Lymphoma Therapy and Adverse Events: Nursing Strategies for Thinking Critically and Acting Decisively.

PubMed

Goodrich, Amy; Wagner-Johnston, Nina; Delibovi, Dana

2017-02-01

Multiple treatment options, combined with disease heterogeneity, have created nursing challenges in the management of adverse events (AEs) during antilymphoma therapy. Testing has revealed that less than half of participating nurses correctly graded peripheral neuropathy and neutropenia related to antilymphoma regimens. This article identifies nursing challenges in the management of AEs associated with therapy for lymphomas and describes how strategies in critical thinking can help meet those challenges. A comprehensive literature search in oncology nursing, nursing education, and critical thinking was conducted; participant responses to pre- and post-tests at nursing education programs were evaluated; and a roundtable meeting of authors was convened. Oncology nurses can cultivate critical thinking skills, practice thinking critically in relation to team members and patients, leverage information from the Patient-Reported Outcomes Common Terminology Criteria for Adverse Events, and manage workflow to allow more opportunity for critical thinking.

19 CFR 192.11 - Description of the AES.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 2 2012-04-01 2012-04-01 false Description of the AES. 192.11 Section 192.11... TREASURY (CONTINUED) EXPORT CONTROL Filing of Export Information Through the Automated Export System (AES) § 192.11 Description of the AES. AES is a voluntary program that allows all exporters required to report...

19 CFR 192.11 - Description of the AES.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 2 2014-04-01 2014-04-01 false Description of the AES. 192.11 Section 192.11... TREASURY (CONTINUED) EXPORT CONTROL Filing of Export Information Through the Automated Export System (AES) § 192.11 Description of the AES. AES is a voluntary program that allows all exporters required to report...

19 CFR 192.11 - Description of the AES.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 2 2011-04-01 2011-04-01 false Description of the AES. 192.11 Section 192.11... TREASURY (CONTINUED) EXPORT CONTROL Filing of Export Information Through the Automated Export System (AES) § 192.11 Description of the AES. AES is a voluntary program that allows all exporters required to report...

19 CFR 192.11 - Description of the AES.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 2 2013-04-01 2013-04-01 false Description of the AES. 192.11 Section 192.11... TREASURY (CONTINUED) EXPORT CONTROL Filing of Export Information Through the Automated Export System (AES) § 192.11 Description of the AES. AES is a voluntary program that allows all exporters required to report...

Comparison of Combined Aerobic and High-Force Eccentric Resistance Exercise With Aerobic Exercise Only for People With Type 2 Diabetes Mellitus

PubMed Central

Marcus, Robin L; Smith, Sheldon; Morrell, Glen; Addison, Odessa; Dibble, Leland E; Wahoff-Stice, Donna; LaStayo, Paul C

2008-01-01

Background and Purpose: The purpose of this study was to compare the outcomes between a diabetes exercise training program using combined aerobic and high-force eccentric resistance exercise and a program of aerobic exercise only. Subjects and Methods: Fifteen participants with type 2 diabetes mellitus (T2DM) participated in a 16-week supervised exercise training program: 7 (mean age=50.7 years, SD=6.9) in a combined aerobic and eccentric resistance exercise program (AE/RE group) and 8 (mean age=58.5 years, SD=6.2) in a program of aerobic exercise only (AE group). Outcome measures included thigh lean tissue and intramuscular fat (IMF), glycosylated hemoglobin, body mass index (BMI), and 6-minute walk distance. Results: Both groups experienced decreases in mean glycosylated hemoglobin after training (AE/RE group: −0.59% [95% confidence interval (CI)=−1.5 to 0.28]; AE group: −0.31% [95% CI=−0.60 to −0.03]), with no significant between-group differences. There was an interaction between group and time with respect to change in thigh lean tissue cross-sectional area, with the AE/RE group gaining more lean tissue (AE/RE group: 15.1 cm2 [95% CI=7.6 to 22.5]; AE group: −5.6 cm2 [95% CI=−10.4 to 0.76]). Both groups experienced decreases in mean thigh IMF cross-sectional area (AE/RE group: −1.2 cm2 [95% CI=−2.6 to 0.26]; AE group: −2.2 cm2 [95% CI=−3.5 to −0.84]) and increases in 6-minute walk distance (AE/RE group: 45.5 m [95% CI=7.5 to 83.6]; AE group: 29.9 m [95% CI=−7.7 to 67.5]) after training, with no between-group differences. There was an interaction between group and time with respect to change in BMI, with the AE/RE group experiencing a greater decrease in BMI. Discussion and Conclusion: Significant improvements in long-term glycemic control, thigh composition, and physical performance were demonstrated in both groups after participating in a 16-week exercise program. Subjects in the AE/RE group demonstrated additional improvements in thigh lean tissue and BMI. Improvements in thigh lean tissue may be important in this population as a means to increase resting metabolic rate, protein reserve, exercise tolerance, and functional mobility. PMID:18801851

Globalization, Adult Education & Training. Impacts & Issues. Global Perspectives on Adult Education and Training Series.

ERIC Educational Resources Information Center

Walters, Shirley, Ed.

An introduction (Maurice Amutabi et al.) begins this 25-chapter book on adult education and training (AET) in a context of globalization. Chapter titles and authors are as follows: "The Impact of Globalization on Adult Education (AE)" (Ove Korsgaard); "In Defense of Civil Society: Canadian AE in Neo-Conservative Times" (Michael…

Investigation of Participation in Adult Education in Turkey: AES Data Analysis

ERIC Educational Resources Information Center

Dincer, N. Nergiz; Tekin-Koru, Ayca; Askar, Petek

2016-01-01

The aim of this study is to identify the determinants of participation in adult education in Turkey. The analysis is conducted using the Adult Education Survey (AES), conducted by TurkStat. The results indicate that economic growth in the sector of employment significantly and positively affects the odds for adult education participation. The data…

Comparison of Vector Competence of Aedes mediovittatus and Aedes aegypti for Dengue Virus: Implications for Dengue Control in the Caribbean

PubMed Central

Poole-Smith, B. Katherine; Hemme, Ryan R.; Delorey, Mark; Felix, Gilberto; Gonzalez, Andrea L.; Amador, Manuel; Hunsperger, Elizabeth A.; Barrera, Roberto

2015-01-01

Background Aedes mediovittatus mosquitoes are found throughout the Greater Antilles in the Caribbean and often share the same larval habitats with Ae. Aegypti, the primary vector for dengue virus (DENV). Implementation of vector control measures to control dengue that specifically target Ae. Aegypti may not control DENV transmission in Puerto Rico (PR). Even if Ae. Aegypti is eliminated or DENV refractory mosquitoes are released, DENV transmission may not cease when other competent mosquito species like Ae. Mediovittatus are present. To compare vector competence of Ae. Mediovittatus and Ae. Aegypti mosquitoes, we studied relative infection and transmission rates for all four DENV serotypes. Methods To compare the vector competence of Ae. Mediovittatus and Ae. Aegypti, mosquitoes were exposed to DENV 1–4 per os at viral titers of 5–6 logs plaque-forming unit (pfu) equivalents. At 14 days post infectious bloodmeal, viral RNA was extracted and tested by qRT-PCR to determine infection and transmission rates. Infection and transmission rates were analyzed with a generalized linear model assuming a binomial distribution. Results Ae. Aegypti had significantly higher DENV-4 infection and transmission rates than Ae. mediovittatus. Conclusions This study determined that Ae. Mediovittatus is a competent DENV vector. Therefore dengue prevention programs in PR and the Caribbean should consider both Ae. Mediovittatus and Ae. Aegypti mosquitoes in their vector control programs. PMID:25658951

"Utopia" and "Passion": A Commentary on "Sustainability and Accounting Education: The Elephant in the Classroom"

ERIC Educational Resources Information Center

Contrafatto, Massimo

2013-01-01

In this commentary, Massimo Contrafatto explains his understanding of Gray's interpretation of accounting education for sustainability (AE4S), and contributes some personal insights to the future development of AE4S. Gray reflected on an educational engagement experiment where the complex issues surrounding sustainability were dealt with in an…

Holding back the tiger: Successful control program protects Australia from Aedes albopictus expansion

PubMed Central

Devine, Gregor; Davis, Joseph; Crunkhorn, Bruce; van den Hurk, Andrew; Whelan, Peter; Russell, Richard; Walker, James; Horne, Peter; Ehlers, Gerhard; Ritchie, Scott

2017-01-01

Background The Asian tiger mosquito, Aedes albopictus, is an important vector of dengue, chikungunya and Zika viruses and is a highly invasive and aggressive biter. Established populations of this species were first recognised in Australia in 2005 when they were discovered on islands in the Torres Strait, between mainland Australia and Papua New Guinea. A control program was implemented with the original goal of eliminating Ae. albopictus from the Torres Strait. We describe the evolution of management strategies that provide a template for Ae. albopictus control that can be adopted elsewhere. Methodology / Principal findings The control strategy implemented between 2005 and 2008 targeted larval habitats using source reduction, insect-growth regulator and pyrethroid insecticide to control larvae and adults in the containers. However, the infrequency of insecticide reapplication, the continual accumulation and replacement of containers, and imminent re-introduction of mosquitoes through people’s movement from elsewhere compromised the program. Consequently, in 2009 the objective of the program changed from elimination to quarantine, with the goal of preventing Ae albopictus from infesting Thursday and Horn islands, which are the transport hubs connecting the Torres Strait to mainland Australia. However, larval control strategies did not prevent the species establishing on these islands in 2010. Thereafter, an additional strategy adopted by the quarantine program in early 2011 was harborage spraying, whereby the vegetated, well shaded resting sites of adult Ae. albopictus were treated with a residual pyrethroid insecticide. Inclusion of this additional measure led to a 97% decline in Ae. albopictus numbers within two years. In addition, the frequency of container treatment was increased to five weeks between treatments, compared to an average of 8 weeks that occurred in the earlier iterations of the program. By 2015 and 2016, Ae. albopictus populations on the two islands were undetectable in 70–90% of surveys conducted. Importantly, a comprehensive surveillance network in selected strategic areas has not identified established populations of this species on the Australian mainland. Conclusions / Significance The program has successfully reduced Ae. albopictus populations on Thursday Island and Horn Island to levels where it is undetectable in up to 90% of surveys, and has largely removed the risk of mainland establishment via that route. The vector management strategies adopted in the later years of the program have been demonstrably successful and provide a practical management framework for dengue, chikungunya or Zika virus outbreaks vectored by Ae. albopictus. As of June 2016, Ae. albopictus had not established on the Australian mainland and this program has likely contributed significantly to this outcome. PMID:28192520

Insulin pump-associated adverse events in children and adolescents--a prospective study.

PubMed

Wheeler, Benjamin J; Heels, Kristine; Donaghue, Kim C; Reith, David M; Ambler, Geoffrey R

2014-09-01

Intensive insulin regimens are now the mainstay of modern, type 1 diabetes mellitus management. Insulin pumps (CSII) are a key technique used. Although there has been considerable study of outcomes, there are few recent data on CSII-associated adverse events (AEs) and their incidence and characteristics. Phone calls to our 24-h diabetes support service were screened for CSII-associated AEs. Phone interviews were conducted with the parent/patient, within 96 h of the event. Interviews explored AE characteristics and the role of the user, as well as questions relating to outcome and the impact to the family and patient. Comparisons were made with clinic CSII patients not reporting an AE. Over a 16-week study period, 50 confirmed AEs occurred in 45 of 405 (11.1%) patients. This was annualized to an AE incidence of 40 AEs/100 person-years. Pump malfunction and infusion set/site failures were the most common events reported, occurring in 27 (54.0%) and 18 (36.0%) AEs, respectively. A user- or education-related issue was implicated in 22 (44.0%) events. Pump replacement occurred in 19 of 50 occurrences (38.0%). Additionally, 16 (32.0%) reported a hospital admission or emergency department attendance as a consequence. When compared with those on CSII not reporting an AE, AEs were associated with age <10 years (odds ratio=3.2 [95% confidence interval, 1.7-6.1]) but not with gender, glycosylated hemoglobin, diabetes duration, or pumping duration. This is the first prospective study to look at AEs in modern-generation insulin pumps. AEs appear common and should be anticipated. Their origin is multifactorial, with the pump, associated consumables, and the user all being important factors. Ongoing support and anticipatory education are essential to minimize pump-associated AEs and their impact.

Application of TURBO-AE to Flutter Prediction: Aeroelastic Code Development

NASA Technical Reports Server (NTRS)

Hoyniak, Daniel; Simons, Todd A.; Stefko, George (Technical Monitor)

2001-01-01

The TURBO-AE program has been evaluated by comparing the obtained results to cascade rig data and to prediction made from various in-house programs. A high-speed fan cascade, a turbine cascade, a turbine cascade and a fan geometry that shower flutter in torsion mode were analyzed. The steady predictions for the high-speed fan cascade showed the TURBO-AE predictions to match in-house codes. However, the predictions did not match the measured blade surface data. Other researchers also reported similar disagreement with these data set. Unsteady runs for the fan configuration were not successful using TURBO-AE .

Proposal of a New Adverse Event Classification by the Society of Interventional Radiology Standards of Practice Committee.

PubMed

Khalilzadeh, Omid; Baerlocher, Mark O; Shyn, Paul B; Connolly, Bairbre L; Devane, A Michael; Morris, Christopher S; Cohen, Alan M; Midia, Mehran; Thornton, Raymond H; Gross, Kathleen; Caplin, Drew M; Aeron, Gunjan; Misra, Sanjay; Patel, Nilesh H; Walker, T Gregory; Martinez-Salazar, Gloria; Silberzweig, James E; Nikolic, Boris

2017-10-01

To develop a new adverse event (AE) classification for the interventional radiology (IR) procedures and evaluate its clinical, research, and educational value compared with the existing Society of Interventional Radiology (SIR) classification via an SIR member survey. A new AE classification was developed by members of the Standards of Practice Committee of the SIR. Subsequently, a survey was created by a group of 18 members from the SIR Standards of Practice Committee and Service Lines. Twelve clinical AE case scenarios were generated that encompassed a broad spectrum of IR procedures and potential AEs. Survey questions were designed to evaluate the following domains: educational and research values, accountability for intraprocedural challenges, consistency of AE reporting, unambiguity, and potential for incorporation into existing quality-assurance framework. For each AE scenario, the survey participants were instructed to answer questions about the proposed and existing SIR classifications. SIR members were invited via online survey links, and 68 members participated among 140 surveyed. Answers on new and existing classifications were evaluated and compared statistically. Overall comparison between the two surveys was performed by generalized linear modeling. The proposed AE classification received superior evaluations in terms of consistency of reporting (P < .05) and potential for incorporation into existing quality-assurance framework (P < .05). Respondents gave a higher overall rating to the educational and research value of the new compared with the existing classification (P < .05). This study proposed an AE classification system that outperformed the existing SIR classification in the studied domains. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

Understanding the positive benefit:risk profile of alemtuzumab in relapsing multiple sclerosis: perspectives from the Alemtuzumab Clinical Development Program.

PubMed

Havrdova, Eva; Cohen, Jeffrey A; Horakova, Dana; Kovarova, Ivana; Meluzinova, Eva

2017-01-01

The introduction of high-efficacy therapies for relapsing-remitting multiple sclerosis has driven re-evaluation of treatment goals and benefit:risk considerations in treatment choice. In the alemtuzumab Phase II and III clinical trials, patients treated with alemtuzumab 12 mg versus subcutaneous interferon beta-1a demonstrated significantly reduced annualized relapse rates and improved magnetic resonance imaging outcomes, and were significantly more likely to achieve no evidence of disease activity and reduction in brain volume loss. In two of the studies, alemtuzumab-treated patients had a significantly reduced risk of 6-month confirmed disease worsening, compared with subcutaneous interferon beta-1a. Benefits were maintained throughout 5 years, with a majority of patients receiving no alemtuzumab retreatment or other disease-modifying therapy. Trial results support alemtuzumab's manageable, consistent safety profile in relapsing-remitting multiple sclerosis. Infusion-associated reactions, the most frequent adverse events (AEs), can be minimized by corticosteroid pretreatment, monitoring, and symptomatic management. Other AEs include infections and autoimmune events. Oral anti-herpes prophylaxis should be initiated on the first day of each alemtuzumab treatment course and continued according to local guidelines. Overall cancer risk was lower in the alemtuzumab clinical trials than in a reference population; however, continuing surveillance will determine if alemtuzumab may be associated with certain malignancies such as thyroid papillary carcinoma and melanoma, which are currently identified as potential risks. The post-approval risk management strategy includes a safety monitoring program. Autoimmune AEs (thyroid events, immune thrombocytopenia, nephropathies) can be detected in a timely manner with the monitoring program, which includes physician and patient education about the signs and symptoms, monthly renal and hematologic monitoring, and quarterly thyroid function monitoring for 48 months after the last alemtuzumab course. Education, vigilance by physicians and patients, and monthly laboratory monitoring are recommended to maintain alemtuzumab's positive benefit:risk profile.

Personality and Biography: Proceedings of the Sixth International Conference on the History of Adult Education. Volume II: Biographies of Adult Educators from Five Continents.

ERIC Educational Resources Information Center

Friedenthal-Haase, Martha, Ed.

This volume contains 36 biographies: "I.T.A. Wallace-Johnson and Radical Adult Education (AE) in Sierra Leone in the Years 1938/1939" (Turay); "Frank C. Laubach as the Father of the Adult Literacy Movement in India" (Ghosh); "A Historical Study on the Theory and Practice of Social and AE in Korea" (Lee); "Integrative Adult Educators" (Yaron);…

Train-the-Trainer for Adult Education. Quality Professional Development Project.

ERIC Educational Resources Information Center

Florida Community Coll., Jacksonville.

This manual aids professional development adult education (AE) facilitators in conducting AE workshops using Quality Professional Development (QPD) Project materials. A workshop outline is provided. Six sections correspond to the six manuals in the training package. Section components are as follows: objectives for five or six units; activities;…

Disciplinary Regimes of "Care" and Complementary Alternative Education

ERIC Educational Resources Information Center

Thomson, Pat; Pennacchia, Jodie

2016-01-01

In schools, the notion of "care" is often synonymous with welfare and disciplinary regimes. Drawing on Foucault, and a study of alternative education (AE) across the UK, and looking in depth at two cases of complementary AE, we identify three types of disciplinary regimes at work in schools: (1) dominant performative reward and…

Vision 2000 Conference Report (Alexandria, Virginia, July 21-24, 1994).

ERIC Educational Resources Information Center

National Council for Agricultural Education, Alexandria, VA.

Representatives of 11 organizations playing a leading role in agricultural education (AE) attended a conference to discuss their vision of AE in the year 2000. During the conference, the issues of greatest concern to AE were prioritized, specific strategies/solutions to accomplish each priority were identified, an action plan to achieve desired…

Into the thermosphere: The atmosphere explorers

NASA Technical Reports Server (NTRS)

Burgess, Eric; Torr, Douglass

1987-01-01

The need to study the lower thermosphere with the new instrument, data handling, and spacecraft technology available in the 1960s led to the formulation and establishment of the Atmospheric Explorer program. This book provides an overview of this program with particular emphasis on the AE3, AE4, and AE5 satellites, which represent early examples of problem-dedicated missions. Both the satellites and their instrumentation on the one hand and the experimental and scientific considerations in studying the thermosphere on the other are discussed.

Paediatric conference.

PubMed

1999-04-01

The venue for the postponed RCN Children in A&E (Within the RCN A&E Nursing Association) Annual Conference, Saturday, April 24 1999 will be The Education Centre, Birmingham Children's Hospital, Steelhouse Lane, Birmingham.

Global Expression Profiling in Atopic Eczema Reveals Reciprocal Expression of Inflammatory and Lipid Genes

PubMed Central

Sääf, Annika M.; Tengvall-Linder, Maria; Chang, Howard Y.; Adler, Adam S.; Wahlgren, Carl-Fredrik; Scheynius, Annika; Nordenskjöld, Magnus; Bradley, Maria

2008-01-01

Background Atopic eczema (AE) is a common chronic inflammatory skin disorder. In order to dissect the genetic background several linkage and genetic association studies have been performed. Yet very little is known about specific genes involved in this complex skin disease, and the underlying molecular mechanisms are not fully understood. Methodology/Findings We used human DNA microarrays to identify a molecular picture of the programmed responses of the human genome to AE. The transcriptional program was analyzed in skin biopsy samples from lesional and patch-tested skin from AE patients sensitized to Malassezia sympodialis (M. sympodialis), and corresponding biopsies from healthy individuals. The most notable feature of the global gene-expression pattern observed in AE skin was a reciprocal expression of induced inflammatory genes and repressed lipid metabolism genes. The overall transcriptional response in M. sympodialis patch-tested AE skin was similar to the gene-expression signature identified in lesional AE skin. In the constellation of genes differentially expressed in AE skin compared to healthy control skin, we have identified several potential susceptibility genes that may play a critical role in the pathological condition of AE. Many of these genes, including genes with a role in immune responses, lipid homeostasis, and epidermal differentiation, are localized on chromosomal regions previously linked to AE. Conclusions/Significance Through genome-wide expression profiling, we were able to discover a distinct reciprocal expression pattern of induced inflammatory genes and repressed lipid metabolism genes in skin from AE patients. We found a significant enrichment of differentially expressed genes in AE with cytobands associated to the disease, and furthermore new chromosomal regions were found that could potentially guide future region-specific linkage mapping in AE. The full data set is available at http://microarray-pubs.stanford.edu/eczema. PMID:19107207

Bridging the Gap between Human Resource Development and Adult Education: Part One, Assumptions, Definitions, and Critiques

ERIC Educational Resources Information Center

Hatcher, Tim; Bowles, Tuere

2006-01-01

Human resource development (HRD) as a scholarly endeavor and as a practice is often criticized in the adult education (AE) literature and by AE scholars as manipulative and oppressive and, through training and other interventions, controlling workers for strictly economic ends (Baptiste, 2001; Cunningham, 2004; Schied, 2001; Welton, 1995).…

Bridging the Gap between Human Resource Development and Adult Education: Part Two, the Critical Turn

ERIC Educational Resources Information Center

Hatcher, Tim; Bowles, Tuere

2006-01-01

Human resource development (HRD) as a scholarly endeavor and as a practice is often criticized in the adult education (AE) literature and by AE scholars as manipulative and oppressive and, through training and other interventions, controlling workers for strictly economic ends (Baptiste, 2001; Cunningham, 2004; Schied, 2001; Welton, 1995). The…

Kicked out of School and Suffering: The Health Needs of Alternative Education Youth in New Zealand

ERIC Educational Resources Information Center

Clark, Terryann; Smith, Jodi; Raphael, Deborah; Jackson, Catherine; Denny, Simon; Fleming, Theresa; Ameratunga, Shanthi; Crengle, Sue

2010-01-01

Anonymous self-report health and wellbeing surveys were completed by alternative education (AE) students in the Auckland and Northland regions of New Zealand, and 11 semi structured interviews were conducted with key informants about their perceptions of health issues for AE students. Both groups reported concerning health-risk behaviours among AE…

Bridging the Gap between Human Resource Development and Adult Education: Part Two, the Critical Turn

ERIC Educational Resources Information Center

Hatcher, Tim; Bowles, Tuere

2014-01-01

Human resource development (HRD) as a scholarly endeavor and as a practice is often criticized in the adult education (AE) literature and by AE scholars as manipulative and oppressive and, through training and other interventions, controlling workers for strictly economic ends (Baptiste, 2001; Cunningham, 2004; Schied, 2001; Welton, 1995). The…

Bridging the Gap between Human Resource Development and Adult Education: Part One, Assumptions, Definitions, and Critiques

ERIC Educational Resources Information Center

Hatcher, Tim; Bowles, Tuere

2013-01-01

Human resource development (HRD) as a scholarly endeavor and as a practice is often criticized in the adult education (AE) literature and by AE scholars as manipulative and oppressive and, through training and other interventions, controlling workers for strictly economic ends (Baptiste, 2001; Cunningham, 2004; Schied, 2001; Welton, 1995).…

Malathion resistance in Aedes aegypti and Culex quinquefasciatus after its use in Aedes aegypti control programs.

PubMed

Coto, M M; Lazcano, J A; de Fernández, D M; Soca, A

2000-12-01

The continued widespread use of malathion in Aedes aegypti control programs in Latin America has generated insecticide resistance to this chemical in Culex quinquefasciatus but not in Ae. aegypti. To determine the extent of this resistance, the susceptibility of Cx. quinquefasciatus and Ae. aegypti from several countries to malathion was evaluated. Bioassay results indicated that all Ae. aegypti strains evaluated from Cuba, Venezuela, Costa Rica, and Jamaica were susceptible to malathion in spite of the historical use of this insecticide in Ae. aegypti control programs in these countries. In contrast, a high level of resistance to this insecticide was found in Cx. quinquefasciatus from Venezuela, Colombia, Brazil, and Cuba. Synergist assays indicated that neither esterases nor mixed-function oxidases (MFOs) were involved as the resistance mechanism to malathion in any of the Ae. aegypti strains tested. In Cx. quinquefasciatus, synergist assays confirmed that esterases played an important role in malathion resistance but MFOs were not involved in causing malathion resistance in this species. Biochemical assays showed that both resistance mechanisms were present in the Ae. aegypti and Cx. quinquefasciatus populations. Acrylamide electrophoresis gels revealed that all Ae. aegypti strains had a strongly staining, clear band, named A4, and had a relative mobility (Rm) value of 0.7. Analysis if the results of this study suggested that malathion could continue to be used for the emergency control of Ae. aegypti, the mosquito vector for dengue and dengue hemorrhagic fever in the Americas, but that malathion is probably not effective for the control of adult Cx. quinquefasciatus in urban areas. Therefore, control operations should integrate nonorganophosphate insecticides such as pyrethroids for control of these 2 species found in the urban environment.

Test and Verification of AES Used for Image Encryption

NASA Astrophysics Data System (ADS)

Zhang, Yong

2018-03-01

In this paper, an image encryption program based on AES in cipher block chaining mode was designed with C language. The encryption/decryption speed and security performance of AES based image cryptosystem were tested and used to compare the proposed cryptosystem with some existing image cryptosystems based on chaos. Simulation results show that AES can apply to image encryption, which refutes the widely accepted point of view that AES is not suitable for image encryption. This paper also suggests taking the speed of AES based image encryption as the speed benchmark of image encryption algorithms. And those image encryption algorithms whose speeds are lower than the benchmark should be discarded in practical communications.

Automated essay scoring and the future of educational assessment in medical education.

PubMed

Gierl, Mark J; Latifi, Syed; Lai, Hollis; Boulais, André-Philippe; De Champlain, André

2014-10-01

Constructed-response tasks, which range from short-answer tests to essay questions, are included in assessments of medical knowledge because they allow educators to measure students' ability to think, reason, solve complex problems, communicate and collaborate through their use of writing. However, constructed-response tasks are also costly to administer and challenging to score because they rely on human raters. One alternative to the manual scoring process is to integrate computer technology with writing assessment. The process of scoring written responses using computer programs is known as 'automated essay scoring' (AES). An AES system uses a computer program that builds a scoring model by extracting linguistic features from a constructed-response prompt that has been pre-scored by human raters and then, using machine learning algorithms, maps the linguistic features to the human scores so that the computer can be used to classify (i.e. score or grade) the responses of a new group of students. The accuracy of the score classification can be evaluated using different measures of agreement. Automated essay scoring provides a method for scoring constructed-response tests that complements the current use of selected-response testing in medical education. The method can serve medical educators by providing the summative scores required for high-stakes testing. It can also serve medical students by providing them with detailed feedback as part of a formative assessment process. Automated essay scoring systems yield scores that consistently agree with those of human raters at a level as high, if not higher, as the level of agreement among human raters themselves. The system offers medical educators many benefits for scoring constructed-response tasks, such as improving the consistency of scoring, reducing the time required for scoring and reporting, minimising the costs of scoring, and providing students with immediate feedback on constructed-response tasks. © 2014 John Wiley & Sons Ltd.

Influence of Occupational Socialization on the Practices and Perspectives of Two Inexperienced Adventure Educators

ERIC Educational Resources Information Center

Zmudy, Mark H.; Curtner-Smith, Matthew D.; Steffen, Jeff

2009-01-01

A relatively small number of researchers have found it interesting and useful to examine why and how persons choose to be and become adventure educators (AEs) and why they teach as they do. The implications of this knowledge are: (1) gaining insight into novice AEs' perceptions of what is required to provide in-depth and high quality instruction…

What's new in atopic eczema? An analysis of systematic reviews published in 2010-11.

PubMed

Torley, D; Futamura, M; Williams, H C; Thomas, K S

2013-07-01

This review provides a summary of key findings from 24 systematic reviews of atopic eczema (AE) published or indexed between 1 August 2010 and 31 December 2011, updating published summaries from previous years. Epidemiological evidence points to the protective effects of early daycare, endotoxin exposure, consumption of unpasteurized milk, and early exposure to dogs, but antibiotic use in early life may increase the risk for AE. With regard to prevention of AE, there is currently no strong evidence of benefit for exclusive breastfeeding, hydrolysed protein formulas, soy formulas, maternal antigen avoidance, omega-3 or omega-6 fatty-acid supplementation, or use of prebiotics or probiotics. With respect to AE treatments, the most compelling new systematic review evidence was for proactive treatment with topical anti-inflammatory agents (topical corticosteroids and topical calcineurin inhibitors) for the prevention of AE flares in patients with moderate to severe AE. A meta-analysis of 4 trials confirmed the superiority of tacrolimus 0.1% over pimecrolimus for the treatment of AE, and a review of 17 trials found that tacrolimus (0.1% or 0.03%) was broadly similar in efficacy to mild/moderate topical corticosteroids. Evidence for the role of education in the management of AE was less conclusive, with evidence from randomized controlled trials showing mixed results. Further work is needed in this area to conduct high-quality trials of educational interventions that are clearly described and reproducible. There is no clear evidence for the efficacy of homeopathy, botanical extracts or Chinese herbal medicine in the treatment of AE, as large well-designed trials are lacking in these areas. © 2013 British Association of Dermatologists.

Adverse Events in Treating Smear-Positive Tuberculosis Patients in China

PubMed Central

Zhang, Tao; Du, Jian; Yin, Xiaoyan; Xue, Fuzhong; Liu, Yanxun; Li, Runzi; Luo, Cheng; Li, Liang; Li, Xiujun

2015-01-01

This study aimed to estimate the adverse events (AE) rate during anti-tuberculosis treatment and to explore AE-related risk factors. New and previously treated smear-positive tuberculosis (TB) cases were enrolled from eight regions in China between April 2009 and October 2010. The AE rate was estimated, and AE risk factors during anti-TB treatment were assessed using Cox proportional models. Among 2091 Chinese subjects with anti-TB treatment, 462 (22.1%, 95% confidence interval (CI), 20.3–23.9) patients developed AE, with liver injury and gastrointestinal reactions constituting the most common AE. Specifically, 9.8% (95% CI, 8.5–11.1) and 6.3% (95% CI, 5.3–7.4) developed liver injuries and gastrointestinal reactions, respectively. We found that AE rate differed by regions, TB knowledge score, symptoms score and smoking status. Liver injuries were associated with age, sex and smoking status; gastrointestinal reactions were associated with education level and symptom score. Improving patients’ knowledge on TB could reduce AE rate. PMID:26729141

Beyond the Dose-Limiting Toxicity Period: Dermatologic Adverse Events of Patients on Phase 1 Trials of the Cancer Therapeutics Evaluation Program

PubMed Central

Drilon, Alexander; Eaton, Anne A.; Schindler, Katja; Gounder, Mrinal M.; Spriggs, David R.; Harris, Pamela; Ivy, S. Percy; Iasonos, Alexia; Lacouture, Mario E.; Hyman, David M.

2017-01-01

BACKGROUND Dermatologic adverse events (AEs) can be key determinants of overall drug tolerability and of the maximum tolerated and recommended phase 2 doses in phase 1 trials. The authors present the largest dedicated analysis of dermatologic AEs on phase 1 trials to date. METHODS Data from a prospectively maintained database of patients with solid tumors who were enrolled onto Cancer Therapeutics Evaluation Program (CTEP)-sponsored phase 1 trials of cytotoxic or molecularly targeted agents (MTAs) from 2000 to 2010 were analyzed. Cumulative incidence, site, and type of drug-related dermatologic AEs were described and compared. The timing of worst drug-related dermatologic AEs was summarized. RESULTS In total, 3517 patients with solid tumors and 6165 unique, drug-related dermatologic AEs were analyzed, including 1545 patients on MTA-only trials, 671 on cytotoxic-only trials, and 1392 on combination MTA and cytotoxic trials. Of 1270 patients who had drug-related dermatologic events, the timing of the worst AE was as follows: 743 (cycle 1), 303 (cycle 2), and 224 (cycle 3 or later). Although the cumulative incidence of grade ≥3 drug-related AEs increased to 2.4% by cycle 6, it was only 1.6% at the end of cycle 1. The cumulative incidence of drug-related AEs was highest in patients who received MTA-only therapy (P <.001) and differed by dose level (P <.001). In patients who received MTA-only therapy, drug-related AEs were most common for combination kinase inhibitor-containing therapy (P <.001). CONCLUSIONS A substantial proportion of drug-related dermatologic AEs occur after the traditional dose-limiting toxicity monitoring period of phase 1 clinical trials. Future designs should account for late toxicities. PMID:26916138

Beyond the dose-limiting toxicity period: Dermatologic adverse events of patients on phase 1 trials of the Cancer Therapeutics Evaluation Program.

PubMed

Drilon, Alexander; Eaton, Anne A; Schindler, Katja; Gounder, Mrinal M; Spriggs, David R; Harris, Pamela; Ivy, S Percy; Iasonos, Alexia; Lacouture, Mario E; Hyman, David M

2016-04-15

Dermatologic adverse events (AEs) can be key determinants of overall drug tolerability and of the maximum tolerated and recommended phase 2 doses in phase 1 trials. The authors present the largest dedicated analysis of dermatologic AEs on phase 1 trials to date. Data from a prospectively maintained database of patients with solid tumors who were enrolled onto Cancer Therapeutics Evaluation Program (CTEP)-sponsored phase 1 trials of cytotoxic or molecularly targeted agents (MTAs) from 2000 to 2010 were analyzed. Cumulative incidence, site, and type of drug-related dermatologic AEs were described and compared. The timing of worst drug-related dermatologic AEs was summarized. In total, 3517 patients with solid tumors and 6165 unique, drug-related dermatologic AEs were analyzed, including 1545 patients on MTA-only trials, 671 on cytotoxic-only trials, and 1392 on combination MTA and cytotoxic trials. Of 1270 patients who had drug-related dermatologic events, the timing of the worst AE was as follows: 743 (cycle 1), 303 (cycle 2), and 224 (cycle 3 or later). Although the cumulative incidence of grade ≥3 drug-related AEs increased to 2.4% by cycle 6, it was only 1.6% at the end of cycle 1. The cumulative incidence of drug-related AEs was highest in patients who received MTA-only therapy (P < .001) and differed by dose level (P < .001). In patients who received MTA-only therapy, drug-related AEs were most common for combination kinase inhibitor-containing therapy (P < .001). A substantial proportion of drug-related dermatologic AEs occur after the traditional dose-limiting toxicity monitoring period of phase 1 clinical trials. Future designs should account for late toxicities. © 2016 American Cancer Society.

Current practices in the management of adverse events associated with targeted therapies for advanced renal cell carcinoma: a national survey of oncologists.

PubMed

Ruiz, Janelle Nicole; Belum, Viswanath Reddy; Creel, Patricia; Cohn, Allen; Ewer, Michael; Lacouture, Mario E

2014-10-01

Oncologists treating patients with targeted therapies encounter adverse events (AEs) that pose management challenges, lead to dosing inconsistencies, and impact patient quality of life. Oncologists' practices and attitudes in the management of targeted therapy-related AEs in patients with renal cell carcinoma (RCC) are poorly understood. We sought to identify unmet needs associated with AE management and understand oncologists' treatment optimization strategies. A 24-item online survey was administered in August 2012 to 119 US oncologists treating patients with advanced RCC. The survey solicited responses regarding demographics, practice settings, AE management practice patterns and beliefs, treatment barriers, and patient education. Respondents indicated that between 25% and 50% of patients require dose modification/discontinuation because of AEs. The greatest barrier to optimizing treatment for RCC is the unpredictability of patient responses to treatment (43%). Most respondents (78%) discuss AE management with patients, but only a minority of them proactively reach out to patients (46%). Most practitioners (70%) refer patients to nononcology specialists when faced with unfamiliar AEs, although finding interested physicians (43%) and time constraints (40%) were the most commonly cited barriers to consulting with other specialties. Results suggest that many patients require dose modification/discontinuation because of AEs and that nononcologists are a frequently utilized resource to manage these events. There is a need for predictive drug toxicity markers to establish counseling and prevention, along with opportunities for increased education on supportive care techniques to maintain health-related quality of life and consistent dosing. Copyright © 2014 Elsevier Inc. All rights reserved.

Concurrent recordings of Electrical Current Emissions and Acoustic Emissions detected from marble specimens subjected to mechanical stress up to fracture

NASA Astrophysics Data System (ADS)

Stavrakas, I.; Hloupis, G.; Triantis, D.; Vallianatos, F.

2012-04-01

The emission of electrical signals during the application of mechanical stress on brittle geo-materials (the so called Pressure Stimulated Current - PSC[1,2]), provides significant information regarding the mechanical status of the studied rock sample, since PSCs are originated as a result of the opening of cracks and microfractures[3]. The latter mechanism for the creation of PSCs it is straightforward to associated with the recording of acoustic emissions (AE). To justify the common origin of PSCs and AE due to opening of cracks, a combined study was performed implicating the concurrent recording of electric current emissions and AE on marble samples when they are subjected to linearly increasing mechanical load up to the fracture. The electric signal detected is recorded by an ultra sensitive electrometer (Keithley 6514). The sensor used for detecting the electric current is a pair of gold plated electrodes adapted bilaterally on the sample found under axial mechanical stress[4]. The AE were recorded through the Physical Acoustics PCI-2 Acquisition System. The experimental results prove the strong association of the recorded electrical signals and the corresponding acoustic emissions justifying their common origin due to opening of microfractures. Furthermore, when the applied mechanical load exceeds the yield stress then an increasing of PSCs amplitude along with that of AE rate is observed. Acknowledgments. This work was partly supported by the THALES Program of the Ministry of Education of Greece and the European Union in the framework of the project entitled "Integrated understanding of Seismicity, using innovative Methodologies of Fracture mechanics along with Earthquake and non extensive statistical physics - Application to the geodynamic system of the Hellenic Arc. SEISMO FEAR HELLARC".

Genetic Diversity of Brazilian Aedes aegypti: Patterns following an Eradication Program

PubMed Central

Monteiro, Fernando A.; Shama, Renata; Martins, Ademir J.; Gloria-Soria, Andrea; Brown, Julia E.; Powell, Jeffrey R.

2014-01-01

Background Aedes aegypti is the most important vector of dengue fever in Brazil, where severe epidemics have recently taken place. Ae. aegypti in Brazil was the subject of an intense eradication program in the 1940s and 50s to control yellow fever. Brazil was the largest country declared free of this mosquito by the Pan-American Health Organization in 1958. Soon after relaxation of this program, Ae. aegypti reappeared in this country, and by the early 1980s dengue fever had been reported. The aim of this study is to analyze the present-day genetic patterns of Ae. aegypti populations in Brazil. Methodology/Principal Findings We studied the genetic variation in samples of 11 widely spread populations of Ae. aegypti in Brazil based on 12 well-established microsatellite loci. Our principal finding is that present-day Brazilian Ae. aegypti populations form two distinct groups, one in the northwest and one in the southeast of the country. These two groups have genetic affinities to northern South American countries and the Caribbean, respectively. This is consistent with what has been reported for other genetic markers such as mitochondrial DNA and allele frequencies at the insecticide resistance gene, kdr. Conclusions/Significance We conclude that the genetic patterns in present day populations of Ae. aegypti in Brazil are more consistent with a complete eradication of the species in the recent past followed by re-colonization, rather than the alternative possibility of expansion from residual pockets of refugia. At least two colonizations are likely to have taken place, one from northern South American countries (e.g., Venezuela) that founded the northwestern group, and one from the Caribbean that founded the southeastern group. The proposed source areas were never declared free of Ae. aegypti. PMID:25233218

Epidemiology of National Collegiate Athletic Association men’s and women’s swimming and diving injuries from 2009/10 to 2013/14

PubMed Central

Kerr, Zachary Y.; Baugh, Christine M.; Hibberd, Elizabeth E.; Snook, Erin M.; Hayden, Ross; Dompier, Thomas P.

2015-01-01

Background/Aim Recent injury data for collegiate-level swimming and diving is limited. Previous data is limited to single seasons, elite and national team athletes, or emergency department data. This study describes the epidemiology of men’s and women’s swimming and diving injuries reported by the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) during the 2009/10-2013/14 academic years. Methods Injuries and athlete-exposure (AE) data reported within nine men’s and 13 women’s swimming and diving programs were analyzed. Injury rates, injury rate ratios (IRR), and injury proportions by body site, diagnosis, and mechanism were reported with 95% confidence intervals (CI). Results The ISP captured 149 and 208 injuries for men’s and women’s swimming and diving, respectively, leading to injury rates of 1.54/1000AEs and 1.71/1000AEs. Among females, divers had a higher injury rate (2.49/1000AEs) than swimmers (1.63/1000AEs; IRR=1.53; 95%CI: 1.07, 2.19). Injury rates for male divers (1.94/1000AEs) and swimmers (1.48/1000AEs) did not differ (IRR=1.33; 95%CI: 0.85, 2.31). Most injuries occurred to the shoulder and resulted in strains. Many injuries were classified as overuse or non-contact. Female swimmers had a higher overuse injury rate (1.04/1000AEs) than male swimmers (0.66/1000AEs; IRR=1.58; 95%CI: 1.14, 2.19). Overuse injury rates for female divers (0.54/1000AEs) and male divers (0.46/1000AEs) did not differ (IRR=1.16; 95%CI: 0.40, 3.34). Conclusions Shoulder, strain, and overuse injuries were common in collegiate men’s and women’s swimming and diving. In addition, divers may have higher injury rates than swimmers, although small reported numbers in this study warrant additional research. PMID:25633831

The design of a community-based health education intervention for the control of Aedes aegypti.

PubMed

Lloyd, L S; Winch, P; Ortega-Canto, J; Kendall, C

1994-04-01

This report describes the process used to develop locally appropriate educational materials and to implement the education component of a community-based Aedes aegypti control program in Merida, Yucatan, Mexico. The process is broken into five stages: formative research, developing recommendations for behavior change, development of educational messages, development and production of educational materials, and distribution of the materials. Appropriate terminology and taxonomies for dengue were obtained from open in-depth interviews; baseline data from a knowledge, beliefs, and practices questionnaire served to confirm this information. A larval survey of house lots was carried out to identify the Ae. aegypti larval production sites found on individual house lots. This enabled the program to target the most important larval habitats. Community groups were organized to work on the development of messages and production of the educational materials to be used. The education intervention was successful in stimulating changes in both knowledge and behavior, which were measured in the evaluations of the intervention. To be successful, community-based strategies must be flexible and adapted to the local setting because of ecologic, cultural, and social differences between localities.

Acute Effects of Aerobic Exercise on Affect and Smoking Craving in the Weeks Before and After a Cessation Attempt.

