A Randomized Controlled Trial of a Cardiopulmonary Resuscitation Video in Advance Care Planning for Progressive Pancreas and Hepatobiliary Cancer Patients

PubMed Central

Volandes, Angelo E.; Chen, Ling Y.; Gary, Kristen A.; Li, Yuelin; Agre, Patricia; Levin, Tomer T.; Reidy, Diane L.; Meng, Raymond D.; Segal, Neil H.; Yu, Kenneth H.; Abou-Alfa, Ghassan K.; Janjigian, Yelena Y.; Kelsen, David P.; O'Reilly, Eileen M.

2013-01-01

Abstract Background Cardiopulmonary resuscitation (CPR) is an important advance directive (AD) topic in patients with progressive cancer; however such discussions are challenging. Objective This study investigates whether video educational information about CPR engenders broader advance care planning (ACP) discourse. Methods Patients with progressive pancreas or hepatobiliary cancer were randomized to an educational CPR video or a similar CPR narrative. The primary end-point was the difference in ACP documentation one month posttest between arms. Secondary end-points included study impressions; pre- and post-intervention knowledge of and preferences for CPR and mechanical ventilation; and longitudinal patient outcomes. Results Fifty-six subjects were consented and analyzed. Rates of ACP documentation (either formal ADs or documented discussions) were 40% in the video arm (12/30) compared to 15% in the narrative arm (4/26), OR=3.6 [95% CI: 0.9–18.0], p=0.07. Post-intervention knowledge was higher in both arms. Posttest, preferences for CPR had changed in the video arm but not in the narrative arm. Preferences regarding mechanical ventilation did not change in either arm. The majority of subjects in both arms reported the information as helpful and comfortable to discuss, and they recommended it to others. More deaths occurred in the video arm compared to the narrative arm, and more subjects died in hospice settings in the video arm. Conclusions This pilot randomized trial addressing downstream ACP effects of video versus narrative decision tools demonstrated a trend towards more ACP documentation in video subjects. This trend, as well as other video effects, is the subject of ongoing study. PMID:23725233

Surveillance Recommendations in Reducing Risk of and Optimally Managing Breast Cancer-Related Lymphedema

PubMed Central

Ostby, Pamela L.; Armer, Jane M.; Dale, Paul S.; Van Loo, Margaret J.; Wilbanks, Cassie L.; Stewart, Bob R.

2014-01-01

Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL), a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical lymphedema (LE). A prospective model for surveillance is necessary in order to detect BCRL at an early stage when there is the best chance to reduce risk or slow progression. Physical methods for monitoring and assessment, such as circumferential arm measures, perometry, bioimpedance; exercise programs; prophylactic and early-intervention compression garments; and referral for complete decongestive therapy are all interventions to consider in the development of a BCRL surveillance program. In addition, supportive-educative programs and interactive engagement for symptom self-management should also be implemented. The importance of interdisciplinary collaboration is integral to the success of an effective personalized medicine program in breast cancer-related lymphedema surveillance. PMID:25563360

Self-Administered, Home-Based SMART (Sensorimotor Active Rehabilitation Training) Arm Training: A Single-Case Report.

PubMed

Hayward, Kathryn S; Neibling, Bridee A; Barker, Ruth N

2015-01-01

This single-case, mixed-method study explored the feasibility of self-administered, home-based SMART (sensorimotor active rehabilitation training) Arm training for a 57-yr-old man with severe upper-limb disability after a right frontoparietal hemorrhagic stroke 9 mo earlier. Over 4 wk of self-administered, home-based SMART Arm training, the participant completed 2,100 repetitions unassisted. His wife provided support for equipment set-up and training progressions. Clinically meaningful improvements in arm impairment (strength), activity (arm and hand tasks), and participation (use of arm in everyday tasks) occurred after training (at 4 wk) and at follow-up (at 16 wk). Areas for refinement of SMART Arm training derived from thematic analysis of the participant's and researchers' journals focused on enabling independence, ensuring home and user friendliness, maintaining the motivation to persevere, progressing toward everyday tasks, and integrating practice into daily routine. These findings suggest that further investigation of self-administered, home-based SMART Arm training is warranted for people with stroke who have severe upper-limb disability. Copyright © 2015 by the American Occupational Therapy Association, Inc.

Prospect for future South-Korea arms control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Y.

1992-04-22

This study deals with the Hot issues of the first five Prime Ministers (PM) meetings, which encompassed 15 months of negotiations and have resulted in the completion of the Agreement on South-North Reconciliation/Non-aggression and Cooperation after 46 years of division. After the signing of the agreement, detailed worker level progress has culminated in North Korea signing the nuclear safety treaty of the International Atomic Energy Agency (IAEA) and Acceptance of International Inspection of Nuclear Facilities South-North civil economic progress is on the way and at the 6th meeting, a head of state meeting was discussed. Taking all this into consideration,more » it is safe to say that an affirmative direction is being taken towards South-North relations. In this arena, a critical element for better South-North relations is arms control. If meetings on arms control between South-North make good progress, the solution for the Korean peninsula's reunification, as well as detente, will be achieved more quickly. Therefore, arms control on the Korean peninsula should be considered as an important point for improvement of the future South-North Korean relationship. The important fact that we should remember is that arms control is a common issue. Arms control should be solved by South-North Korea because a phased arms control can develop prior to conditions for reunification.« less

Control of octopus arm extension by a peripheral motor program.

PubMed

Sumbre, G; Gutfreund, Y; Fiorito, G; Flash, T; Hochner, B

2001-09-07

For goal-directed arm movements, the nervous system generates a sequence of motor commands that bring the arm toward the target. Control of the octopus arm is especially complex because the arm can be moved in any direction, with a virtually infinite number of degrees of freedom. Here we show that arm extensions can be evoked mechanically or electrically in arms whose connection with the brain has been severed. These extensions show kinematic features that are almost identical to normal behavior, suggesting that the basic motor program for voluntary movement is embedded within the neural circuitry of the arm itself. Such peripheral motor programs represent considerable simplification in the motor control of this highly redundant appendage.

Mentoring from Afar: Nurse Mentor Challenges in the Canadian Armed Forces.

PubMed

Neal, Laura D M

2015-06-01

There is an integral connection between leadership, mentoring and professional career progression within the nursing profession. The purpose of this article is to examine recommendations and best practices from the literature and provide a basis to construct a formalized successful mentoring dyad program with guidelines on establishing and maintaining a productive mentoring relationship over long distance. Canadian Armed Forces (CAF) nurses practice within a unique domain both domestically and abroad. The military environment incorporates many aspects of mentoring that could benefit significantly by distance interchange. Supported through examining literature within nursing, CAF publications and other professions along with contrasting successful distance mentoring programs, the findings suggest that a top-down, leadership-driven formal mentoring program could be beneficial to CAF nurses. The literature review outlines definitions of terms for mentorship and distance mentoring or e-mentoring. A cross section of technology is now embedded in all work environments with personal communication devices commonplace. Establishing mentoring relationships from afar is practical and feasible. This article provides a guided discussion for nursing leaders, managers and grassroots nurses to implement mentoring programs over distances. The recommendations and findings of this article could have universal applications to isolated nursing environments outside of Canadian military operational frameworks. Copyright © 2015 Longwoods Publishing.

STS-61 crew utilizing Virtual Reality in training for HST repair mission

NASA Image and Video Library

1993-06-11

Astronaut Jeffrey A. Hoffman, one of four crewmembers for STS-61 that will conduct scheduled spacewalks during the flight, wears a special helmet and gloves designed to assist in proper positioning near the telescope while on the end of the robot arm. Crewmembers are utilizing a new virtual reality training aid which assists in refining positioning patterns for Space Shuttle Endeavour's Remote Manipulator System (RMS) (36890); Astronaut Claude Nicollier looks at a computer display of the Shuttle's robot arm movements as Thomas D. Akers and Kathryn C. Thornton, mission specialists look on. Nicollier will be responsible for maneuvering the astronauts while they stand in a foot restraint on the end of the RMS arm (36891,36894); Hoffman wears a special helmet and gloves designed to assist in proper positioning near the telescope while on the end of the robot arm (35892); Nicollier looks at a computer display of the Shuttle's robot arm movements as Akers looks on (36893); While (l-r) Astronauts Kenneth Bowersox, Kathryn Thornton, Richard O. Covey and Thomas D. Akers watch, Nicollier moves the Robot arm to desired locations in the Shuttle's payload bay using the Virtual Reality program (36895); Bowersox takes his turn maneuvering the RMS while mission specialist Hoffman, wearing the Virtual Reality helmet, follows his own progress on the end of the robot arm. Crewmembers participating during the training session are (l-r) Astronauts Akers, Hoffman, Bowersox, Nicollier, Covey, and Thornton. In the background, David Homan, an engineer in the JSC Engineering Directorate's Automation and Robotics Division, looks on (36896).

Cost-effectiveness Analysis of Fluorouracil, Leucovorin, and Irinotecan versus Epirubicin, Cisplatin, and Capecitabine in Patients with Advanced Gastric Adenocarcinoma

PubMed Central

Wen, Feng; Zheng, Hanrui; Wu, Yifan; Wheeler, John; Zeng, Xiaoxi; Fu, Ping; Li, Qiu

2016-01-01

No standard treatment has been accepted widely for the first-/second-line therapy for advanced gastric cancer (AGC). The current study aimed to determine a preferred strategy between FOLFIRI (fluorouracil, leucovorin, and irinotecan) and ECX (epirubicin, cisplatin,and capecitabine) for AGC from the cost-effectiveness perspective. According to a French intergroup study, two groups (ECX arm and FOLFIRI arm) and three health states (progression-free survival (PFS), progressive disease (PD) and death) were analyzed in the current Markov model. All the medical costs were calculated from a Chinese societal perspective. Although FOLFIRI was an acceptable first-line therapy in the treatment of AGC with a better time-to treatment failure (TTF) compared to ECX, ECX arm (ECX followed by FOLFIRI) gained 0.08 quality-adjusted life months (QALMs) more effectiveness benefit compared with FOLFIRI arm (FOLFIRI followed by ECX). Additionally, a lower cost was found in ECX arm ($23,813.13 versus $24,983.70). Hence, the strategy of FOLFIRI arm is dominated by ECX arm ($4,125.8 per QALM in FOLIRI arm; $3,879.724 per QALM in ECX arm). ECX followed by FOLFIRI was a preferred strategy with more effectiveness and lower cost compared with FOLFIRI followed by ECX for the treatment of AGC. PMID:27824060

The effect of standard dose multivitamin supplementation on disease progression in HIV-infected adults initiating HAART: a randomized double blind placebo-controlled trial in Uganda.

PubMed

Guwatudde, David; Wang, Molin; Ezeamama, Amara E; Bagenda, Danstan; Kyeyune, Rachel; Wamani, Henry; Manabe, Yukari C; Fawzi, Wafaie W

2015-08-19

Efficacy trials investigating the effect of multivitamin (MV) supplementations among patients on Highly Active Antiretroviral Therapy (HAART) have so far been inconclusive. We conducted a randomized, double blind, placebo controlled trial to determine the effect of one recommended daily allowance (RDA) of MV supplementation on disease progression in patients initiating HAART. Eligible subjects were randomized to receive placebo or MV supplementation including vitamins B-complex, C and E. Participants were followed for up to 18 months. Primary endpoints were: change in CD4 cell count, weight and quality of life (QoL). Secondary endpoints were: i) development of a new or recurrent HIV disease progression event, including all-cause mortality; ii) switching from first- to second-line antiretroviral therapy (ART); and iii) occurrence of an adverse event. Intent-to-treat analysis, using linear regression mixed effects models were used to compare changes over time in the primary endpoints between the study arms. Kaplan-Meier time-to-event analysis and the log-rank test was used to compare HIV disease progression events and all-cause mortality. Four hundred participants were randomized, 200 onto MV and 200 onto placebo. By month 18, the average change in CD4 cell count in the MV arm was 141 cells/uL compared to 147 cells/uL in the placebo arm, a mean difference of -6 · 17 [95 % CI -29 · 3, 16 · 9]. The average change in weight in the MV arm was 3 · 9 kg compared to 3 · 3 kg in the placebo arm, a mean difference of 0 · 54 [95 % CI -0 · 40, 1 · 48]; whereas average change in QoL scores in the MV arm was 6 · 8 compared to 8 · 8 in the placebo arm, a mean difference of -2.16 [95 % CI -4 · 59,0 · 27]. No significant differences were observed in these primary endpoints, or in occurrence of adverse events between the trial arms. One RDA of MV supplementation was safe but did not have an effect on indicators of disease progression among HIV infected adults initiating HAART. Clinical trials NCT01228578 , registered on 15th October 2010.

Atmospheric Radiation Measurement Program facilities newsletter, March 2000

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sisterson, D. L.

2000-04-03

The Atmospheric Radiation Measurement Program (ARM Program) is sending a copy of the ARM Video, an education overview of their program. In the video you will see and hear ARM scientists describe the importance of studying climate and climate change. It also contains a tour of some ARM sites and a look at state-of-the-art meteorological instrumentation, along with background information about the radiation budget and the complexity of climate modeling. The video was produced by the US Department of Energy.

Kinematically redundant arm formulations for coordinated multiple arm implementations

NASA Technical Reports Server (NTRS)

Bailey, Robert W.; Quiocho, Leslie J.; Cleghorn, Timothy F.

1990-01-01

Although control laws for kinematically redundant robotic arms were presented as early as 1969, redundant arms have only recently become recognized as viable solutions to limitations inherent to kinematically sufficient arms. The advantages of run-time control optimization and arm reconfiguration are becoming increasingly attractive as the complexity and criticality of robotic systems continues to progress. A generalized control law for a spatial arm with 7 or more degrees of freedom (DOF) based on Whitney's resolved rate formulation is given. Results from a simulation implementation utilizing this control law are presented. Furthermore, results from a two arm simulation are presented to demonstrate the coordinated control of multiple arms using this formulation.

System For Research On Multiple-Arm Robots

NASA Technical Reports Server (NTRS)

Backes, Paul G.; Hayati, Samad; Tso, Kam S.; Hayward, Vincent

1991-01-01

Kali system of computer programs and equipment provides environment for research on distributed programming and distributed control of coordinated-multiple-arm robots. Suitable for telerobotics research involving sensing and execution of low level tasks. Software and configuration of hardware designed flexible so system modified easily to test various concepts in control and programming of robots, including multiple-arm control, redundant-arm control, shared control, traded control, force control, force/position hybrid control, design and integration of sensors, teleoperation, task-space description and control, methods of adaptive control, control of flexible arms, and human factors.

Isolated lower brachial plexus (Klumpke) palsy with compound arm presentation: case report.

PubMed

Buchanan, Edward P; Richardson, Randal; Tse, Raymond

2013-08-01

Klumpke palsy has yet to be clearly documented in the newborn, because previous reports lack any description of the obstetrical history, clinical progression, or outcome. Based on a high incidence of breach presentation in the few clinical series that report Klumpke palsy, hyperabduction with arm overhead during delivery has been the presumed mechanism. We report a child with isolated lower brachial plexus palsy and Horner syndrome who presented at birth with a vertex compound arm presentation. Recognition of this condition and details of the clinical progression and outcome are important, because guidelines for management are currently not available. Copyright © 2013. Published by Elsevier Inc.

Completion of spectral rotating shadowband radiometers and analysis of ARM spectral short-wave data. Technical progress report, November 1, 1994--October 31, 1995

DOE Office of Scientific and Technical Information (OSTI.GOV)

Michalsky, J.; Harrison, L.

1995-04-26

The authors goal in the ARM program is the improvement of radiation models used in GCMs, especially in the shortwave, (1) by providing improved shortwave radiometric measurements for the testing of models and (2) by developing methods for retrieving climatologically sensitive parameters that serve as input to shortwave and longwave models. They are acquiring downwelling direct and diffuse spectral irradiance, at six wavelengths, plus downwelling broadband longwave, and upwelling and downwelling broadband shortwave irradiances that they combined with surface and upper air data from the Albany airport as a test data set for ARM modelers. They have also developed algorithmsmore » to improve shortwave measurements made at the Southern Great Plains (SGP) ARM site by standard thermopile instruments and by the multifolter rotating shadowband radiometer (MFRSR). However, the major objective of the program has been the development of two spectral versions of the rotating shadowband radiometer. The MFRSR, has become a workhose at the CART site in Oklahoma and Kansas, and it is widely deployed in other climate programs. They have spent most of their effort this year developing techniques to retrieve column aerosol, water vapor, and ozone from direct beam spectral measurements of the MFRSR. Additionally, they have had success in calculating shortwave surface albedo and aerosol optical depth from the ratio of direct to diffuse spectral irradiance. Using the surface albedo and the global irradiance, they have calculated cloud optical depths. From cloud optical depth and liquid water measured with the microwave radiometer, they have calculated effective liquid cloud particle radii. In each case the authors have attempted to validate the approach using independent measurements or retrievals of the parameters under investigation. With the exception of the ozone intercomparison, the corroborative measurements have been made at the SGP CART site. This report highlights these results.« less

Effect of using a suspension training system on muscle activation during the performance of a front plank exercise.

PubMed

Byrne, Jeannette M; Bishop, Nicole S; Caines, Andrew M; Crane, Kalynn A; Feaver, Ashley M; Pearcey, Gregory E P

2014-11-01

The objective of the study was to examine the effect of suspension training on muscle activation during performance of variations of the plank exercise. Twenty-one participants took part. All individuals completed 2 repetitions each of 4 different plank exercises that consisted of a floor based plank, or planks with arms suspended, feet suspended, or feet and arms suspended using a TRX Suspension System. During plank performance, muscle activation was recorded from rectus abdominis, external oblique, rectus femoris, and serratus anterior (SA) muscles using electromyography. All planks were performed for a total of 3 seconds. Resulting muscle activation data were amplitude normalized, and root mean square activation was then determined over the full 3 second duration of the exercise. A significant main effect of plank type was found for all muscles. Post hoc analysis and effect size examination indicated that abdominal muscle activation was higher in all suspended conditions compared to the floor based plank. The highest level of abdominal muscle activation occurred in the arms suspended and arms/feet suspended conditions, which did not differ from one another. Rectus femoris activation was greatest during the arms suspended condition, whereas SA activity peaked during normal and feet suspended planks. These results indicate that suspension training as performed in this study seems to be an effective means of increasing muscle activation during the plank exercise. Contrary to expectations, the additional instability created by suspending both the arms and feet did not result in any additional abdominal muscle activation. These findings have implications in prescription and progression of core muscle training programs.

Data management and scientific integration within the Atmospheric Radiation Measurement Program

NASA Technical Reports Server (NTRS)

Gracio, Deborah K.; Hatfield, Larry D.; Yates, Kenneth R.; Voyles, Jimmy W.; Tichler, Joyce L.; Cederwall, Richard T.; Laufersweiler, Mark J.; Leach, Martin J.; Singley, Paul

1995-01-01

The Atmospheric Radiation Measurement (ARM) Program has been developed by the U.S. Department of Energy with the goal to improve the predictive capabilities of General Circulation Models (GCM's) in their treatment of clouds and radiative transfer effects. To achieve this goal, three experimental testbeds were designed for the deployment of instruments that will collect atmospheric data used to drive the GCM's. Each site, known as a Cloud and Radiation Testbed (CART), consists of a highly available, redundant data system for the collection of data from a variety of instrumentation. The first CART site was deployed in April 1992 in the Southern Great Plains (SGP), Lamont, Oklahoma, with the other two sites to follow in September 1995 in the Tropical Western Pacific and in 1997 on the North Slope of Alaska. Approximately 400 MB of data are transferred per day via the Internet from the SGP site to the ARM Experiment Center at Pacific Northwest Laboratory in Richland, Washington. The Experiment Center is central to the ARM data path and provides for the collection, processing, analysis, and delivery of ARM data. Data are received from the CART sites from a variety of instrumentation, observational systems, amd external data sources. The Experiment Center processes these data streams on a continuous basis to provide derived data products to the ARM Science Team in near real-time while providing a three-month running archive of data. A primary requirement of the ARM Program is to preserve and protect all data produced or acquired. This function is performed at Oak Ridge National Laboratory where leading edge technology is employed for the long-term storage of ARM data. The ARM Archive provides access to data for participation outside of the ARM Program. The ARM Program involves a collaborative effort by teams from various DOE National Laboratories, providing multi-disciplinary areas of expertise. This paper will discuss the collaborative methods in which the ARM teams translate the scientific goals of the Program into data products. By combining atmospheric scientists, systems engineers, and software engineers, the ARM Program has successfully designed and developed an environment where advances in understanding the parameterizations of GCM's can be made.

Quality of life of patients with Duchenne muscular dystrophy: from adolescence to young men.

PubMed

Lue, Yi-Jing; Chen, Shun-Sheng; Lu, Yen-Mou

2017-07-01

This study investigated quality of life (QOL) in adolescent and young men with Duchenne muscular dystrophy (DMD). Health-related QOL and global QOL were assessed with the Short Form 36 (SF-36) and World Health Organization Quality of Life-BREF (WHOQOL-BREF). Associations between functional status and QOL were assessed. All domains of the SF-36 were below Taiwan norms (effect size: -14.2 to -0.5), especially Physical Function, Role Physical, and Social Function. Three of the four domains of the WHOQOL-BREF were below Taiwan norms (effect size: -2.0 to -0.7). The Physical Function of the SF-36 was moderately correlated with functional status (mobility, basic activities of daily living, and arm function). The Social Function of the SF-36 and Social Relationships of the WHOQOL-BREF were also moderately correlated with functional status (impairment, basic activities of daily living, and arm function). The adolescent and young men with DMD had poor health-related and global QOL. Poor QOL was related to both physical condition and social health. We suggest that rehabilitation programs focus on using assistive devices to facilitate arm function and encouraging participation in social activities to improve the QOL of patients with DMD. Implications for rehabilitation Duchenne muscular dystrophy (DMD) is a progressive muscle weakness disease that not only impacts physical health but also leads to poor quality of life in many domains. A valuable rehabilitation goal for patients with DMD is to encourage participation in social activities. Medical care and educational programs should plan a formal transition processes for patients with DMD from pediatric to adult care to maximum their quality of life. Arm function is associated with many domains of global quality of life, so a key element in improving quality of life may be to improve arm function.

Conventional armed forces in Europe: Technology scenario development

DOE Office of Scientific and Technical Information (OSTI.GOV)

Houser, G.M.

1990-07-01

In January 1986, the Soviet Union's Mikhail Gorbachev proposed elimination of all nuclear weapons by the year 2000. In April of that year, Mr. Gorbachev proposed substantial reductions of conventional weapons in Europe, from the Atlantic Ocean to the Ural Mountains, including reductions in operational-tactical nuclear weapons. In May 1986, the North Atlantic Treaty Organization (NATO) responded with the Brussels Declaration on Conventional Arms Control,'' which indicated readiness to open East/West discussions on establishing a mandate for negotiating conventional arms control throughout Europe. The Group of 23,'' which met in Vienna beginning in February 1987, concluded the meeting in Januarymore » 1989 with a mandate for the Conventional Armed Forced in Europe (CFE) negotiations. On 6 March 1989, CFE talks began, and these talks have continued through six rounds (as of April 1990). Although US President George Bush, on 30 May 1989, called for agreement within six months to a year, and the Malta meeting of December 1989 called for completion of a CFE agreement by the end of 1990, much remains to be negotiated. This report provides three types of information. First, treaty provisions brought to the table by both sides are compared. Second, on the basis of these provisions, problem areas for each of the provision elements are postulated and possible scenarios for resolving these problem areas are developed. Third, the scenarios are used as requirements for tasks assigned program elements for possible US implementation of a CFE treaty. As progress is achieved during the negotiations, this report could be updated, as necessary, in each of the areas to provide a continuing systematic basis for program implementation and technology development. 8 refs.« less

Creating Access Points to Instrument-Based Atmospheric Data: Perspectives from the ARM Metadata Manager

NASA Astrophysics Data System (ADS)

Troyan, D.

2016-12-01

The Atmospheric Radiation Measurement (ARM) program has been collecting data from instruments in diverse climate regions for nearly twenty-five years. These data are made available to all interested parties at no cost via specially designed tools found on the ARM website (www.arm.gov). Metadata is created and applied to the various datastreams to facilitate information retrieval using the ARM website, the ARM Data Discovery Tool, and data quality reporting tools. Over the last year, the Metadata Manager - a relatively new position within the ARM program - created two documents that summarize the state of ARM metadata processes: ARM Metadata Workflow, and ARM Metadata Standards. These documents serve as guides to the creation and management of ARM metadata. With many of ARM's data functions spread around the Department of Energy national laboratory complex and with many of the original architects of the metadata structure no longer working for ARM, there is increased importance on using these documents to resolve issues from data flow bottlenecks and inaccurate metadata to improving data discovery and organizing web pages. This presentation will provide some examples from the workflow and standards documents. The examples will illustrate the complexity of the ARM metadata processes and the efficiency by which the metadata team works towards achieving the goal of providing access to data collected under the auspices of the ARM program.

Heart failure severity, inappropriate ICD therapy, and novel ICD programming: a MADIT-RIT substudy.

PubMed

Daimee, Usama A; Vermilye, Katherine; Rosero, Spencer; Schuger, Claudio D; Daubert, James P; Zareba, Wojciech; McNitt, Scott; Polonsky, Bronislava; Moss, Arthur J; Kutyifa, Valentina

2017-12-01

The effects of heart failure (HF) severity on risk of inappropriate implantable cardioverter-defibrillator (ICD) therapy have not been thoroughly investigated. We aimed to study the association between HF severity and inappropriate ICD therapy in MADIT-RIT. MADIT-RIT randomized 1,500 patients to three ICD programming arms: conventional (Arm A), high-rate cut-off (Arm B: ≥200 beats/min), and delayed therapy (Arm C: 60-second delay for ≥170 beats/min). We evaluated the association between New York Heart Association (NYHA) class III (n = 256) versus class I-II (n = 251) and inappropriate ICD therapy in Arm A patients with ICD-only and cardiac resynchronization therapy with defibrillator (CRT-D). We additionally assessed benefit of novel ICD programming in Arms B and C versus Arm A by NYHA classification. In Arm A, the risk of inappropriate therapy was significantly higher in those with NYHA III versus NYHA I-II for both ICD (hazard ratio [HR] = 2.55, confidence interval [CI]: 1.51-4.30, P < 0.001) and CRT-D patients (HR = 3.73, CI: 1.14-12.23, P = 0.030). This was consistent for inappropriate ATP and inappropriate ICD therapy < 200 beats/min, but not for inappropriate shocks. Novel ICD programming significantly reduced inappropriate therapy in patients with both NYHA III (Arm B vs Arm A: HR = 0.08, P < 0.001; Arm C vs Arm A: HR = 0.17, P < 0.001) and NYHA I-II (Arm B vs Arm A: HR = 0.25, P < 0.001; Arm C vs Arm A: HR = 0.28, P < 0.001). Patients with more severe HF are at increased risk for inappropriate ICD therapy, particularly ATP due to arrhythmias < 200 beats/min. Novel programming with high-rate cut-off or delayed detection reduces inappropriate ICD therapies in both mild and moderate HF. © 2017 Wiley Periodicals, Inc.

A Study of the Commission on Implications of Armed Services Educational Programs, 1945-1948.

ERIC Educational Resources Information Center

Price, Herbert Hamilton, Jr.

In 1945, the American Council on Education created the civilian Commission on Implications of Armed Forces Educational Programs to study the armed forces education of World War II and its possible effects on postwar civilian education. Those features of the wartime training and education programs which appeared to be worthy of adaptation and…

Changes in arm tissue composition with slowly progressive weight-lifting among women with breast cancer-related lymphedema.

PubMed

Zhang, Xiaochen; Brown, Justin C; Paskett, Electra D; Zemel, Babette S; Cheville, Andrea L; Schmitz, Kathryn H

2017-07-01

Studies in breast cancer-related lymphedema (BRCL) have exclusively examined total arm volume, but not the specific tissue composition that contributes to total volume. We evaluated baseline differences in arm tissue composition [fat mass, lean mass, bone mineral content (BMC), and bone mineral density (BMD)] between the affected and unaffected arms in women with BRCL. We compared changes in arm tissue composition and self-reported lymphedema symptoms after 1 year of weight-lifting versus control. We utilized data from physical activity and lymphedema trial that included 141 women with BRCL. Arm tissue composition was quantified using dual-energy X-ray absorptiometry. The severity of lymphedema was quantified using self-report survey. Weight-lifting was performed at community fitness facilities. At baseline, the affected arm had more fat (∆ = 89.7 g; P < 0.001) and lean mass (∆ = 149.1 g; P < 0.001), but less BMC (∆ = -3.2 g; P < 0.001) and less BMD (∆ = -5.5 mg/cm 2 ; P = 0.04) than the unaffected arm. After 12 months of weight-lifting, composition of the affected arm was improved: lean mass (71.2 g; P = 0.01) and BMD (14.0 mg/cm 2 ; P = 0.02) increased, arm fat percentage decreased (-1.5%; P = 0.003). Composition of the unaffected arm was only improved in lean mass (65.2 g; P = 0·04). Increases in lean mass were associated with less severe BCRL symptoms. Among women with BRCL, slowly progressive weight-lifting could improve arm tissue composition. Changes in arm tissue composition predict changes in symptom burden. Investigating the combined effects of exercise and weight loss on arm tissue composition and BCRL symptoms may provide additional insight into the benefits of lifestyle modification on lymphedema biology.

New Horizons and New Strategies in Arms Control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, J. editor

In the last ten years, since the break-up of the Soviet Union, remarkable progress in arms control and disarmament has occurred. The Nuclear Non-Proliferation Treaty (NPT), the completion of the Comprehensive Test Ban Treaty (CTBT), and the Chemical Weapons Treaty (CWC) are indicative of the great strides made in the non- proliferation arena. Simultaneously, the Intermediate Nuclear Forces Treaty (INF), the Conventional Forces Treaty in Europe (CFE), and the Strategic Arms Reduction Treaties (START), all associated with US-Soviet Union (now Russia) relations have assisted in redefining European relations and the security landscape. Finally, it now appears that progress is inmore » the offing in developing enhanced compliance measures for the Biological and Toxin Weapons Convention (BTWC). In sum, all of these achievements have set the stage for the next round of arms control activities, which may lead to a much broader, and perhaps more diffused multilateral agenda. In this new and somewhat unpredictable international setting, arms control and disarmament issues will require solutions that are both more creative and innovative than heretofore.« less

Report: Basic Facts About Military Service.

ERIC Educational Resources Information Center

High School News Service (DOD), Great Lakes, IL.

The purpose of the report is to inform students, through counselors and advisers, of opportunities and responsibilities in the Armed Forces. The topics covered are: missions of the Armed Forces, the selective service system, enlistment programs, reserve components, commissioning programs, auxiliary benefits, women in the Armed Forces, and basic…

Control of free-flying space robot manipulator systems

NASA Technical Reports Server (NTRS)

Cannon, Robert H., Jr.

1977-01-01

To accelerate the development of multi-armed, free-flying satellite manipulators, a fixed-base cooperative manipulation facility is being developed. The work performed on multiple arm cooperation on a free-flying robot is summarized. Research is also summarized on global navigation and control of free-flying space robots. The Locomotion Enhancement via Arm Pushoff (LEAP) approach is described and progress to date is presented.

Small Arms Marksmanship Manual, NAVPERS 93863.

ERIC Educational Resources Information Center

Bureau of Naval Personnel, Washington, DC.

The Navy's small arms marksmanship training program is designed to achieve proficiency for Navy personnel in handling the rifle, pistol andshotgun. The minimum objective of this program is to qualify Navy personnel as "Marksman," and ensure that personnel who are issued small arms for security, recreation, or competitions are fully qualified in…

Dual-use technology programs

NASA Astrophysics Data System (ADS)

Johns, Lionel S.

1994-10-01

The paper presents the Clinton Administration's commitment to American industrial competitiveness through a strategic focus on research and development and to dual-use technologies in particular. Working in partnership with industry, the dual-use approach is essential for giving our armed forces the world's best, most technically advanced military equipment at affordable cost. The President has set a goal of shifting from a dominant role for military technologies in our Federal R&D investments to a roughly equal balance between military on the one hand and civilian and dual-use on the other. We have already made significant progress toward this goal.

MONARCH 3: Abemaciclib As Initial Therapy for Advanced Breast Cancer.

PubMed

Goetz, Matthew P; Toi, Masakazu; Campone, Mario; Sohn, Joohyuk; Paluch-Shimon, Shani; Huober, Jens; Park, In Hae; Trédan, Olivier; Chen, Shin-Cheh; Manso, Luis; Freedman, Orit C; Garnica Jaliffe, Georgina; Forrester, Tammy; Frenzel, Martin; Barriga, Susana; Smith, Ian C; Bourayou, Nawel; Di Leo, Angelo

2017-11-10

Purpose Abemaciclib, a cyclin-dependent kinase 4 and 6 inhibitor, demonstrated efficacy as monotherapy and in combination with fulvestrant in women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer previously treated with endocrine therapy. Methods MONARCH 3 is a double-blind, randomized phase III study of abemaciclib or placebo plus a nonsteroidal aromatase inhibitor in 493 postmenopausal women with HR-positive, HER2-negative advanced breast cancer who had no prior systemic therapy in the advanced setting. Patients received abemaciclib or placebo (150 mg twice daily continuous schedule) plus either 1 mg anastrozole or 2.5 mg letrozole, daily. The primary objective was investigator-assessed progression-free survival. Secondary objectives included response evaluation and safety. A planned interim analysis occurred after 189 events. Results Median progression-free survival was significantly prolonged in the abemaciclib arm (hazard ratio, 0.54; 95% CI, 0.41 to 0.72; P = .000021; median: not reached in the abemaciclib arm, 14.7 months in the placebo arm). In patients with measurable disease, the objective response rate was 59% in the abemaciclib arm and 44% in the placebo arm ( P = .004). In the abemaciclib arm, diarrhea was the most frequent adverse effect (81.3%) but was mainly grade 1 (44.6%). Comparing abemaciclib and placebo, the most frequent grade 3 or 4 adverse events were neutropenia (21.1% v 1.2%), diarrhea (9.5% v 1.2%), and leukopenia (7.6% v 0.6%). Conclusion Abemaciclib plus a nonsteroidal aromatase inhibitor was effective as initial therapy, significantly improving progression-free survival and objective response rate and demonstrating a tolerable safety profile in women with HR-positive, HER2-negative advanced breast cancer.

Cryotherapy Reduces Progression of Cervical Intraepithelial Neoplasia Grade 1 in South African HIV-Infected Women: A Randomized, Controlled Trial.

PubMed

Firnhaber, Cynthia; Swarts, Avril; Goeieman, Bridgette; Rakhombe, Ntombi; Mulongo, Masangu; Williamson, Anna-Lise; Michelow, Pam; Ramotshela, Sibongile; Faesen, Mark; Levin, Simon; Wilkin, Timothy

2017-12-15

HIV-infected women are at an increased risk of cervical cancer, especially in resource-limited countries. Cervical cancer prevention strategies focus treating cervical high-grade squamous intraepithelial lesions (HSIL). The management of low-grade squamous intraepithelial lesions (LSIL) in HIV-infected women is unknown. HIV treatment clinic in Johannesburg, South Africa. We randomized HIV-infected women with histologic cervical LSIL to cervical cryotherapy vs. no treatment (standard of care). Cervical high-risk human papillomavirus testing (hrHPV) was performed at baseline. All women underwent cervical cytology and colposcopic biopsies 12 months after enrollment. The primary end point was HSIL on histology at month 12. Chi-square was used to compare arms. Overall, 220 HIV-infected women were randomized to cryotherapy (n = 112) or no treatment (n = 108). Median age was 38 years, 94% were receiving antiretroviral therapy; median CD4 was 499 cells per cubic millimeter, and 59% were hrHPV positive. Cryotherapy reduced progression to HSIL: 2/99 (2%) in the cryotherapy arm and 15/103 (15%) in the no treatment arm developed HSIL, 86% reduction (95% confidence interval: 41% to 97%; P = 0.002). Among 17 HSIL end points, 16 were hrHPV+ at baseline. When restricting the analysis to hrHPV+ women, HSIL occurred in 2/61 (3%) in the cryotherapy arm vs. 14/54 (26%) in the no treatment arm, 87% reduction (95% confidence interval: 47% to 97%; P = 0.0004). Participants in the cryotherapy arm experienced greater regression to normal histology and improved cytologic outcomes. Treatment of cervical LSIL with cryotherapy decreased progression to HSIL among HIV-infected women especially if hrHPV positive. These results support treatment of LSIL in human papillomavirus test-and-treat approaches for cervical cancer prevention in resource-constrained settings.

Maintenance sunitinib or observation in metastatic pancreatic adenocarcinoma: a phase II randomised trial.

PubMed

Reni, Michele; Cereda, Stefano; Milella, Michele; Novarino, Anna; Passardi, Alessandro; Mambrini, Andrea; Di Lucca, Giuseppe; Aprile, Giuseppe; Belli, Carmen; Danova, Marco; Bergamo, Francesca; Franceschi, Enrico; Fugazza, Clara; Ceraulo, Domenica; Villa, Eugenio

2013-11-01

New strategies to prolong disease control warrant investigation in patients with metastatic pancreatic adenocarcinoma. This open-label, randomised, multi-centre phase II trial explored the role of maintenance sunitinib after first-line chemotherapy in this setting. Patients with pathologic diagnosis of metastatic pancreatic adenocarcinoma, performance status >50%, no progression after 6 months of chemotherapy were centrally randomised by an independent contract research organisation, which was also responsible for data collection and monitoring, to observation (arm A) or sunitinib at 37.5mg daily until progression or a maximum of 6 months (arm B). The primary outcome measure was the probability of being progression-free at 6 months (PFS-6) from randomisation. Assuming P0 = 10%; P1 = 30%, α .10; β .10, the target accrual was 26 patients per arm. 28 per arm were randomised. One arm B patient had kidney cancer and was excluded. Sunitinib was given for a median of 91 days (7-186). Main grade 3-4 toxicity was thrombocytopenia, neutropenia and hand-foot syndrome (12%), diarrhoea 8%. In arm A versus B, PFS-6 was 3.6% (95% confidence interval (CI): 0-10.6%) and 22.2% (95% CI: 6.2-38.2%; P<0.01); 2 y overall survival was 7.1% (95% CI: 0-16.8%) and 22.9% (95% CI: 5.8-40.0%; P = 0.11), stable disease 21.4% and 51.9% (P = 0.02). This is the first randomised trial on maintenance therapy in metastatic pancreatic adenocarcinoma. The primary end-point was fulfilled and 2 y overall survival was remarkably high, suggesting that maintenance sunitinib is promising and should be further explored in this patient population. Copyright © 2013 Elsevier Ltd. All rights reserved.

Phase II Trial of Cetuximab With or Without Paclitaxel in Patients With Advanced Urothelial Tract Carcinoma

PubMed Central

Wong, Yu-Ning; Litwin, Samuel; Vaughn, David; Cohen, Seth; Plimack, Elizabeth R.; Lee, James; Song, Wei; Dabrow, Michael; Brody, Marion; Tuttle, Holly; Hudes, Gary

2012-01-01

Purpose The benefit of salvage chemotherapy is modest in metastatic urothelial cancer. We conducted a randomized, noncomparative phase II study to measure the efficacy of cetuximab with or without paclitaxel in patients with previously treated urothelial cancer. Patients and Methods Patients with metastatic urothelial cancer who received one line of chemotherapy in the perioperative or metastatic setting were randomly assigned to 4-week cycles of cetuximab 250 mg/m2 with or without paclitaxel 80 mg/m2 per week. We used early progression as an indicator of futility. Either arm would close if seven of the initial 15 patients in that arm progressed at the first disease evaluation at 8 weeks. Results We enrolled 39 evaluable patients. The single-agent cetuximab arm closed after nine of the first 11 patients progressed by 8 weeks. The combination arm completed the full accrual of 28 patients, of whom 22 patients (78.5%) had visceral disease. Twelve of 28 patients had progression-free survival greater than 16 weeks. The overall response rate was 25% (95% CI, 11% to 45%; three complete responses and four partial responses). The median progression-free survival was 16.4 weeks (95% CI, 12 to 25.1 weeks), and the median overall survival was 42 weeks (95% CI, 30.4 to 78 weeks). Treatment-related grade 3 and 4 adverse events that occurred in at least two patients were rash (six cases), fatigue (five cases), and low magnesium (three cases). Conclusion Although it had limited activity as a single agent, cetuximab appears to augment the antitumor activity of paclitaxel in previously treated urothelial cancers. The cetuximab and paclitaxel combination merits additional study to establish its role in the treatment of urothelial cancers. PMID:22927525

Advanced ovarian cancer: phase III randomized study of sequential cisplatin-topotecan and carboplatin-paclitaxel vs carboplatin-paclitaxel.

PubMed

Hoskins, P; Vergote, I; Cervantes, A; Tu, D; Stuart, G; Zola, P; Poveda, A; Provencher, D; Katsaros, D; Ojeda, B; Ghatage, P; Grimshaw, R; Casado, A; Elit, L; Mendiola, C; Sugimoto, A; D'Hondt, V; Oza, A; Germa, J R; Roy, M; Brotto, L; Chen, D; Eisenhauer, E A

2010-10-20

Topotecan has single-agent activity in recurrent ovarian cancer. It was evaluated in a novel combination compared with standard frontline therapy. Women aged 75 years or younger with newly diagnosed stage IIB or greater ovarian cancer, Eastern Cooperative Oncology Group Performance Status of 1 or less, were stratified by type of primary surgery and residual disease, treatment center, and age; then randomly assigned to one of the two 21-day intravenous regimens. Patients in arm 1 (n = 409) were administered four cycles of cisplatin 50 mg/m(2) on day 1 and topotecan 0.75 mg/m(2) on days 1-5, then four cycles of paclitaxel 175 mg/m(2) over 3 hours on day 1 followed by carboplatin (area under the curve = 5) on day 1. Patients in arm 2 (n = 410) were given paclitaxel plus carboplatin as in arm 1 for eight cycles. We compared progression-free survival (PFS), overall survival, and cancer antigen-125 normalization rates in the two treatment arms. A stratified log-rank test was used to assess the primary endpoint, PFS. All statistical tests were two-sided. A total of 819 patients were randomly assigned. At baseline, the median age of the patients was 57 years (range = 28-78); 81% had received debulking surgery, and of these, 55% had less than 1 cm residual disease; 66% of patients were stage III and 388 (47.4%) patients had measurable disease. After a median follow-up of 43 months, 650 patients had disease progression or died without documented progression and 406 had died. Patients in arm 1 had more hematological toxicity and hospitalizations than patients in arm 2; PFS was 14.6 months in arm 1 vs 16.2 months in arm 2 (hazard ratio = 1.10, 95% confidence interval = 0.94 to 1.28, P = .25). Among patients with elevated baseline cancer antigen-125, fewer in arm 1 than in arm 2 had levels return to normal by 3 months after random assignment (51.6% vs 63.3%, P = .007) Topotecan and cisplatin, followed by carboplatin and paclitaxel, were more toxic than carboplatin and paclitaxel alone, but without improved efficacy. Carboplatin plus paclitaxel remains the standard of care for advanced epithelial ovarian cancer.

Randomized comparison of whole brain radiotherapy, 20 Gy in four daily fractions versus 40 Gy in 20 twice-daily fractions, for brain metastases.

PubMed

Graham, P H; Bucci, J; Browne, L

2010-07-01

The present study compared the intracranial control rate and quality of life for two radiation fractionation schemes for cerebral metastases. A total of 113 patients with a Eastern Cooperative Oncology Group performance status <3; and stable (>2 months), absent, or concurrent presentation of extracranial disease were randomized to 40 Gy in 20 twice-daily fractions (Arm A) or 20 Gy in four daily fractions (Arm B), stratified by resection status. The European Organization for Research and Treatment of Cancer Quality of Life 30-item questionnaire was administered monthly during Year 1, bimonthly during Year 2, and then every 6 months to Year 5. The patient age range was 28-83 years (mean 62). Of the 113 patients, 41 had undergone surgical resection, and 74 patients had extracranial disease (31 concurrent and 43 stable). The median survival time was 6.1 months in Arm A and 6.6 months in Arm B, and the overall 5-year survival rate was 3.5%. Intracranial progression occurred in 44% of Arm A and 64% of Arm B patients (p = .03). Salvage surgery or radiotherapy was used in 4% of Arm A patients and 21% of Arm B patients (p = .004). Death was attributed to central nervous system progression in 32% of patients in Arm A and 52% of patients in Arm B (p = .03). The toxicity was minimal, with a minor increase in short-term cutaneous reactions in Arm A. The patients' quality of life was not impaired by the more intense treatment in Arm A. Intracranial disease control was improved and the quality of life was maintained with 40 Gy in 20 twice-daily fractions. This schema should be considered for better prognosis subgroups of patients with cerebral metastases. (c) 2010 Elsevier Inc. All rights reserved.

The Perioperative Educational Program for Improving Upper Arm Dysfunction in Patients with Breast Cancer at 1-Year Follow-Up: A Prospective, Controlled Trial.

PubMed

Sato, Fumiko; Arinaga, Yoko; Sato, Naoko; Ishida, Takanori; Ohuchi, Noriaki

2016-03-01

The many women with breast cancer who underwent axillary lymph node dissection (ALND) suffer from the upper arm dysfunction. In this study, we investigated the effectiveness of a perioperative educational program for improving upper arm dysfunction in breast cancer patients following ALND. This study was a sub-analysis of a previous controlled trial with an educational program. The subjects of this analysis included 64 patients following ALND who completed measurements at 12 months. The perioperative educational program consisted of monitoring of arm dysfunction, exercises, massage, and lifestyle adjustments. The intervention group (37 patients) received this perioperative educational program over 12 months, while 27 patients in the control group received written information about shoulder exercise from on-site staff only before surgery. Primary outcomes were shoulder range of motion (ROM), arm girth, and grip strength. Secondary outcomes were evaluated with the Subjective Perception of Post-Operative Functional Impairment of the Arm (SPOFIA) scores, the Disabilities of the Arm, Shoulder and Hand (DASH) scores, and the Medical Outcome Study 36-Item Short-Form Health Survey v2 (SF-36v2). The SF-36v2 measures health-related quality of life (QOL). Primary and secondary outcomes were compared between groups at 1 week (after drainage tube removal) and 12 months after surgery, using the Mann-Whitney U test. The horizontal extension was significantly improved only in the intervention group. Moreover, the SPOFIA score was significantly improved in the intervention group, and other scores of the secondary outcomes were similar between the two groups. The perioperative educational program may improve postoperative upper arm dysfunction and symptoms.

Progress for the Paralyzed

MedlinePlus

... this page please turn Javascript on. Feature: NIBIB Robotics Progress for the Paralyzed Past Issues / Spring 2013 ... Paralyzed —The expanding options for paralyzed individuals include: robotic arms spinal cord stimulation improved prosthetic limbs restored ...

USGCRP assessments: Meeting the challenges of climate and global change

NASA Astrophysics Data System (ADS)

Dickinson, T.; Kuperberg, J. M.

2016-12-01

The United States Global Change Research Program (USGCRP) is a confederation of the research arms of 13 Federal departments and agencies. Its mission is to build a knowledge base that informs human responses to climate and global change through coordinated and integrated Federal programs of research, education, communication, and decision support. USGCRP has supported several initiatives to promote better understanding of climate change impacts on health, support responses, and build on the progress of the 2014 National Climate Assessment. Most recently, USGCRP released a new report, "The Impacts of Climate Change on Human Health: A Scientific Assessment". This presentation will provide an overview of USGCRP, highlight the importance of assessments, and introduce ways in which assessment findings and underlying data can be translated into critical tools to build resilience.

A versatile system for processing geostationary satellite data with run-time visualization capability

NASA Technical Reports Server (NTRS)

Landsfeld, M.; Gautier, C.; Figel, T.

1995-01-01

To better predict global climate change, scientists are developing climate models that require interdisciplinary and collaborative efforts in their building. We are currently involved in several such projects but will briefly discuss activities in support of two such complementary projects: the Atmospheric Radiation Measurement (ARM) program of the Department of Energy and Sequoia 2000, a joint venture of the University of California, the private sector, and government agencies. Our contribution to the ARM program is to investigate the role of clouds on the top of the atmosphere and on surface radiance fields through the data analysis of surface and satellite observations and complex modeling of the interaction of radiation with clouds. One of our first ARM research activities involves the computation of the broadband shortwave surface irradiance from satellite observations. Geostationary satellite images centered over the first ARM observation site are received hourly over the Internet network and processed in real time to compute hourly and daily composite shortwave irradiance fields. The images and the results are transferred via a high-speed network to the Sequoia 2000 storage facility in Berkeley, where they are archived These satellite-derived results are compared with the surface observations to evaluate the accuracy of the satellite estimate and the spatial representation of the surface observations. In developing the software involved in calculating the surface shortwave irradiance, we have produced an environment whereby we can easily modify and monitor the data processing as required. Through the principles of modular programming, we have developed software that is easily modified as new algorithms for computation are developed or input data availability changes. In addition, the software was designed so that it could be run from an interactive, icon-driven, graphical interface, TCL-TK, developed by Sequoia 2000 participants. In this way, the data flow can be interactively assessed and altered as needed. In this environment, the intermediate data processing 'images' can be viewed, enabling the investigator to easily monitor the various data processing steps as they progress. Additionally, this environment allows the rapid testing of new processing modules and allows their effects to be visually compared with previous results.

Effectiveness of a smart phone app on improving immunization of children in rural Sichuan Province, China: study protocol for a paired cluster randomized controlled trial.

PubMed

Chen, Li; Wang, Wei; Du, Xiaozhen; Rao, Xiuqin; van Velthoven, Michelle Helena; Yang, Ruikan; Zhang, Lin; Koepsell, Jeanne Catherine; Li, Ye; Wu, Qiong; Zhang, Yanfeng

2014-03-20

Although good progress has been achieved in expanding immunization of children in China, disparities exist across different provinces. Information gaps both from the service supply and demand sides hinder timely vaccination of children in rural areas. The rapid development of mobile health technology (mHealth) provides unprecedented opportunities for improving health services and reaching underserved populations. However, there is a lack of literature that rigorously evaluates the impact of mHealth interventions on immunization coverage as well as the usability and feasibility of smart phone applications (apps). This study aims to assess the effectiveness of a smart phone-based app (Expanded Program on Immunization app, or EPI app) on improving the coverage of children's immunization. This cluster randomized trial will take place in Xuanhan County, Sichuan Province, China. Functionalities of the app include the following: to make appointments automatically, record and update children's immunization information, generate a list of children who missed their vaccination appointments, and send health education information to village doctors. After pairing, 36 villages will be randomly allocated to the intervention arm (n=18) and control arm (n=18). The village doctors in the intervention arm will use the app while the village doctors in the control arm will record and manage immunization in the usual way in their catchment areas. A household survey will be used at baseline and at endline (8 months of implementation). The primary outcome is full-dose coverage and the secondary outcome is immunization coverage of the five vaccines that are included in the national Expanded Program on Immunization program as well as Hib vaccine, Rotavirus vaccine and Pneumococcal conjugate vaccine. Multidimensional evaluation of the app will also be conducted to assess usability and feasibility. This study is the first to evaluate the effectiveness of a smart phone app for child immunization in rural China. This study will contribute to the knowledge about the usability and feasibility of a smart phone app for managing immunization in rural China and to similar populations in different settings. Chinese Clinical Trials Registry (ChiCTR): ChiCTR-TRC-13003960.

Health-Related Quality of Life in a Randomized Phase III Study of Bevacizumab, Temozolomide, and Radiotherapy in Newly Diagnosed Glioblastoma.

PubMed

Taphoorn, Martin J B; Henriksson, Roger; Bottomley, Andrew; Cloughesy, Timothy; Wick, Wolfgang; Mason, Warren P; Saran, Frank; Nishikawa, Ryo; Hilton, Magalie; Theodore-Oklota, Christina; Ravelo, Arliene; Chinot, Olivier L

2015-07-01

As glioblastoma progresses, patients experience a decline in health-related quality of life (HRQoL). Delaying this decline is an important treatment goal. In newly diagnosed glioblastoma, progression-free survival was prolonged when bevacizumab was added to radiotherapy plus temozolomide (RT/TMZ) versus placebo plus RT/TMZ (phase III AVAglio study; hazard ratio, 0.64; 95% CI, 0.55 to 0.74; P < .001). To ensure that addition of bevacizumab to standard-of-care therapy was not associated with HRQoL detriment, HRQoL assessment was a secondary objective. Patients completed European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires C30 and BN20 at each tumor assessment (Appendix Table A1, online only). Raw scores were converted to a 100-point scale and mean changes from baseline scores were evaluated (stable: < 10-point change; clinically relevant deterioration/improvement: ≥ 10-point change). Deterioration-free survival was the time to deterioration/progression/death; time to deterioration was the time to deterioration/death. Most evaluable patients who had not progressed (> 74%) completed all HRQoL assessments for at least 1 year of treatment, and almost all completed at least one HRQoL assessment at baseline (98.3% and 97.6%, bevacizumab and placebo arms, respectively). Mean changes from baseline did not reach a clinically relevant difference between arms for most items. HRQoL declined at progression in both arms. The addition of bevacizumab to RT/TMZ resulted in statistically longer (P < .001) deterioration-free survival across all items. Time to deterioration was not statistically longer in the placebo plus RT/TMZ arm (v bevacizumab) for any HRQoL item. The addition of bevacizumab to standard-of-care treatment for newly diagnosed glioblastoma had no impact on HRQoL during the progression-free period. © 2015 by American Society of Clinical Oncology.

A difference in systolic blood pressure between arms is a novel predictor of the development and progression of diabetic nephropathy in patients with type 2 diabetes.

PubMed

Okada, Hiroshi; Fukui, Michiaki; Tanaka, Muhei; Matsumoto, Shinobu; Iwase, Hiroya; Kobayashi, Kanae; Asano, Mai; Yamazaki, Masahiro; Hasegawa, Goji; Nakamura, Naoto

2013-10-01

Recent studies have suggested that a difference in systolic blood pressure (SBP) between arms is associated with both vascular disease and mortality. The aim of this study was to investigate the relationship between a difference in SBP between arms and change in urinary albumin excretion or development of albuminuria in patients with type 2 diabetes. We measured SBP in 408 consecutive patients with type 2 diabetes, and calculated a difference in SBP between arms. We performed follow-up study to assess change in urinary albumin excretion or development of albuminuria, mean interval of which was 4.6 ± 1.7 years. We then evaluated the relationship of a difference in SBP between arms to diabetic nephropathy using multiple regression analysis and multiple Cox regression model. Multiple regression analyses demonstrated that a difference in SBP between arms was independently associated with change in urinary albumin excretion (β = 0.1869, P = 0.0010). Adjusted Cox regression analyses demonstrated that a difference in SBP between arms was associated with an increased hazard of development of albuminuria; hazard ratio was 1.215 (95% confidence interval 1.077-1.376). Moreover, the risk of development of albuminuria was increased in patients with a difference in SBP of equal to or more than 10 mmHg between arms; hazard ratio was 4.168 (95% confidence interval 1.478-11.70). A difference in SBP between arms could be a novel predictor of the development and progression of diabetic nephropathy in patients with type 2 diabetes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Randomized controlled trial of a dose consolidation program.

PubMed

Delate, Thomas; Fairman, Kathleen A; Carey, Shelly M; Motheral, Brenda R

2004-01-01

To evaluate the effectiveness and financial impact of a drug dose consolidation (optimization) program using letter intervention. This pilot program in a large, mid-Atlantic health plan utilized a randomized controlled trial research design. A review of adjudicated pharmacy claims records was performed monthly for 3 consecutive months from November 2002 through February 2003 to identify inefficient (i.e., >once-daily) regimens for any one of 68 dosage strengths of 37 single-source maintenance drugs with once-daily dosing recommendations. Prescribers who had prescribed one or more inefficient regimens were identified and randomized to one of the 2 intervention arms or a control arm. Prescribers in both intervention arms were sent personalized letters with information on their patients. inefficient regimens and suggested dose consolidation options. Patients of prescribers in one intervention arm received a complementary, patient-oriented letter. Pharmacy claims for patients in all arms were examined at 180 days after the date of the letter mailing for conversion to an efficient (once-daily) regimen. Financial modeling analysis calculated net savings as changes in pharmacy expenditures minus administrative costs. A total of 2,614 inefficient regimens, representing 6.7% of claims for the targeted medications, were identified. The rate of consolidation to a suggested dosing option was lower for the Physician Letter arm (7.3%) than for the Physician/Member Letter arm (10.2%) (P = 0.046). Both intervention arms had higher consolidation rates than the Control arm (3.9%) (P = 0.018 and P = 0.000, respectively.). Approximately 30% of the regimens in each study arm were never refilled after being targeted. Financial modeling indicated that a dose consolidation intervention could save 0.03 dollars to 0.07 dollars per member per month (PMPM) in 2003 dollars with full medication compliance but only 0.02 dollars to 0.03 dollars PMPM when savings were calculated with realistic, partial compliance rates. Subanalyses performed at the drug therapy class level revealed few opportunities to justify implementing a dose consolidation program. After taking into consideration program administrative costs, high rates of refill discontinuation, and dose consolidation that occurs naturally without intervention, the results indicated that a letter-based dose consolidation program did not appreciably decrease pharmacy expenditures.

Weapons for the world/update: the U. S. corporate role in International Arms Transfers. [Booklet

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lydenberg, S.

1977-01-01

The substantial growth of American arms exports in recent years has prompted the Council on Economic Priorities to study the role played by U.S. corporations in the sale of U.S. military equipment, training, and services throughout the world. Major findings of this Report include: U.S. arms sales and exports to foreign countries have risen dramatically from $2.9 billion in 1967, to $5 billion in 1971, to $10 to 12 billion annually from 1974 through 1976. Since 1973 a major shift has taken place in the nature of U.S. arms transfers from arms aid under the Military Assistance Program to armsmore » sales under the Foreign Military Sales program. The 10 U.S. corporations (Northrop, McDonnell Douglas, Grumman, Litton, General Electric, Raytheon, FMC, Hughes, Lockheed, and Textron) most extensively involved in U.S. arms exports in 1976 (profiled in this Report) received approximately 30% of their total military business from foreign arms sales. Congress has increased its active participation in U.S. arms-transfer policy through legislation passed in 1975 and 1976. This legislation has extended Congress' control over the Foreign Military Sales program in particular.« less

Meeting the healthcare needs of transgender people within the armed forces: putting UK military policy into practice.

PubMed

Whybrow, Dean; New, Chris; Coetzee, Rik; Bickerstaffe, Paul

2016-12-01

To explain how the healthcare needs of transgender personnel are met within the United Kingdom Armed Forces. It may be that when transgender people disclose their gender preference that they are at increased risk of social exclusion. The United Kingdom Armed Forces has an inclusive organisational policy for the recruitment and management of transgender personnel. This is a position paper about how the healthcare needs of transgender military personnel are met by the United Kingdom Armed Forces. United Kingdom Armed Forces policy was placed into context by reviewing current research, discussing medical terminology and describing the policy. This was followed by an account of how UK AF policy is applied in practice. Where armed forces had an inclusive policy for the management of transgender personnel, there seemed to be little cause for secrecy and zero tolerance of discrimination when compared to nations where this was not the case. Medical terminology has changed to reflect a more inclusive, less stigmatising use of language. The United Kingdom Armed Forces policy has been described as progressive and inclusive. The application of this policy in practice may be dependent upon strong leadership and training. The wider United Kingdom Armed Forces seems capable of adopting a pragmatic and flexible approach to meeting the healthcare needs of transgender personnel. The United Kingdom Armed Forces value diversity within their workforce and have a progressive, inclusive policy for the recruitment and management of transgender personnel. When supporting a transgender military person, healthcare professionals, civilian organisations and military line managers should consider referring to United Kingdom Armed Forces policy as early as possible. Other military and uniformed services may wish to examine the United Kingdom Armed Forces exemplar in order to consider the applicability within their own organisational setting. © 2016 John Wiley & Sons Ltd.

Phase II randomized trial of carboplatin, paclitaxel, bevacizumab with or without cixutumumab (IMC-A12) in patients with advanced non-squamous, non-small-cell lung cancer: a trial of the ECOG-ACRIN Cancer Research Group (E3508).

PubMed

Argiris, A; Lee, J W; Stevenson, J; Sulecki, M G; Hugec, V; Choong, N W; Saltzman, J N; Song, W; Hansen, R M; Evans, T L; Ramalingam, S S; Schiller, J H

2017-12-01

Cixutumumab is a fully human IgG1 monoclonal antibody to the insulin-like growth factor type I receptor that can potentially reverse resistance and enhance the efficacy of chemotherapy. Bevacizumab-eligible patients with stage IV or recurrent non-squamous, non-small-cell lung cancer and good performance status were randomized to receive standard doses of paclitaxel, carboplatin, and bevacizumab to a maximum of six cycles followed by bevacizumab maintenance (CPB) until progression (arm A) or CPB plus cixutumumab 6 mg/kg i.v. weekly (arm B). Of 175 patients randomized, 153 were eligible and treated (78 in arm A; 75 in arm B). The median progression-free survival was 5.8 months (95% CI 5.4-7.1) in arm A versus 7 months (95% CI 5.7-7.6) in arm B (P = 0.33); hazard ratio 0.92 (95% CI 0.65-1.31). Objective response was 46.2% versus 58.7% in arm A versus arm B (P = 0.15). The median overall survival was 16.2 months in arm A versus 16.1 months in arm B (P = 0.95). Grade 3/4 neutropenia and febrile neutropenia, thrombocytopenia, fatigue, and hyperglycemia were increased with cixutumumab. The addition of cixutumumab to CPB increased toxicity without improving efficacy and is not recommended for further development in non-small-cell lung cancer. Both treatment groups had longer OS than historical controls which may be attributed to several factors, and emphasizes the value of a comparator arm in phase II trials. NCT00955305. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Nonnucleoside Reverse-transcriptase Inhibitor- vs Ritonavir-boosted Protease Inhibitor-based Regimens for Initial Treatment of HIV Infection: A Systematic Review and Metaanalysis of Randomized Trials.

PubMed

Borges, Álvaro H; Lundh, Andreas; Tendal, Britta; Bartlett, John A; Clumeck, Nathan; Costagliola, Dominique; Daar, Eric S; Echeverría, Patrícia; Gisslén, Magnus; Huedo-Medina, Tania B; Hughes, Michael D; Huppler Hullsiek, Katherine; Khabo, Paul; Komati, Stephanus; Kumar, Princy; Lockman, Shahin; MacArthur, Rodger D; Maggiolo, Franco; Matteelli, Alberto; Miro, Jose M; Oka, Shinichi; Petoumenos, Kathy; Puls, Rebekah L; Riddler, Sharon A; Sax, Paul E; Sierra-Madero, Juan; Torti, Carlo; Lundgren, Jens D

2016-07-15

Previous studies suggest that nonnucleoside reverse-transcriptase inhibitors (NNRTIs) cause faster virologic suppression, while ritonavir-boosted protease inhibitors (PI/r) recover more CD4 cells. However, individual trials have not been powered to compare clinical outcomes. We searched databases to identify randomized trials that compared NNRTI- vs PI/r-based initial therapy. A metaanalysis calculated risk ratios (RRs) or mean differences (MDs), as appropriate. Primary outcome was death or progression to AIDS. Secondary outcomes were death, progression to AIDS, and treatment discontinuation. We calculated RR of virologic suppression and MD for an increase in CD4 cells at week 48. We included 29 trials with 9047 participants. Death or progression to AIDS occurred in 226 participants in the NNRTI arm and in 221 in the PI/r arm (RR, 1.03; 95% confidence interval, .87-1.22; 12 trials; n = 3825), death in 205 participants in the NNRTI arm vs 198 in the PI/r arm (1.04; 0.86-1.25; 22 trials; n = 8311), and progression to AIDS in 140 participants in the NNRTI arm vs 144 in the PI/r arm (1.00; 0.80-1.25; 13 trials; n = 4740). Overall treatment discontinuation (1.12; 0.93-1.35; 24 trials; n = 8249) and from toxicity (1.21; 0.87-1.68; 21 trials; n = 6195) were comparable, but discontinuation due to virologic failure was more common with NNRTI (1.58; 0.91-2.74; 17 trials; n = 5371). At week 48, there was no difference between NNRTI and PI/r in virologic suppression (RR, 1.03; 0.98-1.09) or CD4(+) recovery (MD, -4.7 cells; -14.2 to 4.8). We found no difference in clinical and viro-immunologic outcomes between NNRTI- and PI/r-based therapy. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Rehabilitation of traumatic brain injury in active duty military personnel and veterans: Defense and Veterans Brain Injury Center randomized controlled trial of two rehabilitation approaches.

PubMed

Vanderploeg, Rodney D; Schwab, Karen; Walker, William C; Fraser, Jamie A; Sigford, Barbara J; Date, Elaine S; Scott, Steven G; Curtiss, Glenn; Salazar, Andres M; Warden, Deborah L

2008-12-01

To determine the relative efficacy of 2 different acute traumatic brain injury (TBI) rehabilitation approaches: cognitive didactic versus functional-experiential, and secondarily to determine relative efficacy for different patient subpopulations. Randomized, controlled, intent-to-treat trial comparing 2 alternative TBI treatment approaches. Four Veterans Administration acute inpatient TBI rehabilitation programs. Adult veterans or active duty military service members (N=360) with moderate to severe TBI. One and a half to 2.5 hours of protocol-specific cognitive-didactic versus functional-experiential rehabilitation therapy integrated into interdisciplinary acute Commission for Accreditation of Rehabilitation Facilities-accredited inpatient TBI rehabilitation programs with another 2 to 2.5 hours daily of occupational and physical therapy. Duration of protocol treatment varied from 20 to 60 days depending on the clinical needs and progress of each participant. The 2 primary outcome measures were functional independence in living and return to work and/or school assessed by independent evaluators at 1-year follow-up. Secondary outcome measures consisted of the FIM, Disability Rating Scale score, and items from the Present State Exam, Apathy Evaluation Scale, and Neurobehavioral Rating Scale. The cognitive-didactic and functional-experiential treatments did not result in overall group differences in the broad 1-year primary outcomes. However, analysis of secondary outcomes found differentially better immediate posttreatment cognitive function (mean+/-SD cognitive FIM) in participants randomized to cognitive-didactic treatment (27.3+/-6.2) than to functional treatment (25.6+/-6.0, t332=2.56, P=.01). Exploratory subgroup analyses found that younger participants in the cognitive arm had a higher rate of returning to work or school than younger patients in the functional arm, whereas participants older than 30 years and those with more years of education in the functional arm had higher rates of independent living status at 1 year posttreatment than similar patients in the cognitive arm. Results from this large multicenter randomized controlled trial comparing cognitive-didactic and functional-experiential approaches to brain injury rehabilitation indicated improved but similar long-term global functional outcome. Participants in the cognitive treatment arm achieved better short-term functional cognitive performance than patients in the functional treatment arm. The current increase in war-related brain injuries provides added urgency for rigorous study of rehabilitation treatments. (http://ClinicalTrials.gov ID# NCT00540020.).

Multi-parametric spinal cord MRI as potential progression marker in amyotrophic lateral sclerosis.

PubMed

El Mendili, Mohamed-Mounir; Cohen-Adad, Julien; Pelegrini-Issac, Mélanie; Rossignol, Serge; Morizot-Koutlidis, Régine; Marchand-Pauvert, Véronique; Iglesias, Caroline; Sangari, Sina; Katz, Rose; Lehericy, Stéphane; Benali, Habib; Pradat, Pierre-François

2014-01-01

To evaluate multimodal MRI of the spinal cord in predicting disease progression and one-year clinical status in amyotrophic lateral sclerosis (ALS) patients. After a first MRI (MRI1), 29 ALS patients were clinically followed during 12 months; 14/29 patients underwent a second MRI (MRI2) at 11±3 months. Cross-sectional area (CSA) that has been shown to be a marker of lower motor neuron degeneration was measured in cervical and upper thoracic spinal cord from T2-weighted images. Fractional anisotropy (FA), axial/radial/mean diffusivities (λ⊥, λ//, MD) and magnetization transfer ratio (MTR) were measured within the lateral corticospinal tract in the cervical region. Imaging metrics were compared with clinical scales: Revised ALS Functional Rating Scale (ALSFRS-R) and manual muscle testing (MMT) score. At MRI1, CSA correlated significantly (P<0.05) with MMT and arm ALSFRS-R scores. FA correlated significantly with leg ALFSRS-R scores. One year after MRI1, CSA predicted (P<0.01) arm ALSFSR-R subscore and FA predicted (P<0.01) leg ALSFRS-R subscore. From MRI1 to MRI2, significant changes (P<0.01) were detected for CSA and MTR. CSA rate of change (i.e. atrophy) highly correlated (P<0.01) with arm ALSFRS-R and arm MMT subscores rate of change. Atrophy and DTI metrics predicted ALS disease progression. Cord atrophy was a better biomarker of disease progression than diffusion and MTR. Our study suggests that multimodal MRI could provide surrogate markers of ALS that may help monitoring the effect of disease-modifying drugs.

Navy DDG-1000 and DDG-51 Destroyer Programs: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2008-10-22

House Armed Services Committee, Navy officials announced a major change in the service’s position on what kind of destroyers it wants to procure over the...software program for the Aegis combat system and the arming of the ship with the SM-3, a version of the Navy’s Standard Missile that is designed for BMD...Assistant Secretary of the Navy (Ship Programs), before the Subcommittee on Seapower and Expeditionary Forces of the House Armed Services Committee, on

Beyond intuitive anthropomorphic control: recent achievements using brain computer interface technologies

NASA Astrophysics Data System (ADS)

Pohlmeyer, Eric A.; Fifer, Matthew; Rich, Matthew; Pino, Johnathan; Wester, Brock; Johannes, Matthew; Dohopolski, Chris; Helder, John; D'Angelo, Denise; Beaty, James; Bensmaia, Sliman; McLoughlin, Michael; Tenore, Francesco

2017-05-01

Brain-computer interface (BCI) research has progressed rapidly, with BCIs shifting from animal tests to human demonstrations of controlling computer cursors and even advanced prosthetic limbs, the latter having been the goal of the Revolutionizing Prosthetics (RP) program. These achievements now include direct electrical intracortical microstimulation (ICMS) of the brain to provide human BCI users feedback information from the sensors of prosthetic limbs. These successes raise the question of how well people would be able to use BCIs to interact with systems that are not based directly on the body (e.g., prosthetic arms), and how well BCI users could interpret ICMS information from such devices. If paralyzed individuals could use BCIs to effectively interact with such non-anthropomorphic systems, it would offer them numerous new opportunities to control novel assistive devices. Here we explore how well a participant with tetraplegia can detect infrared (IR) sources in the environment using a prosthetic arm mounted camera that encodes IR information via ICMS. We also investigate how well a BCI user could transition from controlling a BCI based on prosthetic arm movements to controlling a flight simulator, a system with different physical dynamics than the arm. In that test, the BCI participant used environmental information encoded via ICMS to identify which of several upcoming flight routes was the best option. For both tasks, the BCI user was able to quickly learn how to interpret the ICMSprovided information to achieve the task goals.

Evaluation Plan for the Computerized Adaptive Vocational Aptitude Battery.

ERIC Educational Resources Information Center

Green, Bert F.; And Others

The United States Armed Services are planning to introduce computerized adaptive testing (CAT) into the Armed Services Vocational Aptitude Battery (ASVAB), which is a major part of the present personnel assessment procedures. Adaptive testing will improve efficiency greatly by assessing each candidate's answers as the test progresses and posing…

A randomized phase II study comparing paclitaxel-carboplatin-bevacizumab with or without nitroglycerin patches in patients with stage IV nonsquamous nonsmall-cell lung cancer: NVALT12 (NCT01171170)†.

PubMed

Dingemans, A-M C; Groen, H J M; Herder, G J M; Stigt, J A; Smit, E F; Bahce, I; Burgers, J A; van den Borne, B E E M; Biesma, B; Vincent, A; van der Noort, V; Aerts, J G

2015-11-01

Nitroglycerin (NTG) increases tumor blood flow and oxygenation by inhibiting hypoxia-inducible-factor (HIF)-1. A randomized phase II study has shown improved outcome when NTG patches were added to vinorelbine/cisplatin in patients with advanced nonsmall-cell lung cancer (NSCLC). In addition, there is evidence that the combination of bevacizumab and HIF-1 inhibitors increases antitumor activity. In this randomized phase II trial, chemo-naive patients with stage IV nonsquamous NSCLC were randomized to four cycles of carboplatin (area under the curve 6)-paclitaxel (200 mg/m(2))-bevacizumab 15 mg/kg on day 1 every 3 weeks with or without NTG patches 15 mg (day -2 to +2) followed by bevacizumab with or without NTG until progression. Response was assessed every two cycles. Primary end point was progression-free survival (PFS). The study was powered (80%) to detect a decrease in the hazard of tumor progression of 33% at α = 0.05 with a two-sided log-rank test when 222 patients were enrolled and followed until 195 events were observed. Between 1 January 2011 and 1 January 2013, a total of 223 patients were randomized; 112 control arm and 111 experimental arm; response rate was 54% in control arm and 38% in experimental arm. Median [95% confidence interval (CI)] PFS in control arm was 6.8 months (5.6-7.3) and 5.1 months (4.2-5.8) in experimental arm, hazard ratio (HR) 1.27 (95% CI 0.96-1.67). Overall survival (OS) was 11.6 months (8.8-13.6) in control arm and 9.4 months (7.8-11.3) in experimental arm, HR 1.02 (95% CI 0.71-1.46). In the experimental arm, no additional toxicity was observed except headache (6% versus 52% in patients treated with NTG). Adding NTG to first-line carboplatin-paclitaxel-bevacizumab did not improve PFS and OS in patients with stage IV nonsquamous NSCLC. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Randomized Phase III Trial of Trastuzumab Plus Capecitabine With or Without Pertuzumab in Patients With Human Epidermal Growth Factor Receptor 2-Positive Metastatic Breast Cancer Who Experienced Disease Progression During or After Trastuzumab-Based Therapy.

PubMed

Urruticoechea, Ander; Rizwanullah, Mohammed; Im, Seock-Ah; Ruiz, Antonio Carlos Sánchez; Láng, István; Tomasello, Gianluca; Douthwaite, Hannah; Badovinac Crnjevic, Tanja; Heeson, Sarah; Eng-Wong, Jennifer; Muñoz, Montserrat

2017-09-10

Purpose To assess the efficacy and safety of trastuzumab plus capecitabine with or without pertuzumab in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer who experienced disease progression during or after trastuzumab-based therapy and received a prior taxane. Patients and Methods Patients were randomly assigned to arm A: trastuzumab 8 mg/kg → 6 mg/kg once every 3 weeks plus capecitabine 1,250 mg/m 2 twice a day (2 weeks on, 1 week off, every 3 weeks); or arm B: pertuzumab 840 mg → 420 mg once every 3 weeks plus trastuzumab at the same dose and schedule as arm A plus capecitabine 1,000 mg/m 2 on the same schedule as arm A. The primary end point was independent review facility-assessed progression-free survival (IRF PFS). Secondary end points included overall survival (OS) and safety. Hierarchical testing procedures were used to control type I error for statistical testing of IRF PFS, OS, and objective response rate. Results Randomly assigned (intent-to-treat) populations were 224 and 228 patients in arms A and B, respectively. Median IRF PFS at 28.6 and 25.3 months' median follow-up was 9.0 v 11.1 months (hazard ratio, 0.82; 95% CI, 0.65 to 1.02; P = .0731) and interim OS was 28.1 v 36.1 months (hazard ratio, 0.68; 95% CI, 0.51 to 0.90). The most common adverse events (all grades; incidence of ≥ 10% in either arm and ≥ 5% difference between arms) were hand-foot syndrome, nausea, and neutropenia in arm A, and diarrhea, rash, and nasopharyngitis in arm B. Conclusion The addition of pertuzumab to trastuzumab and capecitabine did not significantly improve IRF PFS. An 8-month increase in median OS to 36.1 months with pertuzumab was observed. Statistical significance for OS cannot be claimed because of the hierarchical testing of OS after the primary PFS end point; however, the magnitude of OS difference is in keeping with prior experience of pertuzumab in metastatic breast cancer. No new safety signals were identified.

Proposals to Establish a New Educational Assistance Program for Veterans and Members of the Armed Forces, and Review of the Veterans Educational Assistance Program (VEAP). Hearing before the Subcommittee on Education, Training and Employment of the Committee on Veterans' Affairs. House of Representatives, Ninety-Eighth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Veterans' Affairs.

