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Showing papers by "University of Salford published in 2012"


Journal ArticleDOI
01 Mar 2012-Brain
TL;DR: Mutations in the C9ORF72 gene may be a major cause not only of frontotemporal dementia with motor neuron disease but also of late onset psychosis, and the behavioural characteristics of patients with C9 ORF72 mutations are qualitatively distinct.
Abstract: The identification of a hexanucleotide repeat expansion in the C9ORF72 gene as the cause of chromosome 9-linked frontotemporal dementia and motor neuron disease offers the opportunity for greater understanding of the relationship between these disorders and other clinical forms of frontotemporal lobar degeneration. In this study, we screened a cohort of 398 patients with frontotemporal dementia, progressive non-fluent aphasia, semantic dementia or mixture of these syndromes for mutations in the C9ORF72 gene. Motor neuron disease was present in 55 patients (14%). We identified 32 patients with C9ORF72 mutations, representing 8% of the cohort. The patients' clinical phenotype at presentation varied: nine patients had frontotemporal dementia with motor neuron disease, 19 had frontotemporal dementia alone, one had mixed semantic dementia with frontal features and three had progressive non-fluent aphasia. There was, as expected, a significant association between C9ORF72 mutations and presence of motor neuron disease. Nevertheless, 46 patients, including 22 familial, had motor neuron disease but no mutation in C9ORF72. Thirty-eight per cent of the patients with C9ORF72 mutations presented with psychosis, with a further 28% exhibiting paranoid, deluded or irrational thinking, whereas <4% of non-mutation bearers presented similarly. The presence of psychosis dramatically increased the odds that patients carried the mutation. Mutation bearers showed a low incidence of motor stereotypies, and relatively high incidence of complex repetitive behaviours, largely linked to patients' delusions. They also showed a lower incidence of acquired sweet food preference than patients without C9ORF72 mutations. Post-mortem pathology in five patients revealed transactive response DNA-binding protein 43 pathology, type A in one patient and type B in three. However, one patient had corticobasal degeneration pathology. The findings indicate that C9ORF72 mutations cause some but not all cases of frontotemporal dementia with motor neuron disease. Other mutations remain to be discovered. C9ORF72 mutations are associated with variable clinical presentations and pathology. Nevertheless, the findings highlight a powerful association between C9ORF72 mutations and psychosis and suggest that the behavioural characteristics of patients with C9ORF72 mutations are qualitatively distinct. Mutations in the C9ORF72 gene may be a major cause not only of frontotemporal dementia with motor neuron disease but also of late onset psychosis.

487 citations


Journal ArticleDOI
TL;DR: CT was a more accurate imaging technique than MRI for providing a cause of death compared with traditional autopsy, and could therefore be acceptable for medicolegal purposes.

444 citations


Journal ArticleDOI
TL;DR: The role of CD44 and CD24 in tumour initiation, development, and metastasis is assessed and their expression and prognostic value in isolating CSCs are still an enduring ambiguity.
Abstract: Cancer stem cell population is a subset of cells capable of dictating invasion, metastasis, heterogeneity, and therapeutic resistance in tumours. Eradication of this rare population is a new insight in cancer treatment. However, prospective identification, characterization, and isolation of these CSCs have been a major challenge. Many studies were performed on surface markers for potential identification and isolation of CSCs. Lack of universal expression of surface markers limits their usage and no best combination of markers has yet been confirmed to identify CSCs capable of initiating and metastasizing tumours. CD44, a hyaluronic acid receptor, is one of the most commonly studied surface markers, which is expressed by almost every tumour cell. CD24, a heat stable antigen, is another surface marker expressed in many tumour types. However, their expression and prognostic value in isolating CSCs are still an enduring ambiguity. In this critical review, we assess the role of CD44 and CD24 in tumour initiation, development, and metastasis. We mainly focus on analysing the significance of CD44 and CD24 as CSC surface markers in combination or with other putative markers in different types of cancer.

422 citations


Journal ArticleDOI
TL;DR: In this paper, the role of trees and grass can play in reducing regional and local temperatures in urban areas during the summer within the urban landscape of Manchester, UK, and the results show that both grass and trees can effectively cool surfaces and so can provide regional cooling, helping reduce the urban heat island in hot weather.

