Influence of pallet pattern on top-to-bottom compression performance of unitized loads

Environmental scaling factors estimate a corrugated container’s ability to withstand various conditions it will encounter during the storage and distribution process. In this project, we examined the compressive resistance of unitized loads using differing pallet stacking patterns. To simulate real-world failure scenarios in our laboratory tests, we used two different nominal board grades of single-wall C-flute regular slotted containers loaded with a plywood panel and bagged salt to direct the failure location to the bottom of the stack. Our results showed that the columnar aligned pattern provided the greatest compressive resistance and the interlocked stacking arrangement yielded the lowest of the patterns evaluated. Based on the study results, we calculated box compression retention multipliers for each pattern and compared them to scaling factors published by the Fibre Box Association.

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Adult-onset sporadic chorea: real-world data from a single-centre retrospective study

Neurological Sciences ◽

10.1007/s10072-021-05332-w ◽

2021 ◽

Author(s):

Roberta Bovenzi ◽

Matteo Conti ◽

Rocco Cerroni ◽

Mariangela Pierantozzi ◽

Alessandro Stefani ◽

...

Keyword(s):

Clinical Examination ◽

Real World ◽

Laboratory Tests ◽

Clinical Course ◽

Diagnostic Workup ◽

Adult Onset ◽

Real World Data ◽

Term Outcome ◽

Long Term Outcome ◽

World Data

Abstract Background Adult-onset sporadic chorea includes a wide and heterogeneous group of conditions whose differential diagnosis and treatments are often challenging and extensive. Objectives To analyse retrospectively cases of adult-onset sporadic chorea from a single Italian centre to provide insights for a practical approach in the management of these patients. Methods A total of 11,071 medical charts from a 9-year period (2012–2020) were reviewed, identifying 28 patients with adult-onset sporadic chorea (genetic forms excluded). All available data regarding phenomenology, diagnostic workup, aetiology, treatments, and long-term outcome from this cohort were collected and analysed. Results Adult-onset sporadic chorea occurred more frequently in females and presented with an acute-subacute onset. Cerebrovascular diseases accounted for 68% of aetiology; further causes were structural brain lesions, internal diseases, and other movement disorder syndromes. Clinical course was mild, with spontaneous resolution or minimal disturbances in 82% of cases. Neuroimaging was fundamental to diagnose 76% of adult-onset sporadic chorea, an appropriate clinical examination contributed to the 14% of diagnoses, whereas basic laboratory tests to the 10%. Conclusions Revision of real-world data of adult-onset sporadic chorea patients from a single Italian cohort suggests that an accurate clinical examination, neuroimaging, and routine laboratory tests are useful to identify those cases underlying potentially severe but treatable conditions. Although in the majority of cases adult-onset sporadic chorea has mild clinical course and good response to symptomatic treatments, it is essential to run a fast diagnostic workup.

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Unresectable hepatocellular carcinoma: prospects for drug therapy with lenvatinib

Malignant tumours ◽

10.18027/2224-5057-2021-11-3-45-52 ◽

2022 ◽

Vol 11 (3) ◽

pp. 45-52

Author(s):

V. V. Breder ◽

D. T. Abdurakhmanov ◽

V. V. Petkau ◽

P. V. Balakhnin ◽

M. V. Volkonsky ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Drug Therapy ◽

Liver Function ◽

Real World ◽

Systemic Therapy ◽

Efficacy And Safety ◽

Study Results ◽

Class B ◽

Pugh Class ◽

Positive Results

There is a number of unresolved issues regarding the systemic therapy administration for hepatocellular carcinoma (HCC). Their solution is facilitated by accumulating real‑world study results. Lenvatinib therapy is a recognized drug with a good efficacy and safety profile for the treatment of HCC. Subanalyses of the REFLECT study showed that the absence of stratification by baseline AFP and baseline liver function, as well as the lack of options for subsequent drug therapy after lenvatinib, also affects the outcomes. Once these factors are taken into account, the hypothesis of superiority of lenvatinib to sorafenib and other drugs can be tested. Real‑world clinical studies have demonstrated positive results of lenvatinib therapy in patients with Child‑Pugh class B liver function, provided recommendations on the sequence of systemic therapy after lenvatinib and on the use of lenvatinib in patients with BCLC stage B, along with considering the possibility of lenvatinib monotherapy and the prospects for its use in patients with nHCC. Further real‑world studies of lenvatinib for HCC in the Russian population are required.

