Challenges in cancer management and opportunities

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Prakash Raj Neupane
Keyword(s):  
Financial Burden ◽  
New Technology ◽  
Treatment Options ◽  
Medical Science ◽  
Cost Effective ◽  
Biological Behavior ◽  
Quality Data ◽  
Tumor Board ◽  
Cancer Management ◽  
Individualized Care

Cancer Care is a heavily invested and researched area in present context of development of medical science. As the burden of disease is increasing and treatment options are limited, especially in economically deprived regions, this is demanding more viable, modern and cost effective methods for diagnosis and treatment. This is driving to the need of more locally conducted research, more technical collaboration with advanced institutes and of course publishing of high quality data. We are gradually adapting new technology like Liquid based biopsy in diagnostics, targeted/ Immunotherapy in treatment and artificial intelligence in some therapies. These have proven effective and useful but at the huge cost of financial burden. New therapeutic modalities like BMT are emerging and gained importance in recent years. Cancer etiogenesis has heterogeneous components and this disease has very unpredictable biological behavior. Understanding of molecular biology, genetics, gene sequencing has given us tremendous amount of information for prognostics and prediction of treatment methods. Proper explanation and interpretation of so much so of information is very crucial. Clinicians and scientists should be learning and there should be provision for molecular tumor board as well. Slowly but gradually, the new generation care givers of the field of oncology should keep them at the edge of technology and should be able to understand the recent developments to give individualized care to patient and optimal use of available technology to tackle the disease. Writing and publishing in more standard formats is another important issue to be learned so as to communicate with the peers world wide. So we encourage the young oncologists to learn in this regard as well.

Recent Technological Advances Provide Highly Efficient and Reduced Risk Solutions for Conveying Wireline Formation Evaluation Toolstrings in Deepwater Operations

2021 ◽  
Author(s):  
Stephen McCormick ◽  
Rajesh Thatha ◽  
Martin Leonard ◽  
Samuel Escott ◽  
Adam Sedgwick ◽  
...  
Keyword(s):  
Data Quality ◽  
Data Acquisition ◽  
New Technology ◽  
High Strength ◽  
Holistic Approach ◽  
Cost Effective ◽  
Quality Data ◽  
Formation Evaluation ◽  
Sensor Position ◽  
Increased Risk

Abstract Obtaining high resolution, quality formation evaluation data is still only possible with wireline logging. However, with the continued push into deeper and more complex drilling environments, many challenges have been placed in the way of wireline logging, including high tension, high deviation, and increased differential pressure. These factors contribute to an increased risk of tool sticking incidents and lost-in-hole scenarios. Several methods of mitigating these issues on surface (powered capstans, pipe conveyance, etc) have been implemented in the past, but none have been successful in reducing or eliminating the risk downhole without introducing further drawbacks. This paper describes how a new wireline conveyance system has eliminated these issues. The conveyance system consists of wheeled carriages that carry the toolstring off-centre. The mass of the toolstring acts as a counterweight to ensure correct tool orientation in the wellbore. This orientation feature also enables a "guide" device to help navigate ledges and washouts. Such a system eliminates toolstring hold ups, allows access to highly deviated wells without pipe conveyance or tractors, and significantly mitigates differential sticking hazards, while also offering additional benefits in operational efficiency and data quality. A case study from a particularly difficult well in New Zealand is presented. Data acquisition in this well was fraught with challenges: In addition to the 2000m tangent section at 67° deviation, well had severe borehole breakouts. Previous experience in similar scenarios with conventional data acquisition methods yeided poor results. The wheeled carriage system was deployed in multiple innovative configurations resulting in the acquisition of excellent quality data from five wireline descents in hole. This wireline conveyance system has been routinely deployed on multiple deepwater operations in the Gulf of Mexico. One such operation is presented where large gains in logging efficiency have been realised, particularly with the elimination of differential sticking risk and time-consuming pipe conveyed logging. The new technology takes a holistic approach to wireline tool conveyance: Prevent sticking issues using wheeled carriages and mitigate fishing risk using ultra-high strength wireline cables. Wheeled carriages greatly reduce the tool-borehole contact area, preventing the incidence of tool sticking. In addition, wheeled carriages reduce drag while ensuring optimum data quality by sensor position and orientation within the wellbore. Ultra-high strength cables provide ability to log at very high tensions and at the same time provide high overpull capability. The result is a safe, efficient, cost effective and complete Wireline data acquisition.

