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Is Your Web Design Hurting Your Business?
Unfortunately, this is a huge problem with many of the websites we see today ‑ across all industries. If you own a business, your web design is crucial to generating new customers — and it can be the single most important element keeping you from increasing revenues!
Why You Need a Mobile Responsive Website
Can you remember the last time you were not within 10 feet of your phone? Tens of millions of individuals just like you use their phones and tablets for everything — including searching the Internet — especially when they want information. If your website is not taking advantage of mobile users, then you may be leaving money on the table.
Five Reasons Your Business Must Embrace Social Media
Still waiting for a good reason to jump into the social media pool headfirst? Businesses that have embraced social media continue to reap many rewards, while strengthening customer loyalty and reaching the right customers at just the right time. If your business is still lagging behind in the social media game, there is no better time than now to take the plunge.
The New Day of the Sophisticated Online Customer
Gone are the days where a customer goes to the phone book, finds a dentist, attorney, roofer, etc., sets an appointment and purchases their products/services. Now, your potential customers have already researched the product or service they are interested in, they know how much it costs, how it works and they know what other people think about you and your business by researching reviews.
How Social Media will Improve your Business?
By now most of us are familiar with social media websites like Facebook, LinkedIn and Twitter. Many people and companies will tell you that social media will solve your business and marketing problems. Let us answer that right away...
Creating an Effective Brand for your Business
Our job as a brand strategy firm is to discover your company's unique distinction and position it in the marketplace. Right now, that marketplace is online. Understanding your company's brand is the first step in marketing that brand. Your brand is basically what current and potential customers think of your business.
Internet Marketing Strategy - More than just having a website
You have a website, now what? Who built your website? Do they know SEO (Search Engine Optimization)? Do you know what search engine optimization is? Do you really understand what your website should be doing for your business? These are common questions business owners ask themselves every day.
How Local Search Engine Optimization Can Save Small Businesses
If you are a local dentist, restaurant, attorney, roofer or any other type of small to medium size local or regional business, there is a way to generate new leads and customers that is more affordable than traditional advertising mediums like the Yellow Pages, TV, Radio, Newspaper, direct mail and billboards. SEO or Search Engine optimization is the newest and most effective way to get ahead of your competition and generate more sales.
Yellow Page Consultants & Local Search Experts
"Let your fingers do the walking" was the Yellow Pages tagline for years. Unfortunately, most consumers are now letting their fingers do the walking while typing into a Google search through their computers or mobile devices like a cell phone or tablet.
Why Are Keywords so Important to Your Website's Visibility?
Keywords are one big part of a combination of many strategic steps in the requirements search engines like Google use when they rank your website in their search results. Keywords are very important and they can make or break your search engine ranking.
Gates Sees Accelerated Decline of Traditional Media's Ad Model
Microsoft thinks the advertising business model for traditional media those venues where advertisers still channel most of their spending will fall apart faster in the coming five years as the kind of interactive, targeted advertising that is defining the Web comes to the fore.
Search engines, SEO and Internet Marketing | Myth and Reality
There are many myths and realities about search engines that business owners need to know before they begin developing a website, re-developing an active website or marketing their website and web presence. Many business owners think that having a website is all they need to be "visible on the search engines."
Yellow Pages vs. Internet Marketing
I worked in the Yellow Pages industry for over 9 years as an account manager for the two top yellow page publishers in this country. It was unbelievable to me how much business owners would spend on a product that they could only change their message on once a year? Plus, they were paying for an ad that would be bunched in with all of their competitors? This was mind-boggling to me.
On-Site and Off-Site Search Engine Marketing
Here's one thing that Internet users - from online shoppers to blog readers to prospective customers of your local business have in common: Over 82% of consumers use search engines to find local businesses. About 93% of online traffic begins at search engines. All business owners that have websites want to be visible in front of their potential customers.
Local Advertising Keys in a Down Economy
We all know is a little slow out there right now. Especially in Michigan. The economy is struggling, but that doesn't mean our businesses have to struggle. The bad economy is no excuse for local businesses to cut their marketing and advertising budgets. If you cut these two things, you basically cut off your lifeline to your business, which are new customers.


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As you may already know, Rootsweb has effectively been shut down due to a security issue. That's where the Tingewick website has been hosted more or less since I first built it, 20 years ago.
It seems it will take 'a few weeks' to resolve and there is a growing feeling that it may have vanished as a free hosting platform and will only return as a (paid-for) offshoot of Ancestry. I'm starting to look for an alternative but hosting a site of this size (more than 20,000 individuals, and growing) is going to cost £100 a year or more.
The site helps vast numbers of visitors. If, say, 100 were willing to pledge sponsorship of £1 each year, I could afford to set it up on a secure, reliable server. As a thank-you, the open public site could revert to showing bare outline trees with just dates and places, but subscribers might access a separate password-secured area which would offer a full version with sources and quotes – even more information than the current site – as well as all the other transcripts, photos etc.
Would it work? Would YOU be willing to pledge £1 a year to get the site back on the air?

subset: commoncrawl


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PAN 2018 fired up and ready
In an effort to highlight the economic impact of the numerous pan vendors across the island, CB Foods continues its annual initiative in search of the island's top pan chicken vendor.
On Saturday, August 25, Folly Oval in Portland brings the heat with 35 pan chicken vendors from the parishes of St Thomas, Kingston and St Andrew, St Catherine, St Ann, St Mary, Portland and Trelawny. Each will showcase their culinary skills at Regional 1 of PAN 2018 with the hopes of advancing to the grand final.
"PAN returns to Portland for the third time, and it's symbolic, considering Portland is the home of jerk. We're happy to be back and have lots in store for our patrons. They can expect amazing food and entertainment for the entire family," explained Kemoi Burke, business development coordinator, CB Foods.
Red Stripe has been a long-standing PAN partner, and this year promises to be another memorable one for the beer brand.
"We don't want to give too much away at this point, but we promise that it will be another memorable year for PAN patrons. Expect ice-cold beer, good vibes and an experience to remember," said Red Stripe's assistant brand manager, Reshima Kelly.
Preparation process
Pan chicken is not complete without jerk seasoning, and Walkerswood ensures that participants are using nothing but the best in their preparation process.
"This year, we continue with our support by providing all contestants with Walkerswood jerk seasoning, as well as our Firestick hot sauce. In addition, we will be sharing a sneak peak of some new Walkerswood flavours that we are working on", said Sean Garbutt, group marketing manager, Associated Manufacturers Limited.
The PAN finalists will compete in a live 60-minute cook-off. A winner and runner-up will be chosen to advance to the grand final. Each parish winner will receive $40,000 in cash, in addition to numerous prizes from several partners, including National Baking Company, Miracle Tomato Ketchup, Nupak Foil and Walkerswood. The runner-up will also receive $20,000, among other prizes.
For the past three years, Miracle Ketchup has been a partner, and participants will create their signature Miracle sauce for a chance to win cash and prizes.
All competitors are vetted and selected through the Social Development Commission.
The participants in Regional 1 of PAN 2018 are:
- St Thomas: Tricia Nicholas, Cordolyn McLaughlin, Paula Drysdale, Anna Kay Lee and Delroy Graham.
- Kingston & St Andrew: Davy Beckford, Kimali Livermore, Engrel Gayle, Donna Marie Burton, Antonio Morrison.
- St Catherine: Elaine Luke, Chadwick McDonald, Jason Whyte, Chevaun Arlando Mendez, Victor Johnson.
- St Ann: Jerome Barrett, Jahmuki Barnes, Kerrian Coombs, Denzil Green, Andrew McNeil.
St Mary: Kareen Johnson, Marilyn Blake, Kenroy James, Omar Walker, Ronique Brown.
- Portland: Keron Lewis, David Watson, Patricia Banton, Shernette Bernard, Samantha Daley.
- Trelawny: Richard Grant, Mario Bailey, Lovelett Moodie, Marshall Miller, Zweli Reid.
In true PAN fashion, there will be something for everyone attending the event. Aside from the entertainment delights for the adults, the young at heart eagerly anticipate the Monster Milk kiddies' village, which has been a hit since its inception.
Patrons will enjoy succulent and specially priced pan chicken at only $400 throughout the day and bar deals courtesy of PAN partners Wisynco (through its Wata, Tru Juice and Coca Cola brands) and Red Stripe.
Comedians Dufton 'Duffy' Shepherd and the Fluffy Diva Miss Kitty will guide the day's proceedings with on-stage activities and giveaways courtesy of PAN partners.
The event starts at noon and runs until 8 p.m.. Admission is free.


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The KA-6 receiver is not only compatible with their own R/C sets but is also fully compatible with all Hitec 2.4 ghz systems, and at an amazing price.
Hitec Red technology is trusted by pilots worldwide to provide a supremely reliable and responsive radio link. Incorporating Hitech's AFHSS (Adaptive Frequencey Hopping Spread Spectrum) technology,
At this price point Hitec users can built their fleet without breaking the bank!
The KA-6 is a FULL RANGE receiver with twin dual diversity antennas.


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Jazz singer Kellylee Evans, with one of the most beautiful voices of her generation, received unanimous critical praise for her 2010 tribute to Nina Simone. C. Michael Bailey, writing in All About Jazz had this to say about Evans' album, "Nina":
Every once in a while an homage project comes along that actually does what it sets out to do: pay homage. That the object of the present homage is the enigmatic Nina Simone makes Canadian Kellylee Evans' Nina that much more a definitive statement of a courageous cultural career. Add to this that Evans thoughtfully does not cover Simone's "Mississippi Goddamn," and this collection properly frames not only Simone, but also Evans, whose musical vision, already established, is a formidable one.
In her most recent effort, 2013's "I Remember When", Evans showcases songs by the likes of Eminem, John Legend, and Kanye West, taking them into her own world of jazz, soul, and hip hop while adding a few classics (hello Gladys Knight), and the quirky "And So We Dance" (aka "Alors on danse" in Stromae's original version).