393 citations


Journal ArticleDOI
TL;DR: In this article, the authors diagnose UK's construction industry to develop a clear understanding about BIM adoption and to form an imperative step of consolidating collective movements towards wider BIM implementation.
Abstract: Purpose – Building information modelling (BIM) implementation is a major change management task, involving diversity of risk areas. The identification of the challenges and barriers is therefore an imperative precondition of this change process. This paper aims to diagnose UK's construction industry to develop a clear understanding about BIM adoption and to form an imperative step of consolidating collective movements towards wider BIM implementation and to provide strategies and recommendations for the UK construction industry for BIM implementation.Design/methodology/approach – Through comprehensive literature review, the paper initially establishes BIM maturity concept, which paves the way for the analysis via qualitative and quantitative methods: interviews are carried out with high profile organisations in Finland to gauge the best practice before combining the results with the analysis of survey questionnaire amongst the major contractors in the UK.Findings – The results are established in the form ...

342 citations


Journal ArticleDOI
TL;DR: The proposed model is not to introduce a new schema in contrast to IFC but to harness the capability of IFC XML and or possibly engage with using Simplified Markup Language (SML) subsets of eXtensible Mark up Language (XML) for exchanging partial data to design an integrated platform that would enhance the BIM usability experience for various disciplines in making key design decisions at a relatively early design stage.

255 citations


Journal ArticleDOI
TL;DR: In this article, the authors studied the grounds of increasing level of organic food consumption such as motivation are most critical in understanding the potential of the organic food to become a genuinely mainstream market, they also associate organic food with natural process, care for the environment and animal welfare and the non-use of pesticides and fertilisers.

243 citations


Journal ArticleDOI
TL;DR: In this article, a systematic review of the literature on educational interventions to improve non-technical skills among undergraduate or postgraduate staff in an acute health care environment was carried out, and a total of 22 studies met the inclusion criteria.
Abstract: Medical Education 2012: 46: 1042–1054 CONTEXT Many quality improvement education programmes have been introduced over the last decade with the purpose of enhancing patient safety. The importance of non-technical skills training is becoming increasingly prominent, but the extent to which educational interventions have been used and the theoretical underpinnings of such interventions remain unclear. These issues were investigated through a systematic review of the literature. METHODS Any studies involving an educational intervention to improve non-technical skills amongst undergraduate or postgraduate staff in an acute health care environment were considered. A standardised search of online databases was carried out independently by two authors and consensus reached on the inclusion of studies. Data extraction and multimodal quality assessment were completed independently, followed by a content analysis of interventions and the extraction of key themes. RESULTS A total of 22 studies met the inclusion criteria. Measured outcomes were variable, as was the strength of conclusions. Theoretical underpinning of interventions was not described in any studies. Content analysis revealed reasonable consistency with the emergence of five key themes: error; communication; teamwork and leadership; systems, and situational awareness. Teaching was often multidisciplinary and methods used included simulation and role-play exercises, and observation. CONCLUSIONS The methodological quality of published studies is reasonable, although the reporting of specific interventions is poor. Although a recognised model to support the design of patient safety education is lacking, a number of theories have been applied to guide educators in future instructional design. Further published work should clearly describe interventions and their theoretical underpinnings, and should aim to further explore which specific aspects of interventions are effective and why. Such research should also try to assess whether such interventions can impact patient outcomes.