Teletinnitus Program at the VA Gulf Coast Veterans Health Care System

2014 ◽  
Vol 4 (1) ◽  
pp. 23-29
Author(s):  
Constance Hilory Tomberlin
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Patient Care ◽  
Health Care System ◽  
Gulf Coast ◽  
New Technology ◽  
Cost Effective ◽  
Veterans Health ◽  
Potential Benefits ◽  
Care System

There are a multitude of reasons that a teletinnitus program can be beneficial, not only to the patients, but also within the hospital and audiology department. The ability to use technology for the purpose of tinnitus management allows for improved appointment access for all patients, especially those who live at a distance, has been shown to be more cost effective when the patients travel is otherwise monetarily compensated, and allows for multiple patient's to be seen in the same time slots, allowing for greater access to the clinic for the patients wishing to be seen in-house. There is also the patient's excitement in being part of a new technology-based program. The Gulf Coast Veterans Health Care System (GCVHCS) saw the potential benefits of incorporating a teletinnitus program and began implementation in 2013. There were a few hurdles to work through during the beginning organizational process and the initial execution of the program. Since the establishment of the Teletinnitus program, the GCVHCS has seen an enhancement in patient care, reduction in travel compensation, improvement in clinic utilization, clinic availability, the genuine excitement of the use of a new healthcare media amongst staff and patients, and overall patient satisfaction.

ASSESSMENT OF THE PLATELET COUNT IN THE PREGNANT WOMEN IN IGIMS, PATNA, BIHAR

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Tanwi Singh ◽  
Anshuman Sinha
Keyword(s):  
Platelet Count ◽  
Pregnant Women ◽  
Screening Test ◽  
Low Cost ◽  
Medical Science ◽  
Cost Effective ◽  
Platelet Indices ◽  
Increased Risk ◽  
Low Platelet Count ◽  
Severity Of The Disease

The major risk associated with low platelet count in pregnancy is the increased risk of bleeding during the childbirth or post that. There is an increased blood supply to the uterus during pregnancy and the surgical procedure requires cutting of major blood vessels. Women with thrombocytopenia are at increased risk of losing excessive blood. The risk is more in case of caesarean delivery as compared to vaginal delivery. Hence based on above findings the present study was planned for Assessment of the Platelet Count in the Pregnant Women in IGIMS, Patna, Bihar. The present study was planned in Department of Pathology, Indira Gandhi Institute of Medical Science, Patna, Bihar, India. The present study was planned from duration of January 2019 to June 2019. In the present study 200 pregnant females samples received for the platelet estimation were enrolled in the present study. Clinically platelet indices can be a useful screening test for early identification of preeclampsia and eclampsia. Also platelet indices can assess the prognosis of this disease in pregnant women and can be used as an effective prognostic marker because it correlates with severity of the disease. Platelet count is a simple, low cost, and rapid routine screening test. Hence the data generated from the present study concludes that platelet count can be used as a simple and cost effective tool to monitor the progression of preeclampsia, thereby preventing complications to develop during the gestational period. Keywords: Platelet Count, Pregnant Women, IGIMS, Patna, Bihar, etc.

Use of Resource-Efficient Plants to Reduce Nitrogen, Phosphorus, and Pesticide Runoff in Residential and Commercial Landscapes

1993 ◽  
Vol 28 (3-5) ◽  
pp. 205-213 ◽  
Author(s):  
Billy Hipp ◽  
Susan Alexander ◽  
Tim Knowles
Keyword(s):  
Comparative Study ◽  
Pollution Prevention ◽  
Cost Effective ◽  
Quality Data ◽  
Water Quality Data ◽  
Discharge System ◽  
Landscape Plant ◽  
Pollutant Concentrations ◽  
Pesticide Runoff ◽  
Nitrogen Phosphorus