PubMed

Abrantes, Ana M; Farris, Samantha G; Minami, Haruka; Strong, David R; Riebe, Deborah; Brown, Richard A

2018-04-02

Aerobic exercise may improve smoking abstinence via reductions in craving and negative affect and increases in positive moods. Acute changes in craving and affect before and after structured exercise sessions have not been examined during the weeks prior to and following quit attempts nor has smoking status been examined in relation to these effects. Given that regular cigarette smoking can be perceived as affect enhancing and craving reducing, it is not known whether exercise could contribute additional affective benefit beyond these effects. Participants (N = 57; 68.4% women) were low-active daily smokers randomized to cessation treatments plus either group-based aerobic exercise (AE) or a health-education control (HEC). Mood, anxiety, and craving were assessed before and after each intervention session for each of the 12 weeks. Carbon monoxide (CO) breath samples ≤ 5ppm indicated smoking abstinence. During the prequit sessions, significantly greater decreases in anxiety following AE sessions relative to HEC sessions were observed. Changes in mood and craving were similar after AE and HEC sessions prior to quitting. Postquit attempt, significant reductions in craving and anxiety were observed after AE sessions but not following HEC. During the postquit period, positive mood increased following AE sessions relative to HEC only among individuals who were abstinence on that day. AE may be effective in acutely reducing anxiety prior to a quit attempt and both anxiety and craving following the quit attempt regardless of abstinence status. The mood-enhancing effects of AE may occur only in the context of smoking abstinence. The current findings underscore the importance of examining the acute effects of aerobic exercise prior to and after a cessation attempt and as a function of smoking status. Given the equivocal results from previous studies on the efficacy of exercise for smoking cessation, increasing our understanding of how aerobic exercise produces its reinforcing benefits for smokers attempting to quit could potentially inform the refinement (e.g., timing/sequencing) of exercise interventions within smoking cessation programs.

Disclosure of Adverse Events in Pediatrics.

PubMed

2016-12-01

Despite increasing attention to issues of patient safety, preventable adverse events (AEs) continue to occur, causing direct and consequential injuries to patients, families, and health care providers. Pediatricians generally agree that there is an ethical obligation to inform patients and families about preventable AEs and medical errors. Nonetheless, barriers, such as fear of liability, interfere with disclosure regarding preventable AEs. Changes to the legal system, improved communications skills, and carefully developed disclosure policies and programs can improve the quality and frequency of appropriate AE disclosure communications. Copyright © 2016 by the American Academy of Pediatrics.

Invasion of cemeteries in Florida by Aedes albopictus.

PubMed

O'Meara, G F; Gettman, A D; Evans, L F; Scheel, F D

1992-03-01

Aedes albopictus has been found in 53 of the 67 Florida counties. The initial discoveries in 11 of these counties were made in cemeteries. At several locations, Ae. albopictus became well-established in cemeteries before appearing in nearby accumulations of waste tires. The recycling of plastic floral baskets may be aiding the spread of Ae. albopictus. Mosquitoes were commonly found in all types of flower-holding containers in cemeteries, except bronze vases. In the laboratory, most Aedes aegypti eggs laid in bronze vases hatched, but larvae subsequently died. The spread of Ae. albopictus in cemeteries seems to occur at the expense of Ae. aegypti populations. At one cemetery immature Ae. albopictus and Ae. aegypti were found in about 70% of the Aedes-positive containers at the start of a monitoring program. In subsequent collections from this site, Ae. albopictus was found in nearly all Aedes-positive containers, whereas there was a progressive decrease in containers with Ae. aegypti. This trend did not appear to be the result of any seasonal pattern because in a nearby cemetery where Ae. albopictus was absent, Ae. aegypti did not show a similar decline. Limiting flower-holding containers to those with drain holes or to bronze vases would greatly limit mosquito production.

Adverse Events among HIV/MDR-TB Co-Infected Patients Receiving Antiretroviral and Second Line Anti-TB Treatment in Mumbai, India

PubMed Central

Isaakidis, Petros; Varghese, Bhanumati; Mansoor, Homa; Cox, Helen S.; Ladomirska, Joanna; Saranchuk, Peter; Da Silva, Esdras; Khan, Samsuddin; Paryani, Roma; Udwadia, Zarir; Migliori, Giovanni Battista; Sotgiu, Giovanni; Reid, Tony

2012-01-01

Background Significant adverse events (AE) have been reported in patients receiving medications for multidrug- and extensively-drug-resistant tuberculosis (MDR-TB & XDR-TB). However, there is little prospective data on AE in MDR- or XDR-TB/HIV co-infected patients on antituberculosis and antiretroviral therapy (ART) in programmatic settings. Methods Médecins Sans Frontières (MSF) is supporting a community-based treatment program for drug-resistant tuberculosis in HIV-infected patients in a slum setting in Mumbai, India since 2007. Patients are being treated for both diseases and the management of AE is done on an outpatient basis whenever possible. Prospective data were analysed to determine the occurrence and nature of AE. Results Between May 2007 and September 2011, 67 HIV/MDR-TB co-infected patients were being treated with anti-TB treatment and ART; 43.3% were female, median age was 35.5 years (Interquartile Range: 30.5–42) and the median duration of anti-TB treatment was 10 months (range 0.5–30). Overall, AE were common in this cohort: 71%, 63% and 40% of patients experienced one or more mild, moderate or severe AE, respectively. However, they were rarely life-threatening or debilitating. AE occurring most frequently included gastrointestinal symptoms (45% of patients), peripheral neuropathy (38%), hypothyroidism (32%), psychiatric symptoms (29%) and hypokalaemia (23%). Eleven patients were hospitalized for AE and one or more suspect drugs had to be permanently discontinued in 27 (40%). No AE led to indefinite suspension of an entire MDR-TB or ART regimen. Conclusions AE occurred frequently in this Mumbai HIV/MDR-TB cohort but not more frequently than in non-HIV patients on similar anti-TB treatment. Most AE can be successfully managed on an outpatient basis through a community-based treatment program, even in a resource-limited setting. Concerns about severe AE in the management of co-infected patients are justified, however, they should not cause delays in the urgently needed rapid scale-up of antiretroviral therapy and second-line anti-TB treatment. PMID:22792406

AE 6: A model environment of trapped electrons for solar maximum

NASA Technical Reports Server (NTRS)

Teague, M. J.; Chan, K. W.; Vette, J. I.

1976-01-01

A projected inner zone electron model environment, AE 6, for the epoch 1980 is presented. It is intended to provide estimates of mission fluxes that spacecraft will encounter in the coming solar maximum years. AE 6 is presented by graphs of omnidirectional integral flux as a function of L shell, the ambient magnetic field B, and the energy E. Results of orbital integrations for altitudes from 150 n.m. to 18,000 n.m. are given for circular orbits with four different inclinations, using the AE 6 and the AE 4 solar maximum models for the inner and outer zones, respectively. The derivation of AE 6 is described, and a brief comparison is given of the radial profiles of equatorial fluxes from several related models. A short summary of the associated computer programs is included.

Relationships of linguistic and motivation variables with drinking outcomes following two mailed brief interventions.

PubMed

Collins, Susan E; Carey, Kate B; Smyth, Joshua

2005-07-01

This study was a post hoc analysis of linguistic and motivation variables found in writing samples following the administration of two mailed brief interventions. At-risk college drinkers (N = 100) received personalized normative feedback (PNF) or an alcohol education (AE) brochure via mail. Participants responded to open-ended questions describing their reactions to the information they received. The writing samples were then coded for linguistic characteristics using the Linguistic Inquiry and Word Count program and for proportions of self-motivational statements using a modified version of the Motivational Interviewing Skills Code. Group comparisons indicated that the PNF group used a significantly higher percentage of first-person-singular and school-related words, whereas the AE group used a higher percentage of discrepancy, second-person and body-related words. Furthermore, the PNF group produced more language consistent with motivation to change than did the AE group. Hierarchical regressions testing mediation and moderation indicated that linguistic references to school and motivation moderated the group effect on changes in consumption during the heaviest drinking week. Further, although the group predicted reduction in heavy, episodic drinking, its effect was completely mediated by linguistic variables. Findings confirmed that PNF elicits distinct verbal responses that are associated with increased motivation and behavior change.

Joint Oil Analysis Program Spectrometer Standards SCP Science (Conostan) Qualification Report for D19-0, D3-100, and D12-XXX Series Standards

DTIC Science & Technology

2015-05-20

Joint Oil Analysis Program Spectrometer Standards SCP Science (Conostan) Qualification Report For D19-0, D3-100, and D12- XXX Series Standards NF...Candidate Type D19-0 ICP-AES Results ..................................................................... 4 Table V. Candidate Type D12- XXX ...Physical Property Results .................................................. 5 Table VI. Candidate Type D12- XXX Rotrode-AES Results

Subprograms for integrating the equations of motion of satellites. FORTRAN 4

NASA Technical Reports Server (NTRS)

Prokhorenko, V. I.

1980-01-01

The subprograms for the formation of the right members of the equations of motion of artificial Earth satellites (AES), integration of systems of differential equations by Adams' method, and the calculation of the values of various functions from the AES parameters of motion are described. These subprograms are written in the FORTRAN 4 language and constitute an essential part of the package of applied programs for the calculation of navigational parameters AES.

Ethical and Methodological Complexities in Research Involving Sexual Minorities

ERIC Educational Resources Information Center

Bettinger, Thomas V.

2010-01-01

While there is growing attention to sexual minorities in adult education (AE) and human resource development (HRD) literature, lesbian, gay, bisexual, transgender, and queer (LGBTQ) people have received very little attention in AE or in HRD research. This article captures methodological issues and concerns from LBGTQ-related research from…

Experiencing Action Evaluation's Cyclic Process: Partnering Conflict, Reflection, and Action

ERIC Educational Resources Information Center

Burrows, Andrea C.; Harkness, Shelly Sheats

2016-01-01

In this article, the authors describe experiences in and offer suggestions from a course entitled "Educational Innovation for Excellence Through Action Research, Conflict Resolution, and Organizational Learning"--an action evaluation (AE). The class was taught using the principles of action research and AE. The authors explore the impact…

Perioperative outcomes for pediatric neurosurgical procedures: analysis of the National Surgical Quality Improvement Program-Pediatrics.

PubMed

Kuo, Benjamin J; Vissoci, Joao Ricardo N; Egger, Joseph R; Smith, Emily R; Grant, Gerald A; Haglund, Michael M; Rice, Henry E

2017-03-01

OBJECTIVE Existing studies have shown a high overall rate of adverse events (AEs) following pediatric neurosurgical procedures. However, little is known regarding the morbidity of specific procedures or the association with risk factors to help guide quality improvement (QI) initiatives. The goal of this study was to describe the 30-day mortality and AE rates for pediatric neurosurgical procedures by using the American College of Surgeons (ACS) National Surgical Quality Improvement Program-Pediatrics (NSQIP-Peds) database platform. METHODS Data on 9996 pediatric neurosurgical patients were acquired from the 2012-2014 NSQIP-Peds participant user file. Neurosurgical cases were analyzed by the NSQIP-Peds targeted procedure categories, including craniotomy/craniectomy, defect repair, laminectomy, shunts, and implants. The primary outcome measure was 30-day mortality, with secondary outcomes including individual AEs, composite morbidity (all AEs excluding mortality and unplanned reoperation), surgical-site infection, and unplanned reoperation. Univariate analysis was performed between individual AEs and patient characteristics using Fischer's exact test. Associations between individual AEs and continuous variables (duration from admission to operation, work relative value unit, and operation time) were examined using the Student t-test. Patient characteristics and continuous variables associated with any AE by univariate analysis were used to develop category-specific multivariable models through backward stepwise logistic regression. RESULTS The authors analyzed 3383 craniotomy/craniectomy, 242 defect repair, 1811 laminectomy, and 4560 shunt and implant cases and found a composite overall morbidity of 30.2%, 38.8%, 10.2%, and 10.7%, respectively. Unplanned reoperation rates were highest for defect repair (29.8%). The mortality rate ranged from 0.1% to 1.2%. Preoperative ventilator dependence was a significant predictor of any AE for all procedure groups, whereas admission from outside hospital transfer was a significant predictor of any AE for all procedure groups except craniotomy/craniectomy. CONCLUSIONS This analysis of NSQIP-Peds, a large risk-adjusted national data set, confirms low perioperative mortality but high morbidity for pediatric neurosurgical procedures. These data provide a baseline understanding of current expected clinical outcomes for pediatric neurosurgical procedures, identify the need for collecting neurosurgery-specific risk factors and complications, and should support targeted QI programs and clinical management interventions to improve care of children.

Assessing the Impact of Atopic Dermatitis on the Patients' Parents with the Visual Instrument 'Caregiver-PRISM'.

PubMed

Marinello, Elena; Linder, Dennis; Spoto, Andrea; Palmer, Katie; Rohrer, Peter Michael; Büchi, Stefan; Trapp, Michael; Trapp, Eva-Maria; Hoerlesberger, Nina; Piaserico, Stefano; Peserico, Andrea; Gatta, Michela; Belloni Fortina, Anna

2016-01-01

There is a need to improve the quality of communication between clinicians and parents of young patients with atopic eczema (AE). To create a tool to measure the suffering that caregivers experience in association with their child's AE (Caregiver Pictorial Representation of Illness and Self-Measure, Caregiver-PRISM), assess the validity and reliability, and identify factors associated with caregiver suffering. Caregiver-PRISM was administered to 45 parents of patients from an AE outpatient service (Padua, Italy). Caregiver-PRISM had a good test-retest reliability (r = 0.85; t7 = 4.13; p < 0.05), content validity and construct validity when used in parents of AE children. Parents with a less positive family affective climate, higher education, or with children following a diet experienced higher suffering associated with their child's AE, demonstrated by lower Caregiver-PRISM scores (p < 0.05). Our results support the use of Caregiver-PRISM in parents of AE patients to assess suffering associated with patients' illness. © 2016 S. Karger AG, Basel.

Adverse events among 2408 unrelated donors of peripheral blood stem cells: results of a prospective trial from the National Marrow Donor Program

PubMed Central

Chitphakdithai, Pintip; Miller, John P.; Logan, Brent R.; King, Roberta J.; Rizzo, J. Douglas; Leitman, Susan F.; Anderlini, Paolo; Haagenson, Michael D.; Kurian, Seira; Klein, John P.; Horowitz, Mary M.; Confer, Dennis L.

2009-01-01

Limited data are available describing donor adverse events (AEs) associated with filgrastim mobilized peripheral blood stem cell (PBSC) collections in unrelated volunteers. We report results in 2408 unrelated PBSC donors prospectively evaluated by the National Marrow Donor Program (NMDP) between 1999 and 2004. Female donors had higher rates of AEs, requiring central line placement more often (17% vs 4%, P < .001), experiencing more apheresis-related AEs (20% vs 7%, P < .001), more bone pain (odds ratio [OR] = 1.49), and higher rates of grades II-IV and III-IV CALGB AEs (OR = 2.22 and 2.32). Obese donors experienced more bone pain (obese vs normal, OR = 1.73) and heavy donors had higher rates of CALGB toxicities (> 95 kg vs < 70 kg, OR = 1.49). Six percent of donors experienced grade III-IV CALGB toxicities and 0.6% experienced toxicities that were considered serious and unexpected. Complete recovery is universal, however, and no late AEs attributable to donation have been identified. In conclusion, PBSC collection in unrelated donors is generally safe, but nearly all donors will experience bone pain, 1 in 4 will have significant headache, nausea, or citrate toxicity, and a small percentage will experience serious short-term adverse events. In addition, women and larger donors are at higher risk for donation-related AEs. PMID:19190248

Area-wide management of Aedes albopictus. Part 2: gauging the efficacy of traditional integrated pest control measures against urban container mosquitoes.

PubMed

Fonseca, Dina M; Unlu, Isik; Crepeau, Taryn; Farajollahi, Ary; Healy, Sean P; Bartlett-Healy, Kristen; Strickman, Daniel; Gaugler, Randy; Hamilton, George; Kline, Daniel; Clark, Gary G

2013-12-01

Aedes (Stegomyia) albopictus (Skuse) is an important disease vector and biting nuisance. During the 2009 active season, six ∼1000-parcel sites were studied, three in urban and three in suburban areas of New Jersey, United States, to examine the efficacy of standard integrated urban mosquito control strategies applied area wide. Active source reduction, larviciding, adulticiding and public education (source reduction through education) were implemented in one site in each county, an education-only approach was developed in a second site and a third site was used as an untreated experimental control. Populations were surveyed weekly with BG-Sentinel traps and ovitraps. A substantial reduction in Ae. albopictus populations was achieved in urban sites, but only modest reductions in suburban sites. Education alone achieved significant reductions in urban adult Ae. albopictus. Egg catches echoed adult catches only in suburban sites. There are significant socioeconomic and climatic differences between urban and suburban sites that impact upon Ae. albopictus populations and the efficacy of the control methods tested. An integrated pest management approach can affect abundances, but labor-intensive, costly source reduction was not enough to maintain Ae. albopictus counts below a nuisance threshold. Nighttime adult population suppression using truck-mounted adulticides can be effective. Area-wide cost-effective strategies are necessary. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Three-Tiered Support for Students with E/BD: Highlights of the Universal Tier

ERIC Educational Resources Information Center

George, Michael P.; George, Nancy L.; Kern, Lee; Fogt, Julie B.

2013-01-01

The scant data available suggest there is a critical need for improving service delivery within alternative education (AE) settings for children and youth with emotional and behavioral disorders (E/BD). A promising approach for improving student outcomes in AE settings is school-wide positive behavior interventions and supports (SWPBIS), an…

Acoustic and Electrical Signal Emission recordings when marble specimens are subjected to compressional mechanical stress

NASA Astrophysics Data System (ADS)

Triantis, Dimos; Stavrakas, Ilias; Hloupis, George; Ninos, Konstantinos; Vallianatos, Filippos

2013-04-01

The detection of Acoustic Emissions (AE) and Electrical Signals (ES) has been proved as a valuable experimental method to characterize the mechanical status of marble specimens when subjected to mechanical stress. In this work, marble specimens with dimensions 10cm x 4cm x 4cm where subjected to sequential loading cycles. The maximum stress of each loading was near the vicinity of fracture and was maintained for a relatively long time (th=200s). Concurrently to the mechanical tests, AE and ES were recorded. Specifically, two AE sensors and five ES sensors were installed on the surface of the specimens and the detected emissions were stored on a PC. The recordings show that AE and ES provide information regarding the damage spreading and location in the bulk of the specimen. Specifically, when the mechanical stress was maintained constant at the high stress value during each loading cycle the cumulative number of the AE hits become gradually less reaching a minimum after the first three loading cycles, indicating the existence of the Kaiser effect. During the eighth loading cycle the AE hits show a significant increase that became maximum at the ninth cycle before where failure occured. A similar behavior was observed for the cumulative energy. A b-value analysis was conducted following both Aki's and Gutenberg-Richter relations on the amplitudes of the AE hits. The b-values were found to increase during the three first loading cycles while consequently they were practically constant until reaching the two final loading cycles where they became gradually lower. The ES significantly increases during the stress increase of each cycle and gradually restores at a background level when the applied stress is maintained constant near the vicinity of fracture. It was observed that the background restoration level becomes gradually higher during the first four loading cycles. Consequently, during the next three loading cycles the background level is maintained practically constant. During the two final loading cycles the background restoration level significantly increases indicating the upcoming fracture. Acknowledgments. This work was supported by the THALES Program of the Ministry of Education of Greece and the European Union in the framework of the project entitled "Integrated understanding of Seismicity, using innovative Methodologies of Fracture mechanics along with Earthquake and non extensive statistical physics - Application to the geodynamic system of the Hellenic Arc. SEISMO FEAR HELLARC".

Design and process of the EMA Cohort Study: the value of antenatal education in childbirth and breastfeeding

PubMed Central

Paz-Pascual, Carmen; Pinedo, Isabel Artieta; Grandes, Gonzalo; de Gamboa, Gurutze Remiro Fernandez; Hermosilla, Itziar Odriozola; de la Hera, Amaia Bacigalupe; Gordon, Janire Payo; Garcia, Guadalupe Manzano; de Pedro, Magdalena Ureta

2008-01-01

Background Antenatal education (AE) started more than 30 years ago with the purpose of decreasing pain during childbirth. Epidural anaesthesia has achieved this objective, and the value of AE is therefore currently questioned. This article describes the protocol and process of a study designed to assess AE results today. Methods/Design A prospective study was designed in which a cohort of 616 nulliparous pregnant women attending midwife offices of the Basque Health Service were followed for 13 months. Three exposure groups were considered based on the number of AE sessions attended: (a) women attending no session, (b) women attending 1 to 4, and (c) women attending 5 or more sessions. Sociodemographic, personality, and outcome variables related to childbirth and breastfeeding were measured. It was expected 40% of pregnant women not to have participated in any AE session. However, 93% had attended at least one session. This low exposure variability decreased statistical power of the study as compared to the initially planned power. Despite this, there was a greater than 80% power for detecting as significant differences between exposure groups of, for instance, 10% in continuation of breastfeeding at one and a half months and in visits for false labour. Women attending more sessions were seen to have a mean higher age and educational level, and to belong to a higher socioeconomic group (p < 0.01). Follow-up was completed in 99% of participants. Discussion Adequate prior estimation of variability in the exposure under study is essential for designing cohort studies. Sociodemographic characteristics may play a confounding role in studies assessing AE and should be controlled in design and analyses. Quality control during the study process and continued collaboration from both public system midwives and eligible pregnant women resulted in a negligible loss rate. PMID:18435856

Avionics Architectures for Exploration: Wireless Technologies and Human Spaceflight

NASA Technical Reports Server (NTRS)

Goforth, Montgomery B.; Ratliff, James E.; Barton, Richard J.; Wagner, Raymond S.; Lansdowne, Chatwin

2014-01-01

The authors describe ongoing efforts by the Avionics Architectures for Exploration (AAE) project chartered by NASA's Advanced Exploration Systems (AES) Program to evaluate new avionics architectures and technologies, provide objective comparisons of them, and mature selected technologies for flight and for use by other AES projects. The AAE project team includes members from most NASA centers and from industry. This paper provides an overview of recent AAE efforts, with particular emphasis on the wireless technologies being evaluated under AES to support human spaceflight.

FORUM: Instructional Communication and Millennial Students: Millennial Students in the College Classroom: Adjusting to Academic Entitlement

ERIC Educational Resources Information Center

Goldman, Zachary W.; Martin, Matthew M.

2016-01-01

Academic entitlement (AE) refers to the expectation of educational success despite the input of personal effort needed to earn it (Boswell, 2012). Entitled students feel that learning should require minimal work and that difficulties encountered during the learning process should be attributed to instructors, rather than themselves. AE has become…

Phonological awareness intervention and attention efficiency in children at risk: evidence of effectiveness on visual attention.

PubMed

Porta, María Elsa; Carrada, Mariana Andrea; Ison, Mirta Susana

2016-05-31

Using a pretest and posttest comparison group design, this 20 weeks study investigated the effects of a phonological awareness training program (PATP) on attention efficiency (AE) in 57 children (age = 5 to 6 years) at risk. The experimental group received the PATP (EG; n=30). We obtained pretest and posttest measures of phonological awareness and AE. The ANOVA showed significant interaction effects of the PATP and time on phonological awareness and AE. For both groups, posttest AE score means were higher than pretest score means. Pretest measures showed that the AE score mean for the EG was lower than that for the Control Group (CG; n=31); whereas posttest data showed no between group differences. Contrast analysis showed that the EG gained a greater level of phonological awareness ability and AE over CG. Our results indicate that children's attention efficiency not only improved as they developed, but also increased by means of a PATP.

Managing adverse effects of immunotherapy.

PubMed

Gerson, James N; Ramamurthy, Chethan; Borghaei, Hossein

2018-05-01

Remarkable efficacy has been achieved in a variety of cancer types by targeting immune checkpoints. The cytotoxic T-lymphocyte-associated antigen 4 inhibitor ipilimumab, the programmed death 1 inhibitors nivolumab and pembrolizumab, and the programmed death ligand 1 inhibitors atezolizumab, avelumab, and durvalumab are the agents currently approved by the US Food and Drug Administration for the treatment of certain advanced malignancies. These agents mark a departure from both standard cytotoxic chemotherapy and targeted therapy. However, they are associated with a unique set of immune-related adverse events (irAEs), which can manifest as a wide range of autoimmune phenomena. The irAEs can affect any system in the body and in rare cases are life-threatening. It is critical for the practicing medical oncologist to recognize and promptly treat any irAEs that may develop.

Division I College Football Concussion Rates Are Higher at Higher Altitudes.

PubMed

Lynall, Robert C; Kerr, Zachary Y; Parr, Matthew S; Hackney, Anthony C; Mihalik, Jason P

2016-02-01

Retrospective cohort. Participating in sports at high altitude may have a protective effect on the brain, according to research studies. Research using validated data-collection methods in a previously unexplored cohort may better estimate the association between concussion injury risk and altitude. To determine the association between concussion rates and altitude during college football games. Athletic trainers from 21 Division I football programs provided exposure and injury data to the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) from the 2009-2010 to 2013-2014 academic years. The elevation of each stadium was determined. Concussion rates per 1000 athlete-exposures (AEs) were compared in 2 ways, based on the sample of stadium elevations: (1) median split (elevation higher than 178 m or lower than 178 m), and (2) quartile split. Rate ratios (RRs), rate differences, and 95% confidence intervals (CIs) were computed. One hundred sixty-nine concussions were reported over 49 040 AEs (3.45/1000 AEs). Using the median split, the concussion rate above 178 m (RR = 4.18/1000 AEs) was 1.47 times the concussion rate below 178 m (RR = 2.84/1000 AEs; 95% CI: 1.09, 2.00; P = .01). The concussion rate at the highest altitude quartile (higher than 284 m; RR = 5.01/1000 AEs) was 1.67 times greater than the concussion rate at the lowest altitude quartile (lower than 43 m; RR = 3.00/1000 AEs; 95% CI: 1.13, 2.48; P = .01). College football game concussion rates appear to increase at higher altitudes. The clinical significance of this relatively small increase is unknown. Future research should explore potential physiologic underpinnings associated with concussion risk at relatively higher and lower altitudes. Prognosis, level 2b.

Damping Rate Measurements of Medium n Alfv'en Eigenmodes in JET

NASA Astrophysics Data System (ADS)

Klein, Alexander; Testa, Duccio; Snipes, Joseph; Fasoli, Ambrogio; Carfantan, Hervé

2007-11-01

Alfv'en Eigenmodes (AE's) with mode numbers 5 < n < 20 are expected to be unstable in burning tokamaks and may lead to loss of fast particle confinement. The active MHD spectroscopy program at JET has already provided a wealth of information about low n (n <= 2) AE's in the past decade, but a recently installed array of four antennas is capable of driving higher mode numbered (n < 100, 30 < f < 350 kHz) perturbations. In the latest JET campaign, the damping rates for several types of AE's were measured parasitically in a wide range of tokamak scenarios. We review the active MHD diagnostic and present the first measurements of medium-n AE stability on JET, then describe future plans for the active MHD spectroscopy project. The data analysis involves a novel method for resolving multiple AE's that exist at identical frequencies, which uses techniques based on the SparSpec code.

An Adaptive Evaluation Structure for Computer-Based Instruction.

ERIC Educational Resources Information Center

Welsh, William A.

Adaptive Evaluation Structure (AES) is a set of linked computer programs designed to increase the effectiveness of interactive computer-assisted instruction at the college level. The package has four major features, the first of which is based on a prior cognitive inventory and on the accuracy and pace of student responses. AES adjusts materials…

Detecting adverse events in surgery: comparing events detected by the Veterans Health Administration Surgical Quality Improvement Program and the Patient Safety Indicators.

PubMed

Mull, Hillary J; Borzecki, Ann M; Loveland, Susan; Hickson, Kathleen; Chen, Qi; MacDonald, Sally; Shin, Marlena H; Cevasco, Marisa; Itani, Kamal M F; Rosen, Amy K

2014-04-01

The Patient Safety Indicators (PSIs) use administrative data to screen for select adverse events (AEs). In this study, VA Surgical Quality Improvement Program (VASQIP) chart review data were used as the gold standard to measure the criterion validity of 5 surgical PSIs. Independent chart review was also used to determine reasons for PSI errors. The sensitivity, specificity, and positive predictive value of PSI software version 4.1a were calculated among Veterans Health Administration hospitalizations (2003-2007) reviewed by VASQIP (n = 268,771). Nurses re-reviewed a sample of hospitalizations for which PSI and VASQIP AE detection disagreed. Sensitivities ranged from 31% to 68%, specificities from 99.1% to 99.8%, and positive predictive values from 31% to 72%. Reviewers found that coding errors accounted for some PSI-VASQIP disagreement; some disagreement was also the result of differences in AE definitions. These results suggest that the PSIs have moderate criterion validity; however, some surgical PSIs detect different AEs than VASQIP. Future research should explore using both methods to evaluate surgical quality. Published by Elsevier Inc.

Adverse event management in mass drug administration for neglected tropical diseases.

PubMed

Caplan, Arthur; Zink, Amanda

2014-03-01

The ethical challenges of reporting and managing adverse events (AEs) and serious AEs (SAEs) in the context of mass drug administration (MDA) for the treatment of neglected tropical diseases (NTDs) require reassessment of domestic and international policies on a global scale. Although the World Health Organization has set forth AE/SAE guidelines specifically for NTD MDA that incorporate suspected causality, and recommends that only SAEs get reported in this setting, most regulatory agencies continue to require the reporting of all SAEs exhibiting even a merely temporal relationship to activities associated with an MDA program. This greatly increases the potential for excess "noise" and undue risk aversion and is not only impractical but arguably unethical where huge proportions of populations are being treated for devastating diseases, and no good baseline exists against which to compare possible AE/SAE reports. Other population-specific variables that might change the way drug safety ought to be assessed include differing efficacy rates of a drug, background morbidity/mortality rates of the target disease in question, the growth rate of the incidence of disease, the availability of rescue or salvage therapies, and the willingness of local populations to take risks that other populations might not. The fact that NTDs are controllable and potentially eradicable with well-tolerated, effective, existing drugs might further alter our assessment of MDA safety and AE/SAE tolerability. At the same time, diffuseness of population, communication barriers, lack of resources, and other difficult surveillance challenges may present in NTD-affected settings. These limitations could impair the ability to monitor an MDA program's success, as well as hinder efforts to obtain informed consent or provide rescue therapy. Denying beneficial research interventions and MDA programs intended to benefit millions requires sound ethical justification based on more than the identification of and rote response to AEs and SAEs. Copyright © 2014 Elsevier HS Journals, Inc. All rights reserved.

Sports medicine and the accident and emergency medicine specialist.

PubMed

Abernethy, L; McNally, O; MacAuley, D; O'Neill, S

2002-05-01

Sport and exercise related injuries are responsible for about 5% of the workload in the accident and emergency (A&E) department, yet training in sports medicine is not a compulsory part of the curriculum for Higher Specialist Training. To determine how A&E medicine consultants and specialist trainees view their role and skill requirements in relation to sports medicine. A modified Delphi study, consisting of two rounds of a postal questionnaire. Participants were invited to rate the importance of statements relating to the role and training of the A&E specialist in relation to sports injuries (six statements) and the need for knowledge and understanding of defined skills of importance in sports medicine (16 statements). VALUE OF RESEARCH: This provides a consensus of opinion on issues in sport and exercise medicine that have educational implications for A&E specialists, and should be considered in the curriculum for Higher Specialist Training. There is also the potential for improving the health care provision of A&E departments, to the exercising and sporting population.

The effect of aquatic exercise and education on lowering fall risk in older adults with hip osteoarthritis.

PubMed

Arnold, Cathy M; Faulkner, Robert A

2010-07-01

To evaluate the effect of aquatic exercise and education on fall risk factors in older adults with hip osteoarthritis (OA). Seventy-nine adults, 65 years of age or older with hip OA and at least 1 fall risk factor, were randomly assigned to 1 of 3 groups: aquatics and education (AE; aquatic exercise twice a wk with once-a-wk group education), aquatics only (A; 2 wk aquatic exercise) and control (C; usual activity). Balance, falls efficacy, dual-task function, functional performance (chair stands), and walking performance were measured pre- and postintervention or control period. There was a significant improvement in fall risk factors (full-factorial MANCOVA, baseline values as covariates; p = .038); AE improved in falls efficacy compared with C and in functional performance compared with A and C. The combination of aquatic exercise and education was effective in improving fall risk factors in older adults with arthritis.

Osimertinib: A Novel Dermatologic Adverse Event Profile in Patients with Lung Cancer.

PubMed

Chu, Chia-Yu; Choi, Jennifer; Eaby-Sandy, Beth; Langer, Corey J; Lacouture, Mario E

2018-04-12

Dermatologic adverse events (dAEs) are common with the use of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. First- and second-generation agents (erlotinib, gefitinib, and afatinib) are frequently associated with acneiform rash, pruritus, xerosis, and paronychia; the incidence and characterization of these dAEs have been well described. However, there is evidence that the dAE profile is different with third-generation EGFR-TKIs. Herein, we describe the dAEs associated with third-generation EGFR-TKIs and our clinical experience with osimertinib, a third-generation EGFR-TKI approved by the U.S. Food and Drug Administration for the treatment of metastatic, EGFR T790M mutation-positive non-small cell lung cancer in patients whose disease has progressed on or after EGFR-TKI therapy. Case summaries of patients from two of our institutions who received osimertinib and were referred to a dermatologist for dAEs are also presented. Overall, the evidence suggests that osimertinib is associated with less severe and less frequent dAEs than first- and second-generation EGFR-TKIs and that therefore a different approach is warranted. Finally, we outline dAE management approaches for osimertinib in the context of those typically employed with first- and second-generation EGFR-TKIs. Appropriate prevention and management of dermatologic adverse events (dAEs) associated with the use of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) may help patients to continue therapy and lessen any negative impact on their quality of life. EGFR-TKIs are frequently associated with acneiform rash, pruritus, xerosis, and paronychia; however, dAEs associated with third-generation EGFR-TKIs are lower in frequency and severity. Before therapy, health care providers should discuss the potential osimertinib-associated dAEs and encourage patients to report their dAEs. Patients should also be educated on prophylactic measures to minimize the severity of dAEs and the importance of adherence to the treatment regimen. © AlphaMed Press 2018.

A health visitor for older people in an accident and emergency department.

PubMed

Bridges, J; Meyer, J; McMahon, K; Bentley, J; Winter, J

2000-02-01

Published studies indicate that older people have special needs on discharge from accident and emergency (A&E) departments that are not always fully met. The literature reflects that although a significant proportion of older people have a decrease in functional independence and an increased need for services following discharge from A&E, social and functional assessment by A&E staff can be inadequate, as can the arrangement of follow-up community services. As part of a wider study into the organization of care for older people in A&E, a health visitor for older people was funded to work part-time in the A&E department of a large NHS Trust. The health visitor identified potential clients through reviewing the A&E documentation of patients aged 75 years or over discharged directly from A&E. Telephone calls or home visits were used to follow up those individuals deemed to be vulnerable by the health visitor. Interventions included health education, referral to other agencies and patient or family counselling. None of the clients followed up by the health visitor (n = 212) had been referred by A&E to a specialist in gerontology, which suggests that these clients would otherwise not have received the potential benefit of specialist intervention. The pilot study described here highlights a number of practical issues in relation to the health visitor post for older people in A&E, including the importance of dedicated office space and access to a telephone. Data collected during the study, plus the positive evaluation of the role by a small group of A&E staff confirm the claims made in other studies (e.g. Runciman et al, 1996) that health visitors for older people may be of value in meeting the post-discharge needs of these people.

Protecting military personnel from high risk dietary supplements.

PubMed

Deuster, Patricia A; Lieberman, Harris R

2016-01-01

It is legal tomarketmost naturally occurring substances as dietary supplements in the USA without manufacturers demonstrating they are safe or effective, and an endless variety of ingredients, from esoteric botanicals to unapproved pharmaceuticals, can be found in dietary supplements. Use of certain supplements can pose a risk, but since a robust reporting systemdoes not exist in the USA it is difficult to know which are problematic and the number of adverse events (AE) resulting from their use. Certain populations, includingmilitary personnel, aremore likely to use dietary supplements than the general population. Approximately 70% of military personnel take dietary supplements while about 50% of civilians do. Service members prefer supplements purported to enhance physical performance such as supposedly natural stimulants, protein and amino acids, and combination products. Since some of thesemay be problematic, Servicemembers are probably at higher risk of injury than the general population. Ten percent of military populations appear to be taking potentially risky supplements, and the US Department of Defense (DoD) has taken variousmeasures to protect uniformed personnel including education, policy changes, and restricting sales. Actions taken include launching Operation Supplement Safety (OPSS), introducing a High Risk Supplement list, educating health care professionals on reporting AE thatmight be associated with dietary supplements, recommending policy for reporting AE, and developing an online AE reporting system. OPSS is a DoD-wide effort to educate service members, leaders, health care providers, military families, and retirees on how to safely select supplements

Nivolumab-induced thyroid dysfunction lacking antithyroid antibody is frequently evoked in Japanese patients with malignant melanoma.

PubMed

Yano, Seiichi; Ashida, Kenji; Nagata, Hiromi; Ohe, Kenji; Wada, Naoko; Takeichi, Yukina; Hanada, Yuki; Ibayashi, Yuta; Wang, Lixiang; Sakamoto, Shohei; Sakamoto, Ryuichi; Uchi, Hiroshi; Shiratsuchi, Motoaki; Furue, Masutaka; Nomura, Masatoshi; Ogawa, Yoshihiro

2018-06-08

Nivolumab, an anti-programmed cell death-1 monoclonal antibody, has improved the survival of patients with malignant melanoma. Despite its efficacy, nivolumab inconsistently induces thyroid dysfunction as an immune-related adverse event (irAE). This study aimed to evaluate nivolumab-induced thyroid dysfunction to determine the risks and mechanisms of thyroid irAEs. After excluding 10 patients, data of 24 patients with malignant melanoma (aged 17-85 years; 54% female) were retrospectively analyzed. Thyroid irAEs were observed in seven patients (29%). Three patients had hypothyroidism after preceding transient thyrotoxicosis, and the other four patients had hypothyroidism without thyrotoxicosis. Levothyroxine-Na replacement was required in three patients. Antithyroid antibody (ATA) titer was elevated in one of four assessable patients. The average (±SD) time to onset of thyroid irAE was 33.6 (±21.9) weeks. The administration period of nivolumab was longer in patients with thyroid irAEs than in those without thyroid irAEs (P < 0.01). There were no significant differences between patients with and without thyroid irAEs regarding age, sex, tumor stage, response to nivolumab therapy, baseline thyroid function, antithyroid peroxidase antibody (anti-TPO Ab) and antithyroglobulin antibody (anti-Tg Ab). Thyroid dysfunction was a common irAE of nivolumab in malignant melanoma. Neither anti-TPO Ab nor anti-Tg Ab was associated with the risk for nivolumab-induced thyroid dysfunction. A conventional ATA-independent mechanism might be involved in thyroid irAEs. Further studies are required to clarify the mechanism and identify the predictive factors of thyroid irAEs.

Entomological profile of yellow fever epidemics in the Central African Republic, 2006-2010.

PubMed

Ngoagouni, Carine; Kamgang, Basile; Manirakiza, Alexandre; Nangouma, Auguste; Paupy, Christophe; Nakoune, Emmanuel; Kazanji, Mirdad

2012-08-16

The causative agent of yellow fever is an arbovirus of the Flaviviridae family transmitted by infected Aedes mosquitoes, particularly in Africa. In the Central African Republic since 2006, cases have been notified in the provinces of Ombella-Mpoko, Ouham-Pende, Basse-Kotto, Haute-Kotto and in Bangui the capital. As the presence of a vector of yellow fever virus (YFV) represents a risk for spread of the disease, we undertook entomological investigations at these sites to identify potential vectors of YFV and their abundance. Between 2006 and 2010, 5066 mosquitoes belonging to six genera and 43 species were identified. The 20 species of the Aedes genus identified included Ae. aegypti, the main vector of YFV in urban settings, and species found in tropical forests, such as Ae. africanus, Ae. simpsoni, Ae. luteocephalus, Ae. vittatus and Ae. opok. These species were not distributed uniformly in the various sites studied. Thus, the predominant Aedes species was Ae. aegypti in Bangui (90.7 %) and Basse-Kotto (42.2 %), Ae. africanus in Ombella-Mpoko (67.4 %) and Haute-Kotto (77.8 %) and Ae. vittatus in Ouham-Pende (62.2 %). Ae. albopictus was also found in Bangui. The distribution of these dominant species differed significantly according to study site (P < 0.0001). None of the pooled homogenates of Aedes mosquitoes analysed by polymerase chain reaction contained the YFV genome. The results indicate a wide diversity of vector species for YFV in the Central African Republic. The establishment of surveillance and vector control programs should take into account the ecological specificity of each species.

The Role of a Research Administration Program in Adverse Event Reporting

ERIC Educational Resources Information Center

Fedor, Carol; Cola, Philip; Polites, Stephanie

2007-01-01

The reporting, analysis, and management of adverse events (AEs) provide an ongoing assessment of risk in the context of a clinical trial and enhance the protection of human research participants and the informed consent process. Effective and efficient review of AEs has been a long-standing challenge for Institutional Review Boards (IRBs) and…

Ocular Adverse Events Associated with Antibody–Drug Conjugates in Human Clinical Trials

PubMed Central

Miller, Paul E.; Mannis, Mark J.

2015-01-01

Abstract This article reviews ocular adverse events (AEs) reported in association with administration of antibody–drug conjugates (ADCs) in human clinical trials. References reporting ocular toxicity or AEs associated with ADCs were collected using online publication searches. Articles, abstracts, or citations were included if they cited ocular toxicities or vision-impairing AEs with a confirmed or suspected association with ADC administration. Twenty-two references were found citing ocular or vision-impairing AEs in association with ADC administration. All references reported use of ADCs in human clinical trials for treatment of various malignancies. The molecular target and cytotoxic agent varied depending on the ADC used. Ocular AEs affected a diversity of ocular tissues. The most commonly reported AEs involved the ocular surface and included blurred vision, dry eye, and corneal abnormalities (including microcystic corneal disease). Most ocular AEs were not severe (≤ grade 2) or dose limiting. Clinical outcomes were not consistently reported, but when specified, most AEs improved or resolved with cessation of treatment or with ameliorative therapy. A diverse range of ocular AEs are reported in association with administration of ADCs for the treatment of cancer. The toxicologic mechanism(s) and pathogenesis of such events are not well understood, but most are mild in severity and reversible. Drug development and medical professionals should be aware of the clinical features of these events to facilitate early recognition and intervention in the assessment of preclinical development programs and in human clinical trials. PMID:26539624

78 FR 68016 - Disadvantaged Business Enterprise: Program Implementation Modifications

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

... 2105-AE08 Disadvantaged Business Enterprise: Program Implementation Modifications AGENCY: Office of the... to the Department's Disadvantaged Business Enterprise (DBE) program found in the Notice of Proposed... notice of proposed rulemaking (NPRM) entitled, ``Disadvantaged Business Enterprise: Program...

Affordable Development and Demonstration of a Small NTR Engine and Stage: How Small is Big Enough?

NASA Technical Reports Server (NTRS)

Borowski, S. K.; Sefcik, R. J.; Fittje, J. E.; McCurdy, D. R.; Qualls, A. L.; Schnitzler, B. G.; Werner, J.; Weitzberg, A.; Joyner, C. R.