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Valuing new medicines in the early 21:st century

Nordic Journal of Health Economics ◽

10.5617/njhe.5538 ◽

2017 ◽

Vol 5 (1) ◽

pp. 7-22

Author(s):

Katarina Steen Carlsson ◽

Bengt Jönsson

Keyword(s):

Health Care ◽

Clinical Practice ◽

Real World ◽

Patent Protection ◽

New Technologies ◽

New Technology ◽

Treatment Strategies ◽

Real World Data ◽

Study Results ◽

Pricing And Reimbursement

What is the actual value of new medicines? The answer to this question is the key to rational use of new technologies in health care and for design of appropriate incentives for innovation. In this paper we present methods, data and study results for valuing new medical technologies in a life cycle perspective, relevant for development of a new approach to contract and payment for innovation that can replace present systems for pricing and reimbursement. Focus is on value in clinical practice, and on the data needs and methods needed for the development of outcome-based payment systems that balances risks and rewards for innovation in health care. We provide an overview of studies from the Swedish context on the value of new medicines introduced in the treatment of diabetes, cancer, cardiovascular disease and rheumatoid arthritis. These studies using national health data and quality registers emphasise the importance of continuing efforts to collect relevant data for assessment of value after a medicine reaches the market and starts to be used in clinical practice. It is only when medicines are used in clinical practice that the benefits for real-world patient populations can be identified, measured and valued. Analyses of real-world data will also assist further development and tailoring of treatment strategies to optimize the value of the new technology. While an effective patent system rewards innovation for a limited period of time, many innovations may continue to provide value to society long after patent protection, and these values must be included in the assessment of value of innovation.

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From Touchpad to Smart Lens

International Journal of Mobile Human Computer Interaction ◽

10.4018/jmhci.2013040101 ◽

2013 ◽

Vol 5 (2) ◽

pp. 1-20 ◽

Cited By ~ 4

Author(s):

Matthias Baldauf ◽

Peter Fröhlich ◽

Jasmin Buchta ◽

Theresa Stürmer

Keyword(s):

Real World ◽

User Study ◽

Direct Interaction ◽

The Other ◽

Use Case ◽

Interaction Techniques ◽

Public Displays ◽

New Approaches ◽

Study Results ◽

Completion Times

Today’s smartphones provide the technical means to serve as interfaces for public displays in various ways. Even though recent research has identified several new approaches for mobile-display interaction, inter-technique comparisons of respective methods are scarce. The authors conducted an experimental user study on four currently relevant mobile-display interaction techniques (‘Touchpad’, ‘Pointer’, ‘Mini Video’, and ‘Smart Lens’) and learned that their suitability strongly depends on the task and use case at hand. The study results indicate that mobile-display interactions based on a traditional touchpad metaphor are time-consuming but highly accurate in standard target acquisition tasks. The direct interaction techniques Mini Video and Smart Lens had comparably good completion times, and especially Mini Video appeared to be best suited for complex visual manipulation tasks like drawing. Smartphone-based pointing turned out to be generally inferior to the other alternatives. Examples for the application of these differentiated results to real-world use cases are provided.

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P1-088: Z-PROFILE: real-world utilization and effectiveness of Elbasvir/Grazoprevir in adult patients with chronic hepatitis C in Canada - final study results

Journal of Viral Hepatitis ◽

10.1111/jvh.62_12923 ◽

2018 ◽

Vol 25 ◽

pp. 68-68

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Real World ◽

Adult Patients ◽

Final Study ◽

Study Results

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Patient-Reported Outcomes from a 1-Year, Real-World, Head-to-Head Comparison of OnabotulinumtoxinA and Topiramate for Headache Prevention in Adults With Chronic Migraine

Journal of Primary Care & Community Health ◽

10.1177/2150132720959936 ◽

2020 ◽

Vol 11 ◽

pp. 215013272095993 ◽

Cited By ~ 1

Author(s):

Andrew M. Blumenfeld ◽

Atul T. Patel ◽

Ira M. Turner ◽

Kathleen B. Mullin ◽

Aubrey Manack Adams ◽

...