This report of a hearing on educational benefits for veterans and members of the armed forces focuses on four proposals to establish a new educational assistance program for veterans and members of the armed forces and presents a review of the Veterans Educational Assistance Program (VEAP). Testimony includes statements from members of the U.S.…

Scenarios for exercising technical approaches to verified nuclear reductions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Doyle, James

2010-01-01

Presidents Obama and Medvedev in April 2009 committed to a continuing process of step-by-step nuclear arms reductions beyond the new START treaty that was signed April 8, 2010 and to the eventual goal of a world free of nuclear weapons. In addition, the US Nuclear Posture review released April 6, 2010 commits the US to initiate a comprehensive national research and development program to support continued progress toward a world free of nuclear weapons, including expanded work on verification technologies and the development of transparency measures. It is impossible to predict the specific directions that US-RU nuclear arms reductions willmore » take over the 5-10 years. Additional bilateral treaties could be reached requiring effective verification as indicated by statements made by the Obama administration. There could also be transparency agreements or other initiatives (unilateral, bilateral or multilateral) that require monitoring with a standard of verification lower than formal arms control, but still needing to establish confidence to domestic, bilateral and multilateral audiences that declared actions are implemented. The US Nuclear Posture Review and other statements give some indication of the kinds of actions and declarations that may need to be confirmed in a bilateral or multilateral setting. Several new elements of the nuclear arsenals could be directly limited. For example, it is likely that both strategic and nonstrategic nuclear warheads (deployed and in storage), warhead components, and aggregate stocks of such items could be accountable under a future treaty or transparency agreement. In addition, new initiatives or agreements may require the verified dismantlement of a certain number of nuclear warheads over a specified time period. Eventually procedures for confirming the elimination of nuclear warheads, components and fissile materials from military stocks will need to be established. This paper is intended to provide useful background information for establishing a conceptual approach to a five-year technical program plan for research and development of nuclear arms reductions verification and transparency technologies and procedures.« less

ARM Climate Research Facility Quarterly Ingest Status Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koontz, A.; Sivaraman, C.

2016-10-01

The purpose of this report is to provide a concise status update for ingests maintained by the Atmospheric Radiation Measurement (ARM) Climate Research Facility. The report is divided into the following sections: (1) new ingests for which development has begun, (2) progress on existing ingests, (3) future ingests that have been recently approved, (4) other work that leads to an ingest, and (5) top requested ingests from the ARM Data Archive. New information is highlighted in blue text.

ARM Climate Research Facility Quarterly Ingest Status Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koontz, A.; Sivaraman, C.

2016-07-01

The purpose of this report is to provide a concise status update for ingests maintained by the Atmospheric Radiation Measurement (ARM) Climate Research Facility. The report is divided into the following sections: (1) new ingests for which development has begun, (2) progress on existing ingests, (3) future ingests that have been recently approved, (4) other work that leads to an ingest, and (5) top requested ingests from the ARM Data Archive. New information is highlighted in blue text.

Arctic Atmospheric Measurements Using Manned and Unmanned Aircraft, Tethered Balloons, and Ground-Based Systems at U.S. DOE ARM Facilities on the North Slope Of Alaska

NASA Astrophysics Data System (ADS)

Ivey, M.; Dexheimer, D.; Roesler, E. L.; Hillman, B. R.; Hardesty, J. O.

2016-12-01

The U.S. Department of Energy (DOE) provides scientific infrastructure and data to the international Arctic research community via research sites located on the North Slope of Alaska and an open data archive maintained by the ARM program. In 2016, DOE continued investments in improvements to facilities and infrastructure at Oliktok Point Alaska to support operations of ground-based facilities and unmanned aerial systems for science missions in the Arctic. The Third ARM Mobile Facility, AMF3, now deployed at Oliktok Point, was further expanded in 2016. Tethered instrumented balloons were used at Oliktok to make measurements of clouds in the boundary layer including mixed-phase clouds and to compare measurements with those from the ground and from unmanned aircraft operating in the airspace above AMF3. The ARM facility at Oliktok Point includes Special Use Airspace. A Restricted Area, R-2204, is located at Oliktok Point. Roughly 4 miles in diameter, it facilitates operations of tethered balloons and unmanned aircraft. R-2204 and a new Warning Area north of Oliktok, W-220, are managed by Sandia National Laboratories for DOE Office of Science/BER. These Special Use Airspaces have been successfully used to launch and operate unmanned aircraft over the Arctic Ocean and in international airspace north of Oliktok Point.A steady progression towards routine operations of unmanned aircraft and tethered balloon systems continues at Oliktok. Small unmanned aircraft (DataHawks) and tethered balloons were successfully flown at Oliktok starting in June of 2016. This poster will discuss how principal investigators may apply for use of these Special Use Airspaces, acquire data from the Third ARM Mobile Facility, or bring their own instrumentation for deployment at Oliktok Point, Alaska.

A Randomized Controlled Trial to Evaluate if Computerized Cognitive Rehabilitation Improves Neurocognition in Ugandan Children with HIV.

PubMed

Boivin, Michael J; Nakasujja, Noeline; Sikorskii, Alla; Opoka, Robert O; Giordani, Bruno

2016-08-01

Clinically stable children with HIV can have neuromotor, attention, memory, visual-spatial, and executive function impairments. We evaluated neuropsychological and behavioral benefits of computerized cognitive rehabilitation training (CCRT) in Ugandan HIV children. One hundred fifty-nine rural Ugandan children with WHO Stage I or II HIV disease (6 to 12 years; 77 boys, 82 girls; M = 8.9, SD = 1.86 years) were randomized to one of three treatment arms over a 2-month period. The CCRT arm received 24 one-hour sessions over 2 months, using Captain's Log (BrainTrain Corporation) programmed for games targeting working memory, attention, and visual-spatial analysis. These games progressed in difficulty as the child's performance improved. The second arm was a "limited CCRT" with the same games rotated randomly from simple to moderate levels of training. The third arm was a passive control group receiving no training. All children were assessed at enrollment, 2 months (immediately following CCRT), and 3 months after CCRT completion. The CCRT group had significantly greater gains through 3 months of follow-up compared to passive controls on overall Kaufman Assessment Battery for Children-second edition (KABC-II) mental processing index (p < .01), planning (p = .04), and knowledge (p = .03). The limited CCRT group performed better than controls on learning (p = .05). Both CCRT arms had significant improvements on CogState Groton maze learning (p < .01); although not on CogState attention/memory, TOVA/impulsivity, or behavior rating inventory for executive function and child behavior checklist (psychiatric behavior/symptom problems) ratings by caregiver. CCRT intervention can be effective for neurocognitive rehabilitation in children with HIV in low-resource settings, especially in children who are clinically stable on ARV treatment.

The effect of a multi-component camp-based weight-loss program on children's motor skills and physical fitness: a randomized controlled trial.

PubMed

Larsen, Kristian Traberg; Huang, Tao; Larsen, Lisbeth Runge; Olesen, Line Grønholt; Andersen, Lars Bo; Møller, Niels Christian

2016-07-15

Many weight-loss programs in children are performed without specific foci on training both physical fitness and motor skills. The aim of this study was to describe the effect of a one-year weight-loss program on children's motor skills and physical fitness. Participants included 115 overweight fifth-grade children (12.0 years) randomized into either a Day-Camp Intervention Arm (DCIA), with a subsequent family-based support program or a low-intense Standard Intervention Arm (SIA). Physical fitness was assessed by vertical jump, hand grip strength, and a progressive cardio-respiratory fitness test. Motor skills were assessed by the Movement Assessment Battery for Children - second edition (M-ABC-2), age band 3. Loss to follow-up after 52 weeks was 19 % and 32 % in the DCIA and SIA, respectively. Balance skills were improved post-camp, but not after 52 weeks in children from the DCIA compared to the SIA. Contrary to the expected, children from the SIA improved aiming and catching skills relative to the DCIA children. Overall z-scores of the physical fitness components and cardio-respiratory fitness improved more in children from the DCIA compared to children from the SIA. In conclusion, the day-camp intervention led to improvements in physical fitness but not in motor skills compared to the standard intervention. Including both motor skills and physical fitness could advantageously be considered in future immersive intervention programmes. Clinicaltrials NCT01574352, March 26, 2012 (retrospectively registered).

Preventing substance use among early Asian-American adolescent girls: initial evaluation of a web-based, mother-daughter program.

PubMed

Fang, Lin; Schinke, Steven P; Cole, Kristin C A

2010-11-01

This study examined the efficacy and generalizability of a family-oriented, web-based substance use prevention program to young Asian-American adolescent girls. Between September and December 2007, a total of 108 Asian-American girls aged 10-14 years and their mothers were recruited through online advertisements and from community service agencies. Mother-daughter dyads were randomly assigned to an intervention arm or to a test-only control arm. After pretest measurement, intervention-arm dyads completed a 9-session web-based substance use prevention program. Guided by family interaction theory, the program aimed to improve girls' psychological states, strengthen substance use prevention skills, increase mother-daughter interactions, enhance maternal monitoring, and prevent girls' substance use. Study outcomes were assessed using generalized estimating equations. At posttest, relative to control-arm girls, intervention-arm girls showed less depressed mood; reported improved self-efficacy and refusal skills; had higher levels of mother-daughter closeness, mother-daughter communication, and maternal monitoring; and reported more family rules against substance use. Intervention-arm girls also reported fewer instances of alcohol, marijuana, and illicit prescription drug use, and expressed lower intentions to use substances in the future. A family-oriented, web-based substance use prevention program was efficacious in preventing substance use behavior among early Asian-American adolescent girls. Copyright © 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Rb1 loss modifies but does not initiate alveolar rhabdomyosarcoma

PubMed Central

2013-01-01

Background Alveolar rhabdomyosarcoma (aRMS) is a myogenic childhood sarcoma frequently associated with a translocation-mediated fusion gene, Pax3:Foxo1a. Methods We investigated the complementary role of Rb1 loss in aRMS tumor initiation and progression using conditional mouse models. Results Rb1 loss was not a necessary and sufficient mutational event for rhabdomyosarcomagenesis, nor a strong cooperative initiating mutation. Instead, Rb1 loss was a modifier of progression and increased anaplasia and pleomorphism. Whereas Pax3:Foxo1a expression was unaltered, biomarkers of aRMS versus embryonal rhabdomyosarcoma were both increased, questioning whether these diagnostic markers are reliable in the context of Rb1 loss. Genome-wide gene expression in Pax3:Foxo1a,Rb1 tumors more closely approximated aRMS than embryonal rhabdomyosarcoma. Intrinsic loss of pRb function in aRMS was evidenced by insensitivity to a Cdk4/6 inhibitor regardless of whether Rb1 was intact or null. This loss of function could be attributed to low baseline Rb1, pRb and phospho-pRb expression in aRMS tumors for which the Rb1 locus was intact. Pax3:Foxo1a RNA interference did not increase pRb or improve Cdk inhibitor sensitivity. Human aRMS shared the feature of low and/or heterogeneous tumor cell pRb expression. Conclusions Rb1 loss from an already low pRb baseline is a significant disease modifier, raising the possibility that some cases of pleomorphic rhabdomyosarcoma may in fact be Pax3:Foxo1a-expressing aRMS with Rb1 or pRb loss of function. PMID:24274149

RANDOMIZED TRIAL OF PEGYLATED LIPOSOMAL DOXORUBICIN (PLD) PLUS CARBOPLATIN VERSUS CARBOPLATIN IN PLATINUM-SENSITIVE (PS) PATIENTS WITH RECURRENT EPITHELIAL OVARIAN OR PERITONEAL CARCINOMA AFTER FAILURE OF INITIAL PLATINUM-BASED CHEMOTHERAPY (SOUTH WEST ONCOLOGY GROUP PROTOCOL S0200)

PubMed Central

Alberts, David S.; Liu, P. Y.; Wilczynski, Sharon P.; Clouser, Mary C.; Lopez, Ana Maria; Michelin, David P.; Lanzotti, Victor J.; Markman, Maurie

2008-01-01

Objective Because debate continues over the role of combination, platinum-based chemotherapy for platinum sensitive (PS), recurrent ovarian cancer (OC), we compared overall survival (OS), progression-free survival (PFS), confirmed complete response rate and time to treatment failure in this population. Methods Patients with recurrent stage III or IV OC, a progression-free and platinum-free interval of 6- 24 months after first-line platinum-based chemotherapy and up to 12 courses of a non-platinum containing consolidation treatment were eligible. Patients were randomized to IV pegylated liposomal doxorubicin (PLD) (30 mg/m2) plus IV carboplatin (AUC=5 mg/mL × min) once every 4 weeks (PLD arm) or IV carboplatin alone (AUC=5mg/mL × min) once every 4 weeks. Results The PLD arm enrolled 31 patients and the carboplatin alone arm 30 for a total of 61 patients out of 900 planned. Response rates were 67% for the PLD arm and 32% for the carboplatin only arm (Fisher’s exact p=0.02). The estimated median PFS was 12 and 8 months for PLD versus carboplatin alone. The estimated median OS on the PLD arm was 26 months and 18 months on the carboplatin only arm (p=0.02). Twenty-six percent of the patients on the PLD arm reported grade 4 toxicities, all hematological in nature. Conclusion This study was closed early because of slow patient accrual. The response rate, median PFS and OS results are intriguing. These data suggest that there may be an advantage to the PLD plus carboplatin combination treatment in patients with PS, recurrent OC. The regimen should be further tested. PMID:17949799

ARM Airborne Carbon Measurements (ARM-ACME) and ARM-ACME 2.5 Final Campaign Reports

DOE Office of Scientific and Technical Information (OSTI.GOV)

Biraud, S. C.; Tom, M. S.; Sweeney, C.

2016-01-01

We report on a 5-year multi-institution and multi-agency airborne study of atmospheric composition and carbon cycling at the Atmospheric Radiation Measurement (ARM) Climate Research Facility’s Southern Great Plains (SGP) site, with scientific objectives that are central to the carbon-cycle and radiative-forcing goals of the U.S. Global Change Research Program and the North American Carbon Program (NACP). The goal of these measurements is to improve understanding of 1) the carbon exchange of the Atmospheric Radiation Measurement (ARM) SGP region; 2) how CO 2 and associated water and energy fluxes influence radiative-forcing, convective processes, and CO 2 concentrations over the ARM SGPmore » region, and 3) how greenhouse gases are transported on continental scales.« less

Two-year outcomes of a randomized, family-based substance use prevention trial for Asian American adolescent girls.

PubMed

Fang, Lin; Schinke, Steven P

2013-09-01

Asian Americans have been largely ignored in the prevention outcome literature. In this study, we tested a parent-child program with a sample of Asian American adolescent girls and their mothers, and evaluated the program's efficacy on decreasing girls' substance use and modifying risk and protective factors at individual, family, and peer levels. A total of 108 Asian American mother-daughter dyads recruited through online advertisements and from community service agencies were randomly assigned to an intervention arm (n = 56) or to a test-only control arm (n = 52). The intervention consisted of a nine-session substance abuse prevention program, delivered entirely online. Guided by family interaction theory, the prevention program aimed to strengthen the quality of girls' relationships with their mothers while increasing girls' resilience to resist substance use. Intent-to-treat analyses showed that at 2-year follow-up, intervention-arm dyads had significantly higher levels of mother-daughter closeness, mother-daughter communication, maternal monitoring, and family rules against substance use compared with the control-arm dyads. Intervention-arm girls also showed sustained improvement in self-efficacy and refusal skills and had lower intentions to use substances in the future. Most important, intervention-arm girls reported fewer instances of alcohol and marijuana use and prescription drug misuse relative to the control-arm girls. The study suggests that a culturally generic, family-based prevention program was efficacious in enhancing parent-child relationships, improving girls' resiliency, and preventing substance use behaviors among Asian American girls. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Germany's Armed Forces in the Second World War: Manpower, Armaments, and Supply.

ERIC Educational Resources Information Center

Balsamo, Larry T.

1991-01-01

Discusses the state of Germany's armed forces in World War II. Describes Germany's progress from inferior weaponry and unprepared military at the beginning of the war to superior weapons and fighting. Stresses heavy German dependence on horse drawn supply. Credits Germany's defeat to human attrition accelerated by Hitler's operational leadership.…

The JAU-JPL anthropomorphic telerobot

NASA Technical Reports Server (NTRS)

Jau, Bruno M.

1989-01-01

Work in progress on the new anthropomorphic telerobot is described. The initial robot configuration consists of a seven DOF arm and a sixteen DOF hand, having three fingers and a thumb. The robot has active compliance, enabling subsequent dual arm manipulations. To control the rather complex configuration of this robot, an exoskeleton master arm harness and a glove controller were built. The controller will be used for teleoperational tasks and as a research tool to efficiently teach the computer controller advanced manipulation techniques.

Final Report for High Latitude Climate Modeling: ARM Takes Us Beyond Case Studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Russell, Lynn M; Lubin, Dan

2013-06-18

The main thrust of this project was to devise a method by which the majority of North Slope of Alaska (NSA) meteorological and radiometric data, collected on a daily basis, could be used to evaluate and improve global climate model (GCM) simulations and their parameterizations, particularly for cloud microphysics. Although the standard ARM Program sensors for a less complete suite of instruments for cloud and aerosol studies than the instruments on an intensive field program such as the 2008 Indirect and Semi-Direct Aerosol Campaign (ISDAC), the advantage they offer lies in the long time base and large volume of datamore » that covers a wide range of meteorological and climatological conditions. The challenge has been devising a method to interpret the NSA data in a practical way, so that a wide variety of meteorological conditions in all seasons can be examined with climate models. If successful, climate modelers would have a robust alternative to the usual “case study” approach (i.e., from intensive field programs only) for testing and evaluating their parameterizations’ performance. Understanding climate change on regional scales requires a broad scientific consideration of anthropogenic influences that goes beyond greenhouse gas emissions to also include aerosol-induced changes in cloud properties. For instance, it is now clear that on small scales, human-induced aerosol plumes can exert microclimatic radiative and hydrologic forcing that rivals that of greenhouse gas–forced warming. This project has made significant scientific progress by investigating what causes successive versions of climate models continue to exhibit errors in cloud amount, cloud microphysical and radiative properties, precipitation, and radiation balance, as compared with observations and, in particular, in Arctic regions. To find out what is going wrong, we have tested the models' cloud representation over the full range of meteorological conditions found in the Arctic using the ARM North Slope of Alaska (NSA) data.« less

Phase III, randomised, multicentre trial of maintenance immunotherapy with low-dose interleukin-2 and interferon-alpha for metastatic renal cell cancer.

PubMed

Passalacqua, Rodolfo; Buzio, Carlo; Buti, Sebastiano; Porta, Camillo; Labianca, Roberto; Pezzuolo, Debora; Camisa, Roberta; Sabbatini, Roberto; Benecchi, Luigi; Messina, Caterina; Cengarle, Rita; Vaglio, Augusto; Dalla Chiesa, Matteo; Tomasello, Gianluca; Caminiti, Caterina

2010-04-01

This is the first phase III randomised trial to evaluate maintenance immunotherapy in metastatic renal cell cancer (mRCC). Patients were randomised to receive treatment with a 4-week cycle of subcutaneous low doses IL-2 + IFN in months 1, 3 and 5, and then every 3 months until the first documented disease progression (arm A, suspension), or the same regimen, with chronic maintenance of immunotherapy, regardless of tumour response, until death or intolerable toxicity (arm B, maintenance). The primary endpoint was overall survival (OS); secondary endpoints were time from first progression to death (TFPTD) and tolerability. One hundred and eighty-three patients were enrolled between January 1998 and November 2003. After a median follow-up of 53.9 months, response rate, median OS and median TFPTD were 14.7% (6.3% CR) versus 11.3% (5.5% CR), 14 versus 14 months, 6 versus 5 months, in arms A and B, respectively with no significant differences between the groups. Cox regression analysis showed that the use of chemotherapy after first progression (HR 0.54; 95% CI 0.35-0.86; p = 0.008), PS = 0 (HR 0.53; 95% CI 0.35-0.81; p = 0.001) and female gender (HR 0.63; 95% CI 0.41-0.98; p = 0.038) were significantly associated with a longer TFPTD; treatment arm was not significant (HR 0.88; 95% CI 0.60-1.31; p = 0.54). Toxicity was mainly limited to WHO grades 1 or 2. Chronic maintenance immunotherapy after disease progression is feasible, but does not significantly increase OS or the TFPTD.

Multi-Parametric Spinal Cord MRI as Potential Progression Marker in Amyotrophic Lateral Sclerosis

PubMed Central

El Mendili, Mohamed-Mounir; Cohen-Adad, Julien; Pelegrini-Issac, Mélanie; Rossignol, Serge; Morizot-Koutlidis, Régine; Marchand-Pauvert, Véronique; Iglesias, Caroline; Sangari, Sina; Katz, Rose; Lehericy, Stéphane; Benali, Habib; Pradat, Pierre-François

2014-01-01

Objective To evaluate multimodal MRI of the spinal cord in predicting disease progression and one-year clinical status in amyotrophic lateral sclerosis (ALS) patients. Materials and Methods After a first MRI (MRI1), 29 ALS patients were clinically followed during 12 months; 14/29 patients underwent a second MRI (MRI2) at 11±3 months. Cross-sectional area (CSA) that has been shown to be a marker of lower motor neuron degeneration was measured in cervical and upper thoracic spinal cord from T2-weighted images. Fractional anisotropy (FA), axial/radial/mean diffusivities (λ⊥, λ//, MD) and magnetization transfer ratio (MTR) were measured within the lateral corticospinal tract in the cervical region. Imaging metrics were compared with clinical scales: Revised ALS Functional Rating Scale (ALSFRS-R) and manual muscle testing (MMT) score. Results At MRI1, CSA correlated significantly (P<0.05) with MMT and arm ALSFRS-R scores. FA correlated significantly with leg ALFSRS-R scores. One year after MRI1, CSA predicted (P<0.01) arm ALSFSR-R subscore and FA predicted (P<0.01) leg ALSFRS-R subscore. From MRI1 to MRI2, significant changes (P<0.01) were detected for CSA and MTR. CSA rate of change (i.e. atrophy) highly correlated (P<0.01) with arm ALSFRS-R and arm MMT subscores rate of change. Conclusion Atrophy and DTI metrics predicted ALS disease progression. Cord atrophy was a better biomarker of disease progression than diffusion and MTR. Our study suggests that multimodal MRI could provide surrogate markers of ALS that may help monitoring the effect of disease-modifying drugs. PMID:24755826

Clinical and radiological outcomes of 5-year drug-free remission-steered treatment in patients with early arthritis: IMPROVED study.

PubMed

Akdemir, Gülşah; Heimans, Lotte; Bergstra, Sytske Anne; Goekoop, Robbert J; van Oosterhout, Maikel; van Groenendael, Johannes H L M; Peeters, André J; Steup-Beekman, Gerda M; Lard, Leroy R; de Sonnaville, Peter B J; Grillet, Bernard A M; Huizinga, Tom W J; Allaart, Cornelia F

2018-01-01

To determine the 5-year outcomes of early remission induction therapy followed by targeted treatment aimed at drug-free remission (DFR) in patients with early arthritis. In 12 hospitals, 610 patients with early (<2 years) rheumatoid arthritis (RA) or undifferentiated arthritis (UA) started on methotrexate (MTX) 25 mg/week and prednisone (60 mg/day tapered to 7.5 mg/day). Patients not in early remission (Disease Activity Score <1.6 after 4 months) were randomised (single blind) to arm 1, adding hydroxychloroquine 400 mg/day and sulfasalazine 2000 mg/day, or arm 2, switching to MTX plus adalimumab 40 mg/2 weeks. Treatment adjustments over time aimed at DFR. Outcomes were remission percentages, functional ability, toxicity and radiological damage progression after 5 years. After 4 months, 387 patients were in early remission, 83 were randomised to arm 1 and 78 to arm 2. After 5 years, 295/610 (48%) patients were in remission, 26% in sustained DFR (SDFR) (≥1 year) (220/387 (57%) remission and 135/387 (35%) SDFR in the early remission group, 50% remission, 11% SDFR in the randomisation arms without differences between the arms). More patients with UA (37% vs 23% RA, p=0.001) and more anticitrullinated protein antibody (ACPA)-negative patients (37% vs 18% ACPA-positive, p<0.001) achieved SDFR.Overall, mean Health Assessment Questionnaire was 0.6 (0.5), and median (IQR) damage progression was 0.5 (0-2.7) Sharp/van der Heijde points, with only five patients showing progression >25 points in 5 years. Five years of DFR-steered treatment in patients with early RA resulted in almost normal functional ability without clinically relevant joint damage across treatment groups. Patients who achieved early remission had the best clinical outcomes. There were no differences between the randomisation arms. SDFR is a realistic treatment goal. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Arms Control Fellowship

NASA Astrophysics Data System (ADS)

The U.S. Arms Control and Disarmament Agency (ACDA) has announced that it is accepting applications for visiting scholars under the William C. Foster Fellows Program for 1986-1987. This program is designed to give specialists in the physical sciences and other disciplines relevant to ACDA activities an opportunity to participate actively in the arms control and disarmament activities of this agency and to give ACDA the perspective and expertise that such people can offer.

Patient-reported outcomes in a phase iii study of everolimus versus placebo in patients with metastatic carcinoma of the kidney that has progressed on vascular endothelial growth factor receptor tyrosine kinase inhibitor therapy.

PubMed

Beaumont, Jennifer L; Butt, Zeeshan; Baladi, Jeanfrancois; Motzer, Robert J; Haas, Tomas; Hollaender, Norbert; Kay, Andrea; Cella, David

2011-01-01

A phase III, randomized, double-blind, placebo-controlled trial was conducted in patients with metastatic renal cell carcinoma. The focus of this paper is to evaluate the patient-reported outcomes. Patients were randomly assigned (2:1) to receive oral everolimus 10 mg once daily or placebo. The Functional Assessment of Cancer Therapy Kidney Symptom Index-Disease-Related Symptoms (FKSI-DRS) and European Organization for the Research and Treatment of Cancer (EORTC) QLQ-C30 were administered before randomization and on day 1 of each cycle. The FKSI-DRS and the EORTC QLQ-C30 Physical Functioning and Global Quality of Life scores were the primary endpoints examined. Longitudinal models were used to compare treatment arms. Sensitivity analyses were conducted to explore the impact of missing data assumptions. Longitudinal trends for FKSI-DRS scores did not differ by treatment arm. Taking nonignorable missing data into account, there were significant differences between treatment arms in the trend over time for physical functioning and global quality of life, with the everolimus arm exhibiting greater decreases. All three of these measures of health-related quality of life were significantly related to progression-free survival. There was no evidence of a difference between everolimus and placebo in longitudinal patterns of disease-related symptoms, and little difference between the arms in physical functioning or global quality of life trends. This supports the conclusion that delay in tumor progression demonstrated by everolimus is associated with minimal impact on symptoms, physical functioning, or quality of life, as reported by patients.

Patient-Reported Outcomes in a Phase III Study of Everolimus Versus Placebo in Patients with Metastatic Carcinoma of the Kidney That Has Progressed on Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitor Therapy

PubMed Central

Butt, Zeeshan; Baladi, Jeanfrancois; Motzer, Robert J.; Haas, Tomas; Hollaender, Norbert; Kay, Andrea; Cella, David

2011-01-01

Purpose. A phase III, randomized, double-blind, placebo-controlled trial was conducted in patients with metastatic renal cell carcinoma. The focus of this paper is to evaluate the patient-reported outcomes. Methods. Patients were randomly assigned (2:1) to receive oral everolimus 10 mg once daily or placebo. The Functional Assessment of Cancer Therapy Kidney Symptom Index—Disease-Related Symptoms (FKSI-DRS) and European Organization for the Research and Treatment of Cancer (EORTC) QLQ-C30 were administered before randomization and on day 1 of each cycle. The FKSI-DRS and the EORTC QLQ-C30 Physical Functioning and Global Quality of Life scores were the primary endpoints examined. Longitudinal models were used to compare treatment arms. Sensitivity analyses were conducted to explore the impact of missing data assumptions. Results. Longitudinal trends for FKSI-DRS scores did not differ by treatment arm. Taking nonignorable missing data into account, there were significant differences between treatment arms in the trend over time for physical functioning and global quality of life, with the everolimus arm exhibiting greater decreases. All three of these measures of health-related quality of life were significantly related to progression-free survival. Conclusions. There was no evidence of a difference between everolimus and placebo in longitudinal patterns of disease-related symptoms, and little difference between the arms in physical functioning or global quality of life trends. This supports the conclusion that delay in tumor progression demonstrated by everolimus is associated with minimal impact on symptoms, physical functioning, or quality of life, as reported by patients. PMID:21459902

Phase III noninferiority trial comparing irinotecan with oxaliplatin, fluorouracil, and leucovorin in patients with advanced colorectal carcinoma previously treated with fluorouracil: N9841.

PubMed

Kim, George P; Sargent, Daniel J; Mahoney, Michelle R; Rowland, Kendrith M; Philip, Philip A; Mitchell, Edith; Mathews, Abraham P; Fitch, Tom R; Goldberg, Richard M; Alberts, Steven R; Pitot, Henry C

2009-06-10

The primary goal of this multicenter phase III trial was to determine whether overall survival (OS) of fluorouracil (FU) -refractory patients was noninferior when treated with second-line infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX4; arm B) versus irinotecan (arm A). Cross-over to the other treatment on disease progression was mandated. Patients who experienced treatment failure with one prior FU-based therapy and had not received prior irinotecan or oxaliplatin, either for metastatic disease or within 6 months of adjuvant FU therapy, were randomly assigned to arm A (irinotecan 350 or 300 mg/m(2) every 3 weeks) or arm B (FOLFOX4). A total of 491 patients were randomly assigned (arm A, n = 245; arm B, n = 246); 288 (59%) had experienced treatment failure with FU for metastatic colorectal cancer. Two hundred twenty-seven patients (46%) received protocol-mandated third-line therapy (arm A, 43%; arm B, 57%). Median survival was 13.8 months (95% CI, 12.2 to 15.0 months) for initial treatment with FOLFOX4 and 14.3 months (95% CI, 12.0 to 15.9 months) for irinotecan (P = .38; hazard ratio = 0.92; 95% CI, 0.8 to 1.1). Response rates (RR; 28% v 15.5%; P = .0009) and time to progression (TTP; 6.2 v 4.4 months; P = .0009) were significantly superior with FOLFOX4. In the nonrandom subset of patients who crossed over, RR and TTP improvements with FOLFOX4 continued into third-line treatment. Irinotecan therapy was associated with more grade 3 nausea, vomiting, diarrhea, and febrile neutropenia; FOLFOX4 was associated with more neutropenia and paresthesias. In patients who experienced treatment failure with front-line FU therapy, OS does not significantly differ whether second-line therapy begins with irinotecan or FOLFOX4. FOLFOX4 produces higher RR and longer TTP. Both arms had notable OS in patients who experienced treatment failure with first-line FU therapy.

The immunological and clinical effects of mutated ras peptide vaccine in combination with IL-2, GM-CSF, or both in patients with solid tumors.

PubMed

Rahma, Osama E; Hamilton, J Michael; Wojtowicz, Malgorzata; Dakheel, Omar; Bernstein, Sarah; Liewehr, David J; Steinberg, Seth M; Khleif, Samir N

2014-02-24

Mutant Ras oncogenes produce proteins that are unique to cancer cells and represent attractive targets for vaccine therapy. We have shown previously that vaccinating cancer patients with mutant ras peptides is feasible and capable of inducing a specific immune response against the relevant mutant proteins. Here, we tested the mutant ras peptide vaccine administered in combination with low dose interleukin-2 (IL-2) or/and granulocyte-macrophage colony-stimulating factor (GM-CSF) in order to enhance the vaccine immune response. 5000 μg of the corresponding mutant ras peptide was given subcutaneously (SQ) along with IL-2 (Arm A), GM-CSF (Arm B) or both (Arm C). IL-2 was given SQ at 6.0 million IU/m²/day starting at day 5, 5 days/week for 2 weeks. GM-CSF was given SQ in a dose of 100 μg/day one day prior to each ras peptide vaccination for 4 days. Vaccines were repeated every 5 weeks on arm A and C, and every 4 weeks on arm B, for a maximum of 15 cycles or until disease progression. We treated 53 advanced cancer patients (38 with colorectal, 11 with pancreatic, 1 with common bile duct and 3 with lung) on 3 different arms (16 on arm A, 18 on arm B, and 19 on arm C). The median progression free survival (PFS) and overall survival (OS) was 3.6 and 16.9 months, respectively, for all patients evaluable for clinical response (n = 48). There was no difference in PFS or OS between the three arms (P = 0.73 and 0.99, respectively). Most adverse events were grade 1-2 toxicities and resolved spontaneously. The vaccine induced an immune response to the relevant ras peptide in a total of 20 out of 37 evaluable patients (54%) by ELISPOT, proliferative assay, or both. While 92.3% of patients on arm B had a positive immune response, only 31% of patients on arm A and 36% of patients on arm C had positive immune responses (P = 0.003, Fisher's exact test). The reported data showed that IL-2 might have a negative effect on the specific immune response induced by the relevant mutant ras vaccine in patients with advanced cancer. This observation deserves further investigations. NCI97C0141.

Anthropometric evaluation of pediatric patients with nonprogressive chronic encephalopathy according to different methods of classification☆

PubMed Central

Teixeira, Jéssica Socas; Gomes, Mirian Martins

2014-01-01

Objective: To perform anthropometric assessment of patients with quadriplegic, chronic non-progressive encephalopathy, comparing two distinct references of nutritional classification and to compare the estimated height to the length measured by stadiometer. Method: Cross-sectional study including 0-3-year children with quadriplegic chronic non-progressive encephalopathy in secondary public hospital. Length, weight, arm circumference, triceps skinfold and knee height were measured. The arm muscle circumference and estimated height were calculated. The following relations were evaluated: weight-for-age, length-for-age and weight-for-length, using as reference the charts of the World Health Organization (WHO) and those proposed by Krick et al. Results: Fourteen children with a mean age of 21 months were evaluated. Assessment of anthropometric indicators showed significant difference between the two classification methods to assess nutritional indicators length/age (p=0.014), weight/age (p=0.014) and weight/length (p=0.001). There was significant correlation between measured length and estimated height (r=0.796, p=0.001). Evaluation of arm circumference and triceps skinfold showed that most patients presented some degree of malnutrition. According to arm muscle circumference, most were eutrophic. Conclusions: Specific curves for children with chronic non-progressive encephalopathy appear to underestimate malnutrition when one takes into account indicators involving weight. Curves developed for healthy children can be a good option for clinical practice and weight-for-length indicator and body composition measurements should be considered as complementary tools. PMID:25479849

Accuracy Analysis and Validation of the Mars Science Laboratory (MSL) Robotic Arm

NASA Technical Reports Server (NTRS)

Collins, Curtis L.; Robinson, Matthew L.

2013-01-01

The Mars Science Laboratory (MSL) Curiosity Rover is currently exploring the surface of Mars with a suite of tools and instruments mounted to the end of a five degree-of-freedom robotic arm. To verify and meet a set of end-to-end system level accuracy requirements, a detailed positioning uncertainty model of the arm was developed and exercised over the arm operational workspace. Error sources at each link in the arm kinematic chain were estimated and their effects propagated to the tool frames.A rigorous test and measurement program was developed and implemented to collect data to characterize and calibrate the kinematic and stiffness parameters of the arm. Numerous absolute and relative accuracy and repeatability requirements were validated with a combination of analysis and test data extrapolated to the Mars gravity and thermal environment. Initial results of arm accuracy and repeatability on Mars demonstrate the effectiveness of the modeling and test program as the rover continues to explore the foothills of Mount Sharp.

The Interface of Clinical Decision-Making With Study Protocols for Knowledge Translation From a Walking Recovery Trial.

PubMed

Hershberg, Julie A; Rose, Dorian K; Tilson, Julie K; Brutsch, Bettina; Correa, Anita; Gallichio, Joann; McLeod, Molly; Moore, Craig; Wu, Sam; Duncan, Pamela W; Behrman, Andrea L

2017-01-01

Despite efforts to translate knowledge into clinical practice, barriers often arise in adapting the strict protocols of a randomized, controlled trial (RCT) to the individual patient. The Locomotor Experience Applied Post-Stroke (LEAPS) RCT demonstrated equal effectiveness of 2 intervention protocols for walking recovery poststroke; both protocols were more effective than usual care physical therapy. The purpose of this article was to provide knowledge-translation tools to facilitate implementation of the LEAPS RCT protocols into clinical practice. Participants from 2 of the trial's intervention arms: (1) early Locomotor Training Program (LTP) and (2) Home Exercise Program (HEP) were chosen for case presentation. The two cases illustrate how the protocols are used in synergy with individual patient presentations and clinical expertise. Decision algorithms and guidelines for progression represent the interface between implementation of an RCT standardized intervention protocol and clinical decision-making. In each case, the participant presents with a distinct clinical challenge that the therapist addresses by integrating the participant's unique presentation with the therapist's expertise while maintaining fidelity to the LEAPS protocol. Both participants progressed through an increasingly challenging intervention despite their own unique presentation. Decision algorithms and exercise progression for the LTP and HEP protocols facilitate translation of the RCT protocol to the real world of clinical practice. The two case examples to facilitate translation of the LEAPS RCT into clinical practice by enhancing understanding of the protocols, their progression, and their application to individual participants.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A147).

Reachability Maps for In Situ Operations

NASA Technical Reports Server (NTRS)

Deen, Robert G.; Leger, Patrick C.; Robinson, Matthew L.; Bonitz, Robert G.

2013-01-01

This work covers two programs that accomplish the same goal: creation of a "reachability map" from stereo imagery that tells where operators of a robotic arm can reach or touch the surface, and with which instruments. The programs are "marsreach" (for MER) and "phxreach." These programs make use of the planetary image geometry (PIG) library. However, unlike the other programs, they are not multi-mission. Because of the complexity of arm kinematics, the programs are specific to each mission.

ARM Mentor Selection Process

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sisterson, D. L.

2015-10-01

The Atmospheric Radiation Measurement (ARM) Program was created in 1989 with funding from the U.S. Department of Energy (DOE) to develop several highly instrumented ground stations to study cloud formation processes and their influence on radiative transfer. In 2003, the ARM Program became a national scientific user facility, known as the ARM Climate Research Facility. This scientific infrastructure provides for fixed sites, mobile facilities, an aerial facility, and a data archive available for use by scientists worldwide through the ARM Climate Research Facility—a scientific user facility. The ARM Climate Research Facility currently operates more than 300 instrument systems that providemore » ground-based observations of the atmospheric column. To keep ARM at the forefront of climate observations, the ARM infrastructure depends heavily on instrument scientists and engineers, also known as lead mentors. Lead mentors must have an excellent understanding of in situ and remote-sensing instrumentation theory and operation and have comprehensive knowledge of critical scale-dependent atmospheric processes. They must also possess the technical and analytical skills to develop new data retrievals that provide innovative approaches for creating research-quality data sets. The ARM Climate Research Facility is seeking the best overall qualified candidate who can fulfill lead mentor requirements in a timely manner.« less

Effectiveness of a smart phone app on improving immunization of children in rural Sichuan Province, China: study protocol for a paired cluster randomized controlled trial

PubMed Central

2014-01-01

Background Although good progress has been achieved in expanding immunization of children in China, disparities exist across different provinces. Information gaps both from the service supply and demand sides hinder timely vaccination of children in rural areas. The rapid development of mobile health technology (mHealth) provides unprecedented opportunities for improving health services and reaching underserved populations. However, there is a lack of literature that rigorously evaluates the impact of mHealth interventions on immunization coverage as well as the usability and feasibility of smart phone applications (apps). This study aims to assess the effectiveness of a smart phone-based app (Expanded Program on Immunization app, or EPI app) on improving the coverage of children’s immunization. Methods/Design This cluster randomized trial will take place in Xuanhan County, Sichuan Province, China. Functionalities of the app include the following: to make appointments automatically, record and update children’s immunization information, generate a list of children who missed their vaccination appointments, and send health education information to village doctors. After pairing, 36 villages will be randomly allocated to the intervention arm (n = 18) and control arm (n = 18). The village doctors in the intervention arm will use the app while the village doctors in the control arm will record and manage immunization in the usual way in their catchment areas. A household survey will be used at baseline and at endline (8 months of implementation). The primary outcome is full-dose coverage and the secondary outcome is immunization coverage of the five vaccines that are included in the national Expanded Program on Immunization program as well as Hib vaccine, Rotavirus vaccine and Pneumococcal conjugate vaccine. Multidimensional evaluation of the app will also be conducted to assess usability and feasibility. Discussion This study is the first to evaluate the effectiveness of a smart phone app for child immunization in rural China. This study will contribute to the knowledge about the usability and feasibility of a smart phone app for managing immunization in rural China and to similar populations in different settings. Trial registration Chinese Clinical Trials Registry (ChiCTR): ChiCTR-TRC-13003960 PMID:24645829

[Effects of educational program of manual lymph massage on the arm functioning and the quality of life in breast cancer patients].

PubMed

Lee, Eun Sook; Kim, Sung Hyo; Kim, Sun Mi; Sun, Jeong Ju

2005-12-01

The purpose of this study was to determine the effect of EPMLM (educational program of manual lymph massage) on the arm functioning and QOL (quality of life) in breast cancer patients with lymphedema. Subjects in the experimental group (n=20) participated in EPMLM for 6 weeks from June to July, 2005. The EPMLM consisted of training of lymph massage for 2 weeks and encourage and support of self-care using lymph massage for 4 weeks. The arm functioning assessed at pre-treatment, 2 weeks, and 6 weeks using Arm functioning questionnaire. The QOL assessed at pre-treatment and 6 weeks using SF-36. The outcome data of experimental group was compared with control group (n=20). The collected data was analyzed by using SPSS 10.0 statistical program. The arm functioning of experimental group was increased from 2 weeks after (W=.224, p=.011) and statistically differenced with control group at 2 weeks (Z=-2.241, p=.024) and 6 weeks (Z=-2.453, p=.013). Physical function of QOL domain increased in experimental group (Z=-1.162, p=.050), also statistically differenced with control group (Z=-2.182, p= .030) at 6 weeks. The results suggest that the educational program of manual lymph massage can improve arm functioning and physical function of QOL domain in breast cancer patients with lymphedema.

The Effect of Integrating Family Planning with a Maternal and Newborn Health Program on Postpartum Contraceptive Use and Optimal Birth Spacing in Rural Bangladesh.

PubMed

Ahmed, Saifuddin; Ahmed, Salahuddin; McKaig, Catharine; Begum, Nazma; Mungia, Jaime; Norton, Maureen; Baqui, Abdullah H

2015-09-01

Meeting postpartum contraceptive need remains a major challenge in developing countries, where the majority of women deliver at home. Using a quasi-experimental trial design, we examine the effect of integrating family planning (FP) with a community-based maternal and newborn health (MNH) program on improving postpartum contraceptive use and reducing short birth intervals <24 months. In this two-arm trial, community health workers (CHWs) provided integrated FP counseling and services during home visits along with their outreach MNH activities in the intervention arm, but provided only MNH services in the control arm. The contraceptive prevalence rate (CPR) in the intervention arm was 15 percent higher than in the control arm at 12 months, and the difference in CPRs remained statistically significant throughout the 24 months of observation. The short birth interval of less than 24 months was significantly lower in the intervention arm. The study demonstrates that it is feasible and effective to integrate FP services into a community-based MNH care program for improving postpartum contraceptive use and lengthening birth intervals. © 2015 The Population Council, Inc.

Quantification of Upper Limb Motor Recovery and EEG Power Changes after Robot-Assisted Bilateral Arm Training in Chronic Stroke Patients: A Prospective Pilot Study

PubMed Central

Geroin, Christian; Bortolami, Marta; Saltuari, Leopold; Manganotti, Paolo

2018-01-01

Background Bilateral arm training (BAT) has shown promise in expediting progress toward upper limb recovery in chronic stroke patients, but its neural correlates are poorly understood. Objective To evaluate changes in upper limb function and EEG power after a robot-assisted BAT in chronic stroke patients. Methods In a within-subject design, seven right-handed chronic stroke patients with upper limb paresis received 21 sessions (3 days/week) of the robot-assisted BAT. The outcomes were changes in score on the upper limb section of the Fugl-Meyer assessment (FM), Motricity Index (MI), and Modified Ashworth Scale (MAS) evaluated at the baseline (T0), posttraining (T1), and 1-month follow-up (T2). Event-related desynchronization/synchronization were calculated in the upper alpha and the beta frequency ranges. Results Significant improvement in all outcomes was measured over the course of the study. Changes in FM were significant at T2, and in MAS at T1 and T2. After training, desynchronization on the ipsilesional sensorimotor areas increased during passive and active movement, as compared with T0. Conclusions A repetitive robotic-assisted BAT program may improve upper limb motor function and reduce spasticity in the chronically impaired paretic arm. Effects on spasticity were associated with EEG changes over the ipsilesional sensorimotor network. PMID:29780410

Two-Year Outcomes of a Randomized, Family-Based Substance Use Prevention Trial for Asian American Adolescent Girls

PubMed Central

Fang, Lin; Schinke, Steven P.

2014-01-01

Asian Americans have been largely ignored in the prevention outcome literature. In this study, we tested a parent-child program with a sample of Asian American adolescent girls and their mothers, and evaluated the program’s efficacy on decreasing girls’ substance use, and modifying risk and protective factors at individual, family, and peer levels. One hundred and eight Asian American mother-daughter dyads recruited through online advertisements and from community service agencies were randomly assigned to an intervention arm (n = 56) or to a test-only control arm (n = 52). The intervention consisted of a nine-session substance abuse prevention program, delivered entirely online. Guided by family interaction theory, the prevention program aimed to strengthen the quality of girls’ relationships with their mothers while increasing girls’ resilience to resist substance use. Intent-to-treat analyses showed that at 2-year follow-up, intervention-arm dyads had significantly higher levels of mother-daughter closeness, mother-daughter communication, maternal monitoring, and family rules against substance use compared to the control-arm dyads. Intervention-arm girls also showed sustained improvement in self-efficacy and refusal skills, and had lower intentions to use substances in the future. Most important, intervention-arm girls reported fewer instances of alcohol and marijuana use, and prescription drug misuse relative to the control-arm girls. The study suggests that a culturally generic, family-based prevention program was efficacious in enhancing parent-child relationships, improving girls’ resiliency, and preventing substance use behaviors among Asian American girls. PMID:23276322

Tool to assess contents of ARM surface meteorology network netCDF files

DOE Office of Scientific and Technical Information (OSTI.GOV)

Staudt, A.; Kwan, T.; Tichler, J.

The Atmospheric Radiation Measurement (ARM) Program, supported by the US Department of Energy, is a major program of atmospheric measurement and modeling designed to improve the understanding of processes and properties that affect atmospheric radiation, with a particular focus on the influence of clouds and the role of cloud radiative feedback in the climate system. The ARM Program will use three highly instrumented primary measurement sites. Deployment of instrumentation at the first site, located in the Southern Great Plains of the United States, began in May of 1992. The first phase of deployment at the second site in the Tropicalmore » Western Pacific is scheduled for late in 1995. The third site will be in the North Slope of Alaska and adjacent Arctic Ocean. To meet the scientific objectives of ARM, observations from the ARM sites are combined with data from other sources; these are called external data. Among these external data sets are surface meteorological observations from the Oklahoma Mesonet, a Kansas automated weather network, the Wind Profiler Demonstration Network (WPDN), and the National Weather Service (NWS) surface stations. Before combining these data with the Surface Meteorological Observations Station (SMOS) ARM data, it was necessary to assess the contents and quality of both the ARM and the external data sets. Since these data sets had previously been converted to netCDF format for use by the ARM Science Team, a tool was written to assess the contents of the netCDF files.« less

Site scientific mission plan for the Southern Great Plains CART site, January-June 1995

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schneider, J.M.; Lamb, P.J.; Sisterson, D.L.

1994-12-01

The Southern Great Plains (SGP) Cloud and Radiation Testbed (CART) site is designed to help satisfy the data needs of the Atmospheric Measurement (ARM) Program Science Team. This document defines the scientific priorities for site activities during the six months beginning on January 1, 1995, and also looks forward in lesser detail to subsequent six-month periods. The primary purpose of this Site Scientific Mission Plan is to provide guidance for the development of plans for site operations. It also provides information on current plans to the ARM functional teams (Management Team, Experiment Support Team [EST], Operations Team, Data Management Teammore » [DMT], Instrument Team [IT], and Campaign Team) and serves to disseminate the plans more generally within the ARM Program and among the members of the Science Team. This document includes a description of the operational status of the site and the primary envisaged site activities, together with information concerning approved and proposed Intensive Observation Periods (IOPs). Amendments will be prepared and distributed whenever the content changes by more than 30% within a six-month period. The primary users of this document are the site operator, the site scientist, the Science Team through the ARM Program Science Director, The ARM Program Experiment Center, and the aforementioned ARM Program functional teams. This plan is a living document that will be updated and reissued every six months as the observational facilities are developed, tested, and augmented and as priorities are adjusted in response to developments in scientific planning and understanding.« less

Navy DDG-1000 and DDG-51 Destroyer Programs: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2008-09-11

July 31, 2008, hearing before the Seapower and Expeditionary Forces subcommittee of the House Armed Services Committee, Navy officials announced a major...Aegis combat system and the arming of the ship with the SM-3, a version of the Navy’s Standard Missile that is designed for BMD operations.7 The Navy has...the Navy (Ship Programs), before the Subcommittee on Seapower and Expeditionary Forces of the House Armed Services Committee, on Surface Combatant

Navy DDG-1000 and DDG-51 Destroyer Programs: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2008-10-09

of the House Armed Services Committee, Navy officials announced a major change in the service’s position on what kind of destroyers it wants to...among other things, the addition of a new software program for the Aegis combat system and the arming of the ship with the SM-3, a version of the...Expeditionary Forces of the House Armed Services Committee, on Surface Combatant Requirements and Acquisition Strategies, July 31, 2008, 11 pp., and the spoken

Report on the Assessment of Arms, Ammunition, and Explosives Accountability and Control; Security Assistance; and Logistics Sustainment for the Iraq Security Forces

DTIC Science & Technology

2008-12-19

Undistributed ISFF-Funded Equipment 105 17. Iraqi Army Maintenance Program 107 18. Class IX Material Management 115 Part V – Medical Sustainability 123...database and are subsequently forwarded to the Army Material Command, Logistics Support Activity for inclusion in the DoD Small Arms and Light Weapons...be forwarded to the Army Material Command, Logistics Support Activity for inclusion in the DoD Small Arms and Light Weapons Serialization Program

Enzalutamide in Men with Chemotherapy-naïve Metastatic Castration-resistant Prostate Cancer: Extended Analysis of the Phase 3 PREVAIL Study

PubMed Central

Beer, Tomasz M.; Armstrong, Andrew J.; Rathkopf, Dana; Loriot, Yohann; Sternberg, Cora N.; Higano, Celestia S.; Iversen, Peter; Evans, Christopher P.; Kim, Choung-Soo; Kimura, Go; Miller, Kurt; Saad, Fred; Bjartell, Anders S.; Borre, Michael; Mulders, Peter; Tammela, Teuvo L.; Parli, Teresa; Sari, Suha; van Os, Steve; Theeuwes, Ad; Tombal, Bertrand

2017-01-01

Enzalutamide significantly improved radiographic progression-free survival (rPFS) and overall survival (OS) among men with chemotherapy-naïve metastatic castration-resistant prostate cancer at the prespecified interim analysis of PREVAIL, a phase 3, double-blind, randomized study. We evaluated the longer-term efficacy and safety of enzalutamide up to the prespecified number of deaths in the final analysis, which included an additional 20 mo of follow-up for investigator-assessed rPFS, 9 mo of follow-up for OS, and 4 mo of follow-up for safety. Enzalutamide reduced the risk of radiographic progression or death by 68% (hazard ratio [HR] 0.32, 95% confidence interval [CI] 0.28–0.37; p < 0.0001) and the risk of death by 23% (HR 0.77, 95% CI 0.67–0.88; p = 0.0002). Median investigator-assessed rPFS was 20.0 mo (95% CI 18.9–22.1) in the enzalutamide arm and 5.4 mo (95% CI 4.1–5.6) in the placebo arm. Median OS was 35.3 mo (95% CI 32.2–not yet reached) in the enzalutamide arm and 31.3 mo (95% CI 28.8–34.2) in the placebo arm. At the time of the OS analysis, 167 patients in the placebo arm had crossed over to receive enzalutamide. The most common adverse events in the enzalutamide arm were fatigue, back pain, constipation, and arthralgia. This final analysis of PREVAIL provides more complete assessment of the clinical benefit of enzalutamide. PMID:27477525

Stress Management and Resiliency Training (SMART) program among Department of Radiology faculty: a pilot randomized clinical trial.

PubMed

Sood, Amit; Sharma, Varun; Schroeder, Darrell R; Gorman, Brian

2014-01-01

To test the efficacy of a Stress Management and Resiliency Training (SMART) program for decreasing stress and anxiety and improving resilience and quality of life among Department of Radiology physicians. The study was approved by the institutional review board. A total of 26 Department of Radiology physicians were randomized in a single-blind trial to either the SMART program or a wait-list control arm for 12 weeks. The program involved a single 90-min group session in the SMART training with two follow-up phone calls. Primary outcomes measured at baseline and week 12 included the Perceived Stress Scale, Linear Analog Self-Assessment Scale, Mindful Attention Awareness Scale, and Connor-Davidson Resilience Scale. A total of 22 physicians completed the study. A statistically significant improvement in perceived stress, anxiety, quality of life, and mindfulness at 12 weeks was observed in the study arm compared to the wait-list control arm; resilience also improved in the active arm, but the changes were not statistically significant when compared to the control arm. A single session to decrease stress among radiologists using the SMART program is feasible. Furthermore, the intervention afforded statistically significant and clinically meaningful improvement in anxiety, stress, quality of life, and mindful attention. Further studies including larger sample size and longer follow-up are warranted. Copyright © 2014. Published by Elsevier Inc.

How do octopuses use their arms?

PubMed

Mather, J A

1998-09-01

A taxonomy of the movement patterns of the 8 flexible arms of octopuses is constructed. Components consist of movements of the arm itself, the ventral suckers and their stalks, as well as the relative position of arms and the skin web between them. Within 1 arm, combinations of components result in a variety of behaviors. At the level of all arms, 1 group of behaviors is described as postures, on the basis of the spread of all arms and the web to make a 2-dimensional surface whose position differs in the 3rd dimension. Another group of arm behaviors is actions, more or less coordinated and involving several to all arms. Arm control appears to be based on radial symmetry, relative equipotentiality of all arms, relative independence of each arm, and separability of components within the arm. The types and coordination of arm behaviors are discussed with relationship to biomechanical limits, muscle structures, and neuronal programming.

Applying economic incentives to increase effectiveness of an outpatient weight loss program (TRIO) - A randomized controlled trial.

PubMed

Finkelstein, Eric A; Tham, Kwang-Wei; Haaland, Benjamin A; Sahasranaman, Aarti

2017-07-01

The prevalence of overweight and obesity has more than doubled in the past three decades, leading to rising rates of non-communicable diseases. This study tests whether adding a payment/rewards (term reward) program to an existing evidence-based weight loss program can increase weight loss and weight loss maintenance. We conducted a parallel-group randomized controlled trial from October 2012 to October 2015 with 161 overweight or obese individuals randomized to either control or reward arm in a 1:2 ratio. Control and reward arm participants received a four month weight loss program at the LIFE (Lifestyle Improvement and Fitness Enhancement) Centre at Singapore General Hospital. Those in the reward arm paid a fee of S$165.00 (1US$ = 1.35S$) to access a program that provided rewards of up to S$660 for meeting weight loss and physical activity goals. Participants could choose to receive rewards as guaranteed cash payments or a lottery ticket with a 1 in 10 chance of winning but with the same expected value. The primary outcome was weight loss at months 4, 8, and 12. 161 participants were randomized to control (n = 54) or reward (n = 107) arms. Average weight loss was more than twice as great in the reward arm compared to the control arm at month 4 when the program concluded (3.4 kg vs 1.4 kg, p < 0.01), month 8 when rewards concluded (3.3 kg vs 1.8 kg, p < 0.05), and at month 12 (2.3 kg vs 0.8 kg, p < 0.05). These results reveal that a payment/rewards program can be used to improve weight loss and weight loss maintenance when combined with an evidence-based weight loss program. Future efforts should attempt to replicate this approach and identify how to cost effectively expand these programs to maximize their reach. This study is registered at www.clinicaltrials.gov (Identifier: NCT01533454). Copyright © 2017 Elsevier Ltd. All rights reserved.

Activity and Safety of Cetuximab Plus Modified FOLFOXIRI Followed by Maintenance With Cetuximab or Bevacizumab for RAS and BRAF Wild-type Metastatic Colorectal Cancer: A Randomized Phase 2 Clinical Trial.

PubMed

Cremolini, Chiara; Antoniotti, Carlotta; Lonardi, Sara; Aprile, Giuseppe; Bergamo, Francesca; Masi, Gianluca; Grande, Roberta; Tonini, Giuseppe; Mescoli, Claudia; Cardellino, Giovanni Gerardo; Coltelli, Luigi; Salvatore, Lisa; Corsi, Domenico Cristiano; Lupi, Cristiana; Gemma, Donatello; Ronzoni, Monica; Dell'Aquila, Emanuela; Marmorino, Federica; Di Fabio, Francesca; Mancini, Maria Laura; Marcucci, Lorenzo; Fontanini, Gabriella; Zagonel, Vittorina; Boni, Luca; Falcone, Alfredo

2018-04-01

The combination of a triple-drug chemotherapy regimen with an anti-epidermal growth factor receptor (EGFR) agent as a first-line treatment of metastatic colorectal cancer (mCRC) showed promising activity along with safety concerns in single-arm phase 2 trials. The role of maintenance following chemotherapy and anti-EGFR and the optimal regimen to be adopted are not established. To evaluate the activity and safety of cetuximab plus modified FOLFOXIRI (mFOLFOXIRI) and explore the role of maintenance with cetuximab or bevacizumab in RAS and BRAF wild-type mCRC. In a prospective, noncomparative, open-label, multicenter, randomized phase 2 trial, patients aged 18 to 75 years with unresectable, previously untreated RAS and BRAF wild-type (before amendment, KRAS wild-type) mCRC were recruited from 21 oncology units in Italy from October 19, 2011, to March 1, 2015 (followed up through May 31, 2017). In total, 323 patients were screened and 143 were randomized to 2 treatment arms to receive as a first-line induction a regimen of mFOLFOXIRI plus cetuximab followed by cetuximab (arm A) or bevacizumab (arm B) until disease progression. Primary analyses were conducted in a modified intention-to-treat population. mFOLFOXIRI plus cetuximab repeated every 2 weeks for up to 8 cycles, followed by maintenance with cetuximab or bevacizumab until disease progression. The primary end point was the 10-month progression-free rate (PFR); secondary end points included progression-free and overall survival, response rate, rate of metastases resection, and adverse events. Of 143 patients randomized, 116 (81.1%) (median [interquartile range (IQR)] age, 59.5 [53-67] years; 34 [29.3%] women) had RAS and BRAF wild-type mCRC. At a median (IQR) follow-up of 44.0 (30.5-52.1) months, 10-month PFRs were 50.8% (90% CI, 39.5%-62.2%) in arm A and 40.4% (90% CI, 29.4%-52.1%) in arm B. The overall response rate was 71.6% (95% CI, 62.4%-79.5%). Main grade 3/4 adverse events were neutropenia (occurring in 36 patients [31%]), diarrhea (in 21 patients [18%]), skin toxic effects (in 18 patients [16%]), asthenia (in 11 patients [9%]), stomatitis (in 7 patients [6%]), and febrile neutropenia (in 3 patients [3%]). Although neither of the 2 arms met the primary end point, the findings indicate that a 4-month induction regimen of mFOLFOXIRI plus cetuximab is feasible and provides relevant activity results, leading to a high surgical resection rate. clinicaltrials.gov Identifier: NCT02295930.

75 FR 4051 - Defense Health Board; DoD Task Force on the Prevention of Suicide by Members of the Armed Forces...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-26

... Prevention of Suicide by Members of the Armed Forces; Meeting AGENCY: Department of Defense (DoD). ACTION... of Suicide by Members of the Armed Forces (hereafter, Task Force) will meet on February 11, 2010, to gather information pertaining to suicide and suicide prevention programs for members of the Armed...

JPRS Report, East Europe

DTIC Science & Technology

1988-12-14

situation in the world healthier, particularly for the program to liquidate nuclear arms and other types of weapons of mass destruction. During the...make preparations for extensive discussions with the aim of radically reducing tactical nuclear weapons, armed forces, and conventional weap- ons...liquidat- ing two classes of nuclear arms as a historic step which will create preconditions for limiting the feverish arms race and for better

The effects of progressive lateralization of the joint center of rotation of reverse total shoulder implants.

PubMed

Costantini, Oren; Choi, Daniel S; Kontaxis, Andreas; Gulotta, Lawrence V

2015-07-01

There has been a renewed interest in lateralizing the center of rotation (CoR) in implants used in reverse shoulder arthroplasty. The aim of this study was to determine the sensitivity of lateralization of the CoR on the glenohumeral joint contact forces, muscle moment arms, torque across the bone-implant interface, and the stability of the implant. A 3-dimensional virtual model was used to investigate how lateralization affects deltoid muscle moment arm and glenohumeral joint contact forces. This model was virtually implanted with 5 progressively lateralized reverse shoulder prostheses. The joint contact loads and deltoid moment arms were calculated for each lateralization over the course of 3 simulated standard humerothoracic motions. Lateralization of the CoR leads to an increase in the overall joint contact forces across the glenosphere. Most of this increased loading occurred through compression, although increases in anterior/posterior and superior/inferior shear were also observed. Moment arms of the deltoid consistently decreased with lateralization. Bending moments at the implant interface increased with lateralization. Progressive lateralization resulted in improved stability ratios. Lateralization results in increased joint loading. Most of that loading occurs through compression, although there were also increases in shear forces. Anterior/posterior shear is currently not accounted for in implant fixation studies, leaving its effect on implant fixation unknown. Future studies should incorporate shear forces into their models to more accurately assess fixation methods. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

High Spectral Resolution Infrared and Raman Lidar Observations for the ARM Program: Clear and Cloudy Sky Applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Revercomb, Henry; Tobin, David; Knuteson, Robert

2009-06-17

This grant began with the development of the Atmospheric Emitted Radiance Interferometer (AERI) for ARM. The AERI has provided highly accurate and reliable observations of downwelling spectral radiance (Knuteson et al. 2004a, 2004b) for application to radiative transfer, remote sensing of boundary layer temperature and water vapor, and cloud characterization. One of the major contributions of the ARM program has been its success in improving radiation calculation capabilities for models and remote sensing that evolved from the multi-year, clear-sky spectral radiance comparisons between AERI radiances and line-by-line calculations (Turner et al. 2004). This effort also spurred us to play amore » central role in improving the accuracy of water vapor measurements, again helping ARM lead the way in the community (Turner et al. 2003a, Revercomb et al. 2003). In order to add high-altitude downlooking AERI-like observations over the ARM sites, we began the development of an airborne AERI instrument that has become known as the Scanning High-resolution Interferometer Sounder (Scanning-HIS). This instrument has become an integral part of the ARM Unmanned Aerospace Vehicle (ARM-UAV) program. It provides both a cross-track mapping view of the earth and an uplooking view from the 12-15 km altitude of the Scaled Composites Proteus aircraft when flown over the ARM sites for IOPs. It has successfully participated in the first two legs of the “grand tour” of the ARM sites (SGP and NSA), resulting in a very good comparison with AIRS observations in 2002 and in an especially interesting data set from the arctic during the Mixed-Phase Cloud Experiment (M-PACE) in 2004.« less

Dual-Arm Generalized Compliant Motion With Shared Control

NASA Technical Reports Server (NTRS)

Backes, Paul G.

1994-01-01

Dual-Arm Generalized Compliant Motion (DAGCM) primitive computer program implementing improved unified control scheme for two manipulator arms cooperating in task in which both grasp same object. Provides capabilities for autonomous, teleoperation, and shared control of two robot arms. Unifies cooperative dual-arm control with multi-sensor-based task control and makes complete task-control capability available to higher-level task-planning computer system via large set of input parameters used to describe desired force and position trajectories followed by manipulator arms. Some concepts discussed in "A Generalized-Compliant-Motion Primitive" (NPO-18134).

Ten-Year Progression-Free and Overall Survival in Patients With Unresectable or Metastatic GI Stromal Tumors: Long-Term Analysis of the European Organisation for Research and Treatment of Cancer, Italian Sarcoma Group, and Australasian Gastrointestinal Trials Group Intergroup Phase III Randomized Trial on Imatinib at Two Dose Levels.

PubMed

Casali, Paolo G; Zalcberg, John; Le Cesne, Axel; Reichardt, Peter; Blay, Jean-Yves; Lindner, Lars H; Judson, Ian R; Schöffski, Patrick; Leyvraz, Serge; Italiano, Antoine; Grünwald, Viktor; Pousa, Antonio Lopez; Kotasek, Dusan; Sleijfer, Stefan; Kerst, Jan M; Rutkowski, Piotr; Fumagalli, Elena; Hogendoorn, Pancras; Litière, Saskia; Marreaud, Sandrine; van der Graaf, Winette; Gronchi, Alessandro; Verweij, Jaap

2017-05-20

Purpose To report on the long-term results of a randomized trial comparing a standard dose (400 mg/d) versus a higher dose (800 mg/d) of imatinib in patients with metastatic or locally advanced GI stromal tumors (GISTs). Patients and Methods Eligible patients with advanced CD117-positive GIST from 56 institutions in 13 countries were randomly assigned to receive either imatinib 400 mg or 800 mg daily. Patients on the 400-mg arm were allowed to cross over to 800 mg upon progression. Results Between February 2001 and February 2002, 946 patients were accrued. Median age was 60 years (range, 18 to 91 years). Median follow-up time was 10.9 years. Median progression-free survival times were 1.7 and 2.0 years in the 400- and 800-mg arms, respectively (hazard ratio, 0.91; P = .18), and median overall survival time was 3.9 years in both treatment arms. The estimated 10-year progression-free survival rates were 9.5% and 9.2% for the 400- and 800-mg arms, respectively, and the estimated 10-year overall survival rates were 19.4% and 21.5%, respectively. At multivariable analysis, age (< 60 years), performance status (0 v ≥ 1), size of the largest lesion (smaller), and KIT mutation (exon 11) were significant prognostic factors for the probability of surviving beyond 10 years. Conclusion This trial was carried out on a worldwide intergroup basis, at the beginning of the learning curve of the use of imatinib, in a large population of patients with advanced GIST. With a long follow-up, 6% of patients are long-term progression free and 13% are survivors. Among clinical prognostic factors, only performance status, KIT mutation, and size of largest lesion predicted long-term outcome, likely pointing to a lower burden of disease. Genomic and/or immune profiling could help understand long-term survivorship. Addressing secondary resistance remains a therapeutic challenge.

Gender norms, poverty and armed conflict in Côte D’Ivoire: engaging men in women’s social and economic empowerment programming

PubMed Central

Falb, K. L.; Annan, J.; King, E.; Hopkins, J.; Kpebo, D.; Gupta, J.

2014-01-01

Engaging men is a critical component in efforts to reduce intimate partner violence (IPV). Little is known regarding men’s perspectives of approaches that challenge inequitable gender norms, particularly in settings impacted by armed conflict. This article describes men’s experiences with a women’s empowerment program and highlights men’s perceptions of gender norms, poverty and armed conflict, as they relate to achieving programmatic goals. Data are from 32 Ivorian men who participated in indepth interviews in 2012. Interviews were undertaken as part of an intervention that combined gender dialogue groups for both women and their male partners with women’s only village savings and loans programs to reduce IPV against women. Findings suggested that in the context of armed conflict, traditional gender norms and economic stressors experienced by men challenged fulfillment of gender roles and threatened men’s sense of masculinity. Men who participated in gender dialogue groups discussed their acceptance of programming and identified improvements in their relationships with their female partners. These men further discussed increased financial planning along with their partners, and attributed such increases to the intervention. Addressing men’s perceptions of masculinity, poverty and armed conflict may be key components to reduce men’s violence against women in conflict-affected settings. PMID:25274720

Informatics in radiology: use of a C-arm fluoroscopy simulator to support training in intraoperative radiography.

PubMed

Bott, Oliver Johannes; Dresing, Klaus; Wagner, Markus; Raab, Björn-Werner; Teistler, Michael

2011-01-01

Mobile image intensifier systems (C-arms) are used frequently in orthopedic and reconstructive surgery, especially in trauma and emergency settings, but image quality and radiation exposure levels may vary widely, depending on the extent of the C-arm operator's knowledge and experience. Current training programs consist mainly of theoretical instruction in C-arm operation, the physical foundations of radiography, and radiation avoidance, and are largely lacking in hands-on application. A computer-based simulation program such as that tested by the authors may be one way to improve the effectiveness of C-arm training. In computer simulations of various scenarios commonly encountered in the operating room, trainees using the virtX program interact with three-dimensional models to test their knowledge base and improve their skill levels. Radiographs showing the simulated patient anatomy and surgical implants are "reconstructed" from data computed on the basis of the trainee's positioning of models of a C-arm, patient, and table, and are displayed in real time on the desktop monitor. Trainee performance is signaled in real time by color graphics in several control panels and, on completion of the exercise, is compared in detail with the performance of an expert operator. Testing of this computer-based training program in continuing medical education courses for operating room personnel showed an improvement in the overall understanding of underlying principles of intraoperative radiography performed with a C-arm, with resultant higher image quality, lower overall radiation exposure, and greater time efficiency. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.313105125/-/DC1. Copyright © RSNA, 2011.

Layers of Experience Using "Arms"

ERIC Educational Resources Information Center

Brown, Laurinda; Coles, Alf; Ball, Derek; Morton, Pat; Coles, Matt; Ordman, Louise; Orr, Barry; Lam, Tung Ken

2008-01-01

This article presents the authors' personal accounts and their experiences in working on mathematics using "arms." "Arms" is an idea that first appeared as a program written by John Warwick and David Wooldridge in an ATM publication "Some Lessons in Mathematics with a Microcomputer," 1983. The introduction to…

AMF3 ARM's Research Facility and MAOS at Oliktok Point Alaska

NASA Astrophysics Data System (ADS)

Helsel, F.; Ivey, M.; Dexheimer, D.; Hardesty, J.; Lucero, D. A.; Roesler, E. L.

2016-12-01

Scientific Infrastructure To Support Atmospheric Science And Aerosol Science For The Department Of Energy's Atmospheric Radiation Measurement Programs Mobile Facility 3 Located At Oliktok Point, Alaska.The Atmospheric Radiation Measurement (ARM) Program's Mobile Facility 3 (AMF3) located at Oliktok Point, Alaska is a U.S. Department of Energy (DOE) site designed to collect data to determine the impact that clouds and aerosols have on solar radiation. The site provides a scientific infrastructure and data archives for the international Arctic research community. The infrastructure at Oliktok is designed to be mobile and it may be relocated in the future to support other ARM science missions. AMF3's present instruments include: scanning precipitation Radar-cloud radar, Raman Lidar, Eddy correlation flux systems, Ceilometer, Balloon sounding system, Atmospheric Emitted Radiance Interferometer (AERI), Micro-pulse Lidar (MPL), Millimeter cloud radar along with all the standard metrological measurements. A Mobile Aerosol Observing System (MAOS) has been added to AMF3 in 2016 more details of the instrumentation at www.arm.gov/sites/amf/mobile-aos. Data from these instruments are placed in the ARM data archives and are available to the international research community. This poster will discuss what instruments are at the ARM Program's AMF3 and highlight the newest addition to AMF3, the Mobile Aerosol Observing System (MAOS).

Ribociclib plus letrozole versus letrozole alone in patients with de novo HR+, HER2- advanced breast cancer in the randomized MONALEESA-2 trial.

PubMed

O'Shaughnessy, Joyce; Petrakova, Katarina; Sonke, Gabe S; Conte, Pierfranco; Arteaga, Carlos L; Cameron, David A; Hart, Lowell L; Villanueva, Cristian; Jakobsen, Erik; Beck, Joseph T; Lindquist, Deborah; Souami, Farida; Mondal, Shoubhik; Germa, Caroline; Hortobagyi, Gabriel N

2018-02-01

Determine the efficacy and safety of first-line ribociclib plus letrozole in patients with de novo advanced breast cancer. Postmenopausal women with HR+ , HER2- advanced breast cancer and no prior systemic therapy for advanced disease were enrolled in the Phase III MONALEESA-2 trial (NCT01958021). Patients were randomized to ribociclib (600 mg/day; 3 weeks-on/1 week-off) plus letrozole (2.5 mg/day; continuous) or placebo plus letrozole until disease progression, unacceptable toxicity, death, or treatment discontinuation. The primary endpoint was investigator-assessed progression-free survival; predefined subgroup analysis evaluated progression-free survival in patients with de novo advanced breast cancer. Secondary endpoints included safety and overall response rate. Six hundred and sixty-eight patients were enrolled, of whom 227 patients (34%; ribociclib plus letrozole vs placebo plus letrozole arm: n = 114 vs. n = 113) presented with de novo advanced breast cancer. Median progression-free survival was not reached in the ribociclib plus letrozole arm versus 16.4 months in the placebo plus letrozole arm in patients with de novo advanced breast cancer (hazard ratio 0.45, 95% confidence interval 0.27-0.75). The most common Grade 3/4 adverse events were neutropenia and leukopenia; incidence rates were similar to those observed in the full MONALEESA-2 population. Ribociclib dose interruptions and reductions in patients with de novo disease occurred at similar frequencies to the overall study population. Ribociclib plus letrozole improved progression-free survival vs placebo plus letrozole and was well tolerated in postmenopausal women with HR+, HER2- de novo advanced breast cancer.

A Randomized Controlled Trial to Evaluate if Computerized Cognitive Rehabilitation Improves Neurocognition in Ugandan Children with HIV

PubMed Central

Nakasujja, Noeline; Sikorskii, Alla; Opoka, Robert O.; Giordani, Bruno

2016-01-01

Abstract Objectives: Clinically stable children with HIV can have neuromotor, attention, memory, visual–spatial, and executive function impairments. We evaluated neuropsychological and behavioral benefits of computerized cognitive rehabilitation training (CCRT) in Ugandan HIV children. Design: One hundred fifty-nine rural Ugandan children with WHO Stage I or II HIV disease (6 to 12 years; 77 boys, 82 girls; M = 8.9, SD = 1.86 years) were randomized to one of three treatment arms over a 2-month period. Methods: The CCRT arm received 24 one-hour sessions over 2 months, using Captain's Log (BrainTrain Corporation) programmed for games targeting working memory, attention, and visual–spatial analysis. These games progressed in difficulty as the child's performance improved. The second arm was a “limited CCRT” with the same games rotated randomly from simple to moderate levels of training. The third arm was a passive control group receiving no training. All children were assessed at enrollment, 2 months (immediately following CCRT), and 3 months after CCRT completion. Results: The CCRT group had significantly greater gains through 3 months of follow-up compared to passive controls on overall Kaufman Assessment Battery for Children–second edition (KABC-II) mental processing index (p < .01), planning (p = .04), and knowledge (p = .03). The limited CCRT group performed better than controls on learning (p = .05). Both CCRT arms had significant improvements on CogState Groton maze learning (p < .01); although not on CogState attention/memory, TOVA/impulsivity, or behavior rating inventory for executive function and child behavior checklist (psychiatric behavior/symptom problems) ratings by caregiver. Conclusions: CCRT intervention can be effective for neurocognitive rehabilitation in children with HIV in low-resource settings, especially in children who are clinically stable on ARV treatment. PMID:27045714

Phase III Noninferiority Trial Comparing Irinotecan With Oxaliplatin, Fluorouracil, and Leucovorin in Patients With Advanced Colorectal Carcinoma Previously Treated With Fluorouracil: N9841

PubMed Central

Kim, George P.; Sargent, Daniel J.; Mahoney, Michelle R.; Rowland, Kendrith M.; Philip, Philip A.; Mitchell, Edith; Mathews, Abraham P.; Fitch, Tom R.; Goldberg, Richard M.; Alberts, Steven R.; Pitot, Henry C.

2009-01-01

Purpose The primary goal of this multicenter phase III trial was to determine whether overall survival (OS) of fluorouracil (FU) -refractory patients was noninferior when treated with second-line infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX4; arm B) versus irinotecan (arm A). Cross-over to the other treatment on disease progression was mandated. Patients and Methods Patients who experienced treatment failure with one prior FU-based therapy and had not received prior irinotecan or oxaliplatin, either for metastatic disease or within 6 months of adjuvant FU therapy, were randomly assigned to arm A (irinotecan 350 or 300 mg/m2 every 3 weeks) or arm B (FOLFOX4). Results A total of 491 patients were randomly assigned (arm A, n = 245; arm B, n = 246); 288 (59%) had experienced treatment failure with FU for metastatic colorectal cancer. Two hundred twenty-seven patients (46%) received protocol-mandated third-line therapy (arm A, 43%; arm B, 57%). Median survival was 13.8 months (95% CI, 12.2 to 15.0 months) for initial treatment with FOLFOX4 and 14.3 months (95% CI, 12.0 to 15.9 months) for irinotecan (P = .38; hazard ratio = 0.92; 95% CI, 0.8 to 1.1). Response rates (RR; 28% v 15.5%; P = .0009) and time to progression (TTP; 6.2 v 4.4 months; P = .0009) were significantly superior with FOLFOX4. In the nonrandom subset of patients who crossed over, RR and TTP improvements with FOLFOX4 continued into third-line treatment. Irinotecan therapy was associated with more grade 3 nausea, vomiting, diarrhea, and febrile neutropenia; FOLFOX4 was associated with more neutropenia and paresthesias. Conclusion In patients who experienced treatment failure with front-line FU therapy, OS does not significantly differ whether second-line therapy begins with irinotecan or FOLFOX4. FOLFOX4 produces higher RR and longer TTP. Both arms had notable OS in patients who experienced treatment failure with first-line FU therapy. PMID:19380443

Is the progression free survival advantage of concurrent gemcitabine plus cisplatin and radiation followed by adjuvant gemcitabine and cisplatin in patients with advanced cervical cancer worth the additional cost? A cost-effectiveness analysis.