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- Albuminuria
- Introduction
- Symptoms
- Diagnosis
- Misdiagnosis
- Causes
- Treatments
- Statistics
- Reference
Have a symptom?
See what questions
a doctor would ask.
See what questions
a doctor would ask.
Albuminuria: The presence of albumin (a blood protein) in the urine. More detailed information about the symptoms, causes, and treatments of Albuminuria is available below.
See full list of 6 symptoms of Albuminuria
Read more about treatments for Albuminuria
Home medical testing related to Albuminuria:
Read more about Deaths and Albuminuria.
Read more about causes of Albuminuria.
More information about causes of Albuminuria:
Research the causes of these diseases that are similar to, or related to, Albuminuria:
Commonly undiagnosed diseases in related medical categories:
Interstitial cystitis an under-diagnosed bladder condition: The medical condition of interstitial cystitic is a bladder condition that can be misdiagnosed as various conditions such as overactive bladder or other causes of pelvic pain...read more »
Read more about Misdiagnosis and Albuminuria
Research related physicians and medical specialists:
Other doctor, physician and specialist research services:
Visit our research pages for current research about Albuminuria treatments.
The US based website ClinicalTrials.gov lists information on both federally and privately supported clinical trials using human volunteers.
Some of the clinical trials listed on ClinicalTrials.gov for Albuminuria include:
See full list of 16 Clinical Trials for Albuminuria
Types of Albuminuria
Related forums and medical stories:
Read about other experiences, ask a question about Albuminuria, or answer someone else's question, on our message boards:
The presence of excessive protein (chiefly albumin but also globulin) in the urine; usually a symptom of kidney disorder - (Source - WordNet 2.1)
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Copyright © 2014 Health Grades Inc. All rights reserved. Last Update: 13 August, 2015 (2:44)


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Federal Guilty Plea
FOR IMMEDIATE RELEASE May 8, 2014
U.S. Department of Justice
Deirdre M. Daly, United States Attorney for the District of Connecticut, today announced that EDWIN CARTER, 51, of Hartford, pleaded guilty yesterday before Chief U.S. District Judge Janet C. Hall in New Haven to possession of firearms by a previously convicted felon.
According to court documents and statements made in court, on November 6, 2013, members of the Hartford Police Department's Special Operations Group and Shooting Task Force executed a court authorized search of CARTER's Plainfield Street residence and recovered an FNH PS90 5.7x28 caliber assault rifle with a high capacity magazine containing 15 live rounds, and one Sarko SAR-I (AK-47) 7.62x39 caliber assault rifle with two high capacity magazines, one containing 27 live rounds and the other containing 26 live rounds.
The FNH PS90 assault rifle had been reported stolen out of East Hartford.
Prior to November 2013, CARTER had sustained three felony convictions in the Connecticut Superior Court, including convictions for assault, weapons in a motor vehicle and possession of narcotics. It is a violation of federal law for a person previously convicted of a felony offense to possess a firearm or ammunition that has moved in interstate or foreign commerce.
CARTER has been detained since his arrest on November 26, 2013.
Judge Hall scheduled sentencing for August 18, 2014, at which time CARTER faces a maximum term of imprisonment of 10 years and a fine of up to $250,000.
This matter is being investigated by the Federal Bureau of Investigation's Northern Connecticut Violent Crimes Task Force, which includes members of the Hartford Police Department, East Hartford Police Department, Connecticut State Police and Connecticut Department of Correction. The case is being prosecuted by Assistant U.S. Attorney John H. Durham.