2015-01-01

In FY11, NASA formulated a plan for Nuclear Thermal Propulsion (NTP) development that included Foundational Technology Development followed by system-level Technology Demonstrations The ongoing NTP project, funded by NASAs Advanced Exploration Systems (AES) program, is focused on Foundational Technology Development and includes 5 key task activities:(1) Fuel element fabrication and non-nuclear validation testing of heritage fuel options;(2) Engine conceptual design;(3) Mission analysis and engine requirements definition;(4) Identification of affordable options for ground testing; and(5) Formulation of an affordable and sustainable NTP development program Performance parameters for Point of Departure designs for a small criticality-limited and full size 25 klbf-class engine were developed during FYs 13-14 using heritage fuel element designs for both RoverNERVA Graphite Composite (GC) and Ceramic Metal (Cermet) fuel forms To focus the fuel development effort and maximize use of its resources, the AES program decided, in FY14, that a leader-follower down selection between GC and cermet fuel was required An Independent Review Panel (IRP) was convened by NASA and tasked with reviewing the available fuel data and making a recommendation to NASA. In February 2015, the IRP recommended and the AES program endorsed GC as the leader fuel In FY14, a preliminary development schedule DDTE plan was produced by GRC, DOE industry for the AES program. Assumptions, considerations and key task activities are presented here Two small (7.5 and 16.5 klbf) engine sizes were considered for ground and flight technology demonstration within a 10-year timeframe; their ability to support future human exploration missions was also examined and a recommendation on a preferred size is provided.

The Effectiveness of an Educational Brochure as a Risk Minimization Activity to Communicate Important Rare Adverse Events to Health-Care Professionals.

PubMed

Bester, Nicolette; Di Vito-Smith, Michelle; McGarry, Theresa; Riffkin, Michael; Kaehler, Stefan; Pilot, Richard; Bwire, Robert

2016-02-01

Educational brochures are an important tool for communicating risk to health-care professionals. It is important to evaluate the impact of any risk minimization tool to understand the effectiveness of the strategy. The objective of this study was to assess the effectiveness (i.e., respondents' awareness and understanding of the communication) of a targeted educational brochure distributed to health-care professionals (HCPs) as a risk minimization strategy for the communication of new rare and important adverse events (AEs). A prospective, non-interventional, online survey was performed following distribution of a specifically designed brochure highlighting new and important adverse events to a targeted HCP population, consisting of known users of the target medicine, as represented by a commercial database. Predefined multiple-choice survey questions assessed overall HCP awareness of the brochure and understanding and retention of information in those HCPs who reported receiving the brochure. The educational brochure was sent to a total of 565 HCPs; 121 (21.4%) responded to the survey. The majority of respondents (95.0%) had previously prescribed or dispensed the target medicine. In all, 88 (72.7%) respondents said they had received the educational brochure, of whom 95.5% stated they had at least scanned the main points. More participants who had received the brochure (86.4% to 96.6%) answered the five individual survey questions correctly compared with those who did not (51.5% to 97.0%); this was significant for four out of five questions (P ≤ 0.005). Significantly more HCPs who received the brochure achieved the predefined pass rate (at least four of five questions answered correctly) compared with HCPs who did not receive the brochure (93.2% vs 57.6%, respectively; P = 0.000003). Distribution of targeted educational brochures may be an effective risk minimization strategy to raise HCP awareness of new rare and important AEs; educational brochures may also be an effective channel for sharing information on how these AEs can be best managed and on the importance and means of reporting AEs. Celgene Pty Ltd, Melbourne, Australia.

Sorbent Structural Impacts Due to Humidity on Carbon Dioxide Removal Sorbents for Advanced Exploration Systems

NASA Technical Reports Server (NTRS)

Watson, David; Knox, James C.; West, Phillip; Stanley, Christine M.; Bush, Richard

2015-01-01

The Life Support Systems Project (LSSP) under the Advanced Exploration Systems (AES) program builds upon the work performed under the AES Atmosphere Resource Recovery and Environmental Monitoring (ARREM) project focusing on the numerous technology development areas. The CO2 removal and associated air drying development efforts are focused on improving the current state-of-the-art system on the International Space Station (ISS) utilizing fixed beds of sorbent pellets by seeking more robust pelletized sorbents, evaluating structured sorbents, and examining alternate bed configurations to improve system efficiency and reliability. A component of the CO2 removal effort encompasses structural stability testing of existing and emerging sorbents. Testing will be performed on dry sorbents and sorbents that have been conditioned to three humidity levels. This paper describes the sorbent structural stability screening efforts in support of the LSS Project within the AES Program.

Gaining the Patient Reported Outcomes Measurement Information System (PROMIS) Perspective in Chronic Kidney Disease: a Midwest Pediatric Nephrology Consortium study

PubMed Central

Selewski, David T.; Massengill, Susan F.; Troost, Jonathan P.; Wickman, Larysa; Messer, Kassandra L.; Herreshoff, Emily; Bowers, Corinna; Ferris, Maria E.; Mahan, John D.; Greenbaum, Larry A.; MacHardy, Jackie; Kapur, Gaurav; Chand, Deepa H.; Goebel, Jens; Barletta, Gina Marie; Geary, Denis; Kershaw, David B.; Pan, Cynthia G.; Gbadegesin, Rasheed; Hidalgo, Guillermo; Lane, Jerome C.; Leiser, Jeffrey D.; Song, Peter X.; Thissen, David; Liu, Yang; Gross, Heather E.; DeWalt, Darren A.; Gipson, Debbie S.

2014-01-01

Background and Objectives Chronic kidney disease is a persistent chronic health condition commonly seen in pediatric nephrology programs. Our study aims to evaluate the sensitivity of the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric instrument to indicators of disease severity and activity in pediatric chronic kidney disease. Methods This cross sectional study included 233 children 8–17 years old with chronic kidney disease from 16 participating institutions in North America. Disease activity indicators, including hospitalization in the previous 6 months, edema, and number of medications consumed daily, as well as disease severity indicators of kidney function and coexisting medical conditions were captured. PROMIS domains, including depression, anxiety, social-peer relationships, pain interference, fatigue, mobility, and upper extremity function, were administered via web-based questionnaires. Absolute effect sizes (AES) were generated to demonstrate the impact of disease on domain scores. Four children were excluded because of missing GFR estimations. Results 221 of the 229 children included in the final analysis completed the entire PROMIS questionnaire. Unadjusted PROMIS domains were responsive to chronic kidney disease activity indicators and number of coexisting conditions. PROMIS domain scores were worse in the presence of recent hospitalizations (depression AES 0.33, anxiety AES 0.42, pain interference AES 0.46, fatigue AES 0.50, mobility AES 0.49), edema (depression AES 0.50, anxiety AES 0.60, pain interference AES 0.77, mobility AES 0.54) and coexisting medical conditions (social peer-relationships AES 0.66, fatigue AES 0.83, mobility AES 0.60, upper extremity function AES 0.48). Conclusions The PROMIS pediatric domains of depression, anxiety, social-peer relationships, pain interference, and mobility were sensitive to the clinical status of children with chronic kidney disease in this multi-center cross sectional study. We demonstrated that a number of important clinical characteristics including recent history of hospitalization and edema affected patient perceptions of depression, anxiety, pain interference, fatigue and mobility. The PROMIS instruments provide a potentially valuable tool to study the impact of chronic kidney disease. Additional studies will be required to assess responsiveness in PROMIS score with changes in disease status over time. PMID:24908324

Insulin pump-associated adverse events are common, but not associated with glycemic control, socio-economic status, or pump/infusion set type.

PubMed

Ross, P; Gray, A R; Milburn, J; Kumarasamy, I M; Wu, F; Farrand, S; Armishaw, J; Wiltshire, E; Rayns, J; Tomlinson, P; Wheeler, B J

2016-12-01

While there have been many outcome-focussed studies examining insulin pump therapy, only a few have looked at potential adverse events (AEs), with none examining the relationship between AEs and pump/infusion set type, ethnicity or socio-economic status. In addition, current data on the incidence and characteristics of pump-associated AEs are confined to one paediatric centre. We aimed to describe the incidence, characteristics and potential predictors of insulin pump-associated AEs in New Zealand adults and children with T1DM. We approached adults and families of children with T1DM on insulin pumps in four main New Zealand centres. Participants completed a questionnaire examining pump-related issues they had experienced in the preceding 12 months. Response rate was 64 % with 174 of 270 eligible people participating in the study. 84 % of subjects reported one or more AEs, with an overall AE incidence of 3.42 per person/year (95 % CI 3.14, 3.73). An event serious enough to require a hospital presentation occurred in 9.8 %, all but one reporting high ketones or diabetic ketoacidosis (DKA). Set/site problems were the AE most commonly reported (by 53 % of respondents), followed by cutaneous complications (43 %) and pump malfunction (38 %). Few predictors of AEs (of any type) were found; however, a negative binomial regression model found that a longer duration of pumping (p = 0.018) and age <18 years (p = 0.043) were both associated with fewer AEs (all types combined). Insulin pump-associated AEs are very common. However, few variables are predictive of them with no relationships seen with glycaemic control, socio-economic status, pump manufacturer or infusion set type. Based on these findings, AEs should be anticipated in both adults and children, with anticipatory patient education and training recommended for their successful and safe use.

Remote monitoring and prognosis of fatigue cracking in steel bridges with acoustic emission

NASA Astrophysics Data System (ADS)

Yu, Jianguo Peter; Ziehl, Paul; Pollock, Adrian

2011-04-01

Acoustic emission (AE) monitoring is desirable to nondestructively detect fatigue damage in steel bridges. Investigations of the relationship between AE signals and crack growth behavior are of paramount importance prior to the widespread application of passive piezoelectric sensing for monitoring of fatigue crack propagation in steel bridges. Tests have been performed to detect AE from fatigue cracks in A572G50 steel. Noise induced AE signals were filtered based on friction emission tests, loading pattern, and a combined approach involving Swansong II filters and investigation of waveforms. The filtering methods based on friction emission tests and load pattern are of interest to the field evaluation using sparse datasets. The combined approach is suitable for data filtering and interpretation of actual field tests. The pattern recognition program NOESIS (Envirocoustics) was utilized for the evaluation of AE data quality. AE parameters are associated with crack length, crack growth rate, maximum stress intensity and stress intensity range. It is shown that AE hits, counts, absolute energy, and signal strength are able to provide warnings at the critical cracking level where cracking progresses from stage II (stable propagation) to stage III (unstable propagation which may result in failure). Absolute energy rate and signal strength rate may be better than count rate to assess the remaining fatigue life of inservice steel bridges.

Use of the Spine Adverse Events Severity System (SAVES) in patients with traumatic spinal cord injury. A comparison with institutional ICD-10 coding for the identification of acute care adverse events.

PubMed

Street, J T; Thorogood, N P; Cheung, A; Noonan, V K; Chen, J; Fisher, C G; Dvorak, M F

2013-06-01

Observational cohort comparison. To compare the previously validated Spine Adverse Events Severity system (SAVES) with International Classification of Diseases, Tenth Revision codes (ICD-10) codes for identifying adverse events (AEs) in patients with traumatic spinal cord injury (TSCI). Quaternary Care Spine Program. Patients discharged between 2006 and 2010 were identified from our prospective registry. Two consecutive cohorts were created based on the system used to record acute care AEs; one used ICD-10 coding by hospital coders and the other used SAVES data prospectively collected by a multidisciplinary clinical team. The ICD-10 codes were appropriately mapped to the SAVES. There were 212 patients in the ICD-10 cohort and 173 patients in the SAVES cohort. Analyses were adjusted to account for the different sample sizes, and the two cohorts were comparable based on age, gender and motor score. The SAVES system identified twice as many AEs per person as ICD-10 coding. Fifteen unique AEs were more reliably identified using SAVES, including neuropathic pain (32 × more; P<0.001), urinary tract infections (1.4 × ; P<0.05), pressure sores (2.9 × ; P<0.001) and intra-operative AEs (2.3 × ; P<0.05). Eight of these 15 AEs more frequently identified by SAVES significantly impacted length of stay (P<0.05). Risk factors such as patient age and severity of paralysis were more reliably correlated to AEs collected through SAVES than ICD-10. Implementation of the SAVES system for patients with TSCI captured more individuals experiencing AEs and more AEs per person compared with ICD-10 codes. This study demonstrates the utility of prospectively collecting AE data using validated tools.

Acoustic emission and acousto-ultrasonic signature analysis of failure mechanisms in carbon fiber reinforced polymer materials

NASA Astrophysics Data System (ADS)

Carey, Shawn Allen

Fiber reinforced polymer composite materials, particularly carbon (CFRPs), are being used for primary structural applications, particularly in the aerospace and naval industries. Advantages of CFRP materials, compared to traditional materials such as steel and aluminum, include: light weight, high strength to weight ratio, corrosion resistance, and long life expectancy. A concern with CFRPs is that despite quality control during fabrication, the material can contain many hidden internal flaws. These flaws in combination with unseen damage due to fatigue and low velocity impact have led to catastrophic failure of structures and components. Therefore a large amount of research has been conducted regarding nondestructive testing (NDT) and structural health monitoring (SHM) of CFRP materials. The principal objective of this research program was to develop methods to characterize failure mechanisms in CFRP materials used by the U.S. Army using acoustic emission (AE) and/or acousto-ultrasonic (AU) data. Failure mechanisms addressed include fiber breakage, matrix cracking, and delamination due to shear between layers. CFRP specimens were fabricated and tested in uniaxial tension to obtain AE and AU data. The specimens were designed with carbon fibers in different orientations to produce the different failure mechanisms. Some specimens were impacted with a blunt indenter prior to testing to simulate low-velocity impact. A signature analysis program was developed to characterize the AE data based on data examination using visual pattern recognition techniques. It was determined that it was important to characterize the AE event , using the location of the event as a parameter, rather than just the AE hit (signal recorded by an AE sensor). A back propagation neural network was also trained based on the results of the signature analysis program. Damage observed on the specimens visually with the aid of a scanning electron microscope agreed with the damage type assigned by the signature analysis program. The load level at which significant damage occurred in the specimens was evaluated using ASME Boiler and Pressure Vessel criteria. AU testing proved inconclusive for characterization of the damage due to common problems associated with AU testing such as: reproducibility difficulties due to degradation of the attachment of the sensors, damage not detected unless in the line of sight between sensors, and large intrinsic variation of the data.

Health care utilization from chemotherapy-related adverse events among low-income breast cancer patients: effect of enrollment in a medical home program.

PubMed

Goyal, Ravi K; Wheeler, Stephanie B; Kohler, Racquel E; Lich, Kristen H; Lin, Ching-Ching; Reeder-Hayes, Katherine; Meyer, Anne-Marie; Mayer, Deborah K

2014-01-01

Chemotherapy-related health care utilization by breast cancer patients can be expensive for payers and patients. This study evaluated the patient-centered medical home program Community Care of North Carolina (CCNC) in terms of its potential to reduce health care utilization associated with chemotherapy-related adverse events (AEs). Early-stage breast cancer cases diagnosed during the 5-year period 2003-2007 were identified in the North Carolina Central Cancer Registry; these cases were then linked to North Carolina Medicaid claims data. We measured health care utilization associated with chemotherapy-related AEs by setting (inpatient, outpatient, or emergency department) during a 15-month postdiagnosis follow-up period. Descriptive and multivariate analyses were performed to examine associations between CCNC enrollment and health care utilization associated with chemotherapy-related AEs. A large proportion of breast cancer patients had at least 1 health care visit associated with a chemotherapy-related AE (n = 412 [72.3%]). The mean numbers of AE-related visits occurring in inpatient, outpatient, and emergency department settings were 0.30 (standard deviation [SD] = 0.83), 6.92 (SD = 10.94), and 0.46 (SD = 1.26), respectively. CCNC enrollment was associated with significantly fewer inpatient admissions (marginal effect, -0.1421; 95% confidence interval, -0.280 to -0.004). In this observational study, we were unable to draw conclusions about the causality of these associations. Patients enrolled in CCNC had fewer inpatient health care visits associated with chemotherapy-related AEs. Future research should continue to explore the extent to which patient-centered medical homes can monitor and help manage the effects of cancer treatments.

Understanding and Managing Immune-Related Adverse Events Associated With Immune Checkpoint Inhibitors in Patients With Advanced Melanoma

PubMed Central

Weinstein, Alyona; Gordon, Ruth-Ann; Kasler, Mary Kate; Burke, Matthew; Ranjan, Smita; Hodgetts, Jackie; Reed, Vanessa; Shames, Yelena; Prempeh-Keteku, Nana; Lingard, Karla

2017-01-01

The immune checkpoint inhibitors ipilimumab, nivolumab, and pembrolizumab represent a substantial improvement in treating advanced melanoma but are associated with adverse events (AEs) likely related to general immunologic enhancement. To ensure that patients receive optimal benefit from these agents, prompt assessment and treatment of AEs are essential. We review the efficacy and safety profiles of these immune checkpoint inhibitors and describe guidelines for managing immune-related AEs. We also present case studies describing the management of toxicities in patients receiving immune checkpoint inhibitor therapy. These cases illustrate the importance of collecting a detailed medical history when administering immunotherapy, as this information is necessary to establish baseline, inform monitoring, and determine the etiology of symptoms. Advanced practice nurses and physician assistants are uniquely positioned to educate patients on the early recognition of AEs and have an important role in establishing appropriate monitoring and open dialogue among services. PMID:29900017

Eczema, Atopic Dermatitis, or Atopic Eczema: Analysis of Global Search Engine Trends.

PubMed

Xu, Shuai; Thyssen, Jacob P; Paller, Amy S; Silverberg, Jonathan I

The lack of standardized nomenclature for atopic dermatitis (AD) creates challenges for scientific communication, patient education, and advocacy. We sought to determine the relative popularity of the terms eczema, AD, and atopic eczema (AE) using global search engine volumes. A retrospective analysis of average monthly search volumes from 2014 to 2016 of Google, Bing/Yahoo, and Baidu was performed for eczema, AD, and AE in English and 37 other languages. Google Trends was used to determine the relative search popularity of each term from 2006 to 2016 in English and the top foreign languages, German, Turkish, Russian, and Japanese. Overall, eczema accounted for 1.5 million monthly searches (84%) compared with 247 000 searches for AD (14%) and 44 000 searches for AE (2%). For English language, eczema accounted for 93% of searches compared with 6% for AD and 1% for AE. Search popularity for eczema increased from 2006 to 2016 but remained stable for AD and AE. Given the ambiguity of the term eczema, we recommend the universal use of the next most popular term, AD.

Integrated design and manufacturing for the high speed civil transport

NASA Technical Reports Server (NTRS)

1993-01-01

In June 1992, Georgia Tech's School of Aerospace Engineering was awarded a NASA University Space Research Association (USRA) Advanced Design Program (ADP) to address 'Integrated Design and Manufacturing for the High Speed Civil Transport (HSCT)' in its graduate aerospace systems design courses. This report summarizes the results of the five courses incorporated into the Georgia Tech's USRA ADP program. It covers AE8113: Introduction to Concurrent Engineering, AE4360: Introduction to CAE/CAD, AE4353: Design for Life Cycle Cost, AE6351: Aerospace Systems Design One, and AE6352: Aerospace Systems Design Two. AE8113: Introduction to Concurrent Engineering was an introductory course addressing the basic principles of concurrent engineering (CE) or integrated product development (IPD). The design of a total system was not the objective of this course. The goal was to understand and define the 'up-front' customer requirements, their decomposition, and determine the value objectives for a complex product, such as the high speed civil transport (HSCT). A generic CE methodology developed at Georgia Tech was used for this purpose. AE4353: Design for Life Cycle Cost addressed the basic economic issues for an HSCT using a robust design technique, Taguchi's parameter design optimization method (PDOM). An HSCT economic sensitivity assessment was conducted using a Taguchi PDOM approach to address the robustness of the basic HSCT design. AE4360: Introduction to CAE/CAD permitted students to develop and utilize CAE/CAD/CAM knowledge and skills using CATIA and CADAM as the basic geometric tools. AE6351: Aerospace Systems Design One focused on the conceptual design refinement of a baseline HSCT configuration as defined by Boeing, Douglas, and NASA in their system studies. It required the use of NASA's synthesis codes FLOPS and ACSYNT. A criterion called the productivity index (P.I.) was used to evaluate disciplinary sensitivities and provide refinements of the baseline HSCT configuration. AE6352: Aerospace Systems Design Two was a continuation of Aerospace Systems Design One in which wing concepts were researched and analyzed in more detail. FLOPS and ACSYNT were again used at the system level while other off-the-shelf computer codes were used for more detailed wing disciplinary analysis and optimization. The culmination of all efforts and submission of this report conclude the first year's efforts of Georgia Tech's NASA USRA ADP. It will hopefully provide the foundation for next year's efforts concerning continuous improvement of integrated design and manufacturing for the HSCT.

Psychological quality of life and its association with academic employability skills among newly-registered students from three European faculties

PubMed Central

2011-01-01

Background In accord with new European university reforms initiated by the Bologna Process, our objectives were to assess psychological quality of life (QoL) and to analyse its associations with academic employability skills (AES) among students from the Faculty of Language, Literature, Humanities, Arts and Education, Walferdange Luxembourg (F1, mostly vocational/applied courses); the Faculty of Social and Human Sciences, Liege, Belgium (F2, mainly general courses); and the Faculty of Social Work, Iasi, Romania (F3, mainly vocational/professional courses). Method Students who redoubled or who had studied at other universities were excluded. 355 newly-registered first-year students (145 from F1, 125 from F2, and 85 from F3) were invited to complete an online questionnaire (in French, German, English or Romanian) covering socioeconomic data, the AES scale and the QoL-psychological, QoL-social relationships and QoL-environment subscales as measured with the World Health Organisation Quality of Life short-form (WHOQoL-BREF) questionnaire. Analyses included multiple regressions with interactions. Results QoL-psychological, QoL-social relationships and QoL-environment' scores were highest in F1 (Luxembourg), and the QoL-psychological score in F2 (Belgium) was the lower. AES score was higher in F1 than in F3 (Romania). A positive link was found between QoL-psychological and AES for F1 (correlation coefficient 0.29, p < 0.01) and F3 (correlation coefficient 0.30, p < 0.05), but the association was negative for F2 (correlation coefficient -0.25, p < 0.01). QoL-psychological correlated positively with QoL-social relationships (regression coefficient 0.31, p < 0.001) and QoL-environment (regression coefficient 0.35, p < 0.001). Conclusions Psychological quality of life is associated with acquisition of skills that increase employability from the faculties offering vocational/applied/professional courses in Luxembourg and Romania, but not their academically orientated Belgian counterparts. In the context of developing a European Higher Educational Area, these measurements are major indicators that can be used as a guide to promoting programs geared towards counseling, improvement of the social environment, and services to assist with university work and facilitate achievement of future professional projects. PMID:21501507

Psychological quality of life and its association with academic employability skills among newly-registered students from three European faculties.

PubMed

Baumann, Michèle; Ionescu, Ion; Chau, Nearkasen

2011-04-18

In accord with new European university reforms initiated by the Bologna Process, our objectives were to assess psychological quality of life (QoL) and to analyse its associations with academic employability skills (AES) among students from the Faculty of Language, Literature, Humanities, Arts and Education, Walferdange Luxembourg (F1, mostly vocational/applied courses); the Faculty of Social and Human Sciences, Liege, Belgium (F2, mainly general courses); and the Faculty of Social Work, Iasi, Romania (F3, mainly vocational/professional courses). Students who redoubled or who had studied at other universities were excluded. 355 newly-registered first-year students (145 from F1, 125 from F2, and 85 from F3) were invited to complete an online questionnaire (in French, German, English or Romanian) covering socioeconomic data, the AES scale and the QoL-psychological, QoL-social relationships and QoL-environment subscales as measured with the World Health Organisation Quality of Life short-form (WHOQoL-BREF) questionnaire. Analyses included multiple regressions with interactions. QoL-psychological, QoL-social relationships and QoL-environment' scores were highest in F1 (Luxembourg), and the QoL-psychological score in F2 (Belgium) was the lower. AES score was higher in F1 than in F3 (Romania). A positive link was found between QoL-psychological and AES for F1 (correlation coefficient 0.29, p<0.01) and F3 (correlation coefficient 0.30, p<0.05), but the association was negative for F2 (correlation coefficient -0.25, p<0.01). QoL-psychological correlated positively with QoL-social relationships (regression coefficient 0.31, p<0.001) and QoL-environment (regression coefficient 0.35, p<0.001). Psychological quality of life is associated with acquisition of skills that increase employability from the faculties offering vocational/applied/professional courses in Luxembourg and Romania, but not their academically orientated Belgian counterparts. In the context of developing a European Higher Educational Area, these measurements are major indicators that can be used as a guide to promoting programs geared towards counseling, improvement of the social environment, and services to assist with university work and facilitate achievement of future professional projects.

Review of risk factors for human echinococcosis prevalence on the Qinghai-Tibet Plateau, China: a prospective for control options

PubMed Central

2014-01-01

Objective Echinococcosis is a major parasitic zoonosis of public health importance in western China. In 2004, the Chinese Ministry of Health estimated that 380,000 people had the disease in the region. The Qinghai-Tibet Plateau is highly co-endemic with both alveolar echinococcosis (AE) and cystic echinococcosis (CE). In the past years, the Chinese government has been increasing the financial support to control the diseases in this region. Therefore, it is very important to identify the significant risk factors of the diseases by reviewing studies done in the region in the past decade to help policymakers design appropriate control strategies. Review Selection criteria for which literature to review were firstly defined. Medline, CNKI (China National Knowledge Infrastructure), and Google Scholar were systematically searched for literature published between January 2000 and July 2011. Significant risk factors found by single factor and/or multiple factors analysis were listed, counted, and summarized. Literature was examined to check the comparability of the data; age and sex specific prevalence with same data structures were merged and used for further analysis. A variety of assumed social, economical, behavioral, and ecological risk factors were studied on the Plateau. Those most at risk were Tibetan herdsmen, the old and female in particular. By analyzing merged comparable data, it was found that females had a significant higher prevalence, and a positive linearity relationship existed between echinococcosis prevalence and increasing age. In terms of behavioral risk factors, playing with dogs was mostly correlated with CE and/or AE prevalence. In terms of hygiene, employing ground water as the drinking water source was significantly correlated with CE and AE prevalence. For definitive hosts, dog related factors were most frequently identified with prevalence of CE or/and AE; fox was a potential risk factor for AE prevalence only. Overgrazing and deforestation were significant for AE prevalence only. Conclusion Tibetan herdsmen communities were at the highest risk of echinococcosis prevalence and should be the focus of echinococcosis control. Deworming both owned and stray dogs should be a major measure for controlling echinococcosis; treatment of wild definitive hosts should also be considered for AE endemic areas. Health education activities should be in concert with the local people’s education backgrounds and languages in order to be able to improve behaviors. Further researches are needed to clarify the importance of wild hosts for AE/CE prevalence, the extent and range of the impacts of ecologic changes (overgrazing and deforestation) on the AE prevalence, and risk factors in Tibet. PMID:24475907

Review of risk factors for human echinococcosis prevalence on the Qinghai-Tibet Plateau, China: a prospective for control options.

PubMed

Wang, Qian; Huang, Yan; Huang, Liang; Yu, Wenjie; He, Wei; Zhong, Bo; Li, Wei; Zeng, Xiangman; Vuitton, Dominique A; Giraudoux, Patrick; Craig, Philip S; Wu, Weiping

2014-01-29

Echinococcosis is a major parasitic zoonosis of public health importance in western China. In 2004, the Chinese Ministry of Health estimated that 380,000 people had the disease in the region. The Qinghai-Tibet Plateau is highly co-endemic with both alveolar echinococcosis (AE) and cystic echinococcosis (CE). In the past years, the Chinese government has been increasing the financial support to control the diseases in this region. Therefore, it is very important to identify the significant risk factors of the diseases by reviewing studies done in the region in the past decade to help policymakers design appropriate control strategies. Selection criteria for which literature to review were firstly defined. Medline, CNKI (China National Knowledge Infrastructure), and Google Scholar were systematically searched for literature published between January 2000 and July 2011. Significant risk factors found by single factor and/or multiple factors analysis were listed, counted, and summarized. Literature was examined to check the comparability of the data; age and sex specific prevalence with same data structures were merged and used for further analysis.A variety of assumed social, economical, behavioral, and ecological risk factors were studied on the Plateau. Those most at risk were Tibetan herdsmen, the old and female in particular. By analyzing merged comparable data, it was found that females had a significant higher prevalence, and a positive linearity relationship existed between echinococcosis prevalence and increasing age. In terms of behavioral risk factors, playing with dogs was mostly correlated with CE and/or AE prevalence. In terms of hygiene, employing ground water as the drinking water source was significantly correlated with CE and AE prevalence. For definitive hosts, dog related factors were most frequently identified with prevalence of CE or/and AE; fox was a potential risk factor for AE prevalence only. Overgrazing and deforestation were significant for AE prevalence only. Tibetan herdsmen communities were at the highest risk of echinococcosis prevalence and should be the focus of echinococcosis control. Deworming both owned and stray dogs should be a major measure for controlling echinococcosis; treatment of wild definitive hosts should also be considered for AE endemic areas. Health education activities should be in concert with the local people's education backgrounds and languages in order to be able to improve behaviors. Further researches are needed to clarify the importance of wild hosts for AE/CE prevalence, the extent and range of the impacts of ecologic changes (overgrazing and deforestation) on the AE prevalence, and risk factors in Tibet.

Atmosphere Explorer (AE) spacecraft system description

NASA Technical Reports Server (NTRS)

1972-01-01

The principal design and performance characteristics of the AE spacecraft system designed to support the Atmosphere Explorer C, D, and E missions are summarized. It has been prepared for the information of experimenters and other participants in the Atmosphere Explorer program as a general guide for design and operational planning. The description represents the spacecraft system as defined at the conclusion of the interface definition study.

Dose-Effect Relationships for Adverse Events After Cranial Radiation Therapy in Long-term Childhood Cancer Survivors

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

Dijk, Irma W.E.M. van, E-mail: i.w.vandijk@amc.uva.nl; Cardous-Ubbink, Mathilde C.; Pal, Helena J.H. van der

Purpose: To evaluate the prevalence and severity of clinical adverse events (AEs) and treatment-related risk factors in childhood cancer survivors treated with cranial radiation therapy (CRT), with the aim of assessing dose-effect relationships. Methods and Materials: The retrospective study cohort consisted of 1362 Dutch childhood cancer survivors, of whom 285 were treated with CRT delivered as brain irradiation (BI), as part of craniospinal irradiation (CSI), and as total body irradiation (TBI). Individual CRT doses were converted into the equivalent dose in 2-Gy fractions (EQD{sub 2}). Survivors had received their diagnoses between 1966 and 1996 and survived at least 5 yearsmore » after diagnosis. A complete inventory of Common Terminology Criteria for Adverse Events grade 3.0 AEs was available from our hospital-based late-effect follow-up program. We used multivariable logistic and Cox regression analyses to examine the EQD{sub 2} in relation to the prevalence and severity of AEs, correcting for sex, age at diagnosis, follow-up time, and the treatment-related risk factors surgery and chemotherapy. Results: There was a high prevalence of AEs in the CRT group; over 80% of survivors had more than 1 AE, and almost half had at least 5 AEs, both representing significant increases in number of AEs compared with survivors not treated with CRT. Additionally, the proportion of severe, life-threatening, or disabling AEs was significantly higher in the CRT group. The most frequent AEs were alopecia and cognitive, endocrine, metabolic, and neurologic events. Using the EQD{sub 2}, we found significant dose-effect relationships for these and other AEs. Conclusion: Our results confirm that CRT increases the prevalence and severity of AEs in childhood cancer survivors. Furthermore, analyzing dose-effect relationships with the cumulative EQD{sub 2} instead of total physical dose connects the knowledge from radiation therapy and radiobiology with the clinical experience.« less

National Household Education Survey. Adult and Course Data Files User's Manual.

ERIC Educational Resources Information Center

Brick, J. Michael; And Others

This manual provides documentation and guidance for users of the public release data files (adult file and course file) for Adult Education (AE) component of the 1991 National Household Education Survey (NHES:91). The NHES:91 was a random-digit dial telephone survey developed by the National Center for Education Statistics (NCES) and conducted by…

Peak Performance...Reaching for Excellence in Agricultural Education Research. Proceedings of the Annual National Agricultural Education Research Meeting (22nd, Denver, Colorado, December 1, 1995). Volume XXII.

ERIC Educational Resources Information Center

Birkenholz, Robert J., Ed.; Schumacher, Leon G., Ed.

The theme of this conference reflects the continuing need to conduct and report research that addresses significant problems and issues in Agricultural Education. Selected research papers are as follows: "Opportunities and Obstacles for Distance Education in Agricultural Education (AE)" (Murphy, Terry); "Faculty Needs Associated with Agricultural…

The inner zone electron model AE-5

NASA Technical Reports Server (NTRS)

Teague, M. J.; Vette, J. I.

1972-01-01

A description is given of the work performed in the development of the inner radiation zone electron model, AE-5. A complete description of the omnidirectional flux model is given for energy thresholds E sub T in the range 4.0 E sub T/(MeV) 0.04 and for L values in the range 2.8 L 1.2 for an epoch of October 1967. Confidence codes for certain regions of B-L space and certain energies are given based on data coverage and the assumptions made in the analysis. The electron model programs that can be supplied to a user are referred to. One of these, a program for accessing the model flux at arbitrary points in B-L space and arbitrary energies, includes the latest outer zone electron model and proton model. The model AE-5, is based on data from five satellites, OGO 1, OGO 3, 1963-38C, OV3-3, and Explorer 26, spanning the period December 1964 to December 1967.

The learning styles of orthopedic residents, faculty, and applicants at an academic program.

PubMed

Richard, Raveesh Daniel; Deegan, Brian Francis; Klena, Joel Christian

2014-01-01

To train surgeons effectively, it is important to understand how they are learning. The Kolb Learning Style Inventory (LSI) is based on the theory of experiential learning, which divides the learning cycle into 4 stages: active experimentation (AE), abstract conceptualization (AC), concrete experience, and reflective observation. The purpose of this investigation was to assess the learning styles of orthopedic residents, faculty, and applicants at an east-coast residency program. A total of 90 Kolb LSI, Version 3.1 surveys, and demographic questionnaires were distributed to all residency applicants, residents, and faculty at an academic program. Data collected included age, sex, type of medical school (MD or DO), foreign medical graduate status, and either year since college graduation, postgraduate year level (residents only), or years since completion of residency (faculty only). Seventy-one completed Kolb LSI surveys (14 residents, 14 faculty members, and 43 applicants) were recorded and analyzed for statistical significance. The most prevalent learning style among all participants was converging (53.5%), followed by accommodating (18.3%), diverging (18.3%), and assimilating (9.9%) (p = 0.13). The applicant and resident groups demonstrated a high tendency toward AE followed by AC. The faculty group demonstrated a high tendency toward AC followed by AE. None of the 24 subjects who were 26 years or under had assimilating learning styles, in significant contrast to the 12% of 27- to 30-year-olds and 18% of 31 and older group (p < 0.01). The majority of applicants, residents, and faculty in the orthopedic residency program were "convergers." The converging learning style involves problem solving and decision making, with the practical application of ideas and the use of hypothetical-deductive reasoning. Learning through AE decreased with age, whereas learning through AC increased. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Management of adrenal emergencies in educated patients with adrenal insufficiency-A prospective study.

PubMed

Burger-Stritt, Stephanie; Kardonski, Pavel; Pulzer, Alina; Meyer, Gesine; Quinkler, Marcus; Hahner, Stefanie

2018-07-01

To evaluate the management of adrenal emergencies (AE) requiring parenteral glucocorticoid (GC) treatment in patients with chronic adrenal insufficiency (AI). Prospective, multicentre, questionnaire-based study. Participating patients (n = 150) with chronic AI were provided with a questionnaire on the management of emergency situations, which had to be completed and sent back in case of an AE. In addition, patients were contacted by phone on a regular basis. Fifty-nine AE in 39 patients were documented. The time interval from contact to arrival of a medical professional was 20 minutes (1-240). In total, in 43 AE, patients received parenteral GC by a medical professional. The time interval between showing the emergency card and GC injection by a medical professional was 60 minutes (5-360). A total of 26 patients administered GC by self-injection. The time from the beginning of symptoms to GC injection was significantly shorter in case of self-injection (self-injection vs injection by medical professional; 85 minutes [20-280] vs 232.5 minutes [1-3135]; P < .001). After self-injection, 62% of the patients were treated outpatient, compared to 27% of the patients after exclusive injection by a medical professional (P = .008). To improve the emergency management, most of the patients (84%) indicated a need for an easier way of self-injection. While management of AE by both patients and medical professionals still shows high variability, patients profit from the option of self-injection. Patient care, including education of patients and health-professionals, as well as the way of GC administration, needs further optimization. © 2018 John Wiley & Sons Ltd.

Detection of immune-related adverse events by medical imaging in patients treated with anti-programmed cell death 1.

PubMed

Mekki, Ahmed; Dercle, Laurent; Lichtenstein, Philip; Marabelle, Aurélien; Michot, Jean-Marie; Lambotte, Olivier; Le Pavec, Jérôme; De Martin, Eleonora; Balleyguier, Corinne; Champiat, Stéphane; Ammari, Samy

2018-06-01

Programmed death receptor-1 blocking antibodies (anti-PD1) are a new standard of care in many cancer types. Patients benefit from improved survival but have the risk of immune-related adverse events (irAE). We evaluated if medical imaging procedures, used for anti-tumour response assessment, can detect irAEs. All consecutive patients treated with anti-PD1 and with a medical imaging acquisition performed within 2 weeks with irAEs ≥2 were retrospectively included. Data were gathered from June 2014 to February 2017, and a central review was performed. The primary and secondary end-points were i) to evaluate the overall detection rate of irAEs by medical imaging and ii) to provide a comprehensive radiological description of irAEs. Fifty-three patients (31 women, 22 men; average age: 61 years) were included. The primary tumour was melanoma (n = 32), lung cancer (n = 18) and other (n = 3). Patients were treated with nivolumab (n = 27) or pembrolizumab (n = 26). Of 74 medical imaging procedures analysed (ratio = 1.4 medical imaging per patient), 55 irAE were detected. The detection rate was overall: 74% (95 confidence interval: 63-84%), positron emission tomography with 18F-fludeoxyglucose integrated with computed tomography (18F-FDG PET/CT): 83% (n = 10/12), magnetic resonance imaging: 83% (n = 5/6), computed tomography scan: 79% (n = 19/24), ultrasonography: 70% (n = 19/27), standard X-rays: 40% (n = 2/5), lung/mediastinum: 100% (n = 7/7), enterocolitis: 100% (n = 8/8), hypophysitis: 100% (n = 3/3), thyroiditis: 75% (n = 15/20), hepatitis: 67% (n = 2/3), arthralgia or arthritis: 40% (n = 2/5) and pancreas: 28% (n = 2/7). Medical imaging detected 74% of irAE in patients treated with anti-PD1. Beyond response assessment, medical imaging can detect irAE and guide towards specific management. We described the most frequent sites and patterns of imaging findings. Copyright © 2018 Elsevier Ltd. All rights reserved.

Adverse Events Associated With Infusion of Hematopoietic Stem Cell Products: A Prospective and Multicenter Surveillance Study.

PubMed

Ikeda, Kazuhiko; Ohto, Hitoshi; Okuyama, Yoshiki; Yamada-Fujiwara, Minami; Kanamori, Heiwa; Fujiwara, Shin-Ichiro; Muroi, Kazuo; Mori, Takehiko; Kasama, Kinuyo; Iseki, Tohru; Nagamura-Inoue, Tokiko; Fujii, Nobuharu; Ashida, Takashi; Kameda, Kazuaki; Kanda, Junya; Hirose, Asao; Takahashi, Tsutomu; Nagai, Kazuhiro; Minakawa, Keiji; Tanosaki, Ryuji

2018-06-01

Adverse events (AEs) associated with blood transfusions, including component-specific red cell, platelet, and plasma products, have been extensively surveyed. In contrast, surveillance of AEs associated with hematopoietic stem cell (HSC) products in HSC transplantation (HSCT) has been less rigorous, even though HSC products include a diversity of immature and mature hematopoietic cells, substantial plasma, and dimethyl sulfoxide (DMSO) in the case of cryopreserved HSC products. HSC infusion-related AEs have been attributed to DMSO toxicity, but AEs associated with the infusion of noncryopreserved HSC products are not uncommon. To quantify the frequencies, types, and risk factors of HSC infusion-related AEs, we implemented national surveillance for AEs observed within 24 hours after infusion. Herein we report on 1125 HSCTs, including 570 peripheral blood stem cell transplantations (PBSCTs) (290 autologous [auto-] and 280 allogeneic [allo-]), 332 allo-bone marrow transplantations (allo-BMTs) and 223 allo-cord blood transplantations (allo-CBTs). Unexpectedly, incidences of grade ≥ 2 AEs were most frequent in allo-BMTs (37.7%) with no DMSO in any product compared with auto-/allo-PBSCTs (20.9%, P < .001) and allo-CBTs (19.3%, P < .001) typically cryopreserved with DMSO. Hypertension was most often noted in BMTs, whereas nausea/vomiting, fever, and allergic reactions were most frequent in allo-PBSCTs. In a multivariate analysis, a history of transfusion reactions was a risk factor for overall AEs in all HSCTs (odds ratio [OR] = 1.459, P = .045). For grade ≥ 2 AEs in allo-HSCTs, a history of transfusion reactions (OR = 1.551, P = .044) for overall AEs, and high infusion volume (OR = 7.544, P = .005) and allo-PBSCTs (versus BMTs, OR = 9.948, P = .002) for allergic reactions were identified as risk factors. These findings suggest that some factors unrelated to DMSO, such as allo-antigens, contribute to HSC infusion-related AEs. As severe AEs, a total of 117 grade ≥ 3 AEs were reported in 1125 HSCTs, including life-threatening complications in 3 (0.3%) HSCTs: 1 allo-CBT (anaphylaxis) and 2 allo-PBSCTs (hypoxia, kidney injury) with cryopreserved product. Our data show that HSC infusion risks vary by product, can be severe, and should be monitored with the same rigor as modern transfusion hemovigilance programs. Copyright © 2018. Published by Elsevier Inc.

Section 136, The Mental Health Act 1983; levels of knowledge among accident and emergency doctors, senior nurses, and police constables.

PubMed

Lynch, R M; Simpson, M; Higson, M; Grout, P

2002-07-01

Section 136 of the Mental Health Act 1983 empowers the police to detain those suspected of being mentally ill in public places, and convey them to a place of safety. In practice, accident and emergency (A&E) departments are often used. The authors assessed levels of knowledge of section 136 between A&E doctors, senior nurses, and police constables. Doctors and senior nurses in all (A&E) departments in the Yorkshire region were asked to complete a multiple choice tick box type questionnaire, as were police constables from the Humberside Police Force. 179 completed questionnaires were returned, of which 16 were completed by consultants, 14 by SpRs, 24 by SHOs, 33 by senior nurses, and 92 by police officers. Some 24.1% of A&E staff and 10.9% of police failed to recognise that a person has to appear to be suffering from a mental disorder to be placed on a section 136; 40.2% of police did not know that section 136 is a police power; 55.2% of A&E staff and 14.1% of police incorrectly thought that a person could be placed on a section 136 in their own home; 43.75% of consultants and 50% of SpRs did not consider A&E departments to be a place of safety; 49.4% of A&E staff and 29.3% of police thought that patients could be transferred on a section 136. Only 10.3% of A&E staff and 22.8% of police had received any formal training. The knowledge among A&E staff and the police of this difficult and complex piece of mental health legislation is poor and requires action through formal education and training. This study not only reflects the levels of knowledge within the groups, it may also reflect the different perceptions of each group as to their role and duties within section 136 of the Mental Health Act 1983.

Navigation as a New Form of Search for Agricultural Learning Resources in Semantic Repositories

NASA Astrophysics Data System (ADS)

Cano, Ramiro; Abián, Alberto; Mena, Elena

Education is essential when it comes to raise public awareness on the environmental and economic benefits of organic agriculture and agroecology (OA & AE). Organic.Edunet, an EU funded project, aims at providing a freely-available portal where learning contents on OA & AE can be published and accessed through specialized technologies. This paper describes a novel mechanism for providing semantic capabilities (such as semantic navigational queries) to an arbitrary set of agricultural learning resources, in the context of the Organic.Edunet initiative.