Keyword(s):

Chronic Migraine ◽

Real World ◽

Patient Reported Outcomes ◽

Work Productivity ◽

Preventive Treatment ◽

Activity Impairment ◽

Treatment Benefit ◽

Study Results ◽

Patient Reported ◽

Headache Impact

Introduction/Objective: Chronic migraine (CM) is associated with impaired health-related quality of life and substantial socioeconomic burden, but many people with CM are underdiagnosed and do not receive appropriate preventive treatment. OnabotulinumtoxinA and topiramate have demonstrated efficacy (treatment benefit under ideal conditions) for the prevention of headaches in people with CM in clinical trials, but real-world studies suggest markedly different clinical effectiveness (treatment benefit based on a blend of efficacy and tolerability). This study sought to evaluate patient-reported outcomes (PROs) of onabotulinumtoxinA versus topiramate immediate release for people with CM. Methods: FORWARD was a prospective, multicenter, randomized, parallel-group, open-label, phase 4 study comparing onabotulinumtoxinA 155 U every 12 weeks with topiramate 50 to 100 mg/day for ≤36 weeks in people with CM. PROs measured included the Headache Impact Test (HIT-6), 9-item Patient Health Questionnaire Quick Depression Assessment (PHQ-9), Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI:SHP), and Functional Impact of Migraine Questionnaire (FIMQ). Results: A total of 282 patients were randomized and treated with onabotulinumtoxinA (n = 140) or topiramate (n = 142). From baseline to week 30, mean HIT-6 test scores improved significantly in patients taking onabotulinumtoxinA compared with topiramate ( P < .001). Improvements in depression over time were observed via larger changes in PHQ-9 scores with onabotulinumtoxinA than topiramate ( P < .001). Work productivity assessed via WPAI:SHP scores revealed significant improvements with onabotulinumtoxinA versus topiramate in Work Productivity Loss ( P = .024) and Activity Impairment ( P < .001) domains. Results from the FIMQ also revealed a larger reduction from baseline with onabotulinumtoxinA vs topiramate ( P < .0001). Conclusion: OnabotulinumtoxinA treatment had more favorable real-world effectiveness than topiramate on depression, headache impact, functioning and daily living, activity, and work productivity. The overall study results suggest that the beneficial effects on a range of PROs are the result of improved effectiveness when onabotulinumtoxinA is used as preventive treatment for CM. Trial Registration: ClinicalTrials.gov: NCT02191579; https://clinicaltrials.gov/ct2/show/NCT02191579

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A multi-layer cellular automata approach for algorithmic generation of virtual case studies: VIBe

Water Science & Technology ◽

10.2166/wst.2010.782 ◽

2010 ◽

Vol 61 (1) ◽

pp. 37-45 ◽

Cited By ~ 21

Author(s):

R. Sitzenfrei ◽

S. Fach ◽

H. Kinzel ◽

W. Rauch

Keyword(s):

Boundary Conditions ◽

Case Studies ◽

Real World ◽

New Technologies ◽

Single Case ◽

Software Tool ◽

Simulation Software ◽

Data Availability ◽

Study Results

Analyses of case studies are used to evaluate new or existing technologies, measures or strategies with regard to their impact on the overall process. However, data availability is limited and hence, new technologies, measures or strategies can only be tested on a limited number of case studies. Owing to the specific boundary conditions and system properties of each single case study, results can hardly be generalized or transferred to other boundary conditions. virtual infrastructure benchmarking (VIBe) is a software tool which algorithmically generates virtual case studies (VCSs) for urban water systems. System descriptions needed for evaluation are extracted from VIBe whose parameters are based on real world case studies and literature. As a result VIBe writes Input files for water simulation software as EPANET and EPA SWMM. With such input files numerous simulations can be performed and the results can be benchmarked and analysed stochastically at a city scale. In this work the approach of VIBe is applied with parameters according to a section of the Inn valley and therewith 1,000 VCSs are generated and evaluated. A comparison of the VCSs with data of real world case studies shows that the real world case studies fit within the parameter ranges of the VCSs. Consequently, VIBe tackles the problem of limited availability of case study data.

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Real-world outcomes of ponatinib in treatment of advanced gastrointestinal stromal tumors (GIST) after tyrosine kinase inhibitor (TKI) failure.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e22508 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e22508-e22508 ◽

Cited By ~ 1

Author(s):

Michael C. Heinrich ◽

Lisa McGarry ◽

David Kerstein ◽

Hui Huang

Keyword(s):

