The English HCV lookback programme has identified some individuals with transfusion-transmitted HCV infection. The path from the collection of donations from HCV-infected donors to the identification of infected recipients was constructed. The probability of different outcomes at each branch was derived from data collected during this programme. This path of probabilities was then used to produce a complete estimate of the number of recipients infected by blood transfusions (dead and alive at the end of 1995) by re-entry of blood components that fell out of the lookback at various steps prior to recipient testing, and entry of components from HCV-infected donations that were never identified for lookback. Less than 14,000 recipients were estimated to have been infected with HCV during the decade prior to the start of donation testing. Over 60% of these were expected to have died by the end of 1995. Transfusion has infected a large group of individuals. However, this group constitutes a very small, and declining, proportion of all HCV infections in the population.
Background: Lung cancer (LC) care is resource and cost intensive. We launched a Multidisciplinary LC Clinic (MDC), where patients with a new LC diagnosis received concurrent oncology consultation, resulting in improved time to LC assessment and treatment. Here, we evaluate the impact of MDC on health resource utilization, patient and caregiver costs, and secondary patient benefits. Methods: We retrospectively analyzed patients in a rapid assessment clinic with a new LC diagnosis pre-MDC (September 2016–February 2017) and post-MDC implementation (February 2017–December 2018). Data are reported as means; unpaired t-tests and ANOVA were used to assess for significance. We also conducted a cost analysis. Resource utilization, out-of-pocket costs, procedure-related costs, and indirect costs were evaluated from the societal perspective and presented in 2019 Canadian dollars (CAD); multi-way worst/best case and threshold sensitivity analyses were conducted. Results: We reviewed 428 patients (78 traditional model, 350 MDC). Patients in the MDC model required significantly fewer oncology visits from LC diagnosis to first LC treatment (1.62 vs. 2.68, p < 0.001), which was significant for patients with stage 1, 3, and 4 disease. Compared with the traditional model, there was no change in mean biopsies/patient (1.32 traditional vs. 1.17 MDC, p = 0.18) or staging investigations/patient (2.24 traditional vs. 2.02 MDC, p = 0.20). Post-MDC, there was an increase in invasive mediastinal staging for patients with stage 2/3 LC (15.0% vs. 60.0%, p < 0.001). Over 22 months, MDC resulted in savings of CAD 48,389 including CAD 24,167 CAD in direct patient out-of-pocket expenses. For the threshold analyses, MDC was estimated to cost CAD 25,708 per quality-adjusted life year (QALY), considered to be below current willingness to pay thresholds (at CAD 80,000 per QALY). MDC also facilitated oncology assessment for 29 non-LC patients. Conclusions: An MDC led to a reduction in patient visits and direct patient and caregiver costs.
In 1967 and 1969, two oceanographic cruises were made in the Black Sea under the guidance of the Woods Hole Oceanographic Institute: The cruises included scientists from many countries and disciplines. Their aims were to determine the recent geological and geochemical evolution of the Black Sea, to map the shallow structure of the basin, and to study the interaction between the oxidized surface waters and the anoxic waters beneath them. The results were published 23 years ago, as AAPG Memoir 20 (Ross and Degens, 1974). During the 1969 cruise, the vessel Atlantis II collected 40 piston cores, which formed the basis of most of the subsequent geological studies that were restricted to very recent sedimentation. Speculations concerning the origin of the basin and the relationship of the geology offshore to that exposed around the margins of the Black Sea were rooted in pre-plate tectonic concepts of basin formation and were in any case hampered by a lack of relevant data (Brinkmann, 1974).In 1976, the Glomar Challenger visited the Black Sea on Leg 42B of the Deep Sea Drilling Project and drilled and cored three deep-water sites (379, 380, and 381). Well 381 north of the Bosporus encountered sediments as old as Miocene, including some apparently deposited in shallow water (Ross, 1978).The next major volume in Western literature to deal with the Black Sea was published a decade later, collecting papers presented two years earlier at a conference in Yalta. In this volume, a number of seismic reflection lines
The Rioni Basin in West Georgia is an Oligocene foredeep that evolved into a Miocene to Pliocene foreland basin, north of the Achara-Trialeti thrust belt and south of the Greater Caucasus. It extends to the west into the Black Sea. A large number of exploration wildcats have been drilled onshore since the nineteenth century and have led to the discovery of three fields. Exploration was prompted by seeps and restricted to frontal ramp anticlines mapped at surface. No wells have been drilled offshore. Supsa (discovered 1889) contains 29 MMbbl oil in clastic Sarmatian reservoirs. The field has around 50 wells but less than 0.5 MMbbl have been produced. Shromisubani (discovered 1973) contains oil within Maeotian and Pontian clastic reservoirs, Chaladidi oil within Upper Cretaceous chalk. Despite this long and apparently intensive exploration effort, several factors make the basin an exciting target for field redevelopment and further exploration. The quality of existing seismic is very poor both on-and offshore. Reinterpretation of the structure of the fold and thrust belt has suggested the presence of new targets and plays which may be imaged by modern seismic methods. In addition, due to problems associated with central planning, discovered fields have not been optimallymore » developed or even fully appraised. The application of new technology, geological interpretation and investment promises to delineate substantial remaining reserves even after more than one hundred years of exploration.« less
Abstract Die Reaktion des Liganden mit Chloropalladat(II) bzw. ‐platinat(II) in schwachsaurem, wäßrigen Alkohol führt zu den quadratisch‐planaren Komplexen (I) mit über eine Aminogruppe koordiniertem Liganden (Ausbeute a 80, b 12%).
Seven fundamental questions on the relationship of lithospheric stresses and sedimentary basin origin and evolution are posed and elaborated. These are: (1) How is the evolution of sedimentary basins tied to lithospheric dynamics? (2) What are the sources of stress that lead to formation of sedimentary basins? (3) How does the interaction between internally and externally applied stresses affect the formation and evolution of sedimentary basins? (4) How do space and time variations of rheology and pore pressure affect stress transmission, strain, vertical motions, and stratigraphy during basin evolution? (5) What factors influence spatial and temporal variations of rheology in, and around, different kinds of sedimentary basins? (6) What is the role of magmatism in basin formation and what deep-seated processes does it reflect? (7) What is the relationship between basin evolution, thermal history, and fluid flow? These fundamental questions can be investigated by developing fully-dynamic models of processes at the basin and sub-basin scale. Models must incorporate or honour basin history and plate reconstructions; the intregration of structural and sedimentological data; direct observations of the physical state; and the synthesis of geological and geophysical data, including tectono/dynamic stratigraphy, petrological and geochemical data, and geophysical data (gravity, magnetics, heat flow, deep and shallow seismics). A number of type basins — in passive margin, foreland, rift, and strike-slip tectonic settings — suitable for modelling studies elucidating the fundamental questions are identified.