Third National Even Start Evaluation: Follow-Up Findings from the Experimental Design Study. NCEE 2005-3002

ERIC Educational Resources Information Center

Ricciuti, Anne E., St.Pierre, Robert G.; Lee, Wang; Parsad, Amanda

2004-01-01

Citation: Ricciuti, A.E., R.G. St.Pierre, W. Lee, A. Parsad & T. Rimdzius. Third National Even Start Evaluation: Follow-Up Findings From the Experimental Design Study. U.S. Department of Education, Institute of Education Sciences, National Center for Education Evaluation and Regional Assistance. Washington, D.C., 2004. Background: The Even…

Evidence-Based Policy-Making: The Usability of the Eurostat Adult Education Survey

ERIC Educational Resources Information Center

Boeren, Ellen

2014-01-01

This article reflects on European education policy which is driven by benchmarks and indicators. While the European benchmark on adult lifelong learning participation--15% to be achieved by 2020--is measured by the Labour Force Survey, the Eurostat Adult Education Survey (AES) was designed to better understand the topic of adult lifelong learning…

Report: Third Regional Seminar, Southeastern Region Adult Basic Education Staff Development Project (New Orleans, May 5-10, 1970).

ERIC Educational Resources Information Center

Southern Regional Education Board, Atlanta, GA.

The regional seminars of the Southern Regional Education Board (SREB) are designed to provide inservice training and planning experiences to foster the professional growth of state department of education, university, and local AE/ABE staff members. The third regional seminar was aimed at developing ongoing, self-supporting training programs…

Adult Education Participation Decisions and Barriers: Review of Conceptual Frameworks and Empirical Studies. Working Paper Series.

ERIC Educational Resources Information Center

Silva, Tim; Cahalan, Margaret; Lacireno-Paquet, Natalie

In preparation for the next National Household Education Survey (NHES), the conceptual frameworks of participatory behavior and methods used by other researchers to study factors promoting or inhibiting participation were examined. The following items were reviewed: the adult education (AE) barriers questions included on the 1991 and 1995 editions…

Middle School Injuries: A 20-Year (1988–2008) Multisport Evaluation

PubMed Central

Beachy, Glenn; Rauh, Mitchell

2014-01-01

Context: Data on the incidence of injury in middle school sports are limited. Objective: To describe overall, practice, and game injury rate patterns in 29 middle school sports. Design: Descriptive epidemiology study. Setting: Injury data collected over a 20-year period (1988–2008) at a single school. Patients or Other Participants: Boy (n = 8078) and girl (n = 5960) athletes participating in 14 and 15 middle school sports, respectively. Main Outcome Measure(s): Injury status and athlete-exposures (AEs) were collected by certified athletic trainers. Incidence rates per 1000 AEs (injuries/AEs) were calculated for overall incidence, practices and games, injury location, injury type, and injury severity (time lost from participation). Rate ratios (RRs) and 95% confidence intervals (CIs) were used to compare injury rates for sex-matched sports. Results: Football had the highest injury rate for all injuries (16.03/1000 AEs) and for time-loss injuries (8.486/1000 AEs). In matched middle school sports, girls exhibited a higher injury rate for all injuries (7.686/1000 AEs, RR = 1.15, 95% CI = 1.1, 1.2) and time-loss injuries (2.944/1000 AEs, RR = 1.09, 95% CI = 1.0, 1.2) than boys (all injuries: 6.684/1000 AEs, time-loss injuries: 2.702/1000 AEs). Girls had a higher injury rate during practices (3.30/1000 AEs) than games (1.67/1000 AEs, RR = 1.97, 95% CI = 1.7, 2.4) for all sports. Only gymnastics (RR = 0.96, 95% CI = 0.3, 3.8) had a higher game injury rate for girls. Practice and game injury rates were nearly identical for boys in all sports (RR = 0.99, 95% CI = 0.9, 1.1). Only football (RR = 0.49, 95% CI = 0.4, 0.6) and boys' wrestling (RR = 0.50, 95% CI = 0.3, 0.8) reported higher game injury rates. Tendinitis injuries accounted for 19.1% of all middle school injuries. Conclusions: The risk for sport-related injury at the middle school level was greater during practices than games and greater for girls than boys in sex-matched sports. Conditioning programs may be needed to address the high rate of tendinitis injuries. PMID:25167211

Middle school injuries: a 20-year (1988-2008) multisport evaluation.

PubMed

Beachy, Glenn; Rauh, Mitchell

2014-01-01

Data on the incidence of injury in middle school sports are limited. To describe overall, practice, and game injury rate patterns in 29 middle school sports. Descriptive epidemiology study. Injury data collected over a 20-year period (1988-2008) at a single school. Boy (n = 8078) and girl (n = 5960) athletes participating in 14 and 15 middle school sports, respectively. Injury status and athlete-exposures (AEs) were collected by certified athletic trainers. Incidence rates per 1000 AEs (injuries/AEs) were calculated for overall incidence, practices and games, injury location, injury type, and injury severity (time lost from participation). Rate ratios (RRs) and 95% confidence intervals (CIs) were used to compare injury rates for sex-matched sports. Football had the highest injury rate for all injuries (16.03/1000 AEs) and for time-loss injuries (8.486/1000 AEs). In matched middle school sports, girls exhibited a higher injury rate for all injuries (7.686/1000 AEs, RR = 1.15, 95% CI = 1.1, 1.2) and time-loss injuries (2.944/1000 AEs, RR = 1.09, 95% CI = 1.0, 1.2) than boys (all injuries: 6.684/1000 AEs, time-loss injuries: 2.702/1000 AEs). Girls had a higher injury rate during practices (3.30/1000 AEs) than games (1.67/1000 AEs, RR = 1.97, 95% CI = 1.7, 2.4) for all sports. Only gymnastics (RR = 0.96, 95% CI = 0.3, 3.8) had a higher game injury rate for girls. Practice and game injury rates were nearly identical for boys in all sports (RR = 0.99, 95% CI = 0.9, 1.1). Only football (RR = 0.49, 95% CI = 0.4, 0.6) and boys' wrestling (RR = 0.50, 95% CI = 0.3, 0.8) reported higher game injury rates. Tendinitis injuries accounted for 19.1% of all middle school injuries. The risk for sport-related injury at the middle school level was greater during practices than games and greater for girls than boys in sex-matched sports. Conditioning programs may be needed to address the high rate of tendinitis injuries.

Nationwide Investigation of the Pyrethroid Susceptibility of Mosquito Larvae Collected from Used Tires in Vietnam

PubMed Central

Kawada, Hitoshi; Higa, Yukiko; Nguyen, Yen T.; Tran, Son H.; Nguyen, Hoa T.; Takagi, Masahiro

2009-01-01

Pyrethroid resistance is envisioned to be a major problem for the vector control program since, at present, there are no suitable chemical substitutes for pyrethroids. Cross-resistance to knockdown agents, which are mainly used in mosquito coils and related products as spatial repellents, is the most serious concern. Since cross-resistance is a global phenomenon, we have started to monitor the distribution of mosquito resistance to pyrethroids. The first pilot study was carried out in Vietnam. We periodically drove along the national road from the north end to the Mekong Delta in Vietnam and collected mosquito larvae from used tires. Simplified susceptibility tests were performed using the fourth instar larvae of Aedes aegypti, Aedes albopictus, and Culex quinquefasciatus. Compared with the other species, Ae. aegypti demonstrated the most prominent reduction in susceptibility. For Ae. aegypti, significant increases in the susceptibility indices with a decrease in the latitude of collection points were observed, indicating that the susceptibility of Ae. aegypti against d-allethrin was lower in the southern part, including mountainous areas, as compared to that in the northern part of Vietnam. There was a significant correlation between the susceptibility indices in Ae. aegypti and the sum of annual pyrethroid use for malaria control (1998–2002). This might explain that the use of pyrethroids as residual treatment inside houses and pyrethroid-impregnated bed nets for malaria control is attributable to low pyrethroid susceptibility in Ae. aegypti. Such insecticide treatment appeared to have been intensively administered in the interior and along the periphery of human habitation areas where, incidentally, the breeding and resting sites of Ae. aegypti are located. This might account for the strong selection pressure toward Ae. aegypti and not Ae. albopictus. PMID:19274072

The Impact of Aerobic Exercise on Brain-Derived Neurotrophic Factor and Neurocognition in Individuals With Schizophrenia: A Single-Blind, Randomized Clinical Trial

PubMed Central

Kimhy, David; Vakhrusheva, Julia; Bartels, Matthew N.; Armstrong, Hilary F.; Ballon, Jacob S.; Khan, Samira; Chang, Rachel W.; Hansen, Marie C.; Ayanruoh, Lindsey; Lister, Amanda; Castrén, Eero; Smith, Edward E.; Sloan, Richard P.

2015-01-01

Individuals with schizophrenia display substantial neurocognitive deficits for which available treatments offer only limited benefits. Yet, findings from studies of animals, clinical and nonclinical populations have linked neurocognitive improvements to increases in aerobic fitness (AF) via aerobic exercise training (AE). Such improvements have been attributed to up-regulation of brain-derived neurotrophic factor (BDNF). However, the impact of AE on neurocognition, and the putative role of BDNF, have not been investigated in schizophrenia. Employing a proof-of-concept, single-blind, randomized clinical trial design, 33 individuals with schizophrenia were randomized to receive standard psychiatric treatment (n = 17; “treatment as usual”; TAU) or attend a 12-week AE program (n = 16) utilizing active-play video games (Xbox 360 Kinect) and traditional AE equipment. Participants completed assessments of AF (indexed by VO2 peak ml/kg/min), neurocognition (MATRICS Consensus Cognitive Battery), and serum-BDNF before and after and 12-week period. Twenty-six participants (79%) completed the study. At follow-up, the AE participants improved their AF by 18.0% vs a −0.5% decline in the TAU group (P = .002) and improved their neurocognition by 15.1% vs −2.0% decline in the TAU group (P = .031). Hierarchical multiple regression analyses indicated that enhancement in AF and increases in BDNF predicted 25.4% and 14.6% of the neurocognitive improvement variance, respectively. The results indicate AE is effective in enhancing neurocognitive functioning in people with schizophrenia and provide preliminary support for the impact of AE-related BDNF up-regulation on neurocognition in this population. Poor AF represents a modifiable risk factor for neurocognitive dysfunction in schizophrenia for which AE training offer a safe, nonstigmatizing, and side-effect-free intervention. PMID:25805886

The nature, patterns, clinical outcomes, and financial impact of intraoperative adverse events in emergency surgery.

PubMed

Ramly, Elie P; Bohnen, Jordan D; Farhat, Maha R; Razmdjou, Shadi; Mavros, Michael N; Yeh, Daniel D; Lee, Jarone; Butler, Kathryn; De Moya, Marc; Velmahos, George C; Kaafarani, Haytham M A

2016-07-01

Little is known about intraoperative adverse events (iAEs) in emergency surgery (ES). We sought to describe iAEs in ES and to investigate their clinical and financial impact. The 2007 to 2012 administrative and American College of Surgeons-National Surgical Quality Improvement Program databases at our tertiary academic center were: (1) linked, (2) queried for all ES procedures, and then (3) screened for iAEs using the ICD-9-CM-based Patient Safety Indicator "accidental puncture/laceration". Flagged cases were systematically reviewed to: (1) confirm or exclude the occurrence of iAEs (defined as inadvertent injuries during the operation) and (2) extract additional variables such as procedure type, approach, complexity (measured by relative value units), need for adhesiolysis, and extent of repair. Univariate and multivariate analyses were performed to assess the independent impact of iAEs on 30-day morbidity, mortality, and hospital charges. Of a total of 9,288 patients, 1,284 (13.8%) patients underwent ES, of which 23 had iAEs (1.8%); 18 of 23 (78.3%) of the iAEs involved the small bowel or spleen, 10 of 23 (43.5%) required suture repair, and 8 of 23 (34.8%) required tissue or organ resection. Compared with those without iAEs, patients with iAEs were older (median age 62 vs 50; P = .04); their procedures were more complex (total relative value unit 46.7, interquartile range [27.5 to 52.6] vs 14.5 [.5 to 30.2]; P < .001), longer in duration (>3 hours: 52% vs 8%; P < .001), and more often required adhesiolysis (39.1% vs 13.5% P = .001). Patients with iAEs had increased total charges ($31,080 vs $11,330, P < .001), direct charges ($20,030 vs $7,387, P < .001), and indirect charges ($11,460 vs $4,088, P < .001). On multivariable analyses, iAEs were independently associated with increased 30-day morbidity (odds ratio, 3.56 [CI, 1.10 to 11.54]; P = .03) and prolonged postoperative length of stay (LOS; LOS >7 days; odds ratio, 5.60 [1.54 to 20.35]; P = .01]. A trend toward increased mortality did not reach statistical significance. In ES, iAEs are independently associated with significantly higher postoperative morbidity and prolonged LOS. Copyright © 2015 Elsevier Inc. All rights reserved.

Career prospects and professional landscape after advanced endoscopy fellowship training: a survey assessing graduates from 2009 to 2013.

PubMed

Granato, Christine M; Kaul, Vivek; Kothari, Truptesh; Damania, Dushyant; Kothari, Shivangi

2016-08-01

The advanced endoscopy (AE) fellowship is a popular career track for graduating gastroenterology fellows. The number of fellows completing AE fellowships and the number of programs offering this training have increased in the past 5 years. Despite this, we suspect that the number of AE attending (staff physician) positions have decreased (relative to the number of fellows graduating), raising concerns regarding AE job market saturation. Our aim was to survey practicing gastroenterology physicians who completed an AE fellowship within the past 5 years regarding their current professional status. A 16-question survey was distributed using Research Electronic Data Capture by e-mail to practicing gastroenterologists who completed an AE fellowship between 2009 and 2013. The survey questions elicited information regarding demographics, professional status, and additional information. A total of 96 invitations were distributed via e-mail. Forty-one of 96 respondents (43%) replied to the survey. Approximately half of the respondents were employed in an academic practice, with the remainder in private practice (56% and 44%, respectively). Nearly half (46%) of the respondents found it "difficult" to find an AE position after training. Thirty-nine percent of private-practice endoscopists were performing > 200 ERCPs/year, whereas 65% were doing so in academic settings (P = .09). Fifty-six percent of respondents were in small practices (0 to 1 partner), with a significantly smaller group size in private versus academic practice (72% versus 43%, P = .021). Seventy-eight percent of respondents believed the AE job market was saturated; most responded that the AE job market was saturated in both academic and private practice (44%), whereas 34% believed the job market was saturated in academics only. Most respondents (73%) who were training AE fellows found it difficult to place them in AE attending positions. Respondents from academic practice found it significantly more difficult to balance work and personal life compared with those in private practice (87% versus 33%, respectively; P = .0004). This index survey highlights the trends related to the current state of the post-AE fellowship professional landscape. Further evaluation and discussion are needed to address these evolving issues in professional practice in the field of gastroenterology. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR EXTRACTION OF METALS FROM SOIL, DUST, AIR FILTER, AND SURFACE AND DERMAL WIPE SAMPLES FOR AA (GRAPHITE FURNACE OR FLAME) OR ICP-AES ANALYSIS (BCO-L-3.1)

EPA Science Inventory

The purpose of this SOP is to describe the acid digestion of soil, house dust, air filter, and surface or dermal wipe samples for analysis using inductively coupled plasma atomic emissions spectrometry (ICP-AES) and/or graphite furnace atomic absorption spectrometry (GFAAS) or fl...

A Study of the Applicability of Atomic Emission Spectroscopy (AES), Fourier Transform Infrared (FT-IR) Spectroscopy, Direct Reading and Analytical Ferrography on High Performance Aircraft Engine Lubricating Oils

DTIC Science & Technology

1998-01-01

Ferrography on High Performance Aircraft Engine Lubricating Oils Allison M. Toms, Sharon 0. Hem, Tim Yarborough Joint Oil Analysis Program Technical...turbine engines by spectroscopy (AES and FT-IR) and direct reading and analytical ferrography . A statistical analysis of the data collected is...presented. Key Words: Analytical ferrography ; atomic emission spectroscopy; condition monitoring; direct reading ferrography ; Fourier transform infrared

Impact on clinical practice of the implementation of guidelines for the toxicity management of targeted therapies in kidney cancer. The protect-2 study.

PubMed

Lainez, Nuria; García-Donas, Jesús; Esteban, Emilio; Puente, Javier; Sáez, M Isabel; Gallardo, Enrique; Pinto-Marín, Álvaro; Vázquez-Estévez, Sergio; León, Luis; García-Carbonero, Icíar; Suárez-Rodríguez, Cristina; Molins, Carmen; Climent-Duran, Miguel A; Lázaro-Quintela, Martín; González Del Alba, Aranzazu; Méndez-Vidal, María José; Chirivella, Isabel; Afonso, Francisco J; López-Brea, Marta; Sala-González, Nuria; Domenech, Montserrat; Basterretxea, Laura; Santander-Lobera, Carmen; Gil-Arnáiz, Irene; Fernández, Ovidio; Caballero-Díaz, Cristina; Mellado, Begoña; Marrupe, David; García-Sánchez, José; Sánchez-Escribano, Ricardo; Fernández Parra, Eva; Villa Guzmán, José C; Martínez-Ortega, Esther; Belén González, María; Morán, Marina; Suarez-Paniagua, Beatriz; Lecumberri, María J; Castellano, Daniel

2016-02-22

The impact of such recommendations after their implementation of guidelines has not usually been evaluated. Herein, we assessed the impact and compliance with the Spanish Oncology Genitourinary Group (SOGUG) Guidelines for toxicity management of targeted therapies in metastatic renal cell carcinoma (mRCC) in daily clinical practice. Data on 407 mRCC patients who initiated first-line targeted therapy during the year before and the year after publication and implementation of the SOGUG guideline program were available from 34 Spanish Hospitals. Adherence to SOGUG Guidelines was assessed in every cycle. Adverse event (AE) management was consistent with the Guidelines as a whole for 28.7% out of 966 post-implementation cycles compared with 23.1% out of 892 pre-implementation cycles (p = 0.006). Analysis of adherence by AE in non-compliant cycles showed significant changes in appropriate management of hypertension (33% pre-implementation vs. 44.5% post-implementation cycles; p < 0.0001), diarrhea (74.0% vs. 80.5%; p = 0.011) and dyslipemia (25.0% vs. 44.6%; p < 0.001). Slight but significant improvements in AE management were detected following the implementation of SOGUG recommendations. However, room for improvement in the management of AEs due to targeted agents still remains and could be the focus for further programs in this direction.

Exploring impacts of multi-year, community-based care programs for orphans and vulnerable children: a case study from Kenya.

PubMed

Larson, Bruce A; Wambua, Nancy; Masila, Juliana; Wangai, Susan; Rohr, Julia; Brooks, Mohamad; Bryant, Malcolm

2013-01-01

The Community-Based Care for Orphans and Vulnerable Children (CBCO) program operated in Kenya during 2006-2010. In Eastern Province, the program provided support to approximately 3000 orphans and vulnerable children (OVC) living in 1500 households. A primary focus of the program was to support savings and loan associations composed of OVC caregivers (typically elderly women) to improve household and OVC welfare. Cross-sectional data were collected in 2011 from 1500 randomly selected households from 3 populations: program participants (CBCO group, n=500), households in the same villages as program participants but not in the program (the local-community-group = Group L, n=300), and households living in nearby villages where the program did not operate (the adjacent-community-group, Group A, n=700). Primary welfare outcomes evaluated are household food security, as measured by the Household Food Insecurity Access instrument, and OVC educational attainment. We compared outcomes between the CBCO and the subset of Group L not meeting program eligibility criteria (L-N) to investigate disparities within local communities. We compared outcomes between the CBCO group and the subset of Group A meeting eligibility criteria (A-E) to consider program impact. We compared outcomes between households not eligible for the program in the local and adjacent community groups (L-N and A-N) to consider if the adjacent communities are similar to the local communities. In May-June 2011, at the end of the OVC program, the majority of CBCO households continued to be severely food insecure, with rates similar to other households living in nearby communities. Participation rates in primary school are high, reflecting free primary education. Among the 18-22 year olds who were "children" during the program years, relatively few children completed secondary school across all study groups. Although the CBCO program likely provided useful services and benefits to program participants, disparities continued to exist in food security and educational outcomes between program participants and their non-OVC peers in the local community. Outcomes for CBCO households were similar to those observed for OVC households in adjacent communities.

Exploring impacts of multi-year, community-based care programs for orphans and vulnerable children: A case study from Kenya

PubMed Central

Larson, Bruce A.; Wambua, Nancy; Masila, Juliana; Wangai, Susan; Rohr, Julia; Brooks, Mohamad; Bryant, Malcolm

2013-01-01

The Community-Based Care for Orphans and Vulnerable Children (CBCO) program operated in Kenya during 2006–2010. In Eastern Province, the program provided support to approximately 3000 orphans and vulnerable children (OVC) living in 1500 households. A primary focus of the program was to support savings and loan associations composed of OVC caregivers (typically elderly women) to improve household and OVC welfare. Cross-sectional data were collected in 2011 from 1500 randomly selected households from 3 populations: program participants (CBCO group, n = 500), households in the same villages as program participants but not in the program (the local-community-group = Group L, n = 300), and households living in nearby villages where the program did not operate (the adjacent-community-group, Group A, n = 700). Primary welfare outcomes evaluated are household food security, as measured by the Household Food Insecurity Access instrument, and OVC educational attainment. We compared outcomes between the CBCO and the subset of Group L not meeting program eligibility criteria (L-N) to investigate disparities within local communities. We compared outcomes between the CBCO group and the subset of Group A meeting eligibility criteria (A-E) to consider program impact. We compared outcomes between households not eligible for the program in the local and adjacent community groups (L-N and A-N) to consider if the adjacent communities are similar to the local communities. In May-June 2011, at the end of the OVC program, the majority of CBCO households continued to be severely food insecure, with rates similar to other households living in nearby communities. Participation rates in primary school are high, reflecting free primary education. Among the 18–22 year olds who were “children” during the program years, relatively few children completed secondary school across all study groups. Although the CBCO program likely provided useful services and benefits to program participants, disparities continued to exist in food security and educational outcomes between program participants and their non-OVC peers in the local community. Outcomes for CBCO households were similar to those observed for OVC households in adjacent communities. PMID:23745629

Wisconsin K-12 Career Education Consortium. Final Project Performance Report. Volume I of Two Volumes.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Public Instruction, Madison.

To demonstrate career education methods and procedures, seven Wisconsin school districts were chosen to participate in an incremental improvement project. Project activities were conducted district-wide and by individual districts. District-wide dissemination activities involved promoting demonstration packets and assessment/evaluation (AE)…

Individualization for Education at Scale: MIIC Design and Preliminary Evaluation

ERIC Educational Resources Information Center

Brinton, Christopher G.; Rill, Ruediger; Ha, Sangtae; Chiang, Mung; Smith, Robert; Ju, William

2015-01-01

We present the design, implementation, and preliminary evaluation of our Adaptive Educational System (AES): the Mobile Integrated and Individualized Course (MIIC). MIIC is a platform for personalized course delivery which integrates lecture videos, text, assessments, and social learning into a mobile native app, and collects clickstream-level…

Immune-Related Adverse Events Associated with Anti-PD-1/PD-L1 Treatment for Malignancies: A Meta-Analysis

PubMed Central

Wang, Peng-Fei; Chen, Yang; Song, Si-Ying; Wang, Ting-Jian; Ji, Wen-Jun; Li, Shou-Wei; Liu, Ning; Yan, Chang-Xiang

2017-01-01

Background: Treatment of cancers with programmed cell death protein 1 (PD-1) pathway inhibitors can lead to immune-related adverse events (irAEs), which could be serious and even fetal. Therefore, clinicians should be aware of the characteristics of irAEs associated with the use of such drugs. Methods: The MEDLINE, EMBASE, and Cochrane databases were searched to find potential studies using the following strategies: anti-PD-1/PD-L1 treatment; irAEs; and cancer. R© package Meta was used to pool incidence. Results: Forty-six studies representing 12,808 oncologic patients treated with anti-PD-1/PD-L1 agents were included in the meta-analysis. The anti-PD-1/PD-L1 agents included nivolumab, pembrolizumab, atezolizumab, durvalumab, avelumab, and BMS-936559. The tumor types were melanomas, Hodgkin lymphomas, urothelial carcinomas, breast cancers, non-small cell lung cancers, renal cell carcinomas (RCC), colorectal cancers, and others. We described irAEs according to organ systems, namely, the skin (pruritus, rash, maculopapular rash, vitiligo, and dermatitis), endocrine system (hypothyroidism, hyperthyroidism, hypophysitis, thyroiditis, and adrenal insufficiency), digestive system (colitis, diarrhea, pancreatitis, and increased AST/ALT/bilirubin), respiratory system (pneumonitis, lung infiltration, and interstitial lung disease), and urinary system (increased creatinine, nephritis, and renal failure). In patients treated with the PD-1 signaling inhibitors, the overall incidence of irAEs was 26.82% (95% CI, 21.73–32.61; I2, 92.80) in any grade and 6.10% (95% CI, 4.85–7.64; I2, 52.00) in severe grade, respectively. The development of irAEs was unrelated to the dose of anti-PD-1/PD-L1 agents. The incidence of particular irAEs varied when different cancers were treated with different drugs. The incidence of death due to irAEs was around 0.17%. Conclusion: The occurrence of irAEs was organ-specific and related to drug and tumor types. PMID:29093678

Larval occurrence, oviposition behavior and biting activity of potential mosquito vectors of dengue on Samui Island, Thailand.

PubMed

Thavara, U; Tawatsin, A; Chansang, C; Kong-ngamsuk, W; Paosriwong, S; Boon-Long, J; Rongsriyam, Y; Komalamisra, N

2001-12-01

A 1995 outbreak of dengue haemorrhagic fever (DHF) occurred on Samui Island in Thailand with an incidence of almost 500 cases/100,000 population. To find and develop effective strategies to control this disease through cost-effective vector control programs, entomological studies were carried out on the island between 1996 and 1998. There were two species of DHF vectors, Aedes aegypti and Ae. albopictus prevailing on the island, and the population of Ae. aegypti remained relatively constant throughout the year while the abundance of Ae. albopictus increased substantially during the rainy season (May-December) and then declined drastically in the dry season (January-April). The ranges of the three Aedes larval indices, Breteau index (BI), house index (HI) and container index (CI) were 93-310, 43-89 and 16-50 respectively. The ceramic or earthen jars both inside and outside the dwellings and concrete water storage tanks (mostly in toilets and bathrooms) served as the main breeding places of Ae. aegypti whereas coconut husks and coconut floral spathes found outdoors were the major breeding sites of Ae. albopictus. The number of washing water jars, concrete tanks and natural sites infested with Aedes larvae increased significantly in rainy season, with 60% of ovitraps become positive for Ae. albopictus eggs with an average number of 26 eggs/trap in 3 days of setting. There was a complete lack of oviposition by Ae. aegypti in outdoor ovitraps (15 m away from the houses). The indoor biting rate ranged from 1.5 to 8.1 mosquitoes/man-hour, while the outdoor rate was between 5 and 78 mosquitoes/man-hour. Of the indoor biting mosquitoes, 75.4% were identified as Ae. aegypti and 99% of the outdoor ones were Ae. albopictus. The diel biting activity of Aedes during the period from 0800 h to 1700 h in the houses was higher in the morning than in the afternoon period, with a low prevalence between 1300 h and 1400 h.

A Comparison of Van Allen Belt Radiation Environment Modeling Programs: AE8/AP8 Legacy, AE9/AP9, and SPENVIS

NASA Technical Reports Server (NTRS)

Reed, Evan; Pellish, Jonathan

2016-01-01

In the space surrounding Earth there exists an active radiation environment consisting mostly of electrons and protons that have been trapped by Earths magnetic field. This radiation, also known as the Van Allen Belts, has the potential to damage man-made satellites in orbit; thus, proper precautions must be taken to shield NASA assets from this phenomenon. Data on the Van Allen Belts has been collected continuously by a multitude of space-based instruments since the beginning of space exploration. Subsequently, using theory to fill in the gaps in the collected data, computer models have been developed that take in the orbital information of a hypothetical mission and output the expected particle fluence and flux for that orbit. However, as new versions of the modeling system are released, users are left wondering how the new version differs from the old. Therefore, we performed a comparison of three different editions of the modeling system: AE8/AP8 (legacy), which is included in the model 9 graphical user interface as an option for ones calculations, AE9/AP9, and the Space Environment Information System (SPENVIS), which is an online-based form of AE8/AP8 developed by NASA and the European Space Agency that changed the code to allow the program to extrapolate data to predict fluence and flux at higher energies. Although this evaluation is still ongoing, it is predicted that the model 8 (legacy) and SPENVIS version will have identical outputs with the exception of the extended energy levels from SPENVIS, while model 9 will provide different fluences than model 8 based on additional magnetic field descriptions and on-orbit data.

The Impact on Annual Earnings of Adult Upper Secondary Education in Sweden

ERIC Educational Resources Information Center

Stenberg, Anders

2010-01-01

The public supply of adult education is very different between countries, making it likely that there is scope for efficiency gains. The contribution of this paper is to provide an economic evaluation of the earnings impact of adult education at upper secondary level (AE) in Sweden, where the supply is plausibly larger than in any other country.…

Silence or Sanism: A Review of the Dearth of Discussions on Mental Illness in Adult Education

ERIC Educational Resources Information Center

Procknow, Greg

2017-01-01

This literature review engages mental illness in adult education (AE) to locate what research exists and to suggest a research agenda moving forward. This structured review located research related to mental health issues published in the conference proceedings of the Canadian Association for the Study of Adult Education (CASAE) and the Adult…

A History of the Adult Education Movement in the United States.

ERIC Educational Resources Information Center

Knowles, Malcolm S.

This book, which is a revised version of a book first published in 1962, examines the present state of the field of adult education (AE) by examining its origins and patterns of growth. Part 1, which traces the emergence of institutions for the education of adults, covers the following topics: colonial foundations and antecedents in 1600-1779…

Evaluating the Vector Control Potential of the In2Care® Mosquito Trap Against Aedes aegypti and Aedes albopictus Under Semifield Conditions in Manatee County, Florida.

PubMed

Buckner, Eva A; Williams, Katie F; Marsicano, Ambyr L; Latham, Mark D; Lesser, Christopher R

2017-09-01

Successful integrated vector management programs may need new strategies in addition to conventional larviciding and adulticiding strategies to target Aedes aegypti and Ae. albopictus, which can develop in small, often cryptic, artificial and natural containers. The In2Care® mosquito trap was recently developed to target and kill larval and adult stages of these invasive container-inhabiting Aedes mosquitoes by utilizing autodissemination. Gravid females that visit the trap pick up pyriproxyfen (PPF) that they later transfer to nearby larval habitats as well as Beauveria bassiana spores that slowly kill them. We assessed the efficacy of the In2Care mosquito trap in a semifield setting against locally sourced strains of Ae. aegypti and Ae. albopictus. We found that the In2Care mosquito trap is attractive to gravid Ae. aegypti and Ae. albopictus females and serves as an egg sink, preventing any adult emergence from the trap (P = 0.0053 for both species). Adult females successfully autodisseminated PPF to surrounding water-filled containers, leading to a statistically significant reduction in new mosquito emergence (P ≤ 0.0002 for both species). Additionally, we found effective contamination with Beauveria bassiana spores, which significantly reduced the survivorship of exposed Ae. aegypti and Ae. albopictus (P ≤ 0.008 for both species in all experimental setups). In summary, the In2Care mosquito trap successfully killed multiple life stages of 2 main mosquito vector species found in Florida under semifield conditions.

Defibrotide for the Treatment of Hepatic Veno-Occlusive Disease: Final Results From the International Compassionate-Use Program.

PubMed

Corbacioglu, Selim; Carreras, Enric; Mohty, Mohamad; Pagliuca, Antonio; Boelens, Jaap Jan; Damaj, Gandhi; Iacobelli, Massimo; Niederwieser, Dietger; Olavarría, Eduardo; Suarez, Felipe; Ruutu, Tapani; Verdonck, Leo; Hume, Robin; Nejadnik, Bijan; Lai, Chinglin; Finetto, Giorgia; Richardson, Paul

2016-10-01

Hepatic veno-occlusive disease, also called sinusoidal obstruction syndrome (VOD/SOS), is an unpredictable and potentially fatal complication of hematopoietic cell transplantation (HCT) or nontransplantation-associated chemotherapy/radiotherapy. In cases of severe hepatic VOD/SOS, typically defined by associated multiorgan failure (MOF, also known as multiorgan dysfunction), mortality exceeds 80%. Preclinical and early clinical data have provided a rationale for defibrotide treatment in hepatic VOD/SOS. Based on this evidence and in recognition of the dismal prognosis for these patients, defibrotide was made available through an international multicenter compassionate-use program conducted from December 1998 to March 2009. Physicians participating in the program voluntarily provided demographic and outcome data for patients given defibrotide. Efficacy and safety analyses were performed using the data received for 710 treated patients. Defibrotide was given at 10, 25, 40, 60, or 80 mg/kg/day for a median of 15 days (range, 1 to 119 days). By Kaplan-Meier analysis, the estimated overall day +100 survival was 54% (58% in the 25 mg/kg/day dose group). Adverse events (AEs) were reported in 53% of patients. The most common AEs were MOF, progression of hepatic VOD/SOS, sepsis, and graft-versus-host disease, which were consistent with the AEs expected for this patient population. No clinically meaningful trends in AEs were identified by gender, age, or dose group. Safety and efficacy resultswere consistent with prior studies of defibrotide in hepatic VOD/SOS, and subgroup analyses lend support to the use of the 25 mg/kg/day dose. Copyright © 2016 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Efficacy and Safety of Pembrolizumab in Patients Enrolled in KEYNOTE-030 in the United States: An Expanded Access Program.

PubMed

Gangadhar, Tara C; Hwu, Wen-Jen; Postow, Michael A; Hamid, Omid; Daud, Adil; Dronca, Roxana; Joseph, Richard; O'Day, Steven J; Hodi, F S; Pavlick, Anna C; Kluger, Harriet; Oxborough, Romina P; Yang, Aiming; Gazdoiu, Mihaela; Kush, Debra A; Ebbinghaus, Scot; Salama, April K S

KEYNOTE-030 (ClinicalTrials.gov ID, NCT02083484) was a global expanded access program that allowed access to pembrolizumab, an antiprogrammed death 1 antibody, for patients with advanced melanoma before its regulatory approval. Patients with unresectable stage III/IV melanoma that progressed after standard-of-care therapy, including ipilimumab and, if BRAF mutant, a BRAF inhibitor, were eligible to receive pembrolizumab 2 mg/kg every 3 weeks. Response was assessed by immune-related response criteria by investigator review. Adverse events (AEs) were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. In the United States, 979 patients enrolled between April and September 2014. Of the 947 evaluable patients, 621 (65.6%) remained on treatment and transitioned to receive commercial pembrolizumab following approval by the Food and Drug Administration, whereas 326 (34.4%) discontinued, most commonly for disease progression (39.6%) or death (26.4%). Objective response rate was 14.5% (95% confidence interval, 12.2%-16.8%) in the treated population (n=947) and 22.1% (95% confidence interval, 18.8%-25.5%) in patients who had ≥1 response assessment reported (n=619). Twelve patients achieved complete response. One hundred eighty-one (19.1%) patients experienced ≥1 treatment-related AE, most commonly general disorders (8.0%), skin/subcutaneous tissue disorders (7.3%), and gastrointestinal disorders (6.4%); 29 (3.1%) patients experienced ≥1 grade 3/4 treatment-related AE. Immune-mediated AEs were also reported. There were no treatment-related deaths. The safety and efficacy observed in this expanded access program were consistent with those previously reported for similar populations and support the use of pembrolizumab for patients with advanced melanoma.

Epidemiology of Quadriceps Strains in National Collegiate Athletic Association Athletes, 2009–2010 Through 2014–2015

PubMed Central

Eckard, Timothy G.; Kerr, Zachary Y.; Padua, Darin A.; Djoko, Aristarque; Dompier, Thomas P.

2017-01-01

Context:  Few researchers have examined the rates and patterns of quadriceps strains in student-athletes in the National Collegiate Athletic Association (NCAA). Objective:  To describe the epidemiology of quadriceps strains in 25 NCAA sports during the 2009–2010 through 2014–2015 academic years. Design:  Descriptive epidemiology study. Setting:  Convenience sample of NCAA programs from 25 sports during the 2009–2010 through 2014–2015 academic years. Patients or Other Particpants:  Collegiate student-athletes participating in men's and women's NCAA athletics during the 2009–2010 through 2014–2015 academic years. Main Outcome Measure(s):  Aggregate quadriceps strain injury and exposure data from the NCAA Injury Surveillance Program during the 2009–2010 through 2014–2015 academic years were analyzed. Quadriceps strain injury rates and injury rate ratios (IRRs) were reported with 95% confidence intervals (CIs). Results:  Overall, 517 quadriceps strains were reported, resulting in an injury rate of 1.07/10 000 athlete-exposures (AEs). The sports with the highest overall quadriceps strain rates were women's soccer (5.61/10 000 AEs), men's soccer (2.52/10 000 AEs), women's indoor track (2.24/10 000 AEs), and women's softball (2.15/10 000 AEs). Across sex-comparable sports, women had a higher rate of quadriceps strains than men overall (1.97 versus 0.65/10 000 AEs; IRR = 3.03; 95% CI = 2.45, 3.76). The majority of quadriceps strains were sustained during practice (77.8%). However, the quadriceps strain rate was higher during competition than during practice (1.29 versus 1.02/10 000 AEs; IRR = 1.27; 95% CI = 1.03, 1.56). Most quadriceps strains occurred in the preseason (57.8%), and rates were higher during the preseason compared with the regular season (2.29 versus 0.63/10 000 AEs; IRR = 3.60; 95% CI = 3.02, 4.30). Common injury mechanisms were noncontact (63.2%) and overuse (21.9%). Most quadriceps strains restricted participation by less than 1 week (79.3%). Conclusions:  Across 25 sports, higher quadriceps strain rates were found in women versus men, in competitions versus practices, and in the preseason versus the regular season. Most quadriceps strains were minor in severity, although further surveillance is needed to better examine the risk factors associated with incidence and severity. PMID:28383282

Developing A&E nursing responses to people who deliberately self-harm: the provision and evaluation of a series of reflective workshops.

PubMed

Holdsworth, N; Belshaw, D; Murray, S

2001-10-01

Accident & Emergency (A&E) departments and Medical Admission Units (MAUs) are an essential part of emergency mental health care in the UK. Deliberate self-harm and attempted suicide are particular challenges to nursing staff in such departments. Two registered mental nurses with experience of education facilitated a series of workshops with nurses from four A&E departments, two Minor Injuries Units and two MAUs. These were focused upon the assessment and management of deliberate self-harm and attempted suicide. During the workshops, participants provided systematic information on presentations of deliberate self-harm and attempted suicide, and on their professional responses to such presentations. These accounts provided invaluable information on deliberate self-harm and attempted suicide as seen by nursing staff in A&E and MAUs. Critical reflection upon nursing responses to these presentations revealed particular concerns nurses had relating to their experience with this client group which might inform future practice. Evaluation of the workshops indicated a subsequent decrease in work-related stress, which was probably a consequence of improved professional coping responses by the nurses concerned.

Cross-National Patterns of Participation in Adult Education and Policy Trends in Korea, Norway, and Vietnam

ERIC Educational Resources Information Center

Desjardins, Richard; Melo, Veriene; Lee, Jeongwoo

2016-01-01

Using comparative data, this article examines the level and distribution of participation in adult education (AE) opportunities among countries that participated in PIAAC (Programme for the International Assessment of Adult Competencies). It considers observed cross-country patterns in relation to some mechanisms that drive unequal chances to…

The Academic Experiences Survey (AES): Measuring Perceptions of Academic Climate in Liberal Arts Institutions

ERIC Educational Resources Information Center

Galotti, Kathleen M.; Clare, Lacey R.; McManus, Courtney; Nixon, Andrea Lisa

2016-01-01

In today's educational climate, liberal arts institutions must demonstrate that their educational goals are being met. This paper presents reliability and stability testing of a concise, research-based survey instrument designed to examine student perceptions of academic experiences that is particularly suited to institutions rooted in the liberal…

Safety of Aerobic Exercise in People With Diabetic Peripheral Neuropathy: Single-Group Clinical Trial

PubMed Central

Pasnoor, Mamatha; Singh, Rupali; D'Silva, Linda J.; Yoo, Min; Billinger, Sandra A.; LeMaster, Joseph W.; Dimachkie, Mazen M.; Herbelin, Laura; Wright, Douglas E.

2015-01-01

Background Exercise is recommended for people with diabetes, but little is known about exercise in people with diabetic peripheral neuropathy (DPN). Objective The primary purpose of this preliminary study was to examine adverse events (AEs) during moderate-intensity, supervised aerobic exercise in people with DPN. The secondary purpose was to examine changes in fatigue, aerobic fitness, and other outcomes after intervention. Design This was a single-group preliminary study. Setting The setting was an academic medical center. Participants Participants were 18 people who were sedentary and had type 2 diabetes and peripheral neuropathy (mean age=58.1 years, SD=5). Intervention The intervention was a supervised 16-week aerobic exercise program (3 times per week at 50% to >70% oxygen uptake reserve). Measurements Adverse events were categorized as related or unrelated to the study, anticipated or unanticipated, and serious or not serious. Outcomes included fatigue (Multidimensional Fatigue Inventory), cardiovascular fitness (peak oxygen uptake), body composition (dual-energy x-ray absorptiometry), sleep quality, plasma metabolic markers, and peripheral vascular function. Results During the study, 57 nonserious AEs occurred. Improvements were found in general fatigue (mean change=−3.5; 95% confidence interval [95% CI]=−1.3, −5.3), physical fatigue (mean change=−3.1; 95% CI=−1.2, −5.0), peak oxygen uptake (mean change=1.1 mL·kg−1·min−1; 95% CI=0.2, 1.9), total body fat (mean change=−1%; 95% CI=−0.3, −1.7), fat mass (mean change=−1,780 g; 95% CI=−616.2, −2,938.7), and peripheral blood flow (mean change=2.27%; 95% CI=0.6, 4.0). Limitations This was a small-scale, uncontrolled study. A future randomized controlled trial is needed to fully assess the effects of exercise on the outcomes. Conclusions This study provides new support for supervised aerobic exercise in people with DPN. However, it is important for physical therapists to carefully prescribe initial exercise intensity and provide close monitoring and education to address the anticipated AEs as people who are sedentary and have DPN begin an exercise program. PMID:25278335

[Proposals for the study of the second victim phenomenon in Spanish Primary Care Centres and Hospitals].

PubMed

Carrillo, I; Ferrús, L; Silvestre, C; Pérez-Pérez, P; Torijano, M L; Iglesias-Alonso, F; Astier, P; Olivera, G; Maderuelo-Fernández, J A

2016-07-01

To identify the Spanish studies conducted since 2014 on second victims. Its main objective was to identify a global response to the second victim problem, assessing the impact of adverse events (AE) on caregivers and developing of a set of tools to reduce their impact. Descriptive studies in which a sample of managers and safety coordinators from Hospitals and Primary Care were surveyed to determine the activities being carried out as regards second victims, as well as a sample of health professionals to describe their experience as a second victims. Qualitative studies are included to design a guide of recommended actions following an AE, an online awareness program on this phenomenon, an application (app) with activities on safety that are the responsibility of the managers, and a web tool for the analysis of AEs. A total of 1,493 professionals (managers, safety coordinators and caregivers) from eight Spanish regions participated. The guide of recommendations, the online program, and the developed applications are accessible on the website: www.segundasvictimas.es, which has received more than 2,500 visits in one year. Study results represent a starting point in the study of the second victim phenomenon in Spain. The tools developed raise the awareness of the medical healthcare community about this problem, and provide professionals with basic skills to manage the impact of AEs. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

76 FR 59574 - Procedures for Transportation Workplace Drug and Alcohol Testing Programs: Federal Drug Testing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-27

... 2105-AE13 Procedures for Transportation Workplace Drug and Alcohol Testing Programs: Federal Drug...) published an interim final rule (IFR) authorizing the use of a new Federal Drug Testing Custody and Control Form (CCF) in its drug testing program. Use of the form is authorized beginning October 1, 2010. This...