Real World ◽

Kinase Inhibitor ◽

Unmet Need ◽

Rapid Progression ◽

Phase 2 ◽

Duration Of Treatment ◽

Real World Data ◽

Study Results ◽

Starting Dose ◽

Exon 11

e22508 Background: Imatinib is standard front-line treatment for advanced KIT+ GIST. For patients whose tumors progress on imatinib, sunitinib is indicated, followed by regorafenib for those with disease progression on both imatinib and sunitinib. Patients refractory to 2 prior TKIs typically experience rapid progression (median PFS: 4.8 mos for regorafenib; 0.9 mos for placebo [Demetri Lancet 2013]), and with failure of all approved TKIs, unmet need remains high. The oral TKI ponatinib, approved for TKI-refractory CML and Ph+ ALL, has shown activity in heavily-pretreated (76% with ≥4 prior regimens) advanced KIT+ GIST patients in a Phase 2, single-arm study (Heinrich ASCO 2015) at starting dose of 45 mg/day: clinical benefit rate (CBR = CR + PR + SD for ≥16 wks) of 37% and median PFS of 4.3 mos were observed in 30 patients with KIT exon-11-mutant GIST and CBR of 14% and median PFS of 2.0 mos in 15 patients whose GIST lacked a KIT exon 11 mutation. Methods: To examine real-world outcomes, we retrospectively identified patients receiving ponatinib off-label for GIST (ICD-9 171.5x, 171.9x) between 01Jan2014 and 31Dec2016 from sole-source US specialty-pharmacy records. Using patient, physician and pharmacy dispensing data, patient characteristics, treatment setting and dosing were noted, and duration of treatment (DOT) was examined using Kaplan-Meier techniques. Results: We identified 26 probable GIST patients receiving ponatinib over this 2-year period: 58% male; median age 57.5 yrs. Where reported, all received prior TKIs, but data for prior lines of therapy were incomplete. Most (69%) were treated in an academic setting, and the most frequent starting dose was 45 mg (77%). DOT ranged from < 1 to > 19 mos, with an estimated median DOT of 3.8 mos. At 3 mos, 61% of patients were estimated to remain on ponatinib, and at 6 mos, 34%. Conclusions: Available real-world data show that patients treated with ponatinib for TKI-refractory GIST had a median DOT of almost 4 mos, with 1/3 remaining on therapy for > 6 mos. Using DOT as a surrogate for PFS, these results are consistent with Phase 2 study results, and suggest ponatinib may have activity in patients who have exhausted other treatment options.

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An observational study of patients with advanced melanoma receiving pembrolizumab in a real-world U.S. community oncology practice.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e21015 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e21015-e21015

Author(s):

Charles Lance Cowey ◽

Frank Xiaoqing Liu ◽

Jenny Black-Shinn ◽

Kendall Lee Stevinson ◽

Marley Boyd ◽

...

Keyword(s):

Clinical Trials ◽

Brain Metastases ◽

Real World ◽

Performance Status ◽

Progression Free Survival ◽

Advanced Melanoma ◽

Ecog Performance Status ◽

Study Results ◽

Line Of Therapy ◽

Oncology Practice

e21015 Background: PD-1 monoclonal antibodies are promising immunotherapies approved for treatment of patients (pts) with advanced melanoma. As the first US FDA approved PD-1 antibody, pembrolizumab (pembro) has demonstrated efficacy and safety in clinical trial settings. However, patterns of real world utilization and pt outcomes associated with pembro are limited. Methods: Adult pts with advanced melanoma who initiated pembro between 9/1/ 2014-3/31/2016 were identified retrospectively fromelectronic health records (EHR) of McKesson Specialty Health and followed through 9/ 30/2016. Pts in clinical trials were excluded. Demographic, disease, treatment characteristics and reasons for treatment discontinuation of pembro were abstracted from structured data elements of the EHR with further supplementation of unstructured data within the patient chart (progress notes, radiology scan reports). Overall survival (OS) and physician-reported progression free survival (PFS) from pembro initiation were analyzed using Kaplan Meier analysis. Results: 182 pts, with a median follow-up of 9.9 mos (range = 0.0-25.0), were included. Median age at pembro initiation was 66.0 yrs; 30.8% had an elevated lactate dehydrogenase (LDH); 23.6% had brain metastases and 65.4% had an ECOG performance status of 0 or 1. The most common reason for pembro discontinuation was progression (45.5%) followed by treatment-related toxicity (24.4%). In the overall population, median PFS from pembro initiation was 4.2 mos (95% CI = 3.2-5.3). Median OS was 19.4 mos (14.0-NR) with 12 and 24-month survival probabilities of 61.4% (95% CI = 53.4-68.5) and 43.9% (95% CI = 31.1-55.9). In multivariable analyses, characteristics predictive of worse survival included receipt of pembro at a later line of therapy (HR = 3.36, p = 0.0013 for 3L+), presence of brain metastases (HR = 2.67, p = 0.0007) and elevated LDH (HR = 4.10, p < 0.0001). Conclusions: The study results are consistent with those from pembro clinical trials (KeyNote001) and are in support of the effectiveness of pembro in real world treatment of advanced melanoma. Presence of brain metastases, elevated LDH, and use of pembro 3L+ were associated with worse survival outcome.

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