Runoff from typical urban and suburban landscapes may contain significant levels of nitrogen, phosphorus, and a broad spectrum of various pesticides (mainly herbicides and insecticides) due to excessive application rates of these chemicals and high irrigation requirements of most commonly used landscape plant species. Preliminary water quality data (runoff) from a comparative study of 20 microwatersheds using 4 different levels of maintenance, show reductions in these types of pollutants in runoff for microwatersheds planted to resource efficient plants. Utilization of plants indigenous to an ecoregion (and other resource efficient plants) in landscape design and management allows considerable reduction in inputs from fertilizer, water, and pesticides. This results in lower pollutant concentrations in runoff and is estimated to result in lower total pollutant loadings from such systems. Installation of native or resource efficient plants in new developments (commercial and residential) and replacement of existing landscapes with these plants as older plants die or neighborhoods are updated could provide cities and suburban areas with a cost-effective, low-maintenance, and aesthetically-pleasing pollution control technology. Data from the comparative study should provide municipalities charged with meeting the new requirements of the National Pollutant Elimination Discharge System with a way to compare the pollution prevention effectiveness of resource-efficient landscapes with more traditional structural urban runoff controls.

scholarly journals Genotyping of GATA4 Gene Variant (G296S) in Malaysian Congenital Heart Disease Subjects by Real-Time PCR High Resolution Melting Analysis

2013 ◽  
Vol 32 (2) ◽  
pp. 152-157
Author(s):  
Nora Fawzi ◽  
Ramachandran Vasudevan ◽  
Patimah Ismail ◽  
Mazeni Alwi ◽  
Ahmad Fazli Abdul Aziz ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
High Resolution ◽  
Congenital Heart ◽  
High Resolution Melting ◽  
New Technology ◽  
Cost Effective ◽  
Study Cohort ◽  
Hrm Analysis ◽  
Melting Analysis

Summary Background: Congenital heart disease (CHD) is the most common birth defect; however, the underlying etiology is unrecognized in the majority of cases. GATA-binding protein 4 (GATA4), a cardiac transcription factor gene, has a crucial role in the cardiogenesis process; hence, a number of heterozygote sequence variations were identified as a cause of CHD. G296S heterozygote variant is the most frequently reported GATA4 gene sequence alteration. This study aims to investigate the role of G296S variant of the GATA4 gene in Malaysian CHD subjects. Methods: We have investigated 86 Malaysian CHD subjects with cardiac septation defects for the presence of the GATA4 gene heterozygote variant (G296S) by the new technology of high resolution melting (HRM) analysis. Results: Genotyping of G296S (c.886G>A) by HRM analysis shows that all the sample genotypes were of the wild GG type genotype and the heterozygote mutant GA genotype was totally absent from this study cohort. Conclusions: The results of our study showed that the G296S variant of the GATA4 gene was not associated with the development of CHD in Malaysian subjects. The use of HRM analysis proved a cost-effective, high-throughput, specific and sensitive genotyping technique which eliminates the need for unnecessary sequencing.

scholarly journals Treatment options in moderate and severe depression: decision analysis supporting a clinical guideline

2006 ◽  
Vol 189 (6) ◽  
pp. 494-501 ◽  
Author(s):  
Judit Simon ◽  
Stephen Pilling ◽  
Rachel Burbeck ◽  
David Goldberg
Keyword(s):  
Combination Therapy ◽  
Decision Analysis ◽  
Secondary Care ◽  
Treatment Options ◽  
Severe Depression ◽  
Cost Effective ◽  
Current Evidence ◽  
Resource Utilisation ◽  
Moderate Depression ◽  
The Cost

BackgroundTreatment options for depression include antidepressants, psychological therapy and a combination of the two.AimsTo develop cost-effective clinical guidelines.MethodSystematic literature reviews were used to identify clinical, utility and cost data. A decision analysis was then conducted to compare the benefits and costs of antidepressants with combination therapy for moderate and severe depression in secondary care in the UK.ResultsOver the 15-month analysis period, combination therapy resulted in higher costs and an expected 0.16 increase per person in the probability of remission and no relapse compared with antidepressants. The cost per additional successfully treated patient was £4056 (95% CI 1400–18 300); the cost per quality-adjusted life year gained was £5777 (95% CI 1900–33 800) for severe depression and £14 540 (95% CI 4800–79 400) for moderate depression.ConclusionsCombination therapy is likely to be a cost-effective first-line secondary care treatment for severe depression. Its cost-effectiveness for moderate depression is more uncertain from current evidence. Targeted combination therapy could improve resource utilisation.

