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PPV value was far less than what was previously reported in the literature for CA-125, and the authors concluded that this might have been due to the multicenter nature of the trial. The interim conclusions further noted that most cancers were diagnosed in late stages, too many surgical procedures were performed to nd one cancer, and only about 5% of surgical procedures found ovarian cancer.17 Other tumor markers have also been used as screening tools for ovarian cancer with some improvement in sensitivity but a decrease in speci city. These include CEA, OVX1, M-CSF, CA-125II, CA 72-4, CA 15-3, lipid-associated sialic acid (LASA), HE4, mesothelin, osteopontin, kallikrein(s), and soluble EGF receptor.15, 18 Zhang and colleagues studied 498 serum samples and used a modeling tool to test the use of four serum markers (CA125II, CA 72-4, CA 15-3, MCSF) to screen women for ovarian cancer. Using these four markers, they calculated sensitivity of 71% for detecting women with EOC. Since ovarian cancer has a prevalence of 1 in 2500 in the United States, a good screening test would need to have a sensitivity of 75% and a speci city of 99.7%.19 A new test that has come to the market for epithelial ovarian cancer screening is called OvaSure, released through LabCorp. The test employs six molecular markers to screen women for ovarian cancer (Leptin, prolactin, insulin-like growth factor II, osteopontin, macrophage inhibitory factor, and CA-125). It was initially studied in serum samples of 365 healthy controls and 160 patients with ovarian cancer. In control patients, the speci city was 99.67%. In the patients with ovarian cancer, the serum panel identi ed all stage III and IV disease and 89% of stage I/II disease.20 On July 2, 2008, the Society of Gynecologic Oncologists (SGO) released a statement regarding the use of OvaSure:

A summation of the preference value of each attribute can then be obtained with a weight of unity for each attribute, or with different weight values for different attributes if the end users desire to emphasis one attribute over another Based on the summation of the preference value of each attribute, the similar cases can be retrieved from the case base, and the similarity calculation can also be used to guide the adaptation process..

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These attributes sharply distinguish this new network environment from traditional communication services and infrastructure. The model presented here is one that provides not merely dedicated services and resources to external processes, e.g., a dedicated VPN or tunnel, but also a full range of capabilities for managing, controlling, and monitoring those resources, even by individual applications. This environment can be partitioned so that each partition can also have its own management and control function, which also can be highly customized for individual requirements. Therefore, packages of distinct capabilities can be integrated into customized end-delivered service suites, which can either expose these capabilities or render them totally transparent. For example, although this technique can incorporate functions for scheduling and reservations, these capabilities are not required. Therefore, a particular partition does not have to incorporate this capability. There are many types of applications and services that have irregular demands over time and unknown advance requirements. For such applications and services, it is not practical to try to predetermine exact

It has been emphasized that the payback for helping employees work more efficiently is enormous. Altman observed: The basic insight is that a company that manages to lift the efficiency of its employees from 65% to 70% gets a 5% improvement in productivity. In terms of cost-discipline, that is huge.

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57. Argyris and Schon, Organizational Learning, iii. 58. Id., 2 3. 59. Id., 11. 60. Id., 3. 61. Id., 9. 62. Id., 39 40. 63. Lory Hough, A Meeting of the Minds, John F. Kennedy School of Government Bulletin,

Protection of Human Subjects of Biomedical and Behavioral Research. In The Belmont Report, three broad ethical principles relevant to research with human subjects were identified: 1. Respect for persons the obligation to respect the autonomy of individuals and protect individuals with diminished autonomy; 2. Beneficence the obligation to do no harm, to maximize possible benefits and minimize possible harm; and 3. Justice the obligation to ensure that all persons share equally in the burdens and benefits of research. The Belmont Report also included specific guidelines for the protection of human subjects. These guidelines were the basis for the regulations regarding the protection of human research participants issued by the Department of Health and Human Services (HHS) in 1981. Additional protections for children were added to the regulations in 1983 (45 C.F.R. Subtitle A, Part 46). Only institutions receiving federal research support are legally required to comply with the rules and regulations drafted under the National Research Act. However, as DeMers and Bersoff note, researchers should be familiar with the Act s regulations because they reflect current legal opinion of appropriate conduct in research activity (1985, p. 333).

K(P6 x1 , . . . , xn 1 , xn ) = (xn + 1)K(P6 x1 , . . . , xn 1 ) +K(P6 x1 , . . . ., xn 2 ), for n 2.

k 2 2 2 kz 1 + tan 2 z = ( 1) ( k x + k y ) 2

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