PubMed

Smith, B; Cohn, D E; Clements, A; Tierney, B J; Straughn, J M

2013-09-01

The objective of this study is to determine whether concurrent and adjuvant chemoradiation with gemcitabine/cisplatin is cost-effective in patients with stage IIB to IVA cervical cancer. A cost-effectiveness model compared two arms of the trial performed by Duenas-Gonzalez et al. [1]: concurrent and adjuvant chemoradiation with gemcitabine/cisplatin (RT/GC+GC) versus concurrent radiation with cisplatin (RT/C). Major adverse events (AEs) and progression free survival (PFS) rates of each arm were incorporated in the model. AEs were defined as any hospitalization including grade 4 anemia, grade 4 neutropenia, and death. Medicare data and literature review were used to estimate costs. Incremental cost-effectiveness ratios (ICERs) per progression-free life-year saved (PF-LYS) were calculated. Sensitivity analyses were performed for pertinent uncertainties. For 10,000 women with locally advanced cervical cancer, the cost of therapy and AEs was $173.9 million (M) for RT/C versus $259.8M for RT/GC+GC. There were 879 additional 3-year progression-free survivors in the RT/GC+GC arm. The ICER for RT/GC+GC was $97,799 per PF-LYS. When the rate of hospitalization was equalized to 4.3%, the ICER for RT/GC+GC exceeded $80,000. The resultant ICER when increasing PFS in the RT/GC+GC arm by 5% was $62,605 per PF-LYS. When the cost of chemotherapy was decreased by 50%, the ICER was below $50,000 at $41,774 per PF-LYS. Radiation and gemcitabine/cisplatin for patients with stage IIB to IVA cervical cancer are not cost-effective. The increased financial burden of radiation with gemcitabine/cisplatin and associated toxicities appears to outweigh the benefit of increased 3-year PFS and is primarily dependent on chemotherapy drug costs. Copyright © 2013 Elsevier Inc. All rights reserved.

Pattern of spread and prognosis in lower limb-onset ALS

PubMed Central

TURNER, MARTIN R.; BROCKINGTON, ALICE; SCABER, JAKUB; HOLLINGER, HANNAH; MARSDEN, RACHAEL; SHAW, PAMELA J.; TALBOT, KEVIN

2011-01-01

Our objective was to establish the pattern of spread in lower limb-onset ALS (contra- versus ipsi-lateral) and its contribution to prognosis within a multivariate model. Pattern of spread was established in 109 sporadic ALS patients with lower limb-onset, prospectively recorded in Oxford and Sheffield tertiary clinics from 2001 to 2008. Survival analysis was by univariate Kaplan-Meier log-rank and multivariate Cox proportional hazards. Variables studied were time to next limb progression, site of next progression, age at symptom onset, gender, diagnostic latency and use of riluzole. Initial progression was either to the contralateral leg (76%) or ipsilateral arm (24%). Factors independently affecting survival were time to next limb progression, age at symptom onset, and diagnostic latency. Time to progression as a prognostic factor was independent of initial direction of spread. In a regression analysis of the deceased, overall survival from symptom onset approximated to two years plus the time interval for initial spread. In conclusion, rate of progression in lower limb-onset ALS is not influenced by whether initial spread is to the contralateral limb or ipsilateral arm. The time interval to this initial spread is a powerful factor in predicting overall survival, and could be used to facilitate decision-making and effective care planning. PMID:20001488

A randomized phase 2 study exploring the role of bevacizumab and a chemotherapy-free approach in HER2-positive metastatic breast cancer: The HAT study (BOOG 2008-2003), a Dutch Breast Cancer Research Group trial.

PubMed

Drooger, Jan C; van Tinteren, Harm; de Groot, Steffen M; Ten Tije, Albert J; de Graaf, Hiltje; Portielje, Johanneke E A; Jager, Agnes; Honkoop, Aafke; Linn, Sabine C; Kroep, Judith R; Erdkamp, Frans L G; Hamberg, Paul; Imholz, Alex L T; van Rossum-Schornagel, Quirine C; Heijns, Joan B; van Leeuwen-Stok, A Elise; Sleijfer, Stefan

2016-10-01

To explore the role of bevacizumab and a chemotherapy-free approach, the authors evaluated the combination of bevacizumab, trastuzumab, and paclitaxel (HAT) and the regimen of trastuzumab and bevacizumab (HA) with the addition of paclitaxel after progression (HA-HAT) as first-line treatment for patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. In a noncomparative phase 2 trial, patients were randomized between HAT and HA-HAT. The primary endpoint was the progression-free rate at 1 year (1-year PFR). In the HA-HAT group, progression-free survival (PFS) was separately established for HA (PFS1) and HAT (PFS2). Eighty-four patients received HAT (n = 39) or HA-HAT (n = 45). The 1-year PFR was 74.4% (95% confidence interval [CI], 61.8%-89.4%) and 62.2% (95% CI, 49.6%-89.4%) in the HAT and HA-HAT arms, respectively. The median PFS was 19.8 months (95% CI, 14.9-25.6 months) in the HAT arm and 19.6 months (95% CI, 12.0-32.0 months) in the HA-HAT arm. In the HA-HAT arm, the median PFS1 was 10.4 months (95% CI, 6.2-15.0 months), and the median PFS2 was 8.2 months (95% CI, 7.0-12.6 months). The number and severity of adverse events were comparable between the arms. Both HAT and HA-HAT have promising activity in patients with HER2-positive metastatic breast cancer. In particular, starting with only targeted agents and delaying chemotherapy is worth further exploration. Cancer 2016;122:2961-2970. © 2016 American Cancer Society. © 2016 American Cancer Society.

Long Detection Programming in Single-Chamber Defibrillators Reduces Unnecessary Therapies and Mortality: The ADVANCE III Trial.

PubMed

Gasparini, Maurizio; Lunati, Maurizio G; Proclemer, Alessandro; Arenal, Angel; Kloppe, Axel; Martínez Ferrer, Josè B; Hersi, Ahmad S; Gulaj, Marcin; Wijffels, Maurits C E; Santi, Elisabetta; Manotta, Laura; Varma, Niraj

2017-11-01

This study sought to evaluate the effects of programming a long detection in single-chamber (VVI) implantable cardioverter-defibrillators (ICDs) in the multicenter prospective ADVANCE III (Avoid DeliVering TherApies for Non-sustained Arrhythmias in ICD PatiEnts III) trial. Programming strategies may reduce unnecessary ICD shocks and their adverse effects but to date have been described only for dual-chamber ICDs. A total of 545 subjects (85% male; atrial fibrillation 25%, left ventricular ejection fraction 31%, ischemic etiology 68%, secondary prevention indications 32%) receiving a VVI ICD were randomized to long detection (30 of 40 intervals) or standard programming (18 of 24 intervals) based on device type, atrial fibrillation history, and indication. In both arms, antitachycardia pacing (ATP) therapy during charging was programmed for episodes with cycle length 320 to 200 ms and shock only for cycle length <200 ms. Wavelet and stability functions enabled. Therapies delivered were compared using a negative binomial regression model. A total of 267 patients were randomized to long detection and 278 to the control group. Median follow-up was 12 months. One hundred twelve therapies (shocks and ATP) occurred in the long detection arm versus 257 in the control arm, for a 48% reduction with 30 of 40 intervals (95% confidence interval [CI]: 0.36 to 0.76; p = 0.002). In the long detection arm, overall shocks were reduced by 40% compared to the control arm (48 vs. 24; 95% CI: 0.38 to 0.94; p = 0.026) and appropriate shocks by 51% (34 vs. 74; 95% CI: 0.26 to 0.94; p = 0.033). Syncopal events did not differ between arms, but survival improved in the long detection arm. Among patients implanted with a VVI ICD, programming with the long detection interval significantly reduced appropriate therapies, shocks, and all-cause mortality. (Avoid DeliVering TherApies for Non-sustained Arrhythmias in ICD PatiEnts III [ADVANCEIII]; NCT00617175). Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Participation in Armed Forces, National, and International Sports Activities

DTIC Science & Technology

1987-03-09

American Games , Olympic Games , and other authorized national and international sports competitions (to include qualifying and preparatory events) as long...concerning the participation of Armed Forces personnel in Armed Forces, national, and international sports competitions ; establishes a Senior Military Sports ...program is to ensure that the U.S. Armed Forces are appropriately represented in national and international sports competitions . 3. The purpose of this

PROGRAMMED INSTRUCTION IN THE BRITISH ARMED FORCES, A REPORT ON RESEARCH AND DEVELOPMENT.

ERIC Educational Resources Information Center

WALLIS, D.; AND OTHERS

THE BRITISH ARMED SERVICES HAVE APPLIED PROGRAMING IN SCHOLASTIC SUBJECTS. A MARKED IMPROVEMENT IN THE TECHNOLOGY OF TRAINING HAS RESULTED IN THE DEVELOPMENT OF A MORE SYSTEMATIC DERIVATION OF TRAINING OBJECTIVES, CLOSER ASSESSMENT OF KNOWLEDGE AND ABILITY OF POTENTIAL STUDENTS, AND MORE ACCURATE SPECIFICATION OF CONTENTS, METHODS, AND MATERIALS…

75 FR 52625 - Amendment to the International Traffic in Arms Regulations: Export Exemption for Technical Data

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-27

... the provisions of the Department of Defense National Industrial Security Program Operating Manual, an... Department of Defense National Industrial Security Program Operating Manual (unless such requirements are in..., Arms Control and International Security, Department of State. [FR Doc. 2010-21450 Filed 8-26-10; 8:45...

77 FR 70151 - 36(b)(1) Arms Sales Notification

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-23

... defined in Section 47(6) of the Arms Export Control Act. (iii) Description and Quantity or Quantities of.... The sensitivity is primarily in the software programs that instruct the system how to operate in the... Only Memory (ROM) maps, which do not provide the software program itself. The overall hardware is...

2006 Joint Services Small Arms Systems Annual Symposium, Exhibition and Firing Demonstration

DTIC Science & Technology

2006-05-18

FE FE FE /F H FE/FH FE FH EXIT EX IT EX IT EX IT EXIT FH - FIRE HOSE FE - FIRE EXTINGUISHER N S W E LOUNGE 20 20 LOUNGE 20 20 31’ AAI Corporation 302...Sniper Rifle Congressional Program, Mr. Neil E . Lee, US Army ARDEC • Plasma Transfer Arc Fabrication of Enhanced Performance Barrels, Mr. Kris C...Years of Small Arms (1326 – 1626)”, Dr. Stephen C. Small, JSSAP/ARDEC Session IV: International Programs • Small Arms in NATO Transformation, Mr. Vernon E

Development of the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial Protocol: A National Cluster-Randomized Trial of Resident Duty Hour Policies.

PubMed

Bilimoria, Karl Y; Chung, Jeanette W; Hedges, Larry V; Dahlke, Allison R; Love, Remi; Cohen, Mark E; Tarpley, John; Mellinger, John; Mahvi, David M; Kelz, Rachel R; Ko, Clifford Y; Hoyt, David B; Lewis, Frank H

2016-03-01

Debate continues regarding whether to further restrict resident duty hour policies, but little high-level evidence is available to guide policy changes. To inform decision making regarding duty hour policies, the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial is being conducted to evaluate whether changing resident duty hour policies to permit greater flexibility in work hours affects patient postoperative outcomes, resident education, and resident well-being. Pragmatic noninferiority cluster-randomized trial of general surgery residency programs with 2 study arms. Participating in the study are Accreditation Council for Graduate Medical Education (ACGME)-approved US general surgery residency programs (n = 118), their affiliated hospitals (n = 154), surgical residents and program directors, and general surgery patients from July 1, 2014, to June 30, 2015, with additional patient safety outcomes collected through June 30, 2016. The data collection platform for patient outcomes is the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), thus only hospitals participating in the ACS NSQIP were included. In the usual care arm, programs adhered to current ACGME resident duty hour standards. In the intervention arm, programs were allowed to deviate from current standards regarding maximum shift lengths and minimum time off between shifts through an ACGME waiver. Death or serious morbidity within 30 days of surgery measured through ACS NSQIP, as well as resident satisfaction and well-being measured through a survey delivered at the time of the 2015 American Board of Surgery in Training Examination (ABSITE). A total of 118 general surgery residency programs and 154 hospitals were enrolled in the FIRST Trial and randomized. Fifty-nine programs (73 hospitals) were randomized to the usual care arm and 59 programs (81 hospitals) were randomized to the intervention arm. Intent-to-treat analysis will be used to estimate the effectiveness of assignment to the intervention arm on patient outcomes, resident education, and resident well-being compared with the usual care arm. Several sensitivity analyses will be performed to determine whether there were differential effects when examining only inpatients, high-risk patients, and emergent/urgent cases. To our knowledge, the FIRST Trial is the first national randomized clinical trial of duty hour policies. Results of this study may be informative to policymakers and other stakeholders engaged in restructuring graduate medical training to enhance the quality of patient care and resident education. clinicaltrials.org Identifier: NCT02050789.

Large-scale Chromosomal Movements During Interphase Progression in Drosophila

PubMed Central

Csink, Amy K.; Henikoff, Steven

1998-01-01

We examined the effect of cell cycle progression on various levels of chromosome organization in Drosophila. Using bromodeoxyuridine incorporation and DNA quantitation in combination with fluorescence in situ hybridization, we detected gross chromosomal movements in diploid interphase nuclei of larvae. At the onset of S-phase, an increased separation was seen between proximal and distal positions of a long chromsome arm. Progression through S-phase disrupted heterochromatic associations that have been correlated with gene silencing. Additionally, we have found that large-scale G1 nuclear architecture is continually dynamic. Nuclei display a Rabl configuration for only ∼2 h after mitosis, and with further progression of G1-phase can establish heterochromatic interactions between distal and proximal parts of the chromosome arm. We also find evidence that somatic pairing of homologous chromosomes is disrupted during S-phase more rapidly for a euchromatic than for a heterochromatic region. Such interphase chromosome movements suggest a possible mechanism that links gene regulation via nuclear positioning to the cell cycle: delayed maturation of heterochromatin during G1-phase delays establishment of a silent chromatin state. PMID:9763417

Gender-specific intervention to reduce underage drinking among early adolescent girls: a test of a computer-mediated, mother-daughter program.

PubMed

Schinke, Steven P; Cole, Kristin C A; Fang, Lin

2009-01-01

This study evaluated a gender-specific, computer-mediated intervention program to prevent underage drinking among early adolescent girls. Study participants were adolescent girls and their mothers from New York, New Jersey, and Connecticut. Participants completed pretests online and were randomly divided between intervention and control arms. Intervention-arm girls and their mothers interacted with a computer program aimed to enhance mother-daughter relationships and to teach girls skills for managing conflict, resisting media influences, refusing alcohol and drugs, and correcting peer norms about underage drinking, smoking, and drug use. After intervention, all participants (control and intervention) completed posttest and follow-up measurements. Two months following program delivery and relative to control-arm participants, intervention-arm girls and mothers had improved their mother-daughter communication skills and their perceptions and applications of parental monitoring and rule-setting relative to girls' alcohol use. Also at follow-up, intervention-arm girls had improved their conflict management and alcohol use-refusal skills; reported healthier normative beliefs about underage drinking; demonstrated greater self-efficacy about their ability to avoid underage drinking; reported less alcohol consumption in the past 7 days, 30 days, and year; and expressed lower intentions to drink as adults. Study findings modestly support the viability of a mother-daughter, computer-mediated program to prevent underage drinking among adolescent girls. The data have implications for the further development of gender-specific approaches to combat increases in alcohol and other substance use among American girls.

The KALI multi-arm robot programming and control environment

NASA Technical Reports Server (NTRS)

Backes, Paul; Hayati, Samad; Hayward, Vincent; Tso, Kam

1989-01-01

The KALI distributed robot programming and control environment is described within the context of its use in the Jet Propulsion Laboratory (JPL) telerobot project. The purpose of KALI is to provide a flexible robot programming and control environment for coordinated multi-arm robots. Flexibility, both in hardware configuration and software, is desired so that it can be easily modified to test various concepts in robot programming and control, e.g., multi-arm control, force control, sensor integration, teleoperation, and shared control. In the programming environment, user programs written in the C programming language describe trajectories for multiple coordinated manipulators with the aid of KALI function libraries. A system of multiple coordinated manipulators is considered within the programming environment as one motion system. The user plans the trajectory of one controlled Cartesian frame associated with a motion system and describes the positions of the manipulators with respect to that frame. Smooth Cartesian trajectories are achieved through a blending of successive path segments. The manipulator and load dynamics are considered during trajectory generation so that given interface force limits are not exceeded.

Darwin : The Third DOE ARM TWP ARCS Site /

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clements, William E.; Jones, L. A.; Baldwin, T.

2002-01-01

The United States Department of Energy's (DOE) Atmospheric Radiation Measurement (ARM) Program began operations in its Tropical Western Pacific (TWP) locale in October 1996 when the first Atmospheric Radiation and Cloud Station (ARCS) began collecting data on Manus Island in Papua New Guinea (PNG). Two years later, in November 1998, a second ARCS began operations on the island of Nauru in the Central Pacific. Now a third ARCS has begun collecting data in Darwin, Australia. The Manus, Nauru, and Darwin sites are operated through collaborative agreements with the PNG National Weather Service, The Nauru Department of Industry and Economic Developmentmore » (IED), and the Australian Bureau of Meteorology's (BOM) Special Services Unit (SSU) respectively. All ARM TWP activities in the region are coordinated with the South Pacific Regional Environment Programme (SPREP) based in Apia, Samoa. The Darwin ARM site and its role in the ARM TWP Program are discussed.« less

Progressing MoodSwings. The upgrade and evaluation of MoodSwings 2.0: An online intervention for bipolar disorder.

PubMed

Lauder, S; Cosgrove, V E; Gliddon, E; Grimm, D; Dodd, S; Berk, L; Castle, D; Suppes, T S; Berk, M

2017-05-01

MoodSwings 2.0 is a self-guided online intervention for bipolar disorder. The intervention incorporates technological improvements on an earlier validated version of the intervention (MoodSwings 1.0). The previous MoodSwings trial provides this study with a unique opportunity to progress previous work, whilst being able to take into consideration lesson learnt, and technological enhancements. The structure and technology of MoodSwings 2.0 are described and the relevance to other online health interventions is highlighted. An international team from Australia and the US updated and improved the programs content pursuant to changes in DSM-5, added multimedia components and included larger numbers of participants in the group discussion boards. Greater methodological rigour in this trial includes an attention control condition, quarterly telephone assessments, and red flag alerts for significant clinical change. This paper outlines these improvements, including additional security and safety measures. A 3 arm RCT is currently evaluating the enhanced program to assess the efficacy of MS 2.0; the primary outcome is change in depressive and manic symptoms. To our knowledge this is the first randomized controlled online bipolar study with a discussion board attention control and meets the key methodological criteria for online interventions. Copyright © 2017. Published by Elsevier Inc.

Progressing MoodSwings. The upgrade and evaluation of MoodSwings 2.0: An online intervention for Bipolar Disorder

PubMed Central

Lauder, S.; Cosgrove, V.E.; Gliddon, E.; Grimm, D.; Dodd, S.; Berk, L.; Castle, D.; Suppes, T.S.; Berk, M.

2017-01-01

MoodSwings 2.0 is a self-guided online intervention for bipolar disorder. The intervention incorporates technological improvements on an earlier validated version of the intervention (MoodSwings 1.0). The previous MoodSwings trial provides this study with a unique opportunity to progress previous work, whilst being able to take into consideration lesson learnt, and technological enhancements. The structure and technology of MoodSwings 2.0 are described and the relevance to other online health interventions is highlighted. An international team from Australia and the US updated and improved the programs content pursuant to changes in DSM-5, added multimedia components and included larger numbers of participants in the group discussion boards. Greater methodological rigour in this trial includes an attention control condition, quarterly telephone assessments, and red flag alerts for significant clinical change. This paper outlines these improvements, including additional security and safety measures. A 3 arm RCT is currently evaluating the enhanced program to assess the efficacy of MS 2.0; the primary outcome is change in depressive and manic symptoms. To our knowledge this is the first randomised controlled online bipolar study with a discussion board attention control and meets the key methodological criteria for online interventions PMID:28257919

AGOR 28: SIO Shipyard Representative Bi-Weekly Progress Report

DTIC Science & Technology

2016-02-15

Handles for Bridge port and stbd side sliding windows reinstalled with better adhesive. Should be good now. Have to remember to lift up on...handle before attempting to slide. Woody has expressed concern with potential interference of ships main crane and CAST 6 winches. SIO plans to...swap forward CTD handling arm with the after overboarding arm. This may exacerbate potential interferences with stowed crane . A possible solution

U.S.-Russian cooperation in nuclear disarmament and nonproliferation

NASA Astrophysics Data System (ADS)

Podvig, Pavel

2010-02-01

The United States and Russia, the two largest nuclear powers, have a special obligation to provide leadership in nuclear disarmament and in strengthening the nuclear non-proliferation regime. In the past year the two countries made an effort to restart the arms control process by concluding a new treaty that would bring their legal disarmament obligations in line with the realities of their post-cold war relationships. The process of negotiating deeper nuclear reductions in the new environment turned out to be rather difficult, since the approaches that the countries used in the past are not well suited to dealing with issues like conversion of strategic nuclear delivery systems to conventional missions, tactical nuclear weapons, or dismantlement of nuclear warheads. This presentation considers the recent progress in U.S.-Russian arms control process and outlines the key issues at the negotiations. It also considers prospects for further progress in bilateral nuclear disarmament and issues that will be encountered at later stages of the process. The author argues that success of the arms reductions will depend on whether the United States and Russia will be able to build an institutional framework for cooperation on a range of issues - from traditional arms control to securing nuclear materials and from missile defense to strengthening the international nuclear safeguards. )

Samarium-153-EDTMP (Quadramet®) with or without vaccine in metastatic castration-resistant prostate cancer: A randomized Phase 2 trial.

PubMed

Heery, Christopher R; Madan, Ravi A; Stein, Mark N; Stadler, Walter M; Di Paola, Robert S; Rauckhorst, Myrna; Steinberg, Seth M; Marté, Jennifer L; Chen, Clara C; Grenga, Italia; Donahue, Renee N; Jochems, Caroline; Dahut, William L; Schlom, Jeffrey; Gulley, James L

2016-10-18

PSA-TRICOM is a therapeutic vaccine in late stage clinical testing in metastatic castration-resistant prostate cancer (mCRPC). Samarium-153-ethylene diamine tetramethylene phosphonate (Sm-153-EDTMP; Quadramet®), a radiopharmaceutical, binds osteoblastic bone lesions and emits beta particles causing local tumor cell destruction. Preclinically, Sm-153-EDTMP alters tumor cell phenotype facilitating immune-mediated killing. This phase 2 multi-center trial randomized patients to Sm-153-EDTMP alone or with PSA-TRICOM vaccine. Eligibility required mCRPC, bone metastases, prior docetaxel and no visceral disease. The primary endpoint was the proportion of patients without radiographic disease progression at 4 months. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and immune responses. Forty-four patients enrolled. Eighteen and 21 patients were evaluable for the primary endpoint in Sm-153-EDTMP alone and combination arms, respectively. There was no statistical difference in the primary endpoint, with two of 18 (11.1%) and five of 21 (23.8%) in Sm-153-EDTMP alone and combination arms, respectively, having stable disease at approximately the 4-month evaluation time point (P = 0.27). Median PFS was 1.7 vs. 3.7 months in the Sm-153-EDTMP alone and combination arms (P = 0.041, HR = 0.51, P = 0.046). No patient in the Sm-153-EDTMP alone arm achieved prostate-specific antigen (PSA) decline > 30% compared with four patients (of 21) in the combination arm, including three with PSA decline > 50%. Toxicities were similar between arms and related to number of Sm-153-EDTMP doses administered. These results provide the rationale for clinical evaluation of new radiopharmaceuticals, such as Ra-223, in combination with PSA-TRICOM.

Samarium-153-EDTMP (Quadramet®) with or without vaccine in metastatic castration-resistant prostate cancer: A randomized Phase 2 trial

PubMed Central

Heery, Christopher R.; Madan, Ravi A.; Stein, Mark N.; Stadler, Walter M.; Di Paola, Robert S.; Rauckhorst, Myrna; Steinberg, Seth M.; Marté, Jennifer L.; Chen, Clara C.; Grenga, Italia; Donahue, Renee N.; Jochems, Caroline; Dahut, William L.; Schlom, Jeffrey; Gulley, James L.

2016-01-01

PSA-TRICOM is a therapeutic vaccine in late stage clinical testing in metastatic castration-resistant prostate cancer (mCRPC). Samarium-153-ethylene diamine tetramethylene phosphonate (Sm-153-EDTMP; Quadramet®), a radiopharmaceutical, binds osteoblastic bone lesions and emits beta particles causing local tumor cell destruction. Preclinically, Sm-153-EDTMP alters tumor cell phenotype facilitating immune-mediated killing. This phase 2 multi-center trial randomized patients to Sm-153-EDTMP alone or with PSA-TRICOM vaccine. Eligibility required mCRPC, bone metastases, prior docetaxel and no visceral disease. The primary endpoint was the proportion of patients without radiographic disease progression at 4 months. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and immune responses. Forty-four patients enrolled. Eighteen and 21 patients were evaluable for the primary endpoint in Sm-153-EDTMP alone and combination arms, respectively. There was no statistical difference in the primary endpoint, with two of 18 (11.1%) and five of 21 (23.8%) in Sm-153-EDTMP alone and combination arms, respectively, having stable disease at approximately the 4-month evaluation time point (P = 0.27). Median PFS was 1.7 vs. 3.7 months in the Sm-153-EDTMP alone and combination arms (P = 0.041, HR = 0.51, P = 0.046). No patient in the Sm-153-EDTMP alone arm achieved prostate-specific antigen (PSA) decline > 30% compared with four patients (of 21) in the combination arm, including three with PSA decline > 50%. Toxicities were similar between arms and related to number of Sm-153-EDTMP doses administered. These results provide the rationale for clinical evaluation of new radiopharmaceuticals, such as Ra-223, in combination with PSA-TRICOM. PMID:27486817

Safety results from a phase III study (TURANDOT trial by CECOG) of first-line bevacizumab in combination with capecitabine or paclitaxel for HER-2-negative locally recurrent or metastatic breast cancer.

PubMed

Lang, I; Inbar, M J; Kahán, Z; Greil, R; Beslija, S; Stemmer, S M; Kaufman, B; Zvirbule, Z; Steger, G G; Messinger, D; Brodowicz, T; Zielinski, C

2012-11-01

We report safety data from a randomised, phase III study (CECOG/BC.1.3.005) evaluating first-line bevacizumab plus paclitaxel or capecitabine for locally recurrent or metastatic breast cancer. Patients aged ≥18 years with human epidermal growth factor receptor-2-negative breast adenocarcinoma were randomised to Arm A: bevacizumab 10 mg/kg days 1 and 15; paclitaxel 90 mg/m(2) days 1, 8, and 15, every 4 weeks; or Arm B: bevacizumab 15 mg/kg day 1; capecitabine 1000 mg/m(2) b.i.d., days 1-14, every 3 weeks, until disease progression, unacceptable toxicity or consent withdrawal. A post hoc interim safety analysis included 561 patients (Arm A: 284, Arm B: 277). The regimens demonstrated similar frequencies of all-grade and serious adverse events (SAEs), but different safety profiles. Treatment-related events occurred in 85.2% (Arm A) and 78.0% (Arm B) of patients. Fatigue was most common in Arm A (30.6% versus 23.5% Arm B), and hand-foot syndrome (HFS) most common in Arm B (49.5% versus 2.5% Arm A). Diarrhoea (Arm A: 0.4%, Arm B: 1.4%) and pulmonary embolism (Arm A: 0.7%, Arm B: 1.1%) were the most frequently reported SAEs. These findings are in-line with safety data for bevacizumab plus paclitaxel or capecitabine, reported in previous phase III trials. Copyright © 2012 Elsevier Ltd. All rights reserved.

Further analysis of PREVAIL: enzalutamide use in chemotherapy-naïve men with metastatic castration-resistant prostate cancer

PubMed Central

Aragon-Ching, Jeanny B

2014-01-01

PREVAIL was a phase III multinational, double-blind, placebo-controlled trial that enrolled chemotherapy-naïve men with metastatic castration-resistant prostate cancer (mCRPC), which showed remarkable improvement in co-primary endpoints with an overall 81% reduction in the risk of radiographic progression, as well as 29% reduction in the risk of death in favor of the enzalutamide arm over placebo. All secondary endpoints including time to subsequent chemotherapy initiation and prostate specific antigen (PSA) progression were in favor of the enzalutamide arm. The results of PREVAIL shows the utility of enzalutamide that would likely soon expand the indication to asymptomatic or minimally symptomatic men with mCRPC not previously treated with chemotherapy. PMID:25080931

Further analysis of PREVAIL: enzalutamide use in chemotherapy-naïve men with metastatic castration-resistant prostate cancer.

PubMed

Aragon-Ching, Jeanny B

2014-01-01

PREVAIL was a phase III multinational, double-blind, placebo-controlled trial that enrolled chemotherapy-naïve men with metastatic castration-resistant prostate cancer (mCRPC), which showed remarkable improvement in co-primary endpoints with an overall 81% reduction in the risk of radiographic progression, as well as 29% reduction in the risk of death in favor of the enzalutamide arm over placebo. All secondary endpoints including time to subsequent chemotherapy initiation and prostate specific antigen (PSA) progression were in favor of the enzalutamide arm. The results of PREVAIL shows the utility of enzalutamide that would likely soon expand the indication to asymptomatic or minimally symptomatic men with mCRPC not previously treated with chemotherapy.

Evaluation of pseudoprogression rates and tumor progression patterns in a phase III trial of bevacizumab plus radiotherapy/temozolomide for newly diagnosed glioblastoma.

PubMed

Wick, Wolfgang; Chinot, Olivier L; Bendszus, Martin; Mason, Warren; Henriksson, Roger; Saran, Frank; Nishikawa, Ryo; Revil, Cedric; Kerloeguen, Yannick; Cloughesy, Timothy

2016-10-01

Evaluation of glioblastoma disease status may be complicated by treatment-induced changes and discordance between enhancing and nonenhancing MRI. Exploratory analyses are presented (prospectively assessed pseudoprogression and therapy-related tumor pattern changes) from the AVAglio trial (bevacizumab or placebo plus radiotherapy/temozolomide for newly diagnosed glioblastoma). MRI was done every 8 weeks (beginning 4 wk after chemoradiotherapy) using prespecified and standardized T1 and T2 protocols. Progressive disease (PD) at 10 weeks was reconfirmed at 18 weeks to distinguish pseudoprogression. Progression-free survival (PFS), excluding cases of confirmed pseudoprogression, was assessed (post-hoc/exploratory). Tumor progression patterns were determined at each disease assessment/PD (prespecified/exploratory). Of patients with PD in the bevacizumab and placebo arms, 143/354 (40.4%) and 155/387 (40.1%), respectively, had PD due to contrast-enhancing lesions, and 51/354 (14.4%) and 53/387 (13.7%) had PD due to nonenhancing lesions. Of all patients in the bevacizumab arm (n = 458), 2.2% had confirmed pseudoprogression versus 9.3% in the placebo arm (n = 463). Baseline characteristics did not differ between patients with/without pseudoprogression (including for MGMT status). Excluding confirmed pseudoprogression, PFS (hazard ratio: 0.65, 95% CI: 0.56-0.75; P < .0001, bevacizumab vs placebo) was comparable to the intent-to-treat population. At PD, most patients had the same tumor focus (local/multifocal, >84%) and infiltrative profile (>88%) as at baseline; no shift to a diffuse or multifocal phenotype was observed. Pseudoprogression complicated progression assessment in a small but relevant number of patients but had negligible impact on PFS. Bevacizumab did not appear to adversely impact tumor progression patterns. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Web-based telerehabilitation for the upper extremity after stroke.

PubMed

Reinkensmeyer, David J; Pang, Clifton T; Nessler, Jeff A; Painter, Christopher C

2002-06-01

Stroke is a leading cause of disability in the United States and yet little technology is currently available for individuals with stroke to practice and monitor rehabilitation therapy on their own. This paper provides a detailed design description of a telerehabilitation system for arm and hand therapy following stroke. The system consists of a Web-based library of status tests, therapy games, and progress charts, and can be used with a variety of input devices, including a low-cost force-feedback joystick capable of assisting or resisting in movement. Data from home-based usage by a chronic stroke subject are presented that demonstrate the feasibility of using the system to direct a therapy program, mechanically assist in movement, and track improvements in movement ability.

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

This document contains the summaries of papers presented at the 1996 Atmospheric Radiation Measurement (ARM) Science Team meeting held at San Antonio, Texas. The history and status of the ARM program at the time of the meeting helps to put these papers in context. The basic themes have not changed. First, from its beginning, the Program has attempted to respond to the most critical scientific issues facing the US Global Change Research Program. Second, the Program has been strongly coupled to other agency and international programs. More specifically, the Program reflects an unprecedented collaboration among agencies of the federal researchmore » community, among the US Department of Energy`s (DOE) national laboratories, and between DOE`s research program and related international programs, such as Global Energy and Water Experiment (GEWEX) and the Tropical Ocean Global Atmosphere (TOGA) program. Next, ARM has always attempted to make the most judicious use of its resources by collaborating and leveraging existing assets and has managed to maintain an aggressive schedule despite budgets that have been much smaller than planned. Finally, the Program has attracted some of the very best scientific talent in the climate research community and has, as a result, been productive scientifically.« less

Generating Variable Wind Profiles and Modeling Their Effects on Small-Arms Trajectories

DTIC Science & Technology

2016-04-01

ARL-TR-7642 ● APR 2016 US Army Research Laboratory Generating Variable Wind Profiles and Modeling Their Effects on Small-Arms... Wind Profiles and Modeling Their Effects on Small-Arms Trajectories by Timothy A Fargus Weapons and Materials Research Directorate, ARL...Generating Variable Wind Profiles and Modeling Their Effects on Small-Arms Trajectories 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM

Data systems for science integration within the Atmospheric Radiation Measurement Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gracio, D.K.; Hatfield, L.D.; Yates, K.R.

The Atmospheric Radiation Measurement (ARM) Program was developed by the US Department of Energy to support the goals and mission of the US Global Change Research Program. The purpose of the ARM program is to improve the predictive capabilities of General Circulation Models (GCMs) in their treatment of clouds and radiative transfer effects. Three experimental testbeds were designed for the deployment of instruments to collect atmospheric data used to drive the GCMs. Each site, known as a Cloud and Radiation Testbed (CART), consists of a highly available, redundant data system for the collection of data from a variety of instrumentation.more » The first CART site was deployed in April 1992 in the Southern Great Plains (SGP), Lamont, Oklahoma, with the other two sites to follow in early 1996 in the Tropical Western Pacific (TWP) and in 1997 on the North Slope of Alaska (NSA). Approximately 1.5 GB of data are transferred per day via the Internet from the CART sites, and external data sources to the ARM Experiment Center (EC) at Pacific Northwest Laboratory in Richland, Washington. The Experimental Center is central to the ARM data path and provides for the collection, processing, analysis and delivery of ARM data. Data from the CART sites from a variety of instrumentation, observational systems and from external data sources are transferred to the Experiment Center. The EC processes these data streams on a continuous basis to provide derived data products to the ARM Science Team in near real-time while maintaining a three-month running archive of data.« less

United States Armed Forces' Voluntary Education Program: The Effect on Enlisted Servicemember Retention.

ERIC Educational Resources Information Center

Brauchle, Kenneth C.

The relationship between servicemembers' participation in the U.S. Armed Forces' off-duty voluntary higher education programs and retention of enlisted personnel in military service was examined through a review of existing and new data. The primary data source was a 1992 Department of Defense-sponsored survey of a stratified sample of…

Eastern Cooperative Oncology Group and American College of Radiology Imaging Network Randomized Phase 2 Trial of Neoadjuvant Preoperative Paclitaxel/Cisplatin/Radiation Therapy (RT) or Irinotecan/Cisplatin/RT in Esophageal Adenocarcinoma: Long-Term Outcome and Implications for Trial Design

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kleinberg, Lawrence R., E-mail: kleinla@jhmi.edu; Catalano, Paul J.; Forastiere, Arlene A.

Purpose: Toxicity, pathologic complete response, and long-term outcomes are reported for the neoadjuvant therapies assessed in a randomized phase 2 Eastern Cooperative Oncology Group and American College of Radiology Imaging Network trial for operable esophageal adenocarcinoma, staged as II-IVa by endoscopy/ultrasonography (EUS). Methods and Materials: A total of 86 eligible patients began treatment. For arm A, preoperative chemotherapy was cisplatin, 30 mg/m{sup 2}, and irinotecan, 50 mg/m{sup 2}, on day 1, 8, 22, 29 during 45 Gy radiation therapy (RT), 1.8 Gy per day over 5 weeks. Adjuvant therapy was cisplatin, 30 mg/m{sup 2}, and irinotecan, 65 mg/m{sup 2} daymore » 1, 8 every 21 days for 3 cycles. Arm B therapy was cisplatin, 30 mg/m{sup 2}, and paclitaxel, 50 mg/m{sup 2}, day 1, 8, 15, 22, 29 with RT, followed by adjuvant cisplatin, 75 mg/m{sup 2}, and paclitaxel, 175 mg/m{sup 2}, day 1 every 21 days for 3 cycles. Stratification included EUS stage and performance status. Results: In arm A, median overall survival was 35 months, and 5-, 6-, and 7-year survival rates were 46%, 39%, and 35%, respectively, whereas for arm B, they were 21 months and 27%, 27%, and 23%, respectively. Median progression- or recurrence-free survival (PFS) was 39.8 months with a 3-year PFS of 50% for arm A and 12.4 months (P=.046) with 3-year PFS of 28% for arm B. Eighty percent of the observed incidents of progression occurred within 19 months. Survival did not differ significantly by EUS and performance status strata. Conclusions: Long-term survival was similar for both arms and did not appear superior to results achieved with other standard regimens.« less

[Molecular cytogenetic analysis of chromosomal aberrations in cells of low grade gliomas and its contribution for tumour classification].

PubMed

Lhotská, H; Zemanová, Z; Kramář, F; Lizcová, L; Svobodová, K; Ransdorfová, S; Bystřická, D; Krejčík, Z; Hrabal, P; Dohnalová, A; Kaiser, M; Michalová, K

2014-01-01

Low-grade gliomas represent a heterogeneous group of primary brain malignancies. The current diagnostics of these tumors rely strongly on histological classification. With the development of molecular cytogenetic methods several genetic markers were described, contributing to a better distinction of glial subtypes. The aim of this study was to assess the frequency of acquired chromosomal aberrations in lowgrade gliomas and to search for new genomic changes associated with higher risk of tumor progression. We analysed biopsy specimens from 41 patients with histological dia-gnosis of low-grade glioma using interphase fluorescence in situ hybridization (I FISH) and single nucleotide polymorphism (SNP) array techniques (19 females and 22 males, medium age 42 years). Besides notorious and most frequent finding of combined deletion of 1p/ 19q (81.25% patients) several other recurrent aberrations were described in patients with oligodendrogliomas: deletions of p and q arms of chromosome 4 (25% patients), deletions of the short arms of chromosome 9 (18.75% patients), deletions of the long arms of chromosome 13 and monosomy of chromosome 18 (18.75% patients). In bio-psy specimens from patients with astrocytomas, we often observed deletion of 1p (24% patients), amplification of the long arms of chromosome 7 (16% patients), deletion of the long arm of chromosome 13 (20% patients), segmental uniparental disomy (UPD) of the short arms of chromosome 17 (60% patients) and deletion of the long arms of chromosome 19 (28% patients). In one patient we detected a shuttered chromosome 10 resulting from chromothripsis. Using a combination of I FISH and SNP array, we detected not only known chromosomal changes but also new or less frequent recur-rent aberrations. Their role in cancer  cell progression and their impact on low grade gliomas classification remains to be elucidated in a larger cohort of patients.

Randomized study of sequential cisplatin-topotecan/carboplatin-paclitaxel versus carboplatin-paclitaxel: effects on quality of life.

PubMed

Brotto, Lori; Brundage, Michael; Hoskins, Paul; Vergote, Ignace; Cervantes, Andres; Casado, Herraez A; Poveda, A; Eisenhauer, Elizabeth; Tu, Dongsheng

2016-03-01

A recent phase III trial compared the efficacy of cisplatin-topotecan (a topoisomerase I inhibitor) followed by carboplatin-paclitaxel (Arm 1) versus paclitaxel-carboplatin (Arm 2) in women with newly diagnosed stage IIB or greater ovarian cancer. There was a significantly lower response rate in the experimental arm compared to standard treatment, and less likelihood of normalized CA125 within the first 3 months. At 43 months follow-up, there were no significant group differences in progression-free survival. There were also significantly more side effects in the experimental arm. The current study examined quality of life (QoL) endpoints using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and the ovarian cancer module, QLQ-OV28, administered prior to randomization, at day 1 of treatment cycles 3, 5, and 7, at completion of the last cycle, and at 3 and 6 months following completion of chemotherapy. Global QoL, physical symptoms, fatigue, and role, emotional, cognitive and social function (all from the EORTC QLQ-C30) significantly improved in both treatment arms, with no significant between-arm differences. Between-group differences in pain, insomnia, and peripheral neuropathy reported while on treatment did not differ at follow-up. Nausea and vomiting improved more with standard treatment both during and after treatment. Body image significantly differed between the groups only at cycle 5 (more deterioration in Arm 2) but group differences disappeared at follow-up. A stratified analysis of global QoL by debulking surgery status found no greater effect indicating that overall improvements in QoL were unrelated to surgical recovery. There was no significant QoL advantage of cisplatin-topotecan. This finding, combined with no progression-free survival conferred by this combination, reaffirms carboplatin-paclitaxel as the standard of care for women with newly diagnosed ovarian cancer.

Health-related quality of life in the randomised KEYNOTE-002 study of pembrolizumab versus chemotherapy in patients with ipilimumab-refractory melanoma.

PubMed

Schadendorf, Dirk; Dummer, Reinhard; Hauschild, Axel; Robert, Caroline; Hamid, Omid; Daud, Adil; van den Eertwegh, Alfons; Cranmer, Lee; O'Day, Steven; Puzanov, Igor; Schachter, Jacob; Blank, Christian; Salama, April; Loquai, Carmen; Mehnert, Janice M; Hille, Darcy; Ebbinghaus, Scot; Kang, S Peter; Zhou, Wei; Ribas, Antoni

2016-11-01

In KEYNOTE-002, pembrolizumab significantly prolonged progression-free survival and was associated with a better safety profile compared with chemotherapy in patients with advanced melanoma that progressed after ipilimumab. We present health-related quality of life (HRQoL) outcomes from KEYNOTE-002. Patients were randomly assigned 1:1:1 to pembrolizumab 2 or 10 mg/kg every 3 weeks (Q3W) or investigator-choice chemotherapy. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Core 30 instrument. A constrained longitudinal data analysis model was implemented to assess between-arm differences in HRQoL scores. The study is registered with ClinicalTrials.gov, number NCT01704287. Of the 540 patients enrolled, 520 were included in the HRQoL analysis. Baseline global health status (GHS) was similar across treatment arms. Compliance rates at week 12 were 76.6% (n = 108), 82.3% (n = 121), and 86.4% (n = 133) for the control, pembrolizumab 2 mg/kg Q3W, and pembrolizumab 10 mg/kg Q3W arms, respectively. From baseline to week 12, GHS/HRQoL scores were maintained to a higher degree in the pembrolizumab arms compared with the chemotherapy arm (decrease of -2.6 for each pembrolizumab arm versus -9.1 for chemotherapy; P = 0.01 for each pembrolizumab arm versus chemotherapy). Fewer patients treated with pembrolizumab experienced deterioration in GHS at week 12 (31.8% for pembrolizumab 2 mg/kg, 26.6% for 10 mg/kg, and 38.3% for chemotherapy), with similar trends observed for the individual functioning and symptoms scales. HRQoL was better maintained with pembrolizumab than with chemotherapy in KEYNOTE-002, supporting the use of pembrolizumab in patients with ipilimumab-refractory melanoma. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The HAAPI (Home Arm Assistance Progression Initiative) Trial: A Novel Robotics Delivery Approach in Stroke Rehabilitation.

PubMed

Wolf, Steven L; Sahu, Komal; Bay, R Curtis; Buchanan, Sharon; Reiss, Aimee; Linder, Susan; Rosenfeldt, Anson; Alberts, Jay

2015-01-01

Geographical location, socioeconomic status, and logistics surrounding transportation impede access of poststroke individuals to comprehensive rehabilitative services. Robotic therapy may enhance telerehabilitation by delivering consistent and state-of-the art therapy while allowing remote monitoring and adjusting therapy for underserved populations. The Hand Mentor Pro (HMP) was incorporated within a home exercise program (HEP) to improve upper-extremity (UE) functional capabilities poststroke. To determine the efficacy of a home-based telemonitored robotic-assisted therapy as part of a HEP compared with a dose-matched HEP-only intervention among individuals less than 6 months poststroke and characterized as underserved. In this prospective, single-blinded, multisite, randomized controlled trial, 99 hemiparetic participants with limited access to UE rehabilitation were randomized to either (1) the experimental group, which received combined HEP and HMP for 3 h/d ×5 days ×8 weeks, or (2) the control group, which received HEP only at an identical dosage. Weekly communication between the supervising therapist and participant promoted compliance and progression of the HEP and HMP prescription. The Action Research Arm Test and Wolf Motor Function Test along with the Fugl-Meyer Assessment (UE) were primary and secondary outcome measures, respectively, undertaken before and after the interventions. Both groups demonstrated improvement across all UE outcomes. Robotic + HEP and HEP only were both effectively delivered remotely. There was no difference between groups in change in motor function over time. Additional research is necessary to determine the appropriate dosage of HMP and HEP. © The Author(s) 2015.

The HAAPI (Home Arm Assistance Progression Initiative) Trial: - A Novel Robotics Delivery Approach in Stroke Rehabilitation

PubMed Central

Wolf, Steven L.; Sahu, Komal; Bay, R. Curtis; Buchanan, Sharon; Reiss, Aimee; Linder, Susan; Rosenfeldt, Anson; Alberts, Jay

2015-01-01

Background Geographical location, socioeconomic status and logistics surrounding transportation impede access of post-stroke individuals to comprehensive rehabilitative services. Robotic therapy may enhance telerehabilitation by delivering consistent and state-of-the art therapy while allowing for the remote monitoring and adjusting therapy for underserved populations. The Hand Mentor Pro (HMP), was incorporated within a home exercise program (HEP) to improve upper extremity functional capabilities post-stroke. Objective To determine the efficacy of a home-based telemonitored robotic-assisted therapy as part of a HEP compared with a dose-matched HEP-only intervention among individuals less than 6 months post-stroke and characterized as underserved. Methods In this prospective, single-blinded, multisite, randomized controlled trial, 99 hemiparetic participants with limited access to upper extremity rehabilitation were randomized to the: 1) experimental group which received combined HEP and HMP for 3 hrs/day x 5 days x 8 weeks; or 2) control group which received HEP only at an identical dosage. Weekly communication between the supervising therapist and participant promoted compliance and progression of the HEP and HMP prescription. The Action Research Arm Test and Wolf Motor Function Test along with the Fugl Meyer Assessment (upper extremity) were primary and secondary outcome measures respectively, undertaken before and after the interventions. Results Both groups demonstrated improvement across all upper extremity outcomes. Conclusions Robotic+HEP and HEP only were both effectively delivered remotely. There was no difference between groups in change in motor function over time, additional research is necessary to determine appropriate dosage of HMP and HEP. PMID:25782693

Optimal training for emergency needle thoracostomy placement by prehospital personnel: didactic teaching versus a cadaver-based training program.

PubMed

Grabo, Daniel; Inaba, Kenji; Hammer, Peter; Karamanos, Efstathios; Skiada, Dimitra; Martin, Matthew; Sullivan, Maura; Demetriades, Demetrios

2014-09-01

Tension pneumothorax can rapidly progress to cardiac arrest and death if not promptly recognized and appropriately treated. We sought to evaluate the effectiveness of traditional didactic slide-based lectures (SBLs) as compared with fresh tissue cadaver-based training (CBT) for placement of needle thoracostomy (NT). Forty randomly selected US Navy corpsmen were recruited to participate from incoming classes of the Navy Trauma Training Center at the LAC + USC Medical Center and were then randomized to one of two NT teaching methods. The following outcomes were compared between the two study arms: (1) time required to perform the procedure, (2) correct placement of the needle, and (3) magnitude of deviation from the correct position. During the study period, a total of 40 corpsmen were enrolled, 20 randomized to SBL and 20 to CBT arms. When outcomes were analyzed, time required to NT placement was not different between the two arms. Examination of the location of needle placement revealed marked differences between the two study groups. Only a minority of the SBL group (35%) placed the NT correctly in the second intercostal space. In comparison, the majority of corpsmen assigned to the CBT group demonstrated accurate placement in the second intercostal space (75%). In a CBT module, US Navy corpsmen were better trained to place NT accurately than their traditional didactic SBL counterparts. Further studies are indicated to identify the optimal components of effective simulation training for NT and other emergent interventions.

Gender norms, poverty and armed conflict in Côte D'Ivoire: engaging men in women's social and economic empowerment programming.

PubMed

Falb, K L; Annan, J; King, E; Hopkins, J; Kpebo, D; Gupta, J

2014-12-01

Engaging men is a critical component in efforts to reduce intimate partner violence (IPV). Little is known regarding men's perspectives of approaches that challenge inequitable gender norms, particularly in settings impacted by armed conflict. This article describes men's experiences with a women's empowerment program and highlights men's perceptions of gender norms, poverty and armed conflict, as they relate to achieving programmatic goals. Data are from 32 Ivorian men who participated in indepth interviews in 2012. Interviews were undertaken as part of an intervention that combined gender dialogue groups for both women and their male partners with women's only village savings and loans programs to reduce IPV against women. Findings suggested that in the context of armed conflict, traditional gender norms and economic stressors experienced by men challenged fulfillment of gender roles and threatened men's sense of masculinity. Men who participated in gender dialogue groups discussed their acceptance of programming and identified improvements in their relationships with their female partners. These men further discussed increased financial planning along with their partners, and attributed such increases to the intervention. Addressing men's perceptions of masculinity, poverty and armed conflict may be key components to reduce men's violence against women in conflict-affected settings. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Double-Blind, Randomized Trial of Docetaxel Plus Vandetanib Versus Docetaxel Plus Placebo in Platinum-Pretreated Metastatic Urothelial Cancer

PubMed Central

Choueiri, Toni K.; Ross, Robert W.; Jacobus, Susanna; Vaishampayan, Ulka; Yu, Evan Y.; Quinn, David I.; Hahn, Noah M.; Hutson, Thomas E.; Sonpavde, Guru; Morrissey, Stephanie C.; Buckle, Geoffrey C.; Kim, William Y.; Petrylak, Daniel P.; Ryan, Christopher W.; Eisenberger, Mario A.; Mortazavi, Amir; Bubley, Glenn J.; Taplin, Mary-Ellen; Rosenberg, Jonathan E.; Kantoff, Philip W.

2012-01-01

Purpose Vandetanib is an oral once-daily tyrosine kinase inhibitor with activity against vascular endothelial growth factor receptor 2 and epidermal growth factor receptor. Vandetanib in combination with docetaxel was assessed in patients with advanced urothelial cancer (UC) who progressed on prior platinum-based chemotherapy. Patients and Methods The primary objective was to determine whether vandetanib 100 mg plus docetaxel 75 mg/m2 intravenously every 21 days prolonged progression-free survival (PFS) versus placebo plus docetaxel. The study was designed to detect a 60% improvement in median PFS with 80% power and one-sided α at 5%. Patients receiving docetaxel plus placebo had the option to cross over to single-agent vandetanib at progression. Overall survival (OS), overall response rate (ORR), and safety were secondary objectives. Results In all, 142 patients were randomly assigned and received at least one dose of therapy. Median PFS was 2.56 months for the docetaxel plus vandetanib arm versus 1.58 months for the docetaxel plus placebo arm, and the hazard ratio for PFS was 1.02 (95% CI, 0.69 to 1.49; P = .9). ORR and OS were not different between both arms. Grade 3 or higher toxicities were more commonly seen in the docetaxel plus vandetanib arm and included rash/photosensitivity (11% v 0%) and diarrhea (7% v 0%). Among 37 patients who crossed over to single-agent vandetanib, ORR was 3% and OS was 5.2 months. Conclusion In this platinum-pretreated population of advanced UC, the addition of vandetanib to docetaxel did not result in a significant improvement in PFS, ORR, or OS. The toxicity of vandetanib plus docetaxel was greater than that for vendetanib plus placebo. Single-agent vandetanib activity was minimal. PMID:22184381

Dopaminergic modulation of arm swing during gait among Parkinson’s disease patients

PubMed Central

Sterling, Nicholas W.; Cusumano, Joseph P.; Shaham, Noam; Piazza, Stephen J.; Liu, Guodong; Kong, Lan; Du, Guangwei; Lewis, Mechelle M.; Huang, Xuemei

2015-01-01

Background Reduced arm swing amplitude, symmetry, and coordination during gait have been reported in Parkinson’s disease (PD), but the relationship between dopaminergic depletion and these upper limb gait changes remains unclear. This study investigated the effects of dopaminergic drugs on arm swing velocity, symmetry, and coordination in PD. Methods Forearm angular velocity was recorded in 16 PD and 17 control subjects (Controls) during free walking trials. Angular velocity amplitude of each arm, arm swing asymmetry, and maximum cross-correlation were compared between control and PD groups, and between OFF- and ON-medication states among PD subjects. Results Compared to Controls, PD subjects in the OFF-medication state exhibited lower angular velocity amplitude of the slower- (p=0.0018), but not faster- (p=0.2801) swinging arm. In addition, PD subjects demonstrated increased arm swing asymmetry (p=0.0046) and lower maximum cross-correlation (p=0.0026). Following dopaminergic treatment, angular velocity amplitude increased in the slower- (p=0.0182), but not faster- (p=0.2312) swinging arm among PD subjects. Furthermore, arm swing asymmetry decreased (p=0.0386), whereas maximum cross-correlation showed no change (p=0.7436). Pre-drug angular velocity amplitude of the slower-swinging arm was correlated inversely with the change in arm swing asymmetry (R=−0.73824, p=0.0011). Conclusions This study provides quantitative evidence that reduced arm swing and symmetry in PD can be modulated by dopaminergic replacement. The lack of modulations of bilateral arm coordination suggests that additional neurotransmitters may also be involved in arm swing changes in PD. Further studies are warranted to investigate the longitudinal trajectory of arm swing dynamics throughout PD progression. PMID:25502948

Dopaminergic modulation of arm swing during gait among Parkinson's disease patients.

PubMed

Sterling, Nicholas W; Cusumano, Joseph P; Shaham, Noam; Piazza, Stephen J; Liu, Guodong; Kong, Lan; Du, Guangwei; Lewis, Mechelle M; Huang, Xuemei

2015-01-01

Reduced arm swing amplitude, symmetry, and coordination during gait have been reported in Parkinson's disease (PD), but the relationship between dopaminergic depletion and these upper limb gait changes remains unclear. We aimed to investigate the effects of dopaminergic drugs on arm swing velocity, symmetry, and coordination in PD. Forearm angular velocity was recorded in 16 PD and 17 control subjects (Controls) during free walking trials. Angular velocity amplitude of each arm, arm swing asymmetry, and maximum cross-correlation were compared between control and PD groups, and between OFF- and ON-medication states among PD subjects. Compared to Controls, PD subjects in the OFF-medication state exhibited lower angular velocity amplitude of the slower- (p = 0.0018), but not faster- (p = 0.2801) swinging arm. In addition, PD subjects demonstrated increased arm swing asymmetry (p = 0.0046) and lower maximum cross-correlation (p = 0.0026). Following dopaminergic treatment, angular velocity amplitude increased in the slower- (p = 0.0182), but not faster- (p = 0.2312) swinging arm among PD subjects. Furthermore, arm swing asymmetry decreased (p = 0.0386), whereas maximum cross-correlation showed no change (p = 0.7436). Pre-drug angular velocity amplitude of the slower-swinging arm was correlated inversely with the change in arm swing asymmetry (R = -0.73824, p = 0.0011). This study provides quantitative evidence that reduced arm swing and symmetry in PD can be modulated by dopaminergic replacement. The lack of modulations of bilateral arm coordination suggests that additional neurotransmitters may also be involved in arm swing changes in PD. Further studies are warranted to investigate the longitudinal trajectory of arm swing dynamics throughout PD progression.

Arm swing magnitude and asymmetry during gait in the early stages of Parkinson's disease.

PubMed

Lewek, Michael D; Poole, Roxanne; Johnson, Julia; Halawa, Omar; Huang, Xuemei

2010-02-01

The later stages of Parkinson's disease (PD) are characterized by altered gait patterns. Although decreased arm swing during gait is the most frequently reported motor dysfunction in individuals with PD, quantitative descriptions of gait in early PD have largely ignored upper extremity movements. This study was designed to perform a quantitative analysis of arm swing magnitude and asymmetry that might be useful in the assessment of early PD. Twelve individuals with early PD (in "off" state) and eight controls underwent gait analysis using an optically-based motion capture system. Participants were instructed to walk at normal and fast velocities, and then on heels (to minimize push-off). Arm swing was measured as the excursion of the wrist with respect to the pelvis. Arm swing magnitude for each arm, and inter-arm asymmetry, were compared between groups. Both groups had comparable gait velocities (p = 0.61), and there was no significant difference between the groups in the magnitude of arm swing in all walking conditions for the arm that swung more (p = 0.907) or less (p = 0.080). Strikingly, the PD group showed significantly greater arm swing asymmetry (asymmetry angle: 13.9 + or - 7.9%) compared to the control group (asymmetry angle: 5.1 + or - 4.0%; p = 0.003). Unlike arm swing magnitude, arm swing asymmetry unequivocally differs between people with early PD and controls. Such quantitative evaluation of arm swing, especially its asymmetry, may have utility for early and differential diagnosis, and for tracking disease progression in patients with later PD. Copyright 2009 Elsevier B.V. All rights reserved.

Arm Swing Magnitude and Asymmetry During Gait in the Early Stages of Parkinson's Disease

PubMed Central

Lewek, Michael D.; Poole, Roxanne; Johnson, Julia; Halawa, Omar; Huang, Xuemei

2009-01-01

The later stages of Parkinson's disease (PD) are characterized by altered gait patterns. Although decreased arm swing during gait is the most frequently reported motor dysfunction in individuals with PD, quantitative descriptions of gait in early PD have largely ignored upper extremity movements. This study was designed to perform a quantitative analysis of arm swing magnitude and asymmetry that might be useful in the assessment of early PD. Twelve individuals with early PD (in “off” state) and eight controls underwent gait analysis using an optically-based motion capture system. Participants were instructed to walk at normal and fast velocities, and then on heels (to minimize push-off). Arm swing was measured as the excursion of the wrist with respect to the pelvis. Arm swing magnitude for each arm, and inter-arm asymmetry, were compared between groups. Both groups had comparable gait velocities (p=0.61), and there was no significant difference between the groups in the magnitude of arm swing in all walking conditions for the arm that swung more (p=0.907) or less (p=0.080). Strikingly, the PD group showed significantly greater arm swing asymmetry (asymmetry angle: 13.9±7.9%) compared to the control group (asymmetry angle: 5.1±4.0%; p=0.003). Unlike arm swing magnitude, arm swing asymmetry unequivocally differs between people with early PD and controls. Such quantitative evaluation of arm swing, especially its asymmetry, may have utility for early and differential diagnosis, and for tracking disease progression in patients with later PD. PMID:19945285

Highlights from the functional single nucleotide polymorphisms associated with human muscle size and strength or FAMuSS study.

PubMed

Pescatello, Linda S; Devaney, Joseph M; Hubal, Monica J; Thompson, Paul D; Hoffman, Eric P

2013-01-01

The purpose of the Functional Single Nucleotide Polymorphisms Associated with Human Muscle Size and Strength study or FAMuSS was to identify genetic factors that dictated the response of health-related fitness phenotypes to resistance exercise training (RT). The phenotypes examined were baseline muscle strength and muscle, fat, and bone volume and their response to RT. FAMuSS participants were 1300 young (24 years), healthy men (42%) and women (58%) that were primarily of European-American descent. They were genotyped for ~500 polymorphisms and completed the Paffenbarger Physical Activity Questionnaire to assess energy expenditure and time spent in light, moderate, and vigorous intensity habitual physical activity and sitting. Subjects then performed a 12-week progressive, unilateral RT program of the nondominant arm with the dominant arm used as a comparison. Before and after RT, muscle strength was measured with the maximum voluntary contraction and one repetition maximum, while MRI measured muscle, fat, and bone volume. We will discuss the history of how FAMuSS originated, provide a brief overview of the FAMuSS methods, and summarize our major findings regarding genotype associations with muscle strength and size, body composition, cardiometabolic biomarkers, and physical activity.

Highlights from the Functional Single Nucleotide Polymorphisms Associated with Human Muscle Size and Strength or FAMuSS Study

PubMed Central

Pescatello, Linda S.; Devaney, Joseph M.; Hubal, Monica J.; Thompson, Paul D.; Hoffman, Eric P.

2013-01-01

The purpose of the Functional Single Nucleotide Polymorphisms Associated with Human Muscle Size and Strength study or FAMuSS was to identify genetic factors that dictated the response of health-related fitness phenotypes to resistance exercise training (RT). The phenotypes examined were baseline muscle strength and muscle, fat, and bone volume and their response to RT. FAMuSS participants were 1300 young (24 years), healthy men (42%) and women (58%) that were primarily of European-American descent. They were genotyped for ~500 polymorphisms and completed the Paffenbarger Physical Activity Questionnaire to assess energy expenditure and time spent in light, moderate, and vigorous intensity habitual physical activity and sitting. Subjects then performed a 12-week progressive, unilateral RT program of the nondominant arm with the dominant arm used as a comparison. Before and after RT, muscle strength was measured with the maximum voluntary contraction and one repetition maximum, while MRI measured muscle, fat, and bone volume. We will discuss the history of how FAMuSS originated, provide a brief overview of the FAMuSS methods, and summarize our major findings regarding genotype associations with muscle strength and size, body composition, cardiometabolic biomarkers, and physical activity. PMID:24455711

Carotid Baroreflex Function During Prolonged Exercise

NASA Technical Reports Server (NTRS)

Raven, P. B.

1999-01-01

Astronauts are often required to work (exercise) at moderate to high intensities for extended periods while performing extra-vehicular activities (EVA). Although the physiologic responses associated with prolonged exercise have been documented, the mechanisms involved in blood pressure regulation under these conditions have not yet been fully elucidated. An understanding of this issue is pertinent to the ability of humans to perform work in microgravity and complies with the emphasis of NASA's Space Physiology and Countermeasures Program. Prolonged exercise at a constant workload is know to result in a progressive decrease in mean arterial pressure (MAP) concomitant with a decrease in stroke volume and a compensatory increase in heart rate. The continuous decrease in MAP during the exercise, which is related to the thermoregulatory redistribution of circulating blood volume to the cutaneous circulation, raises the question as to whether there is a loss of baroreflex regulation of arterial blood pressure. We propose that with prolongation of the exercise to 60 minutes, progressive increases on central command reflect a progressive upward resetting of the carotid baroreflex (CBR) such that the operating point of the CBR is shifted to a pressure below the threshold of the reflex rendering it ineffectual in correcting the downward drift in MAP. In order to test this hypothesis, experiments have been designed to uncouple the global hemodynamic response to prolonged exercise from the central command mediated response via: (1) continuous maintenance of cardiac filling volume by intravenous infusion of a dextran solution; and (2) whole body surface cooling to counteract thermoregulatory cutaneous vasodialation. As the type of work (exercise) performed by astronauts is inherently arm and upper body dependent, we will also examine the physiologic responses to prolonged leg cycling and arm ergometry exercise in the supine positions with and without level lower body negative pressure (-10 torr) to mimic spaceflight- related decreases in cardiac filling volumes.

Transarterial chemoembolization plus or minus intravenous bevacizumab in the treatment of hepatocellular cancer: A pilot study

PubMed Central

2012-01-01

Background Stimulation of vascular endothelial growth factor (VEGF) has been observed following transarterial chemoembolization (TACE) in hepatocellular cancer (HCC) and may contribute to tumor regrowth. This pilot study examined whether intravenous (IV) bevacizumab, a monoclonal antibody against VEGF, could inhibit neovessel formation after TACE. Methods 30 subjects with HCC undergoing TACE at a single academic institution were randomized with a computer-generated allocation in a one to one ratio to either bevacizumab at a dose of 10 mg/kg IV every 14 days beginning 1 week prior to TACE (TACE-BEV arm) or observation (TACE-O arm). Angiography was performed with TACE at day 8, and again at weeks 10 and 14. Repeat TACE was performed at week 14 if indicated. TACE-BEV subjects were allowed to continue bevacizumab beyond week 16. TACE-O subjects were allowed to cross-over to bevacizumab at week 16 in the setting of progressive disease. The main outcome measure was a comparison of neovessel formation by serial angiography. Secondary outcome measures were progression free survival (PFS) at 16 weeks, overall survival (OS), bevacizumab safety, and an analysis of VEGF levels before and after TACE with and without bevacizumab. Results Among the 30 subjects enrolled, 9 of 15 randomized to the TACE-O arm and 14 of 15 randomized to the TACE-BEV arm completed all 3 angiograms. At week 14, 3 of 9 (33%) TACE-O subjects and 2 of 14 (14%) TACE-BEV subjects demonstrated neovascularity. The PFS at 16 weeks was 0.19 in the TACE-O arm and 0.79 in the TACE-BEV arm (p = 0.021). The median OS was 61 months in the TACE-O arm and 49 months in the TACE-BEV arm (p = 0.21). No life-threatening bevacizumab-related toxicities were observed. There were no substantial differences in bevacizumab pharmacokinetics compared to historical controls. Bevacizumab attenuated the increase in VEGF observed post-TACE. Conclusions IV bevacizumab was well tolerated in selected HCC subjects undergoing TACE, and appeared to diminish neovessel formation at week 14. Trial registration ClinicalTrials.gov NCT00049322. PMID:22244160

A randomized phase II study of the MEK1/MEK2 inhibitor trametinib (GSK1120212) compared with docetaxel in KRAS-mutant advanced non-small-cell lung cancer (NSCLC)†

PubMed Central

Blumenschein, G. R.; Smit, E. F.; Planchard, D.; Kim, D.-W.; Cadranel, J.; De Pas, T.; Dunphy, F.; Udud, K.; Ahn, M.-J.; Hanna, N. H.; Kim, J.-H.; Mazieres, J.; Kim, S.-W.; Baas, P.; Rappold, E.; Redhu, S.; Puski, A.; Wu, F. S.; Jänne, P. A.

2015-01-01

Background KRAS mutations are detected in 25% of non-small-cell lung cancer (NSCLC) and no targeted therapies are approved for this subset population. Trametinib, a selective allosteric inhibitor of MEK1/MEK2, demonstrated preclinical and clinical activity in KRAS-mutant NSCLC. We report a phase II trial comparing trametinib with docetaxel in patients with advanced KRAS-mutant NSCLC. Patients and methods Eligible patients with histologically confirmed KRAS-mutant NSCLC previously treated with one prior platinum-based chemotherapy were randomly assigned in a ratio of 2 : 1 to trametinib (2 mg orally once daily) or docetaxel (75 mg/m2 i.v. every 3 weeks). Crossover to the other arm after disease progression was allowed. Primary end point was progression-free survival (PFS). The study was prematurely terminated after the interim analysis of 92 PFS events, which showed the comparison of trametinib versus docetaxel for PFS crossed the futility boundary. Results One hundred and twenty-nine patients with KRAS-mutant NSCLC were randomized; of which, 86 patients received trametinib and 43 received docetaxel. Median PFS was 12 weeks in the trametinib arm and 11 weeks in the docetaxel arm (hazard ratio [HR] 1.14; 95% CI 0.75–1.75; P = 0.5197). Median overall survival, while the data are immature, was 8 months in the trametinib arm and was not reached in the docetaxel arm (HR 0.97; 95% CI 0.52–1.83; P = 0.934). There were 10 (12%) partial responses (PRs) in the trametinib arm and 5 (12%) PRs in the docetaxel arm (P = 1.0000). The most frequent adverse events (AEs) in ≥20% of trametinib patients were rash, diarrhea, nausea, vomiting, and fatigue. The most frequent grade 3 treatment-related AEs in the trametinib arm were hypertension, rash, diarrhea, and asthenia. Conclusion Trametinib showed similar PFS and a response rate as docetaxel in patients with previously treated KRAS-mutant-positive NSCLC. Clinicaltrials.gov registration number NCT01362296. PMID:25722381

Avoiding criminal liabilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blattner, J.W.; Bramble, G.M.

1994-06-01

Armed with more than 120 investigative agents, the US Environmental Protection Agency, through its attorneys at the Dept. of Justice, charges 5 to 10 engineers and business people with criminal violations of the nation's environmental regulations in any given week. There are some 10,000 pages of federal (let alone state) environmental regulations. The rules apply to large and small companies alike. As a practical matter, the sheer scope and complexity of environmental regulatory programs make 100% compliance virtually unattainable for most industrial enterprises. Where it is no longer a defense to claim lack of knowledge of one's regulatory obligations, andmore » where courts allow the inference of criminal knowledge based on what the defendant should have known, what is a company to do The environmental audit provides a solution to this problem. Progressive audit programs are established with three goals in mind: to ensure that programs and practices at facilities are in compliance with applicable rules and regulations; to affirm that management systems are in place at the facilities to support ongoing compliance; and to identify needs or opportunities where it may be desirable to go beyond compliance to protect human health and the environment. This paper discusses the implementation of an audit program.« less

Gender-Specific Intervention to Reduce Underage Drinking Among Early Adolescent Girls: A Test of a Computer-Mediated, Mother-Daughter Program*

PubMed Central

Schinke, Steven P.; Cole, Kristin C. A.; Fang, Lin

2009-01-01

Objective: This study evaluated a gender-specific, computer-mediated intervention program to prevent underage drinking among early adolescent girls. Method: Study participants were adolescent girls and their mothers from New York, New Jersey, and Connecticut. Participants completed pretests online and were randomly divided between intervention and control arms. Intervention-arm girls and their mothers interacted with a computer program aimed to enhance mother-daughter relationships and to teach girls skills for managing conflict, resisting media influences, refusing alcohol and drugs, and correcting peer norms about underage drinking, smoking, and drug use. After intervention, all participants (control and intervention) completed posttest and follow-up measurements. Results: Two months following program delivery and relative to control-arm participants, intervention-arm girls and mothers had improved their mother-daughter communication skills and their perceptions and applications of parental monitoring and rule-setting relative to girls' alcohol use. Also at follow-up, intervention-arm girls had improved their conflict management and alcohol use-refusal skills; reported healthier normative beliefs about underage drinking; demonstrated greater self-efficacy about their ability to avoid underage drinking; reported less alcohol consumption in the past 7 days, 30 days, and year; and expressed lower intentions to drink as adults. Conclusions: Study findings modestly support the viability of a mother-daughter, computer-mediated program to prevent underage drinking among adolescent girls. The data have implications for the further development of gender-specific approaches to combat increases in alcohol and other substance use among American girls. PMID:19118394

Effects of a Home-Based Upper Limb Training Program in Patients With Multiple Sclerosis: A Randomized Controlled Trial.

PubMed

Ortiz-Rubio, Araceli; Cabrera-Martos, Irene; Rodríguez-Torres, Janet; Fajardo-Contreras, Waldo; Díaz-Pelegrina, Ana; Valenza, Marie Carmen

2016-12-01

To evaluate the effects of a home-based upper limb training program on arm function in patients with multiple sclerosis (MS). Additionally, the effects of this program on manual dexterity, handgrip strength, and finger prehension force were analyzed. Randomized, single-blind controlled trial. Home based. Patients with a clinical diagnosis of MS acknowledging impaired manual ability (N=37) were randomized into 2 groups. Patients in the experimental group were included in a supervised home-based upper limb training program for 8 weeks twice a week. Patients in the control group received information in the form of a leaflet with a schedule of upper limb exercise training. The primary outcome measure was arm function (motor functioning assessed using the finger tapping test and a functional measure, the Action Research Arm Test). The secondary outcome measures were manual dexterity assessed with the Purdue Pegboard Test and handgrip strength and finger prehension force evaluated with a handgrip and a pinch dynamometer, respectively. After 8 weeks, a significant between-group improvement (P<.05) was found on the Action Research Arm Test bilaterally and the finger tapping test in the most affected upper limb. The secondary outcomes also improved in the most affected limb in the experimental group. An 8-week home-based intervention program focused on upper limbs twice a week improved arm function and physiologic variables with a primary focus on the more affected extremity in patients with MS compared with the control group. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Progression of Geographic Atrophy and Genotype in Age-Related Macular Degeneration

PubMed Central

Klein, Michael L.; Ferris, Frederick L.; Francis, Peter J.; Lindblad, Anne S.; Chew, Emily Y.; Hamon, Sara C.; Ott, Jurg

2009-01-01

Purpose To determine if genotype is associated with rate of growth of geographic atrophy (GA) in eyes with age-related macular degeneration (AMD). Design Prospective analysis of participants in a randomized controlled clinical trial. Participants 114 eyes of 114 participants in the Age-Related Eye Disease Study (AREDS). Methods Fundus photographs from AREDS participants with GA from whom a DNA specimen had been obtained and serial photographs had been taken over a minimum of 2 years were evaluated for progression as determined by change in cumulative area of GA. All fundus photographs were scanned, digitized, and centrally graded longitudinally for area of GA. The relationship of GA progression with previously identified genetic variants associated with AMD was assessed. Main Outcome Measures Genotype frequencies and change in cumulative area of GA. Results The mean growth rate of geographic atrophy for the 114 eyes was 1.79 mm2/year (range= 0.17–4.76 mm2/year). No association between growth rate and genotype was present for variants in the CFH, C2, C3, APOE, and TLR3genes. For the single nucleotide polymorphism (SNP) rs10490924 in LOC387715/ARMS2, there was a significant association of GA growth rate, both adjusted and unadjusted for initial lesion size, with the homozygous risk genotype as compared to the homozygous non-risk genotype (unadjusted p-value = 0.002; Bonferroni corrected p-value = 0.014) and for allelic association(Bonferroni corrected p-value = 0.011). Analyses of other measures of geographic atrophy progression (progression to central GA from extrafoveal GA and development of bilateral GA in those initially with unilateral GA) showed no statistically significant association between progression and the LOC387715/ARMS2/HTRA1 genotype. Conclusion GA growth rates calculated from digitized serial fundus photographs showed no association with variants in the CFH, C2, C3, APOE, and TLR3 genes. There was a nominally statistically significant association with the LOC387715/ARMS2/HTRA1 genotype, although this finding was not supported by analyses of secondary measures of GA progression. Replication in other populations would be needed to establish the existence of an association. PMID:20381870

Phase II randomized study of trabectedin given as two different every 3 weeks dose schedules (1.5 mg/m2 24 h or 1.3 mg/m2 3 h) to patients with relapsed, platinum-sensitive, advanced ovarian cancer.

PubMed

Del Campo, J M; Roszak, A; Bidzinski, M; Ciuleanu, T E; Hogberg, T; Wojtukiewicz, M Z; Poveda, A; Boman, K; Westermann, A M; Lebedinsky, C

2009-11-01

This randomized, open-label, phase II clinical trial evaluated the optimal regimen of trabectedin administered every 3 weeks in patients with platinum-sensitive, relapsed, advanced ovarian cancer (AOC). Patients previously treated with less than two or two previous chemotherapy lines were randomized to receive trabectedin 1.5 mg/m(2) 24 h (arm A, n = 54) or 1.3 mg/m(2) 3 h (arm B, n = 53). Objective response rate (ORR) per RECIST was the primary efficacy end point. Toxic effects were graded according to the National Cancer Institute-Common Toxicity Criteria v. 2.0. ORR was 38.9% [95% confidence interval (CI) 25.9% to 53.1%; arm A] and 35.8% (95% CI 23.1% to 50.2%; arm B) (intention-to-treat primary analysis). Median time to progression was 6.2 months (95% CI 5.3-8.6 months; arm A) and 6.8 months (95% CI 4.6-7.4 months; arm B). Frequent severe adverse events were nausea/vomiting (24%, arm A; 15%, arm B) and fatigue (15%, arm A; 10%, arm B). Common severe laboratory abnormalities were transient, noncumulative neutropenia (55%, arm A; 37%, arm B) and transaminase increases (alanine aminotransferase, 55%, arm A; 59%, arm B). Both every-3-weeks trabectedin regimes, 1.5 mg/m(2) 24 h and 1.3 mg/m(2) 3 h, were active and reasonably well tolerated in AOC platinum-sensitive patients. Trabectedin every-3-weeks has promising activity and deserves to be further evaluated in relapsed AOC.

A Phase 2 Randomized Study of Ramucirumab (IMC-1121B) with or without Dacarbazine in Patients with Metastatic Melanoma

PubMed Central

Carvajal, Richard D.; Wong, Michael K.; Thompson, John A.; Gordon, Michael S.; Lewis, Karl D.; Pavlick, Anna C.; Wolchok, Jedd D.; Rojas, Patrick B.; Schwartz, Jonathan D.; Bedikian, Agop Y.