Spinosad as an effective larvicide for control of Aedes albopictus and Aedes aegypti, vectors of dengue in southern Mexico.

PubMed

Marina, Carlos F; Bond, J Guillermo; Casas, Mauricio; Muñoz, José; Orozco, Arnoldo; Valle, Javier; Williams, Trevor

2011-01-01

Field trials were conducted during the wet and dry seasons in periurban and semi-rural cemeteries in southern Mexico to determine the efficacy of a suspension concentrate formulation of spinosad (Tracer 480SC) on the inhibition of development of Aedes albopictus L. and Ae. aegypti Skuse. For this, oviposition traps were treated with spinosad (1 or 5 mg L(-1)), Bacillus thuringiensis israelensis (Bti, VectoBac 12AS), a sustained release formulation of temephos and a water control. Ae. albopictus was subordinate to Ae. aegypti during the dry season, but became dominant or codominant during the wet season at both sites. The two species could not be differentiated in field counts on oviposition traps. Mean numbers of larvae + pupae of Aedes spp. in Bti-treated containers were similar to the control at both sites during both seasons. The duration of complete absence of aquatic stages varied from 5 to 13 weeks for the spinosad treatments and from 6 to 9 weeks for the temephos treatment, depending on site, season and product concentration. Predatory Toxorhynchites theobaldi Dyar and Knab suffered low mortality in control and Bti treatments, but high mortality in spinosad and temephos treatments. Egg counts and percentage of egg hatch of Aedes spp. increased significantly between the dry and wet seasons, but significant treatment differences were not detected. Temephos granules and a suspension concentrate formulation of spinosad were both highly effective larvicides against Ae. aegypti and Ae. albopictus. These compounds merit detailed evaluation for inclusion in integrated control programs targeted at Ae. aegypti and Ae. albopictus in regions where they represent important vectors of human diseases. Copyright © 2010 Society of Chemical Industry.

An experimental approach to non - extensive statistical physics and Epidemic Type Aftershock Sequence (ETAS) modeling. The case of triaxially deformed sandstones using acoustic emissions.

NASA Astrophysics Data System (ADS)

Stavrianaki, K.; Vallianatos, F.; Sammonds, P. R.; Ross, G. J.

2014-12-01

Fracturing is the most prevalent deformation mechanism in rocks deformed in the laboratory under simulated upper crustal conditions. Fracturing produces acoustic emissions (AE) at the laboratory scale and earthquakes on a crustal scale. The AE technique provides a means to analyse microcracking activity inside the rock volume and since experiments can be performed under confining pressure to simulate depth of burial, AE can be used as a proxy for natural processes such as earthquakes. Experimental rock deformation provides us with several ways to investigate time-dependent brittle deformation. Two main types of experiments can be distinguished: (1) "constant strain rate" experiments in which stress varies as a result of deformation, and (2) "creep" experiments in which deformation and deformation rate vary over time as a result of an imposed constant stress. We conducted constant strain rate experiments on air-dried Darley Dale sandstone samples in a variety of confining pressures (30MPa, 50MPa, 80MPa) and in water saturated samples with 20 MPa initial pore fluid pressure. The results from these experiments used to determine the initial loading in the creep experiments. Non-extensive statistical physics approach was applied to the AE data in order to investigate the spatio-temporal pattern of cracks close to failure. A more detailed study was performed for the data from the creep experiments. When axial stress is plotted against time we obtain the trimodal creep curve. Calculation of Tsallis entropic index q is performed to each stage of the curve and the results are compared with the ones from the constant strain rate experiments. The Epidemic Type Aftershock Sequence model (ETAS) is also applied to each stage of the creep curve and the ETAS parameters are calculated. We investigate whether these parameters are constant across all stages of the curve, or whether there are interesting patterns of variation. This research has been co-funded by the European Union (European Social Fund) and Greek national resources under the framework of the "THALES Program: SEISMO FEAR HELLARC" project of the "Education & Lifelong Learning" Operational Programme.

Epidemiology of Exertional Heat Illnesses in Youth, High School, and College Football.

PubMed

Yeargin, Susan W; Kerr, Zachary Y; Casa, Douglas J; Djoko, Aristarque; Hayden, Ross; Parsons, John T; Dompier, Thomas P

2016-08-01

Data on exertional heat illness (EHI) in youth football are limited and have not been compared across competition levels. This study describes the epidemiology of EHI events in youth, high school (HS), and college football in the 2012-2014 seasons. One hundred and eighteen youth teams (players age 5-14 yr), 96 HS programs (~14-18 yr), and 34 college programs (~18-23 yr) participated. During games and practices, athletic trainers recorded EHI events and athlete exposures (AE), defined as one athlete participating in one game/practice. We calculated the number of reported EHI by time in season, game/practice, and need for emergency transportation. EHI rates, risk, included rate ratios (IRR), and risk ratios (RR) with 95% confidence intervals (CI) were calculated in 2015. EHI rates for youth, HS, and college football were 1.82, 0.57, and 1.67/10,000 AE, respectively. Rates were highest during the preseason (youth: 2.76; HS: 1.47; college: 3.66/10,000 AE). Game rates were higher than practice rates in youth (4.04 vs 1.22/10,000 AE; IRR = 3.31; 95% CI, 1.75-6.26) and college (4.42 vs 1.38/10,000 AE; IRR = 3.21; 95% CI, 2.00-5.16); the practice rate was higher than the game rate in HS (0.63 vs 0.27/10,000 AE; IRR = 2.33; 95% CI, 1.01-5.38). The EHI risk was higher in college (0.9%) than in youth (0.6%; RR = 1.59; 95% CI, 1.06-2.37) and HS (0.5%; RR = 2.01; 95% CI, 1.43-2.81). Common EHI events included heat cramps (youth: 15.8%; HS: 28.6%; college: 45.6%), heat exhaustion (youth: 42.1%; HS: 32.9%; college: 20.0%), and dehydration (youth: 31.6%; HS: 28.6%; college: 28.9%). EHI risk was low. Higher preseason football EHI rates across levels emphasize developing and continually modifying preseason heat acclimatization policies. Lower EHI rates in HS games and youth practices may be attributable to night events, suggesting the importance of modifying/canceling events based on environmental conditions.

75 FR 15613 - Hazardous Materials Transportation; Registration and Fee Assessment Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-30

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Part 107 [Docket No. PHMSA-2009-0201 (HM-208H)] RIN 2137-AE47 Hazardous Materials Transportation... registration program are to gather information about the transportation of hazardous materials, and to fund the...

78 FR 79567 - Supplemental Nutrition Assistance Program: Trafficking Controls and Fraud Investigations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-31

... DEPARTMENT OF AGRICULTURE Food and Nutrition Service 7 CFR Parts 271 and 274 RIN 0584-AE26 Supplemental Nutrition Assistance Program: Trafficking Controls and Fraud Investigations AGENCY: Food and Nutrition Service, USDA. ACTION: Final rule, Interim final rule; notice of approval of Information...

The Impact of Aerobic Exercise on Brain-Derived Neurotrophic Factor and Neurocognition in Individuals With Schizophrenia: A Single-Blind, Randomized Clinical Trial.

PubMed

Kimhy, David; Vakhrusheva, Julia; Bartels, Matthew N; Armstrong, Hilary F; Ballon, Jacob S; Khan, Samira; Chang, Rachel W; Hansen, Marie C; Ayanruoh, Lindsey; Lister, Amanda; Castrén, Eero; Smith, Edward E; Sloan, Richard P

2015-07-01

Individuals with schizophrenia display substantial neurocognitive deficits for which available treatments offer only limited benefits. Yet, findings from studies of animals, clinical and nonclinical populations have linked neurocognitive improvements to increases in aerobic fitness (AF) via aerobic exercise training (AE). Such improvements have been attributed to up-regulation of brain-derived neurotrophic factor (BDNF). However, the impact of AE on neurocognition, and the putative role of BDNF, have not been investigated in schizophrenia. Employing a proof-of-concept, single-blind, randomized clinical trial design, 33 individuals with schizophrenia were randomized to receive standard psychiatric treatment (n = 17; "treatment as usual"; TAU) or attend a 12-week AE program (n = 16) utilizing active-play video games (Xbox 360 Kinect) and traditional AE equipment. Participants completed assessments of AF (indexed by VO2 peak ml/kg/min), neurocognition (MATRICS Consensus Cognitive Battery), and serum-BDNF before and after and 12-week period. Twenty-six participants (79%) completed the study. At follow-up, the AE participants improved their AF by 18.0% vs a -0.5% decline in the TAU group (P = .002) and improved their neurocognition by 15.1% vs -2.0% decline in the TAU group (P = .031). Hierarchical multiple regression analyses indicated that enhancement in AF and increases in BDNF predicted 25.4% and 14.6% of the neurocognitive improvement variance, respectively. The results indicate AE is effective in enhancing neurocognitive functioning in people with schizophrenia and provide preliminary support for the impact of AE-related BDNF up-regulation on neurocognition in this population. Poor AF represents a modifiable risk factor for neurocognitive dysfunction in schizophrenia for which AE training offer a safe, nonstigmatizing, and side-effect-free intervention. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Environmental Control and Life Support System Reliability for Long-Duration Missions Beyond Lower Earth Orbit

NASA Technical Reports Server (NTRS)

Sargusingh, Miriam J.; Nelson, Jason R.

2014-01-01

NASA has highlighted reliability as critical to future human space exploration, particularly in the area of environmental controls and life support systems. The Advanced Exploration Systems (AES) projects have been encouraged to pursue higher reliability components and systems as part of technology development plans. However, no consensus has been reached on what is meant by improving on reliability, or on how to assess reliability within the AES projects. This became apparent when trying to assess reliability as one of several figures of merit for a regenerable water architecture trade study. In the spring of 2013, the AES Water Recovery Project hosted a series of events at Johnson Space Center with the intended goal of establishing a common language and understanding of NASA's reliability goals, and equipping the projects with acceptable means of assessing the respective systems. This campaign included an educational series in which experts from across the agency and academia provided information on terminology, tools, and techniques associated with evaluating and designing for system reliability. The campaign culminated in a workshop that included members of the Environmental Control and Life Support System and AES communities. The goal of this workshop was to develop a consensus on what reliability means to AES and identify methods for assessing low- to mid-technology readiness level technologies for reliability. This paper details the results of that workshop.

ECLSS Reliability for Long Duration Missions Beyond Lower Earth Orbit

NASA Technical Reports Server (NTRS)

Sargusingh, Miriam J.; Nelson, Jason

2014-01-01

Reliability has been highlighted by NASA as critical to future human space exploration particularly in the area of environmental controls and life support systems. The Advanced Exploration Systems (AES) projects have been encouraged to pursue higher reliability components and systems as part of technology development plans. However there is no consensus on what is meant by improving on reliability; nor on how to assess reliability within the AES projects. This became apparent when trying to assess reliability as one of several figures of merit for a regenerable water architecture trade study. In the spring of 2013, the AES Water Recovery Project (WRP) hosted a series of events at the NASA Johnson Space Center (JSC) with the intended goal of establishing a common language and understanding of our reliability goals, and equipping the projects with acceptable means of assessing our respective systems. This campaign included an educational series in which experts from across the agency and academia provided information on terminology, tools and techniques associated with evalauating and designing for system reliability. The campaign culminated in a workshop at JSC with members of the ECLSS and AES communities with the goal of developing a consensus on what reliability means to AES and identifying methods for assessing our low to mid-technology readiness level (TRL) technologies for reliability. This paper details the results of the workshop.

Management of adverse events related to new cancer immunotherapy (immune checkpoint inhibitors).

PubMed

Bourke, Jack M; O'Sullivan, Michael; Khattak, Muhammad A

2016-11-07

New immunotherapies have significantly improved survival in certain advanced cancers in recent years, particularly metastatic melanoma and lung cancer. The most effective of these therapies are the immune checkpoint inhibitors (ICIs) such as ipilimumab, nivolumab and pembrolizumab. The use of ICIs will continue to increase in the coming years as evidence of their benefit in a range of other cancers builds. ICIs are associated with novel immune-related adverse events (irAEs), which can involve a wide range of organs. The most common irAEs involve the skin (rash, pruritus), gastrointestinal tract (diarrhoea, colitis) and endocrine system (thyroid, pituitary). While severity is generally mild, life-threatening complications can occur if not recognised and treated promptly. Due to the diverse manifestations of irAEs, patients may present to doctors who are not familiar with these drugs, which creates the potential for delays in management. Management of irAEs depends on severity and the organ affected. Systemic steroids are often required and ICI therapy may be withheld or discontinued. Additional immunosuppressive medications may be necessary in steroid-refractory cases. This review provides an overview of the potential toxicities and their management for general clinicians. Broader awareness of these issues among medical professionals will hopefully reduce unnecessary delays in diagnosis and treatment. Patient and carer education regarding irAEs is extremely important; patients and carers should be advised to seek urgent medical attention if required.

ECLSS Reliability for Long Duration Missions Beyond Lower Earth Orbit

NASA Technical Reports Server (NTRS)

Sargusingh, Miriam J.; Nelson, Jason

2014-01-01

Reliability has been highlighted by NASA as critical to future human space exploration particularly in the area of environmental controls and life support systems. The Advanced Exploration Systems (AES) projects have been encouraged to pursue higher reliability components and systems as part of technology development plans. However, there is no consensus on what is meant by improving on reliability; nor on how to assess reliability within the AES projects. This became apparent when trying to assess reliability as one of several figures of merit for a regenerable water architecture trade study. In the Spring of 2013, the AES Water Recovery Project (WRP) hosted a series of events at the NASA Johnson Space Center (JSC) with the intended goal of establishing a common language and understanding of our reliability goals and equipping the projects with acceptable means of assessing our respective systems. This campaign included an educational series in which experts from across the agency and academia provided information on terminology, tools and techniques associated with evaluating and designing for system reliability. The campaign culminated in a workshop at JSC with members of the ECLSS and AES communities with the goal of developing a consensus on what reliability means to AES and identifying methods for assessing our low to mid-technology readiness level (TRL) technologies for reliability. This paper details the results of the workshop.

Randomized controlled trial of exercise interventions to improve sleep quality and daytime sleepiness in individuals with multiple sclerosis: A pilot study.

PubMed

Siengsukon, Catherine F; Aldughmi, Mayis; Kahya, Melike; Bruce, Jared; Lynch, Sharon; Ness Norouzinia, Abigail; Glusman, Morgan; Billinger, Sandra

2016-01-01

Nearly 70% of individuals with multiple sclerosis (MS) experience sleep disturbances. Increasing physical activity in people with MS has been shown to produce a moderate improvement in sleep quality, and exercise has been shown to improve sleep quality in non-neurologically impaired adults. The purpose of this pilot randomized controlled trial study was to examine the effect of two exercise interventions on sleep quality and daytime sleepiness in individuals with MS. Twenty-eight individuals with relapsing-remitting or secondary progressive MS were randomized into one of two 12-week exercise interventions: a supervised, moderate-intensity aerobic exercise (AE) program or an unsupervised, low-intensity walking and stretching (WS) program. Only individuals who were ≥ 70% compliant with the programs were included in analysis ( n  = 12 AE; n  = 10 WS). Both groups demonstrated a moderate improvement in sleep quality, although only the improvement by the WS group was statistically significant. Only the AE group demonstrated a significant improvement in daytime sleepiness. Change in sleep quality and daytime sleepiness was not correlated with disease severity or with change in cardiovascular fitness, depression, or fatigue. The mechanisms for improvement in sleep quality and daytime sleepiness need further investigation, but may be due to introduction of zeitgebers to improve circadian rhythm.

Response surface methodology based extraction of Tribulus terrestris leads to an upsurge of antilithiatic potential by inhibition of calcium oxalate crystallization processes.

PubMed

Kaushik, Jyoti; Tandon, Simran; Gupta, Varun; Nayyar, Jasamrit; Singla, Surinder Kumar; Tandon, Chanderdeep

2017-01-01

Tribulus terrestris has significant antilithiatic efficacy established via both in vitro as well as in vivo studies and is used in numerous anti-urolithiatic herbal formulations viz. Cystone, Uriflow, Uritone and Neeri. However, to fully utilize its antilithiatic potential, the influence of different extraction parameters on antilithiatic ability of T. terrestris aqueous extract needs elucidation. Thus, the current study was undertaken using statistically optimized extraction conditions for aqueous extract preparation. Response surface methodology was employed to observe the influence of three variables i.e. temperature (°C), time (h) and solid: liquid ratio (S: L) on the extraction yield (%) and protein content (mg/g) of T. terrestris aqueous extract. RSM results revealed that the high S:L ratio, low temperature and reduced incubation time were optimal conditions for aqueous extraction. Under such extraction conditions the protein content reached the value of 26.6±1.22 mg/g and the obtained extraction yield was 27.32±1.62%. The assessment of antilithiatic activity of 4 selected extracts (AE1-4), revealed enhanced nucleation and aggregation inhibition of calcium oxalate crystals with AE1 and AE2, which in addition significantly altered the size and morphology of calcium oxalate monohydrate (COM) crystals compared to AE3 and AE4. In vitro cell culture based studies on renal epithelial cells (MDCK, NRK-52E and PK 15) proved that the AE1 showed higher cytoprotective potency by increasing cell viability as compared to the oxalate treated group. The free radical scavenging activity of aqueous extract lowered the reactive oxygen specie's induced damage and potentially reduced the signals of programmed cell death due to oxalate injury. In addition, modulation of the COM crystal morphology was enhanced by AE1 as compared to AE2. The FTIR and GC-MS analysis of AE1, showed the presence of biomolecules which could aid in the attenuation of lithiatic process. In the light of these results the utility of the RSM approach to fully optimize the antilithiatic potential of T. terrestris cannot be undermined.

Response surface methodology based extraction of Tribulus terrestris leads to an upsurge of antilithiatic potential by inhibition of calcium oxalate crystallization processes

PubMed Central

Kaushik, Jyoti; Tandon, Simran; Gupta, Varun; Nayyar, Jasamrit; Singla, Surinder Kumar; Tandon, Chanderdeep

2017-01-01

Tribulus terrestris has significant antilithiatic efficacy established via both in vitro as well as in vivo studies and is used in numerous anti-urolithiatic herbal formulations viz. Cystone, Uriflow, Uritone and Neeri. However, to fully utilize its antilithiatic potential, the influence of different extraction parameters on antilithiatic ability of T. terrestris aqueous extract needs elucidation. Thus, the current study was undertaken using statistically optimized extraction conditions for aqueous extract preparation. Response surface methodology was employed to observe the influence of three variables i.e. temperature (°C), time (h) and solid: liquid ratio (S: L) on the extraction yield (%) and protein content (mg/g) of T. terrestris aqueous extract. RSM results revealed that the high S:L ratio, low temperature and reduced incubation time were optimal conditions for aqueous extraction. Under such extraction conditions the protein content reached the value of 26.6±1.22 mg/g and the obtained extraction yield was 27.32±1.62%. The assessment of antilithiatic activity of 4 selected extracts (AE1-4), revealed enhanced nucleation and aggregation inhibition of calcium oxalate crystals with AE1 and AE2, which in addition significantly altered the size and morphology of calcium oxalate monohydrate (COM) crystals compared to AE3 and AE4. In vitro cell culture based studies on renal epithelial cells (MDCK, NRK-52E and PK 15) proved that the AE1 showed higher cytoprotective potency by increasing cell viability as compared to the oxalate treated group. The free radical scavenging activity of aqueous extract lowered the reactive oxygen specie’s induced damage and potentially reduced the signals of programmed cell death due to oxalate injury. In addition, modulation of the COM crystal morphology was enhanced by AE1 as compared to AE2. The FTIR and GC-MS analysis of AE1, showed the presence of biomolecules which could aid in the attenuation of lithiatic process. In the light of these results the utility of the RSM approach to fully optimize the antilithiatic potential of T. terrestris cannot be undermined. PMID:28846699

Template growth of Au, Ni and Ni–Au nanoclusters on hexagonal boron nitride/Rh(111): a combined STM, TPD and AES study

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

Wu, Fanglue; Huang, Dali; Yue, Yuan

In this study, the template growth of Au, Ni, and Ni–Au bimetallic nanoclusters on hexagonal boron nitride/Rh(111), i.e. h-BN/Rh(111), was investigated via scanning tunneling microscopy (STM), temperature programmed-desorption (TPD), and Auger electron spectroscopy (AES). STM study shows that template growth of Au clusters on h-BN/Rh(111) forms mainly well-dispersed monolayer clusters. In contrast, Ni forms large multilayer clusters showing a relatively high diffusivity on h-BN/Rh(111) substrate. Ni–Au bimetallic clusters are effectively formed first by Au deposition followed by Ni deposition, with the Au clusters functioning as nucleation sites for the subsequently deposited Ni. Further structural analysis was carried out via TPDmore » and AES. The resulting TPD and AES data show the surface composition and charge transfer between Au and Ni of the bimetallic clusters. These results suggest that the h-BN/Rh(111) substrate represents a unique candidate for supporting Ni–Au bimetallic clusters in further catalytic reactions.« less

Template growth of Au, Ni and Ni–Au nanoclusters on hexagonal boron nitride/Rh(111): a combined STM, TPD and AES study

DOE PAGES

Wu, Fanglue; Huang, Dali; Yue, Yuan; ...

2017-09-12

In this study, the template growth of Au, Ni, and Ni–Au bimetallic nanoclusters on hexagonal boron nitride/Rh(111), i.e. h-BN/Rh(111), was investigated via scanning tunneling microscopy (STM), temperature programmed-desorption (TPD), and Auger electron spectroscopy (AES). STM study shows that template growth of Au clusters on h-BN/Rh(111) forms mainly well-dispersed monolayer clusters. In contrast, Ni forms large multilayer clusters showing a relatively high diffusivity on h-BN/Rh(111) substrate. Ni–Au bimetallic clusters are effectively formed first by Au deposition followed by Ni deposition, with the Au clusters functioning as nucleation sites for the subsequently deposited Ni. Further structural analysis was carried out via TPDmore » and AES. The resulting TPD and AES data show the surface composition and charge transfer between Au and Ni of the bimetallic clusters. These results suggest that the h-BN/Rh(111) substrate represents a unique candidate for supporting Ni–Au bimetallic clusters in further catalytic reactions.« less

Experimental Evidence on the Effectiveness of Automated Essay Scoring in Teacher Education Cases

ERIC Educational Resources Information Center

Riedel, Eric; Dexter, Sara L.; Scharber, Cassandra; Doering, Aaron

2006-01-01

Research on computer-based writing evaluation has only recently focused on the potential for providing formative feedback rather than summative assessment. This study tests the impact of an automated essay scorer (AES) that provides formative feedback on essay drafts written as part of a series of online teacher education case studies. Seventy…

28 CFR 0.40 - General functions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... proposed acquisitions under the Savings and Loan Holding Company Amendments of 1967 (12 U.S.C. 1730a(e...)), furnishing advice on oil and gas leasing under the Outer Continental Shelf Lands Act Amendments of 1978 (43 U... programs or agreements and small business production or raw material pools, the national defense program...

28 CFR 0.40 - General functions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... proposed acquisitions under the Savings and Loan Holding Company Amendments of 1967 (12 U.S.C. 1730a(e...)), furnishing advice on oil and gas leasing under the Outer Continental Shelf Lands Act Amendments of 1978 (43 U... programs or agreements and small business production or raw material pools, the national defense program...

28 CFR 0.40 - General functions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... proposed acquisitions under the Savings and Loan Holding Company Amendments of 1967 (12 U.S.C. 1730a(e...)), furnishing advice on oil and gas leasing under the Outer Continental Shelf Lands Act Amendments of 1978 (43 U... programs or agreements and small business production or raw material pools, the national defense program...

28 CFR 0.40 - General functions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... proposed acquisitions under the Savings and Loan Holding Company Amendments of 1967 (12 U.S.C. 1730a(e...)), furnishing advice on oil and gas leasing under the Outer Continental Shelf Lands Act Amendments of 1978 (43 U... programs or agreements and small business production or raw material pools, the national defense program...

77 FR 26471 - Procedures for Transportation Workplace Drug and Alcohol Testing Programs: 6-acetylmorphine (6-AM...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

... 2105-AE14 Procedures for Transportation Workplace Drug and Alcohol Testing Programs: 6-acetylmorphine... Department is amending certain provisions of its drug testing procedures for 6-acetylmorphine (6-AM), a... (email). SUPPLEMENTARY INFORMATION: Background For its drug testing regulation, the Department of...

Numerical Modeling in Problems of Near-Earth Object Dynamics

NASA Astrophysics Data System (ADS)

Aleksandrova, A. G.; Bordovitsyna, T. V.; Chuvashov, I. N.

2017-05-01

A method of numerical modeling is used to solve three most interesting problems of artificial Earth satellite (AES) dynamics. Orbital evolution of an ensemble of near-Earth objects at altitudes in the range from 1 500 to 60 000 km is considered, chaoticity of motion of objects in the geosynchronous zone is studied by the MEGNOanalysis, the parameters of AES motion are determined, and the models of forces are considered from measurements for GLONASS satellites. The recent versions of algorithms and programs used to perform investigations are briefly described.

Epidemiology of National Collegiate Athletic Association men's and women's swimming and diving injuries from 2009/2010 to 2013/2014.

PubMed

Kerr, Zachary Y; Baugh, Christine M; Hibberd, Elizabeth E; Snook, Erin M; Hayden, Ross; Dompier, Thomas P

2015-04-01

Recent injury data for collegiate-level swimming and diving are limited. This study describes the epidemiology of men's and women's swimming and diving injuries reported by the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) during the 2009/2010 to 2013/2014 academic years. Injuries and athlete-exposure (AE) data reported within 9 men's and 13 women's swimming and diving programmes were analysed. Injury rates, injury rate ratios (IRR), and injury proportions by body site, diagnosis and mechanism were reported with 95% CIs. The ISP captured 149 and 208 injuries for men's and women's swimming and diving, respectively, leading to injury rates of 1.54/1000 and 1.71/1000 AEs. Among females, divers had a higher injury rate (2.49/1000 AEs) than swimmers (1.63/1000 AEs; IRR=1.53; 95% CI 1.07 to 2.19). Injury rates for male divers (1.94/1000 AEs) and swimmers (1.48/1000 AEs) did not differ (IRR=1.33; 95% CI 0.85 to 2.31). Most injuries occurred to the shoulder, resulted in strains and were classified as overuse or non-contact. Female swimmers had a higher overuse injury rate (1.04/1000 AEs) than male swimmers (0.66/1000 AEs; IRR=1.58; 95% CI 1.14 to 2.19). Overuse injury rates for female divers (0.54/1000 AEs) and male divers (0.46/1000 AEs) did not differ (IRR=1.16; 95% CI 0.40 to 3.34). Injury rates in 2012/2013-2013/2014 were lower than those in 2009/2010-2011/2012 for women's swimming (IRR=0.70; 95% CI 0.52 to 0.95) and diving (IRR=0.56; 95% CI 0.30 to 1.08), respectively. No time trends existed for men's swimmers or divers. Shoulder, strain and overuse injuries were common in collegiate men's and women's swimming and diving. Female swimmers were more likely to suffer an overuse injury than male swimmers. In addition, divers may have higher injury rates than swimmers, although small reported numbers warrant additional research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Zika virus infection-the next wave after dengue?

PubMed

Wong, Samson Sai-Yin; Poon, Rosana Wing-Shan; Wong, Sally Cheuk-Ying

2016-04-01

Zika virus was initially discovered in east Africa about 70 years ago and remained a neglected arboviral disease in Africa and Southeast Asia. The virus first came into the limelight in 2007 when it caused an outbreak in Micronesia. In the ensuing decade, it spread widely in other Pacific islands, after which its incursion into Brazil in 2015 led to a widespread epidemic in Latin America. In most infected patients the disease is relatively benign. Serious complications include Guillain-Barré syndrome and congenital infection which may lead to microcephaly and maculopathy. Aedes mosquitoes are the main vectors, in particular, Ae. aegypti. Ae. albopictus is another potential vector. Since the competent mosquito vectors are highly prevalent in most tropical and subtropical countries, introduction of the virus to these areas could readily result in endemic transmission of the disease. The priorities of control include reinforcing education of travellers to and residents of endemic areas, preventing further local transmission by vectors, and an integrated vector management programme. The container habitats of Ae. aegypti and Ae. albopictus means engagement of the community and citizens is of utmost importance to the success of vector control. Copyright © 2016. Published by Elsevier B.V.

Effect of Hip-Focused Injury Prevention Training for Anterior Cruciate Ligament Injury Reduction in Female Basketball Players: A 12-Year Prospective Intervention Study.

PubMed

Omi, Yorikatsu; Sugimoto, Dai; Kuriyama, Setsurou; Kurihara, Tomohisa; Miyamoto, Kenji; Yun, Songjo; Kawashima, Tatsuhiro; Hirose, Norikazu

2018-03-01

Programs to prevent anterior cruciate ligament (ACL) injuries in female basketball players are scarce. Also, ACL injury prevention training that focuses on hip joint function has not been reported. To determine the effectiveness of a hip-focused ACL injury prevention program in female basketball players. Cohort study; Level of evidence, 2. A prospective intervention study was conducted for 12 years. Incidence rates of ACL injuries were collected in the first 4 years (observation period) from college female basketball players. After the observation period, a hip-focused ACL injury prevention program was implemented for 8 years (intervention period). A total of 309 players (mean ± SD age, 19.6 ± 1.2 years; height, 163.7 ± 5.6 cm; weight, 59.1 ± 5.1 kg; body mass index, 22.0 ± 1.4) were tracked in the observation period and compared with 448 players (age, 19.6 ± 1.1 years; height, 162.6 ± 5.8 cm; weight, 58.0 ± 5.7 kg; body mass index, 21.9 ± 1.5) who participated in the intervention period. Athlete-exposures (AEs), ACL numbers and mechanisms of injury (MOIs), relative risk (RR), absolute risk reduction (ARR), numbers needed to treat (NNT), and compliance were analyzed. There were 16 ACL injuries (13 noncontact MOIs) in the 4-year observation period, whereas 9 ACL injuries (8 noncontact MOIs) were recorded in the 8-year intervention period. The overall ACL injury incidence was 0.25/1000 AEs in the 4-year observation period compared with 0.10/1000 AEs in the 8-year intervention period, respectively. Compared with the 4-year observation period, significant RR reduction was observed (0.38; 95% CI, 0.17-0.87; P = .017) with ARR and NNT of 0.032 (95% CI, 0.027-0.037) and 31.6 (95% CI, 27.1-37.7), respectively, in the 8-year intervention period. The noncontact ACL injury incidence was 0.21 per 1000 AEs during the 4-year observation period compared with 0.08/1000 AEs in the 8-year intervention period, which also showed significant RR reduction (0.37; 95% CI, 0.15-0.92; P = .026), with ARR and NNT of 0.024 (95% CI, 0.020-0.029) and 41.3 (95% CI, 34.6-51.3), respectively. The mean compliance rate during the intervention periods (8 years) was 89%. A hip-focused injury prevention program demonstrated significant reduction in the incidence of ACL injury in female collegiate basketball players.

Tracking the return of Aedes aegypti to Brazil, the major vector of the dengue, chikungunya and Zika viruses

PubMed Central

Gloria-Soria, Andrea; Caccone, Adalgisa; Evans, Benjamin; Schama, Renata; Martins, Ademir Jesus; Powell, Jeffrey R.

2017-01-01

Background Aedes aegypti, commonly known as “the yellow fever mosquito”, is of great medical concern today primarily as the major vector of dengue, chikungunya and Zika viruses, although yellow fever remains a serious health concern in some regions. The history of Ae. aegypti in Brazil is of particular interest because the country was subjected to a well-documented eradication program during 1940s-1950s. After cessation of the campaign, the mosquito quickly re-established in the early 1970s with several dengue outbreaks reported during the last 30 years. Brazil can be considered the country suffering the most from the yellow fever mosquito, given the high number of dengue, chikungunya and Zika cases reported in the country, after having once been declared “free of Ae. aegypti”. Methodology/Principal findings We used 12 microsatellite markers to infer the genetic structure of Brazilian Ae. aegypti populations, genetic variability, genetic affinities with neighboring geographic areas, and the timing of their arrival and spread. This enabled us to reconstruct their recent history and evaluate whether the reappearance in Brazil was the result of re-invasion from neighboring non-eradicated areas or re-emergence from local refugia surviving the eradication program. Our results indicate a genetic break separating the northern and southern Brazilian Ae. aegypti populations, with further genetic differentiation within each cluster, especially in southern Brazil. Conclusions/Significance Based on our results, re-invasions from non-eradicated regions are the most likely scenario for the reappearance of Ae. aegypti in Brazil. While populations in the northern cluster are likely to have descended from Venezuela populations as early as the 1970s, southern populations seem to have derived more recently from northern Brazilian areas. Possible entry points are also revealed within both southern and northern clusters that could inform strategies to control and monitor this important arbovirus vector. PMID:28742801

Is it worth protecting groundwater from diffuse pollution with agri-environmental schemes? A hydro-economic modeling approach.

PubMed

Hérivaux, Cécile; Orban, Philippe; Brouyère, Serge

2013-10-15

In Europe, 30% of groundwater bodies are considered to be at risk of not achieving the Water Framework Directive (WFD) 'good status' objective by 2015, and 45% are in doubt of doing so. Diffuse agricultural pollution is one of the main pressures affecting groundwater bodies. To tackle this problem, the WFD requires Member States to design and implement cost-effective programs of measures to achieve the 'good status' objective by 2027 at the latest. Hitherto, action plans have mainly consisted of promoting the adoption of Agri-Environmental Schemes (AES). This raises a number of questions concerning the effectiveness of such schemes for improving groundwater status, and the economic implications of their implementation. We propose a hydro-economic model that combines a hydrogeological model to simulate groundwater quality evolution with agronomic and economic components to assess the expected costs, effectiveness, and benefits of AES implementation. This hydro-economic model can be used to identify cost-effective AES combinations at groundwater-body scale and to show the benefits to be expected from the resulting improvement in groundwater quality. The model is applied here to a rural area encompassing the Hesbaye aquifer, a large chalk aquifer which supplies about 230,000 inhabitants in the city of Liege (Belgium) and is severely contaminated by agricultural nitrates. We show that the time frame within which improvements in the Hesbaye groundwater quality can be expected may be much longer than that required by the WFD. Current WFD programs based on AES may be inappropriate for achieving the 'good status' objective in the most productive agricultural areas, in particular because these schemes are insufficiently attractive. Achieving 'good status' by 2027 would demand a substantial change in the design of AES, involving costs that may not be offset by benefits in the case of chalk aquifers with long renewal times. Copyright © 2013 Elsevier Ltd. All rights reserved.

Tracking the return of Aedes aegypti to Brazil, the major vector of the dengue, chikungunya and Zika viruses.

PubMed

Kotsakiozi, Panayiota; Gloria-Soria, Andrea; Caccone, Adalgisa; Evans, Benjamin; Schama, Renata; Martins, Ademir Jesus; Powell, Jeffrey R

2017-07-01

Aedes aegypti, commonly known as "the yellow fever mosquito", is of great medical concern today primarily as the major vector of dengue, chikungunya and Zika viruses, although yellow fever remains a serious health concern in some regions. The history of Ae. aegypti in Brazil is of particular interest because the country was subjected to a well-documented eradication program during 1940s-1950s. After cessation of the campaign, the mosquito quickly re-established in the early 1970s with several dengue outbreaks reported during the last 30 years. Brazil can be considered the country suffering the most from the yellow fever mosquito, given the high number of dengue, chikungunya and Zika cases reported in the country, after having once been declared "free of Ae. aegypti". We used 12 microsatellite markers to infer the genetic structure of Brazilian Ae. aegypti populations, genetic variability, genetic affinities with neighboring geographic areas, and the timing of their arrival and spread. This enabled us to reconstruct their recent history and evaluate whether the reappearance in Brazil was the result of re-invasion from neighboring non-eradicated areas or re-emergence from local refugia surviving the eradication program. Our results indicate a genetic break separating the northern and southern Brazilian Ae. aegypti populations, with further genetic differentiation within each cluster, especially in southern Brazil. Based on our results, re-invasions from non-eradicated regions are the most likely scenario for the reappearance of Ae. aegypti in Brazil. While populations in the northern cluster are likely to have descended from Venezuela populations as early as the 1970s, southern populations seem to have derived more recently from northern Brazilian areas. Possible entry points are also revealed within both southern and northern clusters that could inform strategies to control and monitor this important arbovirus vector.

Patients With Antithyroid Antibodies Are Prone To Develop Destructive Thyroiditis by Nivolumab: A Prospective Study.

PubMed

Kobayashi, Tomoko; Iwama, Shintaro; Yasuda, Yoshinori; Okada, Norio; Tsunekawa, Taku; Onoue, Takeshi; Takagi, Hiroshi; Hagiwara, Daisuke; Ito, Yoshihiro; Morishita, Yoshiaki; Goto, Motomitsu; Suga, Hidetaka; Banno, Ryoichi; Yokota, Kenji; Hase, Tetsunari; Morise, Masahiro; Hashimoto, Naozumi; Ando, Masahiko; Kiyoi, Hitoshi; Gotoh, Momokazu; Ando, Yuichi; Akiyama, Masashi; Hasegawa, Yoshinori; Arima, Hiroshi

2018-03-01

Immune checkpoint inhibitors, including anti-programmed cell death-1 (PD-1) antibodies, have become promising treatments for a variety of advanced malignancies. However, these medicines can cause immune-related adverse events (irAEs), including endocrinopathies. This study examined the incidence of endocrine irAEs induced by nivolumab. Sixty-six patients treated with nivolumab at Nagoya University Hospital were prospectively evaluated for pituitary hormones, thyroid function, antithyroid antibodies (Abs), and glucose levels every 6 weeks after the initiation of nivolumab for 24 weeks. Four out of 66 patients developed destructive thyroiditis, and three patients developed hypothyroidism requiring levothyroxine replacement. The prevalence of positive anti-thyroglobulin Abs (TgAbs) and/or anti-thyroid peroxidase Abs (TPOAbs) at baseline was significantly higher in the group that developed destructive thyroiditis (3/4) compared with the group that did not develop thyroiditis (3/62; P = 0.002). There were no significant differences in other clinical variables between the groups. There were no endocrine irAEs other than destructive thyroiditis during the 24 weeks. The prevalence of TgAbs and/or TPOAbs at baseline was not associated with the development of other irAEs, including pneumonitis, colitis, or skin reactions. Our real-world data showed that destructive thyroiditis was an endocrine irAE that was frequently induced by nivolumab and was significantly associated with positive TgAbs and/or TPOAbs before treatment. Our findings indicate that evaluating these Abs before treatment may help identify patients with a high risk of thyroidal irAEs and may have important clinical benefit.

Potential risk factors associated with human alveolar echinococcosis: Systematic review and meta-analysis.

PubMed

Conraths, Franz J; Probst, Carolina; Possenti, Alessia; Boufana, Belgees; Saulle, Rosella; La Torre, Giuseppe; Busani, Luca; Casulli, Adriano

2017-07-01

Human alveolar echinococcosis (AE) is a severe zoonotic disease caused by the metacestode stage of Echinococcus multilocularis. AE is commonly associated with a long incubation period that may last for more than ten years. The objective of this systematic literature review was to identify and summarize the current knowledge on statistically relevant potential risk factors (PRFs) associated with AE in humans. Six bibliographic databases were searched, generating a total of 1,009 publications. Following the removal of duplicate records and the exclusion of papers that failed to meet the criteria of a previously agreed a priori protocol, 23 publications were retained; however, 6 of these did not contain data in a format that allowed their inclusion in the meta-analysis. The remaining 17 publications (6 case-control and 11 cross-sectional studies) were meta-analysed to investigate associations between AE and PRFs. Pooled odds ratios (OR) were used as a measure of effect and separately analysed for case-control and cross-sectional studies. In the case-control studies, the following PRFs for human AE showed higher odds of outcome: "dog ownership", "cat ownership", "have a kitchen garden", "occupation: farmer", "haymaking in meadows not adjacent to water", "went to forests for vocational reasons", "chewed grass" and "hunting / handling foxes". In the cross-sectional studies, the following PRFs showed higher odds of outcome: "dog ownership", "play with dogs", "gender: female", "age over 20 years", "ethnic group: Tibetan", "low income", "source of drinking water other than well or tap", "occupation: herding" and "low education". Our meta-analysis confirmed that the chance of AE transmission through ingestion of food and water contaminated with E. multilocularis eggs exists, but showed also that food- and water-borne PRFs do not significantly increase the risk of infection. This systematic review analysed international peer-reviewed articles that have over the years contributed to our current understanding of the epidemiology of human AE. The identification of potential risk factors may help researchers and decision makers improve surveillance and/or preventive measures that aim at decreasing human infection with E. multilocularis. More primary studies are needed to confirm potential risk factors and their role in the epidemiology of human AE.

Sex Differences in Reported Concussion Injury Rates and Time Loss From Participation: An Update of the National Collegiate Athletic Association Injury Surveillance Program From 2004-2005 Through 2008-2009.

PubMed

Covassin, Tracey; Moran, Ryan; Elbin, R J

2016-03-01

Epidemiologic studies have identified differences in concussion incidence between the sexes. However, few authors to date have updated injury rates (IRs) and time loss between male and female concussed athletes. To examine sex differences in IRs and time loss in concussed National Collegiate Athletic Association (NCAA) athletes. Descriptive epidemiologic study. National Collegiate Athletic Association athletics. A total of 1702 concusssed NCAA athletes, consisting of 903 females and 779 males participating in soccer, basketball, ice hockey, lacrosse, softball, or baseball over a 5-year period from 2004-2005 through 2008-2009. Using the NCAA Injury Surveillance Program, athletic trainers reported concussions, athlete-exposures (AEs), and time loss across 10 NCAA sports. An IR is the number of injuries in a particular category divided by the number of AEs in that category. During the study period, 1702 concussions were reported during 4 170 427 AEs for an overall total of 5.47 per 10 000 AEs. In sex-comparable sports, females had a 1.4 times higher overall concussion IR than males (IRs = 4.84 and 3.46, respectively), with greater rates in women's baseball/softball, basketball, ice hockey, and soccer than men. Female soccer and basketball players also displayed more time loss after concussion compared with male basketball and soccer players. Female athletes sustained a higher rate of concussion and, in all sports except lacrosse, had greater time loss from concussion than male athletes. Additional research is needed on sex differences in time loss after concussions.

AERC 2000: An International Conference. Proceedings of the Annual Adult Education Research Conference (41st, Vancouver, Canada, June 2-4, 2000).

ERIC Educational Resources Information Center

Sork, Thomas J., Ed.; Chapman, Valerie-Lee, Ed.; St. Clair, Ralf, Ed.

