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Losing the thread of sentences and memory loss are followed by periods of confusion, often accompanied by visual hallucinations (see p 230) Sleep may be disrupted for several reasons The most worrying is REM sleep behavioural disturbance, in which patients act out their vivid dreams..

Recalling that the market Sharpe Ratio Sr is de ned to be the excess return over the volatility we have that

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:

The request parameters and request results that are sent from a client object to a server object or vice versa may include sensitive information. We have seen that the client and server stubs marshal these parameters into a transmittable form. Veryoften the format that is used for this transmission is well known to an attacker, because it is based on a standard data representation, such as NDR , XDR, or CDR. Bylistening to or sniffing the network packets that are transmitted when implementing an object request, attackers can therefore obtain and decode the request parameters. We refer to this method of attack as eavesdropping. Eavesdropping is possible because the attacker knows how object requests are encoded. Object requests, however, have to be encoded in a standardized form in order to facilitate c interoperability. In order to prevent eavesdropping, we must, therefore, avoid transmitting object request data in an encoding that is known to other people. This is generally achieved by encrypting the messages before they are sent through the network and decrypting the messages immediately after they have been received.

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.

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,