2017-01-01

SUMMARY Background To evaluate the efficacy and safety of ramucirumab (IMC-1121B; LY3009806), a fully human monoclonal antibody targeting the vascular endothelial growth factor receptor-2, alone and in combination with dacarbazine in chemotherapy-naïve patients with metastatic melanoma (MM). Methods Eligible patients received ramucirumab (10 mg/kg) + dacarbazine (1000 mg/m2) (Arm A) or ramucirumab only (10 mg/kg) (Arm B) every 3 weeks. The primary endpoint was progression-free survival (PFS); secondary endpoints included overall survival (OS), overall response, and safety. Findings Of 106 randomized patients, 102 received study treatment (Arm A, N = 52; Arm B, N = 50). Baseline characteristics were similar in both arms. Median PFS was 2·6 months (Arm A) and 1·7 months (Arm B); median 6-month PFS rates were 30·7% and 17·9% and 12-month PFS rates were 23·7% and 15·6%, respectively. In Arm A, 9 (17·3%) patients had partial response (PR) and 19 (36·5%), stable disease (SD); PR and SD in Arm B were 2 (4·0%) and 21 (42·0%), respectively. Median OS was 8·7 months in Arm A and 11·1 months in Arm B. Patients in both arms tolerated the treatment with limited grade 3/4 toxicities. Interpretation Ramucirumab alone or in combination with dacarbazine was associated with an acceptable safety profile in patients with MM. Although the study was not powered for comparison between treatment arms, PFS appeared greater with combination therapy. Sustained disease control was observed on both study arm Funding Funded by ImClone Systems LLC, a wholly-owned subsidiary of Eli Lilly and Company, Bridgewater, NJ PMID:24930625

Attitude Control of Flexible Structures.

DTIC Science & Technology

1990-09-01

arm has been determined experimentally and compared with analytical * predictions obtained by using the GIFTS finite element analysis program. The...frequencies of the flexible arm have been determined experimentally and compared with analytical predictiens obtained by using the GIFTS finite element...exception of the first mode. Table V shows the difference between the frequencies obtained from the GIFTS program and the experimental values. TABLE

Gender Norms, Poverty and Armed Conflict in Côte D'Ivoire: Engaging Men in Women's Social and Economic Empowerment Programming

ERIC Educational Resources Information Center

Falb, K. L.; Annan, J.; King, E.; Hopkins, J.; Kpebo, D.; Gupta, J.

2014-01-01

Engaging men is a critical component in efforts to reduce intimate partner violence (IPV). Little is known regarding men's perspectives of approaches that challenge inequitable gender norms, particularly in settings impacted by armed conflict. This article describes men's experiences with a women's empowerment program and highlights men's…

Personnel occupied woven envelope robot

NASA Technical Reports Server (NTRS)

Wessling, Francis; Teoh, William; Ziemke, M. Carl

1988-01-01

The Personnel Occupied Woven Envelope Robot (POWER) provides an alternative to extravehicular activity (EVA) of space suited astronauts and/or use of long slender manipulator arms such as are used in the Shuttle Remote Manipulator System. POWER provides the capability for a shirt sleeved astronaut to perform such work by entering a control pod through air locks at both ends of an inflated flexible bellows (access tunnel). The exoskeleton of the tunnel is a series of six degrees of freedom (Six-DOF) articulated links compressible to 1/6 of their fully extended length. The operator can maneuver the control pod to almost any location within about 50 m of the base attachment to the space station. POWER can be envisioned as a series of hollow Six-DOF manipulator segments or arms wherein each arm grasps the shoulder of the next arm. Inside the hollow arms ia a bellow-type access tunnel. The control pod is the fist of the series of linked hollow arms. The fingers of the fist are conventional manipulator arms under direct visual control of the nearby operator in the pod. The applications and progress to date of the POWER system is given.

Decadal Vision Progress Report Implementation Plans and Status for the Next Generation ARM Facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mather, James

The reconfiguration of the ARM facility, formally initiated in early 2014, is geared toward implementing the Next Generation of the ARM Facility, which will more tightly link ARM measurements and atmospheric models. The strategy is outlined in the ARM Climate Research Facility Decadal Vision (DOE 2014a). The strategy includes the implementation of a high-resolution model, initially at the Southern Great Plains (SGP) site, and enhancements at the SGP and North Slope of Alaska (NSA) sites to provide additional observations to support modeling and process studies. Enhancements at the SGP site focus on ground-based instruments while enhancements at the NSA makemore » use of Unmanned Aerial Systems (UAS) and Tethered Balloon Systems (TBS). It is also recognized that new data tools and data products will need to be developed to take full advantage of these improvements. This document provides an update on the status of these ARM facility enhancements, beginning with the measurement enhancements at the SGP and NSA, followed by a discussion of the modeling project including associated data-processing activities.« less

Review of science issues, deployment strategy, and status for the ARM north slope of Alaska-Adjacent Arctic Ocean climate research site

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stamnes, K.; Ellingson, R.G.; Curry, J.A.

1999-01-01

Recent climate modeling results point to the Arctic as a region that is particularly sensitive to global climate change. The Arctic warming predicted by the models to result from the expected doubling of atmospheric carbon dioxide is two to three times the predicted mean global warming, and considerably greater than the warming predicted for the Antarctic. The North Slope of Alaska-Adjacent Arctic Ocean (NSA-AAO) Cloud and Radiation Testbed (CART) site of the Atmospheric Radiation Measurement (ARM) Program is designed to collect data on temperature-ice-albedo and water vapor-cloud-radiation feedbacks, which are believed to be important to the predicted enhanced warming inmore » the Arctic. The most important scientific issues of Arctic, as well as global, significance to be addressed at the NSA-AAO CART site are discussed, and a brief overview of the current approach toward, and status of, site development is provided. ARM radiometric and remote sensing instrumentation is already deployed and taking data in the perennial Arctic ice pack as part of the SHEBA (Surface Heat Budget of the Arctic ocean) experiment. In parallel with ARM`s participation in SHEBA, the NSA-AAO facility near Barrow was formally dedicated on 1 July 1997 and began routine data collection early in 1998. This schedule permits the US Department of Energy`s ARM Program, NASA`s Arctic Cloud program, and the SHEBA program (funded primarily by the National Science Foundation and the Office of Naval Research) to be mutually supportive. In addition, location of the NSA-AAO Barrow facility on National Oceanic and Atmospheric Administration land immediately adjacent to its Climate Monitoring and Diagnostic Laboratory Barrow Observatory includes NOAA in this major interagency Arctic collaboration.« less

Military Personnel: Performance Measures Needed to Determine How Well DOD’s Credentialing Program Helps Servicemembers

DTIC Science & Technology

2016-10-01

Section 2015 of Title 10 directed DOD to carry out a program to enable servicemembers to obtain professional credentials related to their military...which amended 10 U.S.C. § 2015 to require DOD to carry out a program to enable members of the armed forces to obtain, while serving in the armed...Internal Control in the Federal Government, GAO-14-704G (Washington, D.C.: Sept. 10 , 2014). 6See GAO, Tax Administration: IRS Needs to Further Refine

Contributions of the Atmospheric Radiation Measurement (ARM) Program and the ARM Climate Research Facility to the U.S. Climate Change Science Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

SA Edgerton; LR Roeder

The Earth’s surface temperature is determined by the balance between incoming solar radiation and thermal (or infrared) radiation emitted by the Earth back to space. Changes in atmospheric composition, including greenhouse gases, clouds, and aerosols can alter this balance and produce significant climate change. Global climate models (GCMs) are the primary tool for quantifying future climate change; however, there remain significant uncertainties in the GCM treatment of clouds, aerosol, and their effects on the Earth’s energy balance. The 2007 assessment (AR4) by the Intergovernmental Panel on Climate Change (IPCC) reports a substantial range among GCMs in climate sensitivity to greenhousemore » gas emissions. The largest contributor to this range lies in how different models handle changes in the way clouds absorb or reflect radiative energy in a changing climate (Solomon et al. 2007). In 1989, the U.S. Department of Energy (DOE) Office of Science created the Atmospheric Radiation Measurement (ARM) Program within the Office of Biological and Environmental Research (BER) to address scientific uncertainties related to global climate change, with a specific focus on the crucial role of clouds and their influence on the transfer of radiation in the atmosphere. To address this problem, BER has adopted a unique two-pronged approach: * The ARM Climate Research Facility (ACRF), a scientific user facility for obtaining long-term measurements of radiative fluxes, cloud and aerosol properties, and related atmospheric characteristics in diverse climate regimes. * The ARM Science Program, focused on the analysis of ACRF data to address climate science issues associated with clouds, aerosols, and radiation, and to improve GCMs. This report describes accomplishments of the BER ARM Program toward addressing the primary uncertainties related to climate change prediction as identified by the IPCC.« less

22 CFR 126.6 - Foreign-owned military aircraft and naval vessels, and the Foreign Military Sales program.

Code of Federal Regulations, 2011 CFR

2011-04-01

... INTERNATIONAL TRAFFIC IN ARMS REGULATIONS GENERAL POLICIES AND PROVISIONS § 126.6 Foreign-owned military... pursuant to the Arms Export Control Act or the Foreign Assistance Act of 1961, as amended, and (2) The... the Arms Export Control Act pursuant to an Letter of Offer and Acceptance (LOA) authorizing such...

Once-a-Week Versus Once-Every-3-Weeks Cisplatin Chemoradiation for Locally Advanced Head and Neck Cancer: A Phase III Randomized Noninferiority Trial.

PubMed

Noronha, Vanita; Joshi, Amit; Patil, Vijay Maruti; Agarwal, Jaiprakash; Ghosh-Laskar, Sarbani; Budrukkar, Ashwini; Murthy, Vedang; Gupta, Tejpal; D'Cruz, Anil K; Banavali, Shripad; Pai, Prathamesh S; Chaturvedi, Pankaj; Chaukar, Devendra; Pande, Nikhil; Chandrasekharan, Arun; Talreja, Vikas; Vallathol, Dilip Harindran; Mathrudev, Vijayalakshmi; Manjrekar, Aparna; Maske, Kamesh; Bhelekar, Arati Sanjay; Nawale, Kavita; Kannan, Sadhana; Gota, Vikram; Bhattacharjee, Atanu; Kane, Shubhada; Juvekar, Shashikant L; Prabhash, Kumar

2018-04-10

Purpose Chemoradiation with cisplatin 100 mg/m 2 given once every 3 weeks is the standard of care in locally advanced head and neck squamous cell cancer (LAHNSCC). Increasingly, low-dose once-a-week cisplatin is substituted because of perceived lower toxicity and convenience. However, there is no level 1 evidence of comparable efficacy to cisplatin once every 3 weeks. Patients and Methods In this phase III randomized trial, we assessed the noninferiority of cisplatin 30 mg/m 2 given once a week compared with cisplatin 100 mg/m 2 given once every 3 weeks, both administered concurrently with curative intent radiotherapy in patients with LAHNSCC. The primary end point was locoregional control (LRC); secondary end points included toxicity, compliance, response, progression-free survival, and overall survival. Results Between 2013 and 2017, we randomly assigned 300 patients, 150 to each arm. Two hundred seventy-nine patients (93%) received chemoradiotherapy in the adjuvant setting. At a median follow-up of 22 months, the estimated cumulative 2-year LRC rate was 58.5% in the once-a-week arm and 73.1% in the once-every-3-weeks arm, leading to an absolute difference of 14.6% (95% CI, 5.7% to 23.5%); P = .014; hazard ratio (HR), 1.76 (95% CI, 1.11 to 2.79). Acute toxicities of grade 3 or higher occurred in 71.6% of patients in the once-a-week arm and in 84.6% of patients in the once-every-3-weeks arm ( P = .006). Estimated median progression-free survival in the once-a-week arm was 17.7 months (95% CI, 0.42 to 35.05 months) and in the once-every-3-weeks arm, 28.6 months (95% CI, 15.90 to 41.30 months); HR, 1.24 (95% CI, 0.89 to 1.73); P = .21. Estimated median overall survival in the once-a-week arm was 39.5 months and was not reached in the once-every-3-weeks arm (HR, 1.14 [95% CI, 0.79 to 1.65]; P = .48). Conclusion Once-every-3-weeks cisplatin at 100 mg/m 2 resulted in superior LRC, albeit with more toxicity, than did once-a-week cisplatin at 30 mg/m 2 , and should remain the preferred chemoradiotherapy regimen for LAHNSCC in the adjuvant setting.

Grants for adaptive sports programs for disabled veterans and disabled members of the Armed Forces. Final rule.

PubMed

2015-05-04

This final rule amends Department of Veterans Affairs (VA) regulations to establish a new program to provide grants to eligible entities to provide adaptive sports activities to disabled veterans and disabled members of the Armed Forces. This rulemaking is necessary to implement a change in the law that authorizes VA to make grants to entities other than the United States Olympic Committee for adaptive sports programs. It establishes procedures for evaluating grant applications under this grant program, and otherwise administering the grant program. This rule implements section 5 of the VA Expiring Authorities Extension Act of 2013.

Changing the Officer Promotion System to Support Unit Focused Stability (UFS)

DTIC Science & Technology

2005-05-26

arms officers will be reduced by one-third.78 This decrement is far from trivial. Since many combat arms officers define career success by these two...their own priorities and definitions of career success , or by inventing informal “work-arounds” to regain the status quo of the old personnel...progression models so that its members are not forced to choose between personal career success and unit cohesion? Perhaps a study of the officer

CCDC103 mutations cause primary ciliary dyskinesia by disrupting assembly of ciliary dynein arms

PubMed Central

Panizzi, Jennifer R.; Becker-Heck, Anita; Castleman, Victoria H.; Al-Mutairi, Dalal; Liu, Yan; Loges, Niki T.; Pathak, Narendra; Austin-Tse, Christina; Sheridan, Eamonn; Schmidts, Miriam; Olbrich, Heike; Werner, Claudius; Häffner, Karsten; Hellman, Nathan; Chodhari, Rahul; Gupta, Amar; Kramer-Zucker, Albrecht; Olale, Felix; Burdine, Rebecca D.; Schier, Alexander F.; O’Callaghan, Christopher; Chung, Eddie MK; Reinhardt, Richard; Mitchison, Hannah M.; King, Stephen M.; Omran, Heymut; Drummond, Iain A.

2012-01-01

Cilia are essential for fertilization, respiratory clearance, cerebrospinal fluid circulation, and to establish laterality1. Cilia motility defects cause Primary Ciliary Dyskinesia (PCD, MIM 242650), a disorder affecting 1:15-30,000 births. Cilia motility requires the assembly of multisubunit dynein arms that drive cilia bending2. Despite progress in understanding the genetic basis of PCD, mutations remain to be identified for several PCD linked loci3. Here we show that the zebrafish cilia paralysis mutant schmalhanstn222 (smh) mutant encodes the coiled-coil domain containing 103 protein (Ccdc103), a foxj1a regulated gene. Screening 146 unrelated PCD families identified patients in six families with reduced outer dynein arms, carrying mutations in CCDC103. Dynein arm assembly in smh mutant zebrafish was rescued by wild-type but not mutant human CCDC103. Chlamydomonas Ccdc103 functions as a tightly bound, axoneme-associated protein. The results identify Ccdc103 as a novel dynein arm attachment factor that when mutated causes Primary Ciliary Dyskinesia. PMID:22581229

Cardio Respiratory Adaptations with Long Term Personalized Exercise Program in a T12 Spinal Cord Injured Person

ERIC Educational Resources Information Center

Vasiliadis, Angelo; Christoulas, Kosmas; Evaggelinou, Christina; Vrabas, Ioannis

2009-01-01

The purpose of this study was to investigate the physiological adaptations in cardio respiratory endurance with a personalized exercise program with arm-cranking exercise in a paraplegic person (incomplete T12 spinal cord injury). A 32 year-old man with spinal cord injury (T12) participated in the present study performing 30 minutes arm cranking…

Selection, training and retention of an armed private security department.

PubMed

Hollar, David B

2009-01-01

To arm or not to arm security officers? One hospital which has opted for arming its officers is Cook Children's Healthcare System, Fort Worth, TX, an integrated pediatric healthcare facility with over 4000 employees. Because of its location in a major metropolitan area and based on several factors including demographics, exterior risk assessments and crime statistics, the hospital's Administration and its Risk Manager supported the decision to operate as an armed security force, according to the author. In this article he shares its current program and presents some thoughts and ideas that may benefit others who are considering this important step.

Commerical Crew Program (CCP) Access Arm Installation

NASA Image and Video Library

2016-08-15

The Crew Access Arm and White Room for Boeing's CST-100 Starliner are attached to the Crew Access Tower at Cape Canaveral Air Force Station’s Space Launch Complex 41. The arm will serve as the connection that astronauts will walk through prior to boarding the Starliner spacecraft when stacked atop a United Launch Alliance Atlas V rocket. This installation completes the major construction of the first new Crew Access Tower to be built at the Cape since the Apollo era. Under a Commercial Crew Transportation Capability contract with NASA, Boeing’s Starliner system will be certified by NASA's Commercial Crew Program to fly crews to and from the International Space Station.

ARM-Led Improvements Aerosols in Climate and Climate Models

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ghan, Steven J.; Penner, Joyce E.

2016-07-25

The DOE ARM program has played a foundational role in efforts to quantify aerosol effects on climate, beginning with the early back-of-the-envelope estimates of direct radiative forcing by anthropogenic sulfate and biomass burning aerosol (Penner et al., 1994). In this chapter we review the role that ARM has played in subsequent detailed estimates based on physically-based representations of aerosols in climate models. The focus is on quantifying the direct and indirect effects of anthropogenic aerosol on the planetary energy balance. Only recently have other DOE programs applied the aerosol modeling capability to simulate the climate response to the radiative forcing.

Involved-Field Radiotherapy versus Elective Nodal Irradiation in Combination with Concurrent Chemotherapy for Locally Advanced Non-Small Cell Lung Cancer: A Prospective Randomized Study

PubMed Central

Chen, Ming; Bao, Yong; Ma, Hong-Lian; Wang, Jin; Wang, Yan; Peng, Fang; Zhou, Qi-Chao; Xie, Cong-Hua

2013-01-01

This prospective randomized study is to evaluate the locoregional failure and its impact on survival by comparing involved field radiotherapy (IFRT) with elective nodal irradiation (ENI) in combination with concurrent chemotherapy for locally advanced non-small cell lung cancer. It appears that higher dose could be delivered in IFRT arm than that in ENI arm, and IFRT did not increase the risk of initially uninvolved or isolated nodal failures. Both a tendency of improved locoregional progression-free survival and a significant increased overall survival rate are in favor of IFRT arm in this study. PMID:23762840

Nurse-assisted education and exercise decrease the prevalence and morbidity of lymphedema following breast cancer surgery.

PubMed

Sisman, H; Sahin, B; Duman, B B; Tanriverdi, G

2012-01-01

To evaluate an educational and exercise program for the prevention and progression of post-mastectomy lymphedema of the arm and shoulder. Fifty-five patients who had undergone mastectomy and axillary lymph node dissection between June 2009 and January 2010 were included in this study. The patients were informed by a trainer nurse about the precautions they should take to prevent the development of lymphedema. The patients were also trained for the appropriate exercises and were given written educational material prepared by the investigators. Among the participants, 96.4% underwent modified radical mastectomy (MRM) and 3.6% breast-conserving (BCS) surgery. The mean postoperative follow-up period was 9.87 ± 17.55 months. The degree of lymphedema was found lower, even within 6 months, in the patients that exercised as compared to the patients that did not (p<0.05). The results indicate that the risk of development and progression of mastectomy-related lymphedema was reduced with education and exercise provided by trained nurses at an early stage.

Normalized Movement Quality Measures for Therapeutic Robots Strongly Correlate With Clinical Motor Impairment Measures

PubMed Central

Celik, Ozkan; O’Malley, Marcia K.; Boake, Corwin; Levin, Harvey S.; Yozbatiran, Nuray; Reistetter, Timothy A.

2016-01-01

In this paper, we analyze the correlations between four clinical measures (Fugl–Meyer upper extremity scale, Motor Activity Log, Action Research Arm Test, and Jebsen-Taylor Hand Function Test) and four robotic measures (smoothness of movement, trajectory error, average number of target hits per minute, and mean tangential speed), used to assess motor recovery. Data were gathered as part of a hybrid robotic and traditional upper extremity rehabilitation program for nine stroke patients. Smoothness of movement and trajectory error, temporally and spatially normalized measures of movement quality defined for point-to-point movements, were found to have significant moderate to strong correlations with all four of the clinical measures. The strong correlations suggest that smoothness of movement and trajectory error may be used to compare outcomes of different rehabilitation protocols and devices effectively, provide improved resolution for tracking patient progress compared to only pre-and post-treatment measurements, enable accurate adaptation of therapy based on patient progress, and deliver immediate and useful feedback to the patient and therapist. PMID:20388607

Impact of palbociclib plus letrozole on patient-reported health-related quality of life: results from the PALOMA-2 trial.

PubMed

Rugo, H S; Diéras, V; Gelmon, K A; Finn, R S; Slamon, D J; Martin, M; Neven, P; Shparyk, Y; Mori, A; Lu, D R; Bhattacharyya, H; Bartlett, C Huang; Iyer, S; Johnston, S; Ettl, J; Harbeck, N

2018-04-01

Patient-reported outcomes are integral in benefit-risk assessments of new treatment regimens. The PALOMA-2 study provides the largest body of evidence for patient-reported health-related quality of life (QOL) for patients with metastatic breast cancer (MBC) receiving first-line endocrine-based therapy (palbociclib plus letrozole and letrozole alone). Treatment-naïve postmenopausal women with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2-) MBC were randomized 2 : 1 to palbociclib plus letrozole (n = 444) or placebo plus letrozole (n = 222). Patient-reported outcomes were assessed at baseline, day 1 of cycles 2 and 3, and day 1 of every other cycle from cycle 5 using the Functional Assessment of Cancer Therapy (FACT)-Breast and EuroQOL 5 dimensions (EQ-5D) questionnaires. As of 26 February 2016, the median duration of follow-up was 23 months. Baseline scores were comparable between the two treatment arms. No significant between-arm differences were observed in change from baseline in FACT-Breast Total, FACT-General Total, or EQ-5D scores. Significantly greater improvement in pain scores was observed in the palbociclib plus letrozole arm (-0.256 versus -0.098; P = 0.0183). In both arms, deterioration of FACT-Breast Total score was significantly delayed in patients without progression versus those with progression and patients with partial or complete response versus those without. No significant difference was observed in FACT-Breast and EQ-5D index scores in patients with and without neutropenia. Overall, women with MBC receiving first-line endocrine therapy have a good QOL. The addition of palbociclib to letrozole maintains health-related QOL and improves pain scores in treatment-naïve postmenopausal patients with ER+/HER2- MBC compared with letrozole alone. Significantly greater delay in deterioration of health-related QOL was observed in patients without progression versus those who progressed and in patients with an objective response versus non-responders. ClinicalTrials.gov: NCT01740427 (https://clinicaltrials.gov/ct2/show/NCT01740427).

Impact of palbociclib plus letrozole on patient-reported health-related quality of life: results from the PALOMA-2 trial

PubMed Central

Rugo, H S; Diéras, V; Gelmon, K A; Finn, R S; Slamon, D J; Martin, M; Neven, P; Shparyk, Y; Mori, A; Lu, D R; Bhattacharyya, H; Bartlett, C Huang; Iyer, S; Johnston, S; Ettl, J; Harbeck, N

2018-01-01

Abstract Background Patient-reported outcomes are integral in benefit–risk assessments of new treatment regimens. The PALOMA-2 study provides the largest body of evidence for patient-reported health-related quality of life (QOL) for patients with metastatic breast cancer (MBC) receiving first-line endocrine-based therapy (palbociclib plus letrozole and letrozole alone). Patients and methods Treatment-naïve postmenopausal women with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) MBC were randomized 2 : 1 to palbociclib plus letrozole (n = 444) or placebo plus letrozole (n = 222). Patient-reported outcomes were assessed at baseline, day 1 of cycles 2 and 3, and day 1 of every other cycle from cycle 5 using the Functional Assessment of Cancer Therapy (FACT)-Breast and EuroQOL 5 dimensions (EQ-5D) questionnaires. Results As of 26 February 2016, the median duration of follow-up was 23 months. Baseline scores were comparable between the two treatment arms. No significant between-arm differences were observed in change from baseline in FACT-Breast Total, FACT-General Total, or EQ-5D scores. Significantly greater improvement in pain scores was observed in the palbociclib plus letrozole arm (−0.256 versus −0.098; P = 0.0183). In both arms, deterioration of FACT-Breast Total score was significantly delayed in patients without progression versus those with progression and patients with partial or complete response versus those without. No significant difference was observed in FACT-Breast and EQ-5D index scores in patients with and without neutropenia. Conclusions Overall, women with MBC receiving first-line endocrine therapy have a good QOL. The addition of palbociclib to letrozole maintains health-related QOL and improves pain scores in treatment-naïve postmenopausal patients with ER+/HER2− MBC compared with letrozole alone. Significantly greater delay in deterioration of health-related QOL was observed in patients without progression versus those who progressed and in patients with an objective response versus non-responders. ClinicalTrials.gov: NCT01740427 (https://clinicaltrials.gov/ct2/show/NCT01740427) PMID:29360932

A Phase II Randomized Study of Lapatinib Combined With Capecitabine, Vinorelbine, or Gemcitabine in Patients With HER2-Positive Metastatic Breast Cancer With Progression After a Taxane (Latin American Cooperative Oncology Group 0801 Study).

PubMed

Gómez, Henry L; Neciosup, Silvia; Tosello, Célia; Mano, Max; Bines, José; Ismael, Gustavo; Santi, Patrícia X; Pinczowski, Hélio; Nerón, Yeni; Fanelli, Marcello; Fein, Luis; Sampaio, Carlos; Lerzo, Guillermo; Capó, Adolfo; Zarba, Juan J; Blajman, César; Varela, Mirta S; Martínez-Mesa, Jeovany; Werutsky, Gustavo; Barrios, Carlos H

2016-02-01

Novel targeted agents and combinations have become available in multiple lines of treatment for human epidermal growth factor receptor 2-positive (HER2(+)) metastatic breast cancer (MBC). In this context, alternatives to the lapatinib (L) and capecitabine (C) regimen, evaluating L combined with other cytotoxic drugs, are warranted. In the present phase II, multicenter study, patients with HER2(+) MBC with progression after taxane were randomized between L, 1250 mg, combined with C, 2000 mg/m(2) on days 1 to 14 (LC), vinorelbine (V), 25 mg/m(2) on days 1 and 8 (LV), or gemcitabine (G), 1000 mg/m(2) on days 1 and 8 (LG), every 21 days. The primary endpoint was the overall response rate. A total of 142 patients were included from 2009 to 2012. No differences were found in the patient baseline characteristics. The median age was 51 years, 69% were postmenopausal, 32% had liver metastasis, 57% were hormone receptor negative, and 48% had been previously treated with trastuzumab. The overall response rate was 49% (95% confidence interval [CI], 34.8%-63.4%), 56% (95% CI, 40%-70.4%), and 41% (95% CI, 27%-56.8%) in the LC, LV, and LG groups, respectively. The median progression-free survival was 9 months in the LC arm and 7 months in the other 2 arms (P = .28). The most common grade 3 and 4 adverse events were hand-foot syndrome (18%), diarrhea (6%), and increased alanine aminotransferase/aspartate aminotransferase (4%) in the LC arm; neutropenia (36%), diarrhea (9%), and febrile neutropenia (6%) in the LV arm; and neutropenia (47%), alanine aminotransferase/aspartate aminotransferase (13%), and rash (4%) in the LG arm. LV and LG seem to be active combinations in patients with HER2(+) MBC after taxane failure. The overall toxicity was manageable in all regimens. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

One-pot synthesis of star-shaped macromolecules containing polyglycidol and poly(ethylene oxide) arms.

PubMed

Lapienis, Grzegorz; Penczek, Stanislaw

2005-01-01

Synthesis of fully hydrophilic star-shaped macromolecules with different kinds of arms (A(x)B(y)C(z)) based on polyglycidol (PGL, A(x)) and poly(ethylene oxide) (PEO, C(z)) arms and diepoxy compounds (diglycidyl ethers of ethylene glycol (DGEG) or neopentyl glycol (DGNG) in the core, B(y)) forming the core is described. Precursors of arms were prepared by polymerization of glycidol with protected -OH groups. The first-generation stars were formed in the series of consecutive-parallel reactions of arms A(x) with diepoxy compounds (B). These first-generation stars (A(x)B(y)), having approximately O-, Mt+ groups on the cores, were used as multianionic initiators for the second generation of arms (C(z)) built by polymerization of ethylene oxide. The products with M(n) up to 10(5) and having up to approximately 40 arms were obtained. The number of arms (f) was determined by direct measurements of M(n) of the first-generation stars (M(n) of arms A(x) is known), compared with f calculated from the branching index g, determined from R(g) measured with size-exclusion chromatography (SEC) triple detection with TriSEC software. The progress of the star formation was monitored by 1H NMR and SEC. These novel water-soluble stars, having a large number of hydroxyl groups, both at the ends of PEO arms as well as within the PGL arms, can be functionalized and further used for attaching compounds of interest. This approach opens, therefore, a new way of "multiPEGylation".

Computer-assisted upper extremity training using interactive biking exercise (iBikE) platform.

PubMed

Jeong, In Cheol; Finkelstein, Joseph

2012-01-01

Upper extremity exercise training has been shown to improve clinical outcomes in different chronic health conditions. Arm-operated bicycles are frequently used to facilitate upper extremity training however effective use of these devices at patient homes is hampered by lack of remote connectivity with clinical rehabilitation team, inability to monitor exercise progress in real time using simple graphical representation, and absence of an alert system which would prevent exertion levels exceeding those approved by the clinical rehabilitation team. We developed an interactive biking exercise (iBikE) platform aimed at addressing these limitations. The platform uses a miniature wireless 3-axis accelerometer mounted on a patient wrist that transmits the cycling acceleration data to a laptop. The laptop screen presents an exercise dashboard to the patient in real time allowing easy graphical visualization of exercise progress and presentation of exercise parameters in relation to prescribed targets. The iBikE platform is programmed to alert the patient when exercise intensity exceeds the levels recommended by the patient care provider. The iBikE platform has been tested in 7 healthy volunteers (age range: 26-50 years) and shown to reliably reflect exercise progress and to generate alerts at pre-setup levels. Implementation of remote connectivity with patient rehabilitation team is warranted for future extension and evaluation efforts.

Program Director Perceptions of Surgical Resident Training and Patient Care under Flexible Duty Hour Requirements.

PubMed

Saadat, Lily V; Dahlke, Allison R; Rajaram, Ravi; Kreutzer, Lindsey; Love, Remi; Odell, David D; Bilimoria, Karl Y; Yang, Anthony D

2016-06-01

The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial was a national, cluster-randomized, pragmatic, noninferiority trial of 117 general surgery programs, comparing standard ACGME resident duty hour requirements ("Standard Policy") to flexible, less-restrictive policies ("Flexible Policy"). Participating program directors (PDs) were surveyed to assess their perceptions of patient care, resident education, and resident well-being during the study period. A survey was sent to all PDs of the general surgery residency programs participating in the FIRST trial (N = 117 [100% response rate]) in June and July 2015. The survey compared PDs' perceptions of the duty hour requirements in their arm of the FIRST trial during the study period from July 1, 2014 to June 30, 2015. One hundred percent of PDs in the Flexible Policy arm indicated that residents used their additional flexibility in duty hours to complete operations they started or to stabilize a critically ill patient. Compared with the Standard Policy arm, PDs in the Flexible Policy arm perceived a more positive effect of duty hours on the safety of patient care (68.9% vs 0%; p < 0.001), continuity of care (98.3% vs 0%; p < 0.001), and resident ability to attend educational activities (74.1% vs 3.4%; p < 0.001). Most PDs in both arms reported that safety of patient care (71.8%), continuity of care (94.0%), quality of resident education (83.8%), and resident well-being (55.6%) would be improved with a hypothetical permanent adoption of more flexible duty hours. Program directors involved in the FIRST trial perceived improvements in patient safety, continuity of care, and multiple aspects of resident education and well-being with flexible duty hours. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mather, James

Atmospheric Radiation Measurement (ARM) Program standard data format is NetCDF 3 (Network Common Data Form). The object of this tutorial is to provide a basic introduction to NetCDF with an emphasis on aspects of the ARM application of NetCDF. The goal is to provide basic instructions for reading and visualizing ARM NetCDF data with the expectation that these examples can then be applied to more complex applications.

Sample size requirements for one-year treatment effects using deep gray matter volume from 3T MRI in progressive forms of multiple sclerosis.

PubMed

Kim, Gloria; Chu, Renxin; Yousuf, Fawad; Tauhid, Shahamat; Stazzone, Lynn; Houtchens, Maria K; Stankiewicz, James M; Severson, Christopher; Kimbrough, Dorlan; Quintana, Francisco J; Chitnis, Tanuja; Weiner, Howard L; Healy, Brian C; Bakshi, Rohit

2017-11-01

The subcortical deep gray matter (DGM) develops selective, progressive, and clinically relevant atrophy in progressive forms of multiple sclerosis (PMS). This patient population is the target of active neurotherapeutic development, requiring the availability of outcome measures. We tested a fully automated MRI analysis pipeline to assess DGM atrophy in PMS. Consistent 3D T1-weighted high-resolution 3T brain MRI was obtained over one year in 19 consecutive patients with PMS [15 secondary progressive, 4 primary progressive, 53% women, age (mean±SD) 50.8±8.0 years, Expanded Disability Status Scale (median, range) 5.0, 2.0-6.5)]. DGM segmentation applied the fully automated FSL-FIRST pipeline ( http://fsl.fmrib.ox.ac.uk ). Total DGM volume was the sum of the caudate, putamen, globus pallidus, and thalamus. On-study change was calculated using a random-effects linear regression model. We detected one-year decreases in raw [mean (95% confidence interval): -0.749 ml (-1.455, -0.043), p = 0.039] and annualized [-0.754 ml/year (-1.492, -0.016), p = 0.046] total DGM volumes. A treatment trial for an intervention that would show a 50% reduction in DGM brain atrophy would require a sample size of 123 patients for a single-arm study (one-year run-in followed by one-year on-treatment). For a two-arm placebo-controlled one-year study, 242 patients would be required per arm. The use of DGM fraction required more patients. The thalamus, putamen, and globus pallidus, showed smaller effect sizes in their on-study changes than the total DGM; however, for the caudate, the effect sizes were somewhat larger. DGM atrophy may prove efficient as a short-term outcome for proof-of-concept neurotherapeutic trials in PMS.

Activity of upper limb muscles during human walking.

PubMed

Kuhtz-Buschbeck, Johann P; Jing, Bo

2012-04-01

The EMG activity of upper limb muscles during human gait has rarely been studied previously. It was examined in 20 normal volunteers in four conditions: walking on a treadmill (1) with unrestrained natural arm swing (Normal), (2) while volitionally holding the arms still (Held), (3) with the arms immobilized (Bound), and (4) with the arms swinging in phase with the ipsilateral legs, i.e. opposite-to-normal phasing (Anti-Normal). Normal arm swing involved weak rhythmical lengthening and shortening contractions of arm and shoulder muscles. Phasic muscle activity was needed to keep the unrestricted arms still during walking (Held), indicating a passive component of arm swing. An active component, possibly programmed centrally, existed as well, because some EMG signals persisted when the arms were immobilized during walking (Bound). Anti-Normal gait involved stronger EMG activity than Normal walking and was uneconomical. The present results indicate that normal arm swing has both passive and active components. Copyright © 2011 Elsevier Ltd. All rights reserved.

Primary reaction control system/remote manipulator system interaction with loaded arm. Space shuttle engineering and operations support

NASA Technical Reports Server (NTRS)

Taylor, E. C.; Davis, J. D.

1978-01-01

A study of the interaction between the orbiter primary reaction control system (PRCS) and the remote manipulator system (RMS) with a loaded arm is documented. This analysis was performed with the Payload Deployment and Retrieval Systems Simulation (PDRSS) program with the passive arm bending option. The passive-arm model simulates the arm as massless elastic links with locked joints. The study was divided into two parts. The first part was the evaluation of the response of the arm to step inputs (i.e. constant jet torques) about each of the orbiter body axes. The second part of the study was the evaluation of the response of the arm to minimum impulse primary RCS jet firings with both single pulse and pulse train inputs.

Technical Steps to Support Nuclear Arsenal Downsizing: A Report by the APS Panel on Public Affairs

DTIC Science & Technology

2010-02-01

play a critical role in advancing the US plan to balance deter- rence with downsizing the US nuclear arsenal. In particular, S&T are essential to enable...nuclear-armed nations must be assured that they will continue to be able to meet those critical security needs. While individual nuclear-armed...steps are essential to progress towards the eventual elimination of nuclear arsenals. Science and technology (S&T) will play a critical role in

Hand-arm vibration syndrome: a common occupational hazard in industrialized countries.

PubMed

Heaver, C; Goonetilleke, K S; Ferguson, H; Shiralkar, S

2011-06-01

Regular exposure to hand-transmitted vibration can result in symptoms and signs of peripheral vascular, neurological and other disorders collectively known as the hand-arm vibration syndrome (HAVS). A significant proportion of workers can suffer from HAVS after using vibrating power tools. HAVS is a chronic and progressive disorder. Early recognition and prevention is the key to managing vibrating tool exposures and health effects. This article gives a broad overview of the condition with a detailed account of its pathogenesis, identification and management.

Multi-Hazard Shelter Incentive Programs

DTIC Science & Technology

1985-09-01

by strategic "nuclear missiles. This could pave the way for arms control measures to eliminate the weapons themselves." 9 The following year, the...the idea of a policy change that would emphasize strategic defense. The Arms Control and Disarmament Agency (ACDA), in response to a question from...emergency control centers and program N> management) has been equally divided between the Federal government and the States. Therefore, the rfecedent e

Does an outcome-based approach to continuing medical education improve physicians' competences in rational prescribing?

PubMed

Esmaily, Hamideh M; Savage, Carl; Vahidi, Rezagoli; Amini, Abolghasem; Dastgiri, Saeed; Hult, Hakan; Dahlgren, Lars Owe; Wahlstrom, Rolf

2009-11-01

Continuing medical education (CME) is compulsory in Iran, and traditionally it is lecture-based, which is mostly not successful. Outcome-based education has been proposed for CME programs. To evaluate the effectiveness of an outcome-based educational intervention with a new approach based on outcomes and aligned teaching methods, on knowledge and skills of general physicians (GPs) working in primary care compared with a concurrent CME program in the field of "Rational prescribing". The method used was cluster randomized controlled design. All GPs working in six cities in one province in Iran were invited to participate. The cities were matched and randomly divided into an intervention arm for education on rational prescribing with an outcome-based approach, and a control arm for a traditional program on the same topic. Knowledge and skills were assessed using a pre- and post-test, including case scenarios. In total, 112 GPs participated. There were significant improvements in knowledge and prescribing skills after the training in the intervention arm as well as in comparison with the changes in the control arm. The overall intervention effect was 26 percentage units. The introduction of an outcome-based approach in CME appears to be effective when creating programs to improve GPs' knowledge and skills.

Health Cars Robotics: A Progress Report

NASA Technical Reports Server (NTRS)

Fiorini, P.; Ali, K.; Seraji, H.

1997-01-01

This paper describes the approach followed in the design of a service robot for health care applications. This paper describes the architecture of the subsystem, the features of the manipulator arm, and the operator interface.

Randomized, Double-Blind, Phase III Trial of Ipilimumab Versus Placebo in Asymptomatic or Minimally Symptomatic Patients With Metastatic Chemotherapy-Naive Castration-Resistant Prostate Cancer.

PubMed

Beer, Tomasz M; Kwon, Eugene D; Drake, Charles G; Fizazi, Karim; Logothetis, Christopher; Gravis, Gwenaelle; Ganju, Vinod; Polikoff, Jonathan; Saad, Fred; Humanski, Piotr; Piulats, Josep M; Gonzalez Mella, Pablo; Ng, Siobhan S; Jaeger, Dirk; Parnis, Francis X; Franke, Fabio A; Puente, Javier; Carvajal, Roman; Sengeløv, Lisa; McHenry, M Brent; Varma, Arvind; van den Eertwegh, Alfonsus J; Gerritsen, Winald

2017-01-01

Purpose Ipilimumab increases antitumor T-cell responses by binding to cytotoxic T-lymphocyte antigen 4. We evaluated treatment with ipilimumab in asymptomatic or minimally symptomatic patients with chemotherapy-naive metastatic castration-resistant prostate cancer without visceral metastases. Patients and Methods In this multicenter, double-blind, phase III trial, patients were randomly assigned (2:1) to ipilimumab 10 mg/kg or placebo every 3 weeks for up to four doses. Ipilimumab 10 mg/kg or placebo maintenance therapy was administered to nonprogressing patients every 3 months. The primary end point was overall survival (OS). Results Four hundred patients were randomly assigned to ipilimumab and 202 to placebo; 399 were treated with ipilimumab and 199 with placebo. Median OS was 28.7 months (95% CI, 24.5 to 32.5 months) in the ipilimumab arm versus 29.7 months (95% CI, 26.1 to 34.2 months) in the placebo arm (hazard ratio, 1.11; 95.87% CI, 0.88 to 1.39; P = .3667). Median progression-free survival was 5.6 months in the ipilimumab arm versus 3.8 with placebo arm (hazard ratio, 0.67; 95.87% CI, 0.55 to 0.81). Exploratory analyses showed a higher prostate-specific antigen response rate with ipilimumab (23%) than with placebo (8%). Diarrhea (15%) was the only grade 3 to 4 treatment-related adverse event (AE) reported in ≥ 10% of ipilimumab-treated patients. Nine (2%) deaths occurred in the ipilimumab arm due to treatment-related AEs; no deaths occurred in the placebo arm. Immune-related grade 3 to 4 AEs occurred in 31% and 2% of patients, respectively. Conclusion Ipilimumab did not improve OS in patients with metastatic castration-resistant prostate cancer. The observed increases in progression-free survival and prostate-specific antigen response rates suggest antitumor activity in a patient subset.

Enzalutamide in Men with Chemotherapy-naïve Metastatic Castration-resistant Prostate Cancer: Extended Analysis of the Phase 3 PREVAIL Study.

PubMed

Beer, Tomasz M; Armstrong, Andrew J; Rathkopf, Dana; Loriot, Yohann; Sternberg, Cora N; Higano, Celestia S; Iversen, Peter; Evans, Christopher P; Kim, Choung-Soo; Kimura, Go; Miller, Kurt; Saad, Fred; Bjartell, Anders S; Borre, Michael; Mulders, Peter; Tammela, Teuvo L; Parli, Teresa; Sari, Suha; van Os, Steve; Theeuwes, Ad; Tombal, Bertrand

2017-02-01

Enzalutamide significantly improved radiographic progression-free survival (rPFS) and overall survival (OS) among men with chemotherapy-naïve metastatic castration-resistant prostate cancer at the prespecified interim analysis of PREVAIL, a phase 3, double-blind, randomized study. We evaluated the longer-term efficacy and safety of enzalutamide up to the prespecified number of deaths in the final analysis, which included an additional 20 mo of follow-up for investigator-assessed rPFS, 9 mo of follow-up for OS, and 4 mo of follow-up for safety. Enzalutamide reduced the risk of radiographic progression or death by 68% (hazard ratio [HR] 0.32, 95% confidence interval [CI] 0.28-0.37; p<0.0001) and the risk of death by 23% (HR 0.77, 95% CI 0.67-0.88; p=0.0002). Median investigator-assessed rPFS was 20.0 mo (95% CI 18.9-22.1) in the enzalutamide arm and 5.4 mo (95% CI 4.1-5.6) in the placebo arm. Median OS was 35.3 mo (95% CI 32.2-not yet reached) in the enzalutamide arm and 31.3 mo (95% CI 28.8-34.2) in the placebo arm. At the time of the OS analysis, 167 patients in the placebo arm had crossed over to receive enzalutamide. The most common adverse events in the enzalutamide arm were fatigue, back pain, constipation, and arthralgia. This final analysis of PREVAIL provides more complete assessment of the clinical benefit of enzalutamide. PREVAIL is registered on ClinicalTrials.gov as NCT01212991. According to data from longer follow-up, enzalutamide continued to provide benefit over placebo in patients with metastatic castration-resistant prostate cancer. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

TBCRC 019: A Phase II Trial of Nanoparticle Albumin-Bound Paclitaxel with or without the Anti-Death Receptor 5 Monoclonal Antibody Tigatuzumab in Patients with Triple-Negative Breast Cancer.

PubMed

Forero-Torres, Andres; Varley, Katherine E; Abramson, Vandana G; Li, Yufeng; Vaklavas, Christos; Lin, Nancy U; Liu, Minetta C; Rugo, Hope S; Nanda, Rita; Storniolo, Anna M; Traina, Tiffany A; Patil, Sujata; Van Poznak, Catherine H; Nangia, Julie R; Irvin, William J; Krontiras, Helen; De Los Santos, Jennifer F; Haluska, Paul; Grizzle, William; Myers, Richard M; Wolff, Antonio C

2015-06-15

Tigatuzumab (TIG), an agonistic anti-DR5 antibody, triggers apoptosis in DR5(+) human tumor cells without crosslinking. TIG has strong in vitro/in vivo activity against basal-like breast cancer cells enhanced by chemotherapy agents. This study evaluates activity of TIG and chemotherapy in patients with metastatic triple-negative breast cancer (TNBC). Randomized 2:1 phase II trial of albumin-bound paclitaxel (nab-PAC) ± TIG in patients with TNBC stratified by prior chemotherapy. Patients received nab-PAC weekly × 3 ± TIG every other week, every 28 days. Primary objective was within-arm objective response rate (ORR). Secondary objectives were safety, progression-free survival (PFS), clinical benefit, and TIG immunogenicity. Metastatic research biopsies were required. Among 64 patients (60 treated; TIG/nab-PAC n = 39 and nab-PAC n = 21), there were 3 complete remissions (CR), 8 partial remissions (PR; 1 almost CR), 11 stable diseases (SD), and 17 progressive diseases (PD) in the TIG/nab-PAC arm (ORR, 28%), and no CRs, 8 PRs, 4 SDs, and 9 PDs in the nab-PAC arm (ORR, 38%). There was a numerical increase in CRs and several patients had prolonged PFS (1,025+, 781, 672, 460, 334) in the TIG/nab-PAC arm. Grade 3 toxicities were 28% and 29%, respectively, with no grade 4-5. Exploratory analysis suggests an association of ROCK1 gene pathway activation with efficacy in the TIG/nab-PAC arm. ORR and PFS were similar in both. Preclinical activity of TIG in basal-like breast cancer and prolonged PFS in few patients in the combination arm support further investigation of anti-DR5 agents. ROCK pathway activation merits further evaluation. ©2015 American Association for Cancer Research.

Atmospheric radiation measurement unmanned aerospace vehicle (ARM-UAV) program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bolton, W.R.

1996-11-01

ARM-UAV is part of the multi-agency U.S. Global Change Research Program and is addressing the largest source of uncertainty in predicting climatic response: the interaction of clouds and the sun`s energy in the Earth`s atmosphere. An important aspect of the program is the use of unmanned aerospace vehicles (UAVs) as the primary airborne platform. The ARM-UAV Program has completed two major flight series: The first series conducted in April, 1994, using an existing UAV (the General Atomics Gnat 750) consisted of eight highly successful flights at the DOE climate site in Oklahoma. The second series conducted in September/October, 1995, usingmore » two piloted aircraft (Egrett and Twin Otter), featured simultaneous measurements above and below clouds and in clear sky. Additional flight series are planned to continue study of the cloudy and clear sky energy budget in the Spring and Fall of 1996 over the DOE climate site in Oklahoma. 3 refs., 4 figs., 1 tab.« less

Antidepressant medicine use and risk of developing diabetes during the diabetes prevention program and diabetes prevention program outcomes study.

PubMed

Rubin, Richard R; Ma, Yong; Peyrot, Mark; Marrero, David G; Price, David W; Barrett-Connor, Elizabeth; Knowler, William C

2010-12-01

To assess the association between antidepressant medicine use and risk of developing diabetes during the Diabetes Prevention Program (DPP) and Diabetes Prevention Program Outcomes Study (DPPOS). DPP/DPPOS participants were assessed for diabetes every 6 months and for antidepressant use every 3 months in DPP and every 6 months in DPPOS for a median 10.0-year follow-up. Controlled for factors associated with diabetes risk, continuous antidepressant use compared with no use was associated with diabetes risk in the placebo (adjusted hazard ratio 2.34 [95% CI 1.32-4.15]) and lifestyle (2.48 [1.45-4.22]) arms, but not in the metformin arm (0.55 [0.25-1.19]). Continuous antidepressant use was significantly associated with diabetes risk in the placebo and lifestyle arms. Measured confounders and mediators did not account for this association, which could represent a drug effect or reflect differences not assessed in this study between antidepressant users and nonusers.

Cabazitaxel Versus Topotecan in Patients with Small-Cell Lung Cancer with Progressive Disease During or After First-Line Platinum-Based Chemotherapy.

PubMed

Evans, Tracey L; Cho, Byoung Chul; Udud, Katalin; Fischer, Juergen R; Shepherd, Frances A; Martinez, Pablo; Ramlau, Rodryg; Syrigos, Konstantinos N; Shen, Liji; Chadjaa, Mustapha; Wolf, Martin

2015-08-01

Patients with small-cell lung cancer (SCLC) typically respond well to initial chemotherapy. However, relapse invariably occurs, and topotecan, the only approved second-line treatment option, has limited efficacy. Taxanes have activity in SCLC, and cabazitaxel is a second-generation taxane with potential for enhanced activity in chemorefractory malignancies. Patients with SCLC who relapsed after initial platinum-based chemotherapy were randomly assigned to receive cabazitaxel 25 mg/m every 21 days or topotecan 1.5 mg/m on days 1-5 every 21 days. Two patient subgroups, defined by chemosensitive and chemo-resistant/refractory disease, were assessed in combination and separately. The safety profile of cabazitaxel and topotecan was consistent with previous studies, and despite considerable toxicity in both arms, no new safety concerns were identified. Patients receiving cabazitaxel had inferior progression-free survival compared with topotecan (1.4 versus 3.0 months, respectively; two-sided p < 0.0001; hazard ratio = 2.17, 95% confidence interval = 1.563-3.010), and results were similar in both the chemosensitive and chemorefractory subgroups. No complete responses were observed in either arm, and no partial responses were observed in the cabazitaxel group. The partial response rate in the topotecan arm was 10%. Median overall survival was 5.2 months in the cabazitaxel arm and 6.8 months in the topotecan arm (two-sided p = 0.0125; hazard ratio = 1.57, 95% confidence interval = 1.10-2.25). Cabazitaxel, a next-generation taxane, had inferior efficacy when compared with standard-dose topotecan in the treatment of relapsed SCLC. Topotecan remains a suboptimal therapy, and continued efforts to develop improved second-line treatments are warranted.

Design of the aerosol sampling manifold for the Southern Great Plains site

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leifer, R.; Knuth, R.H.; Guggenheim, S.F.

1995-04-01

To meet the needs of the ARM program, the Environmental Measurements Laboratory (EML) has the responsibility to establish a surface aerosol measurements program at the Southern Great Plains (SGP) site in Lamont, OK. At the present time, EML has scheduled installation of five instruments at SGP: a single wavelength nephelometer, an optical particle counter (OPC), a condensation particle counter (CPC), an optical absorption monitor (OAM), and an ozone monitor. ARM`s operating protocol requires that all the observational data be placed online and sent to the main computer facility in real time. EML currently maintains a computer file containing back trajectorymore » (BT) analyses for the SGP site. These trajectories are used to characterize air mass types as they pass over the site. EML is continuing to calculate and store the resulting trajectory analyses for future use by the ARM science team.« less

Electro-osmotically driven liquid delivery method and apparatus

DOEpatents

Rakestraw, David J.; Anex, Deon S.; Yan, Chao; Dadoo, Rajeev; Zare, Richard N.

1999-01-01

Method and apparatus for controlling precisely the composition and delivery of liquid at sub-.mu.L/min flow rate. One embodiment of such a delivery system is an electro-osmotically driven gradient flow delivery system that generates dynamic gradient flows with sub-.mu.L/min flow rates by merging a plurality of electro-osmotic flows. These flows are delivered by a plurality of delivery arms attached to a mixing connector, where they mix and then flow into a receiving means, preferably a column. Each inlet of the plurality of delivery arms is placed in a corresponding solution reservoir. A plurality of independent programmable high-voltage power supplies is used to apply a voltage program to each of the plurality of solution reservoirs to regulate the electro-osmotic flow in each delivery arm. The electro-osmotic flow rates in the delivery arms are changed with time according to each voltage program to deliver the required gradient profile to the column.

Induction gemcitabine in standard dose or prolonged low-dose with cisplatin followed by concurrent radiochemotherapy in locally advanced non-small cell lung cancer: a randomized phase II clinical trial

PubMed Central

Vrankar, Martina; Zwitter, Matjaz; Bavcar, Tanja; Milic, Ana; Kovac, Viljem

2014-01-01

Background The optimal combination of chemotherapy with radiation therapy for treatment locally advanced non-small cell lung cancer (NSCLC) remains an open issue. This randomized phase II study compared gemcitabine in two different schedules and cisplatin - as induction chemotherapy, followed by radiation therapy concurrent with cisplatin and etoposid. Patients and methods. Eligible patients had microscopically confirmed inoperable non-metastatic non-small cell lung cancer; fulfilled the standard criteria for platin-based chemotherapy; and signed informed consent. Patients were treated with 3 cycles of induction chemotherapy with gemcitabine and cisplatin. Two different aplications of gemcitabine were compared: patients in arm A received gemcitabine at 1250 mg/m2 in a standard half hour i.v. infusion on days 1 and 8; patients in arm B received gemcitabine at 250 mg/m2 in prolonged 6-hours i.v. infusion on days 1 and 8. In both arms, cisplatin 75 mg/m2 on day 2 was administered. All patients continued treatment with radiation therapy with 60–66 Gy concurrent with cisplatin 50 mg/m2 on days 1, 8, 29 and 36 and etoposid 50 mg/m2 on days 1–5 and 29–33. The primary endpoint was response rate (RR) after induction chemotherapy; secondary endpoints were toxicity, progression-free survival (PFS) and overall survival (OS). Results From September 2005 to November 2010, 106 patients were recruited to this study. No statistically signifficant differences were found in RR after induction chemotherapy between the two arms (48.1% and 57.4%, p = 0.34). Toxicity profile was comparable and mild with grade 3/4 neutropenia as primary toxicity in both arms. One patient in arm B suffered from acute peripheral ischemia grade 4 and an amputation of lower limb was needed. With a median follow-up of 69.3 months, progression-free survival and median survival in arm A were 15.7 and 24.8 months compared to 18.9 and 28.6 months in arm B. The figures for 1- and 3-year overall survival were 73.1% and 30.8% in arm A, and 81.5 % and 44.4% in arm B, respectively. Conclusions Among the two cisplatin-based doublets of induction chemotherapy for inoperable NSCLC, both schedules of gemcitabine have a comparable toxicity profile. Figures for RR, PFS and OS are among the best reported in current literature. While there is a trend towards better efficacy of the treament with prolonged infusion of gemcitabine, the difference between the two arms did not reach statistical significance. PMID:25435850

ML Crew Access Arm Move

NASA Image and Video Library

2017-10-16

The Orion crew access arm departs Precision Fabricating and Cleaning in Cocoa, Florida, atop a flatbed truck. The access arm is transported to a storage location at NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Design of the arm-wrestling robot's force acquisition system based on Qt

NASA Astrophysics Data System (ADS)

Huo, Zhixiang; Chen, Feng; Wang, Yongtao

2017-03-01

As a collection of entertainment and medical rehabilitation in a robot, the research on the arm-wrestling robot is of great significance. In order to achieve the collection of the arm-wrestling robot's force signals, the design and implementation of arm-wrestling robot's force acquisition system is introduced in this paper. The system is based on MP4221 data acquisition card and is programmed by Qt. It runs successfully in collecting the analog signals on PC. The interface of the system is simple and the real-time performance is good. The result of the test shows the feasibility in arm-wrestling robot.

New wheat-rye 5DS-4RS·4RL and 4RS-5DS·5DL translocation lines with powdery mildew resistance.

PubMed

Fu, Shulan; Ren, Zhenglong; Chen, Xiaoming; Yan, Benju; Tan, Feiquan; Fu, Tihua; Tang, Zongxiang

2014-11-01

Powdery mildew is one of the serious diseases of wheat (Triticum aestivum L., 2 n = 6 × = 42, genomes AABBDD). Rye (Secale cereale L., 2 n = 2 × = 14, genome RR) offers a rich reservoir of powdery mildew resistant genes for wheat breeding program. However, extensive use of these resistant genes may render them susceptible to new pathogen races because of co-evolution of host and pathogen. Therefore, the continuous exploration of new powdery mildew resistant genes is important to wheat breeding program. In the present study, we identified several wheat-rye addition lines from the progeny of T. aestivum L. Mianyang11 × S. cereale L. Kustro, i.e., monosomic addition lines of the rye chromosomes 4R and 6R; a disomic addition line of 6R; and monotelosomic or ditelosomic addition lines of the long arms of rye chromosomes 4R (4 RL) and 6R (6 RL). All these lines displayed immunity to powdery mildew. Thus, we concluded that both the 4 RL and 6 RL arms of Kustro contain powdery mildew resistant genes. It is the first time to discover that 4 RL arm carries powdery mildew resistant gene. Additionally, wheat lines containing new wheat-rye translocation chromosomes were also obtained: these lines retained a short arm of wheat chromosome 5D (5 DS) on which rye chromosome 4R was fused through the short arm 4 RS (designated 5 DS-4 RS · 4 RL; 4 RL stands for the long arm of rye chromosome 4R); or they had an extra short arm of rye chromosome 4R (4 RS) that was attached to the short arm of wheat chromosome 5D (5 DS) (designated 4 RS-5 DS · 5 DL; 5 DL stands for the long arm of wheat chromosome 5D). These two translocation chromosomes could be transmitted to next generation stably, and the wheat lines containing 5 DS-4 RS · 4 RL chromosome also displayed immunity to powdery mildew. The materials obtained in this study can be used for wheat powdery mildew resistant breeding program.

Role of dopamine D2 receptors in optimizing choice strategy in a dynamic and uncertain environment

PubMed Central

Kwak, Shinae; Huh, Namjung; Seo, Ji-Seon; Lee, Jung-Eun; Han, Pyung-Lim; Jung, Min W.

2014-01-01

In order to investigate roles of dopamine receptor subtypes in reward-based learning, we examined choice behavior of dopamine D1 and D2 receptor-knockout (D1R-KO and D2R-KO, respectively) mice in an instrumental learning task with progressively increasing reversal frequency and a dynamic two-armed bandit task. Performance of D2R-KO mice was progressively impaired in the former as the frequency of reversal increased and profoundly impaired in the latter even with prolonged training, whereas D1R-KO mice showed relatively minor performance deficits. Choice behavior in the dynamic two-armed bandit task was well explained by a hybrid model including win-stay-lose-switch and reinforcement learning terms. A model-based analysis revealed increased win-stay, but impaired value updating and decreased value-dependent action selection in D2R-KO mice, which were detrimental to maximizing rewards in the dynamic two-armed bandit task. These results suggest an important role of dopamine D2 receptors in learning from past choice outcomes for rapid adjustment of choice behavior in a dynamic and uncertain environment. PMID:25389395

Intermittent versus continuous oxaliplatin and fluoropyrimidine combination chemotherapy for first-line treatment of advanced colorectal cancer: results of the randomised phase 3 MRC COIN trial

PubMed Central

Adams, Richard A; Meade, Angela M; Seymour, Matthew T; Wilson, Richard H; Madi, Ayman; Fisher, David; Kenny, Sarah L; Kay, Edward; Hodgkinson, Elizabeth; Pope, Malcolm; Rogers, Penny; Wasan, Harpreet; Falk, Stephen; Gollins, Simon; Hickish, Tamas; Bessell, Eric M; Propper, David; Kennedy, M John; Kaplan, Richard; Maughan, Timothy S

2011-01-01

Summary Background When cure is impossible, cancer treatment should focus on both length and quality of life. Maximisation of time without toxic effects could be one effective strategy to achieve both of these goals. The COIN trial assessed preplanned treatment holidays in advanced colorectal cancer to achieve this aim. Methods COIN was a randomised controlled trial in patients with previously untreated advanced colorectal cancer. Patients received either continuous oxaliplatin and fluoropyrimidine combination (arm A), continuous chemotherapy plus cetuximab (arm B), or intermittent (arm C) chemotherapy. In arms A and B, treatment continued until development of progressive disease, cumulative toxic effects, or the patient chose to stop. In arm C, patients who had not progressed at their 12-week scan started a chemotherapy-free interval until evidence of disease progression, when the same treatment was restarted. Randomisation was done centrally (via telephone) by the MRC Clinical Trials Unit using minimisation. Treatment allocation was not masked. The comparison of arms A and B is described in a companion paper. Here, we compare arms A and C, with the primary objective of establishing whether overall survival on intermittent therapy was non-inferior to that on continuous therapy, with a predefined non-inferiority boundary of 1·162. Intention-to-treat (ITT) and per-protocol analyses were done. This trial is registered, ISRCTN27286448. Findings 1630 patients were randomly assigned to treatment groups (815 to continuous and 815 to intermittent therapy). Median survival in the ITT population (n=815 in both groups) was 15·8 months (IQR 9·4–26·1) in arm A and 14·4 months (8·0–24·7) in arm C (hazard ratio [HR] 1·084, 80% CI 1·008–1·165). In the per-protocol population (arm A, n=467; arm C, n=511), median survival was 19·6 months (13·0–28·1) in arm A and 18·0 months (12·1–29·3) in arm C (HR 1·087, 0·986–1·198). The upper limits of CIs for HRs in both analyses were greater than the predefined non-inferiority boundary. Preplanned subgroup analyses in the per-protocol population showed that a raised baseline platelet count, defined as 400 000 per μL or higher (271 [28%] of 978 patients), was associated with poor survival with intermittent chemotherapy: the HR for comparison of arm C and arm A in patients with a normal platelet count was 0·96 (95% CI 0·80–1·15, p=0·66), versus 1·54 (1·17–2·03, p=0·0018) in patients with a raised platelet count (p=0·0027 for interaction). In the per-protocol population, more patients on continuous than on intermittent treatment had grade 3 or worse haematological toxic effects (72 [15%] vs 60 [12%]), whereas nausea and vomiting were more common on intermittent treatment (11 [2%] vs 43 [8%]). Grade 3 or worse peripheral neuropathy (126 [27%] vs 25 [5%]) and hand–foot syndrome (21 [4%] vs 15 [3%]) were more frequent on continuous than on intermittent treatment. Interpretation Although this trial did not show non-inferiority of intermittent compared with continuous chemotherapy for advanced colorectal cancer in terms of overall survival, chemotherapy-free intervals remain a treatment option for some patients with advanced colorectal cancer, offering reduced time on chemotherapy, reduced cumulative toxic effects, and improved quality of life. Subgroup analyses suggest that patients with normal baseline platelet counts could gain the benefits of intermittent chemotherapy without detriment in survival, whereas those with raised baseline platelet counts have impaired survival and quality of life with intermittent chemotherapy and should not receive a treatment break. Funding Cancer Research UK. PMID:21641867

A phase II study of lapatinib in recurrent/metastatic squamous cell carcinoma of the head and neck.

PubMed

de Souza, Jonas A; Davis, Darren W; Zhang, Yujian; Khattri, Arun; Seiwert, Tanguy Y; Aktolga, Serdal; Wong, Stuart J; Kozloff, Mark F; Nattam, Sreenivasa; Lingen, Mark W; Kunnavakkam, Rangesh; Stenson, Kerstin M; Blair, Elizabeth A; Bozeman, Jeffrey; Dancey, Janet E; Vokes, Everett E; Cohen, Ezra E W

2012-04-15

This study sought to determine the efficacy and safety profile of lapatinib in patients with recurrent/metastatic squamous cell carcinoma of the head and neck (SCCHN). This phase II multiinstitutional study enrolled patients with recurrent/metastatic SCCHN into two cohorts: those without (arm A) and those with (arm B) before exposure to an epidermal growth factor receptor (EGFR) inhibitor. All subjects were treated with lapatinib 1,500 mg daily. Primary endpoints were response rate (arm A) and progression-free survival (PFS; arm B). The biologic effects of lapatinib on tumor growth and survival pathways were assessed in paired tumor biopsies obtained before and after therapy. Forty-five patients were enrolled, 27 in arm A and 18 in arm B. Diarrhea was the most frequent toxicity occurring in 49% of patients. Seven patients experienced related grade 3 toxicity (3 fatigue, 2 hyponatremia, 1 vomiting, and 1 diarrhea). In an intent-to-treat analysis, no complete or partial responses were observed, and stable disease was the best response observed in 41% of arm A (median duration, 50 days, range, 34-159) and 17% of arm B subjects (median, 163 days, range, 135-195). Median PFS was 52 days in both arms. Median OS was 288 (95% CI, 62-374) and 155 (95% CI, 75-242) days for arms A and B, respectively. Correlative analyses revealed an absence of EGFR inhibition in tumor tissue. Lapatinib as a single agent in recurrent/metastatic SCCHN, although well tolerated, appears to be inactive in either EGFR inhibitor naive or refractory subjects. ©2012 AACR.

Design and pilot validation of A-gear: a novel wearable dynamic arm support.

PubMed

Kooren, Peter N; Dunning, Alje G; Janssen, Mariska M H P; Lobo-Prat, Joan; Koopman, Bart F J M; Paalman, Micha I; de Groot, Imelda J M; Herder, Just L

2015-09-18

Persons suffering from progressive muscular weakness, like those with Duchenne muscular dystrophy (DMD), gradually lose the ability to stand, walk and to use their arms. This hinders them from performing daily activities, social participation and being independent. Wheelchairs are used to overcome the loss of walking. However, there are currently few efficient functional substitutes to support the arms. Arm supports or robotic arms can be mounted to wheelchairs to aid in arm motion, but they are quite visible (stigmatizing), and limited in their possibilities due to their fixation to the wheelchair. The users prefer inconspicuous arm supports that are comfortable to wear and easy to control. In this paper the design, characterization, and pilot validation of a passive arm support prototype, which is worn on the body, is presented. The A-gear runs along the body from the contact surface between seat and upper legs via torso and upper arm to the forearm. Freedom of motion is accomplished by mechanical joints, which are nearly aligned with the human joints. The system compensates for the arm weight, using elastic bands for static balance, in every position of the arm. As opposed to existing devices, the proposed kinematic structure allows trunk motion and requires fewer links and less joint space without compromising balancing precision. The functional prototype has been validated in three DMD patients, using 3D motion analysis. Measurements have shown increased arm performance when the subjects were wearing the prototype. Upward and forward movements were easier to perform. The arm support is easy to put on and remove. Moreover, the device felt comfortable for the subjects. However, downward movements were more difficult, and the patients would prefer the device to be even more inconspicuous. The A-gear prototype is a step towards inconspicuousness and therefore well-received dynamic arm supports for people with muscular weakness.

Bimonthly 24 h infusion of high-dose 5-fluorouracil vs EAP regimen in patients with advanced gastric cancer. A randomized phase II study.

PubMed

Popov, I P; Jelić, S B; Krivokapić, Z V; Jezdić, S D; Pesko, P M; Micev, M T; Babić, D R

2008-01-01

To investigate the activity and toxicity of high dose (HD) infusional 5-FU in comparison to EAP regimen as first-line chemotherapy in patients with advanced gastric cancer. Histologically confirmed measurable advanced gastric cancer, age < 72 yr, ECOG performance status 0-2, no prior chemo- and radiotherapy, adequate organ functions. EAP arm: doxorubicin (40 mg/m(2)), etoposide (360 mg/m(2)), and cisplatin (80 mg/m(2)) every 28 d; HD 5-FU arm: 5-FU 2.6 g/m(2) 24 h infusion, biweekly. Sixty patients were randomized. Patient characteristics (arms EAP/HD 5-FU): Median age 57/55 yr, median PS 1/1, LAD (patients) 3/8, M1 (patients) 27/22. Median number of cycles (range): EAP arm 4 (2-8), HD 5-FU arm 2 (1-8). Worst toxicity per cycle (grade 3 and 4 in%): Neutropenia 20/3, thrombocytopenia 9/0, anemia 9/13, diarrhea 3/10, nausea 17/7, vomiting 10/0 for EAP and HD 5-FU arms, respectively. All patients were eligible for response in both arms. Confirmed response rate (95%CI): EAP arm 34% [16-50%]/HD 5-FU arm 10% (0-21%), no change: 46/40%, progression of disease: 20/50, respectively. Overall survival (range): EAP arm A 7 mo [3-27], HD 5-FU arm 6 mo (4-25). Infusional HD 5-FU showed a low incidence of severe toxicity. But given the low efficacy of 5-FU in the dosage we applied in the study, it cannot be recommended as a single treatment for further studies. Assessment of higher dose intensity and/or dose density of 5-FU, with introduction of other active drugs in combination, could be an option for further studies.

Phase II trial of temozolomide and sorafenib in advanced melanoma patients with or without brain metastases

PubMed Central

Amaravadi, Ravi K.; Schuchter, Lynn M.; McDermott, David F.; Kramer, Amy; Giles, Lydia; Gramlich, Kristi; Carberry, Mary; Troxel, Andrea B.; Letrero, Richard; Nathanson, Katherine L.; Atkins, Michael B.; O’Dwyer, Peter J.; Flaherty, Keith T.

2009-01-01

Purpose The combination of the oral alkylating agent temozolomide and the oral multi-kinase inhibitor sorafenib was evaluated in advanced melanoma patients. Patients and Methods Patients with metastatic melanoma (N=167) were treated on four arms. All patients received sorafenib at 400 mg orally twice daily without interruption. Patients without brain metastases or prior temozolomide were randomized between Arm A: extended dosing of temozolomide (EDT; 75 mg/m2 temozolomide daily for 6/8 weeks) and Arm B: standard dosing (SDT; 150 mg/m2 temozolomide daily for 5/28 days). Patients previously treated with temozolomide were enrolled on Arm C: EDT. Patients with brain metastases and no prior temozolomide were assigned to Arm D: SDT. The primary endpoint was 6-month progression-free survival (PFS) rate. Secondary endpoints included response rate, toxicity rates, and the rates of BRAF or NRAS mutations. Results The 6-month PFS rate for arms A, B, C, and D were 50%, 40%, 11%, and 23%. The median PFS for patients on arm A, B, C, and D was 5.9, 4.2, 2.2, and 3.5 months, respectively. No significant differences were observed between Arms A and B in 6-month PFS rate, median PFS, or response rates. Treatment was well tolerated in all arms. No significant differences in toxicity were observed between arms A and B except for more grade 3–4 lymphopenia in arm A. Conclusion Temozolomide plus sorafenib was well tolerated and demonstrated activity in melanoma patients without prior history of temozolomide. The activity of this combination regimen warrants further investigation. PMID:19996224

Tradeoffs in manipulator structure and control. Part 4: Flexible manipulator analysis program. [user manual

NASA Technical Reports Server (NTRS)

Book, W. J.

1974-01-01

The Flexible Manipulator Analysis Program (FMAP) is a collection of FORTRAN coding to allow easy analysis of the flexible dynamics of mechanical arms. The user specifies the arm configuration and parameters and any or all of several frequency domain analyses to be performed, while the time domain impulse response is obtained by inverse Fourier transformation of the frequency response. A detailed explanation of how to use FMAP is provided.

The Contribution of the Peruvian Armed Forces to the Socio-Economic Development of the Country.

DTIC Science & Technology

1986-03-01

action programs was insurgency. Civic action was seen as a tool to eliminate or reduce the causes of economic and social discontent, the main source of...literacy programs, providing tr ahsportation, and didactic material. 2. Supply and maintainance of school furniture. 3. Construction, imrovement, and... Photography , Oceanography, lMapping, and Transportation. About the capacities and performance of the armed forces in civil defense and emergency

Overview of the United States Department of Energy's ARM (Atmospheric Radiation Measurement) Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stokes, G.M.; Tichler, J.L.

The Department of Energy (DOE) is initiating a major atmospheric research effort, the Atmospheric Radiation Measurement Program (ARM). The program is a key component of DOE's research strategy to address global climate change and is a direct continuation of DOE's decade-long effort to improve the ability of General Circulation Models (GCMs) to provide reliable simulations of regional, and long-term climate change in response to increasing greenhouse gases. The effort is multi-disciplinary and multi-agency, involving universities, private research organizations and more than a dozen government laboratories. The objective of the ARM Research is to provide an experimental testbed for the studymore » of important atmospheric effects, particularly cloud and radiative processes, and to test parameterizations of these processes for use in atmospheric models. This effort will support the continued and rapid improvement of GCM predictive capability. 2 refs.« less

ARM Climate Research Facility Quarterly Value-Added Product Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sivaraman, C.

The purpose of this report is to provide a concise status update for Value-Added Products (VAPs) implemented by the Atmospheric Radiation Measurement (ARM) Climate Research Facility. The report is divided into the following sections: (1) new VAPs for which development has begun; (2) progress on existing VAPs; (3) future VAPs that have been recently approved; (4) other work that leads to a VAP; (5) top requested VAPs from the ARM Data Archive; and (6) a summary of VAP and data releases to production and evaluation. New information is highlighted in blue text. New information about processed data by the developermore » is highlighted in red text. The upcoming milestones and dates are highlighted in green.« less

Effect of an environmental school-based obesity prevention program on changes in body fat and body weight: a randomized trial.

PubMed

Williamson, Donald A; Champagne, Catherine M; Harsha, David W; Han, Hongmei; Martin, Corby K; Newton, Robert L; Sothern, Melinda S; Stewart, Tiffany M; Webber, Larry S; Ryan, Donna H

2012-08-01

This study tested the efficacy of two school-based programs for prevention of body weight/fat gain in comparison to a control group, in all participants and in overweight children. The Louisiana (LA) Health study utilized a longitudinal, cluster randomized three-arm controlled design, with 28 months of follow-up. Children (N = 2,060; mean age = 10.5 years, SD = 1.2) from rural communities in grades 4-6 participated in the study. Seventeen school clusters (mean = 123 children/cluster) were randomly assigned to one of three prevention arms: (i) primary prevention (PP), an environmental modification (EM) program, (ii) primary + secondary prevention (PP+SP), the environmental program with an added classroom and internet education component, or (iii) control (C). Primary outcomes were changes in percent body fat and BMI z scores. Secondary outcomes were changes in behaviors related to energy balance. Comparisons of PP, PP+SP, and C on changes in body fat and BMI z scores found no differences. PP and PP+SP study arms were combined to create an EM arm. Relative to C, EM decreased body fat for boys (-1.7 ± 0.38% vs. -0.14 ± 0.69%) and attenuated fat gain for girls (2.9 ± 0.22% vs. 3.93 ± 0.37%), but standardized effect sizes were relatively small (<0.30). In conclusion, this school-based EM programs had modest beneficial effects on changes in percent body fat. Addition of a classroom/internet program to the environmental program did not enhance weight/fat gain prevention, but did impact physical activity and social support in overweight children.

Effect of an Environmental School-based Obesity Prevention Program On Changes in Body Fat and Body Weight: A Randomized Trial

PubMed Central

Williamson, D.A.; Champagne, C.M.; Harsha, D.; Han, H.; Martin, C.K.; Newton, R.L.; Sothern, M.; Stewart, T.M.; Webber, L.S.; Ryan, D.

2012-01-01

This study tested the efficacy of two school-based programs for prevention of body weight/fat gain in comparison to a control group, in all participants and in overweight children. The Louisiana (LA) Health study utilized a longitudinal, cluster randomized 3-arm controlled design, with 28 months of follow-up. Children (N=2060; M age = 10.5 years, SD = 1.2) from rural communities in Grades 4 to 6 participated in the study. 17 school clusters (M = 123 children/cluster) were randomly assigned to one of three prevention arms: 1) Primary Prevention (PP), an environmental modification program, 2) Primary + Secondary Prevention (PP+SP), the environmental program with an added classroom and internet education component, or 3) Control (C). Primary outcomes were changes in percent body fat and body mass index z scores. Secondary outcomes were changes in behaviors related to energy balance. Comparisons of PP, PP+SP, and C on changes in body fat and BMI z scores found no differences. PP and PP+SP study arms were combined to create an environmental modification arm (EM). Relative to C, EM decreased body fat for boys (−1.7% ± 0.38% versus −0.14% ± 0.69%) and attenuated fat gain for girls (2.9% ± 0.22% versus 3.93% ± 0.37%), but standardized effect sizes were relatively small (< 0.30). In conclusion, this school-based environmental modification programs had modest beneficial effects on changes in percent body fat. Addition of a classroom/internet program to the environmental program did not enhance weight/fat gain prevention, but did impact physical activity and social support in overweight children. PMID:22402733

Human Toddlers’ Attempts to Match Two Simple Behaviors Provide No Evidence for an Inherited, Dedicated Imitation Mechanism

PubMed Central

Jones, Susan S.