These proceedings contain 102 papers, 32 roundtables, and 5 symposia. Among the papers are "Weathered by Their Experiences" (Aiken); "Politics of Knowledge and Theory Construction in Adult Education (AE)" (Alfred); "Self-Directed Learning as a Political Act" (Andruske); "All Things Bold and Beautiful" (Armstrong); "Violence Against Women" (Baird);…

The Design and the Formative Evaluation of an Adaptive Educational System Based on Cognitive Styles

ERIC Educational Resources Information Center

Triantafillou, Evangelos; Pomportsis, Andreas; Demetriadis, Stavros

2003-01-01

Adaptive Hypermedia Systems (AHS) can be developed to accommodate a variety of individual differences, including learning style and cognitive style. The current research is an attempt to examine some of the critical variables, which may be important in the design of an Adaptive Educational System (AES) based on student's cognitive style. Moreover,…

A Literature Review of Research Quality and Effective Practices in Alternative Education Settings

ERIC Educational Resources Information Center

Flower, Andrea; McDaniel, Sara C.; Jolivette, Kristine

2011-01-01

Effective behavioral practices for students with emotional/behavioral disorders (E/BD) are critical. Students with E/BD are often served in alternative education (AE) settings due to behavior that cannot be supported in a typical school setting or due to court adjudication based on delinquent activity. Like other settings for students with E/BD,…

The Influence of Experience and Cognitive Style on International Entrepreneurial Intentions: The Contribution of Academic Education in this Relation

ERIC Educational Resources Information Center

Sommer, Lutz

2013-01-01

Introduction: The paper at hand examines the influence of Cognitive Style (CS) and International Experience (IE) on International Entrepreneurial Self-Efficacy (IESE) and International Entrepreneurial Intention (IEI) as well as the role of Academic Education (AE) in this context. Method: Based on a survey that was conducted among 111 students the…

ICP-AES Data Validation

EPA Pesticide Factsheets

Document designed to offer data reviewers guidance in determining the validity ofanalytical data generated through the USEPA Contract Laboratory Program (CLP) Statement ofWork (SOW) ISM01.X Inorganic Superfund Methods (Multi-Media, Multi-Concentration)

The working alliance and Clinician-assisted Emotional Disclosure for rheumatoid arthritis.

PubMed

Lumley, Mark A; Anderson, Timothy; Ankawi, Brett; Goldman, Gregory; Perri, LisaCaitlin M; Bianco, Joseph A; Keefe, Francis J

2018-01-01

The working alliance predicts improvement following general psychotherapy, but how it operates in brief interventions conducted with medically ill patients is unknown. Also, the role of the working alliance may differ in emotion-focused versus educational interventions. We report secondary analyses of a randomized clinical trial (Keefe et al.) [35], in which patients with rheumatoid arthritis (RA) received four nurse-provided sessions of either a) Clinician-assisted Emotional Disclosure (CAED), which emphasized the disclosure, expression, and processing of emotions related to stressful events; or b) Arthritis Education (AE), which provided basic education about RA. The Working Alliance Inventory was completed by both patient and nurse after each session. Patients were evaluated on multiple health measures at baseline and 1, 3, and 12months post-treatment. Analyses compared the alliance between interventions and related the alliance to outcomes within interventions. Patients in CAED reported a lower alliance than patients in AE. Interestingly, in CAED, lower alliance ratings predicted better outcomes (improved functioning, lower pain behaviors, lower inflammation, lower daily stress), whereas in AE, the working alliance was largely not predictive of outcomes. Having nurses encourage emotional disclosure among patients with RA reduced the patients' working alliance, but a lower alliance nonetheless predicted better patient outcomes, perhaps reflecting successful engagement in an intervention that is emotionally and relationally challenging. The level and predictive validity of the working alliance likely depends on patient, provider, and intervention factors, and further study of the working alliance in psychosocial interventions in the medical context is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

The history of dengue outbreaks in the Americas.

PubMed

Brathwaite Dick, Olivia; San Martín, José L; Montoya, Romeo H; del Diego, Jorge; Zambrano, Betzana; Dayan, Gustavo H

2012-10-01

Dengue is a viral disease usually transmitted by Aedes aegypti mosquitoes. Dengue outbreaks in the Americas reported in medical literature and to the Pan American Health Organization are described. The outbreak history from 1600 to 2010 was categorized into four phases: Introduction of dengue in the Americas (1600-1946); Continental plan for the eradication of the Ae. aegypti (1947-1970) marked by a successful eradication of the mosquito in 18 continental countries by 1962; Ae. aegypti reinfestation (1971-1999) caused by the failure of the mosquito eradication program; Increased dispersion of Ae. aegypti and dengue virus circulation (2000-2010) characterized by a marked increase in the number of outbreaks. During 2010 > 1.7 million dengue cases were reported, with 50,235 severe cases and 1,185 deaths. A dramatic increase in the number of outbreaks has been reported in recent years. Urgent global action is needed to avoid further disease spread.

The History of Dengue Outbreaks in the Americas

PubMed Central

Brathwaite Dick, Olivia; San Martín, José L.; Montoya, Romeo H.; del Diego, Jorge; Zambrano, Betzana; Dayan, Gustavo H.

2012-01-01

Dengue is a viral disease usually transmitted by Aedes aegypti mosquitoes. Dengue outbreaks in the Americas reported in medical literature and to the Pan American Health Organization are described. The outbreak history from 1600 to 2010 was categorized into four phases: Introduction of dengue in the Americas (1600–1946); Continental plan for the eradication of the Ae. aegypti (1947–1970) marked by a successful eradication of the mosquito in 18 continental countries by 1962; Ae. aegypti reinfestation (1971–1999) caused by the failure of the mosquito eradication program; Increased dispersion of Ae. aegypti and dengue virus circulation (2000–2010) characterized by a marked increase in the number of outbreaks. During 2010 > 1.7 million dengue cases were reported, with 50,235 severe cases and 1,185 deaths. A dramatic increase in the number of outbreaks has been reported in recent years. Urgent global action is needed to avoid further disease spread. PMID:23042846

10 micron Spectroscopy with OSCIR: Silicate Minerology and The Origins of Disks & Protoplanetesimals

NASA Astrophysics Data System (ADS)

Woodward, Chick; Wooden, Diane; Harker, David; Rodgers, Bernadette; Butner, Harold

1999-02-01

The analysis of the silicate mineralogy of pre-main sequence Herbig Ae/Be (HeAeBe) stars to main sequence (beta)-Pic systems, probes the chemical and physical conditions in these potentially planet-forming environments, the condensation of dust from the gas-disk, and the aggregation and accretion of these solids into planetesimals and comets. We propose to obtain 10 micron OSCIR spectra of a selected list of HeAeBe and (beta)-Pic like systems. Use of our ground-based data, combined with the ISO SWS database, and our extensive analytical modeling efforts will permit us to develop a fundamental understanding of connections between silicate mineralogy and the origins and evolution of disks and protoplanetesimals. This program will provide a framework to extend our understanding of planetary formation processes and the mineralogy of dust in differing circumstellar environs and comets to be studied with the NASA STARDUST and SIRTF missions.

Community-Based Control of Aedes aegypti By Using Mesocyclops in Southern Vietnam

PubMed Central

Nam, Vu Sinh; Yen, Nguyen Thi; Duc, Hoang Minh; Tu, Tran Cong; Thang, Vu Trong; Le, Nguyen Hoang; San, Le Hoang; Loan, Luu Le; Huong, Vu Thi Que; Khanh, Ly Huynh Kim; Trang, Huynh Thi Thuy; Lam, Leonie Z. Y.; Kutcher, Simon C.; Aaskov, John G.; Jeffery, Jason A. L.; Ryan, Peter A.; Kay, Brian H.

2012-01-01

We previously reported a new community-based mosquito control strategy that resulted in elimination of Aedes aegypti (Linn.) in 40 of 46 communes in northern and central Vietnam, and with annual recurrent total costs (direct and indirect) of only $0.28–$0.89 international dollars per person. This control strategy was extended to four provinces in southern Vietnam in Long An and Hau Giang (2004–2007) and to Long An, Ben Tre, and Vinh Long (2005–2010). In a total of 14 communes with 124,743 residents, the mean ± SD of adult female Ae. aegypti was reduced from 0.93 ± 0.62 to 0.06 ± 0.09, and the reduction of immature Ae. aegypti averaged 98.8%. By the final survey, no adults could be collected in 6 of 14 communes, and one commune, Binh Thanh, also had no immature forms. Although the community-based programs also involved community education and clean-up campaigns, the prevalence of Mesocyclops in large water storage containers > 50 liters increased from 12.77 ± 8.39 to 75.69 ± 9.17% over periods of 15–45 months. At the conclusion of the study, no confirmed dengue cases were detected in four of the five communes for which diagnostic serologic analysis was performed. The rate of progress was faster in communes that were added in stages to the program but the reason for this finding was unclear. At the completion of the formal project, sustainability funds were set up to provide each commune with the financial means to ensure that community-based dengue control activities continued. PMID:22556087

An Overview of the Semi-Span Super-Sonic Transport (S4T) Wind-Tunnel Model Program

NASA Technical Reports Server (NTRS)

Silva, Walter A.; Perry, Boyd, III; Florance, James R.; Sanetrik, Mark D.; Wieseman, Carol D.; Stevens, William L.; Funk, Christie J.; Christhilf, David M.; Coulson, David A.

2012-01-01

A summary of computational and experimental aeroelastic (AE) and aeroservoelastic (ASE) results for the Semi-Span Super-Sonic Transport (S4T) wind-tunnel model is presented. A broad range of analyses and multiple AE and ASE wind-tunnel tests of the S4T wind-tunnel model have been performed in support of the ASE element in the Supersonics Program, part of the NASA Fundamental Aeronautics Program. This paper is intended to be an overview of multiple papers that comprise a special S4T technical session. Along those lines, a brief description of the design and hardware of the S4T wind-tunnel model will be presented. Computational results presented include linear and nonlinear aeroelastic analyses, and rapid aeroelastic analyses using CFD-based reduced-order models (ROMs). A brief survey of some of the experimental results from two open-loop and two closed-loop wind-tunnel tests performed at the NASA Langley Transonic Dynamics Tunnel (TDT) will be presented as well.

IUE observations of new A star candidate proto-planetary systems

NASA Technical Reports Server (NTRS)

Grady, Carol A.

1994-01-01

As a result of the detection of accreting gas in the A5e PMS Herbig Ae star, HR 5999, most of the observations for this IUE program were devoted to Herbig Ae stars rather than to main sequence A stars. Mid-UV emission at optical minimum light was detected for UX Ori (A1e), BF Ori (A5e), and CQ Tau (F2e). The presence of accreting gas in HD 45677 and HD 50138 prompted reclassification of these stars as Herbig Be stars rather than as protoplanetary nebulae. Detailed results are discussed.

Spatial autocorrelation of West Nile virus vector mosquito abundance in a seasonally wet suburban environment

NASA Astrophysics Data System (ADS)

Trawinski, P. R.; Mackay, D. S.

2009-03-01

The objective of this study is to quantify and model spatial dependence in mosquito vector populations and develop predictions for unsampled locations using geostatistics. Mosquito control program trap sites are often located too far apart to detect spatial dependence but the results show that integration of spatial data over time for Cx. pipiens-restuans and according to meteorological conditions for Ae. vexans enables spatial analysis of sparse sample data. This study shows that mosquito abundance is spatially correlated and that spatial dependence differs between Cx. pipiens-restuans and Ae. vexans mosquitoes.

Characteristics of Aedes aegypti adult mosquitoes in rural and urban areas of western and coastal Kenya

PubMed Central

Ndenga, Bryson Alberto; Mutuku, Francis Maluki; Ngugi, Harun Njenga; Mbakaya, Joel Omari; Aswani, Peter; Musunzaji, Peter Siema; Vulule, John; Mukoko, Dunstan; Kitron, Uriel; LaBeaud, Angelle Desiree

2017-01-01

Aedes aegypti is the main vector for yellow fever, dengue, chikungunya and Zika viruses. Recent outbreaks of dengue and chikungunya have been reported in Kenya. Presence and abundance of this vector is associated with the risk for the occurrence and transmission of these diseases. This study aimed to characterize the presence and abundance of Ae. aegypti adult mosquitoes from rural and urban sites in western and coastal regions of Kenya. Presence and abundance of Ae. aegypti adult mosquitoes were determined indoors and outdoors in two western (urban Kisumu and rural Chulaimbo) and two coastal (urban Ukunda and rural Msambweni) sites in Kenya. Sampling was performed using quarterly human landing catches, monthly Prokopack automated aspirators and monthly Biogents-sentinel traps. A total of 2,229 adult Ae. aegypti mosquitoes were collected: 785 (35.2%) by human landing catches, 459 (20.6%) by Prokopack aspiration and 985 (44.2%) by Biogents-sentinel traps. About three times as many Ae. aegypti mosquitoes were collected in urban than rural sites (1,650 versus 579). Comparable numbers were collected in western (1,196) and coastal (1,033) sites. Over 80% were collected outdoors through human landing catches and Prokopack aspiration. The probability of collecting Ae. aegypti mosquitoes by human landing catches was significantly higher in the afternoon than morning hours (P<0.001), outdoors than indoors (P<0.001) and in urban than rural sites (P = 0.008). Significantly more Ae. aegypti mosquitoes were collected using Prokopack aspiration outdoors than indoors (P<0.001) and in urban than rural areas (P<0.001). Significantly more mosquitoes were collected using Biogents-sentinel traps in urban than rural areas (P = 0.008) and in western than coastal sites (P = 0.006). The probability of exposure to Ae. aegypti bites was highest in urban areas, outdoors and in the afternoon hours. These characteristics have major implications for the possible transmission of arboviral diseases and for the planning of surveillance and control programs. PMID:29261766

Evaluation of Late Adverse Events in Long-Term Wilms' Tumor Survivors

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

Dijk, Irma van, E-mail: i.w.vandijk@amc.uva.n; Oldenburger, Foppe; Cardous-Ubbink, Mathilde C.

2010-10-01

Purpose: To evaluate the prevalence and severity of adverse events (AEs) and treatment-related risk factors in long-term Wilms' tumor (WT) survivors, with special attention to radiotherapy. Methods and Materials: The single-center study cohort consisted of 185 WT survivors treated between 1966 and 1996, who survived at least 5 years after diagnosis. All survivors were invited to a late-effects clinic for medical assessment of AEs. AEs were graded for severity in a standardized manner. Detailed radiotherapy data enabled us to calculate the equivalent dose in 2 Gy fractions (EQD{sub 2}) to compare radiation doses in a uniform way. Risk factors weremore » evaluated with multivariate logistic regression analysis. Results: Medical follow-up was complete for 98% of survivors (median follow-up, 18.9 years; median attained age, 22.9 years); 123 survivors had 462 AEs, of which 392 had Grade 1 or 2 events. Radiotherapy to flank/abdomen increased the risk of any AE (OR, 1.08 Gy{sup -1} [CI, 1.04-1.13]). Furthermore, radiotherapy to flank/abdomen was associated with orthopedic events (OR, 1.09 Gy{sup -1} [CI, 1.05-1.13]) and second tumors (OR, 1.11 Gy{sup -1} [CI, 1.03-1.19]). Chest irradiation increased the risk of pulmonary events (OR, 1.14 Gy{sup -1} [CI, 1.06-1.21]). Both flank/abdominal and chest irradiation were associated with cardiovascular events (OR, 1.05 Gy{sup -1} [CI, 1.00-1.10], OR, 1.06 Gy{sup -1} [CI, 1.01-1.12]) and tissue hypoplasia (OR, 1.17 Gy{sup -1} [CI, 1.10-1.24], OR 1.10 Gy{sup -1} [CI, 1.03-1.18]). Conclusion: The majority of AEs, overall as well as in irradiated survivors, were mild to moderate. Nevertheless, the large amount of AEs emphasizes the importance of follow-up programs for WT survivors.« less

The role of agri-environment schemes in conservation and environmental management.

PubMed

Batáry, Péter; Dicks, Lynn V; Kleijn, David; Sutherland, William J

2015-08-01

Over half of the European landscape is under agricultural management and has been for millennia. Many species and ecosystems of conservation concern in Europe depend on agricultural management and are showing ongoing declines. Agri-environment schemes (AES) are designed partly to address this. They are a major source of nature conservation funding within the European Union (EU) and the highest conservation expenditure in Europe. We reviewed the structure of current AES across Europe. Since a 2003 review questioned the overall effectiveness of AES for biodiversity, there has been a plethora of case studies and meta-analyses examining their effectiveness. Most syntheses demonstrate general increases in farmland biodiversity in response to AES, with the size of the effect depending on the structure and management of the surrounding landscape. This is important in the light of successive EU enlargement and ongoing reforms of AES. We examined the change in effect size over time by merging the data sets of 3 recent meta-analyses and found that schemes implemented after revision of the EU's agri-environmental programs in 2007 were not more effective than schemes implemented before revision. Furthermore, schemes aimed at areas out of production (such as field margins and hedgerows) are more effective at enhancing species richness than those aimed at productive areas (such as arable crops or grasslands). Outstanding research questions include whether AES enhance ecosystem services, whether they are more effective in agriculturally marginal areas than in intensively farmed areas, whether they are more or less cost-effective for farmland biodiversity than protected areas, and how much their effectiveness is influenced by farmer training and advice? The general lesson from the European experience is that AES can be effective for conserving wildlife on farmland, but they are expensive and need to be carefully designed and targeted. © 2015 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

Characteristics of Aedes aegypti adult mosquitoes in rural and urban areas of western and coastal Kenya.

PubMed

Ndenga, Bryson Alberto; Mutuku, Francis Maluki; Ngugi, Harun Njenga; Mbakaya, Joel Omari; Aswani, Peter; Musunzaji, Peter Siema; Vulule, John; Mukoko, Dunstan; Kitron, Uriel; LaBeaud, Angelle Desiree

2017-01-01

Aedes aegypti is the main vector for yellow fever, dengue, chikungunya and Zika viruses. Recent outbreaks of dengue and chikungunya have been reported in Kenya. Presence and abundance of this vector is associated with the risk for the occurrence and transmission of these diseases. This study aimed to characterize the presence and abundance of Ae. aegypti adult mosquitoes from rural and urban sites in western and coastal regions of Kenya. Presence and abundance of Ae. aegypti adult mosquitoes were determined indoors and outdoors in two western (urban Kisumu and rural Chulaimbo) and two coastal (urban Ukunda and rural Msambweni) sites in Kenya. Sampling was performed using quarterly human landing catches, monthly Prokopack automated aspirators and monthly Biogents-sentinel traps. A total of 2,229 adult Ae. aegypti mosquitoes were collected: 785 (35.2%) by human landing catches, 459 (20.6%) by Prokopack aspiration and 985 (44.2%) by Biogents-sentinel traps. About three times as many Ae. aegypti mosquitoes were collected in urban than rural sites (1,650 versus 579). Comparable numbers were collected in western (1,196) and coastal (1,033) sites. Over 80% were collected outdoors through human landing catches and Prokopack aspiration. The probability of collecting Ae. aegypti mosquitoes by human landing catches was significantly higher in the afternoon than morning hours (P<0.001), outdoors than indoors (P<0.001) and in urban than rural sites (P = 0.008). Significantly more Ae. aegypti mosquitoes were collected using Prokopack aspiration outdoors than indoors (P<0.001) and in urban than rural areas (P<0.001). Significantly more mosquitoes were collected using Biogents-sentinel traps in urban than rural areas (P = 0.008) and in western than coastal sites (P = 0.006). The probability of exposure to Ae. aegypti bites was highest in urban areas, outdoors and in the afternoon hours. These characteristics have major implications for the possible transmission of arboviral diseases and for the planning of surveillance and control programs.

The Epidemiology of Stress Fractures in Collegiate Student-Athletes, 2004-2005 Through 2013-2014 Academic Years.

PubMed

Rizzone, Katherine H; Ackerman, Kathryn E; Roos, Karen G; Dompier, Thomas P; Kerr, Zachary Y

2017-10-01

  Stress fractures are injuries caused by cumulative, repetitive stress that leads to abnormal bone remodeling. Specific populations, including female athletes and endurance athletes, are at higher risk than the general athletic population. Whereas more than 460 000 individuals participate in collegiate athletics in the United States, no large study has been conducted to determine the incidence of stress fractures in collegiate athletes.   To assess the incidence of stress fractures in National Collegiate Athletic Association (NCAA) athletes and investigate rates and patterns overall and by sport.   Descriptive epidemiology study.   National Collegiate Athletic Association institutions.   National Collegiate Athletic Association athletes.   Data were analyzed from the NCAA Injury Surveillance Program for the academic years 2004-2005 through 2013-2014. We calculated rates and rate ratios (RRs) with 95% confidence intervals (CIs).   A total of 671 stress fractures were reported over 11 778 145 athlete-exposures (AEs) for an overall injury rate of 5.70 per 100 000 AEs. The sports with the highest rates of stress fractures were women's cross-country ( 28.59/100  000 AEs), women's gymnastics ( 25.58/100  000 AEs), and women's outdoor track ( 22.26/100  000 AEs). Among sex-comparable sports (baseball/softball, basketball, cross-country, ice hockey, lacrosse, soccer, swimming and diving, tennis, indoor track, and outdoor track), stress fracture rates were higher in women (9.13/100 000 AEs) than in men (4.44/100 000 AEs; RR = 2.06; 95% CI = 1.71, 2.47). Overall, stress fracture rates for these NCAA athletes were higher in the preseason (7.30/100 000 AEs) than in the regular season (5.12/100 000 AEs; RR = 1.43; 95% CI = 1.22, 1.67). The metatarsals (n = 254, 37.9%), tibia (n = 147, 21.9%), and lower back/lumbar spine/pelvis (n = 81, 12.1%) were the most common locations of injury. Overall, 21.5% (n = 144) of stress fractures were recurrent injuries, and 20.7% (n = 139) were season-ending injuries.   Women experienced stress fractures at higher rates than men, more often in the preseason, and predominantly in the foot and lower leg. Researchers should continue to investigate biological and biomechanical risk factors for these injuries as well as prevention interventions.

Patients With Antithyroid Antibodies Are Prone To Develop Destructive Thyroiditis by Nivolumab: A Prospective Study

PubMed Central

Kobayashi, Tomoko; Iwama, Shintaro; Yasuda, Yoshinori; Okada, Norio; Tsunekawa, Taku; Onoue, Takeshi; Takagi, Hiroshi; Hagiwara, Daisuke; Ito, Yoshihiro; Morishita, Yoshiaki; Goto, Motomitsu; Suga, Hidetaka; Banno, Ryoichi; Yokota, Kenji; Hase, Tetsunari; Morise, Masahiro; Hashimoto, Naozumi; Ando, Masahiko; Kiyoi, Hitoshi; Gotoh, Momokazu; Ando, Yuichi; Akiyama, Masashi; Hasegawa, Yoshinori; Arima, Hiroshi

2018-01-01

Abstract Context Immune checkpoint inhibitors, including anti–programmed cell death-1 (PD-1) antibodies, have become promising treatments for a variety of advanced malignancies. However, these medicines can cause immune-related adverse events (irAEs), including endocrinopathies. Objective This study examined the incidence of endocrine irAEs induced by nivolumab. Patients and Main Outcome Measured Sixty-six patients treated with nivolumab at Nagoya University Hospital were prospectively evaluated for pituitary hormones, thyroid function, antithyroid antibodies (Abs), and glucose levels every 6 weeks after the initiation of nivolumab for 24 weeks. Results Four out of 66 patients developed destructive thyroiditis, and three patients developed hypothyroidism requiring levothyroxine replacement. The prevalence of positive anti-thyroglobulin Abs (TgAbs) and/or anti–thyroid peroxidase Abs (TPOAbs) at baseline was significantly higher in the group that developed destructive thyroiditis (3/4) compared with the group that did not develop thyroiditis (3/62; P = 0.002). There were no significant differences in other clinical variables between the groups. There were no endocrine irAEs other than destructive thyroiditis during the 24 weeks. The prevalence of TgAbs and/or TPOAbs at baseline was not associated with the development of other irAEs, including pneumonitis, colitis, or skin reactions. Conclusions Our real-world data showed that destructive thyroiditis was an endocrine irAE that was frequently induced by nivolumab and was significantly associated with positive TgAbs and/or TPOAbs before treatment. Our findings indicate that evaluating these Abs before treatment may help identify patients with a high risk of thyroidal irAEs and may have important clinical benefit. PMID:29600292

Effects of agri-environmental schemes on farmland birds: do food availability measurements improve patterns obtained from simple habitat models?

PubMed Central

Ponce, Carlos; Bravo, Carolina; Alonso, Juan Carlos

2014-01-01

Studies evaluating agri-environmental schemes (AES) usually focus on responses of single species or functional groups. Analyses are generally based on simple habitat measurements but ignore food availability and other important factors. This can limit our understanding of the ultimate causes determining the reactions of birds to AES. We investigated these issues in detail and throughout the main seasons of a bird's annual cycle (mating, postfledging and wintering) in a dry cereal farmland in a Special Protection Area for farmland birds in central Spain. First, we modeled four bird response parameters (abundance, species richness, diversity and “Species of European Conservation Concern” [SPEC]-score), using detailed food availability and vegetation structure measurements (food models). Second, we fitted new models, built using only substrate composition variables (habitat models). Whereas habitat models revealed that both, fields included and not included in the AES benefited birds, food models went a step further and included seed and arthropod biomass as important predictors, respectively, in winter and during the postfledging season. The validation process showed that food models were on average 13% better (up to 20% in some variables) in predicting bird responses. However, the cost of obtaining data for food models was five times higher than for habitat models. This novel approach highlighted the importance of food availability-related causal processes involved in bird responses to AES, which remained undetected when using conventional substrate composition assessment models. Despite their higher costs, measurements of food availability add important details to interpret the reactions of the bird community to AES interventions and thus facilitate evaluating the real efficiency of AES programs. PMID:25165523

Optimizing the Combination of Acoustic and Electric Hearing in the Implanted Ear

PubMed Central

Karsten, Sue A.; Turner, Christopher W.; Brown, Carolyn J.; Jeon, Eun Kyung; Abbas, Paul J.; Gantz, Bruce J.

2016-01-01

Objectives The aim of this study was to determine an optimal approach to program combined acoustic plus electric (A+E) hearing devices in the same ear to maximize speech-recognition performance. Design Ten participants with at least 1 year of experience using Nucleus Hybrid (short electrode) A+E devices were evaluated across three different fitting conditions that varied in the frequency ranges assigned to the acoustically and electrically presented portions of the spectrum. Real-ear measurements were used to optimize the acoustic component for each participant, and the acoustic stimulation was then held constant across conditions. The lower boundary of the electric frequency range was systematically varied to create three conditions with respect to the upper boundary of the acoustic spectrum: Meet, Overlap, and Gap programming. Consonant recognition in quiet and speech recognition in competing-talker babble were evaluated after participants were given the opportunity to adapt by using the experimental programs in their typical everyday listening situations. Participants provided subjective ratings and evaluations for each fitting condition. Results There were no significant differences in performance between conditions (Meet, Overlap, Gap) for consonant recognition in quiet. A significant decrement in performance was measured for the Overlap fitting condition for speech recognition in babble. Subjective ratings indicated a significant preference for the Meet fitting regimen. Conclusions Participants using the Hybrid ipsilateral A+E device generally performed better when the acoustic and electric spectra were programmed to meet at a single frequency region, as opposed to a gap or overlap. Although there is no particular advantage for the Meet fitting strategy for recognition of consonants in quiet, the advantage becomes evident for speech recognition in competing-talker babble and in patient preferences. PMID:23059851

Dynamic neutral beam current and voltage control to improve beam efficacy in tokamaks

NASA Astrophysics Data System (ADS)

Pace, D. C.; Austin, M. E.; Bardoczi, L.; Collins, C. S.; Crowley, B.; Davis, E.; Du, X.; Ferron, J.; Grierson, B. A.; Heidbrink, W. W.; Holcomb, C. T.; McKee, G. R.; Pawley, C.; Petty, C. C.; Podestà, M.; Rauch, J.; Scoville, J. T.; Spong, D. A.; Thome, K. E.; Van Zeeland, M. A.; Varela, J.; Victor, B.

2018-05-01

An engineering upgrade to the neutral beam system at the DIII-D tokamak [J. L. Luxon, Nucl. Fusion 42, 614 (2002)] enables time-dependent programming of the beam voltage and current. Initial application of this capability involves pre-programmed beam voltage and current injected into plasmas that are known to be susceptible to instabilities that are driven by energetic ( E ≥ 40 keV) beam ions. These instabilities, here all Alfvén eigenmodes (AEs), increase the transport of the beam ions beyond a classical expectation based on particle drifts and collisions. Injecting neutral beam power, P beam ≥ 2 MW, at reduced voltage with increased current reduces the drive for Alfvénic instabilities and results in improved ion confinement. In lower-confinement plasmas, this technique is applied to eliminate the presence of AEs across the mid-radius of the plasmas. Simulations of those plasmas indicate that the mode drive is decreased and the radial extent of the remaining modes is reduced compared to a higher beam voltage case. In higher-confinement plasmas, this technique reduces AE activity in the far edge and results in an interesting scenario of beam current drive improving as the beam voltage reduces from 80 kV to 65 kV.

Dynamic neutral beam current and voltage control to improve beam efficacy in tokamaks

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

Austin, Max E.; Bardoczi, Laszlo; Collins, Cami S.

Here, an engineering upgrade to the neutral beam system at the DIII-D tokamak enables time-dependent programming of the beam voltage and current. Initial application of this capability involves pre-programmed beam voltage and current injected into plasmas that are known to be susceptible to instabilities that are driven by energetic (E ≥ 40 keV) beam ions. These instabilities, here all Alfvén eigenmodes (AEs), increase the transport of the beam ions beyond a classical expectation based on particle drifts and collisions. Injecting neutral beam power, P beam ≥ 2MW, at reduced voltage with increased current reduces the drive for Alfvénic instabilities andmore » results in improved ion confinement. In lower-confinement plasmas, this technique is applied to eliminate the presence of AEs across the mid-radius of the plasmas. Simulations of those plasmas indicate that the mode drive is decreased and the radial extent of the remaining modes is reduced compared to a higher beam voltage case. In higher-confinement plasmas, this technique reduces AE activity in the far edge and results in an interesting scenario of beam current drive improving as the beam voltage reduces from 80 kV to 65 kV.« less

Dynamic neutral beam current and voltage control to improve beam efficacy in tokamaks

DOE PAGES

Austin, Max E.; Bardoczi, Laszlo; Collins, Cami S.; ...

2018-04-20

Here, an engineering upgrade to the neutral beam system at the DIII-D tokamak enables time-dependent programming of the beam voltage and current. Initial application of this capability involves pre-programmed beam voltage and current injected into plasmas that are known to be susceptible to instabilities that are driven by energetic (E ≥ 40 keV) beam ions. These instabilities, here all Alfvén eigenmodes (AEs), increase the transport of the beam ions beyond a classical expectation based on particle drifts and collisions. Injecting neutral beam power, P beam ≥ 2MW, at reduced voltage with increased current reduces the drive for Alfvénic instabilities andmore » results in improved ion confinement. In lower-confinement plasmas, this technique is applied to eliminate the presence of AEs across the mid-radius of the plasmas. Simulations of those plasmas indicate that the mode drive is decreased and the radial extent of the remaining modes is reduced compared to a higher beam voltage case. In higher-confinement plasmas, this technique reduces AE activity in the far edge and results in an interesting scenario of beam current drive improving as the beam voltage reduces from 80 kV to 65 kV.« less

A controlled naturalistic study on a weekly music therapy and activity program on disruptive and depressive behaviors in dementia.

PubMed

Han, Peimin; Kwan, Melanie; Chen, Denise; Yusoff, Siti Zubaidah; Chionh, Hui Ling; Goh, Jenny; Yap, Philip

2010-01-01

This study explores the effects of a weekly structured music therapy and activity program (MAP) on behavioral and depressive symptoms in persons with dementia (PWD) in a naturalistic setting. PWD attended a weekly group MAP conducted by a qualified music therapist and occupational therapist for 8 weeks. Two validated scales, the Apparent Emotion Scale (AES) and the Revised Memory and Behavioral Problems Checklist (RMBPC), were used to measure change in outcomes of mood and behavior. Twenty-eight subjects completed the intervention, while 15 wait-list subjects served as controls. Baseline AES and RMBPC scores were not significantly different between the intervention and control groups. After intervention, RMBPC scores improved significantly (p = 0.006) with 95% CI of the difference between the mean intervention and control group scores compared to baseline at -62.1 to -11.20. Total RMBPC scores in the intervention group improved from 75.3 to 54.5, but worsened in the control group, increasing from 62.3 to 78.6. AES scores showed a nonsignificant trend towards improvement in the intervention group. The results suggest that a weekly MAP can ameliorate behavioral and depressive symptoms in PWD. Copyright © 2011 S. Karger AG, Basel.

Low-Cost, Net-Shape Ceramic Radial Turbine Program

DTIC Science & Technology

1985-05-01

PROGRAM ELEMENT. PROJECT. TASK Garrett Turbine Engine Company AE OKUI UBR 111 South 34th Street, P.O. Box 2517 Phoenix, Arizona 85010 %I. CONTROLLING...processing iterations. Program management and materials characterization were conducted at Garrett Turbine Engine Company (GTEC), test bar and rotor...automotive gas turbine engine rotor development efforts at ACC. xvii PREFACE This is the final technical report of the Low-Cost, Net- Shape Ceramic

Raw sewage as breeding site to Aedes (Stegomyia) aegypti (Diptera, culicidae).

PubMed

Chitolina, R F; Anjos, F A; Lima, T S; Castro, E A; Costa-Ribeiro, M C V

2016-12-01

The selection of oviposition sites by females of Aedes (Stegomyia) aegypti is a key factor for the larval survival and egg dispersion and has a direct influence in vector control programs. In this study, we evaluated the aspects of reproductive physiology of Ae. aegypti mosquitoes tested in the presence of raw sewage. Ae. aegypti females were used in oviposition bioassays according to two methodologies: (i) choice assay, in which three oviposition substrates were offered in the same cage: treatment (raw sewage), positive control (distilled water) and negative control (1% sodium hypochlorite) and; (ii) no choice assay, in which only one substrate was available. The physicochemical and microbiological analysis of the raw sewage used in this study indicated virtually no levels of chlorine, low levels of dissolved oxygen and high levels of nitrogenous compounds as well as the presence of Escherichia coli and total fecal coliforms. After 72h of oviposition, the eggs were counted and there was no statistically significant difference (p>0.05) in the oviposition rate between raw sewage and positive control in both methodologies. In addition, females were dissected to evaluate egg-retention and also there were no appreciable differences in egg retention even when raw sewage was the only substrate offered. The data also showed that egg hatching and larvae development occurred normally in the raw sewage. Therefore, the present study suggests that Ae. aegypti can adapt to new sites and lay eggs in polluted water, such as the raw sewage. These findings are of particular importance for the control and surveillance programs against Ae. aegypti in countries where the conditions of poor infrastructure and lack of basic sanitation are still an issue. Copyright © 2016 Elsevier B.V. All rights reserved.

Schools as Potential Risk Sites for Vector-Borne Disease Transmission: Mosquito Vectors in Rural Schools in Two Municipalities in Colombia.

PubMed

Olano, Víctor Alberto; Matiz, María Inés; Lenhart, Audrey; Cabezas, Laura; Vargas, Sandra Lucía; Jaramillo, Juan Felipe; Sarmiento, Diana; Alexander, Neal; Stenström, Thor Axel; Overgaard, Hans J

2015-09-01

Dengue and other vector-borne diseases are of great public health importance in Colombia. Vector surveillance and control activities are often focused at the household level. Little is known about the importance of nonhousehold sites, including schools, in maintaining vector-borne disease transmission. The objectives of this paper were to determine the mosquito species composition in rural schools in 2 municipalities in Colombia and to assess the potential risk of vector-borne disease transmission in school settings. Entomological surveys were carried out in rural schools during the dry and rainy seasons of 2011. A total of 12 mosquito species were found: Aedes aegypti, Anopheles pseudopunctipennis, Culex coronator, Cx. quinquefasciatus, and Limatus durhamii in both immature and adult forms; Ae. fluviatilis, Cx. nigripalpus, Cx. corniger, and Psorophora ferox in immature forms only; and Ae. angustivittatus, Haemagogus equinus, and Trichoprosopon lampropus in adult forms only. The most common mosquito species was Cx. quinquefasciatus. Classrooms contained the greatest abundance of adult female Ae. aegypti and Cx. quinquefasciatus. The most common Ae. aegypti breeding sites were containers classified as "others" (e.g., cans), followed by containers used for water storage. A high level of Ae. aegypti infestation was found during the wet season. Our results suggest that rural schools are potentially important foci for the transmission of dengue and other mosquito-borne diseases. We propose that public health programs should be implemented in rural schools to prevent vector-borne diseases.

Safety and Tolerability of PD-1/PD-L1 Inhibitors Compared with Chemotherapy in Patients with Advanced Cancer: A Meta-Analysis.

PubMed

Nishijima, Tomohiro F; Shachar, Shlomit S; Nyrop, Kirsten A; Muss, Hyman B

2017-04-01

Compared with chemotherapy, significant improvement in survival outcomes with the programmed death receptor-1 (PD-1) inhibitors nivolumab and pembrolizumab and the programmed death-ligand 1 (PD-L1) inhibitor atezolizumab has been shown in several types of advanced solid tumors. We conducted a systematic review and meta-analysis to compare safety and tolerability between PD-1/PD-L1 inhibitors and chemotherapy. PubMed and American Society of Clinical Oncology (ASCO) databases were searched 1966 to September 2016. Eligible studies included randomized controlled trials (RCTs) comparing single-agent U.S. Food and Drug Administration-approved PD-1/PD-L1 inhibitors (nivolumab, pembrolizumab, or atezolizumab) with chemotherapy in cancer patients reporting any all-grade (1-4) or high-grade (3-4) adverse events (AEs), all- or high-grade treatment-related symptoms, hematologic toxicities and immune-related AEs, treatment discontinuation due to toxicities, or treatment-related deaths. The summary incidence, relative risk, and 95% confidence intervals were calculated. A total of 3,450 patients from 7 RCTs were included in the meta-analysis: 4 nivolumab, 2 pembrolizumab, and 1 atezolizumab trials. The underlying malignancies included were non-small cell lung cancer (4 trials) and melanoma (3 trials). Compared with chemotherapy, the PD-1/PD-L1 inhibitors had a significantly lower risk of all- and high-grade fatigue, sensory neuropathy, diarrhea and hematologic toxicities, all-grade anorexia, nausea, and constipation, any all- and high-grade AEs, and treatment discontinuation. There was an increased risk of all-grade rash, pruritus, colitis, aminotransferase elevations, hypothyroidism, and hyperthyroidism, and all- and high-grade pneumonitis with PD1/PD-L1 inhibitors. PD-1/PD-L1 inhibitors are overall better tolerated than chemotherapy. Our results provide further evidence supporting the favorable risk/benefit ratio for PD-1/PD-L1 inhibitors. The Oncologist 2017;22:470-479 IMPLICATIONS FOR PRACTICE: We conducted a systematic review and meta-analysis to compare summary toxicity endpoints and clinically relevant adverse events between programmed death receptor-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors and chemotherapy. PD1/PD-L1 inhibitors were associated with a lower risk of treatment-related symptoms (fatigue, anorexia, nausea, diarrhea, constipation, and sensory neuropathy) but a higher risk of immune-related adverse events (AEs). Summary toxicity endpoints favor PD1/PD-L1 inhibitors (any all- and high-grade AEs and treatment discontinuation). PD1/PD-L1 inhibitors are overall better tolerated than chemotherapy. In addition to efficacy data from trials, our findings provide useful information for clinicians for well-balanced discussions with their patients on the risks and benefits of treatment options for advanced cancer. © AlphaMed Press 2017.

Safety and Tolerability of PD‐1/PD‐L1 Inhibitors Compared with Chemotherapy in Patients with Advanced Cancer: A Meta‐Analysis

PubMed Central

Shachar, Shlomit S.; Nyrop, Kirsten A.; Muss, Hyman B.

2017-01-01

Abstract Background. Compared with chemotherapy, significant improvement in survival outcomes with the programmed death receptor‐1 (PD‐1) inhibitors nivolumab and pembrolizumab and the programmed death‐ligand 1 (PD‐L1) inhibitor atezolizumab has been shown in several types of advanced solid tumors. We conducted a systematic review and meta‐analysis to compare safety and tolerability between PD‐1/PD‐L1 inhibitors and chemotherapy. Methods. PubMed and American Society of Clinical Oncology (ASCO) databases were searched 1966 to September 2016. Eligible studies included randomized controlled trials (RCTs) comparing single‐agent U.S. Food and Drug Administration–approved PD‐1/PD‐L1 inhibitors (nivolumab, pembrolizumab, or atezolizumab) with chemotherapy in cancer patients reporting any all‐grade (1–4) or high‐grade (3–4) adverse events (AEs), all‐ or high‐grade treatment‐related symptoms, hematologic toxicities and immune‐related AEs, treatment discontinuation due to toxicities, or treatment‐related deaths. The summary incidence, relative risk, and 95% confidence intervals were calculated. Results. A total of 3,450 patients from 7 RCTs were included in the meta‐analysis: 4 nivolumab, 2 pembrolizumab, and 1 atezolizumab trials. The underlying malignancies included were non‐small cell lung cancer (4 trials) and melanoma (3 trials). Compared with chemotherapy, the PD‐1/PD‐L1 inhibitors had a significantly lower risk of all‐ and high‐grade fatigue, sensory neuropathy, diarrhea and hematologic toxicities, all‐grade anorexia, nausea, and constipation, any all‐ and high‐grade AEs, and treatment discontinuation. There was an increased risk of all‐grade rash, pruritus, colitis, aminotransferase elevations, hypothyroidism, and hyperthyroidism, and all‐ and high‐grade pneumonitis with PD1/PD‐L1 inhibitors. Conclusion. PD‐1/PD‐L1 inhibitors are overall better tolerated than chemotherapy. Our results provide further evidence supporting the favorable risk/benefit ratio for PD‐1/PD‐L1 inhibitors. Implications for Practice. We conducted a systematic review and meta‐analysis to compare summary toxicity endpoints and clinically relevant adverse events between programmed death receptor‐1 (PD‐1)/programmed death‐ligand 1 (PD‐L1) inhibitors and chemotherapy. PD1/PD‐L1 inhibitors were associated with a lower risk of treatment‐related symptoms (fatigue, anorexia, nausea, diarrhea, constipation, and sensory neuropathy) but a higher risk of immune‐related adverse events (AEs). Summary toxicity endpoints favor PD1/PD‐L1 inhibitors (any all‐ and high‐grade AEs and treatment discontinuation). PD1/PD‐L1 inhibitors are overall better tolerated than chemotherapy. In addition to efficacy data from trials, our findings provide useful information for clinicians for well‐balanced discussions with their patients on the risks and benefits of treatment options for advanced cancer. PMID:28275115

Acoustic emission non-destructive testing of structures using source location techniques.

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

Beattie, Alan G.

2013-09-01

The technology of acoustic emission (AE) testing has been advanced and used at Sandia for the past 40 years. AE has been used on structures including pressure vessels, fire bottles, wind turbines, gas wells, nuclear weapons, and solar collectors. This monograph begins with background topics in acoustics and instrumentation and then focuses on current acoustic emission technology. It covers the overall design and system setups for a test, with a wind turbine blade as the object. Test analysis is discussed with an emphasis on source location. Three test examples are presented, two on experimental wind turbine blades and one onmore » aircraft fire extinguisher bottles. Finally, the code for a FORTRAN source location program is given as an example of a working analysis program. Throughout the document, the stress is on actual testing of real structures, not on laboratory experiments.« less

Who gives pain relief to children?