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A measurement of event-plane correlations involving two or three event planes of different order is presented as a function of centrality for 7 mu b(-1) Pb + Pb collision data at v root s(NN) = 2.76 TeV, recorded by the ATLAS experiment at the Large Hadron Collider. Fourteen correlators are measured using a standard event-plane method and a scalar-product method, and the latter method is found to give a systematically larger correlation signal. Several different trends in the centrality dependence of these correlators are observed. These trends are not reproduced by predictions based on the Glauber model, which includes only the correlations from the collision geometry in the initial state. Calculations that include the final-state collective dynamics are able to describe qualitatively, and in some cases also quantitatively, the centrality dependence of the measured correlators. These observations suggest that both the fluctuations in the initial geometry and the nonlinear mixing between different harmonics in the final state are important for creating these correlations in momentum space.
We demonstrate near-infrared cavity-enhanced optical frequency comb spectroscopy of water in a premixed methane/air flat flame. The detection system is based on an Er:fiber femtosecond laser, a high finesse optical cavity containing the flame, and a fast-scanning Fourier transform spectrometer (FTS). High absorption sensitivity is obtained by the combination of a high-bandwidth two-point comb-cavity lock and auto-balanced detection in the FTS. The system allows recording high-temperature water absorption spectra with a resolution of 1 GHz and a bandwidth of 50 nm in an acquisition time of 0.4 s, with absorption sensitivity of 4.2 x 10 (9) cm(-1) Hz(-1/2) per spectral element.
Technological developments over the years have resulted in many different techniques for detection of nitric oxide (NO) in both the atmosphere and from biological sources. One such technique is Faraday Modulation Spectroscopy (FAMOS), which is a laser-based spectroscopic technique for detection of paramagnetic molecules in gas phase. The technique uses a modulated magnetic field that introduce rotation of the polarization plane of linearly polarized laser light, which can be related to the concentration of the molecules. This enables sensitive and selective detection of paramagnetic gaseous compounds and the technique is thus well suited for detection of NO for biomedical applications in low concentrations which is essential for breath analysis.
In this thesis, a system for breath analysis is developed and coupled to a Faraday modulation spectrometer for sensitive detection of NO at 5.33 μm based on a room temperature continuous wave distributed feedback (DFB) QCL. It also provides a theoretical model of FAMOS utilizing the most sensitive Q3/2 (3/2 ) transition in NO. The results from this study indicate that the mid-infrared FAMOS system, which was built around a continuous wave (cw) quantum cascade laser (QCL) emitting light with an output power of approximately 70 mW, is fully capable of detection of ppb levels of NO in exhaled human breath.
Measurement is an important activity in nearly all branches of science and technology. A measurement technique provides an observer with a numerical value corresponding to the variable being measured. Researchers envision that laser spectroscopy will serve as a functional tool for measurement to detect molecules in gas phase. One such a laser spectroscopic technique for measurement is noise-immune cavity enhanced optical heterodyne molecular spectroscopy (NICE-OHMS), which is a highly sensitive laser-based spectroscopic technique for detection of molecules in gas phase. The technique was developed in the mid-1990s at the Joint Institute for Laboratory Astrophysics (JILA).
In this thesis, a realization of instrumentation for detection of acetylene in breath by a fiber laser-based NICE-OHMS instrumentation working in the near-infrared wavelength region is obtained. The results of this study show that the NICE-OHMS system is fully capable of detection of parts-per-billion (ppb) levels of acetylene in exhaled human breath.
The Zeno effect is investigated for soliton type pulses in a nonlinear directional coupler with dissipation. The effect consists in increase of the coupler transparency with increase of the dissipative losses in one of the arms. It is shown that localized dissipation can lead to switching of solitons between the arms. Power losses accompanying the switching can be fully compensated by using a combination of dissipative and active (in particular, parity-time-symmetric) segments.
The generation of Faraday waves in superfluid Fermi-Bose mixtures in elongated traps is investigated. The generation of waves is achieved by periodically changing a parameter of the system in time. Two types of modulations of parameters are considered: a variation of the fermion-boson scattering length and the boson-boson scattering length. We predict the properties of the generated Faraday patterns and study the parameter regions where they can be excited.
Collective oscillations of superfluid mixtures of ultra cold fermionic and bosonic atoms are investigated while varying the fermion-boson scattering length. We study the dynamics with respect to excited center of mass modes and breathing modes in the mixture. Parametric resonances are also analyzed when the scattering length varies periodically in time, by comparing partial differential equation (PDE) models and ordinary differential equation (ODE) models for the dynamics. An application to the recent experiment with fermionic Li-6 and bosonic Li-7 atoms, which approximately have the same masses, is discussed.
We report a measurement of the parameter y(CP) in D-0-(D) over bar (0) oscillations performed by taking advantage of quantum coherence between pairs of D-0(D) over bar (0) mesons produced in e(+)e(-) annihilations near threshold. In this work, doubly-tagged D-0(D) over bar (0) events, where one D decays to a CP eigenstate and the other D decays in a semileptonic mode, are reconstructed using a data sample of 2.92 fb(-1) collected with the BESIII detector at the center-of-mass energy of root s = 3.773 GeV. We obtain y(CP) = (-2.0 +/- 1.3 +/- 0.7)%, where the first uncertainty is statistical and the second is systematic. This result is compatible with the current world average.
Using 2.92 fb(-1) of electron-positron annihilation data collected at root s = 3.773 GeV with the BESIII detector, we obtain the first measurements of the absolute branching fraction B(D+ -> K(L)(0)e(+)nu(e)) = (4.481 +/- 0.027(stat) +/- 0.103(sys))% and the CP asymmetry A(CP)(D+-> KL0e+nu e) = (-0.59 +/- 0.60(stat) +/- 1.48(sys))%. From the D+ -> K(L)(0)e(+)nu(e) differential decay rate distribution, the product of the hadronic form factor and the magnitude of the Cabibbo-Kobayashi-Maskawa matrix element, f(+)(K)(0)vertical bar V-cs vertical bar, is determined to be 0.728 +/- 0.006(stat) +/- 0.011(sys). Using vertical bar V-cs vertical bar from the SM constrained fit with the measured f(+)(K)(0)vertical bar V-cs vertical bar, f(+)(K)(0) = 0.748 +/- 0.007(stat) +/- 0.012(sys) is obtained, and utilizing the unquenched Lattice QCD (LQCD) calculation for f(+)(K)(0), vertical bar V-cs vertical bar = 0.975 +/- 0.008(stat) +/- 0.015(sys) +/- 0.025(LQCD).
In an analysis of a 2.92 fb(-1) data sample taken at 3.773 GeV with the BESIII detector operated at the BEPCII collider, we measure the absolute decay branching fractions B(D-0 -> K(-)e(+)nu(e)) = (3.505 +/- 0.014 +/- 0.033)% and B(D-0 -> pi(-)e(+)nu(e)) = (0.295 +/- 0.004 +/- 0.003)%. From a study of the differential decay rates we obtain the products of hadronic form factor and the magnitude of the Cabibbo-Kobayashi-Maskawa (CKM) matrix element f(+)(K)(0)vertical bar V-cs vertical bar = 0.7172 +/- 0.0025 +/- 0.0035 and f(+)(pi)(0)vertical bar V-cd vertical bar = 0.1435 +/- 0.0018 +/- 0.0009. Combining these products with the values of vertical bar V-cs(d)vertical bar from the SM constraint fit, we extract the hadronic form factors f(+)(K)(0) = 0.7368 +/- 0.0026 +/- 0.0036 and f(+)(pi)(0) = 0.6372 +/- 0.0080 +/- 0.0044, and their ratio f(+)(pi)(0)/f(+)(K)(0) = 0.8649 +/- 0.0112 +/- 0.0073. These form factors and their ratio are used to test unquenched lattice QCD calculations of the form factors and a light cone sum rule (LCSR) calculation of their ratio. The measured value of f(+)(K(pi))(0)vertical bar V-cs(d)vertical bar and the lattice QCD value for f(+)(K(pi))(0) are used to extract values of the CKM matrix elements of vertical bar V-cs vertical bar = 0.9601 +/- 0.0033 +/- 0.0047 +/- 0.0239 and vertical bar V-cd vertical bar = 0.2155 +/- 0.0027 +/- 0.0014 +/- 0.0094, where the third errors are due to the uncertainties in lattice QCD calculations of the form factors. Using the LCSR value for f(+)(pi)(0)/f(+)(K)(0), we determine the ratio vertical bar V-cd vertical bar/vertical bar V-cs vertical bar = 0.238 +/- 0.004 +/- 0.002 +/- 0.011, where the third error is from the uncertainty in the LCSR normalization. In addition, we measure form factor parameters for three different theoretical models that describe the weak hadronic charged currents for these two semileptonic decays. All of these measurements are the most precise to date.
We here report for the first time the synergistic implementation of structured illumination microscopy (SIM) and multifocus microscopy (MFM). This imaging modality is designed to alleviate the problem of insufficient volumetric acquisition speed in superresolution biological imaging. SIM is a wide-field super-resolution technique that allows imaging with visible light beyond the classical diffraction limit. Employing multifocus diffractive optics we obtain simultaneous wide-field 3D imaging capability in the SIM acquisition sequence, improving volumetric acquisition speed by an order of magnitude. Imaging performance is demonstrated on biological specimens.
For 15 years, lensless microscopes have been constructed based on the use of holography, a digital CCD detector, and a computer for image reconstruction by use of, e.g., Fourier transformation. Thus, no lens is involved and therefore the conventional resolution limit of half the wavelength no longer applies. Instead of being limited by the wavelength, the resolution is in this case limited by how exact one can measure the phases of the light. It is remarkable that the interference-limited resolution is approximately 0.01X, whereas the diffraction-limited resolution is only of the order of 0.5X. It is my hope that by combining these two techniques it will be possible to increase the magnification in optical systems by at least an order of magnitude. The calculations at so indicate that information does not necessarily decrease with distance.
Film flow measurements at several axial positions in round pipes with variousaxial power distributions are presented for conditions corresponding to normaloperation of a BWR. It is confirmed that the film flow rate approaches zero atthe onset of dryout. Selected phenomenological models of annular two-phaseflow are shown to reasonably reproduce the measurements. It is concluded thatmodels are in better agreement with measurements if terms corresponding topossible boiling induced entrainment are excluded.
A method to perform film flow analysis in subchannels as a post-processto a standard two-field subchannel code is suggested. It is shown that thisapproach may yield accurate prediction of dryout power in rod bundles to alow computational cost and that the influence of the power distribution is wellpredicted by the model.
Measurements of film mass flow rate for annular, diabatic steam-water flow in tubes are presented. The measurements were carried out with four axial power distributions and at several axial positions at conditions typical for boiling water reactors, i.e. 7 MPa pressure and total mass flux in a range from 750 to 1750 kg/m2s. The results show that the influence of the axial power distribution on the dryout power corresponds to a consistent tendency in the film flow rate and that the film tends to zero when dryout is approached. Furthermore it is demonstrated that two selected phenomenological models of annular flow well predict the present data. A model for additional entrainment due to boiling is shown to degrade the predictions.
This paper was published when the measurements with non-uniform powerdistribution were still ongoing. Therefore only the measurements with uniformand top-peaked power profiles were included. The paper compares the measured data with deposition and entrainmentmodels by Hewitt & Govan (1990) and Okawa et al. (2003). These models are also discussed in Sections 4.2.1 and 4.2.2. The issue of a correct boundarycondition at the onset of annular flow was avoided by starting the integrationof the film flow model from the most upstream measurement point. In this way the net mass exchange rate (deposition less entrainment) could be studied without any initial bias from the boundary condition.The entrainment correlation proposed by Okawa et al. (2003) included a heat flux dependent term to account for boiling entrainment (Section 4.2.2). Paper 2 concludes that the model agrees better with measurements if this term is omitted. The result suggests that boiling entrainment may not be an important effect at the investigated conditions.
Measurements of film flow rates in diabatic annular flow in tubes with various axial power distributions were carried out in the high-pressure two-phase flow loop at the Royal Institute of Technology (KTH), Sweden. The measurements were performed at conditions typical for boiling water reactors, i.e. 7 MPa pressure and total mass flux in a range from 750 to 1750 kg/m(2)s. Four different axial power distributions were used and the film mass flow was measured at 7 axial locations for each set of boundary conditions. The results show that the outlet peaked distribution gives less film than the inlet peaked one. This result is consistent with well known trends from measurements of dryout power. The measurements also show that the film flow at the onset of dryout is very small at investigated conditions in agreement with earlier studies. Finally it is shown that the present data is well predicted by two selected phenomenological models of annular flow.
The influence of axial power distributions on dryout occurrence in nuclear fuel assemblies has been studied extensively for several decades. Even though it is well known that axial power shapes which may significantly vary in nuclear reactors during their operation significantly change the dryout power level, this particular influence is rather difficult to capture with current correlations. In this paper it is shown that this influence can be captured using a phenomenological liquid film model coupled to a standard sub-channel code. The model has been applied to various geometries, including a round pipe, as well as 5 x 5 and 8 x 8 fuel rod assemblies, and highly accurate predictions have been obtained.
This paper presents film flow measurement technique and the results with uniform power distribution. Based on these measurements it is possible to estimate the critical film thickness. The measured film thickness was plotted versus steam quality and slightlyextrapolated up to the measured critical steam quality. The conclusions werein line with Hewitt et al. (1965), i.e. that the critical film thickness is insignificantly small. This does not contradict e.g. Ueda & Isayama (1981) since the conditions were not the same, but for the flow conditions and heat fluxes that are typical for BWR operation it was concluded that the critical film thickness is, for practical purposes, zero.
Westinghouse is currently developing the MEFISTO code with the main goal to achieve fast, robust, practical and reliable prediction of steady-state dryout Critical Power in Boiling Water Reactor (BWR) fuel bundle based on a mechanistic approach. A computationally efficient simulation scheme was used to achieve this goal, where the code resolves all relevant field (drop, steam and multi-film) mass balance equations, within the annular flow region, at the sub-channel level while relying on a fast and robust two-phase (liquid/steam) sub-channel solution to provide the cross-flow information. The MEFISTO code can hence provide highly detailed solution of the multi-film flow in BWR fuel bundle while enhancing flexibility and reducing the computer time by an order of magnitude as compared to a standard three-field sub-channel analysis approach. Models for the numerical computation of the one-dimensional field flowrate distributions in an open channel (e.g. a sub-channel), including the numerical treatment of field cross-flows, part-length rods, spacers grids and post-dryout conditions are presented in this paper. The MEFISTO code is then applied to dryout prediction in BWR fuel bundle using VIPRE-W as a fast and robust two-phase sub-channel driver code. The dryout power is numerically predicted by iterating on the bundle power so that the minimum film flowrate in the bundle reaches the dryout criteria. Predicted dryout powers (including trends with flow, pressure, inlet subcooling and power distribution) and predicted dryout locations (both axial and radial) are compared to experimental results, using the entire Westinghouse SVEA-96 Optima3 dryout database, and are shown to yield excellent results.
We have previously shown that the use of the fair sampling assumption in EPR experiments could be questioned on the basis of experimental data. We continue our analysis of the data from the optical EPR experimental performed by Weihs et al. in Innsbruck 1997-1998, and we discuss whether a non-rotationally invariant source can account for the experimental results.
We present some recent results of a new statistical analysis of the optical EPR experiment performed by Weihs et al in Innsbruck 1997-1998. Under the commonly used assumption of fair sampling, we show that the coincidence counts exhibit a small and anomalous non-signalling component, which seems impossible to explain by using the conventional quantum mechanics, and we discuss some possible interpretations of this phenomenon.