2012-01-01

Influential theories of imitation have proposed that humans inherit a neural mechanism – an “active intermodal matching “ (AIM) mechanism or a mirror neuron system - that functions from birth to automatically match sensory input from others’ actions to motor programs for performing those same actions, and thus produces imitation. To test these proposals, 160 1- to 2½-year-old toddlers were asked to imitate two simple movements– bending the arm to make an elbow, and moving the bent elbow laterally. Both behaviors were almost certain to be in each child’s repertoire, and the lateral movement was goal-directed (used to hit a plastic cup). Thus, one or both behaviors should have been imitable by toddlers with a functioning AIM or mirror neuron system. Each child saw the two behaviors repeated 18 times, and was encouraged to imitate. Children were also asked to locate their own elbows. Almost no children below age 2 imitated either behavior. Instead, younger children gave clear evidence of a developmental progression, from reproducing only the outcome of the models’ movements (hitting the object), through trying (but failing) to reproduce the model’s arm posture and/or the arm-cup relations they had seen, to accurate imitation of arm bending by age 2 and of both movements by age 2½. Across age levels, almost all children who knew the word ‘elbow’ imitated both behaviors: very few who did not know the word imitated either behavior. The evidence is most consistent with a view of early imitation as the product of a complex system of language, cognitive, social, and motor competencies that develop in infancy. The findings do not rule out a role for an inherited neural mechanism, but they suggest that such a system would not by itself be sufficient to explain imitation at any age. PMID:23251500

Cloud Overlapping Detection Algorithm Using Solar and IR Wavelengths with GOES Data Over ARM/SGP Site

NASA Technical Reports Server (NTRS)

Kawamoto, K.; Minnis, P.; Smith, W. L., Jr.

2001-01-01

One of the most perplexing problems in satellite cloud remote sensing is the overlapping of cloud layers. Although most techniques assume a one layer cloud system in a given retrieval of cloud properties, many observations are affected by radiation from more than one cloud layer. As such, cloud overlap can cause errors in the retrieval of many properties including cloud height, optical depth, phase, and particle size. A variety of methods have been developed to identify overlapped clouds in a given satellite imager pixel. Baum et al used CO2 slicing and a spatial coherence method to demonstrate a possible analysis method for nighttime detection of multilayered clouds. Jin and Rossow also used a multispectral CO2 slicing technique for a global analysis of overlapped cloud amount. Lin et al. used a combination infrared (IR), visible (VIS), and microwave data to detect overlapped clouds over water. Recently, Baum and Spinhirne proposed a 1.6 and 11 micron bispectral threshold method. While all of these methods have made progress in solving this stubborn problem none have yet proven satisfactory for continuous and consistent monitoring of multilayer cloud systems. It is clear that detection of overlapping clouds from passive instruments such as satellite radiometers is in an immature stage of development and requires additional research. Overlapped cloud systems also affect the retrievals of cloud properties over the Atmospheric Radiation Measurement (ARM) domains and hence should be identified as accurately as possible. To reach this goal, it is necessary to determine which information can be exploited for detecting multilayered clouds from operational meteorological satellite data used by ARM. This paper examines the potential information available in spectral data available on the Geostationary Operational Environmental Satellite (GOES) imager and the National Oceanic Atmospheric Administration (NOAA) Advanced Very High Resolution Radiometer (AVHRR) used over the ARM Program's Southern Great Plains (SGP), and North Slope of Alaska (NSA) sites to study the capability of detecting overlapping clouds.

Hypercaloric enteral nutrition in Amyotrophic Lateral Sclerosis: a randomized double-blind placebo-controlled trial

PubMed Central

Wills, Anne-Marie; Hubbard, Jane; Macklin, Eric A.; Glass, Jonathan; Tandan, Rup; Simpson, Ericka P; Brooks, Benjamin; Gelinas, Deborah; Mitsumoto, Hiroshi; Mozaffar, Tahseen; Hanes, Gregory P.; Ladha, Shafeeq S.; Heiman-Patterson, Terry; Katz, Jonathan; Lou, Jau-Shin; Mahoney, Katy; Grasso, Daniela; Lawson, Robert; Yu, Hong; Cudkowicz, Merit

2014-01-01

Background Amyotrophic Lateral Sclerosis (ALS) is a rapidly fatal neurodegenerative disease with few therapeutic options. Mild obesity is associated with greater survival in ALS patients and calorie-dense diets increase survival in an ALS mouse model. We therefore hypothesized that hypercaloric diets might lead to weight gain and slow ALS disease progression. Methods In this double-blind, placebo-controlled, multi-center clinical trial, we enrolled adults with ALS without a history of diabetes, significant liver or cardiovascular disease, who were already receiving percutaneous enteral nutrition. We randomly assigned participants to one of three dietary interventions: replacement calories using an isocaloric diet (controls) vs. a high-carbohydrate hypercaloric diet (HC/HC), vs. a high-fat hypercaloric diet (HF/HC). Participants received the intervention diets for four months and were followed for five months. The primary outcomes were safety and tolerability. Secondary outcomes included measures of disease progression, survival, and metabolism. This trial is registered with Clinicaltrials.gov, number NCT00983983. Findings A total of 24 participants were enrolled of whom 20 initiated study diet (six control, eight HC/HC, six HF/HC). Baseline demographics were similar among the three study arms. The HC/HC diet was better tolerated with fewer serious adverse events than the control diet (zero vs. nine, p<0·001) and fewer dose discontinuations due to adverse events (0% vs. 50%). There were no deaths in the HC/HC arm vs. three deaths (43%) in the control arm (logrank p = 0·03). The HF/HC arm was not statistically different from the controls in adverse events, tolerability, deaths or disease progression. Interpretation Our results suggest that hypercaloric enteral nutrition is safe and tolerable in ALS and support the study of nutritional interventions at earlier stages of the disease. Funding The Muscular Dystrophy Association with additional support from the National Center for Research Resources, the National Institutes of Health, and the Harvard NeuroDiscovery Center. PMID:24582471

5-Fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) plus sunitinib or bevacizumab as first-line treatment for metastatic colorectal cancer: a randomized Phase IIb study

PubMed Central

Hecht, J Randolph; Mitchell, Edith P; Yoshino, Takayuki; Welslau, Manfred; Lin, Xun; Chow Maneval, Edna; Paolini, Jolanda; Lechuga, Maria Jose; Kretzschmar, Albrecht

2015-01-01

Background Sunitinib is an oral inhibitor of tyrosine kinase receptors implicated in tumor proliferation, angiogenesis, and metastasis. In this randomized, multicenter, open-label Phase IIb study, sunitinib plus mFOLFOX6 (oxaliplatin plus leucovorin plus 5-fluorouracil) was compared with bevacizumab plus mFOLFOX6 as first-line therapy in patients with metastatic colorectal cancer. Methods Patients were stratified by performance status, baseline lactate dehydrogenase level, and prior adjuvant treatment, and randomized 1:1 to receive sunitinib 37.5 mg/day for 4 weeks on and 2 weeks off plus mFOLFOX6 every 2 weeks or bevacizumab 5 mg/kg every 2 weeks plus mFOLFOX6 every 2 weeks. The primary endpoint was progression-free survival. Secondary endpoints included objective response rate, overall survival, safety, and quality of life. Results Enrollment was closed early following accrual of 191 patients, based on an interim analysis showing an inferior trend in the primary progression-free survival efficacy endpoint for sunitinib. Ninety-six patients were randomized to sunitinib plus mFOLFOX6 and 95 to bevacizumab plus mFOLFOX6. Median progression-free survival was 9.3 months and 15.4 months, respectively, but the objective response rate was similar between the study arms. Median overall survival was 23.7 months and 34.1 months, respectively. Dose reductions and interruptions were more common with sunitinib. Hematologic toxicity was more common in the sunitinib arm. Conclusion While the results of the sunitinib arm are comparable with those of previously reported FOLFOX combinations, the sunitinib-based combination was associated with more toxicity than that observed with bevacizumab and mFOLFOX6. The bevacizumab arm had an unexpectedly good outcome, and was much better than that seen in the Phase III trials. Combination therapy with sunitinib plus mFOLFOX6 is not recommended for patients with metastatic colorectal cancer. PMID:26109878

The Effect of Omega-3 Fatty Acid Supplementation on the Inflammatory Response to eccentric strength exercise.

PubMed

Jouris, Kelly B; McDaniel, Jennifer L; Weiss, Edward P

2011-01-01

Omega-3 fatty acids (omega-3) have anti-inflammatory properties. However, it is not known if omega-3 supplementation attenuates exercise-induced inflammation. We tested the hypothesis that omega-3 supplementation reduces inflammation that is induced by eccentric arm curl exercise. Healthy adult men and women (n=11; 35 ± 10 y) performed eccentric biceps curls on two occasions, once after 14d of dietary omega-3 restriction (control trial) and again after 7d of 3,000 mg/d omega-3 supplementation (omega-3 trial). Before and 48 h after eccentric exercise, signs of inflammation was assessed by measuring soreness ratings, swelling (arm circumference and arm volume), and temperature (infrared skin sensor). Arm soreness increased (p < 0.0001) in response to eccentric exercise; the magnitude of increase in soreness was 15% less in the omega-3 trial (p = 0.004). Arm circumference increased after eccentric exercise in the control trial (p = 0.01) but not in the omega-3 trial (p = 0.15). However, there was no difference between trials (p = 0.45). Arm volume and skin temperature did not change in response to eccentric exercise in either trial. These findings suggest that omega-3 supplementation decreases soreness, as a marker of inflammation, after eccentric exercise. Based on these findings, omega-3 supplementation could provide benefits by minimizing post-exercise soreness and thereby facilitate exercise training in individuals ranging from athletes undergoing heavy conditioning to sedentary subjects or patients who are starting exercise programs or medical treatments such as physical therapy or cardiac rehabilitation. Key pointsDietary supplementation with omega-3 fatty acids has been shown to reduce inflammation in numerous inflammatory diseases such as rheumatoid arthritis, inflammatory bowel disease, and Chrohn's disease.Although strenuous exercise is known to cause acute increases in inflammation, it is not clear if omega-3 fatty acid supplementation attenuates this adverse response to exercise.Our research demonstrates that 3000 mg·d-1 omega-3 fatty acid supplementation minimizes the severe, delayed-onset muscle soreness that results from strenuous eccentric strength exercise.This information, along with a plethora of information showing that omega-3 fatty acid supplementation has other health benefits, demonstrates that a readily available over the counter nutritional supplement (i.e. omega-3 fatty acids) reduces delayed-onset soreness caused by strenuous strength exercise.This information has obvious relevance to athletic populations but also to other groups such as physical therapy patients and newly admitted cardiac rehabilitation patients, as muscle soreness, if left unchecked, can slow the progress in adapting to a new exercise program.Furthermore, as inflammation is known to be involved in the pathogenesis if numerous diseases, including heart disease, cancer, and diabetes, it is likely prudent for individuals to use inflammation-attenuating interventions, such as omega-3 supplementation, to keep inflammatory responses to physical activity at a minimum.

Microwave and Millimeter-Wave Radiometric Studies of Temperature, Water Vapor and Clouds

DOE Office of Scientific and Technical Information (OSTI.GOV)

Westwater, Edgeworth

2011-05-06

The importance of accurate measurements of column amounts of water vapor and cloud liquid has been well documented by scientists within the Atmospheric Radiation Measurement (ARM) Program. At the North Slope of Alaska (NSA), both microwave radiometers (MWR) and the MWRProfiler (MWRP), been used operationally by ARM for passive retrievals of the quantities: Precipitable Water Vapor (PWV) and Liquid Water Path (LWP). However, it has been convincingly shown that these instruments are inadequate to measure low amounts of PWV and LWP. In the case of water vapor, this is especially important during the Arctic winter, when PWV is frequently lessmore » than 2 mm. For low amounts of LWP (< 50 g/m{sup 2}), the MWR and MWRP retrievals have an accuracy that is also not acceptable. To address some of these needs, in March-April 2004, NOAA and ARM conducted the NSA Arctic Winter Radiometric Experiment - Water Vapor Intensive Operational Period at the ARM NSA/Adjacent Arctic Ocean (NSA/AAO) site. After this experiment, the radiometer group at NOAA moved to the Center for Environmental Technology (CET) of the Department of Electrical and Computer Engineering of the University of Colorado at Boulder. During this 2004 experiment, a total of 220 radiosondes were launched, and radiometric data from 22.235 to 380 GHz were obtained. Primary instruments included the ARM MWR and MWRP, a Global Positioning System (GPS), as well as the CET Ground-based Scanning Radiometer (GSR). We have analyzed data from these instruments to answer several questions of importance to ARM, including: (a) techniques for improved water vapor measurements; (b) improved calibration techniques during cloudy conditions; (c) the spectral response of radiometers to a variety of conditions: clear, liquid, ice, and mixed phase clouds; and (d) forward modeling of microwave and millimeter wave brightness temperatures from 22 to 380 GHz. Many of these results have been published in the open literature. During the third year of this contract, we participated in another ARM-sponsored experiment at the NSA during February-March 2007. This experiment is called the Radiative Heating in Underexplored Bands Campaign (RHUBC) and the GSR was operated successfully for the duration of the campaign. One of the principal goals of the experiment was to provide retrievals of water vapor during PWV amounts less than 2 mm and to compare GSR data with ARM radiometers and radiosondes. A secondary goal was to compare the radiometric response of the microwave and millimeter wavelength radiometers to water and ice clouds. In this final report, we will include the separate progress reports for each of the three years of the project and follow with a section on major accomplishments of the project.« less

Introducing Deep Underground Science to Middle Schoolers: Challenges and Rewards

NASA Astrophysics Data System (ADS)

McMahan Norris, Margaret

2010-03-01

Work is in progress to define the mission, vision, scope and preliminary design of the Sanford Center for Science Education (SCSE), the education arm of the Deep Underground Science and Engineering Laboratory (DUSEL), a proposed major research facility of the National Science Foundation. If final funding is approved, DUSEL will be built at the site of the former Homestake Gold Mine in Lead, South Dakota beginning in 2012. The SCSE is envisioned to serve as a model for the integration of a science education center into the fabric of a new national laboratory. Its broad mission is to share the excitement and promise of deep underground science and engineering at Homestake with learners of all ages worldwide. The science to be pursued at DUSEL, whether in physics, astronomy, geomicrobiology, or geoscience, is transformational and sparks the imagination of learners of all ages. While the SCSE is under design, an early education program has been initiated that is designed to build capacity for the envisioned center, to prototype individual programs, and to build partnerships and community support. This talk will give an overview of the middle school portion of that program and its context within the overall content development plan of the SCSE.

Military Education: Implementation of Recommendations at the Armed Forces Staff College. Report to the Chairman, Panel on Military Education, Committee on Armed Services, House of Representatives.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. National Security and International Affairs Div.

This study evaluates the Armed Forces Staff College's implementation of selected recommendations from the April 1989 report of the Panel on Military Education. In particular, this report discusses Phase II officer professional military education (PME) programs taught at the Joint and Combined Staff Officer School in Norfolk, Virginia. The study…

Challenges in Assessing Progress in Multifunctional Operations: Experiences from a Provincial Reconstruction Team in Afghanistan

DTIC Science & Technology

2011-06-01

these measures. Assessment of progress can thus be seen as a process consisting of monitoring and evaluation activities ( Sida , 2007). Input...limited integration and understanding between the Swedish Armed Forces and SIDA at the domestic interagency level. Four participants said that the...military and SIDA personnel had been sent to the PRT with different mandates, objectives and cultures, without practical instructions on how to

Tubaramure, a Food-Assisted Integrated Health and Nutrition Program, Reduces Child Stunting in Burundi: A Cluster-Randomized Controlled Intervention Trial.

PubMed

Leroy, Jef L; Olney, Deanna; Ruel, Marie

2018-03-01

Food-assisted maternal and child health and nutrition (FA-MCHN) programs are widely used to address undernutrition, but little is known about their effectiveness in improving child linear growth. We assessed the impact of Burundi's Tubaramure FA-MCHN program on linear growth. The program targeted women and their children during the first 1000 d and included 1) food rations, 2) strengthening of health services and promotion of their use, and 3) behavior change communication (BCC). A second objective was to assess the differential effect when varying the timing and duration of receiving food rations. We used a 4-arm, cluster-randomized controlled study to assess program impact with the use of cluster fixed-effects double-difference models with repeated cross-sectional data (baseline and follow-up 4 y later with ∼3550 children in each round). Treatment arms received food rations (corn-soy blend and micronutrient-fortified vegetable oil) for the first 1000 d (T24), from pregnancy through the child reaching 18 mo (T18), or from birth through the child reaching 24 mo ["no food during pregnancy" (TNFP)]. All treatment arms received BCC for the first 1000 d. The control arm received no food rations or BCC. Stunting (height-for-age z score <2 SDs) increased markedly from baseline to follow-up, but Tubaramure had a significant (P < 0.05) beneficial effect in the T24 [7.4 percentage points (pp); P < 0.05], T18 (5.7 pp; P < 0.05), and TNFP (4.6; P = 0.09) arms; the differences in effect across arms were not significant (P > 0.01). Secondary analyses showed that the effect was limited to children whose mother and head of household had some primary education and who lived in households with above-median assets. FA-MCHN programs are an effective development tool to improve child linear growth and can protect children from political and economic shocks in vulnerable countries such as Burundi. A better understanding of how to improve the nutritional status of children in the worst-off households is needed. This trial was registered at www.clinicaltrials.gov as NCT01072279.

A phase III, open label, randomized multicenter controlled trial of oral versus intravenous treosulfan in heavily pretreated recurrent ovarian cancer: a study of the North-Eastern German Society of Gynecological Oncology (NOGGO).

PubMed

Sehouli, Jalid; Tomè, Oliver; Dimitrova, Desislava; Camara, Oumar; Runnebaum, Ingo Bernhard; Tessen, Hans Werner; Rautenberg, Beate; Chekerov, Radoslav; Muallem, Mustafa Zelal; Lux, Michael Patrick; Trarbach, Tanja; Gitsch, Gerald

2017-03-01

In recurrent ovarian cancer (ROC), there is a high demand on effective therapies with a mild toxicity profile. Treosulfan is an alkylating agent approved as oral (p.o.) and intravenous (i.v.) formulation for the treatment of recurrent ovarian cancer. Data on safety and efficacy for either formulation are rare. For the first time we conducted a randomized phase III study comparing both formulations in women with ROC. Patients having received at least two previous lines of chemotherapy were randomly assigned to one of two treatment arms: treosulfan i.v. 7000 mg/m 2 d1 q4w or treosulfan p.o. 600 mg/m 2 d1-28 q8w. Primary endpoint was safety regarding hematological and gastrointestinal toxicity grade III/IV, secondary endpoints were other toxicities, clinical benefit rate (CBR), time to progression (TTP), overall survival (OS) and quality of life. 250 patients were treated with treosulfan i.v. (128) or treosulfan p.o. (122). In general treosulfan therapy was well tolerated in both treatment arms. Leukopenia grade III/IV occurred significantly more frequently in the p.o. arm (3.9% i.v. arm, 14.8% p.o. arm, p = 0.002). Other toxicities were similar in both arms. CBR was comparable between arms (41.4% i.v. arm, 36.9% p.o. arm). No difference in TTP (3.7 months i.v. arm, 3.5 months p.o. arm) or OS (13.6 months i.v. arm, 10.4 months p.o. arm, p = 0.087) occurred. Given the safety and efficacy results treosulfan is an acceptable option for heavily pretreated OC patients. Regarding the toxicity profile the i.v. application was better tolerated with less grade III and IV toxicities.

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

Two heavy-lift cranes are used to lower the Orion crew access arm onto a work stand in a storage location at NASA's Kennedy Space Center in Florida. The access arm was transported from Precision Fabricating and Cleaning in Cocoa, Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

The Orion crew access arm is being secured on a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

The Orion crew access arm is being secured onto a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

The Orion crew access arm is secured on a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

The Orion crew access arm is being moved by crane onto a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

A flatbed truck with the Orion crew access arm secured atop travels along a road in Cocoa, Florida, after departing Precision Fabricating and Cleaning. The access arm will be transported to a storage location at NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

The Orion crew access arm departs Precision Fabricating and Cleaning in Cocoa, Florida, atop a flatbed truck. The access arm will be transported to a storage location at NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

Two heavy-lift cranes lower the Orion crew access arm onto a work stand in a storage location at NASA's Kennedy Space Center in Florida. The access arm was transported from Precision Fabricating and Cleaning in Cocoa, Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

A flatbed truck with the Orion crew access arm secured atop arrives in a storage location at NASA's Kennedy Space Center in Florida. The access arm was transported from Precision Fabricating and Cleaning in Cocoa, Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Space robotic experiment in JEM flight demonstration

NASA Technical Reports Server (NTRS)

Nagatomo, Masanori; Tanaka, Masaki; Nakamura, Kazuyuki; Tsuda, Shinichi

1994-01-01

Japan is collaborating on the multinational space station program. The JEM, Japanese Experiment Module, has both a pressurized module and an Exposed Facility (EF). JEM Remote Manipulator System (JEMRMS) will play a dominant role in handling/servicing payloads and the maintenance of the EF, and consists of two robotic arms, a main arm and a small fine arm. JEM Flight Demonstration (JFD) is a space robotics experiment using the prototype small fine arm to demonstrate its capability, prior to the Space Station operation. The small fine arm will be installed in the Space Shuttle cargo bay and operated by a crew from a dedicated workstation in the Aft Flight Deck of the orbiter.

ARM Airborne Carbon Measurements VI (ARM-ACME VI) Field Campaign Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Biraud, Sebastien

2017-05-01

From October 1, 2015 through September 30, 2016, AAF deployed a Cessna 206 aircraft over the Southern Great Plains, collecting observations of trace gas mixing ratios over the ARM/SGP Central Facility. The aircraft payload included two Atmospheric Observing Systems (AOS Inc.) analyzers for continuous measurements of CO2, and a 12-flask sampler for analysis of carbon cycle gases (CO2, CO, CH4, N2O, 13CO2). The aircraft payload also includes solar/infrared radiation measurements. This research (supported by DOE ARM and TES programs) builds upon previous ARM-ACME missions. The goal of these measurements is to improve understanding of: (a) the carbon exchange of themore » ARM region; (b) how CO2 and associated water and energy fluxes influence radiative forcing, convective processes, and CO2 concentrations over the ARM region, and (c) how greenhouse gases are transported on continental scales.« less

The Effect of the Assessment of Recruit Motivation and Strength (ARMS) Program on Army Accessions and Attrition

DTIC Science & Technology

2011-01-01

implementation of the ARMS program occurred in three phases. In 2005, the Army authorized six MEPS (Atlanta, Buffalo, Chicago, Sacramento, San Anto - nio, and...Nashville 0.054 28.5 1.8 0.803 0.298 1,316 Butte 0.052 34.1 2.2 0.800 0.450 482 Anchorage 0.077 32.2 2.6 0.800 0.600 324 Minneapolis 0.077 38.4 2.1 0.786

The safety and reliability of the S and A mechanism designed for the NASA/LSPE program

NASA Technical Reports Server (NTRS)

Montesi, L. J.

1973-01-01

Under contract to the Manned Spacecraft Center, NASA/Houston, NOL developed a number of explosive charges for use in studying the surface of the moon during Apollo 17 activities. The charges were part of the Lunar Seismic Profiling Experiment (LSPE). When the Safety and Arming Device used in the previous ALSEP experiments was found unsuitable for use with the new explosive packages, NOL also designed the Safety and Arming Mechanism, and the safety and reliability tests conducted are described. The results of the test program indicate that the detonation transfer probability between the armed explosive components exceeds 0.9999, and is less than 0.0001 when the explosive components are in the safe position.

Doxycycline for prevention of erlotinib-induced rash in patients with non-small-cell lung cancer (NSCLC) after failure of first-line chemotherapy: A randomized, open-label trial.

PubMed

Deplanque, Gaël; Gervais, Radj; Vergnenegre, Alain; Falchero, Lionel; Souquet, Pierre-Jean; Chavaillon, Jean-Michel; Taviot, Bruno; Fraboulet, Ghislaine; Saal, Hakim; Robert, Caroline; Chosidow, Olivier

2016-06-01

Rash is a common epidermal growth factor receptor inhibitor-induced toxicity that can impair quality of life and treatment compliance. We sought to evaluate the efficacy of doxycycline in preventing erlotinib-induced rash (folliculitis) in patients with non-small-cell lung cancer. This open-label, randomized, prospective, phase II trial was conducted in 147 patients with locally advanced or metastatic non-small-cell lung cancer progressing after first-line chemotherapy, randomized for 4 months with erlotinib alone 150 mg/d per os (control arm) or combined with doxycycline 100 mg/d (doxycycline arm). Incidence and severity of rash, compliance, survival, and safety were assessed. Baseline characteristics of the 147 patients were well balanced in the intent-to-treat population. Folliculitis occurred in 71% of patients in the doxycycline arm and 81% in the control arm (P = .175). The severity of folliculitis and other skin lesions was lower in the doxycycline arm compared with the control arm. Other adverse events were reported at a similar frequency across arms. There was no significant difference in survival between treatment arms. The open-label design of the study and the duration of the treatment with doxycycline are limitations. Doxycycline did not reduce the incidence of erlotinib-induced folliculitis, but significantly reduced its severity. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Neural control of rhythmic arm cycling after stroke

PubMed Central

Loadman, Pamela M.; Hundza, Sandra R.

2012-01-01

Disordered reflex activity and alterations in the neural control of walking have been observed after stroke. In addition to impairments in leg movement that affect locomotor ability after stroke, significant impairments are also seen in the arms. Altered neural control in the upper limb can often lead to altered tone and spasticity resulting in impaired coordination and flexion contractures. We sought to address the extent to which the neural control of movement is disordered after stroke by examining the modulation pattern of cutaneous reflexes in arm muscles during arm cycling. Twenty-five stroke participants who were at least 6 mo postinfarction and clinically stable, performed rhythmic arm cycling while cutaneous reflexes were evoked with trains (5 × 1.0-ms pulses at 300 Hz) of constant-current electrical stimulation to the superficial radial (SR) nerve at the wrist. Both the more (MA) and less affected (LA) arms were stimulated in separate trials. Bilateral electromyography (EMG) activity was recorded from muscles acting at the shoulder, elbow, and wrist. Analysis was conducted on averaged reflexes in 12 equidistant phases of the movement cycle. Phase-modulated cutaneous reflexes were present, but altered, in both MA and LA arms after stroke. Notably, the pattern was “blunted” in the MA arm in stroke compared with control participants. Differences between stroke and control were progressively more evident moving from shoulder to wrist. The results suggest that a reduced pattern of cutaneous reflex modulation persists during rhythmic arm movement after stroke. The overall implication of this result is that the putative spinal contributions to rhythmic human arm movement remain accessible after stroke, which has translational implications for rehabilitation. PMID:22572949

Long-term changes in dietary and food intake behaviour in the Diabetes Prevention Program Outcomes Study.

PubMed

Jaacks, L M; Ma, Y; Davis, N; Delahanty, L M; Mayer-Davis, E J; Franks, P W; Brown-Friday, J; Isonaga, M; Kriska, A M; Venditti, E M; Wylie-Rosett, J

2014-12-01

To compare change in dietary intake, with an emphasis on food groups and food intake behaviour, over time across treatment arms in a diabetes prevention trial and to assess the differences in dietary intake among demographic groups within treatment arms. Data are from the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study. Participants were randomized to a lifestyle intervention (n = 1079), metformin (n = 1073) or placebo (n = 1082) for an average of 3 years, after which the initial results regarding the benefits of the lifestyle intervention were released and all participants were offered a modified lifestyle intervention. Dietary intake was assessed using a food frequency questionnaire at baseline and at 1, 5, 6 and 9 years after randomization. Compared with the metformin and placebo arms, participants in the lifestyle arm maintained a lower total fat and saturated fat and a higher fibre intake up to 9 years after randomization and lower intakes of red meat and sweets were maintained for up to 5 years. Younger participants had higher intakes of poultry and lower intakes of fruits compared with their older counterparts, particularly in the lifestyle arm. Black participants tended to have lower dairy and higher poultry intakes compared with white and Hispanic participants. In the lifestyle arm, men tended to have higher grain, fruit and fish intakes than women. Changes in nutrient intake among participants in the lifestyle intervention were maintained for up to 9 years. Younger participants reported more unhealthy diets over time and thus may benefit from additional support to achieve and maintain dietary goals. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Comparison of accuracy of physical examination findings in initial progress notes between paper charts and a newly implemented electronic health record.

PubMed

Yadav, Siddhartha; Kazanji, Noora; K C, Narayan; Paudel, Sudarshan; Falatko, John; Shoichet, Sandor; Maddens, Michael; Barnes, Michael A

2017-01-01

There have been several concerns about the quality of documentation in electronic health records (EHRs) when compared to paper charts. This study compares the accuracy of physical examination findings documentation between the two in initial progress notes. Initial progress notes from patients with 5 specific diagnoses with invariable physical findings admitted to Beaumont Hospital, Royal Oak, between August 2011 and July 2013 were randomly selected for this study. A total of 500 progress notes were retrospectively reviewed. The paper chart arm consisted of progress notes completed prior to the transition to an EHR on July 1, 2012. The remaining charts were placed in the EHR arm. The primary endpoints were accuracy, inaccuracy, and omission of information. Secondary endpoints were time of initiation of progress note, word count, number of systems documented, and accuracy based on level of training. The rate of inaccurate documentation was significantly higher in the EHRs compared to the paper charts (24.4% vs 4.4%). However, expected physical examination findings were more likely to be omitted in the paper notes compared to EHRs (41.2% vs 17.6%). Resident physicians had a smaller number of inaccuracies (5.3% vs 17.3%) and omissions (16.8% vs 33.9%) compared to attending physicians. During the initial phase of implementation of an EHR, inaccuracies were more common in progress notes in the EHR compared to the paper charts. Residents had a lower rate of inaccuracies and omissions compared to attending physicians. Further research is needed to identify training methods and incentives that can reduce inaccuracies in EHRs during initial implementation. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Application of Item Response Theory to Modeling of Expanded Disability Status Scale in Multiple Sclerosis.

PubMed

Novakovic, A M; Krekels, E H J; Munafo, A; Ueckert, S; Karlsson, M O

2017-01-01

In this study, we report the development of the first item response theory (IRT) model within a pharmacometrics framework to characterize the disease progression in multiple sclerosis (MS), as measured by Expanded Disability Status Score (EDSS). Data were collected quarterly from a 96-week phase III clinical study by a blinder rater, involving 104,206 item-level observations from 1319 patients with relapsing-remitting MS (RRMS), treated with placebo or cladribine. Observed scores for each EDSS item were modeled describing the probability of a given score as a function of patients' (unobserved) disability using a logistic model. Longitudinal data from placebo arms were used to describe the disease progression over time, and the model was then extended to cladribine arms to characterize the drug effect. Sensitivity with respect to patient disability was calculated as Fisher information for each EDSS item, which were ranked according to the amount of information they contained. The IRT model was able to describe baseline and longitudinal EDSS data on item and total level. The final model suggested that cladribine treatment significantly slows disease-progression rate, with a 20% decrease in disease-progression rate compared to placebo, irrespective of exposure, and effects an additional exposure-dependent reduction in disability progression. Four out of eight items contained 80% of information for the given range of disabilities. This study has illustrated that IRT modeling is specifically suitable for accurate quantification of disease status and description and prediction of disease progression in phase 3 studies on RRMS, by integrating EDSS item-level data in a meaningful manner.

An innovative approach for modeling and simulation of an automated industrial robotic arm operated electro-pneumatically

NASA Astrophysics Data System (ADS)

Popa, L.; Popa, V.

2017-08-01

The article is focused on modeling an automated industrial robotic arm operated electro-pneumatically and to simulate the robotic arm operation. It is used the graphic language FBD (Function Block Diagram) to program the robotic arm on Zelio Logic automation. The innovative modeling and simulation procedures are considered specific problems regarding the development of a new type of technical products in the field of robotics. Thus, were identified new applications of a Programmable Logic Controller (PLC) as a specialized computer performing control functions with a variety of high levels of complexit.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-09

The Orion crew access arm is secured in a storage location at NASA's Kennedy Space Center in Florida. The access arm will be prepared for its move to the mobile launcher (ML) tower near the Vehicle Assembly Building at the center. The crew access arm will be installed at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Benefits, Potential Harms, and Optimal Use of Nutritional Supplementation for Preventing Progression of Age-Related Macular Degeneration.

PubMed

Rojas-Fernandez, Carlos H; Tyber, Kevin

2017-03-01

To briefly review age-related macular degeneration (AMD), the main findings from the Age Related Eye Disease Study (AREDS) report number 8 on the use of nutritional supplements for AMD, and to focus on data suggesting that supplement use should be guided using genetic testing of AMD risk genes. A literature search (January 2001 through October 26, 2016) was conducted using MEDLINE and the following MeSH terms: Antioxidants/therapeutic use, Genotype, Macular Degeneration/drug therapy, Macular degeneration/genetics, Dietary Supplements, Proteins/genetics, and Zinc Compounds/therapeutic use. Bibliographies of publications identified were also reviewed. English-language studies assessing AREDS supplement response in patients with AMD in relation to complement factor H gene ( CFH) and age-related maculopathy susceptibility 2 gene ( ARMS2) risk alleles were evaluated. Three of the 4 studies demonstrated a treatment interaction between ARMS2 and CFH genotypes and a differential response to supplements. The fourth study documented an interaction for the CFH genotype only. Reported response interactions included attenuated response, no response, and good response, whereas a subset showed increased progression of AMD. Conversely, one study reported no interactions between CFH and ARMS2 risk alleles and response to supplements. The weight of the evidence supports using genetic testing to guide selection of ocular vitamin use. This approach will avoid using supplements that could speed the progression of AMD in vulnerable patients, avoid using supplements that will have little to no effect in others, and result in appropriately using supplements in those that are likely to derive meaningful benefits.

IMATINIB 800MG DAILY INDUCES DEEPER MOLECULAR RESPONSES THAN IMATINIB 400MG DAILY: RESULTS OF SWOG S0325, AN INTERGROUP RANDOMIZED PHASE II TRIAL IN NEWLY DIAGNOSED CHRONIC PHASE CHRONIC MYELOID LEUKAEMIA

PubMed Central

Deininger, Michael W.; Kopecky, Kenneth J.; Radich, Jerald P.; Kamel-Reid, Suzanne; Stock, Wendy; Paietta, Elisabeth; Emanuel, Peter D.; Tallman, Martin; Wadleigh, Martha; Larson, Richard A.; Lipton, Jeffrey H.; Slovak, Marilyn L.; Appelbaum, Frederick R.; Druker, Brian J.

2014-01-01

The standard dose of imatinib for newly diagnosed patients with chronic phase chronic myeloid leukemia (CP-CML) is 400mg daily (IM400), but the optimal dose is unknown. This randomized phase II study compared the rates of molecular, haematologic and cytogenetic response to IM400 vs. imatinib 400mg twice daily (IM800) in 153 adult patients with CP-CML. Dose adjustments for toxicity were flexible to maximize retention on study. Molecular response (MR) at 12 months was deeper in the IM800 arm (4-log reduction of BCR-ABL1 mRNA: 25% vs. 10% of patients, P=0.038; 3-log reduction: 53% vs. 35%, P=0.049). During the first 12 months BCR-ABL1 levels in the IM800 arm were an average 2.9-fold lower than in the IM400 arm (P=0.010). Complete haematologic response was similar, but complete cytogenetic response was higher with IM800 (85% vs. 67%, P=0.040). Grade 3–4 toxicities were more common for IM800 (58% vs. 31%, P=0.0007), and were most commonly haematologic. Few patients have relapsed, progressed or died, but progression-free (P=0.048) and relapse-free (P=0.031) survival were superior for IM800. In newly diagnosed CP-CML patients, IM800 induced deeper molecular responses than IM400, with a trend for improved progression-free and overall survival, but was associated with more severe toxicity. PMID:24383843

Idelalisib or Placebo in Combination with Bendamustine and Rituximab in Patients with Relapsed/Refractory CLL - Interim Results of a Phase 3 Randomized, Double-blind Placebo-Controlled Trial

PubMed Central

Zelenetz, Andrew D.; Barrientos, Jacqueline C.; Brown, Jennifer R.; Coiffier, Bertrand; Delgado, Julio; Egyed, Miklós; Ghia, Paolo; Illés, Árpád; Jurczak, Wojciech; Marlton, Paula; Montillo, Marco; Morschhauser, Franck; Pristupa, Alexander S.; Robak, Tadeusz; Sharman, Jeff P.; Simpson, David; Smolej, Lukáš; Tausch, Eugen; Adewoye, Adeboye H.; Dreiling, Lyndah K.; Kim, Yeonhee; Stilgenbauer, Stephan; Hillmen, Peter

2017-01-01

Summary Background Bendamustine and rituximab (BR) has been a standard of care for the management of patients with relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL). We evaluated the efficacy and safety of adding idelalisib, a first-in-class targeted PI3Kδ inhibitor, to BR in patients with R/R CLL Methods This trial was a global, multicenter, double-blind, placebo -controlled trial in adult patients (≥18 years) with R/R CLL requiring treatment for their disease. Patients had to have measurable lymphadenopathy (≥1 nodal lesion ≥2.0 cm in the longest diameter and ≥1.0 cm in the longest perpendicular diameter) by computer tomography or magnetic resonance imaging, disease progression within <36 months since last prior therapy, a Karnofsky Performance Status score ≥60 and adequate bone marrow, liver and kidney function. Key exclusion criteria included histological transformation to an aggressive lymphoma (eg, Richter transformation) or disease refractory to bendamustine. Patients were randomised 1:1 using a central interactive web response system that assigned a unique treatment code for each patient, to receive intravenous BR infusions for a maximum of 6 cycles in addition to blinded study drug matching the assigned treatment of either twice-daily oral idelalisib 150 mg or placebo administered continuously until disease progression or intolerable study drug-related toxicity. Randomisation was stratified based on high-risk features (IGHV, del(17p)/TP53 mutation) and refractory vs relapsed disease. The primary endpoint was progression-free survival (PFS) assessed by an independent review committee in the intent-to-treat population. Overall survival was a key secondary endpoint. Crossover was not permitted to the idelalisib arm at progression. The trial is ongoing (ClinicalTrials.gov # NCT01569295). Findings Between 26 June 2012 and 21 August 2014, 416 patients with R/R CLL were enrolled; 207 patients were randomised to the idelalisib and 209 to the placebo arm. After the prespecified interim analysis, the Independent Data Monitoring Committee (IDMC) recommended discontinuation and unblinding of the trial due to efficacy. Updated data are presented in this manuscript with a cutoff date of 07 October 2015. Median (95% CI) PFS was 20·8 (16·6, 26·4) and 11·1 (8·9, 11·1) months in the idelalisib and placebo arms, respectively (hazard ratio [HR], 0·33; 95% CI, 0·25, 0·44; P<0·0001) at a median (Q1, Q3) follow-up of 14 (7, 18) months. The most frequent grade 3 or greater AEs were neutropenia (124/207 [60%]) and febrile neutropenia (48/207 [23%]) in the idelalisib arm and neutropenia (99/209 [47%]) and thrombocytopenia (27/209 [13%]) in the placebo arm. Serious AEs included febrile neutropenia, pneumonia and pyrexia and were common in both treatment arms. An increased risk of infection was observed in the idelalisib vs placebo arm. Interpretation Idelalisib plus BR is superior to BR alone, improving PFS and OS. This regimen represents an important new treatment option for patients with R/R CLL. PMID:28139405

Efficacy of a Student-Led, Community-Based, Multifactorial Fall Prevention Program: Stay in Balance.

PubMed

Der Ananian, Cheryl A; Mitros, Melanie; Buman, Matthew Paul

2017-01-01

Falls are a major public health concern in older adults. Recent fall prevention guidelines recommend the use of multifactorial fall prevention programs (FPPs) that include exercise for community-dwelling older adults; however, the availability of sustainable, community-based FPPs is limited. We conducted a 24-week quasi-experimental study to evaluate the efficacy of a community-based, multifactorial FPP [Stay in Balance (SIB)] on dynamic and functional balance and muscular strength. The SIB program was delivered by allied health students and included a health education program focused on fall risk factors and a progressive exercise program emphasizing lower-extremity strength and balance. All participants initially received the 12-week SIB program, and participants were non-randomly assigned at baseline to either continue the SIB exercise program at home or as a center-based program for an additional 12 weeks. Adults aged 60 and older ( n  = 69) who were at-risk of falling (fall history or 2+ fall risk factors) were recruited to participate. Mixed effects repeated measures using Statistical Application Software Proc Mixed were used to examine group, time, and group-by-time effects on dynamic balance (8-Foot Up and Go), functional balance (Berg Balance Scale), and muscular strength (30 s chair stands and 30 s arm curls). Non-normally distributed outcome variables were log-transformed. After adjusting for age, gender, and body mass index, 8-Foot Up and Go scores, improved significantly over time [ F (2,173)  = 8.92, p  = 0.0; T0 - T2 diff = 1.2 (1.0)]. Berg Balance Scores [ F (2,173)  = 29.0, p  < 0.0001; T0 - T2 diff = 4.96 (0.72)], chair stands [ F (2,171)  = 10.17, p  < 0.0001; T0 - T2 diff = 3.1 (0.7)], and arm curls [ F (2,171)  = 12.7, p  < 0.02; T0 - T2 diff = 2.7 (0.6)] also all improved significantly over time. There were no significant group-by-time effects observed for any of the outcomes. The SIB program improved dynamic and functional balance and muscular strength in older adults at-risk for falling. Our findings indicate continuing home-based strength and balance exercises at home after completion of a center-based FPP program may be an effective and feasible way to maintain improvements in balance and strength parameters.

AMF3 ARM's Research Facility at Oliktok Point Alaska

NASA Astrophysics Data System (ADS)

Helsel, F.; Lucero, D. A.; Ivey, M.; Dexheimer, D.; Hardesty, J.; Roesler, E. L.

2015-12-01

Scientific Infrastructure To Support Atmospheric Science And Aerosol Science For The Department Of Energy's Atmospheric Radiation Measurement Programs Mobile Facility 3 Located At Oliktok Point, Alaska.The Atmospheric Radiation Measurement (ARM) Program's Mobile Facility 3 (AMF3) located at Oliktok Point, Alaska is a U.S. Department of Energy (DOE) site. The site provides a scientific infrastructure and data archives for the international Arctic research community. The infrastructure at Oliktok is designed to be mobile and it may be relocated in the future to support other ARM science missions. AMF-3 instruments include: scanning precipitation Radar-cloud radar, Raman Lidar, Eddy correlation flux systems, Ceilometer, Balloon sounding system, Atmospheric Emitted Radiance Interferometer (AERI), Micro-pulse Lidar (MPL), Millimeter cloud radar along with all the standard metrological measurements. Data from these instruments is placed in the ARM data archives and are available to the international research community. This poster will discuss what instruments are at AMF3 and the challenges of powering an Arctic site without the use of grid power.

Electro-osmotically driven liquid delivery method and apparatus

DOEpatents

Rakestraw, D.J.; Anex, D.S.; Yan, C.; Dadoo, R.; Zare, R.N.

1999-08-24

Method and apparatus are disclosed for controlling precisely the composition and delivery of liquid at sub-{micro}L/min flow rate. One embodiment of such a delivery system is an electro-osmotically driven gradient flow delivery system that generates dynamic gradient flows with sub-{micro}L/min flow rates by merging a plurality of electro-osmotic flows. These flows are delivered by a plurality of delivery arms attached to a mixing connector, where they mix and then flow into a receiving means, preferably a column. Each inlet of the plurality of delivery arms is placed in a corresponding solution reservoir. A plurality of independent programmable high-voltage power supplies is used to apply a voltage program to each of the plurality of solution reservoirs to regulate the electro-osmotic flow in each delivery arm. The electro-osmotic flow rates in the delivery arms are changed with time according to each voltage program to deliver the required gradient profile to the column. 4 figs.

Dementia Care Management in an Underserved Community: The Comparative Effectiveness of Two Different Approaches.

PubMed

Chodosh, Joshua; Colaiaco, Benjamin A; Connor, Karen Ilene; Cope, Dennis Wesley; Liu, Hangsheng; Ganz, David Avram; Richman, Mark Jason; Cherry, Debra Lynn; Blank, Joseph Moshe; Carbone, Raquel Del Pilar; Wolf, Sheldon Mark; Vickrey, Barbara Grace

2015-08-01

To compare the effectiveness and costs of telephone-only approach to in-person plus telephone for delivering an evidence-based, coordinated care management program for dementia. We randomized 151 patient-caregiver dyads from an underserved predominantly Latino community to two arms that shared a care management protocol but implemented in different formats: in-person visits at home and/or in the community plus telephone and mail, versus telephone and mail only. We compared between-arm caregiver burden and care-recipient problem behaviors (primary outcomes) and patient-caregiver dyad retention, care quality, health care utilization, and costs (secondary outcomes) at 6- and 12-months follow-up. Care quality improved substantially over time in both arms. Caregiver burden, care-recipient problem behaviors, retention, and health care utilization did not differ across arms but the in-person program cost more to deliver. Dementia care quality improved regardless of how care management was delivered; large differences in effectiveness or cost offsets were not detected. © The Author(s) 2015.

Three Dimensional Measurements And Display Using A Robot Arm

NASA Astrophysics Data System (ADS)

Swift, Thomas E.

1984-02-01

The purpose of this paper is to describe a project which makes three dimensional measurements of an object using a robot arm. A program was written to determine the X-Y-Z coordinates of the end point of a Minimover-5 robot arm which was interfaced to a TRS-80 Model III microcomputer. This program was used in conjunction with computer graphics subroutines that draw a projected three dimensional object.. The robot arm was direc-ted to touch points on an object and then lines were drawn on the screen of the microcomputer between consecutive points as they were entered. A representation of the entire object is in this way constructed on the screen. The three dimensional graphics subroutines have the ability to rotate the projected object about any of the three axes, and to scale the object to any size. This project has applications in the computer-aided design and manufacturing fields because it can accurately measure the features of an irregularly shaped object.

Moderate Intensity Cycling Exercise after Upper Extremity Resistance Training Interferes Response to Muscle Hypertrophy but Not Strength Gains

PubMed Central

Tomiya, Shigeto; Kikuchi, Naoki; Nakazato, Koichi

2017-01-01

The purpose of the present study was to examine the effect of 30-min moderate intensity cycling exercise immediately after upper-body resistance training on the muscle hypertrophy and strength gain. Fourteen subjects were randomly divided between two groups. One group performed moderate intensity (55% of maximum oxygen consumption [VO2max], 30 min) cycle training immediately after arm resistance training as concurrent training (CT; n = 7, age: 21.8 ± 0.7 years, height: 1.68 ± 0.06 m, weight: 60.3 ± 7.4 kg); the second group performed the same endurance and arm RT on separate days as control group (SEP; n=7, age: 22.1 ± 0.7 years, height: 1.76 ± 0.05 m, weight: 63.8 ± 3.6 kg). The supervised progressive RT program was designed to induce muscular hypertrophy (3-5 sets of 10 repetitions) with bilateral arm-curl exercise using 75% of the one repetition maximum (1RM) with 2-min rest intervals. The RT program was performed for 8 weeks, twice per week. Muscle cross-sectional area (CSA), 1RM, and VO2max were measured pre- and post-training. Significant increases in muscle CSA from pre- to post-training were observed in both the SEP (p = 0.001, effect size [ES] = 0.84) and the CT groups (p = 0.004, ES = 0.45). A significant increase in 1RM from pre- to post-training was observed in the SEP (p = 0.025, ES = 0.91) and CT groups (p = 0.001, ES = 2.38). There were no interaction effects (time × group) for CSA, 1RM, or VO2max. A significantly higher percentage change of CSA was observed in the SEP group (12.1 ± 4.9%) compared to the CT group (5.0 ± 2.7%, p = 0.029), but no significant difference was observed in the 1RM (SEP: 19.8 ± 16.8%, CT: 24.3 ± 11.1%). The data suggest that significant improvement of CSA and strength can be expected with progressive resistance training with subsequent endurance exercise performed immediately or on a different day. Changes in CSA might be affected by subsequent cycling exercise after 8 weeks of training. Key points Moderate intensity cycling exercise immediately after upper-body resistance training influences the magnitude of muscle hypertrophy and relative value of CSA changes. There was no statistically significant difference in the % change in 1RM between groups after concurrent strength training and moderate intensity endurance training. Timing of endurance training could alter the degree of muscular growth induced by resistance training. PMID:28912657

Navy Ohio Replacement (SSBN[X]) Ballistic Missile Submarine Program: Background and Issues for Congress

DTIC Science & Technology

2015-12-17

strategic nuclear arms reduction treaty that included 14 Ohio-class SSBNs, all armed with D- 5s . This recommendation prompted interest in the idea of...a program to extend the service life of the Trident II D-5 SLBM into the 2040s, and to have its next-generation SSBNs carry D- 5s . Following this...Navy states that 10 operational SSBNs—meaning boats not encumbered by lengthy maintenance actions—are needed to meet strategic nuclear deterrence

Environmental effects on composite airframes: A study conducted for the ARM UAV Program (Atmospheric Radiation Measurement Unmanned Aerospace Vehicle)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Noguchi, R.A.

1994-06-01

Composite materials are affected by environments differently than conventional airframe structural materials are. This study identifies the environmental conditions which the composite-airframe ARM UAV may encounter, and discusses the potential degradation processes composite materials may undergo when subjected to those environments. This information is intended to be useful in a follow-on program to develop equipment and procedures to prevent, detect, or otherwise mitigate significant degradation with the ultimate goal of preventing catastrophic aircraft failure.

Compensatory mechanisms of balance to the scaling of arm-swing frequency.

PubMed

Ko, Ji Hyun; Wang, Zheng; Challis, John H; Newell, Karl M

2015-11-05

The present study investigated the contribution of the Hof (2007) mechanism 1 (M1-moving the center of pressure (COP) with respect to the vertical projection of the center of mass (COMTotal)); and mechanism 2 (M2-rotating the trunk and upper limbs around the COMTotal) to postural control and the stability of COP-COMTotal cophase as a function of lateral arm-swing frequency. Young adults were instructed to stand still on a force platform while alternating their arm swinging from above the head to the side of their thigh to create perturbations to postural control. Scaling the frequency of arm-swing (random step changes of 0.2 Hz within a bandwidth of 0.2 to 1.6 Hz) increased the SD of COP but decreased the SD of COMTotal. Increments in arm-swing frequency induced a progressive increase in M1 and decrease in M2 in terms of their relative contribution to postural stability. The cophase between COP and COMTotal became more tightly in-phase over increments of arm-swing frequency. These findings show an adaptive compensatory role of M1 and M2 within the stability of COP-COMTotal coupling in the regulation of human balance control. Copyright © 2015 Elsevier Ltd. All rights reserved.

AMF 1 Site Science

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miller, Mark Alan

This report documents progress on DOE Grant# DE-FG02-08ER64531 funded by the Department of Energy’s Atmospheric Systems Research (ASR) program covering the period between its inception in 2008 and its conclusion in 2014. The Atmospheric Radiation Measurement (ARM) Program’s Mobile Facility #1 (AMF#1) is a collection of state-of-the art atmospheric sensing systems including remote and in situ instrumentation designed to characterize the atmospheric column above and in the immediate vicinity of the deployment location. The grant discussed in this report funded the activities of the AMF#1 Site Scientist Team. Broad responsibilities of this team included examining new deployment sites and recommendingmore » instrument deployment configurations; data quality control during the early stages of deployments and for certain instruments through the course of the deployment; scientific outreach in the host country or location (particularly international deployments); scientific research oriented toward basic questions about cloud physics and radiation transfer in the deployment region; and training of Ph.D. students to conduct future research relevant to the Atmospheric Systems Research (ASR) program.« less

Nivolumab-induced vitiligo in a metastatic melanoma patient: A case report.

PubMed

Edmondson, Lindsay A; Smith, Leticia V; Mallik, Alka

2017-12-01

The programmed-death-1 inhibitors selectively block programmed-death-1 interaction with its receptor, which restores active T-cell response directed at tumor cells, inducing an anti-tumor effect. This nonspecific activation of the immune system can also lead to a wide spectrum of side effects. Nivolumab has been used effectively to prolong survival in patients with metastatic melanoma and is recommended as a category 1 agent for systemic therapy in metastatic or unresectable melanoma per the National Comprehensive Cancer Network guidelines. We present a case of a 64-year-old woman who began nivolumab therapy for metastatic melanoma. After six doses of nivolumab therapy, the patient experienced generalized hypopigmentation on her face, chest, back, arms, and lower extremities. Although vitiligo has been reported in as many as 10.7% of patients undergoing nivolumab therapy in some clinical trials, we believe this is the first case to describe the progression of nivolumab-induced vitiligo in a metastatic melanoma patient. This case provides significant insight into the onset, symptoms, development, and treatment options for patients experiencing vitiligo as a result of nivolumab therapy.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

Two heavy-lift cranes are used to lower the Orion crew access arm onto a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

Two heavy-lift cranes are being used to move the Orion crew access arm and lower it onto a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

Two heavy-lift cranes are used to tilt and lower the Orion crew access arm onto a work stand in a storage location at NASA's Kennedy Space Center in Florida. The access arm was transported from Precision Fabricating and Cleaning in Cocoa, Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

Two heavy-lift cranes are being used to lower the Orion crew access arm onto a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

Two heavy-lift cranes are used to lift the Orion crew access arm up from a flatbed truck in a storage location at NASA's Kennedy Space Center in Florida. The access arm was transported from Precision Fabricating and Cleaning in Cocoa, Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

An automated Y-maze based on a reduced instruction set computer (RISC) microcontroller for the assessment of continuous spontaneous alternation in rats.

PubMed

Heredia-López, Francisco J; Álvarez-Cervera, Fernando J; Collí-Alfaro, José G; Bata-García, José L; Arankowsky-Sandoval, Gloria; Góngora-Alfaro, José L

2016-12-01

Continuous spontaneous alternation behavior (SAB) in a Y-maze is used for evaluating working memory in rodents. Here, the design of an automated Y-maze equipped with three infrared optocouplers per arm, and commanded by a reduced instruction set computer (RISC) microcontroller is described. The software was devised for recording only true entries and exits to the arms. Experimental settings are programmed via a keyboard with three buttons and a display. The sequence of arm entries and the time spent in each arm and the neutral zone (NZ) are saved as a text file in a non-volatile memory for later transfer to a USB flash memory. Data files are analyzed with a program developed under LabVIEW® environment, and the results are exported to an Excel® spreadsheet file. Variables measured are: latency to exit the starting arm, sequence and number of arm entries, number of alternations, alternation percentage, and cumulative times spent in each arm and NZ. The automated Y-maze accurately detected the SAB decrease produced in rats by the muscarinic antagonist trihexyphenidyl, and its reversal by caffeine, having 100 % concordance with the alternation percentages calculated by two trained observers who independently watched videos of the same experiments. Although the values of time spent in the arms and NZ measured by the automated system had small discrepancies with those calculated by the observers, Bland-Altman analysis showed 95 % concordance in three pairs of comparisons, while in one it was 90 %, indicating that this system is a reliable and inexpensive alternative for the study of continuous SAB in rodents.

Understanding effects of armed conflict on health outcomes: the case of Nepal

PubMed Central

2010-01-01

Objective There is abundance of literature on adverse effects of conflict on the health of the population. In contrast to this, sporadic data in Nepal claim improvements in most of the health indicators during the decade-long armed conflict (1996-2006). However, systematic information to support or reject this claim is scant. This study reviews Nepal's key health indicators before and after the violent conflict and explores the possible factors facilitating the progress. Methods A secondary analysis has been conducted of two demographic health surveys-Nepal Family Health Survey (NFHS) 1996 and Nepal Demographic and Health Survey (NDHS) 2006; the latter was supplemented by a study carried out by the Nepal Health Research Council in 2006. Results The data show Nepal has made progress in 16 out of 19 health indicators which are part of the Millennium Development Goals whilst three indicators have remained static. Our analysis suggests a number of conflict and non-conflict factors which may have led to this success. Conclusion The lessons learnt from Nepal could be replicable elsewhere in conflict and post-conflict environments. A nationwide large-scale empirical study is needed to further assess the determinants of Nepal's success in the health sector at a time the country experienced a decade of armed conflict. PMID:21122098

Navy DDG-1000 and DDG-51 Destroyer Programs: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2009-06-04

Aegis combat system and the arming of the ship with the SM-3, a version of the Navy’s Standard Missile that is designed for BMD operations.6 Total...and assigning the construction of those ships to GD/BIW and/or NGSB; • procuring AGS- armed versions of the basic LPD-17 class hull—another option...subcommittee of the House Armed Services Committee.24 22 Christopher P. Cavas, “All

Ballistic missile defense technologies

NASA Astrophysics Data System (ADS)

1985-09-01

A report on Ballistic Missile Technologies includes the following: Executive summary; Introduction; Ballistic missiles then and now; Deterrence, U.S. nuclear strategy, and BMD; BMD capabilities and the strategic balance; Crisis stability, arms race stability, and arms control issues; Ballistic missile defense technologies; Feasibility; Alternative future scenarios; Alternative R&D programs.

ARM/GCSS/SPARC TWP-ICE CRM Intercomparison Study

NASA Technical Reports Server (NTRS)

Fridlind, Ann; Ackerman, Andrew; Petch, Jon; Field, Paul; Hill, Adrian; McFarquhar, Greg; Xie, Shaocheng; Zhang, Minghua

2010-01-01

Specifications are provided for running a cloud-resolving model (CRM) and submitting results in a standardized format for inclusion in a n intercomparison study and archiving for public access. The simulated case study is based on measurements obtained during the 2006 Tropical Warm Pool - International Cloud Experiment (TWP-ICE) led by the U. S. department of Energy Atmospheric Radiation Measurement (ARM) program. The modeling intercomparison study is based on objectives developed in concert with the Stratospheric Processes And their Role in Climate (SPARC) program and the GEWEX cloud system study (GCSS) program. The Global Energy and Water Cycle Experiment (GEWEX) is a core project of the World Climate Research PRogramme (WCRP).

KSC-2009-5915

NASA Image and Video Library

2009-10-27

CAPE CANAVERAL, Fla. – Sunrise at Launch Pad 39B at NASA's Kennedy Space Center in Florida reveals the rotating service structure and the arms of the vehicle stabilization system have been retracted from around the Constellation Program's 327-foot-tall Ares I-X rocket for launch. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, and the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. The data returned from more than 700 sensors throughout the rocket will be used to refine the design of future launch vehicles and bring NASA one step closer to reaching its exploration goals. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

Final results of the TANIA randomised phase III trial of bevacizumab after progression on first-line bevacizumab therapy for HER2-negative locally recurrent/metastatic breast cancer.

PubMed

Vrdoljak, E; Marschner, N; Zielinski, C; Gligorov, J; Cortes, J; Puglisi, F; Aapro, M; Fallowfield, L; Fontana, A; Inbar, M; Kahan, Z; Welt, A; Lévy, C; Brain, E; Pivot, X; Putzu, C; González Martín, A; de Ducla, S; Easton, V; von Minckwitz, G

2016-11-01

The randomised phase III TANIA trial demonstrated that continuing bevacizumab with second-line chemotherapy for locally recurrent/metastatic breast cancer (LR/mBC) after progression on first-line bevacizumab-containing therapy significantly improved progression-free survival (PFS) compared with chemotherapy alone [hazard ratio (HR) = 0.75, 95% confidence interval (CI) 0.61-0.93]. We report final results from the TANIA trial, including overall survival (OS) and health-related quality of life (HRQoL). Patients with HER2-negative LR/mBC that had progressed on or after first-line bevacizumab plus chemotherapy were randomised to receive standard second-line chemotherapy either alone or with bevacizumab. At second progression, patients initially randomised to bevacizumab continued bevacizumab with their third-line chemotherapy, but those randomised to chemotherapy alone were not allowed to cross over to receive third-line bevacizumab. The primary end point was second-line PFS; secondary end points included third-line PFS, combined second- and third-line PFS, OS, HRQoL and safety. Of the 494 patients randomised, 483 received second-line therapy; 234 patients (47% of the randomised population) continued to third-line study treatment. The median duration of follow-up at the final analysis was 32.1 months in the chemotherapy-alone arm and 30.9 months in the bevacizumab plus chemotherapy arm. There was no statistically significant difference between treatment arms in third-line PFS (HR = 0.79, 95% CI 0.59-1.06), combined second- and third-line PFS (HR = 0.85, 95% CI 0.68-1.05) or OS (HR = 0.96, 95% CI 0.76-1.21). Third-line safety results showed increased incidences of proteinuria and hypertension with bevacizumab, consistent with safety results for the second-line treatment phase. No differences in HRQoL were detected. In this trial, continuing bevacizumab beyond first and second progression of LR/mBC improved second-line PFS, but no improvement in longer term efficacy was observed. The second-line PFS benefit appears to be achieved without detrimentally affecting quality of life. NCT01250379. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Loss of alleles from the distal short arm of chromosome 1 occurs late in melanoma tumor progression

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dracopoli, N.C.; Harnett, P.; Bale, S.J.

The gene for familial malignant melanoma and its precursor lesion, the dysplastic nevus, has been assigned to a region of the distal short arm of chromosome 1, which is frequently involved in karyotypic abnormalities in melanoma cells. The authors have examined loci on chromosome 1p for loss-of-constitutional heterozygosity in 35 melanomas and 21 melanoma cell lines to analyze the role of these abnormalities in melanocyte transformation. Loss-of-heterozygosity at loci on chromosome 1p was identified in 15/35 (43%) melanomas and 11/21 (52%) melanoma cell lines. Analysis of multiple metastases derived from the same patient and of melanoma and lymphoblastoid samples frommore » a family with hereditary melanoma showed that the loss-of-heterozygosity at loci on distal 1p is a late event in tumor progression, rather than the second mutation that would occur if melanoma were due to a cellular recessive mechanism. Comparisons with neuroblastoma and multiple endocrine neoplasia (MEN2) suggest that the frequent 1p loss-of-heterozygosity in these malignancies is a common late event of neuroectodermal tumor progression.« less

Effects of diabetes self-management programs on time-to-hospitalization among patients with type 2 diabetes: a survival analysis model.

PubMed

Adepoju, Omolola E; Bolin, Jane N; Phillips, Charles D; Zhao, Hongwei; Ohsfeldt, Robert L; McMaughan, Darcy K; Helduser, Janet W; Forjuoh, Samuel N

2014-04-01

This study compared time-to-hospitalization among subjects enrolled in different diabetes self-management programs (DSMP). We sought to determine whether the interventions delayed the occurrence of any acute event necessitating hospitalization. Electronic medical records (EMR) were obtained for 376 adults enrolled in a randomized controlled trial (RCT) of Type 2 diabetes (T2DM) self-management programs. All study participants had uncontrolled diabetes and were randomized into either: personal digital assistant (PDA), Chronic Disease Self-Management Program (CDSMP), combined PDA and CDSMP (COM), or usual care (UC) groups. Subjects were followed for a maximum of two years. Time-to-hospitalization was measured as the interval between study enrollment and the occurrence of a diabetes-related hospitalization. Subjects enrolled in the CDSMP-only arm had significantly prolonged time-to-hospitalization (Hazard ratio: 0.10; p=0.002) when compared to subjects in the control arm. Subjects in the PDA-only and combined PDA and CDSMP arms showed no improvements in comparison to the control arm. CDSMP can be effective in delaying time-to-hospitalization among patients with T2DM. Reducing unnecessary healthcare utilization, particularly inpatient hospitalization is a key strategy to improving the quality of health care and lowering associated health care costs. The CDSMP offers the potential to reduce time-to-hospitalization among T2DM patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Circulating Tumor Cells and Response to Chemotherapy in Metastatic Breast Cancer: SWOG S0500

PubMed Central

Smerage, Jeffrey B.; Barlow, William E.; Hortobagyi, Gabriel N.; Winer, Eric P.; Leyland-Jones, Brian; Srkalovic, Gordan; Tejwani, Sheela; Schott, Anne F.; O'Rourke, Mark A.; Lew, Danika L.; Doyle, Gerald V.; Gralow, Julie R.; Livingston, Robert B.; Hayes, Daniel F.

2014-01-01

Purpose Increased circulating tumor cells (CTCs; five or more CTCs per 7.5 mL of whole blood) are associated with poor prognosis in metastatic breast cancer (MBC). A randomized trial of patients with persistent increase in CTCs tested whether changing chemotherapy after one cycle of first-line chemotherapy would improve the primary outcome of overall survival (OS). Patients and Methods Patients with MBC who did not have increased CTCs at baseline remained on initial therapy until progression (arm A). Patients with initially increased CTCs that decreased after 21 days of therapy remained on initial therapy (arm B). Patients with persistently increased CTCs after 21 days of therapy were randomly assigned to continue initial therapy (arm C1) or change to an alternative chemotherapy (arm C2). Results Of 595 eligible and evaluable patients, 276 (46%) did not have increased CTCs (arm A). Of those with initially increased CTCs, 31 (10%) were not retested, 165 were assigned to arm B, and 123 were randomly assigned to arm C1 or C2. No difference in median OS was observed between arm C1 and C2 (10.7 and 12.5 months, respectively; P = .98). CTCs were strongly prognostic. Median OS for arms A, B, and C (C1 and C2 combined) were 35 months, 23 months, and 13 months, respectively (P < .001). Conclusion This study confirms the prognostic significance of CTCs in patients with MBC receiving first-line chemotherapy. For patients with persistently increased CTCs after 21 days of first-line chemotherapy, early switching to an alternate cytotoxic therapy was not effective in prolonging OS. For this population, there is a need for more effective treatment than standard chemotherapy. PMID:24888818

Concomitant chemoradiotherapy versus induction docetaxel, cisplatin and 5 fluorouracil (TPF) followed by concomitant chemoradiotherapy in locally advanced head and neck cancer: a phase II randomized study.

PubMed

Paccagnella, A; Ghi, M G; Loreggian, L; Buffoli, A; Koussis, H; Mione, C A; Bonetti, A; Campostrini, F; Gardani, G; Ardizzoia, A; Dondi, D; Guaraldi, M; Cavallo, R; Tomio, L; Gava, A

2010-07-01

Concomitant chemoradiotherapy (CT/RT) is the standard treatment of locally advanced squamous cell carcinoma of the head and neck (SCCHN). We evaluated the efficacy of induction docetaxel (Taxotere), cisplatin, and 5-fluorouracil (TPF) before CT/RT versus CT/RT alone. Patients with stage III-IVM0 SCCHN, Eastern Cooperative Oncology Group performance status of zero to one, were randomly assigned to receive CT/RT alone (arm A: two cycles of cisplatin 20 mg/m(2), days1-4, plus 5-fluorouracil 800 mg/m(2)/day 96 h continuous infusion, during weeks 1 and 6 of radiotherapy) or three cycles of TPF (arm B: docetaxel 75 mg/m(2) and cisplatin 80 mg/m(2), day 1, and 5-fluorouracil 800 mg/m(2)/day 96 h continuous infusion, every 3 weeks) followed by the same CT/RT. The primary end point was the rate of radiologic complete response (CR) at 6-8 weeks after the end of CT/RT. A total of 101 patients were randomly allocated to the study (51 arm A; 50 arm B). CR rates were 21.2% (arm A) versus 50% (arm B). Median progression-free survival and overall survival were, respectively, 19.7 and 33.3 months (arm A) and 30.4 and 39.6 months (arm B). Hematologic and non-hematologic toxic effects during CT/RT were similar in the two arms. Induction TPF followed by CT/RT was associated with higher radiologic CR in patients with locally advanced SCCHN with no negative impact on CT/RT feasibility.

A Media Mix Test of Paid Radio Advertising for Armed Services Recruitment. Volume II.

DTIC Science & Technology

1976-05-01

This was a test of the effectiveness of paid radio recruiting advertising . The four active military services (Army, Navy, Air Force, Marine Corps...service, awareness and knowledge of specific programs and benefits offered by individual services and awareness of armed forces advertising . (Author)

A Media MIX Test of Paid Radio Advertising for Armed Services Recruitment. Volume 3. Addendum.

DTIC Science & Technology

1976-07-01

This was a test of the effectiveness of paid radio recruiting advertising . The four active military services (Army, Navy, Air Force, Marine Corps...service, awareness and knowledge of specific programs and benefits offered by individual services and awareness of armed forces advertising . (Author)

HOW TO PASS ARMED FORCES TESTS.

ERIC Educational Resources Information Center

Cowles Education Corp., New York, NY.

FOLLOWING THE CONTENT OF THE ARMED FORCES EXAMINATIONS, THIS BOOK IS PROGRAMED WITH STEP-BY-STEP DIRECTIONS, TESTS, AND CORRECT ANSWERS AND SOLUTIONS. THE CANDIDATE CAN SIMULATE TAKING THE ACTUAL EXAMS BY ANSWERING THE AUTHENTIC QUESTIONS AND PROBLEMS, MARKING THE ANSWER SHEET, AND EVALUATING HIS OWN APTITUDE BY COMPARING HIS ANSWERS WITH THE…

Development of Hybrid Computer Programs for AAFSS/COBRA/COIN Weapons Effectiveness Studies. Volume I. Simulating Aircraft Maneuvers and Weapon Firing Runs.

DTIC Science & Technology

for the game. Subsequent duels , flown with single armed escorts, calculated reduction in losses and damage states. For the study, hybrid computer...6) a duel between a ground weapon, armed escort, and formation of lift aircraft. (Author)

49 CFR 1562.29 - Armed security officer requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Is not under the influence of alcohol or another intoxicating or hallucinatory drug or substance; and... agency; (v) Is not under the influence of alcohol or another intoxicating or hallucinatory drug or... Marshal Service, in the Armed Security Officer Program; (ii) Not be under the influence of alcohol or...

Instructional Technology in the Armed Forces.

ERIC Educational Resources Information Center

Hitchens, Howard B., Jr.

Broad areas of communications media used in technical training in specific occupational skills within the armed forces are examined in the first part of this report. These areas include: traditional audiovisual media, television, the techniques of programed instruction and instructional systems development, and the use of computers. In the second…

Therapists' Use of the Graded Repetitive Arm Supplementary Program (GRASP) Intervention: A Practice Implementation Survey Study

PubMed Central

McMahon, Naoimh E.; Watkins, Caroline L.; Eng, Janice J.

2014-01-01

Background Only a small percentage of research is ever successfully translated into practice. The Graded Repetitive Arm Supplementary Program (GRASP) is a stroke rehabilitation intervention that anecdotally has had rapid translation from research to clinical practice. This study was conducted to explore the characteristics of this practice implementation. Objectives The aims of this study were: (1) to explore the extent of practice implementation of GRASP in the United Kingdom; (2) using an implementation framework, to explore UK therapists' opinions of implementing GRASP; and (3) if GRASP is found to be used in the United Kingdom, to investigate differences in opinions between therapists who are using GRASP in practice and those who are not. Design A cross-sectional study design was used. Methods Data were collected via an online questionnaire. Participants in this study were members of the College of Occupational Therapy Specialist Section Neurological Practice and the Association of Chartered Physiotherapists Interested in Neurology. Results Of the 274 therapists who responded to the survey, 61 (22.3%) had experience of using GRASP, 114 (41.6%) knew of GRASP but had never used it, and 99 (36.1%) had never heard of GRASP. Therapists displayed positive opinions toward the implementation of a manual with graded progressions of structured upper limb exercises for people after stroke. Opinions were different between therapists who had used GRASP and those who had not. Limitations The findings of this study may be limited by response bias. Conclusions GRASP is a relatively new stroke rehabilitation intervention that has made impressive translation into the knowledge and practice of UK therapists. Therapists' opinions would suggest that GRASP is both an acceptable and feasible intervention and has the potential to be implemented by a greater number of therapists in a range of settings. PMID:24505098

The impact of a food assistance program on nutritional status, disease progression, and food security among people living with HIV in Uganda.

PubMed

Rawat, Rahul; Faust, Elizabeth; Maluccio, John A; Kadiyala, Suneetha

2014-05-01

Although the last decade has seen increased access to antiretroviral therapy across the developing world, widespread food insecurity and undernutrition continue to compromise an effective response to the AIDS epidemic. Limited evidence exists on the potential benefit of food security and nutrition interventions to people living with HIV (PLHIV). We capitalized on an existing intervention to PLHIV in Uganda and conducted a prospective quasi-experimental study evaluating the impact of a monthly household food basket, provided to food insecure antiretroviral therapy-naive PLHIVs for 12 months. The outcomes of interest measured at baseline and follow-up were nutritional status [body mass index; mid-upper arm circumference and hemoglobin (Hb) concentrations], disease severity (CD4 count), and 2 measures of food security: diet quality (Individual Dietary Diversity Score) and food access (Household Food Insecurity Access Scale). We used difference-in-difference propensity score matching to examine the impact of food assistance. Over 12 months, food assistance significantly increased body mass index by 0.6 kg/m (P < 0.01) and mid-upper arm circumference by 6.7 mm (P < 0.05). We found no impact on CD4 count, Hb concentrations, or Individual Dietary Diversity Score. Restricting the analysis to individuals with CD4 counts of greater than 350 cells per microliter, there were significant impacts on Hb concentrations (1.0 g/dL; P < 0.05). At the household level, food assistance increased the Household Food Insecurity Access Scale, by 2.1 points (P < 0.01). This study demonstrates the potential for food assistance programming to be part of the standard of care for PLHIV in areas of widespread food insecurity.

[Digital imaging and robotics in endoscopic surgery].

PubMed

Go, P M

1998-05-23

The introduction of endoscopical surgery has among other things influenced technical developments in surgery. Owing to digitalisation, major progress will be made in imaging and in the sophisticated technology sometimes called robotics. Digital storage makes the results of imaging diagnostics (e.g. the results of radiological examination) suitable for transmission via video conference systems for telediagnostic purposes. The availability of digital video technique renders possible the processing, storage and retrieval of moving images as well. During endoscopical operations use may be made of a robot arm which replaces the camera man. The arm does not grow tired and provides a stable image. The surgeon himself can operate or address the arm and it can remember fixed image positions to which it can return if ordered to do so. The next step is to carry out surgical manipulations via a robot arm. This may make operations more patient-friendly. A robot arm can also have remote control: telerobotics. At the Internet site of this journal a number of supplements to this article can be found, for instance three-dimensional (3D) illustrations (which is the purpose of the 3D spectacles enclosed with this issue) and a quiz (http:@appendix.niwi. knaw.nl).

A Phase II Study of the Central European Society of Anticancer-Drug Research (CESAR) Group: Results of an Open-Label Study of Gemcitabine plus Cisplatin with or without Concomitant or Sequential Gefitinib in Patients with Advanced or Metastatic Transitional Cell Carcinoma of the Urothelium.

PubMed

Miller, Kurt; Morant, Rudolf; Stenzl, Arnulf; Zuna, Ivan; Wirth, Manfred

2016-01-01

This phase II trial evaluated the efficacy and safety of the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, gefitinib, in combination with first-line chemotherapy in advanced urothelial cancer. Chemotherapy-naïve patients with advanced or metastatic urothelial carcinoma were randomized 1:1:1 to receive six cycles of chemotherapy (gemcitabine 1,250 mg/m2 on days 1 and 8, and cisplatin 70 mg/m2 on day 1 of every cycle) concomitantly with gefitinib 250 mg/day (arm A); or with sequential gefitinib (arm B); or alone (arm C). The primary endpoint was the time to progression (TTP). A total of 105 patients received study treatment. Median TTP for arms A, B, and C were 6.1, 6.3, and 7.8 months, respectively. There were no significant differences between treatment arms for any outcomes measured. The most common adverse events were nausea and vomiting. Gefitinib in combination with chemotherapy did not improve efficacy in advanced urothelial cancer. © 2015 S. Karger AG, Basel.

Combatting Terrorism: A Guide for U. S. Naval Forces Afloat

DTIC Science & Technology

1985-12-01

weaponry at an alarming rate . Because of this progress "large numbers of these new weapons will quickly become obsolete and disposed of through arms... rate qualification processes. Consequently, it is many times given to an -: inexperienced, new individual while "more important" posi- 0A * tions are...so as not to unduly tax the regular training schedule. While the training of the crew in anti-terrorist and counterterrorist techniques is in progress

Role and Mechanism of Structural Variation in Progression of Breast Cancer

DTIC Science & Technology

2013-09-01

mutations that occurred throughout tumor evolution, we identified 9 early nonsynonymous point mutations that occurred in cancer genes . Only five of...identified, are mutations in the TP53 gene suggesting its role as a driver mutation   5   • Our data also suggests that in the case of this one patient...generated by breakage-fusion- bridge cycles that promote repeated rounds of mutation within a chromosome arm, or from progressive amplification of genes that

ARM Carbon Cycle Gases Flasks at SGP Site

DOE Data Explorer

Biraud, Sebastien

2013-03-26

Data from flasks are sampled at the Atmospheric Radiation Measurement Program ARM, Southern Great Plains Site and analyzed by the National Oceanic and Atmospheric Administration NOAA, Earth System Research Laboratory ESRL. The SGP site is included in the NOAA Cooperative Global Air Sampling Network. The surface samples are collected from a 60 m tower at the ARM SGP Central Facility, usually once per week in the afternoon. The aircraft samples are collected approximately weekly from a chartered aircraft, and the collection flight path is centered over the tower where the surface samples are collected. The samples are collected by the ARM and LBNL Carbon Project.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-10

A heavy-load transport truck carries the Orion crew access arm along the NASA Causeway east toward State Road 3 at NASA's Kennedy Space Center in Florida. The access arm will be moved to the mobile launcher (ML) near the Vehicle Assembly Building at the center. The crew access arm will be installed at about the 274-foot level on the mobile launcher tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-10

A heavy-load transport truck carries the Orion crew access arm along the NASA Causeway east toward State Road 3 at NASA's Kennedy Space Center in Florida. The access arm will be moved to the mobile launcher (ML) near the Vehicle Assembly Building at the center. The crew access arm will be installed at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

ARM Unmanned Aerial Systems Implementation Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schmid, Beat; Ivey, Mark

Recent advances in Unmanned Aerial Systems (UAS) coupled with changes in the regulatory environment for operations of UAS in the National Airspace increase the potential value of UAS to the U.S. Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) Climate Research Facility. UAS include unmanned aerial vehicles (UAV) and tethered balloon systems (TBS). The roles UAVs and TBSs could play within the ARM Facility, particularly science questions they could help address, have been discussed in several workshops, reports, and vision documents, including: This document describes the implementation of a robust and vigorous program for use of UAV and TBS formore » the science missions ARM supports.« less

Design and pilot evaluation of competitive and cooperative exercise games for arm rehabilitation at home.