241 citations


Journal ArticleDOI
TL;DR: There have been significant benefits demonstrated with pre-operative administration of IE nutrition in some high quality trials, however, bias was identified which may limit the generalizability of these results to all GI surgical candidates and the data needs to be placed in context with other recent innovations in surgical management.
Abstract: Background Post-operative management in gastrointestinal (GI) surgery is becoming well established with 'Enhanced Recovery After Surgery' protocols starting 24 hours prior to surgery with carbohydrate loading and early oral or enteral feeding given to patients the first day following surgery. However, whether or not nutritional intervention should be initiated earlier in the preoperative period remains unclear. Poor pre-operative nutritional status has been linked consistently to an increase in post-operative complications and poorer surgical outcome. Objectives To review the literature on preoperative nutritional support in patients undergoing gastrointestinal surgery (GI). Search methods The searches were initially run in March 2011 and subsequently updated in February 2012. Databases including all EBM Reviews (Cochrane DSR, ACP Journal Club, DARE, CCTR, CMR, HTA and NHSEED) MEDLINE, EMBASE, AMED, British Nursing Index Archive using OvidSP were included and a search was run on each database separately after which duplicates were excluded. Selection criteria The inclusion criteria were randomised controlled trials that evaluated pre-operative nutritional support in GI surgical participants using a nutritional formula delivered by a parenteral, enteral or oral route. The primary outcomes included post-operative complications and length of hospital stay. Data collection and analysis Two observers screened the abstracts for inclusion in the review and performed data extraction. Bias was assessed for each of the included studies using the bias assessment tables in the Cochrane Software Review Manager (version 5.1, Cochrane Collaboration). The trials were analysed using risk ratios with Mantel-Haenszel in fixed effects methods displayed with heterogeneity. Meta-analyses were undertaken on trials evaluating immune enhancing (IE) nutrition, standard oral supplements, enteral and parenteral nutrition (PN) which were administered pre-operatively. Study characteristics were summarised in tables. Dichotomous and ratio data were entered into meta-analyses for the primary outcomes. These were then summarised in tables with assumed and corresponding risk with relative effect giving 95% confidence intervals. Main results The searches identified 9900 titles and, after excluding duplicates, 6433 titles were initially screened. After the initial title screen, 6266 were excluded. Abstracts were screened for 167 studies and 33 articles were identified as meeting the inclusion criteria, of which 13 were included in the review after an assessment of the complete manuscripts. Seven trials evaluating IE nutrition were included in the review, of which 6 were combined in a meta-analysis. These studies showed a low to moderate level of heterogeneity and significantly reduced total post-operative complications (risk ratio (RR) 0.67 CI 0.53 to 0.84). Three trials evaluating PN were included in a meta-analysis and a significant reduction in post-operative complications was demonstrated (RR 0.64 95% CI 0.46 to 0.87) with low heterogeneity, in predominantly malnourished participants. Two trials evaluating enteral nutrition (RR 0.79, 95% CI 0.56 to 1.10) and 3 trials evaluating standard oral supplements (RR 1.01 95% CI 0.56 to 1.10) were included, neither of which showed any difference in the primary outcomes. Authors' conclusions There have been significant benefits demonstrated with pre-operative administration of IE nutrition in some high quality trials. However, bias was identified which may limit the generalizability of these results to all GI surgical candidates and the data needs to be placed in context with other recent innovations in surgical management (eg-ERAS). Some unwanted effects have also been reported with components of IE nutrition in critical care patients and it is unknown whether there would be detrimental effects by administering IE nutrition to patients who could require critical care support after their surgery. The studies evaluating PN demonstrated that the provision of PN to predominantly malnourished surgical candidates reduced post-operative complications; however, these data may not be applicable to current clinical practice, not least because they have involved a high degree of 'hyperalimentation'. Trials evaluating enteral or oral nutrition were inconclusive and further studies are required to select GI surgical patients for these nutritional interventions.

232 citations


Journal ArticleDOI
TL;DR: Cisplatin-based neoadjuvant combination chemotherapy is an established standard, improving overall survival in MIBC and pathologic complete response appears to be an intermediate surrogate for survival, but this finding requires further validation.

220 citations


Journal ArticleDOI
TL;DR: In this paper, the International Mission on Prognosis and Analysis of Clinical Trials and Corticoid Randomisation after significant head injury prognostic models for prediction of outcome after moderate or severe traumatic brain injury were compared in large datasets.
Abstract: Objective: The International Mission on Prognosis and Analysis of Clinical Trials and Corticoid Randomisation After Significant Head injury prognostic models predict outcome after traumatic brain injury but have not been compared in large datasets. The objective of this is study is to validate externally and compare the International Mission on Prognosis and Analysis of Clinical Trials and Corticoid Randomisation after Significant Head injury prognostic models for prediction of outcome after moderate or severe traumatic brain injury. Design: External validation study. Patients: We considered five new datasets with a total of 9,036 patients, comprising three randomized trials and two observational series, containing prospectively collected individual traumatic brain injury patient data. Measurements and Main Results: Outcomes were mortality and unfavorable outcome, based on the Glasgow Outcome Score at 6 months after injury. To assess performance, we studied the discrimination of the models (by area under the receiver operating characteristic curves), and calibration (by comparison of the mean observed to predicted outcomes and calibration slopes). The highest discrimination was found in the Trauma Audit and Research Network trauma registry (area under the receiver operating characteristic curves between 0.83 and 0.87), and the lowest discrimination in the Pharmos trial (area under the receiver operating characteristic curves between 0.65 and 0.71). Although differences in predictor effects between development and validation populations were found (calibration slopes varying between 0.58 and 1.53), the differences in discrimination were largely explained by differences in case mix in the validation studies. Calibration was good, the fraction of observed outcomes generally agreed well with the mean predicted outcome. No meaningful differences were noted in performance between the International Mission on Prognosis and Analysis of Clinical Trials and Corticoid Randomisation After Significant Head injury models. More complex models discriminated slightly better than simpler variants. Conclusions: Since both the International Mission on Prognosis and Analysis of Clinical Trials and the Corticoid Randomisation After Significant Head injury prognostic models show good generalizability to more recent data, they are valid instruments to quantify prognosis in traumatic brain injury.