We analyse optical EPR experimental data performed by Weihs et al in Innsbruck 1997–1998. We show that for some linear combinations of the raw coincidence rates, the experimental results display some anomalous behaviour that a more general source state (like non-maximally entangled state) cannot straightforwardly account for. We attempt to explain these anomalies by taking account of the relative efficiencies of the four channels. For this purpose, we use the fair sampling assumption, and assume explicitly that the detection efficiencies for the pairs of entangled photons can be written as a product of the two corresponding detection efficiencies for the single photons. We show that this explicit use of fair sampling cannot be maintained to be a reasonable assumption as it leads to an apparent violation of the no-signalling principle.
We study Gaussian valence bond states of continuous variable systems, obtained as the outputs of projection operations from an ancillary space of M infinitely entangled bonds connecting neighboring sites, applied at each of $N$ sites of an harmonic chain. The entanglement distribution in Gaussian valence bond states can be controlled by varying the input amount of entanglement engineered in a (2M+1)-mode Gaussian state known as the building block, which is isomorphic to the projector applied at a given site. We show how this mechanism can be interpreted in terms of multiple entanglement swapping from the chain of ancillary bonds, through the building blocks. We provide optical schemes to produce bisymmetric three-mode Gaussian building blocks (which correspond to a single bond, M=1), and study the entanglement structure in the output Gaussian valence bond states. The usefulness of such states for quantum communication protocols with continuous variables, like telecloning and teleportation networks, is finally discussed.
Reflectivity measurements offer unique opportunities for the study of surfaces and interfaces, and specular reflectometry has become a standard tool in materials science to resolve structures normal to the surface of a thin film. Off-specular scattering, which probes lateral structures, is more difficult to analyse, because the Fourier space being probed is highly anisotropic and the scattering pattern is truncated by the interface. As a result, scattering patterns collected with (especially time-of-flight) neutron reflectometers are difficult to transform into reciprocal space for comparison with model calculations. A program package is presented for a generic two-dimensional transformation of reflectometry data into q space and back. The data are represented on an orthogonal grid, allowing cuts along directions relevant for theoretical modelling. This treatment includes background subtraction as well as a full characterization of the resolution function. The method is optimized for computational performance using repeatable operations and standardized instrument settings.
We demonstrate an effective means of achieving compact, truly portable, and entirely self-contained ultrafast blue light sources. Using a variety of nonlinear media to achieve simple second-harmonic generation of a femtosecond Cr:LiSAF laser, we investigate the relative merits of aperiodically poled bulk and waveguide nonlinear crystals in comparison to periodically poled structures. Such a compact and convenient source of ultrashort laser pulses in the blue spectral region could be of great interest for on-site applications spanning a host of disciplines, such as biomedical imaging, optical micromanipulation, and high-resolution spectroscopy.
MITEL Semiconductor is developing the next generation low cost, high performance transceivers for data communication. The increasing quantity of data being transferred over the Internet demands very high capacity interconnects. A low cost, high-performance alternative is the use of parallel fiber interconnects where the light is, for example, coupled into a 12-channel fiber-ribbon. Parallel interconnects require good uniformity in order to reduce escalating costs and complexity. In this paper we report on the static and the modulation properties of 850nm multimode oxide VCSELs for use in such Gb/s transceiver system. Static power-current-voltage characteristics with good uniformity were obtained for different structures, with threshold currents down to sub-mA. A maximum small signal 3-dB bandwidth of 10 GHz and a modulation current efficiency up to 8.4 GHz/√[mA] were measured. Single channel results are presented for VCSELs operated at data rates from 2.5-10Gb/s.
A flip-chip-mounting scheme for high-speed lasers has been realised. The mounting scheme involves a microstructured silicon carrier with integrated membrane transmission lines and self-aligning solder bumps
The iridium(III) catalyzed hydrogenation of carbon dioxide under basic conditions was studied with density functional theory. It was found that the insertion of CO2 into an Ir-H bond proceeds via a two-step mechanism. The rate-limiting step was calculated to be the regeneration of the iridium(III) trihydride intermediate, and the overall barrier for the reaction was calculated to 26.1 kcal mol(-1). The formation of the iridium trihydride proceeds via formation of a cationic Ir(H)(2)(H-2) complex at which the base abstracts a proton from the dihydrogen ligand. (C) 2010 Elsevier B.V. All rights reserved.
This work reviews fundamentals and the recent state-of-art achievements in the field of plasmonic biosensing based terahertz (THz) spectroscopy. Being nonpoisonous and nondestructive to the human tissues, THz signals offer promising, cost-effective, and real-time biodevices for practical pharmaco-logical applications such as enzyme reaction analysis. Rapid developments in the field of THz plasmonics biosensors and immunosensors have brought many methodologies to employ the resonant subwavelength structures operating based on the fundamental physics of multipoles and asymmetric lineshape resonances. In the ongoing hunt for new and advanced THz plasmonic biosensors, the toroidal metasensors have emerged as excellent alternates and are introduced to be a very promising technology for THz immunosensing applications. Here, we provide examples of recently proposed THz plasmonic metasensors for the detection of thin films, chemical and biological substances. This review allows to compare the performance of various biosensing tools based on THz plasmonic approach and to understand the strategic role of toroidal metasensors in highly accurate and sensitive biosensors instrumentation. The possibility of using THz plasmonic biosensors based on toroidal technology in modern medical and clinical practices has been briefly discussed.
This paper investigates the benefits of dynamic restoration with service relocation in resilient optical clouds. Results from the proposed optimization model show that service availability can be significantly improved by allowing a few service relocations.
Photodetectors are a kind of semiconductor devices that convert incoming light to an electrical signal. Photodetectors are classified based on their different structure, fabrication technology, applications and different sensitivity. Infrared photodetectors are widely used in many applications such as night vision, thermal cameras, remote temperature sensing, and medical diagnosis etc.
All detectors have material inside that is sensitive to incoming light. It will absorb the photons and, if the incoming photons have enough energy, electrons will be excited to higher energy levels and if these electrons are free to move, under the effect of an external electric field, a photocurrent is generated.
In this project Fourier Transform Infrared (FT-IR) Spectroscopy is used to investigate a new kind of photodiodes that are based on self-assembled semiconductor nanowires (NWs) which are grown directly on the substrate without any epi-layer. The spectrally resolved photocurrent (at different applied biases) and IV curves (in darkness and illumination) for different temperatures have been studied respectively. Polarization effects (at low and high Temperatures) have been investigated. The experiments are conducted for different samples with high concentration of NWs as well as with lower concentration of NWs in the temperature range from 78 K (-195ºC) to 300 (27ºC). These photodiodes are designed to work in near infrared (NIR) spectral range.
The results show that the NW photodetectors indeed are promising devices with fairly high break down voltage, change of photocurrent spectra with polarized light, low and constant reverse saturation current (Is). The impact of different polarized light on photocurrent spectra has been investigated and an attempt has been made to clarify the observed double peak of InP photocurrent spectrum. Our investigations also include a comparison to a conventional planar InP p-i-n photodetector.
We present a review of properties of ultracold atomic Fermi-Bose mixtures in inhomogeneous and random optical lattices. In the strong interacting limit and at very low temperatures, fermions form, together with bosons or bosonic holes, composite fermions. Composite fermions behave as a spinless interacting Fermi gas, and in the presence of local disorder they interact via random couplings and feel effective random local potential. This opens a wide variety of possibilities of realizing various kinds of ultracold quantum disordered systems. In this paper we review these possibilities, discuss the accessible quantum disordered phases, and methods for their detection. The discussed quantum phases include Fermi glasses, quantum spin glasses, âdirtyâ superfluids, disordered metallic phases, and phases involving quantum percolation.
Atomic layer deposition (ALD), a gas-phase thin film deposition technique based on repeated, self-terminating gas-solid reactions, has become the method of choice in semiconductor manufacturing and many other technological areas for depositing thin conformal inorganic material layers for various applications. ALD has been discovered and developed independently, at least twice, under different names: atomic layer epitaxy (ALE) and molecular layering. ALE, dating back to 1974 in Finland, has been commonly known as the origin of ALD, while work done since the 1960s in the Soviet Union under the name "molecular layering" (and sometimes other names) has remained much less known. The virtual project on the history of ALD (VPHA) is a volunteer-based effort with open participation, set up to make the early days of ALD more transparent. In VPHA, started in July 2013, the target is to list, read and comment on all early ALD academic and patent literature up to 1986. VPHA has resulted in two essays and several presentations at international conferences. This paper, based on a poster presentation at the 16th International Conference on Atomic Layer Deposition in Dublin, Ireland, 2016, presents a recommended reading list of early ALD publications, created collectively by the VPHA participants through voting. The list contains 22 publications from Finland, Japan, Soviet Union, United Kingdom, and United States. Up to now, a balanced overview regarding the early history of ALD has been missing; the current list is an attempt to remedy this deficiency.
In this paper we apply the methodology of transformation optics for design of a novel invisibility cloak which can possess an open tunnel. Such a cloak facilitates the insertion (retrieval) of matter into (from) the cloak's interior without significantly affecting the cloak's performance, overcoming the matter exchange bottleneck inherent to most previously proposed cloak designs. We achieve this by applying a transformation which expands a point at the origin in electromagnetic space to a finite area in physical space in a highly anisotropic manner. The invisibility performance of the proposed cloak is verified by using full-wave finite-element simulations. (C) 2010 Optical Society of America
Direct carrier transport measurements were performed for different InGaAsP/InGaAlAs MQW test structures. Shallow InGaAlAs barrier QW showed faster carrier transport. Semi-insulating regrown FP lasers with InGaAlAs barrier QW showed improved high temperature operation, modal gain, differential modal gain and chirp.
Detailed experimental characterization is performed for 1550 nm semi-insulating regrown buried heterostructure Fabry-Perot (FP) lasers having 20 InGaAsP/InGaAlAs strain-balanced quantum wells (QWs) in the active region. Light-current-voltage performance, electrical impedance, small-signal response below and above threshold, amplified spontaneous emission spectrum below threshold and relative intensity noise spectrum are measured. Different laser parameters such as external differential quantum efficiency eta(d), background optical loss alpha(i), K-factor, D-factor, characteristic temperature T-0, differential gain dg/dn, gain-compression factor epsilon, carrier density versus current, differential carrier lifetime tau(d), optical gain spectrum below threshold, and chirp parameter alpha are extracted from these measurements. The FP lasers exhibited a high T-0 (78-86.5 degrees C) and very high-resonance frequency (23.7 GHz). The results indicate that appropriately designed lasers having a large number of InGaAsP well/InGaAlAs barrier QWs with shallow valence-band discontinuity can be useful for un-cooled high-speed direct-modulated laser applications.
1550 nm re-grown FP lasers having 20 InGaAsP/InGaAlAs strain-balanced QWs exhibit low threshold current density, high T0 (78.0 #x000B0;C) and high resonance frequency (24 GHz) indicating that a large number of shallow barrier QWs are attractive for un-cooled high-speed direct-modulation applications.
A comprehensive simulation study of InGaAsP (well)/InGaAlAs(barrier) 1.55 mu;m strain-compensated MQW lasers is presented. For MQWs, a uniform vertical distribution of holes is achieved due to a reduced effective hole confinement energy by optimizing the bandgap and strain of the barriers and p-doping in the active region. Some preliminary results are also presented for the manufactured lasers using these QWs indicating a good material platform.
Cluster size distributions were investigated in case of different nozzle geometries in argon and xenon using Rayleigh scattering diagnostics. Different nozzle geometries result in different behaviour, therefore both spatial- and temporal cluster size distributions were studied to obtain a well-characterized cluster target. It is shown that the generally used Hagena scaling can result in a significant deviation from the observed data and the behaviour cannot be described by a single material condensation parameter. The results along with the nanoplasma model applied to the data of previous high harmonic generation experiments allow the independent measurement of cluster size and cluster density.
The first members of dipole allowed 3 P o doubly excited series in helium have been observed in resonant photoexcitation of 1 s 2 s 3 S e metastable atoms. A good agreement measured relative photoionization cross sections is achieved when theory includes the radiation damping and, also important, the effects of spin-orbit multiplet splitting on electron angular distribution.
We report the demonstration of a gain-saturated 10.9 nm tabletop soft x-ray laser operating at 1 Hz repetition rate. Lasing occurs by collisional electron impact excitation in the 4dS01-->4pP11 transition of nickel-like Te in a line-focus plasma heated by a chirped-pulse-amplification Ti:sapphire laser. With an average power of 1muW and pulse energy up to approximately 2microJ, this laser extends the ability to conduct tabletop laser experiments to a shorter wavelength.
We have demonstrated the efficient generation of sub-9-nm-wavelength picosecond laser pulses of microjoule energy at 1-Hz repetition rate with a tabletop laser. Gain-saturated lasing was obtained at λ=8.85 nm in nickel-like lanthanum ions excited by collisional electron-impact excitation in a precreated plasma column heated by a picosecond optical laser pulse of 4-J energy. Furthermore, isoelectronic scaling along the lanthanide series resulted in lasing at wavelengths as short as λ=7.36 nm. Simulations show that the collisionally broadened atomic transitions in these dense plasmas can support the amplification of subpicosecond soft-x-ray laser pulses.
We have determined absolute dielectronic recombination rate coefficients for C II, using the CRYRING heavy-ions storage ring. The resonances due to 2s-2p (Delta n= 0) core excitations are detected in the center-of-mass energy range of 0-15 eV. The experimental results are compared with intermediate coupling AUTOSTRUCTURE calculations. Plasma rate coefficients are obtained from the DR spectrum by convoluting it with a Maxwell-Boltzmann energy distribution for temperatures in the range of 10(3)-10(6) K. The derived temperature-dependent plasma recombination rate coefficients are presented graphically and parameterized by using a fit formula for convenient use in plasma modeling codes. The experimental rate coefficients are also compared with the theoretical data available in literature. In the temperature range of 10(3)-2 x 10(4) K, our experimental results show that previous calculations severely underestimate the plasma rate coefficients and also our AUTOSTRUCTURE calculation does not reproduce the experimental plasma rate coefficients well. Above 2x10(4) K, the agreement between the experimental and theoretical rate coefficients is much better, and the deviations are smaller than the estimated uncertainties.
This thesis contains results of electron-ion recombination processes in atomic ions relevant for plasma applications. The measurements were performed at the Stockholm Refrigerated Electron Beam Ion Trap (R-EBIT) and at the CRYRING heavy-ion storage ring. Dielectronic recombination (DR) cross sections, resonant strengths, rate coefficients and energy peak positions in H-like and He-like S are obtained for the first time from the EBIT measurements. Furthermore, the experimentally obtained DR resonant strengths are used to check the behaviour of a scaling formula for low Z, H-and He-like iso-electronic sequences and to update the fitting parameters. KLL DR peak positions for initially He- to B-like Ar ions are obtained experimentally from the EBIT measurements. Both the results from highly charged sulfur and argon are compared with the calculations performed with a distorted wave approximation.
Absolute recombination rate coefficients of B-like C, B-like Ne and Be-like F ions are obtained for the first time with high energy resolution from storage ring measurements. The experimental results are compared with the intermediate coupling AUTOSTRUCTURE calculations. Plasma rate coefficients of each of these ions are obtained by convoluting the energy dependent recombination spectra with a Maxwell-Boltzmann energy distribution in the temperature range of 103-106 K. The resulting plasma rate coefficients are presented and compared with the calculated data available in literature.