scholarly journals Pharmacologic treatment of osteoporosis – 2011

2011 ◽  
Vol 152 (33) ◽  
pp. 1320-1326 ◽  
Author(s):  
Péter Lakatos
Keyword(s):  
Bone Loss ◽  
Fracture Risk ◽  
Hormone Replacement ◽  
Treatment Options ◽  
Osteoporotic Fractures ◽  
Cost Effective ◽  
Similar Efficacy ◽  
High Fracture ◽  
Efficient Treatment ◽  
Treatment Of Osteoporosis

Osteoporosis affects approximately 9% of the population in Hungary resulting in about 100 000 osteoporotic fractures annually. Thirty-five percent of patients with hip fractures due to osteoporosis will die within 1 year. Direct costs of osteoporosis exceed 25 billion forints per year. Apparently, cost-effective reduction of bone loss and consequent fracture risk will add up to not only financial savings but improvement in quality of life, as well. A number of pharmacological modalities are available for this purpose. The mainstay of the treatment of osteoporosis is the bisphosphonate group that includes effective anti-resorptive compounds mitigating bone loss and fragility. The recently registered denosumab exhibits similar efficacy by neutralizing RANK ligand, however, marked differences can be observed between the two drug classes. Strontium has a unique mechanism of action by rebalancing bone turnover, and thus, providing an efficient treatment option for the not fast bone losers who are at high fracture risk. The purely anabolic teriparatide is available for the extremely severe osteoporotic patients and for those who do not respond to other types of therapy. Older treatment options such as hormone replacement therapy, raloxifene, tibolone or calcitonin may also have a restricted place in the management of osteoporosis. Orv. Hetil., 2011, 152, 1320–1326.

scholarly journals Developing the flexible library and information workforce.

2013 ◽  
Vol 19 (64) ◽  
pp. 24-26
Author(s):  
Anne Goulding ◽  
Evelyn Kerslake
Keyword(s):  
Labour Market ◽  
New Technology ◽  
Cost Effective ◽  
Labour Markets ◽  
Labour Market Flexibility ◽  
Defined Media ◽  
Flexible Workforce ◽  
Forward Looking

Flexibility is a vaguely defined media buzzword connoting the progressive, forward-looking workplace. Employers report that increased labour market flexibility has made them more cost-effective, efficient, better able to deal with customer and employee demands and the implementation of new technology. But what is happening to those workers who make up the flexible workforce? For a while in the 1980s it seemed that flexibility could do no wrong; now, however, the shortcomings of flexible labour markets are becoming more apparent.

scholarly journals Combining F-Scan and GAITRite® for use in Clinical Gait Analysis: A Validation Study.

2020 ◽  
Author(s):  
Stephanie Speight ◽  
Selina Reidy ◽  
John Stephenson ◽  
Sarah Reel
Keyword(s):  
Gait Analysis ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Cost Effective ◽  
Quality Data ◽  
Concordance Correlation Coefficient ◽  
Concordance Correlation ◽  
Mean Values ◽  
Level Of Agreement

Abstract BackgroundClinical gait analysis is widely used to aid the assessment and diagnosis of symptomatic pathologies. Equipment based analysis provides clinicians with a more comprehensive assessment using pressure systems such as F-scan, or analysis of the spatial-temporal parameters of gait using GAITRite. There are systems however such as Strideway™ that can measure these parameters simultaneously, but can be expensive. This study aimed to determine whether standalone systems can be used collectively while still providing quality data, as a cost-effective alternative.MethodsTwenty-six participants walked on a standard floor and a GAITRite walkway, three times wearing the F-Scan system. Mid gait protocols were utilised by analysing the contact pressure of the 2 nd metatarsophalangeal joint of the third, fifth and seventh step from each walk. The Bland-Altman method was used to determine a level of agreement between the two surfaces, using mean values from all walks of all participants who successfully completed all required walks. The intraclass correlation coefficient and Lin’s concordance correlation coefficient were calculated as indices of reliability.ResultsThe intraclass correlation coefficient was calculated to be 0.991 and Lin’s concordance correlation coefficient for the data was calculated to be 0.956, indicating very good reproducibility.ConclusionsThe level of agreement in plantar pressures observed on the two surfaces was very high, suggesting that it is feasible to use F-Scan and GAITRite® together in a clinical setting, as an alternative to other less cost-effective standalone systems.

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