Journal ArticleDOI
TL;DR: Variation in amputation incidence occurs across England and the variation may reflect generic differences in local healthcare delivery, although racial factors may also contribute.
Abstract: The study aimed to explore the variation in recorded incidence of lower limb amputation in England. The incidences of amputations in adults with and without diabetes were determined from hospital episode statistics over 3 years to 31 March 2010 and compared between the 151 Primary Care Trusts (PCTs) in England. There were 34,109 amputations, including 16,693 (48.9%) in people with diabetes. The incidence was 2.51 per 1,000 person-years in people with diabetes and 0.11 per 1,000 person-years in people without (relative diabetes risk 23.3). Incidence varied eightfold across PCTs in people both with diabetes (range 0.64–5.25 per 1,000 person-years) and without (0.03–0.24 per 1,000 person-years). Amputations in people with diabetes varied tenfold—both major (range 0.22–2.20 per 1,000 person-years) and minor (range 0.30–3.25 per 1,000 person-years). The incidences of minor and major amputations were positively correlated both in those with (r = 0.537, p < 0.0005) and without (r = 0.611, p < 0.0005) diabetes. Incidences of amputations were also correlated between people with and without diabetes (total amputations r = 0.433, p < 0.0005; major amputations r = 0.528, p < 0.0005). There was a negative correlation between the incidence of amputation and estimated prevalence of ethnic Asians. No association was found between the PCT incidence of either total amputations and general population prevalence of social deprivation (r = −0.138, p = 0.092) or smoking (r = 0.137, p = 0.096). Variation in amputation incidence occurs across England. Because of the similarity in amputation variation between people with and without diabetes the variation may reflect generic differences in local healthcare delivery, although racial factors may also contribute.

Journal ArticleDOI
TL;DR: The aetiology, diagnosis and management of NMSC are reviewed and metastasis from high-risk SCC may be fatal.
Abstract: Nonmelanoma skin cancer (NMSC) represents the most common form of cancer in Caucasians, with continuing increase in incidence worldwide. Basal cell carcinoma (BCC) accounts for 75% of cases of NMSC, and squamous cell carcinoma (SCC) accounts for the remaining majority of NMSC cases. Whilst metastasis from BCC is extremely rare, metastasis from high-risk SCC may be fatal. In this article, we review the aetiology, diagnosis and management of NMSC.

Journal ArticleDOI
TL;DR: 2D FPPA has previously been shown to be valid and has now also been show to be a reliable measure of lower extremity dynamic knee valgus and clinicians can make informed judgments about individual performance and changes in performance resulting from interventions.
Abstract: Context: Two-dimensional (2D) video analysis of frontal-plane dynamic knee valgus during common athletic screening tasks has been purported to identify individuals who may be at high risk of suffering knee injuries such as anterior cruciate ligament tear or patellofemoral pain syndrome. Although the validity of 2D video analysis has been studied, the associated reliability and measurement error have not. Objective: To assess the reliability and associated measurement error of a 2D video analysis of lower limb dynamic valgus. Design: Reliability study. Participants: 20 recreationally active university students (10 women age 21.5 ± 2.3 y, height 170.1 ± 6.1 cm, weight 66.2 ± 10.2 kg, and 10 men age 22.6 ± 3.1 y, height 177.9 ± 6.0 cm, weight 75.8 ± 7.9 kg). Main Outcome Measurement: Within-day and between-days reliability and measurement-error values of 2D frontal-plane projection angle (FPPA) during common screening tasks. Interventions: Participants performed single-leg squat and drop jump and single-leg landings from a standard 28-cm step with standard 2D digital video camera assessment. Results: Women demonstrated significantly higher FPPA in all tests except the left single-leg squat. Within-day ICCs showed good reliability and ranged from .59 to .88, and between-days ICCs were good to excellent, ranging from .72 to .91. Standard error of measurement and smallest detectable difference values ranged from 2.72° to 3.01° and 7.54° to 8.93°, respectively. Conclusions: 2D FPPA has previously been shown to be valid and has now also been shown to be a reliable measure of lower extremity dynamic knee valgus. Using the measurement error values presented along with previously published normative data, clinicians can now make informed judgments about individual performance and changes in performance resulting from interventions.