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A Study of Cirmtuzumab and Ibrutinib in Patients With B-Cell Lymphoid Malignancies
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
|ClinicalTrials.gov Identifier: NCT03088878
Recruitment Status : Recruiting
First Posted : March 23, 2017
Last Update Posted : June 19, 2019
- Study Details
- Tabular View
- No Results Posted
- Disclaimer
- How to Read a Study Record
|Condition or disease
|B-cell Chronic Lymphocytic Leukemia Small Lymphocytic Lymphoma Mantle Cell Lymphoma
|Drug: Cirmtuzumab Drug: Ibrutinib Drug: Cirmtuzumab plus ibrutinib
|Phase 1 Phase 2
|Study Type :
|Interventional (Clinical Trial)
|Estimated Enrollment :
|156 participants
|Intervention Model:
|Single Group Assignment
|None (Open Label)
|Primary Purpose:
|Official Title:
|A Phase 1b/2 Study of the ROR1-Targeting Monoclonal Antibody, Cirmtuzumab (UC-961), and the Bruton Tyrosine Kinase Inhibitor, Ibrutinib, in Patients With B-Cell Lymphoid Malignancies
|Actual Study Start Date :
|January 3, 2018
|Estimated Primary Completion Date :
|October 1, 2020
|Estimated Study Completion Date :
|December 1, 2022
Experimental: Phase 1b - Dose Finding
Cirmutuzumab followed by Cirmtuzumab plus ibrutinib
Drug: Cirmtuzumab
Administered IV every 2 weeks for 5 administrations and then every 4 weeks thereafter
Other Name: UC-961
Drug: Cirmtuzumab plus ibrutinib
Other Names:
Experimental: Phase 1b - Dose Expansion
Cirmtuzumab plus ibrutinib
Drug: Cirmtuzumab plus ibrutinib
Other Names:
Experimental: Phase 2 - Cirmtuzumab plus ibrutinib
Phase 2 safety and efficacy evaluation
Drug: Cirmtuzumab plus ibrutinib
Other Names:
Active Comparator: Phase 2 - Ibrutinib
Phase 2 safety and efficacy evaluation
Drug: Ibrutinib
Self-administered orally once daily
Other Name: Imbruvica
- Phase 1b: Recommended dosing regimen (RDR) [ Time Frame: From baseline to 52 weeks ]Evaluation of cirmtuzumab dose-pharmacodynamic and pharmacokinetic-pharmacodynamic relationships, and safety
- Phase 2: Complete Response (CR) rate [ Time Frame: From randomization to discontinuation of treatment of all study subjects or 72 weeks after accrual of the final subject ]Proportion of subjects achieving a CR in accordance with pre-established response criteria for lymphoma (Cheson 2007; Cheson 2014)
- Phase 1b: Treatment Related Adverse Events [ Time Frame: From baseline to 56 weeks ]Number of participants with adverse events and clinical laboratory abnormalities assessed by CTCAE v.4.03
- Phase 2: Cirmtuzumab Plasma Concentration [ Time Frame: From randomization to discontinuation of treatment of all study subjects or 72 weeks after accrual of the final subject ]Concentrations measured using a validated immunoassay
- Phase 2: ROR1 Cell Surface Expression [ Time Frame: From randomization to discontinuation of treatment of all study subjects or 72 weeks after accrual of the final subject ]Changes in ROR1 cell surface expression on malignant cells in peripheral blood and bone marrow.
- Phase 2: Duration of Response [ Time Frame: From randomization to discontinuation of treatment of all study subjects or 72 weeks after accrual of the final subject ]The interval from the first documentation of objective response to the earlier of the first documentation of disease progression or death from any cause
- Phase 2: Progression Free Survival [ Time Frame: From randomization to discontinuation of treatment of all study subjects or 72 weeks after accrual of the final subject ]The interval from the start of study therapy to the earlier of the first documentation of disease progression or death from any cause
- Phase 2: Time to Treatment Failure [ Time Frame: From randomization to discontinuation of treatment of all study subjects or 72 weeks after accrual of the final subject ]The interval from start of study therapy to the earliest of the first documentation of disease progression, the permanent cessation of study drug due to an adverse event, or death from any cause
- Phase 2: Overall Survival [ Time Frame: From randomization to discontinuation of treatment of all study subjects or 72 weeks after accrual of the final subject ]The interval from the start of study therapy to death from any cause
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
|Ages Eligible for Study:
|18 Years and older (Adult, Older Adult)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
- Histological diagnosis of CLL/SLL or MCL as documented in medical records
- MCL has been previously treated and has relapsed after or progressed during prior therapy
- A medically appropriate candidate for ibrutinib treatment (based on the judgement of the clinical investigator)
- No history of prior BTK-inhibitor-containing therapy
- A medically appropriate candidate for ibrutinib treatment (based on the judgement of the clinical investigator)
- Presence of radiographically measurable lymphadenopathy or extranodal lymphoid malignancy (defined as the presence of ≥1 non-biopsied, non-irradiated lesion that measures ≥2.0 cm in the longest dimension [LD] and ≥1.0 cm in the longest perpendicular dimension [LPD] as assessed by computed tomography [CT] or magnetic resonance imaging [MRI]).
- Current medical need for therapy due to disease-related symptoms, lymphadenopathy, organomegaly, extranodal organ involvement, or progressive disease.
- Completion of all previous therapy (including surgery, radiotherapy, chemotherapy, immunotherapy, or investigational therapy) for the treatment of cancer ≥1 week before the start of study therapy.
- All acute toxic effects of any prior antitumor therapy resolved to ≤ Grade 1 before the start of study therapy (with the exceptions of alopecia, or neurotoxicity [Grade 1 or 2 permitted], or selected laboratory parameters [Grade 1 or Grade 2 permitted with exceptions as noted below]).
Adequate bone marrow function:
a) Absolute neutrophil count (ANC) ≥1.0 × 109/L. b) Platelet count ≥50 × 109/L. b) Hemoglobin ≥8.0 g/dL maintained for ≥1 week from any prior transfusion.
- Note: Grade ≥3 neutropenia, thrombocytopenia, or anemia is permitted if the abnormality is related to bone marrow involvement with hematological malignancy (as documented by bone marrow biopsy/aspirate obtained since the last prior therapy).
Adequate hepatic profile:
- Serum alanine aminotransferase (ALT) ≤3 × upper limit of normal (ULN).
- Serum aspartate aminotransferase (AST) ≤3 × ULN.
- Serum bilirubin ≤1.5 × ULN unless elevated due to Gilbert syndrome.
Adequate renal function:
a) Estimated creatinine clearance (eClCR) >45 mL/minute (with eClCR to be calculated by the Cockcroft-Gault formula), or b) Measured creatinine clearance >45 mL/minute (as assessed with a 24-hour urine collection).
2. Adequate coagulation profile:
- Prothrombin time (PT) ≤1.5 × ULN.
- Activated partial thromboplastin time (aPTT) ≤1.5 × ULN.
Negative viral serology:
- Negative human immunodeficiency virus (HIV) antibody.
- Negative hepatitis B surface antigen (HBsAg) and negative hepatitis B core (HBc) antibody or undetectable hepatitis B (HBV) deoxyribonucleic acid (DNA) by quantitative polymerase chain reaction (PCR) testing.
- Negative hepatitis C virus (HCV) antibody or negative HCV ribonucleic acid (RNA) by quantitative PCR.
- For female subjects of childbearing potential, a negative urine or serum pregnancy test prior to the start of study therapy.
- For female subjects of childbearing potential, willingness to use an effective method of contraception from the start of the screening period until ≥3 months after the last dose of cirmtuzumab and ≥1 month after the last dose of ibrutinib, whichever is later. Note: A female subject is considered to be of childbearing potential unless she has had a hysterectomy, bilateral tubal ligation, or bilateral oophorectomy; has medically documented ovarian failure (with serum estradiol and follicle-stimulating hormone [FSH] levels within the institutional laboratory postmenopausal range and a negative serum or urine beta human chorionic gonadotropin [βHCG]); or is menopausal (age ≥50 years with amenorrhea for ≥6 months).
- For male subjects who can father a child and are having intercourse with females of childbearing potential who are not using adequate contraception, willingness to use an effective method of contraception from the start of study therapy until ≥3 months after the last dose of cirmtuzumab and ≥1 month after the last dose of ibrutinib, whichever is later, and to refrain from sperm donation from the start of study therapy until ≥3 months after administration of the final dose of either of the study drugs. Note: A male subject is considered able to father a child unless he has had a bilateral vasectomy with documented aspermia or a bilateral orchiectomy.
- In the judgment of the investigator, participation in the protocol offers an acceptable benefit-to-risk ratio when considering current disease status, medical condition, and the potential benefits and risks of alternative treatments for the subject's cancer.
- Willingness and ability of the subject to comply with scheduled visits, drug administration plan, protocol-specified laboratory tests, other study procedures, and study restrictions.
- Evidence of a personally signed informed consent indicating that the subject is aware of the neoplastic nature of the disease and has been informed of the procedures to be followed, the experimental nature of the therapy, alternatives, potential risks and discomforts, potential benefits, and other pertinent aspects of study participation.
Exclusion Criteria:
- Known histological transformation to an aggressive lymphoma (ie, Richter transformation). Note: Biopsy documentation of the absence or presence of transformation is not required.
- Known central nervous system malignancy. Note: Central nervous system imaging is only required in subjects with suspected central nervous system malignancy.
- Presence of another cancer with disease manifestations or therapy that could adversely affect subject safety or longevity, create the potential for drug-drug interactions, or compromise the interpretation of study results.
- Significant cardiovascular disease (eg, myocardial infarction, arterial thromboembolism, cerebrovascular thromboembolism) within 3 months prior to start of study therapy; angina requiring therapy; symptomatic peripheral vascular disease; New York Heart Association Class 3 or 4 congestive heart failure; or uncontrolled Grade ≥3 hypertension (diastolic blood pressure ≥100 mmHg or systolic blood pressure ≥160 mmHg) despite antihypertensive therapy.
- Significant screening ECG abnormalities, including unstable cardiac arrhythmia requiring medication, atrial fibrillation/flutter, left bundle branch block, 2nd-degree atrioventricular (AV) block type II, 3rd-degree AV block, Grade ≥2 bradycardia, or corrected QT (QTc) >450 msec (for men) or >470 msec (for women).
- Gastrointestinal disease (eg, gastric or intestinal bypass surgery, pancreatic enzyme insufficiency, malabsorption syndrome, symptomatic inflammatory bowel disease, chronic diarrheal illness, bowel obstruction) that might interfere with drug absorption or with interpretation of gastrointestinal AEs.
- Contraindication for ibrutinib use because of bleeding diathesis.
- Evidence of an ongoing systemic bacterial, fungal, or viral infection (including upper respiratory tract infections) at the time of start of study therapy. Note: Subjects with localized fungal infections of skin or nails are not precluded from participation.
- In subjects with prior hematopoietic progenitor cell transplantation, evidence of ongoing graft-versus-host disease (GVHD).
- Pregnancy or breastfeeding.
- Major surgery within 4 weeks before the start of study therapy.
- Prior solid organ transplantation.
- Prior anti-ROR1 therapy within 12 weeks prior to the start of study therapy.
- Use of a moderate or strong inhibitor or inducer of cytochrome P450 (CYP) 3A4 within 7 days prior to the expected start of ibrutinib therapy.
- Use within 7 days prior to the start of study therapy of a drug known to prolong the QT interval (Study Parts 1 or 2 only) .
- Concurrent participation in another therapeutic or imaging clinical trial.
- Any illness, medical condition, organ system dysfunction, or social situation, including mental illness or substance abuse, deemed by the investigator to be likely to interfere with a subject's ability to provide informed consent, adversely affect the subject's ability to cooperate and participate in the study, or compromise the interpretation of study results.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03088878
|Contact: Alpha Stem Cell Clinic
|United States, California
|City of Hope (City of Hope National Medical Center, City of Hope Medical Center)
|Duarte, California, United States, 91010
|Contact: Karen Rickard-Dickson 626-218-4583 email@example.com
|Contact: Tanya Siddiqi, MD 626-218-2405 firstname.lastname@example.com
|Principal Investigator: Tanya Siddiqi, MD
|UCSD Moores Cancer Center
|La Jolla, California, United States, 92093
|Contact: Alpha Stem Cell Clinic 844-317-7836 firstname.lastname@example.com
|Principal Investigator: Michael Choi, MD
|United States, Connecticut
|Yale Cancer Center
|New Haven, Connecticut, United States, 06510
|Contact: Laura Leary 203-800-1969
|Principal Investigator: Iris Isufi, MD
|United States, New York
|Northwell Health
|New Hyde Park, New York, United States, 11042
|Contact: Alexis Mark 718-470-4743 firstname.lastname@example.com
|Principal Investigator: Jacqueline Barrientos, MD, MS
|Manhattan Hematology Oncology Research Foundation, Inc.
|New York, New York, United States, 10016
|Contact: Phenoia Browne 212-689-6791 ext 228
|Principal Investigator: Alec Goldenberg, MD
|Columbia University Medical Center
|New York, New York, United States, 10032
|Contact: Hanna Weissbrot 212-304-5558 email@example.com
|Principal Investigator: Nicole Lamanna, MD
|United States, Ohio
|The Christ Hospital Lindner Research Center
|Cincinnati, Ohio, United States, 45219
|Contact: Marsha Zartman 513-585-2165
|Principal Investigator: Philip Leming, MD
|United States, Texas
|MD Anderson Cancer Center
|Houston, Texas, United States, 77030
|Contact: Sheri Allred 713-745-0554 firstname.lastname@example.com
|Principal Investigator: William Wierda, MD, PhD
|MD Anderson Cancer Center
|Houston, Texas, United States, 77030
|Contact: Alyssa Sheffield 713-792-2806 email@example.com
|Principal Investigator: Hun Lee, MD
|Principal Investigator:
|Michael Choi, MD
|University of California, San Diego
|Responsible Party:
|Michael Choi, Assistant Clinical Professor, Department of Medicine, University of California, San Diego
|ClinicalTrials.gov Identifier:
|Obsolete Identifiers:
|Other Study ID Numbers:
|First Posted:
|March 23, 2017 Key Record Dates
|Last Update Posted:
|June 19, 2019
|Last Verified:
|June 2019
|Individual Participant Data (IPD) Sharing Statement:
|Plan to Share IPD:
|Studies a U.S. FDA-regulated Drug Product:
|Studies a U.S. FDA-regulated Device Product:
Chronic lymphocytic leukemia
Small lymphocytic lymphoma
Mantle cell lymphoma
Receptor Tyrosine Kinase-like Orphan Receptor 1 (ROR1)
Bruton Tyrosine Kinase (BTK)
Leukemia, Lymphoid
Leukemia, Lymphocytic, Chronic, B-Cell
Lymphoma, Mantle-Cell
Neoplasms by Histologic Type
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Leukemia, B-Cell
Lymphoma, Non-Hodgkin


