FASTER trial

Apart from patients with symptomatic carotid stenosis and endarterectomy, to date, only the Fast Assessment of Stroke and Transient Ischemic Attack to Prevent Early Recurrence (FASTER) trial has addressed the difference between specific treatments administered early for patients with TIA and minor stroke (Kennedy et al. 2007). 

The Fast Assessment of Stroke and Transient Ischemic Attack to Prevent Early Recurrence (FASTER) trial... 

The study concluded that the combination of aspirin and clopidogrel started within 24-hours of symptom onset may be superior to aspirin alone in reducing the risk of stroke at 90 days after TIA or minor stroke, although at the expense of a higher rate of hemorrhage. These results form the basis of the FASTER-2 study, which will determine the risks and benefits of aspirin and clopidogrel compared with aspirin alone in larger numbers of patients. The FASTER trial did not show any benefit for simvastatin in the acute phase after TIA or minor stroke and no statin comparison is included in FASTER-2. 

The fact that there are reaction times left of the first peak proves that the length of the linear pathway may be shorter in some trials. In some subjects these fast trials show a very interesting distance of SET from each other. This is the time that is needed to cross one area. Therefore one has to accept, that in some trials one or two sensory areas are saved. If this is true for faster trials one has to expect that there are some slower trials too which need more areas than the dominant linear pathway possesses. 

The system was installed and certified by TUV and the local authorities. Trials conducted on site after installation proved that the system allowed efficient inspection with scan speeds in excess of 100 mm/s, which is faster than initially required. Implementation of the system has resulted in savings enabling pay back of the full system in less than one year. 

These relations do not hold closely for large impeller cuts, as the head and capacity drop a litde faster than the relations indicate. Allowance should be made by a trial-and-error approach when actually reducing an impeller size. Efficiency will remain nearly constant during all of the changes discussed. 

Autocatalysis, although not rare, is not common either. A study of this phenomenon is crucial for the treatment of oscillating reactions, which are presented in Section 8.8. If the data give an indication of autocatalytic behavior, one quick laboratory test is to use the leftover solution from a completed reaction as the solvent for the next. If the replicate is faster than the first trial, autocatalysis is suggested. 

The trial was run, and FDA approval, on the basis of the results, was obtained. The drug is currently commercially successful. Were it not for the new team member who commissioned this work, this trial would have failed— at a cost of 50 million and the loss of two years of revenue. Moreover, other efficiencies (fewer patients, faster recruiting, better understanding of patient and market stratification) would not have been realized. The cost (in time and resources) for modeling projects should be balanced by the benefits of increased likelihood of success (for a drug that will be successful) and of possibly avoiding a trial for a compound that cannot succeed. 

Direct Fibrinolytics Alfimeprase is a recombinant tmncated form of fibrolase, a fibrinolytic zinc metalloproteinase isolated from the venom of the Southern copperhead snake. It degrades fibrin directly and achieves thrombolysis independent of plasmin formation. This may result in faster recanalization and a decreased risk of hemorrhagic conversion. The initial data on the safety and efficacy of alfimeprase in peripheral arterial occlusion disease appeared very promising, but recent communication from the sponsor revealed that the phase III trials of the drug in peripheral arterial disease and catheter obstruction (NAPA-2 and SONOMA-2) failed to meet their primary and key secondary endpoints of revascularization. A trial for I AT in acute stroke (CARNEROS-1) is planned to begin soon. 

The trial functions in the finite element method are not limited to linear ones. Quadratic functions and even higher-order functions are frequently used. The same considerations hold as for boundary value problems The higher-order trial functions converge faster, but require more work. It is possible to refine both the mesh h and the power of polynomial in the trial function p in an hp method. Some problems have constraints on some of the variables. For flow problems, the pressure must usually be approximated by using a trial function that is one order lower than the polynomial used to approximate the velocity. 

Amounts of heat released in pyrolysis trials were small. Even heats measured at around 130 C, far above the 80"C margin, could adiabatically raise the temperature by less than one centigrade in an hour (6). With so little heat, inaccuracies of measurements could cause qualitative mistakes. Additionally, temperatures were usually determined with thermocouples, whose metallic wires conducted heat up to one thousand times faster than the pyrolzed material, and could again involve substantial errors, especially with small samples and steep temperature gradients. 

While steady improvements in the efficiency of delivery of medical care and prescribing safety will create concomitant improvements in clinical research over time, it is likely that the pace of such advances will not satisfy the demands of sponsors for faster, higher quality and less expensive trials. 

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