PubMed

Gorsic, Maja; Novak, Domen

2016-08-01

People with chronic arm impairment should exercise intensely at home after completing their clinical rehabilitation program, but frequently lack motivation. To address this issue, we present a home rehabilitation system that motivates patients by allowing them to perform arm exercises together with friends or relatives in competitive and cooperative games. Inertial sensors are used to track the patient's arm and control the game. The system was tested with seven adults with arm impairment as well as their friends or spouses. They tested four exercise games (single-player, competitive and two different cooperative games) for 3 minutes each. Of the 7 participants, 4 preferred the competitive game, 2 preferred a cooperative game, and 1 preferred to exercise alone. Competition also increased exercise intensity (measured using inertial sensors) compared to exercising alone. Though preliminary, these results indicate that competitive exercise games could improve arm rehabilitation at home for survivors of neurological and orthopedic injuries.

Reprogramming the articulated robotic arm for glass handling by using Arduino microcontroller

NASA Astrophysics Data System (ADS)

Razali, Zol Bahri; Kader, Mohamed Mydin M. Abdul; Kadir, Mohd Asmadi Akmal; Daud, Mohd Hisam

2017-09-01

The application of articulated robotic arm in industries is raised due to the expansion of using robot to replace human task, especially for the harmful tasks. However a few problems happen with the program use to schedule the arm, Thus the purpose of this project is to design, fabricate and integrate an articulated robotic arm by using Arduino microcontroller for handling glass sorting system. This project was designed to segregate glass and non-glass waste which would be pioneer step for recycling. This robotic arm has four servo motors to operate as a whole; three for the body and one for holding mechanism. This intelligent system is controlled by Arduino microcontroller and build with optical sensor to provide the distinguish objects that will be handled. Solidworks model was used to produce the detail design of the robotic arm and make the mechanical properties analysis by using a CAD software.

Multicenter, Double-Blind, Placebo-Controlled, Randomized Phase II Trial of Gemcitabine/Cisplatin Plus Bevacizumab or Placebo in Patients With Malignant Mesothelioma

PubMed Central

Kindler, Hedy L.; Karrison, Theodore G.; Gandara, David R.; Lu, Charles; Krug, Lee M.; Stevenson, James P.; Jänne, Pasi A.; Quinn, David I.; Koczywas, Marianna N.; Brahmer, Julie R.; Albain, Kathy S.; Taber, David A.; Armato, Samuel G.; Vogelzang, Nicholas J.; Chen, Helen X.; Stadler, Walter M.; Vokes, Everett E.

2012-01-01

Purpose Gemcitabine plus cisplatin is active in malignant mesothelioma (MM), although single-arm phase II trials have reported variable outcomes. Vascular endothelial growth factor (VEGF) inhibitors have activity against MM in preclinical models. We added the anti-VEGF antibody bevacizumab to gemcitabine/cisplatin in a multicenter, double-blind, placebo-controlled randomized phase II trial in patients with previously untreated, unresectable MM. Patients and Methods Eligible patients had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 and no thrombosis, bleeding, or major blood vessel invasion. The primary end point was progression-free survival (PFS). Patients were stratified by ECOG performance status (0 v 1) and histologic subtype (epithelial v other). Patients received gemcitabine 1,250 mg/m2 on days 1 and 8 every 21 days, cisplatin 75 mg/m2 every 21 days, and bevacizumab 15 mg/kg or placebo every 21 days for six cycles, and then bevacizumab or placebo every 21 days until progression. Results One hundred fifteen patients were enrolled at 11 sites; 108 patients were evaluable. Median PFS time was 6.9 months for the bevacizumab arm and 6.0 months for the placebo arm (P = .88). Median overall survival (OS) times were 15.6 and 14.7 months in the bevacizumab and placebo arms, respectively (P = .91). Partial response rates were similar (24.5% for bevacizumab v 21.8% for placebo; P = .74). A higher pretreatment plasma VEGF concentration (n = 56) was associated with shorter PFS (P = .02) and OS (P = .0066), independent of treatment arm. There were no statistically significant differences in toxicity of grade 3 or greater. Conclusion The addition of bevacizumab to gemcitabine/cisplatin in this trial did not significantly improve PFS or OS in patients with advanced MM. PMID:22665541

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-10

A heavy-load transport truck carrying the Orion crew access arm nears the mobile launcher (ML) at NASA's Kennedy Space Center in Florida. The crew access arm will be installed at about the 274-foot level on the mobile launcher tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

Homeland Defense Joint Center for Operational Analysis and Lessons Learned Quarterly Bulletin, Volume 7, Issue 1, December 2004

DTIC Science & Technology

2004-12-01

domestic use of the armed forces. 9Joint Center for Operational Analysis and Lessons Learned (JCOA-LL) Bulletin An almost invisible law In many...enacted a program to increase significantly the role of the armed forces in drug interdiction as part of the Defense Authorization Act for 1989. The...technology, expanded intelligence collection, and the formation of new partnerships are necessary. • Arms control and other multilateral agreements will be

The International Traffic in Arms Regulations: An Impediment to National Security

DTIC Science & Technology

2008-05-02

00-00-2007 to 00-00-2008 4. TITLE AND SUBTITLE The International Traffic in Arms Regulations: An Impediment to National Security 5a . CONTRACT...2008 2. REPORT TYPE Program Research Paper 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE 5a . CONTRACT NUMBER The International Traffic in Arms...certain level of ITAR problems, such as on Koreasat 5 with its dual civil and military uses, U.S. companies will often choose not to expend the bid and

Clouds and more: ARM climate modeling best estimate data: A new data product for climate studies

DOE PAGES

Xie, Shaocheng; McCoy, Renata B.; Klein, Stephen A.; ...

2010-01-01

The U.S. Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) Program (www.arm.gov) was created in 1989 to address scientific uncertainties related to global climate change, with a focus on the crucial role of clouds and their influence on the transfer of radiation atmosphere. Here, a central activity is the acquisition of detailed observations of clouds and radiation, as well as related atmospheric variables for climate model evaluation and improvement.

Single-Column Modeling, GCM Parameterizations and Atmospheric Radiation Measurement Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Somerville, R.C.J.; Iacobellis, S.F.

2005-03-18

Our overall goal is identical to that of the Atmospheric Radiation Measurement (ARM) Program: the development of new and improved parameterizations of cloud-radiation effects and related processes, using ARM data at all three ARM sites, and the implementation and testing of these parameterizations in global and regional models. To test recently developed prognostic parameterizations based on detailed cloud microphysics, we have first compared single-column model (SCM) output with ARM observations at the Southern Great Plains (SGP), North Slope of Alaska (NSA) and Topical Western Pacific (TWP) sites. We focus on the predicted cloud amounts and on a suite of radiativemore » quantities strongly dependent on clouds, such as downwelling surface shortwave radiation. Our results demonstrate the superiority of parameterizations based on comprehensive treatments of cloud microphysics and cloud-radiative interactions. At the SGP and NSA sites, the SCM results simulate the ARM measurements well and are demonstrably more realistic than typical parameterizations found in conventional operational forecasting models. At the TWP site, the model performance depends strongly on details of the scheme, and the results of our diagnostic tests suggest ways to develop improved parameterizations better suited to simulating cloud-radiation interactions in the tropics generally. These advances have made it possible to take the next step and build on this progress, by incorporating our parameterization schemes in state-of-the-art 3D atmospheric models, and diagnosing and evaluating the results using independent data. Because the improved cloud-radiation results have been obtained largely via implementing detailed and physically comprehensive cloud microphysics, we anticipate that improved predictions of hydrologic cycle components, and hence of precipitation, may also be achievable. We are currently testing the performance of our ARM-based parameterizations in state-of-the--art global and regional models. One fruitful strategy for evaluating advances in parameterizations has turned out to be using short-range numerical weather prediction as a test-bed within which to implement and improve parameterizations for modeling and predicting climate variability. The global models we have used to date are the CAM atmospheric component of the National Center for Atmospheric Research (NCAR) CCSM climate model as well as the National Centers for Environmental Prediction (NCEP) numerical weather prediction model, thus allowing testing in both climate simulation and numerical weather prediction modes. We present detailed results of these tests, demonstrating the sensitivity of model performance to changes in parameterizations.« less

Progress report of FY 1998 activities: Continued development of an integrated sounding system in support of the DOE/ARM experimental program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Edgeworth R. Westwater; Yong Han; Vladimir Leuskiy

1998-09-06

Both during September 15-30, 1996 and September 15-October 5, 1997, the Environmental Technology Laboratory (ETL) participated in an experiment at the Southern Great Plains (SGP) Cloud and Radiation Testbed (CART) site that was designed to study many of the ways that ARM is measuring water vapor. These experiments, called the Water Vapor Intensive Operating Periods (WVIOPs), produced some results of significant importance to ARM water vapor measurements. We have spent the major portion of this years activities in analyzing results of these experiments, and improving algorithms for improving the measurement of precipitable water vapor (PWV) from instruments available at ARM.more » The most important ARM instrument for this measurement continues to be the Microwave Radiometer (MWR). Measurements of water vapor at the North Slope of Alaska and Adjacent Arctic Ocean (NSA/AAO) CART site in Barrow, Alaska, area potential problem because of the difficulty of radiosondes to measure low amounts of vapor during cold and extremely dry conditions. The applicability of MWR scaling to radiosondes is questionable because of the low sensitivity of these instrument during dry conditions. It has been suggested by the ARM Instantaneous Radiative Flux Working Group and others that measurements of brightness temperature around 183 GHz could be used to scale during the coldest and driest periods. However, the millimeter wavelengths are vulnerable to cloud effects from both liquid and ice. We have participated in the planning and will participate in the Millimeter wave Arctic Experiment that will evaluate microwave and millimeter wave radiometers during extremely cold conditions. ETL has tested, both in an experiment at the Boulder Atmospheric Observatory and during the two Water Vapor Intensive Operating Periods in 1996 and 1997, a 5-mm scanning radiometer that measures low-altitude temperature profiles; both profiles of lapse rate and absolute temperature can be measured with the instrument. The technique and algorithms were developed for continental conditions and produced excellent agreement with in situ data. Due ETL recommendations, an instrument of this type was purchased and will be deployed in the NSA. During this year, we have developed algorithms for this instrument in the NSA and to blend the data with other sources of temperature information, such as Radio Acoustic Sounding Systems (RASS). In addition, we conducted an extensive analysis of the data from this instrument, and compared the data with a variety of in situ ground truth.« less

Effectiveness of a multimodal standard nursing program on health-related quality of life in Chinese mainland female patients with breast cancer: protocol for a single-blind cluster randomized controlled trial.

PubMed

Zhou, Kaina; Wang, Duolao; He, Xiaole; Huo, Lanting; An, Jinghua; Li, Minjie; Wang, Wen; Li, Xiaomei

2016-08-31

Breast cancer and its treatment-related adverse effects are harmful to physical, psychological, and social functioning, leading to health-related quality of life (HRQoL) impairment in patients. Many programs have been used with this population for HRQoL improvement; however, few studies have considered the physical, psychological, and social health domains comprehensively, and few have constructed multimodal standard nursing interventions based on specific theories. The purpose of this trial is to examine the effect of a health belief model (HBM)-based multimodal standard nursing program (MSNP) on HRQoL in female patients with breast cancer. This is a two-arm single-blind cluster randomized controlled trial (cRCT) in clinical settings. Twelve tertiary hospitals will be randomly selected from the 24 tertiary hospitals in Xi'an, China, and allocated to the intervention arm and control arm using a computer-generated random numbers table. Inpatient female patients with breast cancer from each hospital will receive either MSNP plus routine nursing care immediately after recruitment (intervention arm), or only routine nursing care (control arm). The intervention will be conducted by trained nurses for 12 months. All recruited female patients with breast cancer, participating clinical staff, and trained data collectors from the 12 hospitals will be blind with respect to group allocation. Patients of the control arm will not be offered any information about the MSNP during the study period to prevent bias. The primary outcome is HRQoL measured through the Functional Assessment of Cancer Therapy-Breast version 4.0 at 12 months. Secondary outcomes include pain, fatigue, sleep, breast cancer-related lymphedema, and upper limb function, which are evaluated by a visual analogue scale, the circumference method, and the Constant-Murley Score. This trial will provide important evidence on the effectiveness of multimodal nursing interventions delivered by nurses in clinical settings. Study findings will inform strategies for scaling up comprehensive standard intervention programs on health management in the population of female patients with breast cancer. Chictr.org.cn ChiCTR-IOR-16008253 (April 9, 2016).

'TXT2BFiT' a mobile phone-based healthy lifestyle program for preventing unhealthy weight gain in young adults: study protocol for a randomized controlled trial.

PubMed

Hebden, Lana; Balestracci, Kate; McGeechan, Kevin; Denney-Wilson, Elizabeth; Harris, Mark; Bauman, Adrian; Allman-Farinelli, Margaret

2013-03-18

Despite international efforts to arrest increasing rates of overweight and obesity, many population strategies have neglected young adults as a target group. Young adults are at high risk for unhealthy weight gain which tends to persist throughout adulthood with associated chronic disease health risks. TXT2BFiT is a nine month two-arm parallel-group randomized controlled trial aimed at improving weight management and weight-related dietary and physical activity behaviors among young adults. Participants are recruited via general practice (primary medical care) clinics in Sydney, New South Wales, Australia. All participants receive a mailed resource outlining national physical activity and dietary guidelines and access to the study website. Additional resources accessible to the intervention arm via the study website include Smartphone mobile applications, printable handouts, an interactive healthy weight tracker chart, and a community blog. The study consists of two phases: (1) Intensive phase (weeks 1 to 12): the control arm receives four short message service (SMS) text messages; the intervention arm receives eight SMS messages/week tailored to their baseline stage-of-change, one Email/week, and personalized coaching calls during weeks 0, 2, 5, 8, and 11; and (2) Maintenance phase (weeks 14 to 36): the intervention arm receives one SMS message/month, one Email/month and booster coaching calls during months 5 and 8. A sample of N = 354 (177 per arm) is required to detect differences in primary outcomes: body weight (kg) and body mass index (kg/m2), and secondary outcomes: physical activity, sitting time, intake of specific foods, beverages and nutrients, stage-of-change, self-efficacy and participant well-being, at three and nine months. Program reach, costs, implementation and participant engagement will also be assessed. This mobile phone based program addresses an important gap in obesity prevention efforts to date. The method of intervention delivery is via platforms that are highly accessible and appropriate for this population group. If effective, further translational research will be required to assess how this program might operate in the broader community. Australian New Zealand Clinical Trials Registry ACTRN12612000924853.

Amyotrophic Lateral Sclerosis

MedlinePlus

... and twitching in your arms, shoulders and tongue Difficulty holding your head up or keeping good posture ALS often starts in the hands, feet or limbs, and then spreads to other parts of your body. As the disease advances and nerve cells are destroyed, your muscles progressively ...

Advanced colorectal carcinoma. A prospective randomized trial of sequential methotrexate, 5-fluorouracil, and leucovorin versus 5-fluorouracil alone.

PubMed

Machiavelli, M; Leone, B A; Romero, A; Rabinovich, M G; Vallejo, C T; Bianco, A; Pérez, J E; Rodríguez, R; Cuevas, M A; Alvarez, L A

1991-06-01

One hundred and twenty-five previously untreated patients bearing metastatic or advanced recurrent (inoperable) colorectal carcinoma and measurable disease were prospectively randomized. Those in arm A received 5-fluorouracil (5-FU), 1,200 mg/m2 i.v. infusion over 2 h, while those in arm B received methotrexate (MTX), 200 mg/m2 i.v. (push injection), followed 20 h later by 5-FU, 1,200 mg/m2 i.v. infusion over 2 h, plus calcium leucovorin (LV), 25 mg i.m. every 6 h for eight doses beginning 24 h after MTX administration. Cycles were repeated every 15 days. All patients receiving treatment were evaluable for toxicity and survival, and 118 patients were evaluable for response. The objective regression rate (complete plus partial response) was 12% (7 of 58) in arm A and 28% (17 of 60) in arm B (p = 0.049). No change was observed in 24% (14 of 58) in arm A and in 35% (21 of 60) in arm B (p = 0.28), while progressive disease was registered in 64% (37 of 58) and 37% (22 of 60) in arms A and B, respectively (p = 0.006). Median duration of response was 3 months in arm A and 5 months in arm B (p = 0.39). The median survival was 8.3 months in arm A and 11.2 months in arm B (p = 0.25). No statistically significant differences were found when objective regression and survival were related to site of primary tumor, performance status, and number of involved organs. There were two drug-related deaths in arm B due to severe myelosuppression followed by mucositis and sepsis. Of nonhematologic toxicities, diarrhea was more frequently observed in arm B, as were mucositis and infectious complications. Our results indicate that the sequential schedule MTX-5-FU-LV with 20-h intervals between MTX and 5-FU is superior in terms of objective regression to 5-FU alone given at the dose and schedule used in the present study. However, MTX-5-FU-LV did not have a significant impact on survival.

Randomized Phase II Study of Carboplatin and Paclitaxel With Either Linifanib or Placebo for Advanced Nonsquamous Non–Small-Cell Lung Cancer

PubMed Central

Ramalingam, Suresh S.; Shtivelband, Mikhail; Soo, Ross A.; Barrios, Carlos H.; Makhson, Anatoly; Segalla, José G.M.; Pittman, Kenneth B.; Kolman, Petr; Pereira, Jose R.; Srkalovic, Gordan; Belani, Chandra P.; Axelrod, Rita; Owonikoko, Taofeek K.; Qin, Qin; Qian, Jiang; McKeegan, Evelyn M.; Devanarayan, Viswanath; McKee, Mark D.; Ricker, Justin L.; Carlson, Dawn M.; Gorbunova, Vera A.

2015-01-01

Purpose Linifanib, a potent, selective inhibitor of vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) receptors, has single-agent activity in non–small-cell lung cancer (NSCLC). We evaluated linifanib with carboplatin and paclitaxel as first-line therapy of advanced nonsquamous NSCLC. Patients and Methods Patients with stage IIIB/IV nonsquamous NSCLC were randomly assigned to 3-week cycles of carboplatin (area under the curve 6) and paclitaxel (200 mg/m2) with daily placebo (arm A), linifanib 7.5 mg (arm B), or linifanib 12.5 mg (arm C). The primary end point was progression-free survival (PFS); secondary efficacy end points included overall survival (OS) and objective response rate. Results One hundred thirty-eight patients were randomly assigned (median age, 61 years; 57% men; 84% smokers). Median PFS times were 5.4 months (95% CI, 4.2 to 5.7 months) in arm A (n = 47), 8.3 months (95% CI, 4.2 to 10.8 months) in arm B (n = 44), and 7.3 months (95% CI, 4.6 to 10.8 months) in arm C (n = 47). Hazard ratios (HRs) for PFS were 0.51 for arm B versus A (P = .022) and 0.64 for arm C versus A (P = .118). Median OS times were 11.3, 11.4, and 13.0 months in arms A, B, and C, respectively. HRs for OS were 1.08 for arm B versus A (P = .779) and 0.88 for arm C versus A (P = .650). Both linifanib doses were associated with increased toxicity, including a higher incidence of adverse events known to be associated with VEGF/PDGF inhibition. Baseline plasma carcinoembryonic antigen/cytokeratin 19 fragments biomarker signature was associated with PFS improvement and a trend toward OS improvement with linifanib 12.5 mg. Conclusion Addition of linifanib to chemotherapy significantly improved PFS (arm B), with a modest trend for survival benefit (arm C) and increased toxicity reflective of known VEGF/PDGF inhibitory effects. PMID:25559798

Hydroxyurea with or without imatinib in the treatment of recurrent or progressive meningiomas: a randomized phase II trial by Gruppo Italiano Cooperativo di Neuro-Oncologia (GICNO).

PubMed

Mazza, Elena; Brandes, Alba; Zanon, Silvia; Eoli, Marika; Lombardi, Giuseppe; Faedi, Marina; Franceschi, Enrico; Reni, Michele

2016-01-01

Hydroxyurea (HU) is among the most widely used salvage therapies in progressive meningiomas. Platelet-derived growth factor receptors are expressed in virtually all meningiomas. Imatinib sensitizes transformed cells to the cytotoxic effects of chemotherapeutic agents that interfere with DNA metabolism. The combination of HU with imatinib yielded intriguing results in recurrent malignant glioma. The current trial addressed the activity of this association against meningioma. Patients with recurrent or progressive WHO grade I-III meningioma, without therapeutic indication for surgery, radiotherapy, or stereotactic radiosurgery, aged 18-75 years, ECOG performance status 0-2, and not on enzyme-inducing anti-epileptic drugs were randomized to receive HU 500 mg BID ± imatinib 400 mg QD until progression, unacceptable toxicity, or patient's refusal. The primary endpoint was progression-free survival rate at 9 months (PFS-9). Between September 2009 and February 2012, 15 patients were randomized to receive HU + imatinib (N = 7; Arm A) or HU alone (N = 8; Arm B). Afterward the trial was prematurely closed due to slow enrollment rate. PFS-9 (A/B) was 0/75%, and median PFS was 4/19.5 months. Median and 2-year overall survival (A/B) rates were: 6/27.5 months; 28.5/75%, respectively. Main G3-4 toxicities were: G3 neutropenia in 1/0, G4 headache in 1/1, and G3 vomiting in 1/0. The conduction of a study in recurrent or progressive meningioma remains a challenge. Given the limited number of patients enrolled, no firm conclusions can be drawn about the combination of imatinib and HU. The optimal systemic therapy for meningioma failing surgery and radiation has yet to be identified.

Health-related quality of life impact in a randomised phase III study of the combination of dabrafenib and trametinib versus dabrafenib monotherapy in patients with BRAF V600 metastatic melanoma.

PubMed

Schadendorf, Dirk; Amonkar, Mayur M; Stroyakovskiy, Daniil; Levchenko, Evgeny; Gogas, Helen; de Braud, Filippo; Grob, Jean-Jacques; Bondarenko, Igor; Garbe, Claus; Lebbe, Celeste; Larkin, James; Chiarion-Sileni, Vanna; Millward, Michael; Arance, Ana; Mandalà, Mario; Flaherty, Keith T; Nathan, Paul; Ribas, Antoni; Robert, Caroline; Casey, Michelle; DeMarini, Douglas J; Irani, Jhangir G; Aktan, Gursel; Long, Georgina V

2015-05-01

To present the impact of treatments on health-related quality of life (HRQoL) from the double-blind, randomised phase III COMBI-d study that investigated the combination of dabrafenib and trametinib versus dabrafenib monotherapy in patients with BRAF V600E/K-mutant metastatic melanoma. COMBI-d showed significantly prolonged progression-free survival for the combination. HRQoL was evaluated using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30, a generic cancer questionnaire (completed at baseline, during study treatment, at progression and post progression) assessing various dimensions (global health/QoL, functional status, and symptom impact). A mixed-model, repeated-measures analyses of covariance evaluated differences between arms. Questionnaire completion rates were >95% at baseline, >85% to week 40 and >70% at disease progression. Baseline scores across both arms were comparable for all dimensions. Global health dimension scores were significantly better at weeks 8, 16 and 24 for patients receiving the combination during treatment and at progression. The majority of functional dimension scores (physical, social, role, emotional and cognitive functioning) trended in favour of the combination. Pain scores were significantly improved and clinically meaningful (6-13 point difference) for patients receiving the combination for all follow-up assessments versus those receiving dabrafenib monotherapy. For other symptom dimensions (nausea and vomiting, diarrhoea, dyspnoea, and constipation), scores trended in favour of dabrafenib monotherapy. This analysis demonstrates that the combination of dabrafenib and trametinib provides better preservation of HRQoL and pain improvements versus dabrafenib monotherapy while also delaying progression. (Clinicaltrials.gov registration number: NCT01584648). Copyright © 2015 Elsevier Ltd. All rights reserved.

Issues for Future Nuclear Arms Control

NASA Astrophysics Data System (ADS)

Davis, Jay

2011-04-01

Ratification of the New START treaty may open the door to a path of progressive negotiations that could lead to systematic reduction of the numbers of deployed and reserve nuclear weapons. Those negotiations will require more than merely resolving technical, operational and policy questions. Their success will also demand adding successively larger numbers of partners and the building of trust among parties who have not been involved in such agreements before. At some point, questions of conventional arms limitations and larger confidence building steps will inevitably arise. Jay Davis, who last year chaired an APS/POPA study of technology issues for future nuclear arms control agreements, will outline the path, opportunities, and obstacles that lie ahead. Davis was an UNSCOM inspector in Iraq after the First Gulf War and the first director of the Defense Threat Reduction Agency.

Atezolizumab in platinum-treated locally advanced or metastatic urothelial carcinoma: post-progression outcomes from the phase II IMvigor210 study.

PubMed

Necchi, A; Joseph, R W; Loriot, Y; Hoffman-Censits, J; Perez-Gracia, J L; Petrylak, D P; Derleth, C L; Tayama, D; Zhu, Q; Ding, B; Kaiser, C; Rosenberg, J E

2017-12-01

Conventional criteria for tumor progression may not fully reflect the clinical benefit of immunotherapy or appropriately guide treatment decisions. The phase II IMvigor210 study demonstrated the efficacy and safety of atezolizumab, a programmed death-ligand 1-directed antibody, in patients with platinum-treated locally advanced or metastatic urothelial carcinoma. Patients could continue atezolizumab beyond Response Evaluation Criteria In Solid Tumors (RECIST) v1.1 progression at the investigator's discretion: this analysis assessed post-progression outcomes in these patients. Patients were treated with atezolizumab 1200 mg i.v. every 3 weeks until loss of clinical benefit. Efficacy and safety outcomes in patients who experienced RECIST v1.1 progression and did, or did not, continue atezolizumab were analyzed descriptively. In total, 220 patients who experienced progression from the overall cohort (n = 310) were analyzed: 137 continued atezolizumab for ≥ 1 dose after progression, 19 received other systemic therapy, and 64 received no further systemic therapy. Compared with those who discontinued, patients continuing atezolizumab beyond progression were more likely to have had a baseline Eastern Cooperative Oncology Group performance status of 0 (43.1% versus 31.3%), less likely to have had baseline liver metastases (27.0% versus 41.0%), and more likely to have had an initial response to atezolizumab (responses in 11.7% versus 1.2%). Five patients (3.6%) continuing atezolizumab after progression had subsequent responses compared with baseline measurements. Median post-progression overall survival was 8.6 months in patients continuing atezolizumab, 6.8 months in those receiving another treatment, and 1.2 months in those receiving no further treatment. Atezolizumab exposure-adjusted adverse event frequencies were generally similar before and following progression. In this single-arm study, patients who continued atezolizumab beyond RECIST v1.1 progression derived prolonged clinical benefit without additional safety signals. Identification of patients most likely to benefit from atezolizumab beyond progression remains an important challenge in the management of metastatic urothelial carcinoma. NCT02108652. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

[Breast cancer incidence related with a population-based screening program].

PubMed

Natal, Carmen; Caicoya, Martín; Prieto, Miguel; Tardón, Adonina

2015-02-20

To compare breast cancer cumulative incidence, time evolution and stage at diagnosis between participants and non-participant women in a population-based screening program. Cohort study of breast cancer incidence in relation to participation in a population screening program. The study population included women from the target population of the screening program. The source of information for diagnostics and stages was the population-based cancer registry. The analysis period was 1999-2010. The Relative Risk for invasive, in situ, and total cancers diagnosed in participant women compared with non-participants were respectively 1.16 (0.94-1.43), 2.98 (1.16-7.62) and 1.22 (0.99-1.49). The Relative Risk for participants versus non-participants was 2.47 (1.55-3.96) for diagnosis at stagei, 2.58 (1.67-3.99) for T1 and 2.11 (1.38-3.23) for negative lymph node involvement. The cumulative incidence trend had two joint points in both arms, with an Annual Percent of Change of 92.3 (81.6-103.5) between 1999-2001, 18.2 (16.1-20.3) between 2001-2005 and 5.9 (4.0-7.8) for the last period in participants arm, and 72.6 (58.5-87.9) between 1999-2001, 12.6 (7.9-17.4) between 2001-2005, and 8.6 (6.5-10.6) in the last period in the non-participant arm. Participating in the breast cancer screening program analyzed increased the in situ cumulative cancer incidence, but not the invasive and total incidence. Diagnoses were earlier in the participant arm. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Imatinib 800 mg daily induces deeper molecular responses than imatinib 400 mg daily: results of SWOG S0325, an intergroup randomized PHASE II trial in newly diagnosed chronic phase chronic myeloid leukaemia.

PubMed

Deininger, Michael W; Kopecky, Kenneth J; Radich, Jerald P; Kamel-Reid, Suzanne; Stock, Wendy; Paietta, Elisabeth; Emanuel, Peter D; Tallman, Martin; Wadleigh, Martha; Larson, Richard A; Lipton, Jeffrey H; Slovak, Marilyn L; Appelbaum, Frederick R; Druker, Brian J

2014-01-01

The standard dose of imatinib for newly diagnosed patients with chronic phase chronic myeloid leukaemia (CP-CML) is 400 mg daily (IM400), but the optimal dose is unknown. This randomized phase II study compared the rates of molecular, haematological and cytogenetic response to IM400 vs. imatinib 400 mg twice daily (IM800) in 153 adult patients with CP-CML. Dose adjustments for toxicity were flexible to maximize retention on study. Molecular response (MR) at 12 months was deeper in the IM800 arm (4-log reduction of BCR-ABL1 mRNA: 25% vs. 10% of patients, P = 0·038; 3-log reduction: 53% vs. 35%, P = 0·049). During the first 12 months BCR-ABL1 levels in the IM800 arm were an average 2·9-fold lower than in the IM400 arm (P = 0·010). Complete haematological response was similar, but complete cytogenetic response was higher with IM800 (85% vs. 67%, P = 0·040). Grade 3-4 toxicities were more common for IM800 (58% vs. 31%, P = 0·0007), and were most commonly haematological. Few patients have relapsed, progressed or died, but both progression-free (P = 0·048) and relapse-free (P = 0·031) survival were superior for IM800. In newly diagnosed CP-CML patients, IM800 induced deeper MRs than IM400, with a trend for improved progression-free and overall survival, but was associated with more severe toxicity. © 2013 John Wiley & Sons Ltd.

Determination of Cloud Base Height, Wind Velocity, and Short-Range Cloud Structure Using Multiple Sky Imagers Field Campaign Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, Dong; Schwartz, Stephen E.; Yu, Dantong

Clouds are a central focus of the U.S. Department of Energy (DOE)’s Atmospheric System Research (ASR) program and Atmospheric Radiation Measurement (ARM) Climate Research Facility, and more broadly are the subject of much investigation because of their important effects on atmospheric radiation and, through feedbacks, on climate sensitivity. Significant progress has been made by moving from a vertically pointing (“soda-straw”) to a three-dimensional (3D) view of clouds by investing in scanning cloud radars through the American Recovery and Reinvestment Act of 2009. Yet, because of the physical nature of radars, there are key gaps in ARM's cloud observational capabilities. Formore » example, cloud radars often fail to detect small shallow cumulus and thin cirrus clouds that are nonetheless radiatively important. Furthermore, it takes five to twenty minutes for a cloud radar to complete a 3D volume scan and clouds can evolve substantially during this period. Ground-based stereo-imaging is a promising technique to complement existing ARM cloud observation capabilities. It enables the estimation of cloud coverage, height, horizontal motion, morphology, and spatial arrangement over an extended area of up to 30 by 30 km at refresh rates greater than 1 Hz (Peng et al. 2015). With fine spatial and temporal resolution of modern sky cameras, the stereo-imaging technique allows for the tracking of a small cumulus cloud or a thin cirrus cloud that cannot be detected by a cloud radar. With support from the DOE SunShot Initiative, the Principal Investigator (PI)’s team at Brookhaven National Laboratory (BNL) has developed some initial capability for cloud tracking using multiple distinctly located hemispheric cameras (Peng et al. 2015). To validate the ground-based cloud stereo-imaging technique, the cloud stereo-imaging field campaign was conducted at the ARM Facility’s Southern Great Plains (SGP) site in Oklahoma from July 15 to December 24. As shown in Figure 1, the cloud stereo-imaging system consisted of two inexpensive high-definition (HD) hemispheric cameras (each cost less than $1,500) and ARM’s Total Sky Imager (TSI). Together with other co-located ARM instrumentation, the campaign provides a promising opportunity to validate stereo-imaging-based cloud base height and, more importantly, to examine the feasibility of cloud thickness retrieval for low-view-angle clouds.« less

Training the Unimpaired Arm Improves the Motion of the Impaired Arm and the Sitting Balance in Chronic Stroke Survivors.

PubMed

De Luca, Alice; Giannoni, Psiche; Vernetti, Honore; Capra, Cristina; Lentino, Carmelo; Checchia, Giovanni Antonio; Casadio, Maura

2017-07-01

Robot-assisted rehabilitation of stroke survivors mainly focuses on the impaired side of the body while the role of the unimpaired side in the recovery after stroke is still controversial. The goal of this study is to investigate the influence on sitting balance and paretic arm functions of a training protocol based on movements of the unimpaired arm. Sixteen chronic stroke survivors underwent nineteen training sessions, in which they performed active movements with the unimpaired arm supported by a passive exoskeleton. Performance of the trunk and upper limbs was evaluated before treatment, after treatment and at six months follow up with clinical scales and an instrumented evaluation. A reaching test executed with the exoskeleton was used to assess changes in performance of both arms. The treatment based on the unimpaired arm's movements executed with a correct body posture led to benefits in control of the trunk and of both the trained and the untrained arm. The amount of impaired arm improvement in the Fugl-Meyer score was comparable to the outcome of robotic treatments focused directly on this arm. Our results highlight the importance of taking into account all body schema in the rehabilitation robotic program, instead of focusing only on the impaired side of the body.

"Atmospheric Radiation Measurement (ARM) Research Facility at Oliktok Point Alaska"

NASA Astrophysics Data System (ADS)

Helsel, F.; Ivey, M.; Hardesty, J.; Roesler, E. L.; Dexheimer, D.

2017-12-01

Scientific Infrastructure To Support Atmospheric Science, Aerosol Science and UAS's for The Department Of Energy's Atmospheric Radiation Measurement Programs At The Mobile Facility 3 Located At Oliktok Point, Alaska.The Atmospheric Radiation Measurement (ARM) Program's Mobile Facility 3 (AMF3) located at Oliktok Point, Alaska is a U.S. Department of Energy (DOE) site designed to collect data and help determine the impact that clouds and aerosols have on solar radiation. AMF3 provides a scientific infrastructure to support instruments and collect arctic data for the international arctic research community. The infrastructure at AMF3/Oliktok is designed to be mobile and it may be relocated in the future to support other ARM science missions. AMF3's present base line instruments include: scanning precipitation Radars, cloud Radar, Raman Lidar, Eddy correlation flux systems, Ceilometer, Balloon sounding system, Atmospheric Emitted Radiance Interferometer (AERI), Micro-pulse Lidar (MPL) Along with all the standard metrological measurements. In addition AMF3 provides aerosol measurements with a Mobile Aerosol Observing System (MAOS). Ground support for Unmanned Aerial Systems (UAS) and tethered balloon flights. Data from these instruments and systems are placed in the ARM data archives and are available to the international research community. This poster will discuss what instruments and systems are at the ARM Research Facility at Oliktok Point Alaska.

Using virtual reality environment to facilitate training with advanced upper-limb prosthesis.

PubMed

Resnik, Linda; Etter, Katherine; Klinger, Shana Lieberman; Kambe, Charles

2011-01-01

Technological advances in upper-limb prosthetic design offer dramatically increased possibilities for powered movement. The DEKA Arm system allows users 10 powered degrees of movement. Learning to control these movements by utilizing a set of motions that, in most instances, differ from those used to obtain the desired action prior to amputation is a challenge for users. In the Department of Veterans Affairs "Study to Optimize the DEKA Arm," we attempted to facilitate motor learning by using a virtual reality environment (VRE) program. This VRE program allows users to practice controlling an avatar using the controls designed to operate the DEKA Arm in the real world. In this article, we provide highlights from our experiences implementing VRE in training amputees to use the full DEKA Arm. This article discusses the use of VRE in amputee rehabilitation, describes the VRE system used with the DEKA Arm, describes VRE training, provides qualitative data from a case study of a subject, and provides recommendations for future research and implementation of VRE in amputee rehabilitation. Our experience has led us to believe that training with VRE is particularly valuable for upper-limb amputees who must master a large number of controls and for those amputees who need a structured learning environment because of cognitive deficits.

Rechallenge of oxaliplatin-containing regimens in the third- or later-line therapy for patients with heavily treated metastatic colorectal cancer

PubMed Central

Jiang, Zhimin; Wang, Huizhong; Li, Weiyu; Zhang, Bei; Xie, Derong

2018-01-01

Purpose The third- or later-line therapy available often yield poor survival benefit in patients metastatic colorectal cancer (mCRC). The retrospective study aimed to evaluate efficacy of rechallenge of oxaliplatin-containing regimens. Patients and methods Patients with mCRC who progressed from fluoropyrimidine, oxaliplatin, and irinotecan in the first- and second-line chemotherapy, were treated by reexposure to oxaliplatin-containing regimen. Patients treated by anti-epidermal growth factor receptor (EGFR) antibodies with irinotecan were included in the control arm. Results Ninety-five and 29 patients were treated with either oxaliplatin reexposure or anti-EGFR antibodies with irinotecan, respectively, as the third- or later-line therapy. The median time to treatment failure (TTF) and overall survival (OS) was 3.77 and 12.17 months in the oxaliplatin arm, with 4.77 months of TTF and 11.37 months of OS in the control arm; there was no significance between the 2 arms (p>0.05). Oxaliplatin reexposure resulted in 6.3% objective response rate with no complete response, 6 partial response, 39 stable disease, and 37 progressive disease. The disease control rate was 47.4% (45/95). The multivariate analysis found that patients who achieved disease control by oxaliplatin reexposure had a superior TTF (6.13 vs 1.7 months, p<0.001) and OS (15.73 vs 6.27 months, p<0.001) compared with those presenting with progressive disease. Conclusion This study showed that rechallenge of oxaliplatin-containing chemotherapy in the third- or later-line therapy may lead to tumor control and improved survival in mCRC patients, which was equivalent to that of anti-EGFR antibodies with irinotecan. Clinical significance Rechallenge of oxaliplatin-containing regimens in the third- or later-line of therapy is a common practice, despite few evidence available. The present study found that rechallenge of oxaliplatin-containing regimens produced equivalent tumor control and survival benefit to that of anti-EGFR antibodies with irinotecan in mCRC. PMID:29760556

Complex emergencies in Indonesia.

PubMed

Bradt, D A; Drummond, C M; Richman, M

2001-01-01

Recently, Indonesia has experienced six major provincial, civil, armed conflicts. Underlying causes include the transmigration policy, sectarian disputes, the Asian economic crisis, fall of authoritarian rule, and a backlash against civil and military abuses. The public health impact involves the displacement nationwide of > 1.2 million persons. Violence in the Malukus, Timor, and Kalimantan has sparked the greatest population movements such that five provinces in Indonesia each now harbor > 100,000 internally displaced persons. With a background of government instability, hyperinflation, macroeconomic collapse, and elusive political solutions, these civil armed conflicts are ripe for persistence as complex emergencies. Indonesia has made substantial progress in domestic disaster management with the establishment of central administrative authority, strategic planning, and training programs. Nevertheless, the Indonesian experience reveals recurrent issues in international humanitarian health assistance. Clinical care remains complicated by absences of treatment protocols, inappropriate drug use, high procedural complication rates, and variable referral practices. Epidemiological surveillance remains complicated by unsettled clinical case definitions, non-standardized case management of diseases with epidemic potential, variable outbreak management protocols, and inadequate epidemiological analytic capacity. International donor support has been semi-selective, insufficient, and late. The militia murders of three UN staff in West Timor prompted the withdrawal of UN international staff from West Timor for nearly a year to date. Re-establishing rules of engagement for humanitarian health workers must address security, public health, and clinical threats.

76 FR 71343 - Ethics, Independence, Arm's-Length Role, Ex Parte Communications and Open Government

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-17

... FARM CREDIT ADMINISTRATION [FCA-PS-81; NV 11-25] Ethics, Independence, Arm's-Length Role, Ex Parte...) and the public. The FCA Board also is committed to the ethics principles and laws governing all Executive Branch employees and to the Agency's strong ethics program. DATES: Effective Date: November 7...

Satellite Calibration and Verification of Remotely Sensed Cloud and Radiation Properties Using ARM UAV Data

NASA Technical Reports Server (NTRS)

Minnis, Patrick; Charlock, Thomas P.

1998-01-01

The work proposed under this agreement was designed to validate and improve remote sensing of cloud and radiation properties in the atmosphere for climate studies with special emphasis on the use of satellites for monitoring these parameters to further the goals of the Atmospheric Radiation Measurement (ARM) Program.

Armed Forces VIEW (Vital Information for Education and Work).

ERIC Educational Resources Information Center

Cox, Walter H.; Zerface, W. A., Ed.

Armed Services VIEW (Vital Information for Education and Work) is described as a cooperative program with the Department of Defense which (1) introduces career opportunities and training available through volunteer service enlistment, (2) will be provided to senior high schools at no cost, and (3) presents materials in both printed and microfilm…

34 CFR 642.6 - What definitions apply?

Code of Federal Regulations, 2011 CFR

2011-07-01

... projects funded under the Federal TRIO programs. Veteran means a person who— (1) Served on active duty as a... released under conditions other than dishonorable; (2) Served on active duty as a member of the Armed...) Was a member of a reserve component of the Armed Forces of the United States and was called to active...

78 FR 22850 - 36(b)(1) Arms Sales Notification

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-17

... million * As defined in Section 47(6) of the Arms Export Control Act. (iii) Description and Quantity or... software continues to be modified via a pre-planned product improvement (P3I) program in order to improve its counter- countermeasure capabilities. No software source code or algorithms will be released. The...

Home Page | The Official Home of the Defense Security Cooperation Agency

Science.gov Websites

Contract Awards (leaving DSCA) Major Arms Sales E-SAMM Programs Defense Trade and Arms Transfers Foreign Military Sales Foreign Military Financing Excess Defense Articles Global Train and Equip Section 333 Stakeholders FAQ International Trade Shows End Use Monitoring Contracting Foreign Military Sales (FMS) Video

Analyzing octopus movements using three-dimensional reconstruction.

PubMed

Yekutieli, Yoram; Mitelman, Rea; Hochner, Binyamin; Flash, Tamar

2007-09-01

Octopus arms, as well as other muscular hydrostats, are characterized by a very large number of degrees of freedom and a rich motion repertoire. Over the years, several attempts have been made to elucidate the interplay between the biomechanics of these organs and their control systems. Recent developments in electrophysiological recordings from both the arms and brains of behaving octopuses mark significant progress in this direction. The next stage is relating these recordings to the octopus arm movements, which requires an accurate and reliable method of movement description and analysis. Here we describe a semiautomatic computerized system for 3D reconstruction of an octopus arm during motion. It consists of two digital video cameras and a PC computer running custom-made software. The system overcomes the difficulty of extracting the motion of smooth, nonrigid objects in poor viewing conditions. Some of the trouble is explained by the problem of light refraction in recording underwater motion. Here we use both experiments and simulations to analyze the refraction problem and show that accurate reconstruction is possible. We have used this system successfully to reconstruct different types of octopus arm movements, such as reaching and bend initiation movements. Our system is noninvasive and does not require attaching any artificial markers to the octopus arm. It may therefore be of more general use in reconstructing other nonrigid, elongated objects in motion.

CNTF 1357 G -> A polymorphism and the muscle strength response to resistance training.

PubMed

Walsh, Sean; Kelsey, Bethany K; Angelopoulos, Theodore J; Clarkson, Priscilla M; Gordon, Paul M; Moyna, Niall M; Visich, Paul S; Zoeller, Robert F; Seip, Richard L; Bilbie, Steve; Thompson, Paul D; Hoffman, Eric P; Price, Thomas B; Devaney, Joseph M; Pescatello, Linda S

2009-10-01

The present study examined associations between the ciliary neurotrophic factor (CNTF) 1357 G --> A polymorphism and the muscle strength response to a unilateral, upper arm resistance-training (RT) program among healthy, young adults. Subjects were 754 Caucasian men (40%) and women (60%) who were genotyped and performed a training program of the nondominant (trained) arm with the dominant (untrained) arm as a comparison. Peak elbow flexor strength was measured with one repetition maximum, isometric strength with maximum voluntary contraction, and bicep cross-sectional area with MRI in the trained and untrained arms before and after training. Women with the CNTF GG genotype gained more absolute isometric strength, as measured by MVC (6.5 +/- 0.3 vs. 5.2 +/- 0.5 kg), than carriers of the CNTF A1357 allele in the trained arm pre- to posttraining (P < 0.05). No significant associations were seen in men. Women with the CNTF GG genotype gained more absolute dynamic (1.0 +/- 0.1 vs. 0.6 +/- 0.1 kg) and allometric (0.022 +/- 0.0 vs. 0.015 +/- 0.0 kg/kg(-0.67)) strength, as measured by 1 RM, than carriers of the CNTF A1357 allele in the untrained arm pre- to posttraining (P < 0.05). No significant associations were seen in men. No significant associations, as measured by cross-sectional area, were seen in men or women. The CNTF 1357 G --> A polymorphism explains only a small portion of the variability in the muscle strength response to training in women.

42 CFR 68.5 - Who is ineligible to participate?

Code of Federal Regulations, 2014 CFR

2014-10-01

..., TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) LOAN REPAYMENT PROGRAMS (LRPs) § 68.5 Who is ineligible to... Programs, (7) NIH Undergraduate Scholarship Program (UGSP), (8) Physicians Shortage Area Scholarship... examples of programs that have a service obligation: (1) Armed Forces (Army, Navy, or Air Force...

42 CFR 68.5 - Who is ineligible to participate?

Code of Federal Regulations, 2013 CFR

2013-10-01

..., TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) LOAN REPAYMENT PROGRAMS (LRPs) § 68.5 Who is ineligible to... Programs, (7) NIH Undergraduate Scholarship Program (UGSP), (8) Physicians Shortage Area Scholarship... examples of programs that have a service obligation: (1) Armed Forces (Army, Navy, or Air Force...

Full-Time, Eye-Safe Cloud and Aerosol Lidar Observation at Atmospheric Radiation Measurement Program Sites: Instruments and Data Analysis

NASA Technical Reports Server (NTRS)

Campbell, James R.; Hlavka, Dennis L.; Welton, Ellsworth J.; Flynn, Connor J.; Turner, David D.; Spinhirne, James D.; Scott, V. Stanley, III; Hwang, I. H.; Einaudi, Franco (Technical Monitor)

2001-01-01

Atmospheric radiative forcing, surface radiation budget, and top of the atmosphere radiance interpretation involves a knowledge of the vertical height structure of overlying cloud and aerosol layers. During the last decade, the U.S. Department of Energy through I the Atmospheric Radiation Measurement (ARM) program has constructed four long- term atmospheric observing sites in strategic climate regimes (north central Oklahoma, In Barrow. Alaska, and Nauru and Manus Islands in the tropical western Pacific). Micro Pulse Lidar (MPL) systems provide continuous, autonomous observation of all significant atmospheric cloud and aerosol at each of the central ARM facilities. Systems are compact and transmitted pulses are eye-safe. Eye-safety is achieved by expanding relatively low-powered outgoing Pulse energy through a shared, coaxial transmit/receive telescope. ARM NIPL system specifications, and specific unit optical designs are discussed. Data normalization and calibration techniques are presented. A multiple cloud boundary detection algorithm is also described. These techniques in tandem represent an operational value added processing package used to produce normalized data products for Cloud and aerosol research and the historical ARM data archive.

Remote sensing data from CLARET: A prototype CART data set

NASA Technical Reports Server (NTRS)

Eberhard, Wynn L.; Uttal, Taneil; Clark, Kurt A.; Cupp, Richard E.; Dutton, Ellsworth G.; Fedor, Leonard, S.; Intrieri, Janet M.; Matrosov, Sergey Y.; Snider, Jack B.; Willis, Ron J.

1992-01-01

The data set containing radiation, meteorological , and cloud sensor observations is documented. It was prepared for use by the Department of Energy's Atmospheric Radiation Measurement (ARM) Program and other interested scientists. These data are a precursor of the types of data that ARM Cloud And Radiation Testbed (CART) sites will provide. The data are from the Cloud Lidar And Radar Exploratory Test (CLARET) conducted by the Wave Propagation Laboratory during autumn 1989 in the Denver-Boulder area of Colorado primarily for the purpose of developing new cloud-sensing techniques on cirrus. After becoming aware of the experiment, ARM scientists requested archival of subsets of the data to assist in the developing ARM program. Five CLARET cases were selected: two with cirrus, one with stratus, one with mixed-phase clouds, and one with clear skies. Satellite data from the stratus case and one cirrus case were analyzed for statistics on cloud cover and top height. The main body of the selected data are available on diskette from the Wave Propagation Laboratory or Los Alamos National Laboratory.

From Travis to Today: An Analysis Of Racial Progress in the Us Air Force Officer Corps Since 1971

DTIC Science & Technology

2009-04-01

Over Who Have Completed High School or College, by Race, Hispanic Origin and Sex : Selected Years 1940 to 2007,” http://www.census.gov/population/www...and Over Who Have Completed High School or College, by Race, Hispanic Origin and Sex : Selected Years 1940 to 2007,” http://www.census.gov/population...of Defense, Career Progression of Minority and Women Officers, ix. 38 Dorn, Edwin, Who Defends America? Race, Sex , and Class in the Armed Forces

Physics and Modern Warfare: The Awkward Silence.

ERIC Educational Resources Information Center

Woollett, E. L.

1980-01-01

Discusses the great dependence of the present arms race on a healthy physics enterprise and the pervasive connections between pure and applied science and military needs. This discussion is intended to orient college students about some problems directly related to progress made in science. (HM)

Curiosity Arm Holding Steady, Sol 915

NASA Image and Video Library

2015-03-06

This image from the Navigation Camera (Navcam) on NASA's Curiosity Mars rover shows the position in which the rover held its arm for several days after a transient short circuit triggered onboard fault-protection programming to halt arm activities on Feb. 27, 2015, the 911th Martian day, or sol, of the rover's work on Mars. The rover team chose to hold the arm in the same position for several days of tests to diagnose the underlying cause of the Sol 911 event. Observations with instruments on the rover's mast continued during this period. The Navcam took this image on March 4, 2015, during Sol 915. http://photojournal.jpl.nasa.gov/catalog/PIA19147

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

The Orion crew access arm is secured on a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida and ready to be transported to a storage location at NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Circulating anti-retinal antibodies as immune markers in age-related macular degeneration

PubMed Central

Patel, Nishal; Ohbayashi, Masahara; Nugent, Alex K; Ramchand, Kanchan; Toda, Masako; Chau, Kai-Yin; Bunce, Catey; Webster, Andrew; Bird, Alan C; Ono, Santa Jeremy; Chong, Victor

2005-01-01

Age-related macular maculopathy (ARM) and age-related macular degeneration (AMD) are the leading causes of blindness in the Western world. Despite the magnitude of this clinical problem, very little is known about the pathogenesis of the disease. In this study, we analysed the sera (using indirect immunohistochemistry and Western blot analysis) from a very large cohort of such patients and normal age-matched controls to detect circulating anti-retinal antibodies. Patients with bilateral drusen (n = 64) and with chorioretinal neovascularization (CNV) (n = 51) were recruited in addition to age-matched control subjects (n = 39). The sera were analysed for anti-retinal immunoglobulins on retinal sections. The data were then correlated with the clinical features graded according to the International Classification and Grading System of ARM and AMD. The sera of patients with drusen (93·75%) and CNV (82·27%) were found to have a significantly (P = 0·02) higher titre of autoantibodies to the retina in comparison with controls (8·69%), indicating significant evidence of involvement of the immune process in early stages of AMD. Subsequent statistical analysis of the drusen group showed significant progressive staining (P = 0·0009) in the nuclei layers from early to late stages of ARM. Western blotting confirmed the presence of anti-retinal immunoglobulins to retinal antigens. As anti-retinal immunoglobulins are present in patients with bilateral drusen and exudative AMD, these antibodies could play a significant role in the pathogenesis of AMD. Whilst we do not have evidence that these antibodies precede disease onset, the possibility that their presence might contribute to disease progression needs to be investigated. Finally, the eventual identification of the target antigens detected by these antibodies may permit the future development of new diagnostic methods for ARM and AMD. PMID:15946260

The effect of ICD programming on inappropriate and appropriate ICD Therapies in ischemic and nonischemic cardiomyopathy: the MADIT-RIT trial.

PubMed

Sedláček, Kamil; Ruwald, Anne-Christine; Kutyifa, Valentina; McNitt, Scott; Thomsen, Poul Erik Bloch; Klein, Helmut; Stockburger, Martin; Wichterle, Dan; Merkely, Bela; DE LA Concha, Joaquin Fernandez; Swissa, Moshe; Zareba, Wojciech; Moss, Arthur J; Kautzner, Josef; Ruwald, Martin H

2015-04-01

The MADIT-RIT trial demonstrated reduction of inappropriate and appropriate ICD therapies and mortality by high-rate cut-off and 60-second-delayed VT therapy ICD programming in patients with a primary prophylactic ICD indication. The aim of this analysis was to study effects of MADIT-RIT ICD programming in patients with ischemic and nonischemic cardiomyopathy. First and total occurrences of both inappropriate and appropriate ICD therapies were analyzed by multivariate Cox models in 791 (53%) patients with ischemic and 707 (47%) patients with nonischemic cardiomyopathy. Patients with ischemic and nonischemic cardiomyopathy had similar incidence of first inappropriate (9% and 11%, P = 0.21) and first appropriate ICD therapy (11.6% and 14.1%, P = 0.15). Patients with ischemic cardiomyopathy had higher mortality rate (6.1% vs. 3.3%, P = 0.01). MADIT-RIT high-rate cut-off (arm B) and delayed VT therapy ICD programming (arm C) compared with conventional (arm A) ICD programming were associated with a significant risk reduction of first inappropriate and appropriate ICD therapy in patients with ischemic and nonischemic cardiomyopathy (HR range 0.11-0.34, P < 0.001 for all comparisons). Occurrence of total inappropriate and appropriate ICD therapies was significantly reduced by high-rate cut-off ICD programming and delayed VT therapy ICD programming in both ischemic and nonischemic cardiomyopathy patients. High-rate cut-off and delayed VT therapy ICD programming are associated with significant reduction in first and total inappropriate and appropriate ICD therapy in patients with ischemic and nonischemic cardiomyopathy. © 2014 Wiley Periodicals, Inc.

Perfusion index and plethysmographic variability index in patients with interscalene nerve catheters.

PubMed

Sebastiani, Anne; Philippi, Larissa; Boehme, Stefan; Closhen, Dorothea; Schmidtmann, Irene; Scherhag, Anton; Markstaller, Klaus; Engelhard, Kristin; Pestel, Gunther

2012-12-01

Interscalene nerve blocks provide adequate analgesia, but there are no objective criteria for early assessment of correct catheter placement. In the present study, pulse oximetry technology was used to evaluate changes in the perfusion index (PI) in both blocked and unblocked arms, and changes in the plethysmographic variability index (PVI) were evaluated once mechanical ventilation was instituted. The PI and PVI values were assessed using a Radical-7™ finger pulse oximetry device (Masimo Corp., Irvine, CA, USA) in both arms of 30 orthopedic patients who received an interscalene catheter at least 25 min before induction of general anesthesia. Data were evaluated at baseline, on application of local anesthetics; five, ten, and 15 min after onset of interscalene nerve blocks; after induction of general anesthesia; before and after a 500 mL colloid fluid challenge; and five minutes thereafter. In the 25 patients with successful blocks, the difference between the PI values in the blocked arm and the PI values in the contralateral arm increased within five minutes of the application of the local anesthetics (P < 0.05) and increased progressively until 15 min. After induction of general anesthesia, the PI increased in the unblocked arm while it remained relatively constant in the blocked arm, thus reducing the difference in the PI. A fluid challenge resulted in a decrease in PVI values in both arms. The perfusion index increases after successful interscalene nerve blockade and may be used as an indicator for successful block placement in awake patients. The PVI values before and after a fluid challenge can be useful to detect changes in preload, and this can be performed in both blocked and unblocked arms.

Safety, pharmacokinetics, and antitumor response of depatuxizumab mafodotin as monotherapy or in combination with temozolomide in patients with glioblastoma.

PubMed

Gan, Hui K; Reardon, David A; Lassman, Andrew B; Merrell, Ryan; van den Bent, Martin; Butowski, Nicholas; Lwin, Zarnie; Wheeler, Helen; Fichtel, Lisa; Scott, Andrew M; Gomez, Erica J; Fischer, JuDee; Mandich, Helen; Xiong, Hao; Lee, Ho-Jin; Munasinghe, Wijith P; Roberts-Rapp, Lisa A; Ansell, Peter J; Holen, Kyle D; Kumthekar, Priya

2018-05-18

We recently reported an acceptable safety and pharmacokinetic profile of depatuxizumab mafodotin (depatux-m), formerly called ABT-414, plus radiation and temozolomide in newly diagnosed glioblastoma (arm A). The purpose of this study was to evaluate the safety and pharmacokinetics of depatux-m, either in combination with temozolomide in newly diagnosed or recurrent glioblastoma (arm B) or as monotherapy in recurrent glioblastoma (arm C). In this multicenter phase I dose escalation study, patients received depatux-m (0.5-1.5 mg/kg in arm B, 1.25 mg/kg in arm C) every 2 weeks by intravenous infusion. Maximum tolerated dose (MTD), recommended phase II dose (RP2D), and preliminary efficacy were also determined. Thirty-eight patients were enrolled as of March 1, 2016. The most frequent toxicities were ocular, occurring in 35/38 (92%) patients. Keratitis was the most common grade 3 adverse event observed in 6/38 (16%) patients; thrombocytopenia was the most common grade 4 event seen in 5/38 (13%) patients. The MTD was set at 1.5 mg/kg in arm B and was not reached in arm C. RP2D was declared as 1.25 mg/kg for both arms. Depatux-m demonstrated a linear pharmacokinetic profile. In recurrent glioblastoma patients, the progression-free survival (PFS) rate at 6 months was 30.8% and the median overall survival was 10.7 months. Best Response Assessment in Neuro-Oncology responses were 1 complete and 2 partial responses. Depatux-m alone or in combination with temozolomide demonstrated an acceptable safety and pharmacokinetic profile in glioblastoma. Further studies are currently under way to evaluate its efficacy in newly diagnosed (NCT02573324) and recurrent glioblastoma (NCT02343406).

Phase I Trial of Aflibercept (VEGF Trap) with Radiation Therapy and Concomitant and Adjuvant Temozolomide in Patients with High-Grade Gliomas

PubMed Central

Nayak, Lakshmi; de Groot, John; Wefel, Jeffrey S; Cloughesy, Timothy F; Lieberman, Frank; Chang, Susan M; Omuro, Antonio; Drappatz, Jan; Batchelor, Tracy T; DeAngelis, Lisa M; Gilbert, Mark R; Aldape, Kenneth D; Yung, Alfred WK; Fisher, Joy; Ye, Xiaobu; Chen, Alice; Grossman, Stuart; Prados, Michael; Wen, Patrick Y

2017-01-01

Background Anti-vascular endothelial growth factor (VEGF) therapy has shown promise in the treatment of high-grade gliomas (HGG). Aflibercept is a recombinant human fusion protein that acts as a soluble decoy receptor for VEGF-A, VEGF-B and placental growth factor (PlGF), depleting circulating levels of these growth factors. Methods The Adult Brain Tumor Consortium (ABTC) conducted a phase I trial of aflibercept and temozolomide (TMZ) in patients with newly diagnosed high-grade gliomas (HGG) with 2 dose levels and a 3+3 design. Three arms using aflibercept were examined; with radiation and concomitant temozolomide; with adjuvant temozolomide using the 5/28 regimen; and with adjuvant temozolomide using the 21/28 day regimen. Results Fifty-nine patients were enrolled, 21 in arm 1, 20 in arm 2 and 18 in arm 3. Median age was 56 years (24-69); median KPS 90 (60-100). The maximum tolerated dose (MTD) of aflibercept for all 3 arms was 4mg/kg every 2 weeks. Dose limiting toxicities (DLTs) at the MTD were: Arm 1: 0/21 patients; Arm 2: 2/20 patients (G3 deep vein thrombosis, G4 neutropenia; Arm 3: 3/18 patients (G4 biopsy-confirmed thrombotic microangiopathy, G3 rash, G4 thrombocytopenia). The median number of cycles of aflibercept was 5 (range, 1-16). All patients stopped treatment; 28 (47%) for disease progression, 21 (36%) for toxicities, 8 (14%) for other reasons, and 2 (3%) patients completed the full treatment course. Conclusions This study met its primary endpoint and the MTD of aflibercept with radiation and concomitant and adjuvant temozolomide is 4mg/kg every 2 weeks. PMID:28116649

Phase I trial of aflibercept (VEGF trap) with radiation therapy and concomitant and adjuvant temozolomide in patients with high-grade gliomas.

PubMed

Nayak, Lakshmi; de Groot, John; Wefel, Jeffrey S; Cloughesy, Timothy F; Lieberman, Frank; Chang, Susan M; Omuro, Antonio; Drappatz, Jan; Batchelor, Tracy T; DeAngelis, Lisa M; Gilbert, Mark R; Aldape, Kenneth D; Yung, Alfred W K; Fisher, Joy; Ye, Xiaobu; Chen, Alice; Grossman, Stuart; Prados, Michael; Wen, Patrick Y

2017-03-01

Anti-vascular endothelial growth factor (VEGF) therapy has shown promise in the treatment of high-grade gliomas (HGG). Aflibercept is a recombinant human fusion protein that acts as a soluble decoy receptor for VEGF-A, VEGF-B and placental growth factor, depleting circulating levels of these growth factors. The Adult Brain Tumor Consortium conducted a phase I trial of aflibercept and temozolomide (TMZ) in patients with newly diagnosed HGG with 2 dose levels and a 3+3 design. Three arms using aflibercept were examined; with radiation and concomitant temozolomide; with adjuvant temozolomide using the 5/28 regimen; and with adjuvant temozolomide using the 21/28 day regimen. Fifty-nine patients were enrolled, 21 in arm 1, 20 in arm 2 and 18 in arm 3. Median age was 56 years (24-69); median KPS 90 (60-100). The maximum tolerated dose (MTD) of aflibercept for all 3 arms was 4 mg/kg every 2 weeks. Dose limiting toxicities at the MTD were: Arm 1: 0/21 patients; Arm 2: 2/20 patients (G3 deep vein thrombosis, G4 neutropenia; Arm 3: 3/18 patients) (G4 biopsy-confirmed thrombotic microangiopathy, G3 rash, G4 thrombocytopenia). The median number of cycles of aflibercept was 5 (range, 1-16). All patients stopped treatment; 28 (47%) for disease progression, 21 (36%) for toxicities, 8 (14%) for other reasons, and 2 (3%) patients completed the full treatment course. This study met its primary endpoint and the MTD of aflibercept with radiation and concomitant and adjuvant temozolomide is 4 mg/kg every 2 weeks.

Long-term benefits and risks of frontline nilotinib vs imatinib for chronic myeloid leukemia in chronic phase: 5-year update of the randomized ENESTnd trial.

PubMed

Hochhaus, A; Saglio, G; Hughes, T P; Larson, R A; Kim, D-W; Issaragrisil, S; le Coutre, P D; Etienne, G; Dorlhiac-Llacer, P E; Clark, R E; Flinn, I W; Nakamae, H; Donohue, B; Deng, W; Dalal, D; Menssen, H D; Kantarjian, H M

2016-05-01

In the phase 3 Evaluating Nilotinib Efficacy and Safety in Clinical Trials-Newly Diagnosed Patients (ENESTnd) study, nilotinib resulted in earlier and higher response rates and a lower risk of progression to accelerated phase/blast crisis (AP/BC) than imatinib in patients with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP). Here, patients' long-term outcomes in ENESTnd are evaluated after a minimum follow-up of 5 years. By 5 years, more than half of all patients in each nilotinib arm (300 mg twice daily, 54%; 400 mg twice daily, 52%) achieved a molecular response 4.5 (MR(4.5); BCR-ABL⩽0.0032% on the International Scale) compared with 31% of patients in the imatinib arm. A benefit of nilotinib was observed across all Sokal risk groups. Overall, safety results remained consistent with those from previous reports. Numerically more cardiovascular events (CVEs) occurred in patients receiving nilotinib vs imatinib, and elevations in blood cholesterol and glucose levels were also more frequent with nilotinib. In contrast to the high mortality rate associated with CML progression, few deaths in any arm were associated with CVEs, infections or pulmonary diseases. These long-term results support the positive benefit-risk profile of frontline nilotinib 300 mg twice daily in patients with CML-CP.

Prospective randomized phase II study of FOLFIRI versus FOLFOX7 in advanced gastric adenocarcinoma: a Chinese Western Cooperative Gastrointestinal Oncology Group Study

PubMed Central

Qiu, Meng; Liu, Jiyan; Chen, Jing; Yi, Cheng; Li, Zhiping; Luo, Deyun; Xu, Feng; Cai, Xiaohong; Bi, Feng

2017-01-01

Until now, no standard chemotherapy has been widely accepted for advanced gastric cancer (GC). The current research aimed to compare folinic acid, fluorouracil with irinotecan (mFOLFIRI) or with oxaliplatin (mFOLFOX7) as first-line treatments in patients with locally advanced GC in an open, randomized, phase II study. Previously untreated metastatic or recurrent GC patients with measurable disease received mFOLFIRI (arm A) or mFOLFOX7 (arm B) every 2 weeks. The defined second-line treatment was mFOLFOX7 for arm A and mFOLFIRI for arm B. Primary endpoint was progression-free survival (PFS), and secondary endpoints were overall survival (OS), disease control rate (DCR) and toxicity. The evaluable population consisted of 128 patients (54 in arm A; 74 in arm B). Median PFS of arm A was 2.9 months (m) (95% confidence interval, CI, 1.9 to 4.1 m) versus 4.1 m (95% CI, 3.2 to 4.8 m) for arm B (p = 0.109). Median OS was 9.9 months (95% CI, 6.0 to 13.5 m) for arm A versus 12.0 m for arm B (95% CI, 10.3 to 13.7m; p = 0.431). DCRs for arm A and arm B were 59.3% and 66.3%, respectively (p = 0.850). In subgroup analysis of the patients who completed both treatment lines per protocol, the median first-line PFS was 2.1 m for the mFOLFIRI/mFOLFOX7arm versus 8.0 m for the mFOLFOX7/mFOLFIRI arm (p = 0.053), and the median second-line PFS values were 1.2 m versus 5.1 m (p = 0.287). Total PFS and OS were 8.1m and 11.0 m for the mFOLFIRI/mFOLFOX7 group compared with 12.2m and 20.2 m for the mFOLFOX7/mFOLFIRI group (p = 0.008, p = 0.030). Both regimens were well-tolerated with acceptable and manageable toxicities. Hence, there was no significant difference in the PFS or DCR. However, mFOLFOX7 followed by mFOLFIRI might have a better OS. PMID:29228659

Prospective randomized phase II study of FOLFIRI versus FOLFOX7 in advanced gastric adenocarcinoma: a Chinese Western Cooperative Gastrointestinal Oncology Group Study.

PubMed

Li, Qiu; Wen, Feng; Zhou, Chengya; Qiu, Meng; Liu, Jiyan; Chen, Jing; Yi, Cheng; Li, Zhiping; Luo, Deyun; Xu, Feng; Cai, Xiaohong; Bi, Feng

2017-11-17

Until now, no standard chemotherapy has been widely accepted for advanced gastric cancer (GC). The current research aimed to compare folinic acid, fluorouracil with irinotecan (mFOLFIRI) or with oxaliplatin (mFOLFOX7) as first-line treatments in patients with locally advanced GC in an open, randomized, phase II study. Previously untreated metastatic or recurrent GC patients with measurable disease received mFOLFIRI (arm A) or mFOLFOX7 (arm B) every 2 weeks. The defined second-line treatment was mFOLFOX7 for arm A and mFOLFIRI for arm B. Primary endpoint was progression-free survival (PFS), and secondary endpoints were overall survival (OS), disease control rate (DCR) and toxicity. The evaluable population consisted of 128 patients (54 in arm A; 74 in arm B). Median PFS of arm A was 2.9 months (m) (95% confidence interval, CI , 1.9 to 4.1 m) versus 4.1 m (95% CI , 3.2 to 4.8 m) for arm B ( p = 0.109). Median OS was 9.9 months (95% CI , 6.0 to 13.5 m) for arm A versus 12.0 m for arm B (95% CI , 10.3 to 13.7m; p = 0.431). DCRs for arm A and arm B were 59.3% and 66.3%, respectively ( p = 0.850). In subgroup analysis of the patients who completed both treatment lines per protocol, the median first-line PFS was 2.1 m for the mFOLFIRI/mFOLFOX7arm versus 8.0 m for the mFOLFOX7/mFOLFIRI arm ( p = 0.053), and the median second-line PFS values were 1.2 m versus 5.1 m ( p = 0.287). Total PFS and OS were 8.1m and 11.0 m for the mFOLFIRI/mFOLFOX7 group compared with 12.2m and 20.2 m for the mFOLFOX7/mFOLFIRI group ( p = 0.008, p = 0.030). Both regimens were well-tolerated with acceptable and manageable toxicities. Hence, there was no significant difference in the PFS or DCR. However, mFOLFOX7 followed by mFOLFIRI might have a better OS.

Randomized Phase 2 Trial of S1 and Oxaliplatin-Based Chemoradiotherapy With or Without Induction Chemotherapy for Esophageal Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yoon, Dok Hyun; Jang, Geundoo; Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Seoul

2015-03-01

Purpose: To assess, in a randomized, phase 2 trial, the efficacy and safety of chemoradiotherapy with or without induction chemotherapy (ICT) of S1 and oxaliplatin for esophageal cancer. Patients and Methods: Patients with stage II, III, or IVA esophageal cancer were randomly allocated to either 2 cycles of ICT (oxaliplatin 130 mg/m{sup 2} on day 1 and S1 at 40 mg/m{sup 2} twice daily on days 1-14, every 3 weeks) followed by concurrent chemoradiotherapy (CCRT) (46 Gy, 2 Gy/d with oxaliplatin 130 mg/m{sup 2} on days 1 and 21 and S1 30 mg/m{sup 2} twice daily, 5 days per week during radiation therapy) and esophagectomy (arm A), ormore » the same CCRT followed by esophagectomy without ICT (arm B). The primary endpoint was the pathologic complete response (pCR) rate. Results: A total of 97 patients were randomized (arm A/B, 47/50), 70 of whom underwent esophagectomy (arm A/B, 34/36). The intention-to-treat pCR rate was 23.4% (95% confidence interval [CI] 11.2-35.6%) in arm A and 38% (95% CI 24.5% to 51.5%) in arm B. With a median follow-up duration of 30.3 months, the 2-year progression-free survival rate was 58.4% in arm A and 58.6% in arm B, whereas the 2-year overall survival rate was 60.7% and 63.7%, respectively. Grade 3 or 4 thrombocytopenia during CCRT was more common in arm A than in arm B (35.4% vs 4.1%). The relative dose intensity of S1 (89.5% ± 20.6% vs 98.3% ± 5.2%, P=.005) and oxaliplatin (91.4% ± 16.8% vs 99.0% ± 4.2%, P=.007) during CCRT was lower in arm A compared with arm B. Three patients in arm A, compared with none in arm B, died within 90 days after surgery. Conclusions: Combination chemotherapy of S1 and oxaliplatin is an effective chemoradiotherapy regimen to treat esophageal cancer. However, we failed to show that the addition of ICT to the regimen can improve the pCR rate.« less

Randomized phase 2 trial of S1 and oxaliplatin-based chemoradiotherapy with or without induction chemotherapy for esophageal cancer.

PubMed

Yoon, Dok Hyun; Jang, Geundoo; Kim, Jong Hoon; Kim, Yong-Hee; Kim, Ji Youn; Kim, Hyeong Ryul; Jung, Hwoon-Yong; Lee, Gin-Hyug; Song, Ho Young; Cho, Kyung-Ja; Ryu, Jin-Sook; Kim, Sung-Bae

2015-03-01

To assess, in a randomized, phase 2 trial, the efficacy and safety of chemoradiotherapy with or without induction chemotherapy (ICT) of S1 and oxaliplatin for esophageal cancer. Patients with stage II, III, or IVA esophageal cancer were randomly allocated to either 2 cycles of ICT (oxaliplatin 130 mg/m(2) on day 1 and S1 at 40 mg/m(2) twice daily on days 1-14, every 3 weeks) followed by concurrent chemoradiotherapy (CCRT) (46 Gy, 2 Gy/d with oxaliplatin 130 mg/m(2) on days 1 and 21 and S1 30 mg/m(2) twice daily, 5 days per week during radiation therapy) and esophagectomy (arm A), or the same CCRT followed by esophagectomy without ICT (arm B). The primary endpoint was the pathologic complete response (pCR) rate. A total of 97 patients were randomized (arm A/B, 47/50), 70 of whom underwent esophagectomy (arm A/B, 34/36). The intention-to-treat pCR rate was 23.4% (95% confidence interval [CI] 11.2-35.6%) in arm A and 38% (95% CI 24.5% to 51.5%) in arm B. With a median follow-up duration of 30.3 months, the 2-year progression-free survival rate was 58.4% in arm A and 58.6% in arm B, whereas the 2-year overall survival rate was 60.7% and 63.7%, respectively. Grade 3 or 4 thrombocytopenia during CCRT was more common in arm A than in arm B (35.4% vs 4.1%). The relative dose intensity of S1 (89.5% ± 20.6% vs 98.3% ± 5.2%, P=.005) and oxaliplatin (91.4% ± 16.8% vs 99.0% ± 4.2%, P=.007) during CCRT was lower in arm A compared with arm B. Three patients in arm A, compared with none in arm B, died within 90 days after surgery. Combination chemotherapy of S1 and oxaliplatin is an effective chemoradiotherapy regimen to treat esophageal cancer. However, we failed to show that the addition of ICT to the regimen can improve the pCR rate. Copyright © 2015 Elsevier Inc. All rights reserved.

PROGRESS REPORT OF FY 2004 ACTIVITIES: IMPROVED WATER VAPOR AND CLOUD RETRIEVALS AT THE NSA/AAO

DOE Office of Scientific and Technical Information (OSTI.GOV)

E. R. Westwater; V. V. Leuskiy; M. Klein

2004-11-01

The basic goals of the research are to develop and test algorithms and deploy instruments that improve measurements of water vapor, cloud liquid, and cloud coverage, with a focus on the Arctic conditions of cold temperatures and low concentrations of water vapor. The importance of accurate measurements of column amounts of water vapor and cloud liquid has been well documented by scientists within the Atmospheric Radiation Measurement Program. Although several technologies have been investigated to measure these column amounts, microwave radiometers (MWR) have been used operationally by the ARM program for passive retrievals of these quantities: precipitable water vapor (PWV)more » and integrated water liquid (IWL). The technology of PWV and IWL retrievals has advanced steadily since the basic 2-channel MWR was first deployed at ARM CART sites Important advances are the development and refinement of the tipcal calibration method [1,2], and improvement of forward model radiative transfer algorithms [3,4]. However, the concern still remains that current instruments deployed by ARM may be inadequate to measure low amounts of PWV and IWL. In the case of water vapor, this is especially important because of the possibility of scaling and/or quality control of radiosondes by the water amount. Extremely dry conditions, with PWV less than 3 mm, commonly occur in Polar Regions during the winter months. Accurate measurements of the PWV during such dry conditions are needed to improve our understanding of the regional radiation energy budgets. The results of a 1999 experiment conducted at the ARM North Slope of Alaska/Adjacent Arctic Ocean (NSA/AAO) site during March of 1999 [5] have shown that the strength associated with the 183 GHz water vapor absorption line makes radiometry in this frequency regime suitable for measuring low amounts of PWV. As a portion of our research, we conducted another millimeter wave radiometric experiment at the NSA/AAO in March-April 2004. This experiment relied heavily on our experiences of the 1999 experiment. Particular attention was paid to issues of radiometric calibration and radiosonde intercomparisons. Our theoretical and experimental work also supplements efforts by industry (F. Solheim, Private Communication) to develop sub-millimeter radiometers for ARM deployment. In addition to quantitative improvement of water vapor measurements at cold temperature, the impact of adding millimeter-wave window channels to improve the sensitivity to arctic clouds was studied. We also deployed an Infrared Cloud Imager (ICI) during this experiment, both for measuring continuous day-night statistics of the study of cloud coverage and identifying conditions suitable for tipcal analysis. This system provided the first capability of determining spatial cloud statistics continuously in both day and night at the NSA site and has been used to demonstrate that biases exist in inferring cloud statistics from either zenith-pointing active sensors (lidars or radars) or sky imagers that rely on scattered sunlight in daytime and star maps at night [6].« less

Crew Access Arm arrival at Mobile Launcher

NASA Image and Video Library

2017-11-09

A heavy-load transport truck carrying the Orion crew access arm arrives at the mobile launcher (ML) at NASA's Kennedy Space Center in Florida. The crew access arm will be installed at about the 274-foot level on the mobile launcher tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-10

A heavy-load transport truck carrying the Orion crew access arm passes the Vehicle Assembly Building on its way to the mobile launcher at NASA's Kennedy Space Center in Florida. The access arm will be installed at about the 274-foot level on the mobile launcher tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-09

The Orion crew access arm, secured on a stand, is being prepared for its move from a storage location at NASA's Kennedy Space Center in Florida, to the mobile launcher (ML) tower near the Vehicle Assembly Building at the center. The crew access arm will be installed at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-10

A heavy-load transport truck carrying the Orion crew access arm makes its way toward the mobile launcher (ML) at NASA's Kennedy Space Center in Florida. The crew access arm will be installed at about the 274-foot level on the mobile launcher tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

Affirming At-Risk Minorities for Success (ARMS): retention, graduation, and success on the NCLEX-RN.

