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Randomized clinical trials are the primary tool for evaluating new medical interventions. Randomization provides for a fair comparison between treatment and control groups, balancing out, on average, distributions of known and unknown factors among the participants. Unfortunately, these studies often lack a substantial percentage of data. This missing data reduces the benefit provided by the randomization and introduces potential biases in the comparison of the treatment groups. Missing data can arise for a variety of reasons, including the inability or unwillingness of participants to meet appointments for evaluation. And in some studies, some or all of data collection ceases when participants discontinue study treatment. Existing guidelines for the design and conduct of clinical trials, and the analysis of the resulting data, provide only limited advice on how to handle missing data. Thus, approaches to the analysis of data with an appreciable amount of missing values tend to be ad hoc and variable. The Prevention and Treatment of Missing Data in Clinical Trials concludes that a more principled approach to design and analysis in the presence of missing data is both needed and possible. Such an approach needs to focus on two critical elements: (1) careful design and conduct to limit the amount and impact of missing data and (2) analysis that makes full use of information on all randomized participants and is based on careful attention to the assumptions about the nature of the missing data underlying estimates of treatment effects. In addition to the highest priority recommendations, the book offers more detailed recommendations on the conduct of clinical trials and techniques for analysis of trial data.
This guidance is an update of WHO global influenza preparedness plan: the role of WHO and recommendations for national measures before and during pandemics, published March 2005 (WHO/CDS/CSR/GIP/2005.5).
One reason for failure to cure solid tumors by surgery appears to be the impossibility of controlling metastases that are present but latent at the time of operation. This failure is a common clinical experience with aggressive neoplasms. but it is not always appreciated in tumors with longer survival times. e. g .• breast and colon cancer. In addition. recent evidence indicates that after resection of a primary tumor micrometas tases from it might be enhanced by suppression of immune and reticu loendothelial functions of the host. Other factors, such as increase of coagulability and stress in the perioperative period, can also promote tumor growth. The development of new metastases might be facilitated by cells forced into the circulation during operative manipulations. Such events could be important for the outcome of treatment and it is suggested that preventive measures should be directed to this systemic component of solid tumors. Radical surgery can reduce the number of tumor cells to a subclinical 3 6 stage (10 to 10 cells) in which chemotherapy might be more effective than in advanced stages. Chemotherapy, on the other hand, might aggravate the surgical morbidity by influencing the wound healing pro cess, by decreasing the immune response, and/or by toxicity to the bone marrow and to the gastrointestinal tract, for example.
Traditionally, the teaching of phase equilibria emphasizes the relationships between the thermodynamic variables of each phase in equilibrium rather than its engineering applications. This book changes the focus from the use of thermodynamics relationships to compute phase equilibria to the design and control of the phase conditions that a process needs. Phase Equilibrium Engineering presents a systematic study and application of phase equilibrium tools to the development of chemical processes. The thermodynamic modeling of mixtures for process development, synthesis, simulation, design and optimization is analyzed. The relation between the mixture molecular properties, the selection of the thermodynamic model and the process technology that could be applied are discussed. A classification of mixtures, separation process, thermodynamic models and technologies is presented to guide the engineer in the world of separation processes. The phase condition required for a given reacting system is studied at subcritical and supercritical conditions. The four cardinal points of phase equilibrium engineering are: the chemical plant or process, the laboratory, the modeling of phase equilibria and the simulator. The harmonization of all these components to obtain a better design or operation is the ultimate goal of phase equilibrium engineering. - Methodologies are discussed using relevant industrial examples - The molecular nature and composition of the process mixture is given a key role in process decisions - Phase equilibrium diagrams are used as a drawing board for process implementation
Describing the physical properties of quantum materials near critical points with long-range many-body quantum entanglement, this book introduces readers to the basic theory of quantum phases, their phase transitions and their observable properties. This second edition begins with a new section suitable for an introductory course on quantum phase transitions, assuming no prior knowledge of quantum field theory. It also contains several new chapters to cover important recent advances, such as the Fermi gas near unitarity, Dirac fermions, Fermi liquids and their phase transitions, quantum magnetism, and solvable models obtained from string theory. After introducing the basic theory, it moves on to a detailed description of the canonical quantum-critical phase diagram at non-zero temperatures. Finally, a variety of more complex models are explored. This book is ideal for graduate students and researchers in condensed matter physics and particle and string theory.
An exciting and mystical middle grade novel based on the movie Marvel's Doctor Strange! Prepare to enter the supernatural world of the mystic arts! Marvel's Doctor Strange follows the story of the talented neurosurgeon Doctor Stephen Strange who, after a tragic car accident, must put ego aside and learn the secrets of a hidden world of mysticism and alternate dimensions. Based in New York City's Greenwich Village, Doctor Strange must act as an intermediary between the real world and what lies beyond, utilizing a vast array of metaphysical abilities and artifacts to protect the Marvel Cinematic Universe. Acclaimed actor Benedict Cumberbatch (The Imitation Game, the BBC's Sherlock) will star as Doctor Stephen Strange. The cast also includes Chiwetel Ejiofor as Karl Mordo, Tilda Swinton as the Ancient One, and Rachel McAdams.
Rare diseases collectively affect millions of Americans of all ages, but developing drugs and medical devices to prevent, diagnose, and treat these conditions is challenging. The Institute of Medicine (IOM) recommends implementing an integrated national strategy to promote rare diseases research and product development.
Marvel's Captain America: Civil War pits hero against hero! Captain America and Iron Man lead two teams of heroes in a clash that will change the course of the Marvel Cinematic Universe. Following the record-breaking success of Marvel's Captain America: The Winter Soldier, the First Avenger will jump into his next big screen solo adventure on May 6, 2016 in Marvel's Captain America: Civil War! Inspired by a classic Marvel comics storyline, the third cinematic Captain America adventure will put Cap against his fellow Avenger, Iron Man. Chris Evans will reprise his role as Captain America, joined by Robert Downey Jr. as Iron Man and Chadwick Boseman (42, Get On Up) as the Black Panther, a character who will make his big screen debut in the film.
Novel Designs of Early Phase Trials for Cancer Therapeutics provides a comprehensive review by leaders in the field of the process of drug development, the integration of molecular profiling, the changes in early phase trial designs, and endpoints to optimally develop a new generation of cancer therapeutics. The book discusses topics such as statistical perspectives on cohort expansions, the role and application of molecular profiling and how to integrate biomarkers in early phase trials. Additionally, it discusses how to incorporate patient reported outcomes in phase one trials. This book is a valuable resource for medical oncologists, basic and translational biomedical scientists, and trainees in oncology and pharmacology who are interested in learning how to improve their research by using early phase trials.