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The xx emerged with a new, hyper-emotional brand of r&b with their debut album in 2009, described by Pitchfork as "seductive songs set to spare but effective arrangements". Marking their bold white cross across a whole new generation, Romy Madley-Croft and Oliver Sim's sultry vocals became instantly recognisable.
A lot has happened since the end of the band's tour for second album Coexist. Most notably, producer and percussionist Jamie Smith took over clubs and festivals worldwide with his debut album as Jamie xx, In Colour, with contributions from bandmates Romy and Oliver, along with whispers of recording sessions in Reykjavik, Los Angeles and London for the band's next record.
Returning with Hall & Oates-sampling new single On Hold and third album I See You, their ascent to becoming one of Britain's biggest bands continues at a pace. They come to Manchester for two shows in March. These tickets will go in a flash, don't miss out.
Price includes £1 Restoration Levy & £1.80 Venue Extra Charge.
Presented by Now Wave & SJM Concerts
This is a 14+ event.


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How do we present ourselves as individuals and in groups? How does this change when we're looking at ourselves and others? Artist Harold Offeh, invited families to create repetitive poses and positions which were mirrored and distorted in the reflective surfaces around the room. Over the course of the weekend, families explored different modes of display and created GIFs to capture their experiments.
This workshop was programmed in parallel with Atelier E.B: Passer-by.
Harold Offeh is the 2018-19 Serpentine Family Programme Artist in Residence and proposes to work with families to create Familial: Our Live Archive. Over the course of a year, Offeh and will invite artists to develop a series of workshops bringing together children and adults to explore media, technology, identity, architecture and public space. Working together and using performance, participants will contribute to the formation of a live archive.
The Serpentine Galleries have signed up to the Family Arts Standards. We welcome families and to help you enjoy your experience we are committed to ensuring we meet these Standards. For more information on visiting the Serpentine Galleries with your family.