Journal ArticleDOI
TL;DR: In this paper, the authors assessed Copenhagen's 60-year record of transit-oriented development since its internationally renowned 1947 Finger Plan, focusing principally on analysing Orestad's progress since the late 1990s in creating transitoriented development of jobs, housing and retail, education and leisure facilities.

Journal ArticleDOI
TL;DR: These good practice recommendations for outpatient parenteral antimicrobial therapy are an update to a previous consensus statement on OPAT in the UK published in 1998 and will provide a useful resource for teams developing new services, as well as a practical set of quality indicators for existing services.
Abstract: These good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) are an update to a previous consensus statement on OPAT in the UK published in 1998. They are based on previous national and international guidelines, but have been further developed through an extensive consultation process, and are underpinned by evidence from published literature on OPAT. They provide pragmatic guidance on the development and delivery of OPAT services, looking at all aspects of service design, care delivery, outcome monitoring and quality assurance, with the aim of ensuring that OPAT services provide high-quality, low-risk care, whatever the healthcare setting. They will provide a useful resource for teams developing new services, as well as a practical set of quality indicators for existing services.

Journal ArticleDOI
TL;DR: In this paper, the authors examine the organizational contexts constituted for such a purpose and ask fundamental questions about whose priorities are being advocated, where and how this is organized and what the implications of this are for forms of urban transition.
Abstract: Increasingly at the scale of cities, strategies and plans to respond to the challenges of climate change and constrained resources are being developed. A range of climate change plans, low-carbon strategies, peak oil preparations and so on have been developed, often with ambitious aspirations. At the same time, new and reconstituted “intermediary” organizational forms are working between the priorities of these plans and the contexts of their “application”. This is the movement between the “what” of the plans, strategies and preparations and the priorities they embody and the “how” of attempts at their accomplishment. Drawing on research in Greater Manchester, in this paper we examine the organizational contexts constituted for such a purpose and ask fundamental questions about whose priorities are being advocated, where and how this is organized and what the implications of this are for forms of urban transition.

Journal ArticleDOI
TL;DR: The prototype for the first development phase of the VR interactive training environment that allows 'things to go wrong' and consequently allows users not only to 'experience' the resulting implications but also to reflect on those implications as part of the learning process is presented.

Journal ArticleDOI
26 Jan 2012-PLOS ONE
TL;DR: A preliminary screening of pollinators in the UK for parasites is carried out, finding that about a third of bumblebees and wasps, as well as all honey bees, were positive for deformed wing virus, but that this virus was not present in other pollinators.
Abstract: Many pollinator populations are declining, with large economic and ecological implications. Parasites are known to be an important factor in the some of the population declines of honey bees and bumblebees, but little is known about the parasites afflicting most other pollinators, or the extent of interspecific transmission or vectoring of parasites. Here we carry out a preliminary screening of pollinators (honey bees, five species of bumblebee, three species of wasp, four species of hoverfly and three genera of other bees) in the UK for parasites. We used molecular methods to screen for six honey bee viruses, Ascosphaera fungi, Microsporidia, and Wolbachia intracellular bacteria. We aimed simply to detect the presence of the parasites, encompassing vectoring as well as actual infections. Many pollinators of all types were positive for Ascosphaera fungi, while Microsporidia were rarer, being most frequently found in bumblebees. We also detected that most pollinators were positive for Wolbachia, most probably indicating infection with this intracellular symbiont, and raising the possibility that it may be an important factor in influencing host sex ratios or fitness in a diversity of pollinators. Importantly, we found that about a third of bumblebees (Bombus pascuorum and Bombus terrestris) and a third of wasps (Vespula vulgaris), as well as all honey bees, were positive for deformed wing virus, but that this virus was not present in other pollinators. Deformed wing virus therefore does not appear to be a general parasite of pollinators, but does interact significantly with at least three species of bumblebee and wasp. Further work is needed to establish the identity of some of the parasites, their spatiotemporal variation, and whether they are infecting the various pollinator species or being vectored. However, these results provide a first insight into the diversity, and potential exchange, of parasites in pollinator communities.