PubMed

Sutherland, Judith A; Hamilton, Mary Jane; Goodman, Nancy

2007-08-01

Increasing ethnic and racial diversity in the U.S. population combined with inadequate minority representation in the nursing profession requires innovative strategies to recruit, retain, and graduate nurses from diverse ethnic and racial populations. Affirming At-Risk Minorities for Success (ARMS) was funded by a U.S. Department of Health and Human Services Basic Nurse Education and Practice Program grant. Participants (N = 64) were enrolled in a baccalaureate degree nursing program that has been predominantly White/ Anglo and is located in the south-central region of the United States. Research objectives were to increase program retention, graduation rates, and success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) for minority or educationally disadvantaged students through programmatic interventions, including mentoring and advising, tutoring, and educational seminars. The comparison group was non-ARMS students derived from a comprehensive database (N = 265). Results indicated that interventions positively affected graduation rates (measure of retention = 98%), significantly affected grades in the Leadership-Management capstone course, and eliminated the effects of ethnicity on NCLEX-RN success.

KSC-2009-5595

NASA Image and Video Library

2009-10-20

CAPE CANAVERAL, Fla. – Workers prepare to close the arms of the vehicle stabilization system around the towering 327-foot-tall Ares I-X rocket, newly arrived on Launch Pad 39B at NASA's Kennedy Space Center in Florida. The test rocket left the Vehicle Assembly Building at 1:39 a.m. EDT on its 4.2-mile trek to the pad and was "hard down" on the pad’s pedestals at 9:17 a.m. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, along with the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. Part of the Constellation Program, the Ares I-X is the test vehicle for the Ares I. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

KSC-2009-5596

NASA Image and Video Library

2009-10-20

CAPE CANAVERAL, Fla. – The arms of the vehicle stabilization system are closed around the towering 327-foot-tall Ares I-X rocket, newly arrived on Launch Pad 39B at NASA's Kennedy Space Center in Florida. The test rocket left the Vehicle Assembly Building at 1:39 a.m. EDT on its 4.2-mile trek to the pad and was "hard down" on the pad’s pedestals at 9:17 a.m. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, along with the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. Part of the Constellation Program, the Ares I-X is the test vehicle for the Ares I. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

KSC-2009-5916

NASA Image and Video Library

2009-10-27

CAPE CANAVERAL, Fla. – As the sun rises over Launch Pad 39B at NASA's Kennedy Space Center in Florida, the rotating service structure and the arms of the vehicle stabilization system have been retracted from around the Constellation Program's 327-foot-tall Ares I-X rocket, resting atop its mobile launcher platform, for launch. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, and the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. The data returned from more than 700 sensors throughout the rocket will be used to refine the design of future launch vehicles and bring NASA one step closer to reaching its exploration goals. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

KSC-2009-5911

NASA Image and Video Library

2009-10-27

CAPE CANAVERAL, Fla. – Workers on Launch Pad 39B at NASA's Kennedy Space Center in Florida prepare the Constellation Program's 327-foot-tall Ares I-X rocket for launch. The rotating service structure and the arms of the vehicle stabilization system will be moved from around the rocket for liftoff. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, and the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. The data returned from more than 700 sensors throughout the rocket will be used to refine the design of future launch vehicles and bring NASA one step closer to reaching its exploration goals. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

KSC-2009-5912

NASA Image and Video Library

2009-10-27

CAPE CANAVERAL, Fla. - Workers on Launch Pad 39B at NASA's Kennedy Space Center in Florida make final preparations for launch of the Constellation Program's 327-foot-tall Ares I-X rocket. The rotating service structure and the arms of the vehicle stabilization system will be moved from around the rocket for liftoff. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, and the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. The data returned from more than 700 sensors throughout the rocket will be used to refine the design of future launch vehicles and bring NASA one step closer to reaching its exploration goals. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

A comparative study on the CT effective dose for various positions of the patient's arm

NASA Astrophysics Data System (ADS)

Seong, Ji-Hye; Park, Soon-Ki; Kim, Jung-Sun; Jung, Woo-Young; Kim, Ho-Sung; Dong, Kyung-Rae; Chung, Woon-Kwan; Cho, Jae-Hwan; Cho, Young-Kuk

2012-10-01

In a whole body PET/CT (positron emission tomography/computed tomography) scan, lifting the patient's arm to improve the image quality is natural. On the other hand, the arms should be placed lower when the lesion is located in the head and neck. This study compared the CT effective dose for each arm position after applying AEC (automatic exposure control). Forty-five patients who had undergone an 18F-FDG (fluorine-18-fluoro deoxy glucose) whole body PET/CT scan were examined using Biograph Truepoint 40, Biograph Sensation 16, and Discovery STe 8 systems. The CT effective dose of 15 patients for each set of equipment was measured and analyzed comparatively in both the arm-lifted and arm-lowered positions. The ImPACT Ver. 1.0 program was used to measure the CT effective dose. A paired t-test (SPSS 18.0 statistic program) was applied for statistical analysis. In the case of the arm-lifted position, the CT effective dose measured for Biograph 40, Biograph 16, and DSTe 8 systems were 6.33 ± 0.93 mSv, 8.01 ± 1.34 mSv, and 9.69 ± 2.32 mSv, respectively. When the arms were located in the lower position, the respective CT effective doses were 6.97 ± 0.76 mSv, 8.95 ± 1.85 mSv, and 13.07 ± 2.87 mSv, respectively. These results revealed 9.2%, 10.5%, and 25.9% improvement in the CT effective doses for the Biograph 40, Biograph 16 and DSTe 8 systems, respectively, when the arms were raised compared to that when they were lowered (p < 0.05). For the whole body PET/CT case, the CT effective dose applying AEC showed a mean 15.2% decrease in the radiation exposure of the patients when the arm was lifted. The patient with no lesion in the head and neck would show fewer artifacts in the objective part and a lower CT effective dose. For a patient with a lesion in the head and neck, the artifacts in the objective part can be reduced by putting the arms down. The fact that the CT effective dose is increased in a whole-body PET/CT scan should be a concern.

Design and analysis on robotic arm for serving hazard container

NASA Astrophysics Data System (ADS)

Razali, Zol Bahri; Kader, Mohamed Mydin M. Abdul; Yi, Khoo Zern; Daud, Mohd Hisam

2017-09-01

This paper presents about design, analyses development and fabrication of robotic arm for sorting multi-material. The major problem that urges the initiation of the project is the fact that manufacturing industry is growing at relatively faster rate. Most of the company produce high load robotic arm. Less company creates light weight, and affordable robotic arm. As the result, light weight and affordable robot is developing to cover this issue. Plastic material was used to construct the body of the robotic arm, and an optical sensor was implemented to provide basic recognition of object to be carried. The robotic arm used five servomotors for overall operation; four for its joints, and one for the gripping mechanism. The gripper was designed and fabricated using Perspex due to the light weight and high strength of the material. The operation of the robotic arm was governed by Basic Stamp programming sequence and the device was expected to differentiate material and other objects based on reflective theory, and perform subsequent operations afterwards. The SolidWorks was used to model the detail design of the robotic arm, and to simulate the motion of the device.

Center for Neural Engineering at Tennessee State University, ASSERT Annual Progress Report.

DTIC Science & Technology

1995-07-01

neural networks . Their research topics are: (1) developing frequency dependent oscillatory neural networks ; (2) long term pontentiation learning rules...as applied to spatial navigation; (3) design and build a servo joint robotic arm and (4) neural network based prothesis control. One graduate student

Palbociclib Combined with Fulvestrant in Premenopausal Women with Advanced Breast Cancer and Prior Progression on Endocrine Therapy: PALOMA-3 Results.

PubMed

Loibl, Sibylle; Turner, Nicholas C; Ro, Jungsil; Cristofanilli, Massimo; Iwata, Hiroji; Im, Seock-Ah; Masuda, Norikazu; Loi, Sherene; André, Fabrice; Harbeck, Nadia; Verma, Sunil; Folkerd, Elizabeth; Puyana Theall, Kathy; Hoffman, Justin; Zhang, Ke; Bartlett, Cynthia Huang; Dowsett, Mitchell

2017-09-01

The efficacy and safety of palbociclib, a cyclin-dependent kinase 4/6 inhibitor, combined with fulvestrant and goserelin was assessed in premenopausal women with advanced breast cancer (ABC) who had progressed on prior endocrine therapy (ET). One hundred eight premenopausal endocrine-refractory women ≥18 years with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) ABC were among 521 women randomized 2:1 (347:174) to fulvestrant (500 mg) ± goserelin with either palbociclib (125 mg/day orally, 3 weeks on, 1 week off) or placebo. This analysis assessed whether the overall tolerable safety profile and significant progression-free survival (PFS) improvement extended to premenopausal women. Potential drug-drug interactions (DDIs) and ovarian suppression with goserelin were assessed via plasma pharmacokinetics and biochemical analyses, respectively. (ClinicalTrials.gov identifier: NCT01942135) RESULTS: Median PFS for premenopausal women in the palbociclib ( n  = 72) versus placebo arm ( n  = 36) was 9.5 versus 5.6 months, respectively (hazard ratio, 0.50, 95% confidence interval: 0.29-0.87), and consistent with the significant PFS improvement in the same arms for postmenopausal women. Any-grade and grade ≤3 neutropenia, leukopenia, and infections were among the most frequent adverse events reported in the palbociclib arm with concurrent goserelin administration. Hormone concentrations were similar between treatment arms and confirmed sustained ovarian suppression. Clinically relevant DDIs were not observed. Palbociclib combined with fulvestrant and goserelin was an effective and well-tolerated treatment for premenopausal women with prior endocrine-resistant HR+/HER2- ABC. Inclusion of both premenopausal and postmenopausal women in pivotal combination ET trials facilitates access to novel drugs for young women and should be considered as a new standard for clinical trial design. PALOMA-3, the first registrational study to include premenopausal women in a trial investigating a CDK4/6 inhibitor combined with endocrine therapy, has the largest premenopausal cohort reported in an endocrine-resistant setting. In pretreated premenopausal women with hormone receptor-positive advanced breast cancer, palbociclib plus fulvestrant and goserelin (luteinizing hormone-releasing hormone [LHRH] agonist) treatment almost doubled median progression-free survival (PFS) and significantly increased the objective response rate versus endocrine monotherapy, achieving results comparable to those reported for chemotherapy without apparently interfering with LHRH agonist-induced ovarian suppression. The significant PFS gain and tolerable safety profile strongly support use of this regimen in premenopausal women with endocrine-resistant disease who could possibly delay chemotherapy. © AlphaMed Press 2017.

A pilot randomized controlled trial to decrease adaptation difficulties in chinese new immigrants to Hong Kong.

PubMed

Yu, Xiaonan; Stewart, Sunita M; Chui, Jolian P L; Ho, Joy L Y; Li, Anthony C H; Lam, Tai Hing

2014-01-01

Immigration occurs globally, and immigrants are vulnerable to the development of adaptation difficulties. Little evidence is available for effective programs to enhance immigrant adaptation outside of the West. This pilot randomized controlled trial tested the effectiveness of two interventions used to decrease adaptation difficulties by (a) providing knowledge of resources that are relevant to the Hong Kong context or (b) enhancing personal resilience in immigrants to Hong Kong from Mainland China. A total of 220 participants were randomly assigned to three conditions: information, resilience, or control arms. They completed measures on adaptation difficulties, knowledge, and personal resilience at baseline, immediately after the intervention (postintervention), and at a 3-month follow-up. The information intervention resulted in higher increases postintervention in knowledge than did the other two arms. The resilience intervention reported greater increases in personal resilience than did the control arm at both postintervention and 3 months later; it also reported greater increases than the information arm did at the 3-month follow-up. Although both interventions reported greater decreases in adaptation difficulties than the control arm did at postintervention and 3 months later, no significant differences were found when they were compared with each other at both time points. Both programs had high acceptability and were feasible to implement in the community. Change in knowledge had no significant mediation effect on adaption difficulties, but change in personal resilience from baseline to postintervention mediated the effect of the intervention on the outcome of adaptation difficulties at the 3-month follow-up. These findings indicate evidence for benefits of the information and resilience interventions, and they inform further development of our programs. Copyright © 2013. Published by Elsevier Ltd.

Impact of diagnosis of diabetes on health-related quality of life among high risk individuals: the Diabetes Prevention Program outcomes study.

PubMed

Marrero, D; Pan, Q; Barrett-Connor, E; de Groot, M; Zhang, P; Percy, C; Florez, H; Ackermann, R; Montez, M; Rubin, R R

2014-02-01

The purpose of this study is to assess if diagnosis of type 2 diabetes affected health-related quality of life (HRQoL) among participants in the Diabetes Prevention Program/Diabetes Prevention Program Outcome Study and changes with treatment or diabetes duration. 3,210 participants with pre-diabetes were randomized to metformin (MET), intensive lifestyle intervention (ILS), or placebo (PLB). HRQoL was assessed using the SF-36 including: (1) 8 SF-36 subscales; (2) the physical component (PCS) and mental component summary (MCS) scores; and (3) the SF-6D. The sample was categorized by diabetes free versus diagnosed. For diagnosed subgroup, mean scores in the diabetes-free period, at 6 months, 2, 4 and 6 years post-diagnosis, were compared. PCS and SF-6D scores declined in all participants in all treatment arms (P < .001). MCS scores did not change significantly in any treatment arm regardless of diagnosis. ILS participants reported a greater decrease in PCS scores at 6 months post-diagnosis (P < .001) and a more rapid decline immediately post-diagnosis in SF-6D scores (P = .003) than the MET or PLB arms. ILS participants reported a significant decrease in the social functioning subscale at 6 months (P < .001) and two years (P < .001) post-diagnosis. Participants reported a decline in measures of overall health state (SF-6D) and overall physical HRQoL, whether or not they were diagnosed with diabetes during the study. There was no change in overall mental HRQoL. Participants in the ILS arm with diabetes reported a more significant decline in some HRQoL measures than those in the MET and PLB arms that developed diabetes.

Impact of diagnosis of diabetes on health-related quality of life among high risk individuals: the Diabetes Prevention Program outcomes study

PubMed Central

Pan, Q.; Barrett-Connor, E.; de Groot, M.; Zhang, P.; Percy, C.; Florez, H.; Ackermann, R.; Montez, M.; Rubin, R. R.

2013-01-01

Purpose The purpose of this study is to assess if diagnosis of type 2 diabetes affected health-related quality of life (HRQoL) among participants in the Diabetes Prevention Program/Diabetes Prevention Program Outcome Study and changes with treatment or diabetes duration. Methods 3,210 participants with pre-diabetes were randomized to metformin (MET), intensive lifestyle intervention (ILS), or placebo (PLB). HRQoL was assessed using the SF-36 including: (1) 8 SF-36 subscales; (2) the physical component (PCS) and mental component summary (MCS) scores; and (3) the SF-6D. The sample was categorized by diabetes free versus diagnosed. For diagnosed subgroup, mean scores in the diabetes-free period, at 6 months, 2, 4 and 6 years post-diagnosis, were compared. Results PCS and SF-6D scores declined in all participants in all treatment arms (P <.001). MCS scores did not change significantly in any treatment arm regardless of diagnosis. ILS participants reported a greater decrease in PCS scores at 6 months post-diagnosis (P <.001) and a more rapid decline immediately post-diagnosis in SF-6D scores (P = .003) than the MET or PLB arms. ILS participants reported a significant decrease in the social functioning subscale at 6 months (P <.001) and two years (P <.001) post-diagnosis. Conclusions Participants reported a decline in measures of overall health state (SF-6D) and overall physical HRQoL, whether or not they were diagnosed with diabetes during the study. There was no change in overall mental HRQoL. Participants in the ILS arm with diabetes reported a more significant decline in some HRQoL measures than those in the MET and PLB arms that developed diabetes. PMID:23709097

Physiologic Responses of Able-Bodied and Paraplegic Males to Maximal Arm Ergometry.

ERIC Educational Resources Information Center

Israel, Richard G.; And Others

A study compared physiologic responses of healthy paraplegic males to those of healthy, able-bodied males during maximal arm ergometry. Fifteen able-bodied, healthy adult males and 13 healthy adult male paraplegics followed an exercise program involving heart rate, increased exercise loads, and oxygen uptake. Results from an analysis of the data…

Armed Conflict: A Model for Understanding and Intervention

ERIC Educational Resources Information Center

Death Studies, 2013

2013-01-01

Acts of deadly violence give rise to powerful emotions and trigger pre-programmed responses that often cause affected persons, including leaders, media, armed forces, and the general public, to act in ways that aggravate the situation and feed into cycles of violence. In this article, a model of the cycle of violence is presented that facilitates…

Defibrotide for the treatment of severe hepatic veno-occlusive disease and multiorgan failure after stem cell transplantation: a multicenter, randomized, dose-finding trial.

PubMed

Richardson, Paul G; Soiffer, Robert J; Antin, Joseph H; Uno, Hajime; Jin, Zhezhen; Kurtzberg, Joanne; Martin, Paul L; Steinbach, Gideon; Murray, Karen F; Vogelsang, Georgia B; Chen, Allen R; Krishnan, Amrita; Kernan, Nancy A; Avigan, David E; Spitzer, Thomas R; Shulman, Howard M; Di Salvo, Donald N; Revta, Carolyn; Warren, Diane; Momtaz, Parisa; Bradwin, Gary; Wei, L J; Iacobelli, Massimo; McDonald, George B; Guinan, Eva C

2010-07-01

Therapeutic options for severe hepatic veno-occlusive disease (VOD) are limited and outcomes are dismal, but early phase I/II studies have suggested promising activity and acceptable toxicity using the novel polydisperse oligonucleotide defibrotide. This randomized phase II dose-finding trial determined the efficacy of defibrotide in patients with severe VOD following hematopoietic stem cell transplantation (HSCT) and identified an appropriate dose for future trials. Adult and pediatric patients received either lower-dose (arm A: 25 mg/kg/day; n = 75) or higher-dose (arm B: 40 mg/kg/day; n = 74) i.v. defibrotide administered in divided doses every 6 hours for > or =14 days or until complete response, VOD progression, or any unacceptable toxicity occurred. Overall complete response and day +100 post-HSCT survival rates were 46% and 42%, respectively, with no significant difference between treatment arms. The incidence of treatment-related adverse events was low (8% overall; 7% in arm A, 10% in arm B); there was no significant difference in the overall rate of adverse events between treatment arms. Early stabilization or decreased bilirubin was associated with better response and day +100 survival, and decreased plasminogen activator inhibitor type 1 (PAI-1) during treatment was associated with better outcome; changes were similar in both treatment arms. Defibrotide 25 or 40 mg/kg/day also appears effective in treating severe VOD following HSCT. In the absence of any differences in activity, toxicity or changes in PAI-1 level, defibrotide 25 mg/kg/day was selected for ongoing phase III trials in VOD.

Randomized phase II trial of carboplatin versus paclitaxel and carboplatin in platinum-sensitive recurrent advanced ovarian carcinoma: a GEICO (Grupo Espanol de Investigacion en Cancer de Ovario) study.

PubMed

González-Martín, A J; Calvo, E; Bover, I; Rubio, M J; Arcusa, A; Casado, A; Ojeda, B; Balañá, C; Martínez, E; Herrero, A; Pardo, B; Adrover, E; Rifá, J; Godes, M J; Moyano, A; Cervantes, A

2005-05-01

The aim of this study was to determine whether the response rate for the paclitaxel-carboplatin combination is superior to carboplatin alone in the treatment of patients with platinum-sensitive recurrent ovarian carcinoma. Patients with recurrent ovarian carcinoma, 6 months after treatment with a platinum-based regimen and with no more than two previous chemotherapy lines, were randomized to receive carboplatin area under the curve (AUC) 5 (arm A) or paclitaxel 175 mg/m(2) + carboplatin AUC 5 (arm B). The primary end point was objective response, following a 'pick up the winner' design. Secondary end points included time to progression (TTP), overall survival, tolerability and quality of life (QoL). Eighty-one patients were randomized and included in the intention-to-treat analysis. The response rate in arm B was 75.6% [26.8% complete response (CR) + 48.8% partial response (PR)] [95% confidence interval (CI) 59.7% to 87.6%] and 50% in arm A (20% CR + 30% PR) (95% CI 33.8% to 66.2%). No significant differences were observed in grade 3-4 hematological toxicity. Conversely, mucositis, myalgia/arthralgia and peripheral neurophaty were more frequent in arm B. Median TTP was 49.1 weeks in arm B (95% CI 36.9-61.3) and 33.7 weeks in arm A (95% CI 25.8-41.5). No significant differences were found in the QoL analysis. Paclitaxel-carboplatin combination is a tolerable regimen with a higher response rate than carboplatin monotherapy in platinum-sensitive recurrent ovarian carcinoma.

Search For Star Cluster Age Gradients Across Spiral Arms of Three LEGUS Disk Galaxies

NASA Astrophysics Data System (ADS)

Shabani, F.; Grebel, E. K.; Pasquali, A.; D'Onghia, E.; Gallagher, J. S.; Adamo, A.; Messa, M.; Elmegreen, B. G.; Dobbs, C.; Gouliermis, D. A.; Calzetti, D.; Grasha, K.; Elmegreen, D. M.; Cignoni, M.; Dale, D. A.; Aloisi, A.; Smith, L. J.; Tosi, M.; Thilker, D. A.; Lee, J. C.; Sabbi, E.; Kim, H.; Pellerin, A.

2018-05-01

One of the main theories for explaining the formation of spiral arms in galaxies is the stationary density wave theory. This theory predicts the existence of an age gradient across the arms. We use the stellar cluster catalogues of the galaxies NGC 1566, M51a, and NGC 628 from the Legacy Extragalactic UV Survey (LEGUS) program. In order to test for the possible existence of an age sequence across the spiral arms, we quantified the azimuthal offset between star clusters of different ages in our target galaxies. We found that NGC 1566, a grand-design spiral galaxy with bisymmetric arms and a strong bar, shows a significant age gradient across the spiral arms that appears to be consistent with the prediction of the stationary density wave theory. In contrast, M51a with its two well-defined spiral arms and a weaker bar does not show an age gradient across the arms. In addition, a comparison with non-LEGUS star cluster catalogues for M51a yields similar results. We believe that the spiral structure of M51a is not the result of a stationary density wave with a fixed pattern speed. Instead, tidal interactions could be the dominant mechanism for the formation of spiral arms. We also found no offset in the azimuthal distribution of star clusters with different ages across the weak spiral arms of NGC 628.

Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation.

PubMed

Franck, Johan Anton; Smeets, Rob Johannes Elise Marie; Seelen, Henk Alexander Maria

2017-01-01

Arm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated. This single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge. Eighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation. A majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies.

LRRC6 Mutation Causes Primary Ciliary Dyskinesia with Dynein Arm Defects

PubMed Central

Horani, Amjad; Ferkol, Thomas W.; Shoseyov, David; Wasserman, Mollie G.; Oren, Yifat S.; Kerem, Batsheva; Amirav, Israel; Cohen-Cymberknoh, Malena; Dutcher, Susan K.; Brody, Steven L.; Elpeleg, Orly; Kerem, Eitan

2013-01-01

Despite recent progress in defining the ciliome, the genetic basis for many cases of primary ciliary dyskinesia (PCD) remains elusive. We evaluated five children from two unrelated, consanguineous Palestinian families who had PCD with typical clinical features, reduced nasal nitric oxide concentrations, and absent dynein arms. Linkage analyses revealed a single common homozygous region on chromosome 8 and one candidate was conserved in organisms with motile cilia. Sequencing revealed a single novel mutation in LRRC6 (Leucine-rich repeat containing protein 6) that fit the model of autosomal recessive genetic transmission, leading to a change of a highly conserved amino acid from aspartic acid to histidine (Asp146His). LRRC6 was localized to the cytoplasm and was up-regulated during ciliogenesis in human airway epithelial cells in a Foxj1-dependent fashion. Nasal epithelial cells isolated from affected individuals and shRNA-mediated silencing in human airway epithelial cells, showed reduced LRRC6 expression, absent dynein arms, and slowed cilia beat frequency. Dynein arm proteins were either absent or mislocalized to the cytoplasm in airway epithelial cells from a primary ciliary dyskinesia subject. These findings suggest that LRRC6 plays a role in dynein arm assembly or trafficking and when mutated leads to primary ciliary dyskinesia with laterality defects. PMID:23527195

A Novel Strategy to Prevent Advanced Atherosclerosis and Lower Blood Glucose in a Mouse Model of Metabolic Syndrome.

PubMed

Kanter, Jenny E; Kramer, Farah; Barnhart, Shelley; Duggan, Jeffrey M; Shimizu-Albergine, Masami; Kothari, Vishal; Chait, Alan; Bouman, Stephan D; Hamerman, Jessica A; Hansen, Bo F; Olsen, Grith S; Bornfeldt, Karin E

2018-05-01

Cardiovascular disease caused by atherosclerosis is the leading cause of mortality associated with type 2 diabetes and metabolic syndrome. Insulin therapy is often needed to improve glycemic control, but it does not clearly prevent atherosclerosis. Upon binding to the insulin receptor (IR), insulin activates distinct arms of downstream signaling. The IR-Akt arm is associated with blood glucose lowering and beneficial effects, whereas the IR-Erk arm might exert less desirable effects. We investigated whether selective activation of the IR-Akt arm, leaving the IR-Erk arm largely inactive, would result in protection from atherosclerosis in a mouse model of metabolic syndrome. The insulin mimetic peptide S597 lowered blood glucose and activated Akt in insulin target tissues, mimicking insulin's effects, but only weakly activated Erk and even prevented insulin-induced Erk activation. Strikingly, S597 retarded atherosclerotic lesion progression through a process associated with protection from leukocytosis, thereby reducing lesional accumulation of inflammatory Ly6C hi monocytes. S597-mediated protection from leukocytosis was accompanied by reduced numbers of the earliest bone marrow hematopoietic stem cells and reduced IR-Erk activity in hematopoietic stem cells. This study provides a conceptually novel treatment strategy for advanced atherosclerosis associated with metabolic syndrome and type 2 diabetes. © 2018 by the American Diabetes Association.

Evaluation of overhead support inspection program.

DOT National Transportation Integrated Search

2015-01-01

This study evaluated the adequacy and frequency of the current structural support inspection program for overhead : sign supports (including bridge mounted), mast arm signal supports and high mast light supports. While ODOT provides : statewide guida...

78 FR 76112 - 36(b)(1) Arms Sales Notification

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

...: participation in the F/A-18 Engine Component Improvement Program (CIP), spare and repair parts, system...: participation in the F/A-18 Engine Component Improvement Program (CIP), spare and repair parts, system...

A Programming Environment for Parallel Vision Algorithms

DTIC Science & Technology

1990-04-11

industrial arm on the market , while the unique head was designed by Rochester’s Computer Science and Mechanical Engineering Departments. 9a 4.1 Introduction...R. Constraining-Unification and the Programming Language Unicorn . In Logic Programming, Functions, Relations, and Equations, Degroot and Lind- strom

Novel integrative virtual rehabilitation reduces symptomatology of primary progressive aphasia--a case report.

PubMed

Burdea, Grigore C; Polistico, Kevin; House, Gregory P; Liu, Richard R; Muñiz, Roberto; Macaro, Natalie A; Slater, Lisa M

2015-01-01

BrightBrainer™ integrative cognitive rehabilitation system evaluation in an Adult Day Program by a subject with Primary Progressive Aphasia (PPA) assumed to be of the mixed nonfluent/logopenic variant, and for determination of potential benefits. The subject was a 51-year-old Caucasian male diagnosed with PPA who had attended an Adult Day Program for 18 months prior to BrightBrainer training. The subject interacted with therapeutic games using a controller that measured 3D hand movements and flexion of both index fingers. The computer simulations adapted difficulty level based on task performance; results were stored on a remote server. The clinical trial consisted of 16 sessions, twice/week for 8 weeks. The subject was evaluated through neuropsychological measures, therapy notes and caregiver feedback forms. Neuropsychological testing indicated no depression (BDI 0) and severe dementia (BIMS 1 and MMSE 3). The 6.5 h of therapy consisted of games targeting Language comprehension; Executive functions; Focusing; Short-term memory; and Immediate/working memory. The subject attained the highest difficulty level in all-but-one game, while averaging 1300-arm task-oriented active movement repetitions and 320 index finger flexion movements per session. While neuropsychological testing showed no benefits, the caregiver reported strong improvements in verbal responses, vocabulary use, speaking in complete sentences, following one-step directions and participating in daily activities. This corroborated well with therapy notes. Preliminary findings demonstrate a meaningful reduction of PPA symptoms for the subject, suggesting follow-up imaging studies to detail neuronal changes induced by BrightBrainer system and controlled studies with a sufficiently large number of PPA subjects.

The Relationship of Throwing Arm Mechanics and Elbow Varus Torque: Within-Subject Variation for Professional Baseball Pitchers Across 82,000 Throws.

PubMed

Camp, Christopher L; Tubbs, Travis G; Fleisig, Glenn S; Dines, Joshua S; Dines, David M; Altchek, David W; Dowling, Brittany

2017-11-01

Likely due to the high level of strain exerted across the elbow during the throwing motion, elbow injuries are on the rise in baseball. To identify at-risk athletes and guide postinjury return-to-throw programs, a better understanding of the variables that influence elbow varus torque is desired. To describe the within-subject relationship between elbow varus torque and arm slot and arm rotation in professional baseball pitchers. Descriptive laboratory study. A total of 81 professional pitchers performed 82,000 throws while wearing a motusBASEBALL sensor and sleeve. These throws represented a combination of throw types, such as warm-up/catch, structured long-toss, bullpen throwing from a mound, and live game activity. Variables recorded for each throw included arm slot (angle of the forearm relative to the ground at ball release), arm speed (maximal rotational velocity of the forearm), arm rotation (maximal external rotation of the throwing arm relative to the ground), and elbow varus torque. Linear mixed-effects models and likelihood ratio tests were used to estimate the relationship between elbow varus torque and arm slot, arm speed, and arm rotation within individual pitchers. All 3 metrics-arm slot (χ 2 = 428, P < .001), arm speed (χ 2 = 57,683, P < .001), and arm rotation (χ 2 = 1392, P < .001)-were found to have a significant relationship with elbow varus torque. Within individual athletes, a 1-N.m increase in elbow varus torque was associated with a 13° decrease in arm slot, a 116 deg/s increase in arm speed, and an 8° increase in arm rotation. Elbow varus torque increased significantly as pitchers increased their arm rotation during the arm cocking phase, increased the rotational velocity of their arm during the arm acceleration phase of throwing, and decreased arm slot at ball release. Thus, shoulder flexibility, arm speed, and elbow varus torque (and likely injury risk) are interrelated and should be considered collectively when treating pitchers. It is well established that elbow varus torque is related to ulnar collateral ligament injuries in overhead throwers. This study describes the relationship of arm slot, arm speed, and arm rotation to elbow varus torque in an attempt to identify modifiable risk factors for injury.

Multi-Armed Bandits for Intelligent Tutoring Systems

ERIC Educational Resources Information Center

Clement, Benjamin; Roy, Didier; Oudeyer, Pierre-Yves; Lopes, Manuel

2015-01-01

We present an approach to Intelligent Tutoring Systems which adaptively personalizes sequences of learning activities to maximize skills acquired by students, taking into account the limited time and motivational resources. At a given point in time, the system proposes to the students the activity which makes them progress faster. We introduce two…

Atypical pyoderma gangrenosum mimicking an infectious process.

PubMed

To, Derek; Wong, Aaron; Montessori, Valentina

2014-01-01

We present a patient with atypical pyoderma gangrenosum (APG), which involved the patient's arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics.

Can an Ankle-Foot Orthosis Change Hearts and Minds?

DTIC Science & Technology

2011-01-01

the commercial brace in both comfort and function. He continued to progress in his therapy, returning to recre- ational softball with a local team of...this design, we have been able to return patients with fused ankles to running, basketball, softball , skydiving, and combat arms deployments. We have

For Choice, Not Chance.

ERIC Educational Resources Information Center

Little, Roger

1981-01-01

A return to the draft under current conditions will retard the armed forces' progress in making military service attractive to men and women volunteers. If an army is to be representative of the society it serves, its social composition is less important than its incorporation of the same social values. (Author/GC)

Neoadjuvant Chemoradiation for Distal Rectal Cancer: 5-Year Updated Results of a Randomized Phase 2 Study of Neoadjuvant Combined Modality Chemoradiation for Distal Rectal Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mohiuddin, Mohammed, E-mail: asemuddin@gmail.com; Paulus, Rebecca; Mitchell, Edith

2013-07-01

Purpose: To assess the efficacy of 2 different approaches to neoadjuvant chemoradiation for distal rectal cancers. Methods and Materials: One hundred six patients with T3/T4 distal rectal cancers were randomized in a phase 2 study. Patients received either continuous venous infusion (CVI) of 5-Fluorouracil (5-FU), 225 mg/m{sup 2} per day, 7 days per week plus pelvic hyperfractionated radiation (HRT), 45.6 Gy at 1.2 Gy twice daily plus a boost of 9.6 to 14.4 Gy for T3 or T4 cancers (Arm 1), or CVI of 5-FU, 225 mg/m{sup 2} per day, Monday to Friday, plus irinotecan, 50 mg/m{sup 2} once weeklymore » × 4, plus pelvic radiation therapy (RT), 45 Gy at 1.8 Gy per day and a boost of 5.4 Gy for T3 and 9 Gy for T4 cancers (Arm 2). Surgery was performed 4 to 10 weeks later. Results: All eligible patients (n=103) are included in this analysis; 2 ineligible patients were excluded, and 1 patient withdrew consent. Ninety-eight of 103 patients (95%) underwent resection. Four patients did not undergo surgery for either disease progression or patient refusal, and 1 patient died during induction chemotherapy. The median time of follow-up was 6.4 years in Arm 1 and 7.0 years in Arm 2. The pathological complete response (pCR) rates were 30% in Arm 1 and 26% in Arm 2. Locoregional recurrence rates were 16% in Arm 1 and 17% in Arm 2. Five-year survival rates were 61% and 75% and Disease-specific survival rates were 78% and 85% for Arm1 and Arm 2, respectively. Five second primaries occurred in patients on Arm 1, and 1 second primary occurred in Arm 2. Conclusions: High rates of disease-specific survival were seen in each arm. Overall survival appears affected by the development of unrelated second cancers. The high pCR rates with 5-FU and higher dose radiation in T4 cancers provide opportunity for increased R0 resections and improved survival.« less

Self-recognition mechanism between skin and suckers prevents octopus arms from interfering with each other.

PubMed

Nesher, Nir; Levy, Guy; Grasso, Frank W; Hochner, Binyamin

2014-06-02

Controlling movements of flexible arms is a challenging task for the octopus because of the virtually infinite number of degrees of freedom (DOFs) [1, 2]. Octopuses simplify this control by using stereotypical motion patterns that reduce the DOFs, in the control space, to a workable few [2]. These movements are triggered by the brain and are generated by motor programs embedded in the peripheral neuromuscular system of the arm [3-5]. The hundreds of suckers along each arm have a tendency to stick to almost any object they contact [6-9]. The existence of this reflex could pose significant problems with unplanned interactions between the arms if not appropriately managed. This problem is likely to be accentuated because it is accepted that octopuses are "not aware of their arms" [10-14]. Here we report of a self-recognition mechanism that has a novel role in motor control, restraining the arms from interfering with each other. We show that the suckers of amputated arms never attach to octopus skin because a chemical in the skin inhibits the attachment reflex of the suckers. The peripheral mechanism appears to be overridden by central control because, in contrast to amputated arms, behaving octopuses sometime grab amputated arms. Surprisingly, octopuses seem to identify their own amputated arms, as they treat arms of other octopuses like food more often than their own. This self-recognition mechanism is a novel peripheral component in the embodied organization of the adaptive interactions between the octopus's brain, body, and environment [15, 16]. Copyright © 2014 Elsevier Ltd. All rights reserved.

Modal analysis and control of flexible manipulator arms. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Neto, O. M.

1974-01-01

The possibility of modeling and controlling flexible manipulator arms was examined. A modal approach was used for obtaining the mathematical model and control techniques. The arm model was represented mathematically by a state space description defined in terms of joint angles and mode amplitudes obtained from truncation on the distributed systems, and included the motion of a two link two joint arm. Three basic techniques were used for controlling the system: pole allocation with gains obtained from the rigid system with interjoint feedbacks, Simon-Mitter algorithm for pole allocation, and sensitivity analysis with respect to parameter variations. An improvement in arm bandwidth was obtained. Optimization of some geometric parameters was undertaken to maximize bandwidth for various payload sizes and programmed tasks. The controlled system is examined under constant gains and using the nonlinear model for simulations following a time varying state trajectory.

An agent-vector-host-environment model for controlling small arms and light weapons.

PubMed

Pinto, Andrew D; Sharma, Malika; Muggah, Robert

2011-05-01

Armed violence is a significant public health problem. It results in fatal and non-fatal injuries and disrupts social and economic processes that are essential to the health of individuals and communities. We argue that an agent-vector-host-environment model can be helpful in understanding and describing the availability and misuse of small arms and light weapons. Moreover, such a model can assist in identifying potential control points and in developing mitigation strategies. These concepts have been developed from analogous vector control programs and are applied to controlling arms to reduce their misuse. So-called 'denormalization' and 'de-legitimization' campaigns that focus on the vector - including the industry producing these commodities - can be based on the experience of public health in controlling tobacco use and exposure. This model can assist health professionals, civil society and governments in developing comprehensive strategies to limit the production, distribution and misuse of small arms and light weapons.

SciDAC's Earth System Grid Center for Enabling Technologies Semiannual Progress Report October 1, 2010 through March 31, 2011

DOE Office of Scientific and Technical Information (OSTI.GOV)

Williams, Dean N.

2011-04-02

This report summarizes work carried out by the Earth System Grid Center for Enabling Technologies (ESG-CET) from October 1, 2010 through March 31, 2011. It discusses ESG-CET highlights for the reporting period, overall progress, period goals, and collaborations, and lists papers and presentations. To learn more about our project and to find previous reports, please visit the ESG-CET Web sites: http://esg-pcmdi.llnl.gov/ and/or https://wiki.ucar.edu/display/esgcet/Home. This report will be forwarded to managers in the Department of Energy (DOE) Scientific Discovery through Advanced Computing (SciDAC) program and the Office of Biological and Environmental Research (OBER), as well as national and international collaborators andmore » stakeholders (e.g., those involved in the Coupled Model Intercomparison Project, phase 5 (CMIP5) for the Intergovernmental Panel on Climate Change (IPCC) 5th Assessment Report (AR5); the Community Earth System Model (CESM); the Climate Science Computational End Station (CCES); SciDAC II: A Scalable and Extensible Earth System Model for Climate Change Science; the North American Regional Climate Change Assessment Program (NARCCAP); the Atmospheric Radiation Measurement (ARM) program; the National Aeronautics and Space Administration (NASA), the National Oceanic and Atmospheric Administration (NOAA)), and also to researchers working on a variety of other climate model and observation evaluation activities. The ESG-CET executive committee consists of Dean N. Williams, Lawrence Livermore National Laboratory (LLNL); Ian Foster, Argonne National Laboratory (ANL); and Don Middleton, National Center for Atmospheric Research (NCAR). The ESG-CET team is a group of researchers and scientists with diverse domain knowledge, whose home institutions include eight laboratories and two universities: ANL, Los Alamos National Laboratory (LANL), Lawrence Berkeley National Laboratory (LBNL), LLNL, NASA/Jet Propulsion Laboratory (JPL), NCAR, Oak Ridge National Laboratory (ORNL), Pacific Marine Environmental Laboratory (PMEL)/NOAA, Rensselaer Polytechnic Institute (RPI), and University of Southern California, Information Sciences Institute (USC/ISI). All ESG-CET work is accomplished under DOE open-source guidelines and in close collaboration with the project's stakeholders, domain researchers, and scientists. Through the ESG project, the ESG-CET team has developed and delivered a production environment for climate data from multiple climate model sources (e.g., CMIP (IPCC), CESM, ocean model data (e.g., Parallel Ocean Program), observation data (e.g., Atmospheric Infrared Sounder, Microwave Limb Sounder), and analysis and visualization tools) that serves a worldwide climate research community. Data holdings are distributed across multiple sites including LANL, LBNL, LLNL, NCAR, and ORNL as well as unfunded partners sites such as the Australian National University (ANU) National Computational Infrastructure (NCI), the British Atmospheric Data Center (BADC), the Geophysical Fluid Dynamics Laboratory/NOAA, the Max Planck Institute for Meteorology (MPI-M), the German Climate Computing Centre (DKRZ), and NASA/JPL. As we transition from development activities to production and operations, the ESG-CET team is tasked with making data available to all users who want to understand it, process it, extract value from it, visualize it, and/or communicate it to others. This ongoing effort is extremely large and complex, but it will be incredibly valuable for building 'science gateways' to critical climate resources (such as CESM, CMIP5, ARM, NARCCAP, Atmospheric Infrared Sounder (AIRS), etc.) for processing the next IPCC assessment report. Continued ESG progress will result in a production-scale system that will empower scientists to attempt new and exciting data exchanges, which could ultimately lead to breakthrough climate science discoveries.« less

Prostate-Specific Antigen Persistence After Radical Prostatectomy as a Predictive Factor of Clinical Relapse-Free Survival and Overall Survival: 10-Year Data of the ARO 96-02 Trial

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wiegel, Thomas, E-mail: thomas.wiegel@uniklinik-ulm.de; Bartkowiak, Detlef; Bottke, Dirk

2015-02-01

Objective: The ARO 96-02 trial primarily compared wait-and-see (WS, arm A) with adjuvant radiation therapy (ART, arm B) in prostate cancer patients who achieved an undetectable prostate-specific antigen (PSA) after radical prostatectomy (RP). Here, we report the outcome with up to 12 years of follow-up of patients who retained a post-RP detectable PSA and received salvage radiation therapy (SRT, arm C). Methods and Materials: For the study, 388 patients with pT3-4pN0 prostate cancer with positive or negative surgical margins were recruited. After RP, 307 men achieved an undetectable PSA (arms A + B). In 78 patients the PSA remained above thresholds (median 0.6,more » range 0.05-5.6 ng/mL). Of the latter, 74 consented to receive 66 Gy to the prostate bed, and SRT was applied at a median of 86 days after RP. Clinical relapse-free survival, metastasis-free survival, and overall survival were determined by the Kaplan-Meier method. Results: Patients with persisting PSA after RP had higher preoperative PSA values, higher tumor stages, higher Gleason scores, and more positive surgical margins than did patients in arms A + B. For the 74 patients, the 10-year clinical relapse-free survival rate was 63%. Forty-three men had hormone therapy; 12 experienced distant metastases; 23 patients died. Compared with men who did achieve an undetectable PSA, the arm-C patients fared significantly worse, with a 10-year metastasis-free survival of 67% versus 83% and overall survival of 68% versus 84%, respectively. In Cox regression analysis, Gleason score ≥8 (hazard ratio [HR] 2.8), pT ≥ 3c (HR 2.4), and extraprostatic extension ≥2 mm (HR 3.6) were unfavorable risk factors of progression. Conclusions: A persisting PSA after prostatectomy seems to be an important prognosticator of clinical progression for pT3 tumors. It correlates with a higher rate of distant metastases and with worse overall survival. A larger prospective study is required to determine which patient subgroups will benefit most from which treatment option.« less

Quality of life analyses from the randomized, open-label, phase III PointBreak study of pemetrexed-carboplatin-bevacizumab followed by maintenance pemetrexed-bevacizumab versus paclitaxel-carboplatin-bevacizumab followed by maintenance bevacizumab in patients with stage IIIB or IV nonsquamous non-small-cell lung cancer.

PubMed

Spigel, David R; Patel, Jyoti D; Reynolds, Craig H; Garon, Edward B; Hermann, Robert C; Govindan, Ramaswamy; Olsen, Mark R; Winfree, Katherine B; Chen, Jian; Liu, Jingyi; Guba, Susan C; Socinski, Mark A; Bonomi, Philip

2015-02-01

Treatment impact on quality of life (QoL) informs treatment management decisions in advanced nonsquamous non-small-cell lung cancer (NS NSCLC). QoL outcomes from the phase III PointBreak trial are reported. Chemonaive patients (n = 939) with stage IIIB/IV nonsquamous non-small-cell lung cancer and Eastern Cooperative Oncology Group performance status 0 to 1 were randomized (1:1) to pemetrexed-carboplatin-bevacizumab (pemetrexed arm) or paclitaxel-carboplatin-bevacizumab (paclitaxel arm). Patients without progressive disease received maintenance pemetrexed-bevacizumab (pemetrexed arm) or bevacizumab (paclitaxel arm). QoL was assessed using Functional Assessment of Cancer Therapy (FACT)-General (FACT-G), FACT-Lung (FACT-L), and FACT/Gynecologic Oncology Group-Neurotoxicity (FACT-Ntx) instruments. Subscale scores, total scores, and trial outcome indices were analyzed using linear mixed-effects models. Post hoc analyses examined the association between baseline FACT scores and overall survival (OS). Mean score differences in change from baseline significantly favored the pemetrexed arm for the neurotoxicity subscale score, FACT-Ntx total scores, and FACT-Ntx trial outcome index. They occurred at cycle 2 (p < 0.001) and persisted through induction cycles 2 to 4 and six maintenance cycles. Investigator-assessed, qualitative, drug-related differences in grade 2 (1.6% versus 10.6%) and grade 3 (0.0% versus 4.1%) sensory neuropathy and grade 3/4 fatigue (10.9% versus 5.0%, p = 0.0012) were observed between the pemetrexed and paclitaxel arms. Baseline FACT-G, FACT-L, and FACT-Ntx scores were significant prognostic factors for OS (p < 0.001). Randomized patients reported similar changes in QoL, except for less change from baseline in neurotoxicity on the pemetrexed arm; investigators reported greater neurotoxicity on the paclitaxel arm and greater fatigue on the pemetrexed arm. Higher baseline FACT scores were favorable prognostic factors for OS.

Neutrinos and dark matter in the Black Hills

NASA Astrophysics Data System (ADS)

McMahan Norris, Margaret; Sayler, Bentley

2010-02-01

Where in the U.S. could you walk into a hardware store and be asked about neutrinos? It happens regularly in the Black Hills of South Dakota, where preliminary design is in progress for the Deep Underground Science and Engineering Laboratory (DUSEL), a planned NSF Major Research Experimental Facility Construction (MREFC) initiative to be located at the former Homestake gold mine in Lead, SD. DUSEL has physicists buzzing too, as the particle, astro-, and nuclear physics communities have all identified the need for a new laboratory deep beneath the Earth's surface to address some of the most compelling, transformational science at the frontiers of their disciplines. Elusive particles such as neutrinos and WIMPS (a possible candidate for dark matter) -- though they spark the imagination - are equally elusive when trying to explain to students and the public. That will be the task of the Sanford Center for Science Education, planned to be the education arm of DUSEL. Early prototypes of future programs at the education center are now under development, ranging from professional development for teachers to classroom tours to working with American Indian educators. These programs, which are building capacity for the future education center, will be discussed. )

The corporate determinants of health: how big business affects our health, and the need for government action!

PubMed

Millar, John S

2013-05-14

Corporations have a great effect on the health of Canadians.Good companies create jobs, sell valued products at market value, pay a living wage, empower employees, have progressive human resource policies (parental, mental health leaves, workplace wellness programs, day care), and pay their appropriate corporate taxes. They embrace corporate social responsibility and some have a triple bottom line - people, planet and profits. More good corporations are needed.But others are selling products that are damaging to health and the environment, at prices that do not account for these damaging effects and often target consumers that are ill-informed and susceptible (e.g., children). These include businesses involving tobacco, alcohol, drugs, junk foods and beverages, resource extraction, arms production and the electronic media.Governments have a responsibility to take action when the market mechanism fails in this way.A priority for action is the food and beverage sector. The overconsumption of sugar, fat and salt is causing a rising prevalence of all the major chronic diseases, rising health care costs and declining population health and productivity. Urgent government action is required: taxation, advertising and sales restrictions, and a salt reduction program.

Oral language supports early literacy: a pilot cluster randomized trial in disadvantaged schools.

PubMed

Snow, Pamela C; Eadie, Patricia A; Connell, Judy; Dalheim, Brenda; McCusker, Hugh J; Munro, John K

2014-10-01

This study examined the impact of teacher professional development aimed at improving the capacity of primary teachers in disadvantaged schools to strengthen children's expressive and receptive oral language skills and early literacy success in the first 2 years of school. Fourteen low-SES schools in Victoria, Australia were randomly allocated to a research (n = 8) or control arm (n = 6), resulting in an initial sample of 1254 students, (n = 602 in research arm and n = 652 in control arm). The intervention comprised 6 days of teacher and principal professional development (delivered by language and literacy experts), school-based continuing contact with the research team and completion by one staff member of each research school of a postgraduate unit on early language and literacy. Schools in the control arm received standard teaching according to state auspiced curriculum guidelines. Full data were available on 979 students at follow-up (time 2). Students in the research arm performed significantly better on Test of Language Development: Primary (Fourth Edition) sub-tests (p ≤ .002) and the Reading Progress Test (F = 10.4(1); p = .001) than students in the control arm at time 2. Narrative scores were not significantly different at time 2, although students in research schools showed greater gains. Findings provide "proof of concept" for this approach, and are discussed with respect to implications for teacher professional development and pre-service education concerning the psycholinguistic competencies that underpin the transition to literacy.

U.S. Food and Drug Administration Approval Summary: Ramucirumab for the Treatment of Metastatic Non-Small Cell Lung Cancer Following Disease Progression On or After Platinum-Based Chemotherapy.

PubMed

Larkins, Erin; Scepura, Barbara; Blumenthal, Gideon M; Bloomquist, Erik; Tang, Shenghui; Biable, Missiratch; Kluetz, Paul; Keegan, Patricia; Pazdur, Richard

2015-11-01

On December 12, 2014, the U.S. Food and Drug Administration (FDA) approved ramucirumab for use in combination with docetaxel for the treatment of patients with metastatic non-small cell lung cancer (NSCLC) with disease progression on or after platinum-based chemotherapy. Patients with epidermal growth factor receptor or anaplastic lymphoma kinase genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving ramucirumab. This approval was based on an improvement in overall survival (OS) with an acceptable toxicity profile in a randomized, multicenter, double-blinded, placebo-controlled trial of 1,253 patients with metastatic NSCLC previously treated with a platinum-based combination therapy. Patients were randomized 1:1 to receive either ramucirumab in combination with docetaxel or placebo in combination with docetaxel. The primary endpoint was OS. Patients who received ramucirumab in combination with docetaxel had improved OS (hazard ratio [HR]: 0.86; 95% confidence interval [CI]: 0.75, 0.98). Median OS was 10.5 months on the ramucirumab plus docetaxel arm versus 9.1 months on the placebo plus docetaxel arm. The most frequent (≥ 30%) adverse reactions in ramucirumab-treated patients were fatigue, neutropenia, and diarrhea. The most frequent (≥ 5%) grade 3 and 4 adverse reactions in the ramucirumab arm were fatigue, neutropenia, febrile neutropenia, leukopenia, and hypertension. This report presents key information on the U.S. Food and Drug Administration approval of ramucirumab, a monoclonal antibody targeting vascular endothelial growth factor receptor-2, given in combination with docetaxel for the treatment of patients with metastatic non-small cell lung cancer whose disease has progressed on or after platinum-based chemotherapy. This report specifically addresses the issues of safety in patients with squamous cell tumors, effect of treatment in elderly patients, and uncertainties regarding effects in patients with tumors harboring epidermal growth factor receptor or anaplastic lymphoma kinase genomic tumor aberrations. ©AlphaMed Press.

Phase II trial of pirfenidone in children and young adults with neurofibromatosis type 1 and progressive plexiform neurofibromas.

PubMed

Widemann, Brigitte C; Babovic-Vuksanovic, Dusica; Dombi, Eva; Wolters, Pamela L; Goldman, Stewart; Martin, Staci; Goodwin, Anne; Goodspeed, Wendy; Kieran, Mark W; Cohen, Bruce; Blaney, Susan M; King, Allison; Solomon, Jeffrey; Patronas, Nicholas; Balis, Frank M; Fox, Elizabeth; Steinberg, Seth M; Packer, Roger J

2014-09-01

Pirfenidone, an oral anti-inflammatory, antifibrotic agent with activity in idiopathic pulmonary fibrosis, may mediate anti-tumor activity in neurofibromatosis type 1 (NF1) and plexiform neurofibromas (PN) by inhibition of fibroblast proliferation and collagen synthesis. The primary objective of this open label, single arm phase II trial was to evaluate the activity of pirfenidone in children and young adults with inoperable PN. Patients (3-21 years) with NF1-related progressive PN received pirfenidone at the previously determined optimal dose (500 mg/m(2) orally, q8h) on a continuous dosing schedule (one cycle = 28 days). Volumetric MRI analysis was used to assess response. Progression was defined as ≥ 20% PN volume increase compared to baseline. Pirfenidone would be considered active if it doubled the median time to progression (TTP) compared to the TTP on the placebo arm of a phase II trial with the farnesyltransferase inhibitor tipifarnib, which used near identical eligibility criteria. Toxicities, objective response rate, and quality of life (QOL) also were evaluated. Thirty-six patients were enrolled and tolerated pirfenidone well with intermittent nausea and vomiting as the most frequent toxicities. A dose reduction was required in only three patients. The median TTP for pirfenidone was 13.2 months compared to 10.6 months for the placebo control group from the tipifarnib trial (two-tailed P = 0.92; one-tailed P = 0.46). No objective responses were observed. Pirfenidone was well tolerated, but did not demonstrate activity as defined in this trial and does not warrant further evaluation in children with NF1 and progressive PN. © 2014 Wiley Periodicals, Inc.

Arming Yourself for the Annual Tax Battle.

ERIC Educational Resources Information Center

Pearlman, Dara

1984-01-01

Discusses tax preparation and planning programs for microcomputers, including how programs save time and money, how they may or may not perform calculations accurately, how they compare to services offered by professional tax preparers, and the deduction of software costs. Ten tax programs are listed and described. (MBR)

Autonomous Space Processor for Orbital Debris (ASPOD)

NASA Technical Reports Server (NTRS)

Ramohalli, Kumar; Mitchell, Dominique; Taft, Brett

1992-01-01

A project in the Advanced Design Program at the University of Arizona is described. The project is named the Autonomous Space Processor for Orbital Debris (ASPOD) and is a Universities Space Research Association (USRA) sponsored design project. The development of ASPOD and the students' abilities in designing and building a prototype spacecraft are the ultimate goals of this project. This year's focus entailed the development of a secondary robotic arm and end-effector to work in tandem with an existent arm in the removal of orbital debris. The new arm features the introduction of composite materials and a linear drive system, thus producing a light-weight and more accurate prototype. The main characteristic of the end-effector design is that it incorporates all of the motors and gearing internally, thus not subjecting them to the harsh space environment. Furthermore, the arm and the end-effector are automated by a control system with positional feedback. This system is composed of magnetic and optical encoders connected to a 486 PC via two servo-motor controller cards. Programming a series of basic routines and sub-routines allowed the ASPOD prototype to become more autonomous. The new system is expected to perform specified tasks with a positional accuracy of 0.5 cm.

Effect of Gravity on Robot-Assisted Motor Training After Chronic Stroke: A Randomized Trial

PubMed Central

Conroy, Susan S.; Whitall, Jill; Dipietro, Laura; Jones-Lush, Lauren M.; Zhan, Min; Finley, Margaret A.; Wittenberg, George F.; Krebs, Hermano I.; Bever, Christopher T.

2015-01-01

Objectives To determine the efficacy of 2 distinct 6-week robot-assisted reaching programs compared with an intensive conventional arm exercise program (ICAE) for chronic, stroke-related upper-extremity (UE) impairment. To examine whether the addition of robot-assisted training out of the horizontal plane leads to improved outcomes. Design Randomized controlled trial, single-blinded, with 12-week follow-up. Setting Research setting in a large medical center. Participants Adults (N=62) with chronic, stroke-related arm weakness stratified by impairment severity using baseline UE motor assessments. Interventions Sixty minutes, 3 times a week for 6 weeks of robot-assisted planar reaching (gravity compensated), combined planar with vertical robot-assisted reaching, or intensive conventional arm exercise program. Main Outcome Measure UE Fugl-Meyer Assessment (FMA) mean change from baseline to final training. Results All groups showed modest gains in the FMA from baseline to final with no significant between group differences. Most change occurred in the planar robot group (mean change ± SD, 2.94± 0.77; 95% confidence interval [CI], 1.40 – 4.47). Participants with greater motor impairment (n=41) demonstrated a larger difference in response (mean change ± SD, 2.29±0.72; 95% CI, 0.85–3.72) for planar robot-assisted exercise compared with the intensive conventional arm exercise program (mean change ± SD, 0.43±0.72; 95% CI, −1.00 to 1.86). Conclusions Chronic UE deficits because of stroke are responsive to intensive motor task training. However, training outside the horizontal plane in a gravity present environment using a combination of vertical with planar robots was not superior to training with the planar robot alone. PMID:21849168

RMS massless arm dynamics capability in the SVDS. [equations of motion

NASA Technical Reports Server (NTRS)

Flanders, H. A.

1977-01-01

The equations of motion for the remote manipulator system, assuming that the masses and inertias of the arm can be neglected, are developed for implementation into the space vehicle dynamics simulation (SVDS) program for the Orbiter payload system. The arm flexibility is incorporated into the equations by the computation of flexibility terms for use in the joint servo model. The approach developed in this report is based on using the Jacobian transformation matrix to transform force and velocity terms between the configuration space and the task space to simplify the form of the equations.

Satellite Data Support for the ARM Climate Research Facility, 8/01/2009 - 7/31/2015

DOE Office of Scientific and Technical Information (OSTI.GOV)

Minnis, Patrick; Khaiyer, Mandana M

This report summarizes the support provided by NASA Langley Research for the DOE ARM Program in the form of cloud and radiation products derived from satellite imager data for the period between 8/01/09 through 7/31/15. Cloud properties such as cloud amount, height, and optical depth as well as outgoing longwave and shortwave broadband radiative fluxes were derived from geostationary and low-earth orbiting satellite imager radiance measurements for domains encompassing ARM permanent sites and field campaigns during the performance period. Datasets provided and documents produced are listed.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-10

The Orion crew access arm is secured on a flatbed transporter for its move from a storage location at NASA's Kennedy Space Center in Florida to the mobile launcher (ML) tower near the Vehicle Assembly Building at the center. The crew access arm will be installed at about the 274-foot level on the mobile launcher tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

USAWC (US Army War College) Military Studies Program Paper. An Investigation of the Value of Taiwan To Future United States Relations with the People’s Republic of China.

DTIC Science & Technology

1986-02-18

instrum-ent of power in future U.S.- PRC relations. During the 1949-1978 timeframe, U.S.-PRC relations ran the gamut from armed conflict in the Korean...PRC relations ran the gamut from armed conflict in the Korean War to diplomatic relations declared in 1978. The first thawing in relations occurred...PRC relations. US-PRC relations during the 1949-1978 timeframe ran the gamut frou armed conflict during the Korean War to diplomatic recognition. With

New PD-L1 inhibitors in non-small cell lung cancer - impact of atezolizumab.

PubMed

Seetharamu, Nagashree; Preeshagul, Isabel R; Sullivan, Kevin M

2017-01-01

The era of immunotherapy has changed the face of how we approach treatment for many oncologic and hematologic malignancies. Lung cancer has been in the forefront of checkpoint inhibition for the past 2 years and has paved the path for other subspecialties. While PD-1 inhibitors nivolumab and pembrolizumab have been approved for non-small cell lung cancer (NSCLC), this review focuses on atezolizumab, its landmark studies, and ongoing trials. Atezolizumab is the first programmed death ligand 1 (PD-L1) inhibitor to receive US Food and Drug Administration (FDA) approval for metastatic NSCLC patients who have progressed on frontline chemotherapy. This approval was based on two open-label Phase II multicenter trials, POPLAR (NCT01903993) and BIRCH (NCT02031458). Both studies revealed a benefit in overall survival (OS), progression-free survival, and response rate in the atezolizumab arm when compared to single-agent docetaxol. There were also fewest Grade 3-5 treatment-related adverse events (TRAEs) in the atezolizumab cohort. The open-label randomized Phase III OAK trial (NCT02008227) further established the role of atezolizumab in previously treated NSCLC. This study compared atezolizumab with docetaxel in patients with advanced NSCLC (squamous or nonsquamous histologies) who had progressed on one to two prior chemotherapy regimens. OS in the PD-L1-enriched population was superior in the atezolizumab arm (n=241) at 15.7 months compared with docetaxel (n=222) at 10.3 months (hazard ratio [HR] 0.74, 95% confidence interval [CI] 0.58-0.93; p =0.0102). Patients lacking PD-L1 also had survival benefit with atezolizumab with a median OS (mOS) of 12.6 months versus 8.9 months with chemotherapy (HR 0.75, 95% CI 0.59-0.96). Benefit was noted in both squamous and nonsquamous NSCLC subsets and regardless of PD-L1 expressivity. As seen in the POPLAR and BIRCH studies, the toxicity profile was significantly better with immunotherapy. The future is unfolding rapidly as new checkpoint inhibitors are gaining FDA approval. It is still not known if these agents will be used in combination with chemotherapy, with other immune-modulating agents, radiation therapy, or all of the above. The results of these studies investigating their use in combination with chemotherapy agents, with other immunotherapy agents such as CTLA-4 inhibitors, and with radiation therapy, are eagerly awaited.

Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation

PubMed Central

Smeets, Rob Johannes Elise Marie; Seelen, Henk Alexander Maria

2017-01-01

Background Arm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated. Method This single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge. Results Eighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation. Conclusions A majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies. PMID:28614403

The effects of mirror therapy on arm and hand function in subacute stroke in patients.

PubMed

Radajewska, Alina; Opara, Józef A; Kucio, Cezary; Błaszczyszyn, Monika; Mehlich, Krzysztof; Szczygiel, Jarosław

2013-09-01

The aim of this study was to evaluate the effect of mirror therapy on arm and hand function in subacute stroke in patients. The study included 60 hemiparetic right-handed patients after ischemic stroke 8-10 weeks after onset. They underwent stationary comprehensive rehabilitation in the rehabilitation centre. They were divided into two randomly assigned groups: mirror (n=30) and control (n=30). For both groups, two subgroups were created: one that included patients with right arm paresis (n=15) and the other that included patients with left arm paresis (n=15). The mirror group received an additional intervention: training with a mirror for 5 days/week, 2 sessions/day, for 21 days. Each single session lasted for 15 min. The control group (n=30) underwent a conventional rehabilitation program without mirror therapy. To evaluate self-care in performing activities of daily living, the Functional Index 'Repty' was used. To evaluate hand and arm function, the Frenchay Arm Test and the Motor Status Score were used. Measurements were performed twice: before and after 21 days of applied rehabilitation. No significant improvement in hand and arm function in both subgroups in Frenchay Arm Test and Motor Status Score scales was observed. However, there was a significant improvement in self-care of activities of daily living in the right arm paresis subgroup in the mirror group measured using the Functional Index 'Repty'. Mirror therapy improves self-care of activities of daily living for patients with right arm paresis after stroke.

Employee engagement factors that affect enrollment compared with retention in two coaching programs--the ACTIVATE study.

PubMed

Terry, Paul E; Fowles, Jinnet B; Harvey, Lisa

2010-06-01

This article describes enrollment and retention results from a randomized controlled trial that tested differences between a traditional worksite health promotion program and an activated consumer program on health behaviors and health status. A control arm was included. Baseline survey and clinical data were collected from 631 of 1628 eligible employees (39% response rate) between March and June of 2005. Retention data were collected in March 2007-12 months into an 18-month program. At baseline, participants in the 6 groups (3 arms in each of 2 companies) were comparable in health status but not in patient activation status. Enrollment of high-risk employees into the 2 individualized coaching programs (one focused on traditional health promotion, the other focused on activated consumer navigation) varied significantly by industry type, smoking status, and patient activation. In contrast, retention in the coaching programs was related to sex, age, and industry type. Our findings suggest that one set of strategies may be needed to encourage program enrollment while a distinctly different set of strategies may be needed to sustain participation.

KSC-2009-5542

NASA Image and Video Library

2009-10-20

CAPE CANAVERAL, Fla. - Poised inside Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, the Ares I-X rocket's upper stage is adorned with the American flag, NASA logo, and the logos of the Constellation Program, Ares, and Ares I-X. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, along with the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. Part of the Constellation Program, the Ares I-X is the test vehicle for the Ares I. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

Prospective randomized double-blind multicentre phase II study comparing gemcitabine and cisplatin plus sorafenib chemotherapy with gemcitabine and cisplatin plus placebo in locally advanced and/or metastasized urothelial cancer: SUSE (AUO-AB 31/05).

PubMed

Krege, Susanne; Rexer, Heidrun; vom Dorp, Frank; de Geeter, Patrick; Klotz, Theodor; Retz, Margitte; Heidenreich, Axel; Kühn, Michael; Kamradt, Joern; Feyerabend, Susan; Wülfing, Christian; Zastrow, Stefan; Albers, Peter; Hakenberg, Oliver; Roigas, Jan; Fenner, Martin; Heinzer, Hans; Schrader, Mark

2014-03-01

To evaluate the efficacy and safety of gemcitabine and cisplatin in combination with sorafenib, a tyrosine-kinase inhibitor, compared with chemotherapy alone as first-line treatment in advanced urothelial cancer. The study was a randomized phase II trial. Its primary aim was to show an improvement in progression-free survival (PFS) of 4.5 months by adding sorafenib to conventional chemotherapy. Secondary objectives were objective response rate (ORR), overall survival (OS) and toxicity. The patients included in the trial had histologically confirmed locally advanced and/or metastatic urothelial cancer of the bladder or upper urinary tract. Chemotherapy with gemcitabine (1250 mg/qm on days 1 and 8) and cisplatin (70 mg/qm on day 1) repeated every 21 days, was administered to all patients in a double-blind randomization of additional sorafenib (400 mg twice daily) vs placebo (two tablets twice daily) on days 3-21. Treatment continued until progression or unacceptable toxicity, the maximum number of cycles was limited to eight. The response assessment was repeated after every two cycles. Between October 2006 and October 2010, 98 of 132 planned patients were recruited. Nine patients were ineligible. The final analysis included 40 patients in the sorafenib and 49 patients in the placebo arm. There were no significant differences between the two arms concerning ORR (sorafenib: complete response [CR] 12.5%, partial response [PR] 40%; placebo: CR 12%, PR 35%), median PFS (sorafenib: 6.3 months, placebo: 6.1 months) or OS (sorafenib: 11.3 months, placebo: 10.6 months). Toxicity was moderately higher in the sorafenib arm. Diarrrhoea occurred significantly more often in the sorafenib arm and hand-foot syndrome occurred only in the sorafenib arm. The study was closed prematurely because of slow recruitment. Although the addition of sorafenib to standard chemotherapy showed acceptable toxicity, the trial failed to show a 4.5 months improvement in PFS. © 2013 The Authors. BJU International © 2013 BJU International.

Progressive skeletal benefits of physical activity when young as assessed at the midshaft humerus in male baseball players.

PubMed

Warden, S J; Weatherholt, A M; Gudeman, A S; Mitchell, D C; Thompson, W R; Fuchs, R K

2017-07-01

Physical activity benefits the skeleton, but there is contrasting evidence regarding whether benefits differ at different stages of growth. The current study demonstrates that physical activity should be encouraged at the earliest age possible and be continued into early adulthood to gain most skeletal benefits. The current study explored physical activity-induced bone adaptation at different stages of somatic maturity by comparing side-to-side differences in midshaft humerus properties between male throwing athletes and controls. Throwers present an internally controlled model, while inclusion of control subjects removes normal arm dominance influences. Throwing athletes (n = 90) and controls (n = 51) were categorized into maturity groups (pre, peri, post-early, post-mid, and post-late) based on estimated years from peak height velocity (<-2, -2 to 2, 2 to 4, 4 to 10, and >10 years). Side-to-side percent differences in midshaft humerus cortical volumetric bone mineral density (Ct.vBMD) and bone mineral content (Ct.BMC); total (Tt.Ar), medullary (Me.Ar), and cortical (Ct.Ar) areas; average cortical thickness (Ct.Th); and polar Strength Strain Index (SSI P ) were assessed. Significant interactions between physical activity and maturity on side-to-side differences in Ct.BMC, Tt.Ar, Ct.Ar, Me.Ar, Ct.Th, and SSI P resulted from the following: (1) greater throwing-to-nonthrowing arm differences than dominant-to-nondominant arm differences in controls (all p < 0.05) and (2) throwing-to-nonthrowing arm differences in throwers being progressively greater across maturity groups (all p < 0.05). Regional analyses revealed greatest adaptation in medial and lateral sectors, particularly in the three post-maturity groups. Years throwing predicted 59% of the variance of the variance in throwing-to-nonthrowing arm difference in SSI P (p < 0.001). These data suggest that physical activity has skeletal benefits beginning prior to and continuing beyond somatic maturation and that a longer duration of exposure to physical activity has cumulative skeletal benefits. Thus, physical activity should be encouraged at the earliest age possible and be continued into early adulthood to optimize skeletal benefits.

Efficacy and safety of nilotinib in patients with KIT-mutated metastatic or inoperable melanoma: final results from the global, single-arm, phase II TEAM trial.

PubMed

Guo, J; Carvajal, R D; Dummer, R; Hauschild, A; Daud, A; Bastian, B C; Markovic, S N; Queirolo, P; Arance, A; Berking, C; Camargo, V; Herchenhorn, D; Petrella, T M; Schadendorf, D; Sharfman, W; Testori, A; Novick, S; Hertle, S; Nourry, C; Chen, Q; Hodi, F S

2017-06-01

The single-arm, phase II Tasigna Efficacy in Advanced Melanoma (TEAM) trial evaluated the KIT-selective tyrosine kinase inhibitor nilotinib in patients with KIT-mutated advanced melanoma without prior KIT inhibitor treatment. Forty-two patients with KIT-mutated advanced melanoma were enrolled and treated with nilotinib 400 mg twice daily. TEAM originally included a comparator arm of dacarbazine (DTIC)-treated patients; the design was amended to a single-arm trial due to an observed low number of KIT-mutated melanomas. Thirteen patients were randomized to DTIC before the protocol amendment removing this study arm. The primary endpoint was objective response rate (ORR), determined according to Response Evaluation Criteria In Solid Tumors. ORR was 26.2% (n = 11/42; 95% CI, 13.9%-42.0%), sufficient to reject the null hypothesis (ORR ≤10%). All observed responses were partial responses (PRs; median response duration, 7.1 months). Twenty patients (47.6%) had stable disease and 10 (23.8%) had progressive disease; 1 (2.4%) response was unknown. Ten of the 11 responding patients had exon 11 mutations, four with an L576P mutation. The median progression-free survival and overall survival were 4.2 and 18.0 months, respectively. Three of the 13 patients on DTIC achieved a PR, and another patient had a PR following switch to nilotinib. Nilotinib activity in patients with advanced KIT-mutated melanoma was similar to historical data from imatinib-treated patients. DTIC treatment showed potential activity, although the low patient number limits interpretation. Similar to previously reported results with imatinib, nilotinib showed greater activity among patients with an exon 11 mutation, including L576P, suggesting that nilotinib may be an effective treatment option for patients with specific KIT mutations. ClinicalTrials.gov, NCT01028222. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Mapping Culturally Relevant Pedagogy into Teacher Education Programs: A Critical Framework

ERIC Educational Resources Information Center

Allen, Ayana; Hancock, Stephen D.; W. Lewis, Chance; Starker-Glass, Tehia

2017-01-01

Background/Context: Teacher education programs are charged with the daunting task of preparing the next generation of teachers. However, the extant literature has documented that teacher education programs have struggled to effectively arm teacher candidates with effective pedagogies to meet the needs of our increasingly diverse student…

Changes in U.S.-International Arms Trade Practices

DTIC Science & Technology

1991-09-01

7 August 1991. 13. Deegan , Lt Cal William F, Jr. Saudi AWACS: American Foreign Policy in Conflict. Research Report Number AU- AWC-86-052. Air War...A135 594). 39. Mallory, Capt Craig J. Program Manager for FS-X, Directorate of Multinational Programs, F-16 Systems Program Office. Personal

41 CFR 60-300.40 - Applicability of the affirmative action program requirement.

Code of Federal Regulations, 2011 CFR

2011-07-01

... affirmative action program requirement. 60-300.40 Section 60-300.40 Public Contracts and Property Management... EMPLOYMENT OPPORTUNITY, DEPARTMENT OF LABOR 300-AFFIRMATIVE ACTION AND NONDISCRIMINATION OBLIGATIONS OF... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Affirmative Action Program § 60-300.40 Applicability of...

41 CFR 60-300.40 - Applicability of the affirmative action program requirement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... affirmative action program requirement. 60-300.40 Section 60-300.40 Public Contracts and Property Management... EMPLOYMENT OPPORTUNITY, DEPARTMENT OF LABOR 300-AFFIRMATIVE ACTION AND NONDISCRIMINATION OBLIGATIONS OF... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Affirmative Action Program § 60-300.40 Applicability of...

Wood Programs. Courseware Evaluation for Vocational and Technical Education.

ERIC Educational Resources Information Center

Kaylor, Robert; And Others

This courseware evaluation rates the Wood Programs software developed by the Iowa Department of Public Instruction. (These programs--not contained in this document--include understanding board feet, wood characteristics, wood safety drill, wood dimensions, wood moisture, operating the table saw, radial arm, measurement drill, fraction drill, and…

RISE-306; State Facilitator Program Evaluation, 1975-1976.

ERIC Educational Resources Information Center

Communication Technology Corp., Marlton, NJ.

As an arm of the National Diffusion Network, the Pennsylvania State Facilitator's responsibilities include informing the schools about Title III approved programs and aiding in the actual adoption of such programs by school districts. Two aspects of the facilitator's role were identified for evaluation: (1) whether the facilitator had implemented…

Detection of Rare Mutations in EGFR-ARMS-PCR-Negative Lung Adenocarcinoma by Sanger Sequencing.

PubMed

Liang, Chaoyue; Wu, Zhuolin; Gan, Xiaohong; Liu, Yuanbin; You, You; Liu, Chenxian; Zhou, Chengzhi; Liang, Ying; Mo, Haiyun; Chen, Allen M; Zhang, Jiexia

2018-01-01

This study aimed to identify potential epidermal growth factor receptor (EGFR) gene mutations in non-small cell lung cancer that went undetected by amplification refractory mutation system-Scorpion real-time PCR (ARMS-PCR). A total of 200 specimens were obtained from the First Affiliated Hospital of Guangzhou Medical University from August 2014 to August 2015. In total, 100 ARMS-negative and 100 ARMS-positive specimens were evaluated for EGFR gene mutations by Sanger sequencing. The methodology and sensitivity of each method and the outcomes of EGFR-tyrosine kinase inhibitor (TKI) therapy were analyzed. Among the 100 ARMS-PCR-positive samples, 90 were positive by Sanger sequencing, while 10 cases were considered negative, because the mutation abundance was less than 10%. Among the 100 negative cases, three were positive for a rare EGFR mutation by Sanger sequencing. In the curative effect analysis of EGFR-TKIs, the progression-free survival (PFS) analysis based on ARMS and Sanger sequencing results showed no difference. However, the PFS of patients with a high abundance of EGFR mutation was 12.4 months [95% confidence interval (CI), 11.6-12.4 months], which was significantly higher than that of patients with a low abundance of mutations detected by Sanger sequencing (95% CI, 10.7-11.3 months) (p<0.001). The ARMS method demonstrated higher sensitivity than Sanger sequencing, but was prone to missing mutations due to primer design. Sanger sequencing was able to detect rare EGFR mutations and deemed applicable for confirming EGFR status. A clinical trial evaluating the efficacy of EGFR-TKIs in patients with rare EGFR mutations is needed. © Copyright: Yonsei University College of Medicine 2018

Defibrotide for the Treatment of Severe Hepatic Veno-Occlusive Disease and Multiorgan Failure after Stem Cell Transplantation: A Multicenter, Randomized, Dose-Finding Trial

PubMed Central

Richardson, Paul G.; Soiffer, Robert J.; Antin, Joseph H.; Uno, Hajime; Jin, Zhezhen; Kurtzberg, Joanne; Martin, Paul L.; Steinbach, Gideon; Murray, Karen F.; Vogelsang, Georgia B.; Chen, Allen R.; Krishnan, Amrita; Kernan, Nancy A.; Avigan, David E.; Spitzer, Thomas R.; Shulman, Howard M.; Di Salvo, Donald N.; Revta, Carolyn; Warren, Diane; Momtaz, Parisa; Bradwin, Gary; Wei, L. J.; Iacobelli, Massimo; McDonald, George B.; Guinan, Eva C.