PubMed Central

Spedding, R L; Harley, D; Dunn, F J; McKinney, L A

1999-01-01

OBJECTIVE: To compare pre-hospital parental administration of pain relief for children with that of the accident and emergency (A&E) department staff and to ascertain the reason why pre-hospital analgesia is not being given. DESIGN/METHODS: An anonymous prospective questionnaire was given to parents/guardians of children < 17 years. The children were all self referred with head injuries or limb problems including burns. The first part asked for details of pain relief before attendance in the A&E department. The second part of the questionnaire contained a section for the examining doctor and triage nurse to fill in. The duration of the survey was 28 days. RESULTS: Altogether 203 of 276 (74%) of children did not receive pain relief before attendance at the A&E department. Reasons for parents not giving pain relief included 57/203 (28%) who thought that giving painkillers would be harmful; 43/203 (21%) who did not give painkillers because the accident did not happen at home; and 15/203 (7%) who thought analgesia was the responsibility of the hospital. Eighty eight of the 276 (32%) did not have any painkillers, suitable for children, at home. A&E staff administered pain relief in 189/276 (68%). CONCLUSIONS: Parents often do not give their children pain relief before attending the A&E department. Parents think that giving painkillers may be harmful and often do not have simple analgesics at home. Some parents do not perceive that their child is in pain. Parents require education about appropriate pre-hospital pain relief for their children. PMID:10417932

An integrated pest control strategy against the Asian tiger mosquito in northern Italy: a case study.

PubMed

Baldacchino, Frédéric; Bussola, Francesca; Arnoldi, Daniele; Marcantonio, Matteo; Montarsi, Fabrizio; Capelli, Gioia; Rosà, Roberto; Rizzoli, Annapaola

2017-01-01

In Europe, Aedes albopictus is an invasive mosquito species known to be a major nuisance as well as a vector of a range of arboviruses. A number of studies have indicated that community participation programmes are an effective pest control tool to reduce mosquito populations. However, few studies have evaluated the effectiveness of a community-based approach in Europe. In this study, we examined two Ae. albopictus control strategies that implemented a community-based approach in northern Italy: one was a partial intervention that included a public education campaign and the larviciding of public spaces, and the other was a full intervention that additionally included a door-to-door campaign. This latter consisted of going door to door actively to educate residents about control measures and deliver larvicide tablets for treating catch basins at home. A site where no intervention measures were carried out was used as a control. In the site where a full intervention was carried out, Ae. albopictus egg density was 1.6 times less than at the site that received partial intervention, and 1.9 times less than at the non-intervention site. No significant reduction in egg density was achieved in the partial intervention site. In our study, Ae. albopictus populations were most effectively reduced by larviciding both public and private catch basins. Door-to-door education was effective in convincing residents to apply control measures on their property; however, this method was labour intensive and costly. It may be possible to reduce personnel costs by involving volunteers or using a 'hot spot' approach. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Validation of a Conceptual Quality Framework for Online and Blended Learning with Success Factors and Indicators in Adult Education: A Qualitative Study

ERIC Educational Resources Information Center

Blieck, Yves; Ooghe, Ilse; Zhu, Chang; Depryck, Koen; Struyven, Katrien; Pynoo, Bram; Van Laer, Hilde

2017-01-01

This qualitative study was designed to identify a framework for the quality of OBL in adult education (AE), which are of interest to the needs of students. Following a review of the literature, we opted for the theoretical framework as proposed by Ossiannilsson and Landgren (2012). This framework suggests success factors for OBL that are of…

Safety profile of avelumab in patients with advanced solid tumors: A pooled analysis of data from the phase 1 JAVELIN solid tumor and phase 2 JAVELIN Merkel 200 clinical trials

PubMed Central

Infante, Jeffrey R.; Taylor, Matthew H.; Patel, Manish R.; Wong, Deborah J.; Iannotti, Nicholas; Mehnert, Janice M.; Loos, Anja H.; Koch, Helga; Speit, Isabell; Gulley, James L.

2018-01-01

BACKGROUND Antibodies targeting the programmed death‐ligand 1 (PD‐L1)/programmed cell death protein 1 (PD‐1) checkpoint may cause adverse events (AEs) that are linked to the mechanism of action of this therapeutic class and unique from those observed with conventional chemotherapy. METHODS Patients with advanced solid tumors who were enrolled in the phase 1 JAVELIN Solid Tumor (1650 patients) and phase 2 JAVELIN Merkel 200 (88 patients) trials received avelumab, a human anti–PD‐L1 IgG1 antibody at a dose of 10 mg/kg every 2 weeks. Treatment‐related AEs (TRAEs) were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0). In post hoc analyses, immune‐related AEs (irAEs) were identified via an expanded AE list and medical review, and infusion‐related reactions (IRRs) occurring ≤2 days after infusion and symptoms occurring ≤1 day after infusion and resolving ≤2 days after onset were identified based on prespecified Medical Dictionary for Regulatory Activities (MedDRA) terms. RESULTS Of the 1738 patients analyzed, grade ≥3 TRAEs occurred in 177 (10.2%); the most common were fatigue (17 patients; 1.0%) and IRR (10 patients; 0.6%). TRAEs led to discontinuation in 107 patients (6.2%) and death in 4 patients (0.2%). Grade ≥3 irAEs occurred in 39 patients (2.2%) and led to discontinuation in 34 patients (2.0%). IRRs or related symptoms occurred in 439 patients (25.3%; grade 3 in 0.5% [9 patients] and grade 4 in 0.2% [3 patients]). An IRR occurred at the time of first infusion in 79.5% of 439 patients who had an IRR, within the first 4 doses in 98.6% of 439 patients who had an IRR, and led to discontinuation in 35 patients (2.0%). CONCLUSIONS Avelumab generally was found to be well tolerated and to have a manageable safety profile. A minority of patients experienced grade ≥3 TRAEs or irAEs, and discontinuation was uncommon. IRRs occurred mainly at the time of first infusion, and repeated events were infrequent. Cancer 2018;124:2010‐7. © 2018 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. PMID:29469949

Safety profile of avelumab in patients with advanced solid tumors: A pooled analysis of data from the phase 1 JAVELIN solid tumor and phase 2 JAVELIN Merkel 200 clinical trials.

PubMed

Kelly, Karen; Infante, Jeffrey R; Taylor, Matthew H; Patel, Manish R; Wong, Deborah J; Iannotti, Nicholas; Mehnert, Janice M; Loos, Anja H; Koch, Helga; Speit, Isabell; Gulley, James L

2018-05-01

Antibodies targeting the programmed death-ligand 1 (PD-L1)/programmed cell death protein 1 (PD-1) checkpoint may cause adverse events (AEs) that are linked to the mechanism of action of this therapeutic class and unique from those observed with conventional chemotherapy. Patients with advanced solid tumors who were enrolled in the phase 1 JAVELIN Solid Tumor (1650 patients) and phase 2 JAVELIN Merkel 200 (88 patients) trials received avelumab, a human anti-PD-L1 IgG1 antibody at a dose of 10 mg/kg every 2 weeks. Treatment-related AEs (TRAEs) were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0). In post hoc analyses, immune-related AEs (irAEs) were identified via an expanded AE list and medical review, and infusion-related reactions (IRRs) occurring ≤2 days after infusion and symptoms occurring ≤1 day after infusion and resolving ≤2 days after onset were identified based on prespecified Medical Dictionary for Regulatory Activities (MedDRA) terms. Of the 1738 patients analyzed, grade ≥3 TRAEs occurred in 177 (10.2%); the most common were fatigue (17 patients; 1.0%) and IRR (10 patients; 0.6%). TRAEs led to discontinuation in 107 patients (6.2%) and death in 4 patients (0.2%). Grade ≥3 irAEs occurred in 39 patients (2.2%) and led to discontinuation in 34 patients (2.0%). IRRs or related symptoms occurred in 439 patients (25.3%; grade 3 in 0.5% [9 patients] and grade 4 in 0.2% [3 patients]). An IRR occurred at the time of first infusion in 79.5% of 439 patients who had an IRR, within the first 4 doses in 98.6% of 439 patients who had an IRR, and led to discontinuation in 35 patients (2.0%). Avelumab generally was found to be well tolerated and to have a manageable safety profile. A minority of patients experienced grade ≥3 TRAEs or irAEs, and discontinuation was uncommon. IRRs occurred mainly at the time of first infusion, and repeated events were infrequent. Cancer 2018;124:2010-7. © 2018 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2018 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Unscheduled return visits by patients to the accident and emergency department.

PubMed Central

O'Dwyer, F; Bodiwala, G G

1991-01-01

To determine why patients reattend an A&E department we surveyed 235 patients who returned unscheduled in a one-month period. Sixty-two per cent returned because of persistent symptoms. Sixty-three per cent presented within a week of their initial visit. Only 32% had attempted to see their GP. Thirty-five per cent of all patients claimed that A&E staff had advised them to return if they had problems. Half of the patients did not require treatment and 61% were discharged home. Twenty-one patients had pathology that had been missed on their first visit. Better patient education may minimize misuse of the service allowing better care for those who need it. PMID:1930505

Temporal Dynamics and Spatial Patterns of Aedes aegypti Breeding Sites, in the Context of a Dengue Control Program in Tartagal (Salta Province, Argentina).

PubMed

Espinosa, Manuel; Weinberg, Diego; Rotela, Camilo H; Polop, Francisco; Abril, Marcelo; Scavuzzo, Carlos Marcelo

2016-05-01

Since 2009, Fundación Mundo Sano has implemented an Aedes aegypti Surveillance and Control Program in Tartagal city (Salta Province, Argentina). The purpose of this study was to analyze temporal dynamics of Ae. aegypti breeding sites spatial distribution, during five years of samplings, and the effect of control actions over vector population dynamics. Seasonal entomological (larval) samplings were conducted in 17,815 fixed sites in Tartagal urban area between 2009 and 2014. Based on information of breeding sites abundance, from satellite remote sensing data (RS), and by the use of Geographic Information Systems (GIS), spatial analysis (hotspots and cluster analysis) and predictive model (MaxEnt) were performed. Spatial analysis showed a distribution pattern with the highest breeding densities registered in city outskirts. The model indicated that 75% of Ae. aegypti distribution is explained by 3 variables: bare soil coverage percentage (44.9%), urbanization coverage percentage(13.5%) and water distribution (11.6%). This results have called attention to the way entomological field data and information from geospatial origin (RS/GIS) are used to infer scenarios which could then be applied in epidemiological surveillance programs and in the determination of dengue control strategies. Predictive maps development constructed with Ae. aegypti systematic spatiotemporal data, in Tartagal city, would allow public health workers to identify and target high-risk areas with appropriate and timely control measures. These tools could help decision-makers to improve health system responses and preventive measures related to vector control.

Temporal Dynamics and Spatial Patterns of Aedes aegypti Breeding Sites, in the Context of a Dengue Control Program in Tartagal (Salta Province, Argentina)

PubMed Central

Espinosa, Manuel; Weinberg, Diego; Rotela, Camilo H.; Polop, Francisco; Abril, Marcelo; Scavuzzo, Carlos Marcelo

2016-01-01

Background Since 2009, Fundación Mundo Sano has implemented an Aedes aegypti Surveillance and Control Program in Tartagal city (Salta Province, Argentina). The purpose of this study was to analyze temporal dynamics of Ae. aegypti breeding sites spatial distribution, during five years of samplings, and the effect of control actions over vector population dynamics. Methodology/Principal Findings Seasonal entomological (larval) samplings were conducted in 17,815 fixed sites in Tartagal urban area between 2009 and 2014. Based on information of breeding sites abundance, from satellite remote sensing data (RS), and by the use of Geographic Information Systems (GIS), spatial analysis (hotspots and cluster analysis) and predictive model (MaxEnt) were performed. Spatial analysis showed a distribution pattern with the highest breeding densities registered in city outskirts. The model indicated that 75% of Ae. aegypti distribution is explained by 3 variables: bare soil coverage percentage (44.9%), urbanization coverage percentage(13.5%) and water distribution (11.6%). Conclusions/Significance This results have called attention to the way entomological field data and information from geospatial origin (RS/GIS) are used to infer scenarios which could then be applied in epidemiological surveillance programs and in the determination of dengue control strategies. Predictive maps development constructed with Ae. aegypti systematic spatiotemporal data, in Tartagal city, would allow public health workers to identify and target high-risk areas with appropriate and timely control measures. These tools could help decision-makers to improve health system responses and preventive measures related to vector control. PMID:27223693

Airside HVAC BESTEST. Adaptation of ASHRAE RP 865 Airside HVAC Equipment Modeling Test Cases for ASHRAE Standard 140. Volume 1, Cases AE101-AE445

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

Neymark, J.; Kennedy, M.; Judkoff, R.

This report documents a set of diagnostic analytical verification cases for testing the ability of whole building simulation software to model the air distribution side of typical heating, ventilating and air conditioning (HVAC) equipment. These cases complement the unitary equipment cases included in American National Standards Institute (ANSI)/American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs, which test the ability to model the heat-transfer fluid side of HVAC equipment.

The Epidemiology of Deltoid Ligament Sprains in 25 National Collegiate Athletic Association Sports, 2009–2010 Through 2014–2015 Academic Years

PubMed Central

Kopec, Thomas J.; Hibberd, Elizabeth E.; Roos, Karen G.; Djoko, Aristarque; Dompier, Thomas P.; Kerr, Zachary Y.

2017-01-01

Context: Deltoid ligament sprains among collegiate student-athletes have not been extensively investigated. Research regarding the mechanisms, participation-restriction time, and recurrence of deltoid ligament sprains in collegiate student-athletes is lacking. Objective: To describe the epidemiology of deltoid ligament sprains in 25 National Collegiate Athletic Association championship sports. Design: Descriptive epidemiology study. Setting: National Collegiate Athletic Association Injury Surveillance Program. Main Outcome Measure(s): We analyzed deltoid ligament sprains recorded in the Injury Surveillance Program for the 2009–2010 through 2014–2015 academic years. Deltoid ligament sprain injury rates, rate ratios, and injury proportion ratios with 95% confidence intervals (CIs) were reported. Results: During the study period, 380 deltoid ligament sprains were reported, resulting in a combined injury rate of 0.79/10 000 athlete-exposures (AEs; 95% CI = 0.71, 0.87). Most deltoid ligament sprains occurred in practices (54.2%, n = 206). However, the competition injury rate was higher than the practice injury rate (rate ratio = 3.74; 95% CI = 3.06, 4.57). The highest deltoid ligament sprain rates were in women's gymnastics (2.30/10 000 AEs; 95% CI = 1.05, 3.55), men's soccer (1.73/10 000 AEs; 95% CI = 1.14, 2.32), women's soccer (1.61/10 000 AEs; 95% CI = 1.13, 2.09), and men's football (1.40/10 000 AEs; 95% CI = 1.18, 1.62). Nearly half of all deltoid ligament sprains (49.7%, n = 189) were due to player contact, and 39.5% (n = 150) were non–time-loss injuries (ie, participation restricted for less than 24 hours). Only 8.2% (n = 31) of deltoid ligament sprains were recurrent. Conclusions: The highest deltoid ligament sprain rates were in women's gymnastics, men's and women's soccer, and men's football. However, the rate for women's gymnastics was imprecise (ie, the CI was wide), highlighting the need for further surveillance of deltoid ligament sprains in the sport. Most deltoid ligament sprains were due to player contact. Future researchers should assess interventions that may prevent deltoid ligament sprains. PMID:28318315

Exercise-induced changes in cardiovascular function after stroke: a randomized controlled trial

PubMed Central

Tang, Ada; Krassioukov, Andrei V; Madden, Kenneth M; Mohammadi, Azam; Tsang, Michael YC; Tsang, Teresa SM

2015-01-01

Background and aims Cardiovascular co-morbidities are prevalent after stroke, with heart disease, hypertension and impaired glucose tolerance present in the majority of cases. Exercise has the potential to mediate cardiovascular risk factors commonly present in people with stroke. This single-blinded randomized controlled trial compared the effects of high versus low intensity exercise on fitness, cardiovascular risk factors, and cardiac function after stroke. Methods Fifty participants (age 50–80y, >1y post-stroke) were randomized to a high-intensity Aerobic Exercise (AE) or low-intensity non-aerobic Balance/Flexibility (BF) program (6 months, 3 60-minute sessions/week). Outcomes assessed by VO2peak (primary outcome), arterial stiffness, ambulatory capacity, hemodynamics and cardiac function using echocardiography, and lipid, glucose and homocysteine levels. Assessors were blinded to group allocation. Results Twenty-three (92%) of 25 AE group participants (withdrawals unrelated to the intervention) and all BF group participants completed the program. One BF group participant experienced 2 non-injurious falls during class. No other adverse events occurred. There were no changes in VO2peak in either group (AE 16.9±7 to 17.4±7 ml•kg−1•min−1 vs. BF 16.9±6 to 16.6±5 ml•kg−1•min−1, P=0.45), but AE group demonstrated greater improvement in right atrial emptying fraction (AE 30±22 to 37±22% vs. BF 35±20 to 31±20%, P=0.04). Both groups demonstrated improvements in lipid profiles, glucose and homocysteine levels, and ambulatory capacity (P<0.04). Conclusions This was the first study to examine the effects of aerobic exercise after stroke on cardiovascular hemodynamics. High-intensity exercise improved right-sided function and early myocardial relaxation. Low-intensity exercise may also benefit plasma lipid, glucose and inflammatory markers, and ambulatory capacity. This study is an important step towards understanding mechanisms by which exercise may reduce cardiovascular risk and function. Clinical Trial Registration Information http://www.clinicaltrials.gov. Unique identifier: NCT01189045 PMID:24148695

Characterizing Musculoskeletal Injury among Aeromedical Evacuation Personnel: An Observational Study

DTIC Science & Technology

2016-09-28

three phases: a sampling study, laboratory observations, and field observations. In Phase I, 43 active duty AECMs volunteered to complete a...was administered via SurveyMonkey to volunteers from the USAFSAM Education and Training Department and the four active duty AE squadrons. The

Current Issues in Research on Intelligence. ERIC/AE Digest.

ERIC Educational Resources Information Center

Yekovich, Frank R.

Intelligence has been defined and studied under a number of different rubrics. Three individuals serve as a representative sample of the educational and psychological researchers associated with cognitive psychology who have made significant contributions to current understandings of intelligence. Robert Sternberg's theory contains subcategories…

Use of Active-Play Video Games to Enhance Aerobic Fitness in Schizophrenia: Feasibility, Safety, and Adherence.

PubMed

Kimhy, David; Khan, Samira; Ayanrouh, Lindsey; Chang, Rachel W; Hansen, Marie C; Lister, Amanda; Ballon, Jacob S; Vakhrusheva, Julia; Armstrong, Hilary F; Bartels, Matthew N; Sloan, Richard P

2016-02-01

Active-play video games have been used to enhance aerobic fitness in various clinical populations, but their use among individuals with schizophrenia has been limited. Feasibility, acceptability, safety, and adherence data were obtained for use of aerobic exercise (AE) equipment by 16 individuals with schizophrenia during a 12-week AE program consisting of three one-hour exercise sessions per week. Equipment included exercise video games for Xbox 360 with Kinect motion sensing devices and traditional exercise equipment. Most participants (81%) completed the training, attending an average of 79% of sessions. The proportion of time spent playing Xbox (39%) exceeded time spent on any other type of equipment. When using Xbox, participants played 2.24±1.59 games per session and reported high acceptability and enjoyment ratings, with no adverse events. Measures of feasibility, acceptability, adherence, and safety support the integration of active-play video games into AE training for people with schizophrenia.

[Distribution of Aedes albopictus (Skuse) in Nuevo León, México, 2001-2004].

PubMed

Orta-Pesina, Héctor; Mercado-Hernández, Roberto; Elizondo-Leal, José Fernando

2005-01-01

To determine the distribution of Aedes albopictus (Skuse) in Nuevo Leon between 2001 and 2004. Standardized methods were used to collect 6371 samples of mosquito's larvae from 167 sites. The proportions of samples positive for Ae. albopictus were obtained by municipality and year, using the software program Excel. There were 1179 samples positive for Ae. albopictus. This species was distributed over 10 municipalities, as follows: Five on the Gulf of Mexico Coastal Plains, which predominantly have a semi-warm, sub-humid climate, and precipitations almost year round (Allende, Montemorelos, Linares, General Teran, and Santiago); two (Sabinas Hidalgo, and Cadereyta) localized on the North American Great Plains, which have a warm, semiarid climate, and scarce precipitations. The final three were Apodaca, San Nicolas, and Escobedo distributed over the metropolitan area of Monterrey City. Up to January 2004, the second most important epidemiological vector in the transmission cycle of Ae. albopictus worldwide was found in ten municipalities of Nuevo Leon State, Mexico.

Characterization of a New HIV-1 CRF01_AE/ CRF07_BC recombinant virus in Tianjin, China.

PubMed

Zhou, Zhehua; Ma, Ping; Feng, Yi; Ou, Weidong; Qian, Jing; Gao, Liying; Zhang, Defa; Shao, Yiming; Wei, Min

2018-05-04

Human immunodeficiency virus (HIV) is notorious for its rapid evolving since its transmissions from money to human. Currently, HIV contains multiple subtypes, circulating recombinant forms (CRFs) and unique recombinant forms (URFs). Here, from an HIV-positive mother and her child in Tianjin, China, we identified a novel HIV-1 second-generation recombinant virus (TJ20170316 and TJ20170317) between CRF01_AE and CRF07_BC. Near full-length genomes were obtained from both samples, and they shared very close sequences, except some point mutations. Phylogenetic analyses of the near full-length genomes showed that they consist of CRF01_AE backbone and part CRF07_BC sequences. Recombinant Identification Program (RIP) and Simplot software identified four breakpoints in gag, pol, vif, tat genes in TJ20170316, totally different from other reported CRFs and URFs. The emergence of such URF in Tianjin, China, highlights the complexity of HIV-1 epidemic and more measures should be taken to prevent HIV transmissions.

High-Resolution AES Mapping and TEM Study of Cu(In,Ga)Se2 Thin Film Growth: Preprint

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

Perkins, C. L.; Yan, Y.; Jones, K.

2001-10-01

Presented at 2001 NCPV Program Review Meeting: TEM and high-resolution AES mapping data on CIGS samples. The chalcopyrite Cu(In,Ga)Se{sub 2} (CIGS) shows promise as an absorber layer in thin polycrystalline solar cells, however, details of the PVD growth of this complicated material remain in a developing stage. Previous workers have postulated the existence of a thin film of liquid Cu{sub x}Se on the growing CIGS film, and that this layer acts as a reservoir of copper as well as a layer in which rapid mass transport is possible. In this paper we present transmission electron microscopy (TEM) and high resolutionmore » Auger electron spectroscopy (AES) mapping data taken on samples that had their growth interrupted at a stage when Cu{sub x}Se was expected to be present. The AES maps show CIGS grains which are highly enriched in copper relative to the rest of the CIGS film, and that these same areas contain almost no indium, results consistent with the presence of CuxSe. Small-area diffraction analysis and energy dispersive spectroscopy (EDS) performed on these same samples independently confirm the presence of Cu{sub x}Se at the surface of growing CIGS films.« less

Shoulder Arthroscopy in Adults 60 or Older: Risk Factors That Correlate With Postoperative Complications in the First 30 Days.

PubMed

Rubenstein, William J; Pean, Christian A; Colvin, Alexis C

2017-01-01

To investigate the 30-day postoperative adverse event (AE) rates of adults 60 years or older after shoulder arthroscopy and identify risk factors for complications in this patient population. Patients aged 60 or more who underwent shoulder arthroscopy were identified in the American College of Surgeons National Surgery Quality Improvement Program database from 2006 to 2013 using 12 Current Procedural Terminology codes related to shoulder arthroscopy. Complications were categorized as severe AEs, minor AEs, and infectious AEs for separate analyses. Pearson's χ 2 tests were used to identify associations between patient characteristics and AE occurrence and binary logistic regression for multivariate analysis of independent risk factors. In total, 7,867 patients were included for analysis. Overall, 1.6% (n = 127) of the older adults experienced at least one AE with 1.1% (n = 90) severe AEs, 0.6% (n = 46) minor AEs, and 0.4% (n = 28) infectious complications. Multivariate analysis revealed that age 80 years or older (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 1.2-2.7, P = .01), body mass index greater than 35 (OR = 1.8, 95% CI = 1.1-2.7, P = .01), functionally dependent status (OR = 2.9, 95% CI = 1.3-6.8, P = .01), American Society of Anesthesiologists class greater than 2 (OR = 1.5, 95% CI = 1.0-2.2, P = .04), congestive heart failure (OR = 6.1, 95% CI = 1.8-21.2, P = .03), disseminated cancer (OR = 7.9, 95% CI = 1.4-43.9, P = .02), and existence of an open wound at the time of surgery (OR = 4.0, 95% CI = 1.1-14.6, P = .03) were independently associated with the occurrence of an AE. Nineteen of the patients included in the study required readmission to the hospital within the 30-day period for an overall readmission rate of 0.2%. Patients 60 years or older who underwent shoulder arthroscopy for a variety of indications have a low overall 30-day postoperative complication rate of 1.6%. Although low, this is a higher rate than previously reported for the overall shoulder arthroscopy population. Independent patient characteristics associated with increased risk of AE occurrence included age 80 years or older, body mass index greater than 35, functional dependent status, American Society of Anesthesiologists score of 3 or 4, congestive heart failure, disseminated cancer, and existence of an open wound. Level III, retrospective comparative study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Ball-Contact Injuries in 11 National Collegiate Athletic Association Sports: The Injury Surveillance Program, 2009-2010 Through 2014-2015.

PubMed

Fraser, Melissa A; Grooms, Dustin R; Guskiewicz, Kevin M; Kerr, Zachary Y

2017-07-01

  Surveillance data regarding injuries caused by ball contact in collegiate athletes have not been well examined and are mostly limited to discussions of concussions and catastrophic injuries.   To describe the epidemiology of ball-contact injuries in 11 National Collegiate Athletic Association (NCAA) sports during the 2009-2010 through 2014-2015 academic years.   Descriptive epidemiology study.   Convenience sample of NCAA programs in 11 sports (men's football, women's field hockey, women's volleyball, men's baseball, women's softball, men's and women's basketball, men's and women's lacrosse, and men's and women's soccer) during the 2009-2010 through 2014-2015 academic years.   Collegiate student-athletes participating in 11 sports.   Ball-contact-injury rates, proportions, rate ratios, and proportion ratios with 95% confidence intervals were based on data from the NCAA Injury Surveillance Program during the 2009-2010 through 2014-2015 academic years.   During the 2009-2010 through 2014-2015 academic years, 1123 ball-contact injuries were reported, for an overall rate of 3.54/10 000 AEs. The sports with the highest rates were women's softball (8.82/10 000 AEs), women's field hockey (7.71/10 000 AEs), and men's baseball (7.20/10 000 AEs). Most ball-contact injuries were to the hand/wrist (32.7%) and head/face (27.0%) and were diagnosed as contusions (30.5%), sprains (23.1%), and concussions (16.1%). Among sex-comparable sports (ie, baseball/softball, basketball, and soccer), women had a larger proportion of ball-contact injuries diagnosed as concussions than men (injury proportion ratio = 2.33; 95% confidence interval = 1.63, 3.33). More than half (51.0%) of ball-contact injuries were non-time loss (ie, participation-restriction time <24 hours), and 6.6% were severe (ie, participation-restriction time ≥21 days). The most common severe ball-contact injuries were concussions (n = 18) and finger fractures (n = 10).   Ball-contact-injury rates were the highest in women's softball, women's field hockey, and men's baseball. Although more than half were non-time-loss injuries, severe injuries such as concussions and fractures were reported.

EFFECTS: an expanded access program of everolimus for patients with subependymal giant cell astrocytoma associated with tuberous sclerosis complex.

PubMed

Fogarasi, Andras; De Waele, Liesbeth; Bartalini, Gabriella; Jozwiak, Sergiusz; Laforgia, Nicola; Verhelst, Helene; Petrak, Borivoj; Pedespan, Jean-Michel; Witt, Olaf; Castellana, Ramon; Crippa, Stefania; Gislimberti, Gabriella; Gyorsok, Zsuzsanna

2016-08-08

Everolimus, a mammalian target of rapamycin (mTOR) inhibitor, has been shown to be effective and safe in the treatment of subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex (TSC). The Everolimus For Fast Expanded aCcess in TSC SEGA (EFFECTS) study was designed to provide everolimus access to patients with SEGA associated with TSC and to mainly assess the safety and also efficacy of everolimus in a real-world setting. EFFECTS was a phase 3b, open-label, noncomparative, multicenter, expanded access study. Eligible patients were ≥ 3 years of age, with a definite diagnosis of TSC, and with at least one SEGA lesion identified by MRI or CT scan. Patients received once daily everolimus (dose adjusted to attain a trough level of 5-15 ng/mL). Safety evaluation was the primary objective and included collection of adverse events (AEs) and serious AEs, with their severity and relationship to everolimus. Efficacy evaluation, which was the secondary objective, was based on the best overall response as per medical judgment. Of the 120 patients enrolled, 100 (83.3%) completed the study. Median age of patients was 11 years (range, 1-47). Median daily dose of everolimus was 5.82 mg (range, 2.0-11.8). Median duration of exposure was 56.5 weeks (range, 0.3-130). The overall incidence of AEs was 74.2%. Aphthous stomatitis (18 [15.0%]), pyrexia (18 [15.0%]), bronchitis (11 [9.2%]), and stomatitis (10 [8.3%]) were the most common AEs reported. Overall, 25 patients had grade 3 AEs; most frequent was stomatitis (4 [3.3%]). Grade 4 AEs were reported in three (2.5%) patients. A total of 62 (51.7%) patients had suspected drug-related AEs, of which 15 (12.5%) were of grade 3 or 4. In eight (6.7%) patients, AEs led to drug discontinuation. With regard to efficacy, 81 (67.5%) patients had a partial response, 35 (29.2%) had a stable disease, and one (0.8%) had progressive disease. The response was unknown in three (2.5%) patients. This study confirms the acceptable safety profile of everolimus in patients with SEGA associated with TSC in a real-world setting. The results further support the efficacy of everolimus in the treatment of SEGA associated with TSC. (EudraCT: 2010-022583-13).

The use of nonsteroidal anti-inflammatory drugs and analgesics by liver transplant recipients.

PubMed

Mulka-Gierek, Maria; Foroncewicz, Bartosz; Florczak, Michał; Pączek, Leszek; Krawczyk, Marek; Mucha, Krzysztof

2016-04-01

This study aimed to assess the reasons and the frequency of the use of over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) or analgesics by liver transplant recipients (LTR). Patient awareness of possible drug-related side-effects was also assessed. NSAIDs and analgesics available without prescription belong to the most commonly used class of drugs. However, use of these drugs might be complicated by toxic adverse effects (AEs). Patients at risk for AEs include the transplant recipients. This was a descriptive study. An anonymous survey was carried out in 73 randomly selected LTR, who represented 10% of all LTR at our centre. There were 64% of the patients who confirmed taking NSAIDs or analgesics; 16% of these patients took these drugs at least several times a week and 10% took them daily. For 39% of patients, the only way to manage their pain were OTC NSAIDs or analgesics. As many as 36% of patients were unaware of the risks associated with the use of these drugs. Ninety per cent of LTR consider physicians the most trusted source of drugs information. Our study shows that two-thirds of LTR take OTC NSAIDs or analgesics and one-third are unaware of the AEs associated with these drugs. Therefore, both transplant nurses and doctors should educate their patients about the use and possible AE of these drugs. Considering the high NSAIDs consumption rates, the side effects of these drugs should always be suspected. Especially in patients taking these drugs and referring to medical advisors with specific symptoms, such as: abdominal pain, anaemia, elevated serum creatinine concentration or liver enzymes activity. Awareness of the scale of the problem enables health professionals to cooperate in educating patients. Such practices may reduce uncontrolled abuse of these drugs and related health care costs. © 2016 John Wiley & Sons Ltd.

The Role of Pay Satisfaction in Instructor Satisfaction

ERIC Educational Resources Information Center

Wilson, Jackson

2009-01-01

Voluntary employee turnover is a major factor affecting adventure education (AE) organizations (Garret, 2003). Voluntary turnover often is dysfunctional for both employees and organizations (Birmingham, 1989; Podsakoff, LePine, & LePine, 2007). Turnover can result in increased employee and organizational costs (e.g., McKinney, Bartlett, &…

Design and methods of a postmarketing pharmacoepidemiology study assessing long-term safety of Prolia® (denosumab) for the treatment of postmenopausal osteoporosis.

PubMed

Xue, Fei; Ma, Haijun; Stehman-Breen, Catherine; Haller, Christine; Katz, Leonid; Wagman, Rachel B; Critchlow, Cathy W

2013-10-01

To describe the rationale and methods for a prospective, open-cohort study assessing the long-term safety of Prolia(®) for treatment of postmenopausal osteoporosis (PMO) in postmarketing settings. Data will be derived from United States Medicare, United Healthcare, and Nordic (Denmark, Sweden, Norway) national registries. Observation will begin on the date of first Prolia(®) regulatory approval (May 26, 2010) and continue for 10 years. Women with PMO will be identified by postmenopausal age, osteoporosis diagnosis, osteoporotic fracture, or osteoporosis treatment. Exposure to Prolia(®) and bisphosphonates will be updated during follow-up; exposure cohorts will be defined based on patient-years during which patients are on- or post-treatment. Nine adverse events (AEs) will be assessed based on diagnosis codes: osteonecrosis of the jaw (ONJ), atypical femoral fracture (AFF), fracture healing complications, hypocalcemia, infection, dermatologic AEs, acute pancreatitis, hypersensitivity, and new primary malignancy. Medical review will confirm selected potential cases of ONJ and AFF. Incidence rates (IRs) of AEs will be described overall and for exposure cohorts; multivariate Cox proportional hazard regression models will compare IRs of AEs across exposure cohorts. Utilization patterns of Prolia(®) for approved, and unapproved indications will be described. This study is based on comprehensive preliminary research and considers methodological challenges specific to the study population. The integrated data systems used in this regulatory committed program can serve as a powerful data resource to assess diverse and rare AEs over time. © 2013 Amgen Inc. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd.

National Patient Safety Program in Brazil: Incidents Reported Between 2014 and 2017.

PubMed

Faustino, Tássia Nery; Batalha, Edenise Maria Santos da Silva; Vieira, Silvana Lima; Nicole, Andressa Garcia; Morais, Alexandre Souza; Tronchin, Daisy Maria Rizatto; Melleiro, Marta Maria

2018-05-16

The aim of the study was to analyze the patient safety incidents reported to the Brazilian National Health Surveillance System from March 2014 to March 2017. A documentary study that used the records of the incidents published in the Reports of Adverse Events (AE) in Brazil. The following variables were selected: number of incidents by type, type of health service, hospital unit, and degree of harm. To find whether there was a significant difference across the Brazilian regions by notifications related to general incidents, AE, and deaths, the analysis of variance and the Tukey tests were used. A total of 109,082 incidents were reported, of which 75,088 were AE, with 649 deaths. In relation to the types of incidents reported, there was a higher frequency in the categories other (30.04%) and failures during health care (26.72%). A total of 93.90% of the incidents occurred in hospitals, with 54,950 cases registered in hospitalization units and 30,141 cases in intensive care units. Statistically significant differences across the Brazilian regions were observed in the number of incidents (P = 0.004), AE (P = 0.004), and deaths (P = 0.024). A significant underreporting of incidents was found in Brazil, demonstrating only the tip of a giant iceberg. More than half of the incidents were reported as AE and were registered in hospitals, reiterating the importance of establishing public health policies at national, state, and municipal levels, with adequate supervision of the health service regarding the implementation of the Patient Safety Nuclei and the preparation of new protocols based on the most prevalent incidents.

Safety Profile of Cough and Cold Medication Use in Pediatrics.

PubMed

Green, Jody L; Wang, George Sam; Reynolds, Kate M; Banner, William; Bond, G Randall; Kauffman, Ralph E; Palmer, Robert B; Paul, Ian M; Dart, Richard C

2017-06-01

The safety of cough and cold medication (CCM) use in children has been questioned. We describe the safety profile of CCMs in children <12 years of age from a multisystem surveillance program. Cases with adverse events (AEs) after ingestion of at least 1 index CCM ingredient (brompheniramine, chlorpheniramine, dextromethorphan, diphenhydramine, doxylamine, guaifenesin, phenylephrine, and pseudoephedrine) in children <12 years of age were collected from 5 data sources. An expert panel determined relatedness, dose, intent, and risk factors. Case characteristics and AEs are described. Of the 4202 cases reviewed, 3251 (77.4%) were determined to be at least potentially related to a CCM, with accidental unsupervised ingestions (67.1%) and medication errors (13.0%) the most common exposure types. Liquid (67.3%), pediatric (75.5%), and single-ingredient (77.5%) formulations were most commonly involved. AEs occurring in >20% of all cases included tachycardia, somnolence, hallucinations, ataxia, mydriasis, and agitation. Twenty cases (0.6%) resulted in death; most were in children <2 years of age (70.0%) and none involved a therapeutic dose. The overall reported AE rate was 0.573 cases per 1 million units (ie, tablets, gelatin capsules, or liquid equivalent) sold (95% confidence interval, 0.553-0.593) or 1 case per 1.75 million units. The rate of AEs associated with CCMs in children was low. Fatalities occurred even less frequently. No fatality involved a therapeutic dose. Accidental unsupervised ingestions were the most common exposure types and single-ingredient, pediatric liquid formulations were the most commonly reported products. These characteristics present an opportunity for targeted prevention efforts. Copyright © 2017 by the American Academy of Pediatrics.

Suppression of a Field Population of Aedes aegypti in Brazil by Sustained Release of Transgenic Male Mosquitoes

PubMed Central

Garziera, Luiza; Lacroix, Renaud; Donnelly, Christl A.; Alphey, Luke; Malavasi, Aldo; Capurro, Margareth L.

2015-01-01

The increasing burden of dengue, and the relative failure of traditional vector control programs highlight the need to develop new control methods. SIT using self-limiting genetic technology is one such promising method. A self-limiting strain of Aedes aegypti, OX513A, has already reached the stage of field evaluation. Sustained releases of OX513A Ae. aegypti males led to 80% suppression of a target wild Ae. aegypti population in the Cayman Islands in 2010. Here we describe sustained series of field releases of OX513A Ae. aegypti males in a suburb of Juazeiro, Bahia, Brazil. This study spanned over a year and reduced the local Ae. aegypti population by 95% (95% CI: 92.2%-97.5%) based on adult trap data and 81% (95% CI: 74.9-85.2%) based on ovitrap indices compared to the adjacent no-release control area. The mating competitiveness of the released males (0.031; 95% CI: 0.025-0.036) was similar to that estimated in the Cayman trials (0.059; 95% CI: 0.011 – 0.210), indicating that environmental and target-strain differences had little impact on the mating success of the OX513A males. We conclude that sustained release of OX513A males may be an effective and widely useful method for suppression of the key dengue vector Ae. aegypti. The observed level of suppression would likely be sufficient to prevent dengue epidemics in the locality tested and other areas with similar or lower transmission. PMID:26135160

Adverse events in cardiac surgery, a mixed methods retrospective study in an Italian teaching hospital.

PubMed

Bellandi, Tommaso; Tartaglia, Riccardo; Forni, Silvia; D'Arienzo, Sara; Tulli, Giorgio

2017-08-01

Adverse events (AEs) are a major concern in surgery, but the evidence in cardiac surgery is limited, especially on the contributory factors. According to the data of the National Outcomes Program, a unit was selected to conduct a mixed methods investigation into the incidence, type, and cause of AE, given its mortality rate that was double the national average on coronary artery bypass grafting, valve reparation, and replacement. A retrospective investigation on the performance of a cardiac surgery, combining the routinely collected data on process and outcome measures with a 2-stage structured review of 280 medical records performed by 3 expert clinicians, with the support of a methodologist. At least one risk had been verified in 137 of 280 cases (48.9%, 95% CI, 43.1-54.8). The total number of AE was 42, with an incidence of 15% (95% CI, 10.8-20.2) and a preventability of 80.9% (95% CI, 69.1-92.8). In 11.9% of AE, the consequence is death, disability in 40.5%, and extended hospital stay in 69% of the cases. Adverse events are associated with problems in care management at the ward (89/137, 64.9%, 95% CI, 56.9-72.9), followed by surgical complications (46/137, 33.6%, 95% CI, 25.7-41.5) and infection/sepsis (32/137, 23.4%, 95% CI, 16.3-30.4). An active error was made by the health care workers in 31 of 42 cases with AE, either during the decision making or during the execution of an action. A total of 36 AEs were due to deficiencies attributed to organizational factors and 31 were linked to poor teamwork. The mixed methods approach demonstrated how a deep understanding of AE and poor performance may emerge thanks to the combination of routinely available data and experts' evaluations. The main limitation of this study is its focus on the cardiac surgery rather than on the entire process of care. The evaluation could have been integrated with on-site observations and the analysis of reported incidents. © 2017 John Wiley & Sons, Ltd.

Integrating the Public in Mosquito Management: Active Education by Community Peers Can Lead to Significant Reduction in Peridomestic Container Mosquito Habitats

PubMed Central

Healy, Kristen; Hamilton, George; Crepeau, Taryn; Healy, Sean; Unlu, Isik; Farajollahi, Ary; Fonseca, Dina M.

2014-01-01

Mosquito species that utilize peridomestic containers for immature development are commonly aggressive human biters, and because they often reach high abundance, create significant nuisance. One of these species, the Asian tiger mosquito Aedes albopictus, is an important vector of emerging infectious diseases, such as dengue, chikungunya, and Zika fevers. Integrated mosquito management (IMM) of Ae. albopictus is particularly difficult because it requires access to private yards in urban and suburban residences. It has become apparent that in the event of a public health concern due to this species, homeowners will have to be active participants in the control process by reducing mosquito habitats in their properties, an activity known as source reduction. However, limited attempts at quantifying the effect of source reduction by homeowners have had mixed results. Of note, many mosquito control programs in the US have some form of education outreach, however the primary approach is often passive focusing on the distribution of education materials as flyers. In 2010, we evaluated the use of active community peer education in a source reduction program, using AmeriCorps volunteers. The volunteers were mobilized over a 4-week period, in two areas with approximately 1,000 residences each in urban Mercer and suburban Monmouth counties in New Jersey, USA. The volunteers were first provided training on peridomestic mosquitoes and on basic approaches to reducing the number of container habitats for mosquito larvae in backyards. Within the two treatment areas the volunteers successfully engaged 758 separate homes. Repeated measures analysis of variance showed a significant reduction in container habitats in the sites where the volunteers actively engaged the community compared to untreated control areas in both counties. Our results suggest that active education using community peer educators can be an effective means of source reduction, and a critical tool in the arsenal against peridomestic mosquitoes. PMID:25255027

PERTINENT DRY NEEDLING CONSIDERATIONS FOR MINIMIZING ADVERSE EFFECTS – PART ONE

PubMed Central

Halle, Rob J.