Journal ArticleDOI
TL;DR: A rationale for defining an MCID for the Gait Profile Score (GPS) is proposed based on an analysis of the difference in median GPS for children classified at different levels of the Functional Assessment Questionnaire, finding a strong linear correlation between median score and FAQ level.

Journal ArticleDOI
TL;DR: In this article, a field study of occupants' window opening behavior was carried out from Jan/05 to Apr/06 in a naturally ventilated office building in Sheffield's, UK climate conditions.

Journal ArticleDOI
TL;DR: In this article, a task force made up of a multidisciplinary expert panel including nurses, rheumatologists, occupational therapist, physiotherapist, psychologist, epidemiologist and patient representatives, representing 14 European countries, carried out the development of the recommendations, following the European League Against Rheumatism standardised operating procedures.
Abstract: Objectives The authors aim to develop European League Against Rheumatism recommendations for the role of the nurse in the management of patients with chronic inflammatory arthritis, to identify a research agenda and to determine an educational agenda. Methods A task force made up of a multidisciplinary expert panel including nurses, rheumatologists, occupational therapist, physiotherapist, psychologist, epidemiologist and patient representatives, representing 14 European countries, carried out the development of the recommendations, following the European League Against Rheumatism standardised operating procedures. The task force met twice. In the first meeting, the aims of the task force were defined, and eight research questions were developed. This was followed by a comprehensive, systematic literature search. In the second meeting, the results from the literature review were presented to the task force that subsequently formulated the recommendations, research agenda and educational agenda. Results In total, 10 recommendations were formulated. Seven recommendations covered the contribution of nurses to care and management: education, satisfaction with care, access to care, disease management, psychosocial support, self-management and efficiency of care. Three recommendations focused on professional support for nurses: availability of guidelines or protocols, access to education and encouragement to undertake extended roles. The strength of the recommendations varied from A to C, dependent on the category of evidence (1A–3), and a high level of agreement was achieved. Additionally, the task force agreed upon 10 topics for future research and an educational agenda. Conclusion 10 recommendations for the role of the nurse in the management of chronic inflammatory arthritis were developed using a combination of evidence-based and expert consensus approach.

Journal ArticleDOI
TL;DR: In this paper, the authors investigated the preparedness of homeowners in England and Wales to make changes to their homes in response to the predicted effects of climate change and found that the majority of homes had some energy-saving improvements, while few had property-level flood protection.
Abstract: The need to adapt to climate change impacts, whilst simultaneously limiting greenhouse gas emissions, requires that the government’s efforts are joined by public action. In England and Wales, housing contributes significantly to the emissions and many properties are at risk of flooding. This paper investigates the preparedness of homeowners in England and Wales to make changes to their homes in response to the predicted effects of climate change. A telephone survey of 961 homeowners investigated their interest in purchasing mitigation and adaptation improvements against their concern about climate change, awareness of flood risk and attribution of responsibility for action. Whilst the majority of homes had some energy-saving improvements, few were found to have property-level flood protection. The high levels of awareness about climate change and flooding were coupled with the perception of risks as low. Whilst some respondents accepted personal responsibility for action, most believed that the authorities were responsible for flood protection, and would not pay the costs required to make their home more energy-efficient and better prepared for the eventuality of floods. The results suggest that there is scope for further improvement of energy-saving measures, and that the levels of adoption of flood-protection measures are very low. Multi-faceted strategies, including more effective communication of risks and responsibilities, incentives, and material support for the poorest, will need to be developed to overcome the current reluctance by homeowners to invest in flood-protection measures and further energy conservation solutions in the future.