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ASHEBORO � The Randolph County Public Library is ready for some Halloween fun.
ASHEBORO � The Randolph County Public Library is ready for some Halloween fun.
* Every Child Ready to Read will host a Monster Mash Family Fun Night at the Asheboro Public Library, 201 Worth St., on Tuesday, Oct. 29, from 5:30-6:30 p.m. It�s free, and aimed at children, ages infant to 5 years, and their parents or caregivers, but older siblings are welcome, too.
There will be talking, singing, reading, writing and playing all about monsters. Visit the Children�s Room or call 318-6804 to sign up.
* Treat the kids to a Not-So-Spooky Halloween on Wednesday, Oct. 30, at 3:30 p.m., also at the Asheboro library. Read some fun Halloween stories, sing some silly songs and make a not-so-scary Jack-o-lantern to take home. Kids are invited to wear their costumes; no sign-up is required.
For more information, contact Ross A. Holt at (336) 318- 6806.
* The Archdale library�s Annual Halloween Party for children and families will be at Archdale Public Library, 10433 S. Main St., on Tuesday, Oct. 29, at 7 p.m. Enjoy spooky stories, games and refreshments. It�s free and costumes are welcome. For more information, call 431-3811.


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Hi all. I have searched and haven't found anything yet, but if you do know of the solution to the following issue, please point me to the post.
The issue we are having is that the email campaign analytics don't show if the email has been "opened" until it has also had a click. Also, it does show "Opened" if I view the "sent" email through the system.
We are using the Open Source 2.7.2 version of Zurmo and have Google Apps for Business.
Thanks for your time.


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|Violet Level Quiz #3 - so and such
Part A. Directions: Complete each sentence by choosing "so" or "such."
1. I'm ________ hungry, I could eat a horse.
2. This is __________ a big mess, it will take several days to clean up.
3. It was __________ a hot day yesterday.
4. This room feels ________ hot.
5. Why is he being __________ a jerk?
6. That movie was __________ funny!
7. It was __________ a funny movie we saw it three times.
8. He's having chest pains. __________ matters should be discussed with a doctor.
9. Marie is ___________ in love with her boyfriend.
10. It snowed __________ much last night, school was called of for today.
Part B. Directions: Complete each sentence by choosing "so"or "such" and "that."
1. The movie has been _________ a big success, __________ a sequel is going to be made.
2. She liked the student's writing _________ much _________ she gave him a gold star.
3. They're __________ excited __________ they can't get to sleep.
4. The patient was in __________ pain __________ the doctor gave him a sedative.
5. It was __________ a big explosion __________ it was heard several miles away.
6. These are _________ difficult times __________ we are living through.
7. Henry's __________ rich __________ he doesn't need to work, but he does anyway.
8. This is __________ a popular restaurant __________ a reservation is needed weeks ahead of time.
9. These are ___________ dangerous chemicals __________ you need to wear gloves when you use them.
10. The teacher's class was __________ boring _________ some people actually went to sleep.
Click here for the answers.
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Black Tommies
British Soldiers of African Descent in the First World War
After an introduction discussing the First World War as fought in colonial Africa, this study focuses on the little-known existence of black British soldiers, born and domiciled in the United Kingdom, who enlisted for military service during the War.
Victoria's Cross
The Untold Story of Britain's Highest Award for Bravery
The Victoria Cross is the most prestigious British military accolade and is rarely awarded. This investigation into the origins and bestowal of the medal reveals the political issues that have directed the selection of recipients since its inception. Gary Mead reviews the origins of the decoration; tells some of the heroic stories of qualifying candidates; and asks why some other acts of bravery have been inexplicably overlooked and why no women have ever been awarded the VC.
Army Wives
From Crimea to Afghanistan: the Real Lives of Women Behind the Men of Uniform
Through the centuries, army wives have had to contend with anxiety, separation, injury, bereavement, post-traumatic stress, and the struggle to maintain a normal home life in abnormal circumstances. Using interviews, letters and diaries, this remarkable history gives them a voice, sometimes for the first time. It traces their experiences from the Crimean War – the last in which wives followed their husbands to the front – to the new breed of independent women supporting their men through the war in Afghanistan.
The Last Post
Music, Remembrance and the Great War
Ever since the annual two-minute silence was first observed in 1919, the Last Post has been a powerful symbol of remembrance. In his exploration of this simple bugle call's history, Turner tracks down its earliest known use (as 'Setting the Watch') in the 18th century, examines the role of buglers during the First World War and shows how the Last Post has kept its significance despite early controversy over the nature of the Cenotaph ceremony and the changing meaning of Remembrance today.
The Distant Drum
A Memoir of a Guardsman in the Great War
After having been rejected on medical grounds several times as a volunteer, Fen Noakes was conscripted in June 1917 and sent to France in October to join the 4th Battalion east of Arras. The memoir that he wrote in 1934, 'while the memory is still comparatively undimmed', together with the letters written from the Front to his mother, provide an articulate and very detailed account of living and fighting through the final year of the war.
Those Who Dared
Awards to the British SAS Regiments and Attached SBS Units 1941–1946
The first incarnation of the Special Air Service (and affiliated Special Boat Service) undertook daring missions in North Africa and Europe during the Second World War and was disbanded immediately afterwards. Aimed at the medal collector and military historian, this book records the awards given to men of the units between 1941 and 1946, and gives brief summaries of the units' operations.
The In and Out
A History of the Naval and Military Club
Originally conceived as a 'civilized place of association' for officers on leave from the Peninsular War, the then 'Military Club' was founded, not without controversy, in 1815. Lavishly illustrated with reproductions of Club portraits and photographs, this volume traces the eventful history of the Club, through two world wars and an IRA bomb, and through several London locations before landing in St James's Square – but still sporting the 'In' and 'Out' of its Piccadilly home. Foreword by Prince Philip, the Club's President.
Britain's Great War Experience
Life at Home and Abroad 1914–1918
Beyond the horrors of the Western Front, the First World War sent Britons to the far corners of the globe and affected all aspects of life on the home front. This portfolio of contemporary photographs, documents, letters and ephemera (first published as The Worst Ordeal in 1994) takes the broadest view of the conflict – from the experiences of soldiers, sailors and airmen and their families to dealing with strikes, volunteer work, rationing, conscientious objectors and the Irish rebellion at home.
Tommy's Ark
Soldiers and Their Animals in the Great War
As well as the mascots, carrier pigeons and horses used by the army during the First World War, all manner of animals provided solace and interest for servicemen. Quoting letters, diaries and memoirs, van Emden follows the course of the war year by year, describing soldiers' experiences with animals, from entraining heavy horses in Birmingham to birdwatching at the front; and he also surveys the state of wildlife on the 'murdered earth' of the Western Front.
The Lost Tommies
Throughout the First World War, in the village of Vignacourt near the Somme battlefields, a French couple dedicated themselves to photographing soldiers on leave from the front. But their collection languished forgotten in boxes in an attic until it was recently discovered by researchers, Coulthart among them. This handsome volume presents the most interesting of the 4,000 high-quality glass negatives and identifies the British and Commonwealth troops depicted, many of whom were gathering for the Battle of the Somme.
The Life of Viscount Trenchard, Father of the Royal Air Force
Hugh Trenchard (1872–1956) had an unpromising start in life, failing the Army and Navy entrance exams, but found his métier when he joined the fledgling Royal Flying Corps in 1912. Nicknamed 'Boom' for his stentorian voice, he was obstinate and tactless, yet inspired unflagging loyalty in his men. And, as this fascinating biography makes clear, it was these very qualities that enabled him to create the Royal Air Force in the face of entrenched opposition from the older services.
Germany In Uniform
Once Hitler had taken control of Germany in 1933, he set about a rapid expansion of the armed forces, founding new units and paramilitary organizations. This review of German uniforms draws on the illustrations in the contemporary handbook Uniformfibel 1933 demonstrating the liveries in use at that date for the various branches of the army, navy and air force, as well as those of the police and other state organizations such as the SS and the Hitler Youth.
Fighting Fit 1939
Adam Culling, Curator of the Royal Army Physical Training Corps Museum, presents a number of the Army's training and equipment manuals, books and photographs. Ranging from Physical Training (1937) to Shoot to Kill (1944), the publications reproduced here show how the British soldier was kept fighting fit before and during the Second World War.
Fighting Fit 1914
The mustard-coloured cover and challenging contents of the British Army Manual of Physical Training of 1908 earned it the nickname the 'Yellow Peril'. Excerpts of this as well as other Army training publications such as Methods of Unarmed Attack and Defence (1917) and Bayonet Training (1916) are reproduced in this book, giving an insight into how soldiers of the First World War were prepared for action.
The British Soldiers of the Napoleonic Wars
If Wellington valued the rank and file of his army (despite calling them 'the scum of the earth') much of the civilian population had a low opinion of their qualities. This detailed survey of the ordinary soldiers in the British Army of the Napoleonic era draws on contemporary testimony and records to describe the men and their backgrounds, explain the military organization and harsh code of discipline that governed them, and explore their living conditions and place in society.
Letters and News from the Trenches and the Home Front
During the First World War the Daily Mail published letters from soldiers and civilians as well as reports from the front line and comment by literary figures such as John Galsworthy, Arthur Conan Doyle and Thomas Hardy. This volume mixes these elements from the paper's archive with private diaries, correspondence and photographs from the battle and home fronts to give a valuable contemporary perspective on the war.
Greasepaint and Cordite
The Story of ENSA and Concert Party Entertainment During the Second World War
During the course of the Second World War, the Entertainments National Services Association put on countless productions for the troops across the world, offering everything from music hall turns to Laurence Olivier. The enormous number of shows meant that the talent was spread thinly and performances were often delivered in difficult circumstances and inhospitable climes. Drawing on interviews with surviving ENSA performers, this book tells the colourful story of this most unusual and complex theatrical enterprise.
Sailors in the Dock
Naval Courts Martial Down the Centuries
Some embarrassing cowardice displayed by the captains of several British ships at the Battle of Dungeness in 1652 led to the formulation of the 'Articles of War', establishing a strict code of conduct for the Navy and empowering officers to apply it. This collection of significant legal cases in the history of the Royal Navy ranges from a mutiny at the Battle of Cadiz in 1587 to a captain's decision to scuttle HMS Manchester in the Mediterranean in 1942.