2010-01-01

Therapeutic options for severe hepatic veno-occlusive disease (VOD) are limited and outcomes are dismal, but early phase I/II studies have suggested promising activity and acceptable toxicity using the novel polydisperse oligonucleotide defibrotide. This randomized phase II dose-finding trial determined the efficacy of defibrotide in patients with severe VOD following hematopoietic stem cell transplantation (HSCT) and identified an appropriate dose for future trials. Adult and pediatric patients received either lower-dose (arm A: 25 mg/kg/day; n = 75) or higher-dose (arm B: 40 mg/kg/day; n = 74) i.v. defibrotide administered in divided doses every 6 hours for ≥ 14 days or until complete response, VOD progression, or any unacceptable toxicity occurred. Overall complete response and day + 100 post-HSCT survival rates were 46% and 42%, respectively, with no significant difference between treatment arms. The incidence of treatment-related adverse events was low (8% overall; 7% in arm A, 10% in arm B); there was no significant difference in the overall rate of adverse events between treatment arms. Early stabilization or decreased bilirubin was associated with better response and day + 100 survival, and decreased plasminogen activator inhibitor type 1 (PAI-1) during treatment was associated with better outcome; changes were similar in both treatment arms. Defibrotide 25 or 40 mg/kg/day also appears effective in treating severe VOD following HSCT. In the absence of any differences in activity, toxicity or changes in PAI-1 level, defibrotide 25 mg/kg/day was selected for ongoing phase III trials in VOD. PMID:20167278

Cockpit Resource Management (CRM) training in the 349th military airlift wing

NASA Technical Reports Server (NTRS)

Halliday, John T.; Biegalski, Conrad S.; Inzana, Anthony

1987-01-01

CRM training can be done on a limited budget. It seems that everyone has a special name for their CRM program. A new program was created and entitled, Aircrew Resource Management (ARM) to emphasize the use of the full resources on our aircraft. That is meant to specifically include the loadmasters. The name also emphasizes the concept that all crewmembers are responsible for safe completion of the trip. The loadmasters have been the brightest students to date. They are a classic under-utilized resource. Together, their crew position has been credited with more ARM saves than the engineers and pilots. The seminar-based program is run by two seminar facilitators that is reinforced by Line Oriented Flight Training sessions run by the active-duty counterparts.

Integrative rehabilitation of residents chronic post-stroke in skilled nursing facilities: the design and evaluation of the BrightArm Duo.

PubMed

House, G; Burdea, G; Polistico, K; Roll, D; Kim, J; Grampurohit, N; Damiani, F; Keeler, S; Hundal, J; Pollack, S

2016-11-01

To describe the novel BrightArm Duo bimanual upper extremity (UE) rehabilitation system; to determine its technology acceptance and clinical benefit for older hemiplegic participants. The system table tilted to adjust arm gravity loading. Participants wore arm supports that sensed grasp strength and wrist position on the table. Wrist weights further increased shoulder exertion. Games were designed to improve UE strength, motor function, cognition and emotive state and adapted automatically to each participant. The system underwent feasibility trials spanning 8 weeks in two skilled nursing facilities (SNFs). Participants were evaluated pre-therapy and post-therapy using standardized clinical measures. Computerized measures of supported arm reach, table tilt and number of arm repetitions were stored on a remote server. Seven participants had significant improvements in their active range of shoulder movement, supported arm reach, shoulder strength, grasp strength and their ability to focus. The group demonstrated higher arm function measured with FMA (p = 0.01) and CAHAI (p = 0.05), and had an improvement in depression (Becks Depression Inventory, II). BrightArm Duo technology was well accepted by participants with a rating of 4.4 out of 5 points. Given these findings, it will be beneficial to evaluate the BrightArm Duo application in SNF maintenance programs. Implications for Rehabilitation Integrative rehabilitation that addresses both physical and cognitive domains is promising for post-stroke maintenance in skilled nursing facilities. Simultaneous bilateral arm exercise may improve arm function in older hemiplegic patients several years after stroke. Virtual reality games that adapt to the patient can increase attention and working memory while decreasing depression in elderly.

DARPA challenge: developing new technologies for brain and spinal injuries

NASA Astrophysics Data System (ADS)

Macedonia, Christian; Zamisch, Monica; Judy, Jack; Ling, Geoffrey

2012-06-01

The repair of traumatic injuries to the central nervous system remains among the most challenging and exciting frontiers in medicine. In both traumatic brain injury and spinal cord injuries, the ultimate goals are to minimize damage and foster recovery. Numerous DARPA initiatives are in progress to meet these goals. The PREventing Violent Explosive Neurologic Trauma program focuses on the characterization of non-penetrating brain injuries resulting from explosive blast, devising predictive models and test platforms, and creating strategies for mitigation and treatment. To this end, animal models of blast induced brain injury are being established, including swine and non-human primates. Assessment of brain injury in blast injured humans will provide invaluable information on brain injury associated motor and cognitive dysfunctions. The Blast Gauge effort provided a device to measure warfighter's blast exposures which will contribute to diagnosing the level of brain injury. The program Cavitation as a Damage Mechanism for Traumatic Brain Injury from Explosive Blast developed mathematical models that predict stresses, strains, and cavitation induced from blast exposures, and is devising mitigation technologies to eliminate injuries resulting from cavitation. The Revolutionizing Prosthetics program is developing an avant-garde prosthetic arm that responds to direct neural control and provides sensory feedback through electrical stimulation. The Reliable Neural-Interface Technology effort will devise technologies to optimally extract information from the nervous system to control next generation prosthetic devices with high fidelity. The emerging knowledge and technologies arising from these DARPA programs will significantly improve the treatment of brain and spinal cord injured patients.

SAKK 24/09: safety and tolerability of bevacizumab plus paclitaxel vs. bevacizumab plus metronomic cyclophosphamide and capecitabine as first-line therapy in patients with HER2-negative advanced stage breast cancer - a multicenter, randomized phase III trial.

PubMed

Rochlitz, Christoph; Bigler, Martin; von Moos, Roger; Bernhard, Jürg; Matter-Walstra, Klazien; Wicki, Andreas; Zaman, Khalil; Anchisi, Sandro; Küng, Marc; Na, Kyung-Jae; Bärtschi, Daniela; Borner, Markus; Rordorf, Tamara; Rauch, Daniel; Müller, Andreas; Ruhstaller, Thomas; Vetter, Marcus; Trojan, Andreas; Hasler-Strub, Ursula; Cathomas, Richard; Winterhalder, Ralph

2016-10-10

Adding bevacizumab to chemotherapy improves response rates and progression-free survival (PFS) in metastatic breast cancer (mBC). We aimed to demonstrate decreased toxicity with metronomic chemotherapy/bevacizumab compared with paclitaxel/bevacizumab. This multicenter, randomized phase III trial compared bevacizumab with either paclitaxel (arm A) or daily oral capecitabine-cyclophosphamide (arm B) as first-line treatment in patients with HER2-negative advanced breast cancer. The primary endpoint was the incidence of selected grade 3-5 adverse events (AE) including: febrile neutropenia, infection, sensory/motor neuropathy, and mucositis. Secondary endpoints included objective response rate, disease control rate, PFS, overall survival (OS), quality of life (QoL), and pharmacoeconomics. The study was registered prospectively with ClinicalTrials.gov, number NCT01131195 on May 25, 2010. Between September 2010 and December 2012, 147 patients were included at 22 centers. The incidence of primary endpoint-defining AEs was similar in arm A (25 % [18/71]; 95 % CI 15-35 %) and arm B (24 % [16/68]; 95 % CI 13-34 %; P = 0.96). Objective response rates were 58 % (42/73; 95 % CI 0.46-0.69) and 50 % (37/74; 95 % CI 0.39-0.61) in arms A and B, respectively (P = 0.45). Median PFS was 10.3 months (95 % CI 8.7-11.3) in arm A and 8.5 months (95 % CI 6.5-11.9) in arm B (P = 0.90). Other secondary efficacy endpoints were not significantly different between study arms. The only statistically significant differences in QoL were less hair loss and less numbness in arm B. Treatment costs between the two arms were equivalent. This trial failed to meet its primary endpoint of a reduced rate of prespecified grade 3-5 AEs with metronomic bevacizumab, cyclophosphamide and capecitabine.

Nonrandomized Trial of Feasibility and Acceptability of Strategies for Promotion of Soapy Water as a Handwashing Agent in Rural Bangladesh.

PubMed

Ashraf, Sania; Nizame, Fosiul A; Islam, Mahfuza; Dutta, Notan C; Yeasmin, Dalia; Akhter, Sadika; Abedin, Jaynal; Winch, Peter J; Ram, Pavani K; Unicomb, Leanne; Leontsini, Elli; Luby, Stephen P

2017-02-08

We conducted a nonrandomized trial of strategies to promote soapy water for handwashing in rural Bangladesh and measured uptake. We enrolled households with children < 3 years for three progressively intensive study arms: promotion of soapy water ( N = 120), soapy water promotion plus handwashing stations ( N = 103), and soapy water promotion, stations plus detergent refills ( N = 90); we also enrolled control households ( N = 72). Our handwashing stations included tap-fitted buckets and soapy water bottles. Community promoters visited households and held community meetings to demonstrate soapy water preparation and promote handwashing at key times. Field workers measured uptake 4 months later. In-depth interviews and focus group discussions assessed factors associated with uptake. More households had soapy water at the handwashing place in progressively intensive arms: 18% (promotion), 60% (promotion plus station), and 71% (promotion, station with refills). Compared with the promotion-only arm, more households that received stations had soapy water at the primary handwashing station (44%, P ≤ 0.001; 71%, P < 0.001 with station plus detergent refill). Qualitative findings highlighted several dimensions that affected use: contextual (shared courtyard), psychosocial (perceived value), and technology dimensions (ease of use, convenience). Soapy water may increase habitual handwashing by addressing barriers of cost and availability of handwashing agents near water sources. Further research should inform optimal strategies to scale-up soapy water as a handwashing agent to study health impact. © The American Society of Tropical Medicine and Hygiene.

Nonrandomized Trial of Feasibility and Acceptability of Strategies for Promotion of Soapy Water as a Handwashing Agent in Rural Bangladesh

PubMed Central

Ashraf, Sania; Nizame, Fosiul A.; Islam, Mahfuza; Dutta, Notan C.; Yeasmin, Dalia; Akhter, Sadika; Abedin, Jaynal; Winch, Peter J.; Ram, Pavani K.; Unicomb, Leanne; Leontsini, Elli; Luby, Stephen P.

2017-01-01

We conducted a nonrandomized trial of strategies to promote soapy water for handwashing in rural Bangladesh and measured uptake. We enrolled households with children < 3 years for three progressively intensive study arms: promotion of soapy water (N = 120), soapy water promotion plus handwashing stations (N = 103), and soapy water promotion, stations plus detergent refills (N = 90); we also enrolled control households (N = 72). Our handwashing stations included tap-fitted buckets and soapy water bottles. Community promoters visited households and held community meetings to demonstrate soapy water preparation and promote handwashing at key times. Field workers measured uptake 4 months later. In-depth interviews and focus group discussions assessed factors associated with uptake. More households had soapy water at the handwashing place in progressively intensive arms: 18% (promotion), 60% (promotion plus station), and 71% (promotion, station with refills). Compared with the promotion-only arm, more households that received stations had soapy water at the primary handwashing station (44%, P ≤ 0.001; 71%, P < 0.001 with station plus detergent refill). Qualitative findings highlighted several dimensions that affected use: contextual (shared courtyard), psychosocial (perceived value), and technology dimensions (ease of use, convenience). Soapy water may increase habitual handwashing by addressing barriers of cost and availability of handwashing agents near water sources. Further research should inform optimal strategies to scale-up soapy water as a handwashing agent to study health impact. PMID:28025233

A Sandia weapon review bulletin : defense programs, Autumn 1992.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1992-09-01

Topics in this issue: (1) Focal Point and STEP. Sandia National Laboratories has always focused its advanced weapon development not only on future weapon needs, but also on the engineering and manufacturing sciences needed to meet them. Both areas are changing dramatically. As the nation dismantles many of its warheads, it becomes essential that those that remain are increasingly reliable, secure, capable, and safe. And as development resources diminish, it becomes vital that they are applied to the most critical technologies in a disciplined manner. The mission of the Focal Point program and the Stockpile Transition Enabling Program (STEP) ismore » to develop processes for meeting these challenges. Focal Point offers a decision-making process for allocating Sandia's resources to meets its defense programs strategic goals. (2) Defense Programs news in brief. (3) Dismantling the nuclear stockpile. (4) W88/MK5: Arming, Fuzing, and Firing system meets all requirements and goals. (5) The Common Radar Fuze. (6) Insertable-explosive arming of firing sets. (7) Preparing for fewer underground tests.« less

ARM Climate Research Facility Annual Report 2004

DOE Office of Scientific and Technical Information (OSTI.GOV)

Voyles, J.

2004-12-31

Like a rock that slowly wears away beneath the pressure of a waterfall, planet earth?s climate is almost imperceptibly changing. Glaciers are getting smaller, droughts are lasting longer, and extreme weather events like fires, floods, and tornadoes are occurring with greater frequency. Why? Part of the answer is clouds and the amount of solar radiation they reflect or absorb. These two factors clouds and radiative transfer represent the greatest source of error and uncertainty in the current generation of general circulation models used for climate research and simulation. The U.S. Global Change Research Act of 1990 established an interagency programmore » within the Executive Office of the President to coordinate U.S. agency-sponsored scientific research designed to monitor, understand, and predict changes in the global environment. To address the need for new research on clouds and radiation, the U.S. Department of Energy (DOE) established the Atmospheric Radiation Measurement (ARM) Program. As part of the DOE?s overall Climate Change Science Program, a primary objective of the ARM Program is improved scientific understanding of the fundamental physics related to interactions between clouds and radiative feedback processes in the atmosphere.« less

Atypical Pyoderma Gangrenosum Mimicking an Infectious Process

PubMed Central

To, Derek; Wong, Aaron; Montessori, Valentina

2014-01-01

We present a patient with atypical pyoderma gangrenosum (APG), which involved the patient's arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics. PMID:25024856

Rapidly developing gas gangrene due to a simple puncture wound.

PubMed

Oncel, Selim; Arsoy, Emin Sami

2010-06-01

Gas gangrene, an infection caused by Clostridium perfringens, is a potentially fatal and physically disabling disease due to its sometimes incredibly rapid progression. An adolescent boy was referred to our university hospital with a history of nail puncture in the hand that occurred a few hours previously. The physical examination revealed a swollen and tender arm with crepitations up to the shoulder. Gas was coming out from the puncture wound with digital pressure on the forearm. The plain radiograph of the arm was typical of gas gangrene with the presence of gas under the skin and between muscular fibrils.Having received 1 dose of meropenem, the boy had surgery, in which his entire upper extremity had to be disarticulated from the shoulder. The maintenance antimicrobial therapy with intravenously administered penicillin G and clindamycin was continued for a duration of 10 days, at the end of which, the patient was discharged.The rapidly progressive character and the dramatic ending of this case made us wonder whether antimicrobial prophylaxis would play any role in the preventive management of puncture wounds.

Clinical validation of a nanodiamond-embedded thermoplastic biomaterial

PubMed Central

Lee, Dong-Keun; Kee, Theodore; Liang, Zhangrui; Hsiou, Desiree; Miya, Darron; Wu, Brian; Osawa, Eiji; Chow, Edward Kai-Hua; Kang, Mo K.; Ho, Dean

2017-01-01

Detonation nanodiamonds (NDs) are promising drug delivery and imaging agents due to their uniquely faceted surfaces with diverse chemical groups, electrostatic properties, and biocompatibility. Based on the potential to harness ND properties to clinically address a broad range of disease indications, this work reports the in-human administration of NDs through the development of ND-embedded gutta percha (NDGP), a thermoplastic biomaterial that addresses reinfection and bone loss following root canal therapy (RCT). RCT served as the first clinical indication for NDs since the procedure sites involved nearby circulation, localized administration, and image-guided treatment progress monitoring, which are analogous to many clinical indications. This randomized, single-blind interventional treatment study evaluated NDGP equivalence with unmodified GP. This progress report assessed one control-arm and three treatment-arm patients. At 3-mo and 6-mo follow-up appointments, no adverse events were observed, and lesion healing was confirmed in the NDGP-treated patients. Therefore, this study is a foundation for the continued clinical translation of NDs and other nanomaterials for a broad spectrum of applications. PMID:29078364

Land Combat Systems Industry. Industry Study, Spring 2009

DTIC Science & Technology

2009-01-01

Spring 2009 Industry Study Final Report Land Combat Systems Industry The Industrial College of the Armed Forces...AND SUBTITLE Spring 2009. Industry Study. Land Combat Systems Industry 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6 . AUTHOR(S...Industrial College of the Armed Forces,Washington,DC,20319 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS

Arm Care. Relief and Prevention for Shoulder Tendonitis, Tennis Elbow, Bursitis and Wrist Sprain in Athletics and Other Activities.

ERIC Educational Resources Information Center

Nirschl, Robert P.

The book provides a practical and meaningful treatment program for athletes involved in sports which injure the arm or shoulder to a high degree, such as tennis, baseball, swimming, raquetball, pole vaulting, javelin throwing, and weight training. The book's chapters present information on: (1) symptoms of injury; (2) the anatomy of injury; (3)…

A Novel Hybrid Model for Drawing Trace Reconstruction from Multichannel Surface Electromyographic Activity.

PubMed

Chen, Yumiao; Yang, Zhongliang

2017-01-01

Recently, several researchers have considered the problem of reconstruction of handwriting and other meaningful arm and hand movements from surface electromyography (sEMG). Although much progress has been made, several practical limitations may still affect the clinical applicability of sEMG-based techniques. In this paper, a novel three-step hybrid model of coordinate state transition, sEMG feature extraction and gene expression programming (GEP) prediction is proposed for reconstructing drawing traces of 12 basic one-stroke shapes from multichannel surface electromyography. Using a specially designed coordinate data acquisition system, we recorded the coordinate data of drawing traces collected in accordance with the time series while 7-channel EMG signals were recorded. As a widely-used time domain feature, Root Mean Square (RMS) was extracted with the analysis window. The preliminary reconstruction models can be established by GEP. Then, the original drawing traces can be approximated by a constructed prediction model. Applying the three-step hybrid model, we were able to convert seven channels of EMG activity recorded from the arm muscles into smooth reconstructions of drawing traces. The hybrid model can yield a mean accuracy of 74% in within-group design (one set of prediction models for all shapes) and 86% in between-group design (one separate set of prediction models for each shape), averaged for the reconstructed x and y coordinates. It can be concluded that it is feasible for the proposed three-step hybrid model to improve the reconstruction ability of drawing traces from sEMG.

Effectiveness of the National Program of Complementary Feeding for older adults in Chile on vitamin B12 status in older adults; secondary outcome analysis from the CENEX Study (ISRCTN48153354)

PubMed Central

2013-01-01

Background Older people are at increased risk of vitamin B12 deficiency and the provision of fortified foods may be an effective way to ensure good vitamin B12 status in later life. Aim To evaluate the effectiveness of a vitamin B12 fortified food provided by a national program of complementary food for older people on plasma vitamin B12 levels. Subjects and methods A random sub-sample of 351 subjects aged 65-67y from a large cluster randomised controlled trial provided blood samples at baseline and after 24 months of intervention. The intervention arm (10 clusters 186 participants) received a vitamin B12 fortified food designed to deliver 1.4 μg/day, while the control arm did not receive complementary food (10 clusters, 165 participants). Serum vitamin B12 and folate levels determined by radioimmunoassay were used to estimate the effect of intervention on vitamin B12 levels, adjusting for baseline levels and sex. Results Attrition at 24 months was 16.7% and 23.6% in the intervention and control arms respectively (p = 0.07). Over 24 months of intervention, mean (95% CI) serum vitamin B12 decreased from 392 (359–425) pmol/dL to 357 (300–414) pmol/dL (p < 0.07) in the intervention arm and from 395 (350–440) pmol/dL to 351 (308–395) pmol/dL in the control arm. There was no significant effect of the intervention on folate status. Discussion Our findings suggest that foods fortified with 1.4 μg/daily vitamin B12 as provided by Chile’s national programme for older people are insufficient to ensure adequate vitamin B12 levels in this population. Chile has a long and successful experience with nutrition intervention programs; however, the country’s changing demographic and nutritional profiles require a constant adjustment of the programs. PMID:24016218

Quality of life results from the phase 3 REVEL randomized clinical trial of ramucirumab-plus-docetaxel versus placebo-plus-docetaxel in advanced/metastatic non-small cell lung cancer patients with progression after platinum-based chemotherapy.

PubMed

Pérol, Maurice; Ciuleanu, Tudor-Eliade; Arrieta, Oscar; Prabhash, Kumar; Syrigos, Konstantinos N; Goksel, Tuncay; Park, Keunchil; Kowalyszyn, Ruben Dario; Pikiel, Joanna; Lewanski, Conrad R; Thomas, Michael; Dakhil, Shaker; Kim, Joo-Hang; Karaseva, Nina; Yurasov, Sergey; Zimmermann, Annamaria; Lee, Pablo; Carter, Gebra Cuyun; Reck, Martin; Cappuzzo, Federico; Garon, Edward B

2016-03-01

REVEL demonstrated that ramucirumab+docetaxel (RAM+DTX) improved overall survival, progression-free survival, and objective response rate in patients with advanced/metastatic non-small cell lung cancer with progression after platinum-based chemotherapy. This analysis examined quality of life (QoL) as assessed by the Lung Cancer Symptom Scale (LCSS) and clinician-reported functional status. The LCSS includes 6 symptom and 3 global items measured on a 0-100-mm scale; higher scores represent greater symptom burden. LCSS and ECOG PS data were collected at baseline, every 3-week cycle, the summary visit, and at the 30-day follow-up. LCSS total score and Average Symptom Burden Index (ASBI) were calculated. The primary analysis compared time to deterioration (TtD) between treatment arms for all individual items and summary scores, defined as increase from baseline by ≥ 15 mm using the Kaplan-Meier method and Cox regression. TtD to ECOG PS ≥ 2 was analyzed. There were 1253 patients randomized to receive RAM+DTX or placebo+docetaxel (PL+DTX). Across all assessments, LCSS compliance was approximately 75% and balanced across arms. The mean (SD) baseline LCSS total score was 27.3mm (17.08 mm) on RAM+DTX and 29.6mm (17.59 mm) on PL+DTX. At 30-day follow-up, mean (SD) LCSS total score was 32.0 (19.03) on RAM+DTX and 32.5 (19.87) on PL+DTX. The TtD for all LCSS scores was similar between treatment arms. Stratified HRs (95% CI) for LCSS total score and ASBI were HR=0.99 (0.81, 1.22), p=0.932 and HR=0.93 (0.75, 1.15), p=0.514 with approximately 70% of patients censored. TtD to PS ≥ 2 was similar between treatment arms (HR=1.03 [95% CI: 0.85, 1.26], p=0.743) with approximately two-thirds of the patients censored. In addition to improvement of clinical efficacy outcomes demonstrated in REVEL, these results suggest that adding ramucirumab to docetaxel did not impair patient QoL, symptoms, or functioning. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Central implementation strategies outperform local ones in improving HIV testing in Veterans Healthcare Administration facilities.

PubMed

Goetz, Matthew Bidwell; Hoang, Tuyen; Knapp, Herschel; Burgess, Jane; Fletcher, Michael D; Gifford, Allen L; Asch, Steven M

2013-10-01

Pilot data suggest that a multifaceted approach may increase HIV testing rates, but the scalability of this approach and the level of support needed for successful implementation remain unknown. To evaluate the effectiveness of a scaled-up multi-component intervention in increasing the rate of risk-based and routine HIV diagnostic testing in primary care clinics and the impact of differing levels of program support. Three arm, quasi-experimental implementation research study. Veterans Health Administration (VHA) facilities. Persons receiving primary care between June 2009 and September 2011 INTERVENTION: A multimodal program, including a real-time electronic clinical reminder to facilitate HIV testing, provider feedback reports and provider education, was implemented in Central and Local Arm Sites; sites in the Central Arm also received ongoing programmatic support. Control Arm sites had no intervention Frequency of performing HIV testing during the 6 months before and after implementation of a risk-based clinical reminder (phase I) or routine clinical reminder (phase II). The adjusted rate of risk-based testing increased by 0.4 %, 5.6 % and 10.1 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). During phase II, the adjusted rate of routine testing increased by 1.1 %, 6.3 % and 9.2 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). At study end, 70-80 % of patients had been offered an HIV test. Use of clinical reminders, provider feedback, education and social marketing significantly increased the frequency at which HIV testing is offered and performed in VHA facilities. These findings support a multimodal approach toward achieving the goal of having every American know their HIV status as a matter of routine clinical practice.

A tailored multicomponent program to reduce discomfort in critically ill patients: a cluster-randomized controlled trial.

PubMed

Kalfon, Pierre; Baumstarck, Karine; Estagnasie, Philippe; Geantot, Marie-Agnès; Berric, Audrey; Simon, Georges; Floccard, Bernard; Signouret, Thomas; Boucekine, Mohamed; Fromentin, Mélanie; Nyunga, Martine; Sossou, Achille; Venot, Marion; Robert, René; Follin, Arnaud; Audibert, Juliette; Renault, Anne; Garrouste-Orgeas, Maïté; Collange, Olivier; Levrat, Quentin; Villard, Isabelle; Thevenin, Didier; Pottecher, Julien; Patrigeon, René-Gilles; Revel, Nathalie; Vigne, Coralie; Azoulay, Elie; Mimoz, Olivier; Auquier, Pascal

2017-12-01

Critically ill patients are exposed to stressful conditions and experience several discomforts. The primary objective was to assess whether a tailored multicomponent program is effective for reducing self-perceived discomfort. In a cluster-randomized two-arm parallel trial, 34 French adult intensive care units (ICUs) without planned interventions to reduce discomfort were randomized, 17 to the arm including a 6-month period of program implementation followed by a 6-month period without the program (experimental group), and 17 to the arm with an inversed sequence (control group). The tailored multicomponent program consisted of assessment of ICU-related self-perceived discomforts, immediate and monthly feedback to healthcare teams, and site-specific tailored interventions. The primary outcome was the overall discomfort score derived from the 16-item IPREA questionnaire (0, minimal, 100, maximal overall discomfort) and the secondary outcomes were the discomfort scores of each IPREA item. IPREA was administered on the day of ICU discharge with a considered timeframe from the ICU admission until ICU discharge. During a 1-month assessment period, 398 and 360 patients were included in the experimental group and the control group, respectively. The difference (experimental minus control) of the overall discomfort score between groups was - 7.00 (95% CI - 9.89 to - 4.11, p < 0.001). After adjustment (age, gender, ICU duration, mechanical ventilation duration, and type of admission), the program effect was still positive for the overall discomfort score (difference - 6.35, SE 1.23, p < 0.001) and for 12 out of 16 items. This tailored multicomponent program decreased self-perceived discomfort in adult critically ill patients. Clinicaltrials.gov Identifier NCT02442934.

A randomized controlled trial of Human Papillomavirus (HPV) testing for cervical cancer screening: trial design and preliminary results (HPV FOCAL Trial)

PubMed Central

2010-01-01

Background In the HPV FOCAL trial, we will establish the efficacy of hr-HPV DNA testing as a stand-alone screening test followed by liquid based cytology (LBC) triage of hr-HPV-positive women compared to LBC followed by hr-HPV triage with ≥ CIN3 as the outcome. Methods/Design HPV-FOCAL is a randomized, controlled, three-armed study over a four year period conducted in British Columbia. It will recruit 33,000 women aged 25-65 through the province's population based cervical cancer screening program. Control arm: LBC at entry and two years, and combined LBC and hr-HPV at four years among those with initial negative results and hr-HPV triage of ASCUS cases; Two Year Safety Check arm: hr-HPV at entry and LBC at two years in those with initial negative results with LBC triage of hr-HPV positives; Four Year Intervention Arm: hr-HPV at entry and combined hr-HPV and LBC at four years among those with initial negative results with LBC triage of hr-HPV positive cases Discussion To date, 6150 participants have a completed sample and epidemiologic questionnaire. Of the 2019 women enrolled in the control arm, 1908 (94.5%) were cytology negative. Women aged 25-29 had the highest rates of HSIL (1.4%). In the safety arm 92.2% of women were hr-HPV negative, with the highest rate of hr-HPV positivity found in 25-29 year old women (23.5%). Similar results were obtained in the intervention arm HPV FOCAL is the first randomized trial in North America to examine hr-HPV testing as the primary screen for cervical cancer within a population-based cervical cancer screening program. Trial Registration International Standard Randomised Controlled Trial Number Register, ISRCTN79347302 PMID:20334685

Early versus delayed initiation of antiretroviral therapy for Indian HIV-Infected individuals with tuberculosis on antituberculosis treatment.

PubMed

Sinha, Sanjeev; Shekhar, Rahul C; Singh, Gurjeet; Shah, Nipam; Ahmad, Hafiz; Kumar, Narendra; Sharma, Surendra K; Samantaray, J C; Ranjan, Sanjai; Ekka, Meera; Sreenivas, Vishnu; Mitsuyasu, Ronald T

2012-07-31

For antiretroviral therapy (ART) naive human immunodeficiency virus (HIV) infected adults suffering from tuberculosis (TB), there is uncertainty about the optimal time to initiate highly active antiretroviral therapy (HAART) after starting antituberculosis treatment (ATT), in order to minimize mortality, HIV disease progression, and adverse events. In a randomized, open label trial at All India Institute of Medical Sciences, New Delhi, India, eligible HIV positive individuals with a diagnosis of TB were randomly assigned to receive HAART after 2-4 or 8-12 weeks of starting ATT, and were followed for 12 months after HAART initiation. Participants received directly observed therapy short course (DOTS) for TB, and an antiretroviral regimen comprising stavudine or zidovudine, lamivudine, and efavirenz. Primary end points were death from any cause, and progression of HIV disease marked by failure of ART. A total of 150 patients with HIV and TB were initiated on HAART: 88 received it after 2-4 weeks (early ART) and 62 after 8-12 weeks (delayed ART) of starting ATT. There was no significant difference in mortality between the groups after the introduction of HAART. However, incidence of ART failure was 31% in delayed versus 16% in early ART arm (p = 0.045). Kaplan Meier disease progression free survival at 12 months was 79% for early versus 64% for the delayed ART arm (p = 0.05). Rates of adverse events were similar. Early initiation of HAART for patients with HIV and TB significantly decreases incidence of HIV disease progression and has good tolerability. CTRI/2011/12/002260.

New Madrid Seismotectonic Program. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buschbach, T.C.

1986-06-01

The New Madrid Seismotectonic Program was a large-scale multidisciplinary effort that was designed to define the structural setting and tectonic history of the New Madrid area in order to realistically evaluate earthquake risks in the siting of nuclear facilities. The tectonic model proposed to explain the New Madrid seismicity is the ''zone of weakness'' model, which suggests that an ancient rift complex formed a zone of weakness in the earth's crust along which regional stresses are relieved. The Reelfoot Rift portion of the proposed rift complex is currently seismically active, and it must be considered capable and likely to bemore » exposed to large-magnitude earthquakes in the future. Earthquakes that occur in the Wabash Valley area are less abundant and generally have deeper hypocenters than earthquakes in the New Madrid area. The area of the Southern Indiana Arm must be considered to have seismic risk, although a lesser extent than the Reelfoot Rift. The east-west trending Rough Creek Graben is practically aseismic, probably in large part due to its orientation in the current stress field. The northwest-trending St. Louis Arm of the proposed rift complex includes a pattern of seismicity that extends from southern Illinois along the Mississippi River. This arm must be considered to have seismic risk, but because of the lack of development of a graben associated with the arm and the orientation of the arm in the current stress field, the risk appears to be less than in the Reelfoot Rift portion of the rift complex.« less

Asteroid Redirect Mission Update

NASA Image and Video Library

2017-12-08

Benjamin Reed (right), deputy program manager of NASA’s Satellite Servicing Capabilities Office, shows Dr. Holdren the technologies that NASA is developing for the Restore-L satellite servicing mission. NASA will launch the Restore-L servicer in 2020 to refuel a live satellite and demonstrate that a suite of satellite-servicing technologies are operational. More info: Asteroid Redirect Mission Update – On Sept. 14, 2016, NASA provided an update on the Asteroid Redirect Mission (ARM) and how it contributes to the agency’s journey to Mars and protection of Earth. The presentation took place in the Robotic Operations Center at NASA’s Goddard Space Flight Center in Greenbelt, Maryland. Assistant to the President for Science and Technology Dr. John P. Holdren, NASA Administrator Charles Bolden and NASA’s ARM Program Director, Dr. Michele Gates discussed the latest update regarding the mission. They explained the mission’s scientific and technological benefits and how ARM will demonstrate technology for defending Earth from potentially hazardous asteroids. The briefing aired live on NASA TV and the agency’s website. For more information about ARM go to www.nasa.gov/arm. Credit: NASA/Goddard/Debbie Mccallum NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Asteroid Redirect Mission Update

NASA Image and Video Library

2017-12-08

Benjamin Reed, deputy program manager of NASA’s Satellite Servicing Capabilities Office, shows Dr. Holdren the technologies that NASA is developing for the Restore-L satellite servicing mission. NASA will launch the Restore-L servicer in 2020 to refuel a live satellite and demonstrate that a suite of satellite-servicing technologies are operational. More info: Asteroid Redirect Mission Update – On Sept. 14, 2016, NASA provided an update on the Asteroid Redirect Mission (ARM) and how it contributes to the agency’s journey to Mars and protection of Earth. The presentation took place in the Robotic Operations Center at NASA’s Goddard Space Flight Center in Greenbelt, Maryland. Assistant to the President for Science and Technology Dr. John P. Holdren, NASA Administrator Charles Bolden and NASA’s ARM Program Director, Dr. Michele Gates discussed the latest update regarding the mission. They explained the mission’s scientific and technological benefits and how ARM will demonstrate technology for defending Earth from potentially hazardous asteroids. The briefing aired live on NASA TV and the agency’s website. For more information about ARM go to www.nasa.gov/arm. Credit: NASA/Goddard/Debbie Mccallum NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Astronauts Bob Behnken and Eric Boe walk the Crew Access Arm at

NASA Image and Video Library

2017-08-30

Astronauts Bob Behnken, left, and Eric Boe walk down the Crew Access Arm being built by SpaceX for Launch Complex 39A at NASA’s Kennedy Space Center in Florida. The access arm will be installed on the launch pad, providing a bridge between the launch tower it’s the Fixed Service Structure, as noted below, and SpaceX’s Dragon 2 spacecraft for astronauts flying to the International Space Station on the company’s Falcon 9 rocket as part of NASA’s Commercial Crew Program. The access arm is being readied for installation in early 2018. It will be installed 70 feet higher than the former space shuttle access arm on the launch pad’s Fixed Service Structure. SpaceX continues to modify the historic launch site from its former space shuttle days, removing more than 500,000 pounds of steel from the pad structure, including the Rotating Service Structure that was once used for accessing the payload bay of the shuttle. SpaceX also is using the modernized site to launch commercial payloads, as well as cargo resupply missions to and from the International Space Station for NASA. The first SpaceX launch from the historic Apollo and space shuttle site was this past February. NASA’s Commercial Crew Program is working with private companies, Boeing and SpaceX, with a goal of once again flying people to and from the International Space Station, launching from the United States.

Timing variability of reach trajectories in left versus right hemisphere stroke.

PubMed

Freitas, Sandra Maria Sbeghen Ferreira; Gera, Geetanjali; Scholz, John Peter

2011-10-24

This study investigated trajectory timing variability in right and left stroke survivors and healthy controls when reaching to a centrally located target under a fixed target condition or when the target could suddenly change position after reach onset. Trajectory timing variability was investigated with a novel method based on dynamic programming that identifies the steps required to time warp one trial's acceleration time series to match that of a reference trial. Greater trajectory timing variability of both hand and joint motions was found for the paretic arm of stroke survivors compared to their non-paretic arm or either arm of controls. Overall, the non-paretic left arm of the LCVA group and the left arm of controls had higher timing variability than the non-paretic right arm of the RCVA group and right arm of controls. The shoulder and elbow joint warping costs were consistent predictors of the hand's warping cost for both left and right arms only in the LCVA group, whereas the relationship between joint and hand warping costs was relatively weak in control subjects and less consistent across arms in the RCVA group. These results suggest that the left hemisphere may be more involved in trajectory timing, although the results may be confounded by skill differences between the arms in these right hand dominant participants. On the other hand, arm differences did not appear to be related to differences in targeting error. The paretic left arm of the RCVA exhibited greater trajectory timing variability than the paretic right arm of the LCVA group. This difference was highly correlated with the level of impairment of the arms. Generally, the effect of target uncertainty resulted in slightly greater trajectory timing variability for all participants. The results are discussed in light of previous studies of hemispheric differences in the control of reaching, in particular, left hemisphere specialization for temporal control of reaching movements. Copyright © 2011 Elsevier B.V. All rights reserved.

TIMING VARIABILITY OF REACH TRAJECTORIES IN LEFT VERSUS RIGHT HEMISPHERE STROKE

PubMed Central

Freitas, Sandra Maria Sbeghen Ferreira; Gera, Geetanjali; Scholz, John Peter

2011-01-01

This study investigated trajectory timing variability in right and left stroke survivors and healthy controls when reaching to a centrally located target under a fixed target condition or when the target could suddenly change position after reach onset. Trajectory timing variability was investigated with a novel method based on dynamic programming that identifies the steps required to time warp one trial’s acceleration time series to match that of a reference trial. Greater trajectory timing variability of both hand and joint motions was found for the paretic arm of stroke survivors compared to their non-paretic arm or either arm of controls. Overall, the non-paretic left arm of the LCVA group and the left arm of controls had higher timing variability than the non-paretic right arm of the RCVA group and right arm of controls. The shoulder and elbow joint warping costs were consistent predictors of the hand’s warping cost for both left and right arms only in the LCVA group, whereas the relationship between joint and hand warping costs was relatively weak in control subjects and less consistent across arms in the RCVA group. These results suggest that the left hemisphere may be more involved in trajectory timing, although the results may be confounded by skill differences between the arms in these right hand dominant participants. On the other hand, arm differences did not appear to be related to differences in targeting error. The paretic left arm of the RCVA exhibited greater trajectory timing variability than the paretic right arm of the LCVA group. This difference was highly correlated with the level of impairment of the arms. Generally, the effect of target uncertainty resulted in slightly greater trajectory timing variability for all participants. The results are discussed in light of previous studies of hemispheric differences in the control of reaching, in particular, left hemisphere specialization for temporal control of reaching movements. PMID:21920508

Applying Space Technology to Enhance Control of an Artificial Arm

NASA Technical Reports Server (NTRS)

Atkins, Diane; Donovan, William H.; Novy, Mara; Abramczyk, Robert

1997-01-01

At the present time, myoelectric prostheses perform only one function of the hand: open and close with the thumb, index and middle finger coming together to grasp various shaped objects. To better understand the limitations of the current single-function prostheses and the needs of the individuals who use them, The Institute for Rehabilitation and Research (TIRR), sponsored by the National Institutes of Health (August 1992 - November 1994), surveyed approximately 2500 individuals with upper limb loss. When asked to identify specific features of their current electric prosthesis that needed improvement, the survey respondents overwhelmingly identified the lack of wrist and finger movement as well as poor control capability. Simply building a mechanism with individual finger and wrist motion is not enough. Individuals with upper limb loss tend to reject prostheses that require continuous visual monitoring and concentration to control. Robotics researchers at NASA's Johnson Space Center (JSC) and Rice University have made substantial progress in myoelectric teleoperation. A myoelectric teleoperation system translates signals generated by an able-bodied robot operator's muscles during hand motions into commands that drive a robot's hand through identical motions. Farry's early work in myoelectric teleoperation used variations over time in the myoelectric spectrum as inputs to neural networks to discriminate grasp types and thumb motions. The resulting schemes yielded up to 93% correct classification on thumb motions. More recently, Fernandez achieved 100% correct non-realtime classification of thumb abduction, extension, and flexion on the same myoelectric data. Fernandez used genetic programming to develop functions that discriminate between thumb motions using myoelectric signal parameters. Genetic programming (GP) is an evolutionary programming method where the computer can modify the discriminating functions' form to improve its performance, not just adjust numerical coefficients or weights. Although the function development may require much computational time and many training cases, the resulting discrimination functions can run in realtime on modest computers. These results suggest that myoelectric signals might be a feasible teleoperation medium, allowing an operator to use his or her own hand and arm as a master to intuitively control an anthropomorphic robot in a remote location such as outer space.

Marine ARM GPCI Investigation of Clouds Bridge Display Field Campaign Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Reynolds, R. Michael; Lewis, Ernie

2016-09-01

At the beginning of the U.S. Department of Energy (DOE) Marine Atmospheric Radiation Measurement (ARM) Climate Research Facility Global Energy and Water Experiment (GEWEX) Cloud System Study (GCSS) Pacific Cross-Section Intercomparison (GPCI) Investigation of Clouds (MAGIC) experiment, we recognized that the crew on the ship’s bridge would like to see a display of the meteorological data that was being collected. While a display on the bridge would be marginally useful to the science, it was decided to make a display for the bridge. A display was programmed in Lab View and a personal computer (PC) was set up in themore » bridge. This remained in operation until the ship went to dry dock for upgrades and service. Part of the upgrade was a new meteorological system for the ship. After this time there was no need for the ARM display and so it was not re-installed for the remainder of the program.« less

75 FR 81915 - Defense Federal Acquisition Regulation Supplement; Foreign Participation in Acquisitions in...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

...) states; and Determination of inapplicability of the Balance of Payments Program evaluation factor to... the provisions of the Balance of Payments Program to offers of products (other than arms, ammunition... supplies. (1)(i) Use the provision at 252.225-7000, Buy American Act--Balance of Payments Program...

Enhancing HIV Communication between Parents and Children: Efficacy of the Parents Matter! Program

ERIC Educational Resources Information Center

Miller, Kim S.; Lin, Carol Y.; Poulsen, Melissa N.; Fasula, Amy; Wyckoff, Sarah C.; Forehand, Rex; Long, Nicholas; Armistead, Lisa

2011-01-01

We examine efficacy of the Parents Matter! Program (PMP), a program to teach African-American parents of preadolescents sexual communication and HIV-prevention skills, through a multicenter, randomized control trial. A total of 1115 parent-child participants were randomized to one of three intervention arms (enhanced, brief, control). Percentages…

Sequential FOLFIRI.3 + Gemcitabine Improves Health-Related Quality of Life Deterioration-Free Survival of Patients with Metastatic Pancreatic Adenocarcinoma: A Randomized Phase II Trial

PubMed Central

Anota, Amélie; Mouillet, Guillaume; Trouilloud, Isabelle; Dupont-Gossart, Anne-Claire; Artru, Pascal; Lecomte, Thierry; Zaanan, Aziz; Gauthier, Mélanie; Fein, Francine; Dubreuil, Olivier; Paget-Bailly, Sophie; Taieb, Julien; Bonnetain, Franck

2015-01-01

Background A randomized multicenter phase II trial was conducted to assess the sequential treatment strategy using FOLFIRI.3 and gemcitabine alternately (Arm 2) compared to gemcitabine alone (Arm 1) in patients with metastatic non pre-treated pancreatic adenocarcinoma. The primary endpoint was the progression-free survival (PFS) rate at 6 months. It concludes that the sequential treatment strategy appears to be feasible and effective with a PFS rate of 43.5% in Arm 2 at 6 months (26.1% in Arm 1). This paper reports the results of the longitudinal analysis of the health-related quality of life (HRQoL) as a secondary endpoint of this study. Methods HRQoL was evaluated using the EORTC QLQ-C30 at baseline and every two months until the end of the study or death. HRQoL deterioration-free survival (QFS) was defined as the time from randomization to a first significant deterioration as compared to the baseline score with no further significant improvement, or death. A propensity score was estimated comparing characteristics of partial and complete responders. Analyses were repeated with inverse probability weighting method using the propensity score. Multivariate Cox regression analyses were performed to identify independent factors influencing QFS. Results 98 patients were included between 2007 and 2011. Adjusting on the propensity score, patients of Arm 2 presented a longer QFS of Global Health Status (Hazard Ratio: 0.52 [0.31-0.85]), emotional functioning (0.35 [0.21–0.59]) and pain (0.50 [0.31 – 0.81]) than those of Arm 1. Conclusion Patients of Arm 2 presented a better HRQoL with a longer QFS than those of Arm 1. Moreover, the propensity score method allows to take into account the missing data depending on patients’ characteristics. Trial registration information Eudract N° 2006-005703-34. (Name of the Trial: FIRGEM). PMID:26010884

Beam rider for an Articulated Robot Manipulator (ARM) accurate positioning of long flexible manipulators

NASA Technical Reports Server (NTRS)

Malachowski, M. J.

1990-01-01

Laser beam positioning and beam rider modules were incorporated into the long hollow flexible segment of an articulated robot manipulator (ARM). Using a single laser beam, the system determined the position of the distal ARM endtip, with millimetric precision, in six degrees of freedom, at distances of up to 10 meters. Preliminary designs, using space rated technology for the critical systems, of a two segmented physical ARM, with a single and a dual degree of freedom articulation, were developed, prototyped, and tested. To control the positioning of the physical ARM, an indirect adaptive controller, which used the mismatch between the position of the laser beam under static and dynamic conditions, was devised. To predict the behavior of the system and test the concept, a computer simulation model was constructed. A hierarchical artificially intelligent real time ADA operating system program structure was created. The software was designed for implementation on a dedicated VME bus based Intel 80386 administered parallel processing multi-tasking computer system.

Advanced design for orbital debris removal in support of solar system exploration

NASA Technical Reports Server (NTRS)

1991-01-01

The development of an Autonomous Space Processor for Orbital Debris (ASPOD) is the ultimate goal. The craft will process, in situ, orbital debris using resources available in low Earth orbit (LEO). The serious problem of orbital debris is briefly described and the nature of the large debris population is outlined. This year, focus was on development of a versatile robotic manipulator to augment an existing robotic arm; incorporation of remote operation of robotic arms; and formulation of optimal (time and energy) trajectory planning algorithms for coordinating robotic arms. The mechanical design of the new arm is described in detail. The versatile work envelope is explained showing the flexibility of the new design. Several telemetry communication systems are described which will enable the remote operation of the robotic arms. The trajectory planning algorithms are fully developed for both the time-optimal and energy-optimal problem. The optimal problem is solved using phase plane techniques while the energy optimal problem is solved using dynamics programming.

Autonomous space processor for orbital debris

NASA Technical Reports Server (NTRS)

Ramohalli, Kumar; Marine, Micky; Colvin, James; Crockett, Richard; Sword, Lee; Putz, Jennifer; Woelfle, Sheri

1991-01-01

The development of an Autonomous Space Processor for Orbital Debris (ASPOD) was the goal. The nature of this craft, which will process, in situ, orbital debris using resources available in low Earth orbit (LEO) is explained. The serious problem of orbital debris is briefly described and the nature of the large debris population is outlined. The focus was on the development of a versatile robotic manipulator to augment an existing robotic arm, the incorporation of remote operation of the robotic arms, and the formulation of optimal (time and energy) trajectory planning algorithms for coordinated robotic arms. The mechanical design of the new arm is described in detail. The work envelope is explained showing the flexibility of the new design. Several telemetry communication systems are described which will enable the remote operation of the robotic arms. The trajectory planning algorithms are fully developed for both the time optimal and energy optimal problems. The time optimal problem is solved using phase plane techniques while the energy optimal problem is solved using dynamic programming.

Neural-Dynamic-Method-Based Dual-Arm CMG Scheme With Time-Varying Constraints Applied to Humanoid Robots.

PubMed

Zhang, Zhijun; Li, Zhijun; Zhang, Yunong; Luo, Yamei; Li, Yuanqing

2015-12-01

We propose a dual-arm cyclic-motion-generation (DACMG) scheme by a neural-dynamic method, which can remedy the joint-angle-drift phenomenon of a humanoid robot. In particular, according to a neural-dynamic design method, first, a cyclic-motion performance index is exploited and applied. This cyclic-motion performance index is then integrated into a quadratic programming (QP)-type scheme with time-varying constraints, called the time-varying-constrained DACMG (TVC-DACMG) scheme. The scheme includes the kinematic motion equations of two arms and the time-varying joint limits. The scheme can not only generate the cyclic motion of two arms for a humanoid robot but also control the arms to move to the desired position. In addition, the scheme considers the physical limit avoidance. To solve the QP problem, a recurrent neural network is presented and used to obtain the optimal solutions. Computer simulations and physical experiments demonstrate the effectiveness and the accuracy of such a TVC-DACMG scheme and the neural network solver.

Randomized phase II study of a bendamustine monotherapy schedule for relapsed or refractory low-grade B-cell non-Hodgkin lymphoma or mantle cell lymphoma (RABBIT-14).

PubMed

Itoh, Kuniaki; Igarashi, Tadahiko; Irisawa, Hiroyuki; Aotsuka, Nobuyuki; Masuda, Shinichi; Utsu, Yoshikazu; Tsujimura, Hideki; Tsukasaki, Kunihiro; Wakita, Hisashi

2017-10-30

The aim of this randomized phase II study was to improve the treatment delays and discontinuations associated with bendamustine use by comparing the effect of Benda-14 (intravenous bendamustine, 120 mg/m 2 on days 1 and 15, repeated every 4 weeks for a total of 6 cycles) with those of the standard treatment in relapsed indolent lymphoma and/or mantle cell lymphoma. Forty-six patients were randomly assigned to the treatments from September 2012 to February 2016. Treatment accomplishment rate and median relative dose intensity were similar in both arms: 38 and 63.4% in the Benda-14 arm and 41 and 66.3% in the standard treatment arm, respectively. The overall response rate and median progression-free survival, respectively, were 83% and 21.0 months for Benda-14, and 77% and 15.5 months for the standard treatment. Benda-14 induced favorable responses with less frequent hematological toxicities.

Estimation of limb adiposity by bioimpedance spectroscopy in lymphoedema

NASA Astrophysics Data System (ADS)

Ward, L. C.; Essex, T.; Gaw, R.; Czerniec, S.; Dylke, E.; Abell, B.; Kilbreath, S. L.

2013-04-01

Lymphoedema is a chronic debilitating condition that may occur in approximately 25% of women treated for breast cancer. As the condition progresses, accumulated lymph fluid becomes fibrotic with infiltration of adipose tissue. Bioelectrical impedance spectroscopy is the preferred method for early detection of lymphoedema based on the measurement of impedance of extracellular fluid. The present study assessed whether these impedance measurements could also be used to estimate the adipose tissue content of the arm based on a model previously used to predict whole body composition. Estimates of arm adipose tissue in a cohort of women with lymphoedema were found to be highly correlated (r > 0.82) with measurements of adipose tissue obtained using the reference method of dual energy X-ray absorptiometry. Paired t-tests confirmed that there was no significant difference between the adipose tissue volumes obtained by the two methods. These results support the view that the method shows promise for the estimation of arm adiposity in lymphoedema.

Simulation of cooperating robot manipulators on a mobile platform

NASA Technical Reports Server (NTRS)

Murphy, Steve H.; Wen, John T.; Saridis, George N.

1990-01-01

The dynamic equations of motion for two manipulators holding a common object on a freely moving mobile platform are developed. The full dynamic interactions from arms to platform and arm-tip to arm-tip are included in the formulation. The development of the closed chain dynamics allows for the use of any solution for the open topological tree of base and manipulator links. In particular, because the system has 18 degrees of freedom, recursive solutions for the dynamic simulation become more promising for efficient calculations of the motion. Simulation of the system is accomplished through a MATLAB program, and the response is visualized graphically using the SILMA Cimstation.

Simulating 'the right stuff'

NASA Astrophysics Data System (ADS)

Fischetti, M. A.; Truxal, C.

1985-03-01

The present investigation is mainly concerned with simulators employed in the training of pilots in the Armed Services and other military personnel, taking into account certain problems and approaches for overcoming them. The use of simulators for training programs has a number of advantages compared to training involving a use of the actual equipment. Questions arise, however, regarding the value of such a training. Thus, it has been said that, while simulators gave students practice in manual skill, they could not teach them to handle the stress of being in a real aircraft. It has also been argued that some tasks are not represented accurately enough for proper training. In response to this criticism, the capacity of the simulators has been greatly improved. However, this development leads to problems related to the cost of simulator training. Attention is given to better visuals for flight simulators, the current generation of graphics imagery and expected improvements, possibilities for reducing flight simulator costs, and advances due to progress in microcomputers.

Progress on the Use of Combined Analog and Photon Counting Detection for Raman Lidar

NASA Technical Reports Server (NTRS)

Newsom, Rob; Turner, Dave; Clayton, Marian; Ferrare, Richard

2008-01-01

The Atmospheric Radiation Measurement (ARM) program Raman Lidar (CARL) was upgraded in 2004 with a new data system that provides simultaneous measurements of both the photomultiplier analog output voltage and photon counts. The so-called merge value added procedure (VAP) was developed to combine the analog and count-rate signals into a single signal with improved dynamic range. Earlier versions of this VAP tended to cause unacceptably large biases in the water vapor mixing ratio during the daytime as a result of improper matching between the analog and count-rate signals in the presence of elevated solar background levels. We recently identified several problems and tested a modified version of the merge VAP by comparing profiles of water vapor mixing ratio derived from CARL with simultaneous sonde data over a six month period. We show that the modified merge VAP significantly reduces the daytime bias, and results in mean differences that are within approximately 1% for both nighttime and daytime measurements.

Arm coordination in octopus crawling involves unique motor control strategies.

PubMed

Levy, Guy; Flash, Tamar; Hochner, Binyamin

2015-05-04

To cope with the exceptional computational complexity that is involved in the control of its hyper-redundant arms [1], the octopus has adopted unique motor control strategies in which the central brain activates rather autonomous motor programs in the elaborated peripheral nervous system of the arms [2, 3]. How octopuses coordinate their eight long and flexible arms in locomotion is still unknown. Here, we present the first detailed kinematic analysis of octopus arm coordination in crawling. The results are surprising in several respects: (1) despite its bilaterally symmetrical body, the octopus can crawl in any direction relative to its body orientation; (2) body and crawling orientation are monotonically and independently controlled; and (3) contrasting known animal locomotion, octopus crawling lacks any apparent rhythmical patterns in limb coordination, suggesting a unique non-rhythmical output of the octopus central controller. We show that this uncommon maneuverability is derived from the radial symmetry of the arms around the body and the simple pushing-by-elongation mechanism by which the arms create the crawling thrust. These two together enable a mechanism whereby the central controller chooses in a moment-to-moment fashion which arms to recruit for pushing the body in an instantaneous direction. Our findings suggest that the soft molluscan body has affected in an embodied way [4, 5] the emergence of the adaptive motor behavior of the octopus. Copyright © 2015 Elsevier Ltd. All rights reserved.

RM-10A robotic manipulator system

DOE Office of Scientific and Technical Information (OSTI.GOV)

White, J.R.; Coughlan, J.B.; Harvey, H.W.

1988-01-01

The REMOTE RM-10A is a man-replacement manipulator system that has been developed specifically for use in radioactive and other hazardous environments. It can be teleoperated, with man-in-the-loop, for unstructured tasks or programmed to perform routine tasks automatically much like robots in the automated manufacturing industry. The RM-10A is a servomanipulator utilizing a closed-loop, microprocessor-based control system. The system consists of a slave assembly, master control station, and interconnecting cabling. The slave assembly is the part of the system that enters the hostile environment. It is man-like is size and configuration with two identical arms attached to a torso structure. Eachmore » arm attaches to the torso using two captive screws and two guide pins. The guide pins position and stabilize an arm during removal and reinstallation and also align the two electrical connectors located in the arm support plate and torso. These features allow easy remote replacement of an arm, and commonality of the arms allow interchangeability. The water-resistant slave assembly is equipped with gaskets and O-ring seals in the torso and arm and camera assemblies. In addition, each slave arm's elbow, wrist, and tong are protected by replaceable polyurethane boots. An upper camera assembly, consisting of a color television (TV) camera, 6:1 zoom lens, and a pan/tilt unit, mount to the torso to provide remote viewing capability.« less

Effectiveness of a Proactive Primary Care Program on Preserving Daily Functioning of Older People: A Cluster Randomized Controlled Trial.

PubMed

Bleijenberg, Nienke; Drubbel, Irene; Schuurmans, Marieke J; Dam, Hester Ten; Zuithoff, Nicolaas P A; Numans, Mattijs E; de Wit, Niek J

2016-09-01

To determine the effectiveness of a proactive primary care program on the daily functioning of older people in primary care. Single-blind, three-arm, cluster-randomized controlled trial with 1-year follow-up. Primary care setting, 39 general practices in the Netherlands. Community-dwelling people aged 60 and older (N = 3,092). A frailty screening intervention using routine electronic medical record data to identify older people at risk of adverse events followed by usual care from a general practitioner; after the screening intervention, a nurse-led care program consisting of a comprehensive geriatric assessment, evidence-based care planning, care coordination, and follow-up; usual care. Primary outcome was daily functioning measured using the Katz-15 (6 activities of daily living (ADLs), 8 instrumental activities of daily living (IADLs), one mobility item (range 0-15)); higher scores indicate greater dependence. Secondary outcomes included quality of life, primary care consultations, hospital admissions, emergency department visits, nursing home admissions, and mortality. The participants in both intervention arms had less decline in daily functioning than those in the usual care arm at 12 months (mean Katz-15 score: screening arm, 1.87, 95% confidence interval (CI) = 1.77-1.97; screening and nurse-led care arm, 1.88, 95% CI = 1.80-1.96; control group, 2.03, 95% CI = 1.92-2.13; P = .03). No differences in quality of life were observed. Participants in both intervention groups had less decline than those in the control group at 1-year follow-up. Despite the statistically significant effect, the clinical relevance is uncertain at this point because of the small differences. Greater customizing of the intervention combined with prolonged follow-up may lead to more-robust results. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

The 1994 Louisiana Maneuvers: Is Back to the Future What Our Army Needs?

DTIC Science & Technology

1992-05-26

can link current operational level training to future Combined Arms Training Strategies ( CATS ). The Army Chief of Staff s 1994 Louisiana Maneuver...tactical Combined Arms Training Strategy ( CATS ). An examination of Army tactical training strategies will reflect that operational forces can benefit...from both a CATS structure, and participation in an operational level Battle Command Training Program (BCTP) similar to division and corps BCTP’s

Worldwide Report, Arms Control.

DTIC Science & Technology

1985-11-06

Second Edition p 3 [Commentary by TASS military observer V. Chernyshev: "A Turbid Stream From Washington"] [Text] The more practical steps and...space strike arms and put its "star wars" program into practice . Take, for instance, the foreword to the pamphlet, signed by Defense Secretary C...American empire." According to the American press, the completed "Discovery" flight represented one more practical step in the realization of the so

Multifunctional Battalion Task Force Training: Slovenian Armed Forces Battalion Training Cycle

DTIC Science & Technology

2016-06-10

MULTIFUNCTIONAL BATTALION TASK FORCE TRAINING: SLOVENIAN ARMED FORCES BATTALION TRAINING CYCLE A thesis presented to...Forces Battalion Training Cycle 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Major Ales Avsec 5d...Bn TF) training cycle . It focuses on how the SAF is conducting the infantry and multifunctional Bn TF training. In particular, it deals with mission

The National Guard State Partnership Program and Regional Security in the Western Balkans

DTIC Science & Technology

2014-12-12

expand at the expense of its neighbors, or threaten regional peace and security. Today’s threats in the Western Balkans conceptually resemble the...general threats to the majority of governments in the EU, such as terrorism, arms and human trafficking, international criminal activities, and other...arms and human trafficking, international criminal activities, and other transnational threats . For stakeholders within the region as well as for

H-1 Upgrades (4BW/4BN) (H-1 Upgrades)

DTIC Science & Technology

2015-12-01

automatic blade fold of the new composite rotor blades, new performance matched transmissions, a new four-bladed tail rotor and drive system, upgraded...Upgrades December 2015 SAR March 18, 2016 10:59:17 UNCLASSIFIED 4 Col Steven Girard PMA-276 USMC Light/Attack Helicopter Program Executive Officer...attack helicopter is to provide rotary wing close air support, anti-armor, armed escort, armed/visual reconnaissance and fire support coordination

Autonomous space processor for orbital debris advanced design project in support of solar system exploration

NASA Technical Reports Server (NTRS)

Ramohalli, Kumar; Mitchell, Dominique; Taft, Brett; Chinnock, Paul; Kutz, Bjoern

1992-01-01

This paper is regarding a project in the Advanced Design Program at the University of Arizona. The project is named the Autonomous Space Processor for Orbital Debris (ASPOD) and is a NASA/Universities Space Research Association (USRA) sponsored design project. The development of ASPOD and the students' abilities in designing and building a prototype spacecraft are the ultimate goals of this project. This year's focus entailed the development of a secondary robotic arm and end-effector to work in tandem with an existent arm in the removal of orbital debris. The new arm features the introduction of composite materials and a linear drive system, thus producing a light-weight and more accurate prototype. The main characteristic of the end-effector design is that it incorporates all of the motors and gearing internally, thus not subjecting them to the harsh space environment. Furthermore, the arm and the end-effector are automated by a control system with positional feedback. This system is composed of magnetic and optical encoders connected to a 486 PC via two servo-motor controller cards. Programming a series of basic routines and sub-routines has allowed the ASPOD prototype to become more autonomous. The new system is expected to perform specified tasks with a positional accuracy of 0.5 cm.

Premium-Based Financial Incentives Did Not Promote Workplace Weight Loss In A 2013-15 Study.

PubMed

Patel, Mitesh S; Asch, David A; Troxel, Andrea B; Fletcher, Michele; Osman-Koss, Rosemary; Brady, Jennifer; Wesby, Lisa; Hilbert, Victoria; Zhu, Jingsan; Wang, Wenli; Volpp, Kevin G

2016-01-01

Employers commonly use adjustments to health insurance premiums as incentives to encourage healthy behavior, but the effectiveness of those adjustments is controversial. We gave 197 obese participants in a workplace wellness program a weight loss goal equivalent to 5 percent of their baseline weight. They were randomly assigned to a control arm, with no financial incentive for achieving the goal, or to one of three intervention arms offering an incentive valued at $550. Two intervention arms used health insurance premium adjustments, beginning the following year (delayed) or in the first pay period after achieving the goal (immediate). A third arm used a daily lottery incentive separate from premiums. At twelve months there were no statistically significant differences in mean weight change either between the control group (whose members had a mean gain of 0.1 pound) and any of the incentive groups (delayed premium adjustment, -1.2 pound; immediate premium adjustment, -1.4 pound; daily lottery incentive, -1.0 pound) or among the intervention groups. The apparent failure of the incentives to promote weight loss suggests that employers that encourage weight reduction through workplace wellness programs should test alternatives to the conventional premium adjustment approach by using alternative incentive designs, larger incentives, or both. Project HOPE—The People-to-People Health Foundation, Inc.

Cloud Properties Derived From GOES-7 for Spring 1994 ARM Intensive Observing Period Using Version 1.0.0 of ARM Satellite Data Analysis Program

NASA Technical Reports Server (NTRS)

Minnis, Patrick; Smith, William L., Jr.; Garber, Donald P.; Ayers, J. Kirk; Doelling, David R.

1995-01-01

This document describes the initial formulation (Version 1.0.0) of the Atmospheric Radiation Measurement (ARM) program satellite data analysis procedures. Techniques are presented for calibrating geostationary satellite data with Sun synchronous satellite radiances and for converting narrowband radiances to top-of-the-atmosphere fluxes and albedos. A methodology is documented for combining geostationary visible and infrared radiances with surface-based temperature observations to derive cloud amount, optical depth, height, thickness, temperature, and albedo. The analysis is limited to two grids centered over the ARM Southern Great Plains central facility in north-central Oklahoma. Daytime data taken during 5 Apr. - 1 May 1994, were analyzed on the 0.3 deg and 0.5 deg latitude-longitude grids that cover areas of 0.9 deg x 0.9 deg and 10 deg x 14 deg, respectively. Conditions ranging from scattered low cumulus to thin cirrus and thick cumulonimbus occurred during the study period. Detailed comparisons with hourly surface observations indicate that the mean cloudiness is within a few percent of the surface-derived sky cover. Formats of the results are also provided. The data can be accessed through the World Wide Web computer network.

KSC-2009-5541

NASA Image and Video Library

2009-10-20

CAPE CANAVERAL, Fla. - Inside the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, the 327-foot-tall Ares I-X rocket stands on its mobile launcher platform. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, along with the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. Part of the Constellation Program, the Ares I-X is the test vehicle for the Ares I. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

A randomized phase II trial of ridaforolimus, dalotuzumab, and exemestane compared with ridaforolimus and exemestane in patients with advanced breast cancer.

PubMed

Rugo, Hope S; Trédan, Olivier; Ro, Jungsil; Morales, Serafin M; Campone, Mario; Musolino, Antonino; Afonso, Noémia; Ferreira, Marta; Park, Kyong Hwa; Cortes, Javier; Tan, Antoinette R; Blum, Joanne L; Eaton, Lamar; Gause, Christine K; Wang, Zhen; Im, Ellie; Mauro, David J; Jones, Mary Beth; Denker, Andrew; Baselga, José

2017-10-01

To evaluate whether adding humanized monoclonal insulin growth factor-1 receptor (IGF-1R) antibody (dalotuzumab) to mammalian target of rapamycin (mTOR) inhibitor (ridaforolimus) plus aromatase inhibitor (exemestane) improves outcomes in patients with estrogen receptor (ER)-positive advanced/metastatic breast cancer. This randomized, open-label, phase II trial enrolled 80 postmenopausal women with high-proliferation (Ki67 index staining ≥15%), ER-positive breast cancer that progressed after a non-steroidal aromatase inhibitor (NCT01605396). Randomly assigned patients were given oral ridaforolimus 10 mg QD 5 ×/week, intravenous dalotuzumab 10 mg/kg/week, and oral exemestane 25 mg/day (R/D/E, n = 40), or ridaforolimus 30 mg QD 5 ×/week and exemestane 25 mg/day (R/E; n = 40). Primary end point was progression-free survival (PFS). Median PFS was 23.3 weeks for R/D/E versus 31.9 weeks for R/E (hazard ratio 1.18; 80% CI 0.81-1.72; P = 0.565). Grade 3-5 adverse events were reported in 67.5% of patients in the R/E arm and 59.0% in the R/D/E arm. Stomatitis (95.0 vs. 76.9%; P = 0.021) and pneumonitis (22.5 vs. 5.1%; P = 0.027) occurred more frequently in the R/E than the R/D/E arm; hyperglycemia (27.5 vs. 28.2%) occurred at a similar rate. R/D/E did not improve PFS compared with R/E. Because the PFS reported for R/E was similar to that reported for everolimus plus exemestane in patients with advanced breast cancer, it is possible that lower-dose ridaforolimus in the R/D/E arm (from overlapping toxicities with IGF1R inhibitor) contributed to lack of improved PFS.

Coriolus versicolor (Yunzhi) Use as Therapy in Advanced Hepatocellular Carcinoma Patients with Poor Liver Function or Who Are Unfit for Standard Therapy.

PubMed

Chay, Wen Yee; Tham, Chee Kian; Toh, Han Chong; Lim, Hwee Yong; Tan, Chee Kiat; Lim, Cindy; Wang, Who-Whong; Choo, Su-Pin

2017-08-01

The majority of patients with hepatocellular carcinoma (HCC) are inoperable and results with conventional chemotherapy are dismal. Many end up with no treatment options and resort to alternative medicine. The authors report the use of Coriolus versicolor (CV) in advanced HCC patients with poor liver function or who were unfit to receive standard therapy. Fifteen eligible cases were randomized 2:1 to either CV or placebo. The primary endpoint was the median time to progression (TTP) between both arms. Secondary endpoints include evaluating response rates, toxicity, quality of life (QOL), progression-free survival (PFS), and overall survival (OS). Further correlative studies were performed looking at the effect of CV on the immune system. The median treatment duration was 1.5 cycles and 3 cycles on the placebo and CV arm, respectively. Median TTP was 2.5 (1.4-5.3) months compared to 4.2 (0.4-4.2) months in the CV and placebo arm, respectively, hazard ratio (HR) 0.70 (0.16-3.05 p = 0.634). Median PFS was 2.5 (1.4-5.3) months in the CV and 1.1 (0.4-4.2) months in the placebo arm, HR 0.42 (0.13-1.34, p = 0.144). Median OS was 6.5 (3.3-24.1) and 2.2 (0.8-23.3) months, respectively, HR 0.35 (0.10-1.25, p = 0.105). Social and emotional functioning scores were higher in the CV group compared to placebo group on treatment. CV subjects had less appetite loss and pain symptoms compared to placebo subjects during treatment. There was no difference in TTP with use of CV compared to placebo. CV subjects generally had better QOL on treatment compared to placebo subjects. The utility of this supplement in patients whose primary treatment goal is palliation should be further explored.

Provisional Title: Safety Analysis of Brentuximab Vedotin From the Phase 3 AETHERA Trial in Hodgkin Lymphoma in the Posttransplant Consolidation Setting.

PubMed

Nademanee, A; Sureda, A; Stiff, P; Holowiecki, J; Abidi, M; Hunder, N N; Pecsok, M; Uttarwar, M; Purevjal, I; Sweetenham, J

2018-05-30

The phase 3 AETHERA trial demonstrated brentuximab vedotin's (BV) efficacy as consolidation therapy in patients with classical Hodgkin lymphoma (HL) at high risk of relapse or progression following autologous hematopoietic stem cell transplant (auto-HSCT; hazard ratio [HR]=0.57; P<0.001). The objective of this analysis is to provide further detail on the most common and clinically important treatment-emergent adverse events (TEAEs) in the AETHERA BV arm including their occurrence and management. AEs of clinical importance occurring in patients who participated in AETHERA (BV + best supportive care [BSC], n=165; placebo + BSC, n=164) were evaluated for time to onset, manageability through dose modification, and resolution. As previously reported, peripheral neuropathy (PN; 67%), infections (60%), and neutropenia (35%) were the most common BV-associated TEAEs. Neutropenia was managed with dose delays and granulocyte colony-stimulating factor; no dose reductions or discontinuations were required. The majority (57%) of PN cases were managed with dose delays and reductions. The median time to PN onset was 13.7 (range, 0.1-47.4) weeks. After end of treatment, PN continued to resolve; symptom resolution was similar to that in the placebo arm at 3 years, demonstrating reversibility. BV had no significant impact on preexisting PN. Patients with PN-related dose modifications had progression-free survival (PFS) comparable to patients without. Other less common but serious AEs, including pulmonary toxicities, hepatotoxicity, and cardiotoxicity, were rare in both arms and managed with BV dose modifications or discontinuations. Secondary malignancies were rare and reported in patients with comorbidities or other risk factors. Consolidation therapy with BV for patients with HL at high risk of relapse after auto-HSCT is associated with sustained PFS. The most common AEs in the BV arm were manageable and reversible. Awareness of these AEs and management approaches will enable healthcare providers and patients to plan the safest and most effective treatment plan. Copyright © 2018. Published by Elsevier Inc.

Anthropometric changes in adolescents with anorexia nervosa in response to resistance training.

PubMed

Fernandez-del-Valle, Maria; Larumbe-Zabala, Eneko; Graell-Berna, Montserrat; Perez-Ruiz, Margarita

2015-09-01

The follow-up of anthropometric percentiles such as triceps and mid-thigh skinfold thickness (TSF, MTSF), mid-upper arm and mid-thigh circumferences (MUAC, MTC), and arm and mid-thigh muscle areas (AMA, MTMA) after a resistance training might allow for detecting nutritional progress of fat and muscular tissue during the treatment of anorexia nervosa restricting (AN-R) type patients. A total of 44 AN-R patients were randomized for control (CG 13.0 ± 0.6 years) and intervention (IG 12.7 ± 0.7 years) groups after hospitalization. The intervention group underwent a resistance training program of 8 weeks following the guidelines for healthy adolescents (3 days/week; 70 % of 6 RM). All measurements were obtained prior to starting the program (PRE) and after 8 weeks of training (POST) in both groups. TSF, MTSF, MUAC, and MTC were measured, and AMA and MTMA were calculated. Data were matched with percentile tables for general population. Changes were assessed using statistical tests for categorical data. The distribution of percentile categories within the groups did not differ statistically after 8 weeks (p > 0.05). After training, 73 % of the patients were at the same percentile interval of MUAC, 18 % higher and 9 % lower, while 30 % of CG was at lower percentile categories. Further, 54 % of the IG patients remained at the same percentile interval of MTC after training, and 36 % higher, while 20 % were at lower categories in the CG. The AMA increased (32 %) after training or remained at the same interval (59 %) in the IG, while the IG showed greater frequency of percentile decreases (45 %). Anthropometric measurements could be useful for assessing muscle status in AN-R patients during the treatment process. However, exact standard deviation scores should be used instead of percentile categories to increase the sensitivity to changes in TSF, MTSF, MUAC, MTC or AMA.

Progress toward polio eradication--Somalia, 1998-2013.

PubMed

Mbaeyi, Chukwuma; Kamadjeu, Raoul; Mahamud, Abdirahman; Webeck, Jenna; Ehrhardt, Derek; Mulugeta, Abraham

2014-11-01

Since the 1988 resolution of the World Health Assembly to eradicate polio, significant progress has been made toward achieving this goal, with the result that only Afghanistan, Nigeria, and Pakistan have never successfully interrupted endemic transmission of wild poliovirus. However, one of the greatest challenges of the Global Polio Eradication Initiative has been that of maintaining the polio-free status of countries in unstable regions with weak healthcare infrastructure, a challenge exemplified by Somalia, a country in the Horn of Africa region. Somalia interrupted indigenous transmission of wild poliovirus in 2002, 4 years after the country established its national polio eradication program. But political instability and protracted armed conflict, with significant disruption of the healthcare system, have left Somalia vulnerable to 2 imported outbreaks of wild poliovirus. The first occurred during 2005-2007, resulting in >200 cases of paralytic polio, whereas the second, which began in 2013, is currently ongoing. Despite immense challenges, the country has a sensitive surveillance system that has facilitated prompt detection of outbreaks, but its weak routine immunization system means that supplementary immunization activities constitute the primary strategy for reaching children with polio vaccines. Conducting vaccination campaigns in a setting of conflict has been at times hazardous, but the country's polio program has demonstrated resilience in overcoming many obstacles to ensure that children receive lifesaving polio vaccines. Regaining and maintaining Somalia's polio-free status will depend on finding innovative and lasting solutions to the challenge of administering vaccines in a setting of ongoing conflict and instability. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Computerized Adaptive Testing: From Inquiry to Operation [Book Review].

ERIC Educational Resources Information Center

Gierl, Mark J.

1998-01-01

This book documents the research, development, and implementation efforts that allowed the U.S. Department of Defense to initiate the Computerized Adaptive Testing Armed Services Vocational Aptitude Battery Program for enlistment testing. Traces the history of this program over 30 years. (SLD)

Defense and Arms Control Studies Program

DTIC Science & Technology

1991-01-01

States Military Academy, Poli. Sci. Massachusetts Institute of Technol- ogy, Electr. Eng. Craig Wheeler Cynthia Womack University of California-San...of the Assistant Secretary of Defense (Program Analysis and Evaluation), "Total Force Policy" November 6 - M. Gen. Gene A. Deegan , USMC Vice Director

48 CFR 223.7200 - Definition.

Code of Federal Regulations, 2012 CFR

2012-10-01

... OF DEFENSE SOCIOECONOMIC PROGRAMS ENVIRONMENT, ENERGY AND WATER EFFICIENCY, RENEWABLE ENERGY TECHNOLOGIES, OCCUPATIONAL SAFETY, AND DRUG-FREE WORKPLACE Safeguarding Sensitive Conventional Arms, Ammunition...

48 CFR 223.7201 - Policy.

Code of Federal Regulations, 2012 CFR

2012-10-01

... DEFENSE SOCIOECONOMIC PROGRAMS ENVIRONMENT, ENERGY AND WATER EFFICIENCY, RENEWABLE ENERGY TECHNOLOGIES, OCCUPATIONAL SAFETY, AND DRUG-FREE WORKPLACE Safeguarding Sensitive Conventional Arms, Ammunition, and...