Journal ArticleDOI
TL;DR: Calibration is a process of comparing model results with field data and making the appropriate adjustments so that both results agree as mentioned in this paper, which can involve formal optimization methods or manual methods in which the modeler informally examines alternative model parameters.
Abstract: Calibration is a process of comparing model results with field data and making the appropriate adjustments so that both results agree. Calibration methods can involve formal optimization methods or manual methods in which the modeler informally examines alternative model parameters. The development of a calibration framework typically involves the following: (1) definition of the model variables, coefficients, and equations; (2) selection of an objective function to measure the quality of the calibration; (3) selection of the set of data to be used for the calibration process; and (4) selection of an optimization/manual scheme for altering the coefficient values in the direction of reducing the objective function. Hydraulic calibration usually involves the modification of system demands, fine-tuning the roughness values of pipes, altering pump operation characteristics, and adjusting other model attributes that affect simulation results, in particular those that have significant uncertainty assoc...

Journal ArticleDOI
TL;DR: It can be concluded that meniscectomy leads to symptomatic osteoarthritis of the knee later in life, with a resultant 132-fold increase in the rate of total knee replacement in comparison to their geographical and age-matched peers.
Abstract: We have carried out a prospective, longitudinal 30-year review of 95 adolescents who underwent total meniscectomy in one knee, and have compared the results with those observed 13 years earlier. All the medical records were scrutinised. Of the 63 patients reviewed clinically, 47 reported decreased sporting activity, although subjective satisfaction rose by 3% to 71%. The scores on the WOMAC osteoarthritis index differed significantly between patients grouped by subjective global assessment. Satisfactory function scores increased from 48% to 60%. In the 53 patients consenting to bilateral radiography of the knee, the incidence of narrowing of the articular cartilage in the operated knee increased significantly between the reviews (19% to 36%). Progression of degenerative change paralleled reduction in activity. Outcome measures were best after medial, intermediate after lateral and worst after double meniscectomy.

Journal ArticleDOI
15 Sep 2012-Trials
TL;DR: The STAMPEDE experience shows that recruitment to a MAMS trial and mid-flow changes its design are achievable with good planning, and benefits patients and the scientific community as research treatments are evaluated in a more efficient and cost-effective manner.
Abstract: Background: Systemic Therapy for Advanced or Metastatic Prostate cancer: Evaluation of Drug Efficacy (STAMPEDE) is a randomized controlled trial that follows a novel multi-arm, multi-stage (MAMS) design. We describe methodological and practical issues arising with (1) stopping recruitment to research arms following a pre-planned intermediate analysis and (2) adding a new research arm during the trial. Methods: STAMPEDE recruits men who have locally advanced or metastatic prostate cancer who are starting standard long-term hormone therapy. Originally there were five research and one control arms, each undergoing a pilot stage (focus: safety, feasibility), three intermediate ‘activity’ stages (focus: failure-free survival), and a final ‘efficacy’ stage (focus: overall survival). Lack-of-sufficient-activity guidelines support the pairwise interim comparisons of each research arm against the control arm; these pre-defined activity cut-off becomes increasingly stringent over the stages. Accrual of further patients continues to the control arm and to those research arms showing activity and an acceptable safety profile. The design facilitates adding new research arms should sufficiently interesting agents emerge. These new arms are compared only to contemporaneously recruited control arm patients using the same intermediate guidelines in a time-delayed manner. The addition of new research arms is subject to adequate recruitment rates to support the overall trial aims. Results: (1) Stopping Existing Therapy: After the second intermediate activity analysis, recruitment was discontinued to two research arms for lack-of-sufficient activity. Detailed preparations meant that changes were implemented swiftly at 100 international centers and recruitment continued seamlessly into Activity Stage III with 3 remaining research arms and the control arm. Further regulatory and ethical approvals were not required because this was already included in the initial trial design. (2) Adding New Therapy: An application to add a new research arm was approved by the funder, (who also organized peer review), industrial partner and regulatory and ethical bodies. This was all done in advance of any decision to stop current therapies.

Journal ArticleDOI
TL;DR: In this article, the authors introduce an approach to business simulation with less dependence on business simulation software to provide innovative work experience within a program of study, to boost students' confidence and employability.
Abstract: Purpose – The purpose of this paper is to introduce an approach to business simulation with less dependence on business simulation software to provide innovative work experience within a programme of study, to boost students’ confidence and employability.Design/methodology/approach – The paper is based on analysis of existing business simulation literature, which is synthesised with contemporary pedagogic trends and the outputs of the authors’ longitudinal research on improving the effectiveness of business simulation as a teaching method.Findings – The use of business simulation as a pedagogic tool can be considerably extended beyond built‐in functionality to match the needs of various business‐related disciplines. Learning from their own mistakes enabled students to appreciate the gap between theory and its application.Research limitations/implications – Business simulation can provide an innovative provision of work experience for students, if its design utilises continuous formative feedback and refle...