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This is an excerpt of an article written by me submitted recently to be assessed for publication in a scientific journal that I would like to share with you.
In medical practice is common to find situations that might call into question any practitioner on the epidemiological component of cardiovascular disease (CVD).
How many times we assess patients with multiple cardiovascular risk factors (CRF) and poor adherence to the treatment and they never develop one expected disease resulting from these CRF. While at the other extreme, there are individuals without CRF and with an appropriate lifestyle who begin suffering from an "unexpected" acute or chronic heart disease.
Taking into account the above mentioned, this article attempts to answer the following question: which would be the wiser perspective to address the issue of cardiovascular risk in relation to causation in CVD?
First, it is worth noticing that since Hippocrates, father of medicine, who advised to seek actively in the external causes of disease to the casualty criteria issued in 1965 by the eminent emeritus professor of medical statistics at the University of London, Sir Austin Bradford Hill (temporary , strength of association, biological gradient, specificity of association, consistency of association, biological plausibility, consistency with current knowledge, analogy and experimental demonstration), the issue of relationship between cause and effect has resulted to be very controversial in the epidemiology over the years. (1)
To answer the initial question, the author considers necessary to highlight that epidemiology defines the concept of an illness as an event, circumstance, feature or combination of these factors playing an important role in causing the disease. Obviously, the cause must precede the disease. It is said that a cause is "enough" when it inevitably occurs or starts the disease and "necessary" when the disease cannot develop in its absence. A sufficient cause is usually not a single factor, but often is a set of several components. In general, it is necessary to identify all components of a sufficient cause to carry out effective prevention, since the elimination of one of these components can interfere with the action of others and thus prevent the disease (2)
For example, smoking is one of the components of the sufficient cause of acute myocardial infarction (AMI) but it is not enough by itself to cause disease: some people smoke for 50 years without developing coronary heart disease. Thus, there are other necessary factors. However, quitting smoking reduces the incidence of IMA, but other causal components do not change.
In the same line, one should be aware that there are causality or causation factors as predisposing factors such as age, sex or preexisting health condition that might create a state of sensitivity for an agent prone to cause the disease. In addition, there are facilitating factors such low income, poor nutrition, inadequate housing and insufficient health care, which may favor the development of disease. These factors may be necessary but rarely sufficient to cause disease.
In order to refer to factors positively associated with risk of developing a disease but not enough to cause its expression, the term risk factor is used (3)
The above clearly reflects the complexity of the genesis of any disease, constituting a paradigm in this sense, CVD, for which have been already identified over 177 risk factors, although, in near future, this figure is expected to rise (4)
In the first stage of evolutionary development of epidemiology as a science, the model of
causality was a model of single causes to single effects that was soon replaced by the multiple causes-unique effects. Later, with the so-called Second Revolution in Epidemiology began studies on risk factors that laid the foundation for the emergence of a new causal paradigm in epidemiology: the multiple causes- multiple effects. A paradigm that is unsurpassed to this day being a step forward in the development of epidemiology, although it is a part of the linear approach that has dominated this science to date. Recently, a new concept has come up, the causality complex concept, which does not deny the existence of linear causality but enables the study of a complex system since the perspective of complexity and from simplicity (5)
The focus of causality based on complexity proposes a different analysis model, where the causes are not unique or multiple, but complex. Theoretical models for addressing causation under the assumption of complexity are not fully developed, we would say are being built right now, so there is not extensive documentation regarding its practical application (6)
Nowadays, the cardiovascular prediction models are trending worldwide (7) The author of this paper has published previously some approaches on this issue focusing in arterial hypertension since early stages of life to predict the disease in adulthood using conventional methods (8)
which might lack of the necessary reliability due to the classical statistical methods used.
I firmly believe that the medical community must decipher better tools to handle the with the complex casualty problem to first understand the contemporary health-disease model and secondly to find new ways to predict since the standpoint of complexity.
In the author's opinion, the effective application of the theory of complex causality, would be the most effective way to address the issue of cardiovascular risk in relation to causation in CVD and to do it since the perspective of predisease (before the disease be overt) would be key in the long term (9,10)
- Bradford Hill A. The environment and disease: association or causation? Proc R Soc Med. 1965;58:295-300.
- Porta M, ed. A Dictionary of Epidemiology. 5th. edition. New York: Oxford University Press; 2008. p. 34-37, 65-66, 82-84, 100-103, 116, 129-130, 152-154, 237-238.
- Jirtle RL, Skinner MK. Environmental epigenomics and disease susceptibility. Nat Rev Genet. 2007;8:253-62.
- Ordovas JM. Interacciones entre genes y entorno y factores de riesgo cardiovascular. Rev Esp Cardiol Supl. 2009;9:39B-51B.
- Kundi Michael. Causality and the interpretation of epidemiologic evidence. Ciênc. saúde coletiva [serial on the Internet]. 2007 Apr [cited 2011 July 04] ; 12(2): 419-428.
Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232007000200018&lng=en. doi: 10.1590/S1413-81232007000200018.
- Phillips CV, Goodman KJ: Causal Criteria and Counterfactuals; Nothing More (or Less) than Scientific Common Sense. Emerg Themes Epidemiol.2006,3:5.
- Al-Rawahi A, Lee P. Applicability of the Existing CVD Risk Assessment Tools to Type II Diabetics in Oman: A Review. Oman Med J. 2015 Sep;30(5):315-9. doi: 10.5001/omj.2015.65
- Perez Fernandez GA, Grau Abalo R. From the prehypertensive adolescent to the hypertensive adult. Is possible to predict the conversion? Arch Cardiol Mex. 2012;82(2):112–9.
- Perez Fernandez GA. The arbitrariness of the cut off points. a reflection since the perspective of predisease. Arch Cardiol Mex. 2012;82(3).
- Perez Fernandez GA. Prediction of cardiovascular disease from the early stages of life: A forgotten issue? Qatar Medical Journal 2016; 1(6). DOI: 10.5339/qmj.2016.6. (available at: http://www.qscience.com/doi/full/10.5339/qmj.2016.6)
Note. This editorial has been written by Dr. Guillermo Alberto Perez Fernandez, author of this blog, and reflects his personal opinion about the topic.
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