three dressing products, N-A, Inadine and Aquacel, for patients with diabetic foot ulcers, as well as the feasibility and ...consequences of less frequent dressing changes by health-care professionals.
A multicentre, prospective, observer-blinded, parallel group, randomised controlled trial, with three arms.
Established expert multidisciplinary clinics for the management of diabetic foot ulcers across the UK.
Patients over age 18 with type 1 or type 2 diabetes with a chronic (present for at least 6 weeks) full-thickness foot ulcer (on or below the malleoli) not penetrating to tendon, periosteum or bone, and with a cross-sectional area between 25 and 2500 mm(2).
Participants were randomised 1:1:1 to treatment with one of N-A (a non-adherent, knitted, viscose filament gauze), Inadine (an iodine-impregnated dressing), both traditional dressings, or Aquacel, a newer product.
The primary outcome measure was the number of ulcers healed in each group at week 24. Secondary measures included time to healing, new ulcerations, major and minor amputations, and episodes of secondary infection.
A total of 317 patients were randomised. After 88 withdrawals, 229 remained evaluable. A greater proportion of smaller (25-100 mm(2) ulcers healed within the specified time (48.3% versus 37.3%; p = 0.048). There was, however, no difference between the three dressings in terms of percentage healed by 24 weeks, or in the mean time to healing, whether analysed on the basis of intention to treat (Inadine 44.4%, N-A 38.7%, Aquacel 44.7%; not significant) or per protocol (Inadine 55.2%, N-A 59.4%, Aquacel 63.0%; not significant). There was no difference in the quality of healing, as reflected in the incidence of recurrence within 12 weeks. Likewise, there was no difference in the incidence of adverse events, although a greater proportion of those randomised to the non-adherent dressings were withdrawn from the study (34.9% versus 29.1% Aquacel and 19.4% Inadine; p = 0.038). The only statistically significant difference found in the health economic analysis was the cost associated with the provision of dressings (mean cost per patient: N-A 14.85 pounds, Inadine 17.48 pounds, Aquacel 43.60 pounds). The higher cost of Aquacel was not offset by the fewer dressings required. There was no difference in measures of either generic or condition-specific measures of quality of life. However, there was a significant difference in the change in pain associated with dressing changes between the first and second visits, with least pain reported by those receiving non-adherent dressings (p = 0.012). There was no difference in the costs of professional time, and this may relate to the number of dressing changes undertaken by non-professionals. Fifty-one per cent of all participants had at least one dressing change undertaken by themselves or a non-professional carer, although this ranged from 22% to 82% between the different centres.
As there was no difference in effectiveness, there is no reason why the least costly of the three dressings could not be used more widely across the UK National Health Service, thus generating potentially substantial savings. The option of involving patients and non-professional carers in changing dressings needs to be assessed more formally and could be associated with further significant reductions in health-care costs.
Current Controlled Trials ISRCTN78366977.
The Local Monitoring Committee The Local Monitoring Committee comprises members from the Alsace winegrowing profession, the Association of Alsace Winegrowers, the Institut National des Appellations ...d'Origine, the Alsace Consumers Association, the Agricultural and Viticultural Training School, an agricultural union (la Confédération Paysanne), a nature preservation society (Alsace Nature), an independent winegrower, a neighbour of the trial site, a representative from the Plant Protection Services (DRAAF), a representative from the Regional Directorate for the Environment (DIREN), an elected representative from the Regional Council, an elected representative from the Town Council, the researcher managing the research programme and the President of the INRA Centre in Colmar, who acts as moderator. ...Grapevine fanleaf virus (GFLV), which is transmitted by soil nematodes, is the cause of an often lethal disease of grapevines with worldwide distribution. ...recently, controlling the disease typically involved removing infected individuals and treating the soil in and around the focus of infection with nematicide fumigants, but this is no longer possible, since these nematicides were banned due to their unacceptable environmental impact.\n However, we should also consider that violence here may in fact reflect a quest for listening, for legitimacy in some other form.
Past experiments S. Depierreux et al., Phys. Rev. Lett. 102, 195005 (2009)10.1103/PhysRevLett.102.195005 have exhibited the plasma-induced incoherence (PII) process and the reduced imprint in the ...multikilojoule regime when a thin low-density foam is disposed in front of a solid target. Complementary experiments have been designed to analyze the mechanisms involved, the important parameters, and the role of the optical smoothing in the case of the laser megajoule. Forward stimulated Brillouin scattering (FSBS) is identified as the dominant mechanism governing the angular spray of the laser. FSBS also increases the laser bandwidth and imparts levels of temporal and spatial incoherencies beyond the present capacities of the optical smoothing of the megajoule laser facilities. Such a PII beam becomes suitable to achieve the high degree of irradiation uniformity required to experiment high-convergence efficient direct-drive inertial confinement fusion configurations at the megajoule scale which would otherwise require major changes in the laser chains. By reducing backscattering losses and/or allowing less optically applied smoothing, PII could relax the constraints imposed on the laser system and open the road to an increase in the energy coupled to the target in indirect-drive experiments.
PTK787/ZK 222584 (PTK/ZK) is an oral angiogenesis inhibitor targeting all known vascular endothelial growth factor (VEGF) receptor tyrosine kinases, including VEGFR-1/Flt-1, VEGFR-2/KDR, ...VEGFR-3/Flt-4, the platelet-derived growth factor receptor tyrosine kinase, and the c-kit protein tyrosine kinase. In this phase I dose-escalating study, PTK/ZK was administered bid to exploit the theoretical advantage of maintaining constant drug levels above a threshold known from preclinical data to interfere with VEGF receptor signaling.
Forty-three patients with advanced cancers received single-agent PTK/ZK at doses of 150 to 1,000 mg orally bid. Assessments for safety and pharmacokinetics were performed. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was used as a pharmacodynamic marker of response.
At 1,000 mg bid, the dose-limiting toxicity of reversible grade 3 lightheadedness was observed. Dose-related grade 3 fatigue and vomiting were observed but these were not dose-limiting. Pharmacokinetic data confirmed that PTK/ZK exposure increased with increasing dose up to 500 mg bid and appeared to plateau at higher doses. A greater than 40% reduction in the DCE-MRI bidirectional transfer constant (K(i)) at day 2 predicted for nonprogression of disease.
The maximum-tolerated oral dose of PTK/ZK is 750 mg orally bid. DCE-MRI and pharmacokinetic data indicate that PTK/ZK >/= 1,000 mg total daily dose is the biologically active dose.
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