CardioFocus (United States)

Este artigo descreve a implantação do MR-MPS-SW nível C e da ABNT NBR ISO/IEC 27001 na Coopersystem com as intersecções existentes entre elas, reuso de soluções, diferenças substanciais encontradas e as estratégias adotadas durante a implantação. Também sugere futuros trabalhos que poderão ser realizados na organização para proporcionar uma integração ainda maior.

Youth who have experienced foster care are at risk of negative outcomes in adulthood. The family finding model aims to promote more positive outcomes by finding and engaging relatives of children in foster care in order to provide options for legal and emotional permanency. The present study tested whether family finding, as implemented in North Carolina from 2008 through 2011, improved child welfare outcomes for youth at risk of emancipating foster care without permanency. A randomized controlled trial evaluation was carried out in nine counties in North Carolina. All children eligible for intervention services between 2008 and 2011 underwent random assignment. Effects were tested with an intent-to-treat design. Outcome data were obtained for all subjects from child welfare administrative data. Additional outcome data for a subset of older youth came from in-person interviews. Subjects included 568 children who were in foster care, were 10-17 years old (at time of referral), had no identified permanent placement resource, and had no plan for reunification. The confirmatory outcome was moves to more family-like placements, whether through a step-down in foster care placement or discharge from foster care to legal permanency. No impact on the confirmatory outcome was observed. Findings regarding exploratory impacts are also described; these must be interpreted with caution, given the large number of outcomes compared. The evaluation failed to find evidence that family finding improves the outcomes of older youth at risk of emancipation from foster care.

Although breast cancer is a highly treatable disease, some women reject conventional treatment opting for unproven "alternative therapy" that may contribute to poor health outcomes. This study sought to understand why some women make this decision and to identify messages that might lead to greater acceptance of evidence-based treatment. This study explored treatment decision making through in-depth interviews with 60 breast cancer patients identified by their treating oncologists. Thirty refused some or all conventional treatment, opting for alternative therapies, whereas 30 accepted both conventional and alternative treatments. All completed the Beck Anxiety Inventory and the Rotter Locus of Control scale. Negative first experiences with "uncaring, insensitive, and unnecessarily harsh" oncologists, fear of side effects, and belief in the efficacy of alternative therapies were key factors in the decision to reject potentially life-prolonging conventional therapy. Refusers differed from controls in their perceptions of the value of conventional treatment, believing that chemotherapy and radiotherapy were riskier (p < .0073) and less beneficial (p < .0001) than did controls. Controls perceived alternative medicine alone as riskier than did refusers because its value for treating cancer is unproven (p < .0001). Refusers believed they could heal themselves naturally from cancer with simple holistic methods like raw fruits, vegetables, and supplements. According to interviewees, a compassionate approach to cancer care plus physicians who acknowledge their fears, communicate hope, educate them about their options, and allow them time to come to terms with their diagnosis before starting treatment might have led them to better treatment choices.

Abstract Background: PTEN alterations are major determinants of resistance to several new targeted therapies involving EGFR/PI3K/PTEN pathways. Recent findings also suggested implication of its associated PTENP1 pseudogene. PTEN can be altered at the gene or transcriptional level. PTEN expression is often higher in stroma than in tumor cells complicating readouts of assayed tumor samples. Taking advantage of the stroma of xenografted human tumors in nude mice being produced by the host, we characterized specific PTEN/PTENP1 tumor cell transcript expression levels and mutational status in a large panel of tumor models. Materials and Methods: A total of 192 patient-derived xenografts of 23 different histotypes were investigated. Human and murine PTEN, PTENP1 mRNA levels as well as PTEN gene copy numbers were quantified by quantitative polymerase chain reaction using species specific assays; PTEN transcript was analyzed by sequencing. Results were analyzed by tumor type and compared to sensitivity to cetuximab. Results: PTEN transcript alterations were observed in 32 of the 192 tumor xenografts (17%) and were shown to be due to loss of PTEN gene for 9, to loss of transcript expression for 4 and to frameshift or substitution-missense mutations for 14 and 7 samples, respectively. PTEN expression levels and alteration frequency were both associated with specific histotypes. Melanoma and breast cancer showed most PTEN alterations (6/11 and 6/16 respectively). PTENP1 pseudogene was shown to be well expressed in only 61% of tumor xenografts, whereby expression levels depended on the tumor type. No or low PTENP1 expression was found in tumor models having a PTEN alterations. Finally, in a tumor panel consisting of colon, non-small cell lung, gastric and head and neck cancer we found that none of the PTEN altered tumors analyzed were sensitive to cetuximab in vivo. Conclusion: This study confirmed the multiplicity of PTEN alterations occurring in cancer. PTEN expression levels and alterations were associated with PTENP1 expression levels and depended on tumor types. PTEN alterations were shown to be associated with tumor resistance to cetuximab and their impact on other targeted therapies involving EGFR/PI3K/PTEN pathways should be evaluated. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2011 Nov 12-16; San Francisco, CA. Philadelphia (PA): AACR; Mol Cancer Ther 2011;10(11 Suppl):Abstract nr A52.