Journal ArticleDOI
TL;DR: It is likely that the increased force production, noted via the increased squat performance, contributed to the improved sprint performances, which should be considered to increase short sprint performance.
Abstract: Because previous research has shown a relationship between maximal squat strength and sprint performance, this study aimed to determine if changes in maximal squat strength were reflected in sprint performance. Nineteen professional rugby league players (height = 1.84 ± 0.06 m, body mass [BM] = 96.2 ± 11.11 kg, 1 repetition maximum [1RM] = 170.6 ± 21.4 kg, 1RM/BM = 1.78 ± 0.27) conducted 1RM squat and sprint tests (5, 10, and 20 m) before and immediately after 8 weeks of preseason strength (4-week Mesocycle) and power (4-week Mesocycle) training. Both absolute and relative squat strength values showed significant increases after the training period (pre: 170.6 ± 21.4 kg, post: 200.8 ± 19.0 kg, p < 0.001; 1RM/BM pre: 1.78 ± 0.27 kg·kg(-1), post: 2.05 ± 0.21 kg·kg(-1), p < 0.001; respectively), which was reflected in the significantly faster sprint performances over 5 m (pre: 1.05 ± 0.06 seconds, post: 0.97 ± 0.05 seconds, p < 0.001), 10 m (pre: 1.78 ± 0.07 seconds, post: 1.65 ± 0.08 seconds, p < 0.001), and 20 m (pre: 3.03 ± 0.09 seconds, post: 2.85 ± 0.11 seconds, p < 0.001) posttraining. Whether the improvements in sprint performance came as a direct consequence of increased strength or whether both are a function of the strength and power mesocycles incorporated into the players' preseason training is unclear. It is likely that the increased force production, noted via the increased squat performance, contributed to the improved sprint performances. To increase short sprint performance, athletes should, therefore, consider increasing maximal strength via the back squat.

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TL;DR: The REGents PARk and Tower Environmental Experiment (REPARTEE) comprised two campaigns in London in October 2006 and October/November 2007, where a wide range of measurements of airborne particle physical metrics and chemical composition were made as well as measurements of a considerable range of gas phase species and the fluxes of both particulate and gas phase substances.
Abstract: The REgents PARk and Tower Environmental Experiment (REPARTEE) comprised two campaigns in London in October 2006 and October/November 2007. The experiment design involved measurements at a heavily trafficked roadside site, two urban background sites and an elevated site at 160–190 m above ground on the BT Tower, supplemented in the second campaign by Doppler lidar measurements of atmospheric vertical structure. A wide range of measurements of airborne particle physical metrics and chemical composition were made as well as measurements of a considerable range of gas phase species and the fluxes of both particulate and gas phase substances. Significant findings include (a) demonstration of the evaporation of traffic-generated nanoparticles during both horizontal and vertical atmospheric transport; (b) generation of a large base of information on the fluxes of nanoparticles, accumulation mode particles and specific chemical components of the aerosol and a range of gas phase species, as well as the elucidation of key processes and comparison with emissions inventories; (c) quantification of vertical gradients in selected aerosol and trace gas species which has demonstrated the important role of regional transport in influencing concentrations of sulphate, nitrate and secondary organic compounds within the atmosphere of London; (d) generation of new data on the atmospheric structure and turbulence above London, including the estimation of mixed layer depths; (e) provision of new data on trace gas dispersion in the urban atmosphere through the release of purposeful tracers; (f) the determination of spatial differences in aerosol particle size distributions and their interpretation in terms of sources and physico-chemical transformations; (g) studies of the nocturnal oxidation of nitrogen oxides and of the diurnal behaviour of nitrate aerosol in the urban atmosphere, and (h) new information on the chemical composition and source apportionment of particulate matter size fractions in the atmosphere of London derived both from bulk chemical analysis and aerosol mass spectrometry with two instrument types.

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TL;DR: In this article, an empirical study was carried out from Jan/05 to Apr/06 in a high-rise office building to reveal blind operation patterns and to investigate the variables driving blind usage.