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90 Y resin radioembolization is an emerging treatment in patients with liver-dominant metastatic neuroendocrine tumors (mNETs), despite the absence of level I data. The aim of this study was to evaluate the efficacy of this modality in a meta-analysis of the published literature. Methods: A comprehensive review protocol screened all reports in the literature. Strict selection criteria were applied to ensure consistency among the selected studies: human subjects, complete response data with time interval, resin microspheres, more than 5 patients, not a duplicate cohort, English language, and separate and complete data for resin-based 90 Y treatment of mNET if the study included multiple tumor and microsphere types. Selected studies were critically appraised on 50 study criteria, in accordance with the research reporting standards for radioembolization. Response data (Response Evaluation Criteria in Solid Tumors) were extracted and analyzed using both fixed and random-effects meta-analyses. Results: One hundred fifty-six studies were screened; 12 were selected, totaling 435 procedures for response assessment. Funnel plots showed no evidence of publication bias (P 5 0.841). Critical appraisal revealed a median of 75% of desired criteria included in selected studies. Very high between-study heterogeneity ruled out a fixed-effects model. The random-effects weighted average objective response rate (complete and partial responses, CR and PR, respectively) was 50% (95% confidence interval, 38%-62%), and weighted average disease control rate (CR, PR, and stable disease) was 86% (95% confidence interval, 78%-92%). The percentage of patients with pancreatic mNET was marginally associated with poorer response (P 5 0.030), accounting for approximately 23% of the heterogeneity among studies. The percentage of CR and PR correlated with median survival (R 5 0.85; P 5 0.008). Conclusion: This meta-analysis confirms radioembolization to be an effective treatment option for patients with hepatic mNET. The pooled data demonstrated a high response rate and improved survival for patients responding to therapy.

Abstract-Electric propulsion of ships has experienced steady expansion for several decades. Since the early 20 th century, icebreakers have employed the flexibility and easy control of DC motors to provide for ship operations that split ice with back and forth motion of the ship. More recently, cruise ships have employed diesel-electric propulsion systems to take advantage of the flexibility of diesel, as opposed to steam engines, and because the electric plant can also be used for hotel loads. Research vessels, ferries, tankers, and special purpose vessels have also taken advantage of increased flexibility and fuel efficiency with electric propulsion. Today, the US Navy is building an 'all electric' destroyer to be named 'Zumwalt', that employs two induction motors for propulsion. There are several different classes of motors that might be considered for use in ship propulsion, ranging from DC (commutator) motors through conventional induction and synchronous motors to permanent magnet synchronous machines, doubly fed machines and superconducting AC and Acyclic Homopolar machines. This review paper describes features of some of the major classes of motor that might be used in ship propulsion.

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