High Concentration Photovoltaic (HCPV) power sources must compete with established energy sources such as fossil fuel or nuclear power, and must be as reliable and cost effective as other energy sources. HCPV manufacturers must address issues of technology viability, unique design requirements, immature manufacturing processes, quality control, and the impact these have on the reliability over a 25 year life. SolFocus is investing in proving the lifetime of its HCPV product and developing reliability assessment methods. This approach allows the company to provide an industry standard warranty with good knowledge of the financial risks involved and to set a cornerstone for product and company acceptance in the maturing solar industry. The SolFocus Reliability Program is divided into two major areas; panel and tracker reliability. This paper outlines the processes behind each program and summarizes current results.

Concentrator PV systems utilize different part of solar irradiation arriving at the Earth's surface and typically generate different power profiles than traditional flat plate PV or thin film. These factors need to be taken into account during plant design, particularly for inverter sizing strategies, and will result in very different inverter size/ rated DC power ratios than flat plate PV systems. This paper describes a methodology for sizing inverters for CPV power plants that optimizes the financial return of a project, taking into account energy generation profiles and financial parameters for large scale projects. Using hourly CPV power output throughout the year for a number of locations with high Direct Normal Irradiance (DNI) in southwest US, the optimal inverter size to maximize financial return over the project term is determined taking into account the magnitude and financial value of inverter energy clipping, capital and on-going costs and other project financial parameters. This analysis demonstrates the value of inverter sizing to CPV rated power ratios at or close to 1:1 at CPV standard operating condition (SOC) rating (850W/m2 DNI, 20°C Ambient, On-Sun), or 1:1.25 at standard testing condition (STC) rating (1000W/m2 DNI, 25°C Cell). Concrete examples of how this methodology was applied to several commercial and planned SolFocus sites are presented.

SolFocus' product has been in operation at Victor Valley Community College at the southern edge of the Mojave Desert for more than nine months, and we have analyzed energy output and performance ratios with the goal of better understanding and mitigating the effects of soiling on energy production. We have identified two different soiling mechanisms—particles deposited vertically at night and particles blown horizontally—that have different effects on soiling rates of the NIP and the systems. We have also estimated seasonal variations in soiling rates, and have found significant variation in system soiling across a single field. Local terrain features play a major role, as do short‐term events such as rainfall.

There is no standard for creating a reliability prediction. Therefore, predictions vary greatly in terms of methodological rigor, data quality, extents of analysis, and uncertainty. The documentation of the prediction process employed is often not presented. These inconsistencies can leave the user of the prediction confused, uncertain of the prediction's true value and unable to compare the results of two reliability predictions of the same hardware. IEEE has created a standard that, when followed, results in consistent and complete documentation of a prediction. The prediction users can then understand the strengths and weaknesses of a prediction and compare the value and usefulness of multiple predictions. The standard creates consistency by requiring documentation for specific processes, activities and levels of knowledge.

Since 2007 SolFocus has installed close to 2 MW of concentrated photovoltaic (CPV) power plants at multiple sites around the world. These installations have proved essential for assessing the value and variability of energy generation and performance ratio, as well as how accurately SolFocus is able to model and predict the product performance of its sites. This paper shares the data and results of performance ratio and energy production analyses at 4 of these sites, ISFOC in Puertollano (Spain), Palo Alto Water in California, APS Star Center in Arizona, and EDF in Alto Monte (Italy). The analysis was performed for both the SF-1000S and SF-1100S, SolFocus first and second generation CPV systems, and leveraged over 24 months of site data, including energy output, solar irradiation, temperature, and maintenance activities. Results show that the SolFocus products exhibit consistently high performance ratios (PR) in the field, ranging from 87% to 91%, as measured at the inverter under clean conditions. In addition, the tight distribution of performance ratios between the multiple arrays demonstrates a highly consistent product performance and characteristics. The measured performance ratios are consistent with the modeled values as calculated by the SolFocus proprietary energy calculator. Furthermore, the energy produced under normal conditions at all 4 sites match closely the modeled energy at these sites, validating SolFocus's ability to make accurate energy production projections.

High efficiency high concentration photovoltaic (HCPV) solar plants of megawatt scale are now operational, and opportunities for expanded adoption are plentiful. However, effective bidding for sites requires reliable prediction of energy production. HCPV module nameplate power is rated for specific test conditions; however, instantaneous HCPV power varies due to site specific irradiance and operating temperature, and is degraded by soiling, protective stowing, shading, and electrical connectivity. These factors interact with the selection of equipment typically supplied by third parties, e.g., wire gauge and inverters. We describe a time sequence model accurately accounting for these effects that predicts annual energy production, with specific reference to the impact of the inverter on energy output and interactions between system‐level design decisions and the inverter. We will also show two examples, based on an actual field design, of inverter efficiency calculations and the interaction between string arrangements and inverter selection.