2016-01-01

ABSTRACT Background Dry needling is an evidence-based treatment technique that is accepted and used by physical therapists in the United States. This treatment approach focuses on releasing or inactivating muscular trigger points to decrease pain, reduce muscle tension, and assist patients with an accelerated return to active rehabilitation. Issue While commonly used, the technique has some patient risk and value of the treatment should be based on benefit compared to the potential risk. Adverse effects (AEs) with dry needling can be mild or severe, with overall incidence rates varying from zero to rates of approximately 10 percent. While mild AEs are the rule, any procedure that involves a needle insertion has the potential for an AE, with select regions and the underlying anatomy increasing the risk. Known significant AEs from small diameter needle insertion include pneumothorax, cardiac tamponade, hematoma, infection, central nervous system injury, and other complications. Purpose/Objective Underlying anatomy across individuals has variability, requiring an in-depth knowledge of anatomy prior to any needle placement. This commentary is an overview of pertinent anatomy in the region of the thorax, with a ‘part two’ that addresses the abdomen, pelvis, back, vasovagal response, informed consent and other pertinent issues. The purpose of the commentary is to minimize the risk of a dry needling AE. Conclusions/Implications Dry needling is an effective adjunct treatment procedure that is within the recognized scope of physical therapy practice. Physical therapy education and training provides practitioners with the anatomy, basic sciences, and clinical foundation to use this intervention safely and effectively. A safe and evidenced-based implementation of the procedure is based on a thorough understanding of the underlying anatomy and the potential risks, with risks coordinated with patients via informed consent. Levels of Evidence Level 5 PMID:27525188

Development of the National Cancer Institute’s Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)

PubMed Central

Reeve, Bryce B.; Mitchell, Sandra A.; Clauser, Steven B.; Minasian, Lori M.; Dueck, Amylou C.; Mendoza, Tito R.; Hay, Jennifer; Atkinson, Thomas M.; Abernethy, Amy P.; Bruner, Deborah W.; Cleeland, Charles S.; Sloan, Jeff A.; Chilukuri, Ram; Baumgartner, Paul; Denicoff, Andrea; St. Germain, Diane; O’Mara, Ann M.; Chen, Alice; Kelaghan, Joseph; Bennett, Antonia V.; Sit, Laura; Rogak, Lauren; Barz, Allison; Paul, Diane B.; Schrag, Deborah

2014-01-01

The standard approach for documenting symptomatic adverse events (AEs) in cancer clinical trials involves investigator reporting using the National Cancer Institute’s (NCI’s) Common Terminology Criteria for Adverse Events (CTCAE). Because this approach underdetects symptomatic AEs, the NCI issued two contracts to create a patient-reported outcome (PRO) measurement system as a companion to the CTCAE, called the PRO-CTCAE. This Commentary describes development of the PRO-CTCAE by a group of multidisciplinary investigators and patient representatives and provides an overview of qualitative and quantitative studies of its measurement properties. A systematic evaluation of all 790 AEs listed in the CTCAE identified 78 appropriate for patient self-reporting. For each of these, a PRO-CTCAE plain language term in English and one to three items characterizing the frequency, severity, and/or activity interference of the AE were created, rendering a library of 124 PRO-CTCAE items. These items were refined in a cognitive interviewing study among patients on active cancer treatment with diverse educational, racial, and geographic backgrounds. Favorable measurement properties of the items, including construct validity, reliability, responsiveness, and between-mode equivalence, were determined prospectively in a demographically diverse population of patients receiving treatments for many different tumor types. A software platform was built to administer PRO-CTCAE items to clinical trial participants via the internet or telephone interactive voice response and was refined through usability testing. Work is ongoing to translate the PRO-CTCAE into multiple languages and to determine the optimal approach for integrating the PRO-CTCAE into clinical trial workflow and AE analyses. It is envisioned that the PRO-CTCAE will enhance the precision and patient-centeredness of adverse event reporting in cancer clinical research. PMID:25265940

Five Fatty Acyl-Coenzyme A Reductases Are Involved in the Biosynthesis of Primary Alcohols in Aegilops tauschii Leaves

PubMed Central

Wang, Meiling; Wu, Hongqi; Xu, Jing; Li, Chunlian; Wang, Yong; Wang, Zhonghua

2017-01-01

The diploid Aegilops tauschii is the D-genome donor to hexaploid wheat (Triticum aestivum) and represents a potential source for genetic study in common wheat. The ubiquitous wax covering the aerial parts of plants plays an important role in protecting plants against non-stomatal water loss. Cuticular waxes are complex mixtures of very-long-chain fatty acids, alkanes, primary and/or secondary alcohols, aldehydes, ketones, esters, triterpenes, sterols, and flavonoids. In the present work, primary alcohols were identified as the major components of leaf cuticular wax in Ae. tauschii, with C26:0-OH being the dominant primary alcohol. Analysis by scanning electron microscope revealed that dense platelet-shaped wax crystals were deposited on leaf surfaces of Ae. tauschii. Ten putative wax biosynthetic genes encoding fatty acyl-coenzyme A reductase (FAR) were identified in the genome of Ae. tauschii. Five of these genes, Ae.tFAR1, Ae.tFAR2, Ae.tFAR3, Ae.tFAR4, and Ae.tFAR6, were found expressed in the leaf blades. Heterologous expression of the five Ae.tFARs in yeast (Saccharomyces cerevisiae) showed that Ae.tFAR1, Ae.tFAR2, Ae.tFAR3, Ae.tFAR4, and Ae.tFAR6 were predominantly responsible for the accumulation of C16:0, C18:0, C26:0, C24:0, and C28:0 primary alcohols, respectively. In addition, nine Ae.tFAR paralogous genes were located on D chromosome of wheat and the wheat nullisomic–tetrasomic lines with the loss of Ae.tFAR3 and Ae.tFAR4 paralogous genes had significantly reduced levels of primary alcohols in the leaf blades. Collectively, these data suggest that Ae.tFAR1, Ae.tFAR2, Ae.tFAR3, Ae.tFAR4, and Ae.tFAR6 encode alcohol-forming FARs involved in the biosynthesis of primary alcohols in the leaf blades of Ae. tauschii. The information obtained in Ae. tauschii enables us to better understand wax biosynthesis in common wheat. PMID:28659955

[Phylogenetic relationships and intraspecific variation of D-genome Aegilops L. as revealed by RAPD analysis].

PubMed

Goriunova, S V; Kochieva, E Z; Chikida, N N; Pukhal'skiĭ, V A

2004-05-01

RAPD analysis was carried out to study the genetic variation and phylogenetic relationships of polyploid Aegilops species, which contain the D genome as a component of the alloploid genome, and diploid Aegilops tauschii, which is a putative donor of the D genome for common wheat. In total, 74 accessions of six D-genome Aegilops species were examined. The highest intraspecific variation (0.03-0.21) was observed for Ae. tauschii. Intraspecific distances between accessions ranged 0.007-0.067 in Ae. cylindrica, 0.017-0.047 in Ae. vavilovii, and 0.00-0.053 in Ae. juvenalis. Likewise, Ae. ventricosa and Ae. crassa showed low intraspecific polymorphism. The among-accession difference in alloploid Ae. ventricosa (genome DvNv) was similar to that of one parental species, Ae. uniaristata (N), and substantially lower than in the other parent, Ae. tauschii (D). The among-accession difference in Ae. cylindrica (CcDc) was considerably lower than in either parent, Ae. tauschii (D) or Ae. caudata (C). With the exception of Ae. cylindrica, all D-genome species--Ae. tauschii (D), Ae. ventricosa (DvNv), Ae. crassa (XcrDcrl and XcrDcrlDcr2), Ae. juvenalis (XjDjUj), and Ae. vavilovii (XvaDvaSva)--formed a single polymorphic cluster, which was distinct from clusters of other species. The only exception, Ae. cylindrica, did not group with the other D-genome species, but clustered with Ae. caudata (C), a donor of the C genome. The cluster of these two species was clearly distinct from the cluster of the other D-genome species and close to a cluster of Ae. umbellulata (genome U) and Ae. ovata (genome UgMg). Thus, RAPD analysis for the first time was used to estimate and to compare the interpopulation polymorphism and to establish the phylogenetic relationships of all diploid and alloploid D-genome Aegilops species.

Aerobic exercise upregulates the BDNF-Serotonin systems and improves the cognitive function in rats.

PubMed

Pietrelli, A; Matković, L; Vacotto, M; Lopez-Costa, J J; Basso, N; Brusco, A

2018-05-23

Aerobic exercise (AE) benefits brain health and behavior. Serotonin (5-HT) and brain-derived neurotrophic factor (BDNF) are known to mediate and shape cognitive processes. Both systems share some actions: BDNF is involved in the maturation and function of 5-HT neurons. In turn, 5-HT is involved in neuroplasticity phenomena mediated by BDNF and stimulated by exercise. The aim of this work was to study the long-term effects of AE on BDNF- 5-HT systems and cognitive function in rats at different ages. A lifelong moderate-intensity aerobic training program was designed, in which aerobically exercised (E) and sedentary control (C) rats were studied at middle (8 months) and old age (18 months) by means of biochemical, immunohistochemical and behavioral assays. The levels and expression of BDNF, 5-HT, serotonin transporter (SERT) and 5-HT 1A receptor were determined in selected brain areas involved in memory and learning. Immunopositive cells to neuronal nuclear protein (NeuN) in the hippocampus CA1 area were also quantified. The cognitive function was evaluated by the object recognition test (ORT). Results indicate that AE enhanced spatial and non-spatial memory systems, modulated by age. This outcome temporarily correlated with a significant upregulation of cortical, hippocampal and striatal BDNF levels in parallel with an increase in the number of hippocampal CA1-mature neurons. AE also increased brain and raphe 5-HT levels, as well as the expression of SERT and 5-HT 1A receptor in the cortex and hippocampus. Old AE rats showed a highly conserved response, indicating a remarkable protective effect of exercise on both systems. In summary, lifelong AE positively affects BDNF-5-HT systems, improves cognitive function and protects the brain against the deleterious effects of sedentary life and aging. Copyright © 2018 Elsevier Inc. All rights reserved.

Ecological Modeling of Aedes aegypti (L.) Pupal Production in Rural Kamphaeng Phet, Thailand

PubMed Central

Aldstadt, Jared; Koenraadt, Constantianus J. M.; Fansiri, Thanyalak; Kijchalao, Udom; Richardson, Jason; Jones, James W.; Scott, Thomas W.

2011-01-01

Background Aedes aegypti (L.) is the primary vector of dengue, the most important arboviral infection globally. Until an effective vaccine is licensed and rigorously administered, Ae. aegypti control remains the principal tool in preventing and curtailing dengue transmission. Accurate predictions of vector populations are required to assess control methods and develop effective population reduction strategies. Ae. aegypti develops primarily in artificial water holding containers. Release recapture studies indicate that most adult Ae. aegypti do not disperse over long distances. We expect, therefore, that containers in an area of high development site density are more likely to be oviposition sites and to be more frequently used as oviposition sites than containers that are relatively isolated from other development sites. After accounting for individual container characteristics, containers more frequently used as oviposition sites are likely to produce adult mosquitoes consistently and at a higher rate. To this point, most studies of Ae. aegypti populations ignore the spatial density of larval development sites. Methodology Pupal surveys were carried out from 2004 to 2007 in rural Kamphaeng Phet, Thailand. In total, 84,840 samples of water holding containers were used to estimate model parameters. Regression modeling was used to assess the effect of larval development site density, access to piped water, and seasonal variation on container productivity. A varying-coefficients model was employed to account for the large differences in productivity between container types. A two-part modeling structure, called a hurdle model, accounts for the large number of zeroes and overdispersion present in pupal population counts. Findings The number of suitable larval development sites and their density in the environment were the primary determinants of the distribution and abundance of Ae. aegypti pupae. The productivity of most container types increased significantly as habitat density increased. An ecological approach, accounting for development site density, is appropriate for predicting Ae. aegypti population levels and developing efficient vector control programs. PMID:21267055

Advanced Subsonic Technology (AST) Area of Interest (AOI) 6: Develop and Validate Aeroelastic Codes for Turbomachinery

NASA Technical Reports Server (NTRS)

Gardner, Kevin D.; Liu, Jong-Shang; Murthy, Durbha V.; Kruse, Marlin J.; James, Darrell

1999-01-01

AlliedSignal Engines, in cooperation with NASA GRC (National Aeronautics and Space Administration Glenn Research Center), completed an evaluation of recently-developed aeroelastic computer codes using test cases from the AlliedSignal Engines fan blisk and turbine databases. Test data included strain gage, performance, and steady-state pressure information obtained for conditions where synchronous or flutter vibratory conditions were found to occur. Aeroelastic codes evaluated included quasi 3-D UNSFLO (MIT Developed/AE Modified, Quasi 3-D Aeroelastic Computer Code), 2-D FREPS (NASA-Developed Forced Response Prediction System Aeroelastic Computer Code), and 3-D TURBO-AE (NASA/Mississippi State University Developed 3-D Aeroelastic Computer Code). Unsteady pressure predictions for the turbine test case were used to evaluate the forced response prediction capabilities of each of the three aeroelastic codes. Additionally, one of the fan flutter cases was evaluated using TURBO-AE. The UNSFLO and FREPS evaluation predictions showed good agreement with the experimental test data trends, but quantitative improvements are needed. UNSFLO over-predicted turbine blade response reductions, while FREPS under-predicted them. The inviscid TURBO-AE turbine analysis predicted no discernible blade response reduction, indicating the necessity of including viscous effects for this test case. For the TURBO-AE fan blisk test case, significant effort was expended getting the viscous version of the code to give converged steady flow solutions for the transonic flow conditions. Once converged, the steady solutions provided an excellent match with test data and the calibrated DAWES (AlliedSignal 3-D Viscous Steady Flow CFD Solver). However, efforts expended establishing quality steady-state solutions prevented exercising the unsteady portion of the TURBO-AE code during the present program. AlliedSignal recommends that unsteady pressure measurement data be obtained for both test cases examined for use in aeroelastic code validation.

Investigations of Photochemistry Using Holography and Photoacoustic Spectroscopy.

DTIC Science & Technology

1984-09-28

Donald M. Burland PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT. TASK CD International Business Machines, Inc. AE OKUI UUR San...Hans Coufal Institution: International Business Machines Corporation San Jose Research Laboratory 5600 Cottle Road, San Jose, CA 95193 " Funding

Aggregated adverse-events outcomes in oncology phase III reports: A systematic review.

PubMed

Maillet, Denis; Gan, Hui K; Blay, Jean-Yves; You, Benoit; Péron, Julien

2016-01-01

Randomised controlled trials (RCTs) represent a major source of information on treatment-related adverse events (AEs). In this study, we reviewed the use and the reporting methods of aggregated-AEs (A-AEs) outcomes in RCTs reports published in oncology and compared that to the expectations of European Organisation for Research and Treatment of Cancer (EORTC) membership. RCTs reports published between 2007 and 2011 were reviewed regarding the reporting of A-AEs-outcomes. A-AEs were defined as summary outcome combining several related AEs, usually grouped by organ system e.g. cardiac-AEs, dermatologic-AEs. Trial characteristics associated with the use of A-AEs outcomes were investigated. The expectation of EORTC members concerning A-AEs utilisation was queried through a survey. Among 325 RCTs published between 2007 and 2011, 94 (29%) included one or more A-AE outcomes. A clear description of the nature of AEs included in such aggregations was provided in 19 articles (20%). No description of A-AEs was conversely provided in the other 75 articles (80%). The most commonly used A-AEs-outcomes were dermatologic-AEs (45%) and cardiac-AEs (33%). In multivariate analysis, the use of A-AEs outcomes was more frequent when trials were conducted in Europe (p = 0.038) and in trials performed on colon/rectal cancers (p = 0.016). Finally, there is no consensus of EORTC members regarding the utilisation of A-AEs but a majority of them (88%) felt that a clear description of A-AEs should systematically be reported. The use of A-AEs is infrequent in oncology RCT manuscripts although their use is accepted by most clinicians. However, a clear definition of A-AEs is strongly recommended if they are to be used in order to avoid a loss of important details about drug toxicities that is useful to clinicians. Copyright © 2015 Elsevier Ltd. All rights reserved.

Using nonlinear least squares to assess relative expression and its uncertainty in real-time qPCR studies.

PubMed

Tellinghuisen, Joel

2016-03-01

Relative expression ratios are commonly estimated in real-time qPCR studies by comparing the quantification cycle for the target gene with that for a reference gene in the treatment samples, normalized to the same quantities determined for a control sample. For the "standard curve" design, where data are obtained for all four of these at several dilutions, nonlinear least squares can be used to assess the amplification efficiencies (AE) and the adjusted ΔΔCq and its uncertainty, with automatic inclusion of the effect of uncertainty in the AEs. An algorithm is illustrated for the KaleidaGraph program. Copyright © 2015 Elsevier Inc. All rights reserved.

Spacecraft Charge Monitor

NASA Astrophysics Data System (ADS)

Goembel, L.

2003-12-01

We are currently developing a flight prototype Spacecraft Charge Monitor (SCM) with support from NASA's Small Business Innovation Research (SBIR) program. The device will use a recently proposed high energy-resolution electron spectroscopic technique to determine spacecraft floating potential. The inspiration for the technique came from data collected by the Atmosphere Explorer (AE) satellites in the 1970s. The data available from the AE satellites indicate that the SCM may be able to determine spacecraft floating potential to within 0.1 V under certain conditions. Such accurate measurement of spacecraft charge could be used to correct biases in space plasma measurements. The device may also be able to measure spacecraft floating potential in the solar wind and in orbit around other planets.

Chloroplast and nuclear microsatellite analysis of Aegilops cylindrica.

PubMed

Gandhi, Harish T; Vales, M Isabel; Watson, Christy J W; Mallory-Smith, Carol A; Mori, Naoki; Rehman, Maqsood; Zemetra, Robert S; Riera-Lizarazu, Oscar

2005-08-01

Aegilops cylindrica Host (2n = 4x = 28, genome CCDD) is an allotetraploid formed by hybridization between the diploid species Ae. tauschii Coss. (2n = 2x = 14, genome DD) and Ae. markgrafii (Greuter) Hammer (2n = 2x = 14, genome CC). Previous research has shown that Ae. tauschii contributed its cytoplasm to Ae. cylindrica. However, our analysis with chloroplast microsatellite markers showed that 1 of the 36 Ae. cylindrica accessions studied, TK 116 (PI 486249), had a plastome derived from Ae. markgrafii rather than Ae. tauschii. Thus, Ae. markgrafii has also contributed its cytoplasm to Ae. cylindrica. Our analysis of chloroplast and nuclear microsatellite markers also suggests that D-type plastome and the D genome in Ae. cylindrica were closely related to, and were probably derived from, the tauschii gene pool of Ae. tauschii. A determination of the likely source of the C genome and the C-type plastome in Ae. cylindrica was not possible.

Education and Public Outreach and Engagement at NASA's Analog Missions in 2012

NASA Technical Reports Server (NTRS)

Watkins, Wendy L.; Janoiko, Barbara A.; Mahoney, Erin; Hermann, Nicole B.

2013-01-01

Analog missions are integrated, multi-disciplinary activities that test key features of future human space exploration missions in an integrated fashion to gain a deeper understanding of system-level interactions and operations early in conceptual development. These tests often are conducted in remote and extreme environments that are representative in one or more ways to that of future spaceflight destinations. They may also be conducted at NASA facilities, using advanced modeling and human-in-the-loop scenarios. As NASA develops a capability driven framework to transport crew to a variety of space environments, it will use analog missions to gather requirements and develop the technologies necessary to ensure successful exploration beyond low Earth orbit. NASA s Advanced Exploration Systems (AES) Division conducts these high-fidelity integrated tests, including the coordination and execution of a robust education and public outreach (EPO) and engagement program for each mission. Conducting these mission scenarios in unique environments not only provides an opportunity to test the EPO concepts for the particular future-mission scenario, such as the best methods for conducting events with a communication time delay, but it also provides an avenue to deliver NASA s human space exploration key messages. These analogs are extremely exciting to students and the public, and they are performed in such a way that the public can feel like part of the mission. They also provide an opportunity for crew members to obtain training in education and public outreach activities similar to what they would perform in space. The analog EPO team is responsible for the coordination and execution of the events, the overall social media component for each mission, and public affairs events such as media visits and interviews. They also create new and exciting ways to engage the public, manage and create website content, coordinate video footage for missions, and coordinate and integrate each activity into the mission timeline. In 2012, the AES Analog Missions Project performed three distinct missions - NASA Extreme Environment Mission Operations (NEEMO), which simulated a mission to an asteroid using an undersea laboratory; In-Situ Resource Utilization (ISRU) Field Test, which simulated a robotic mission to the moon searching and drilling for water; and Research and Technology Studies (RATS) integrated tests, which also simulated a mission to an asteroid. This paper will discuss the education and public engagement that occurred during these missions.

Emotional intelligence increases over time: A longitudinal study of Australian pre-registration nursing students.

PubMed

Foster, Kim; Fethney, Judith; McKenzie, Heather; Fisher, Murray; Harkness, Emily; Kozlowski, Desirée

2017-08-01

Emotional intelligence (EI) has been associated with positive outcomes for nursing students. Higher EI is associated with personal wellbeing and stress management, higher academic performance, stronger nursing leadership and practice performance, and greater patient safety. While there is an increasing body of evidence on nursing students' EI, there is minimal evidence on EI over time during pre-registration programs. To measure EI in pre-registration nursing students from program commencement to conclusion to ascertain EI over time and examine the relationship between EI and academic performance. Longitudinal repeated measures study between March 2010-February 2013 at a metropolitan university in Australia. 111 nursing students (74.8% female) contributed data on at least two occasions. Participants were enrolled in a pre-registration Master of Nursing degree. Half the cohort (55.0%) comprised Graduate Entry students who completed the course in two years full time. The other 45% were enrolled in an undergraduate degree in arts, science or health science, combined with the same pre-registration Master of Nursing Degree. These students completed their Combined Degree program in four years full time. Participants had a mean age of 24.7years (SD=7.36). EI was measured for commencing students (T1) using the Assessing Emotions Scale (AES), then a further three times: end of first year (T2; 9 months follow up); beginning of second year (12 months follow up; T3) and end of the program (T4; 24/36 months follow up). Students' EI was found to increase across the program; one subscale of EI (managing others' emotions) was related to higher academic performance; and there was a significant increase in the Utilising Emotions subscale scores over time. Pre-registration nurse education contributes to strengthening students' EI over time. Specific EI education scaffolded throughout programs is recommended in pre-registration curricula. Copyright © 2017. Published by Elsevier Ltd.

15 CFR Appendix D to Part 30 - AES Filing Citation, Exemption and Exclusion Legends

Code of Federal Regulations, 2013 CFR

2013-01-01

... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false AES Filing Citation, Exemption and... Appendix D to Part 30—AES Filing Citation, Exemption and Exclusion Legends I. USML Proof of Filing Citation AES ITN Example: AES X20060101987654. II. AES Proof of Filing Citation subpart A § 30.7 AES ITN...

15 CFR Appendix D to Part 30 - AES Filing Citation, Exemption and Exclusion Legends

Code of Federal Regulations, 2011 CFR

2011-01-01

... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false AES Filing Citation, Exemption and... Appendix D to Part 30—AES Filing Citation, Exemption and Exclusion Legends I. USML Proof of Filing Citation AES ITN Example: AES X20060101987654. II. AES Proof of Filing Citation subpart A § 30.7 AES ITN...

15 CFR Appendix D to Part 30 - AES Filing Citation, Exemption and Exclusion Legends

Code of Federal Regulations, 2012 CFR

2012-01-01

... 15 Commerce and Foreign Trade 1 2012-01-01 2012-01-01 false AES Filing Citation, Exemption and... Appendix D to Part 30—AES Filing Citation, Exemption and Exclusion Legends I. USML Proof of Filing Citation AES ITN Example: AES X20060101987654. II. AES Proof of Filing Citation subpart A § 30.7 AES ITN...

15 CFR Appendix D to Part 30 - AES Filing Citation, Exemption and Exclusion Legends

Code of Federal Regulations, 2014 CFR

2014-01-01

... 15 Commerce and Foreign Trade 1 2014-01-01 2014-01-01 false AES Filing Citation, Exemption and... Appendix D to Part 30—AES Filing Citation, Exemption and Exclusion Legends I. USML Proof of Filing Citation AES ITN Example: AES X20060101987654. II. AES Proof of Filing Citation subpart A § 30.7 AES ITN...

75 FR 5258 - Hazardous Materials Transportation; Registration and Fee Assessment Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-02

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Part 107 [Docket No. PHMSA-2009-0201 (HM-208H)] RIN 2137-AE47 Hazardous Materials Transportation... transportation, certain categories and quantities of hazardous materials. PHMSA's proposal would provide that...

Evaluation of Cold In Place Recycled Mixtures on US-283

DOT National Transportation Integrated Search

1999-11-01

The Kansas Department of Transportation (KDOT) by cold in-place recycling (CIR) recycles approximately 120 to 160 km of pavement a year as a part of their 1-R maintenance program. Originally KDOT utilized asphalt emulsions (AE) as the additive in CIR...

Navy Family Advocacy Program. Appendix. Analysis of Central Registry Reports.

DTIC Science & Technology

1983-12-01

2/76) 2 Suspected Abuzso/Malect/Sexua1 Assault an ae2404 65.) "Suspected Abuso /Neglect/ Sexual Assault and Rape Report" 2226 60.5 NAVMED 6320/15A...ANALYSIS OF SEXUAL ASSAULT REPORTS ........... 50 HAPTER V: SUMAY ANALYSIS Or rAMILY ADVOCACY PROGRAM REPORTS . 56 APPENDIX...cont’d)I PAGE CHAPTER IV: SEXUAL ASSAULT TV-1 Fore . . . . . . . . . . . . . . . . . . . . . 51 IV-2 Type of Maltreatment ............... 53 IV-3

Command History. United States Military Assistance Command, Vietnam 1968. Volume 2

DTIC Science & Technology

1968-01-01

phase of the 1968 plan was put through ae scheduled. The opening of the Tte Offensive. however, temporarily scuttled the program. Temporarily, local...decrease slightly. Completed construction of an additional 1, 200 km oalhighways and tte restoration of more of the VNRS was expected to materialize in...Assistance Program MINRON Mine Squadron \\05 Military Intelligence Service MISC Mobile Infiltration Surveillance Center MIUWG Mobile Inshore Undersea

Cryogenics Testbed Laboratory Flange Baseline Configuration

NASA Technical Reports Server (NTRS)

Acuna, Marie Lei Ysabel D.

2013-01-01

As an intern at Kennedy Space Center (KSC), I was involved in research for the Fluids and Propulsion Division of the NASA Engineering (NE) Directorate. I was immersed in the Integrated Ground Operations Demonstration Units (IGODU) project for the majority of my time at KSC, primarily with the Ground Operations Demonstration Unit Liquid Oxygen (GODU L02) branch of IGODU. This project was established to develop advancements in cryogenic systems as a part of KSC's Advanced Exploration Systems (AES) program. The vision of AES is to develop new approaches for human exploration, and operations in and beyond low Earth orbit. Advanced cryogenic systems are crucial to minimize the consumable losses of cryogenic propellants, develop higher performance launch vehicles, and decrease operations cost for future launch programs. During my internship, I conducted a flange torque tracking study that established a baseline configuration for the flanges in the Simulated Propellant Loading System (SPLS) at the KSC Cryogenics Test Laboratory (CTL) - the testing environment for GODU L02.

Morphological Differentiation of the Eggs of North American Container-Inhabiting Aedes Mosquitoes.

PubMed

Bova, Jake; Paulson, Sally; Paulson, Greg

2016-09-01

Aedes aegypti , Ae. albopictus, Ae. japonicus japonicus, and Ae. triseriatus eggs are described with the aid of color images and images from scanning electron microscopy. All eggs were broadly cigar shaped with Ae. triseriatus and Ae. j japonicus eggs being dull or matte black, while Ae. albopictus and Ae. aegypti eggs were shiny jet black. Aedes triseriatus eggs were lighter in color and had a rougher appearance when compared to those of Ae. j. japonicus. Aedes albopictus and Ae. aegypti eggs can be differentiated by the distinct presence of micropylar collars in Ae. aegypti. Our results reduce the need to rear these mosquitoes, reducing labor and time while providing an accurate identification of the vector mosquitoes.

Predicting the Start of the Aedes albopictus (Diptera: Culicidae) Female Adult Biting Season Using the Spring Temperature in Japan

PubMed Central

Higa, Yukiko; Muto, Atsushi; Hirabayashi, Kimio; Yoshida, Masahiro; Sato, Takashi; Nihei, Naoko; Sawabe, Kyoko; Kobayashi, Mutsuo

2017-01-01

Abstract Aedes albopictus (Skuse) (Diptera: Culicidae) is distributed widely and is common in much of Japan. In Japan, female adults begin to bite in between April and June, except in the southern subtropics where the mosquito has no dormant period. It is difficult to estimate the first Ae. albopictus biting day because it varies annually depending on the location. Over several years, we surveyed the mosquitoes at different locations that covered a range of warmer to cooler areas of Japan. We found an association between the timing of first biting day by Ae. albopictus and spring temperature. In spring months, the strongest correlation was found with mean April temperatures, followed by March. Based on these data, it may, therefore, be possible to apply a simple formula to predict the timing of the first biting day at various geographical locations in Japan. Forecasting maps were created using a simple prediction formula. We found that the first biting day for Ae. albopictus changed depending on early spring temperatures for each year. There was an approximate 20-d difference in first biting day between years with warmer and cooler springs. This prediction model will provide useful insight for planning and practice of Ae. albopictus control programs, targeting larvae and adults, in temperate regions globally. PMID:28968909

76 FR 67591 - Airworthiness Directives; Rolls-Royce Corporation Turbofan Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-02

... Airworthiness Directives; Rolls-Royce Corporation Turbofan Engines AGENCY: Federal Aviation Administration (FAA... 3007A1P, and AE 3007A3 turbofan engines. This AD requires initial and repetitive eddy current inspections... 3007A, AE 3007A1/1, AE 3007A1, AE 3007A1/3, AE 3007A1E, AE 3007A1P, and AE 3007A3 turbofan engines...

The risk of Aedes aegypti breeding and premises condition in South Mexico.

PubMed

Manrique-Saide, Pablo; Davies, Clive R; Coleman, Paul G; Che-Mendoza, Azael; Dzul-Manzanilla, Felipe; Barrera-Pérez, Mario; Hernández-Betancourt, Silvia; Ayora-Talavera, Guadalupe; Pinkus-Rendón, Miguel; Burciaga-Zúñiga, Pierre; Sánchez Tejeda, Gustavo; Arredondo-Jiménez, Juan I

2013-12-01

A recent innovation instrumented for the Dengue Prevention and Control program in Mexico is the use of the premises condition index (PCI) as an indicator of risk for the vector Aedes aegypti infestation in dengue-endemic localities of Mexico. This paper addresses whether further improvements for the dengue control program could be made if the prevalence and productivity of Ae. aegypti populations could be reliably predicted using PCI at the household level, as well as medium-sized neighborhoods. We evaluated the use of PCI to predict the infestation with Aedes aegypti (breeding sites and immature productivity) in Merida, Mexico. The study consisted of a cross-sectional survey based on a cluster-randomized sampling design. We analyzed the statistical association between Aedes infestation and PCI, the extent to which the 3 components of PCI (house maintenance, and tidiness and shading of the patio) contributed to the association between PCI and infestation and whether infestation in a given premises was also affected by the PCI of the surrounding ones. Premises with the lowest PCI had significantly lower Aedes infestation and productivity; and as PCI scores increased infestation levels also tended to increase. Household PCI was significantly associated with Ae. aegypti breeding, largely due to the effect of patio untidiness and patio shade. The mean PCI within the surroundings premises also had a significant and independent explanatory power to predict the risk for infestation, in addition to individual PCI. This is the 1st study in Mexico showing evidence that premises condition as measured by the PCI is related to Ae. aegypti breeding sites and immature productivity. Results suggest that PCI could be used to streamline surveys to inform control efforts at least where Ae. aegypti breeds outdoors, as in Merida. The effect of individual premises, neighborhood condition, and the risk of Aedes infestation imply that the risk for dengue vector infestation can only be minimized by the mass effect at the community level.

Effect of Exposure Type and Timing of Injuries in Division I College Football: A 4-year Single Program Analysis.

PubMed

Krill, Michael K; Borchers, James R; Hoffman, Joshua T; Tatarski, Rachel L; Hewett, Timothy E

2017-02-01

Football players compete with a high risk of injury due to the sport. With the recent efforts to improve safety, the National Collegiate Athletic Association (NCAA) established new terminology to clearly define exposure types and reduce the number of high contact exposures. To compare football injury rates (IR) with a focus on game versus practice, time in season of injury, mechanism of injury and utilizing recent exposure types defined by the NCAA (live contact, full-pads and non-contact). Licensed medical professionals monitored a college football program regular season from 2012-2015. Each injury was classified by timing of the injury, mechanism of injury, and whether it occurred in game or practice. Player attendance and type of exposure (non-contact, full-pad or live contact, which involves live tackling to the ground and/or full-speed blocking and can occur in full-pad or half-pad ('shell') equipment) was documented. IR were calculated per 1000 athlete-exposures (AE). Mid-exact P tests compared rates between variables. The game IR was over three times as high as the practice IR (p < .001). Live contact exposures had the greatest IR of 5.702/1000 AE and were seven times more likely to produce an injury compared to non-contact exposures (p < .001); whereas, live contact exposures were about two times more likely to produce an injury compared to full-pad exposures (p = .004). The majority of injuries observed occurred from a contact mechanism (IR: 2.508/1000 AE). The highest IR during the fall football season occurred in the pre-season at 5.769/1000 AE. Overall IR observed in this cohort were lower than prior studies published before recent NCAA rule changes and guideline implementation to improve athlete safety. Athletes in this cohort were at significantly increased risk of injury from live contact exposures.

Season-Ending Shoulder Injuries in the National Collegiate Athletic Association: Data From the NCAA Injury Surveillance Program, 2009-2010 Through 2013-2014.

PubMed

Goodman, Avi D; DeFroda, Steven F; Gil, Joseph A; Kleiner, Justin E; Li, Neill Y; Owens, Brett D

2018-05-01

Examination of the incidence of shoulder season-ending injury (SEI) in the collegiate athlete population is limited. To determine the incidence of shoulder SEI in the National Collegiate Athletic Association (NCAA) and to investigate the risk factors for a shoulder injury ending an athlete's season. Descriptive epidemiology study. All shoulder injuries from the NCAA Injury Surveillance Program database for the years 2009-2010 to 2013-2014 were extracted, and SEI status was noted. The incidences of SEI and non-SEI were calculated for athlete, activity, and injury characteristics and compared via univariable analysis and risk ratios to determine risk factors for an injury being season ending. Shoulder injuries were season ending in 4.3% of cases. The overall incidence of shoulder SEI was 0.31 per 10,000 athlete exposures (AEs), as opposed to 7.25 per 10,000 AEs for all shoulder injuries. Shoulder instability constituted 49.1% of SEI, with an incidence of 0.15 per 10,000 AEs, while fractures had the highest rate of being season ending (41.9%). Men's wrestling had the highest incidence of shoulder SEI (1.65 per 10,000 AEs), while men's soccer had the highest proportion of shoulder injuries that ended a season (14.6%). Overall, men had a 6.3-fold higher incidence of SEI than women and a 2.4-fold increased likelihood that an injury would be season ending. Injury to the shoulder of an NCAA athlete, while somewhat infrequent, can have significant implications on time lost from play. Incidence of these injuries varies widely by sport and injury, with a number of associated risk factors. Athletes sustaining potentially season-ending shoulder injuries, with their coaches and medical providers, may benefit from these data to best manage expectations and outcomes.

The Siren's Song: Exploitation of Female Flight Tones to Passively Capture Male Aedes aegypti (Diptera: Culicidae).

PubMed

Johnson, Brian J; Ritchie, Scott A

2016-01-01

The need to capture male mosquitoes has intensified recently as a result of a number of male-based sterile insect technique (SIT) and population-modification programs focused on Aedes aegypti (L.) having initiated field releases. Here, we report the results of the successful exploitation of the attraction of male Ae. aegypti to female flight tones to enhance male collections in nonmechanical passive (nonbattery powered) Gravid Aedes Traps (GAT). Prior to field studies, male attraction to female flight tones of 484 and 560 Hz, as well as to a male flight tone of 715 Hz, were assessed in a series of controlled release-recapture and semifield trials. These trials determined that a pure tone of 484 Hz was significantly more attractive to free-flying males than the other flight tones and enabled their collection in sound-baited GATs (ca. 95% capture rate after 2 h; 484 Hz at 65 dB). In contrast, gravid females were unresponsive to male or female flight tones and were evenly distributed among sound-baited and control GATs. Importantly, under normal field conditions sound-baited GATs (484 Hz at 70 dB) captured significantly more male Ae. aegypti per 24-h trap interval (1.3 ± 0.37) than controls (0.2 ± 0.13). Overall, sound-bated GATs captured approximately twice as many Ae. aegypti (male and female; 3.0 ± 0.68 per interval, 30 total) than controls (1.5 ± 0.56 per interval, 15 total). These results reveal that sound-baited GATs are a simple and effective surveillance tool for Ae. aegypti that would allow current male-based SIT and population-modification programs to effectively monitor males in their target populations. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Dermatologic Reactions to Immune Checkpoint Inhibitors : Skin Toxicities and Immunotherapy.

PubMed

Sibaud, Vincent

2018-06-01

The development of immune checkpoint inhibitors [monoclonal antibodies targeting cytotoxic T lymphocyte-associated antigen-4 (CTLA-4), programmed cell death protein 1 (PD-1) or programmed death ligand 1 (PD-L1)] represents a major breakthrough in cancer therapy. Although they present a favorable risk/benefit ratio, immune checkpoint blockade therapies have a very specific safety profile. Due to their unique mechanism of action, they entail a new spectrum of adverse events that are mostly immune related [immune-related adverse events (irAEs)], notably mediated by the triggering of cytotoxic CD4+/CD8+ T cell activation. Cutaneous toxicities appear to be one of the most prevalent irAEs, both with anti-PD-1 and anti-CTLA-4 agents or with the newly developed anti-PD-L1 agents, which corresponds to a class effect. They are observed in more than one-third of the treated patients, mainly in the form of a maculopapular rash (eczema-like spongiotic dermatitis) and pruritus. A wide range of other dermatologic manifestations can also occur, including lichenoid reactions, psoriasis, acneiform rashes, vitiligo-like lesions, autoimmune skin diseases (e.g., bullous pemphigoid, dermatomyositis, alopecia areata), sarcoidosis or nail and oral mucosal changes. In addition, the use of anti-CTLA-4 and anti-PD-1 therapies in combination is associated with the development of more frequent, more severe and earlier cutaneous irAEs compared to single agents. In most cases, these dysimmune dermatologic adverse events remain self-limiting and readily manageable. Early recognition and adequate management, however, are critical to prevent exacerbation of the lesions, to limit treatment interruption and to minimize quality of life impairment. This review describes the variable clinical and histopathologic aspects of dermatologic irAEs induced by immune checkpoint inhibitors. Appropriate treatment and counseling are also proposed, with a step-by-step approach for optimized management by both practicing oncologists and dermatologists.

Coda Wave Interferometry Method Applied in Structural Monitoring to Assess Damage Evolution in Masonry and Concrete Structures

NASA Astrophysics Data System (ADS)

Masera, D.; Bocca, P.; Grazzini, A.

2011-07-01

In this experimental program the main goal is to monitor the damage evolution in masonry and concrete structures by Acoustic Emission (AE) signal analysis applying a well-know seismic method. For this reason the concept of the coda wave interferometry is applied to AE signal recorded during the tests. Acoustic Emission (AE) are very effective non-destructive techniques applied to identify micro and macro-defects and their temporal evolution in several materials. This technique permits to estimate the velocity of ultrasound waves propagation and the amount of energy released during fracture propagation to obtain information on the criticality of the ongoing process. By means of AE monitoring, an experimental analysis on a set of reinforced masonry walls under variable amplitude loading and strengthening reinforced concrete (RC) beams under monotonic static load has been carried out. In the reinforced masonry wall, cyclic fatigue stress has been applied to accelerate the static creep and to forecast the corresponding creep behaviour of masonry under static long-time loading. During the tests, the evaluation of fracture growth is monitored by coda wave interferometry which represents a novel approach in structural monitoring based on AE relative change velocity of coda signal. In general, the sensitivity of coda waves has been used to estimate velocity changes in fault zones, in volcanoes, in a mining environment, and in ultrasound experiments. This method uses multiple scattered waves, which travelled through the material along numerous paths, to infer tiny temporal changes in the wave velocity. The applied method has the potential to be used as a "damage-gauge" for monitoring velocity changes as a sign of damage evolution into masonry and concrete structures.

Colonized Aedes albopictus and its sexual performance in the wild: implications for SIT technology and containment.

PubMed

Hamady, Dieng; Ruslan, Norrafiza Binti; Ahmad, Abu Hassan; Rawi, Che Salmah Md; Ahmad, Hamdan; Satho, Tomomitsu; Miake, Fumio; Zuharah, Wan Fatma; FuKumitsu, Yuki; Saad, Ahmad Ramli; Rajasaygar, Sudha; Vargas, Ronald Enrique Morales; Majid, Abdul Hafiz Ab; Fadzly, Nik; Ghani, Idris Abd; AbuBakar, Sazaly

2013-07-15

Mating is a physiological process of crucial importance underlying the size and maintenance of mosquito populations. In sterile and incompatible insect technologies (SIT and IIT), mating is essential for mass production, persistence, and success of released individuals, and is a central parameter for judging the effectiveness of SIT/IIT programs. Some mosquitoes have an enormous reproductive potential for both themselves and pathogens and mating may contribute to persistence of infection in nature. As Aedes albopictus can transmit flaviviruses both sexually and horizontally, and as infected insects are usually derived from laboratory colonies, we investigated the implications of mating between a long-term laboratory colony of Ae. albopictus and wild populations. Through a series of mating experiments, we examined the reproductive outcomes of sexual cross-affinity between laboratory-raised and wild adults of Ae. albopictus. The results indicated appreciable mating compatibility between laboratory-reared and wild adults, and equivalent levels of egg production among reciprocal crosses. We also observed comparable larval eclosion in lab females mated with wild males, and increased adult longevity in female offspring from wild females|×|laboratory males crosses. Taken together, these data suggest that Ae. albopictus can preserve its reproductive fitness over a long period of time in the laboratory environment and has valuable attributes for SIT application. These observations together with the ability to successfully inseminate heterospecific females indicate the potential of Ae. albopictus to act as an ecological barrier if non-sterilized males are massively released in areas occupied by Aedes aegypti. The observed substantial reproductive fitness combined with the capability to reproduce both, itself and viruses illustrates the potential of Ae. albopictus to pose a serious threat if infected and released accidentally.

Comparison of NASA Team2 and AES-York Ice Concentration Algorithms Against Operational Ice Charts From the Canadian Ice Service

NASA Technical Reports Server (NTRS)

Shokr, Mohammed; Markus, Thorsten

2006-01-01

Ice concentration retrieved from spaceborne passive-microwave observations is a prime input to operational sea-ice-monitoring programs, numerical weather prediction models, and global climate models. Atmospheric Environment Service (AES)- York and the Enhanced National Aeronautics and Space Administration Team (NT2) are two algorithms that calculate ice concentration from Special Sensor Microwave/Imager observations. This paper furnishes a comparison between ice concentrations (total, thin, and thick types) output from NT2 and AES-York algorithms against the corresponding estimates from the operational analysis of Radarsat images in the Canadian Ice Service (CIS). A new data fusion technique, which incorporates the actual sensor's footprint, was developed to facilitate this study. Results have shown that the NT2 and AES-York algorithms underestimate total ice concentration by 18.35% and 9.66% concentration counts on average, with 16.8% and 15.35% standard deviation, respectively. However, the retrieved concentrations of thin and thick ice are in much more discrepancy with the operational CIS estimates when either one of these two types dominates the viewing area. This is more likely to occur when the total ice concentration approaches 100%. If thin and thick ice types coexist in comparable concentrations, the algorithms' estimates agree with CIS'S estimates. In terms of ice concentration retrieval, thin ice is more problematic than thick ice. The concept of using a single tie point to represent a thin ice surface is not realistic and provides the largest error source for retrieval accuracy. While AES-York provides total ice concentration in slightly more agreement with CIS'S estimates, NT2 provides better agreement in retrieving thin and thick ice concentrations.

Custom auroral electrojet indices calculated by using MANGO value-added services

NASA Astrophysics Data System (ADS)

Bargatze, L. F.; Moore, W. B.; King, T. A.

2009-12-01

A set of computational routines called MANGO, Magnetogram Analysis for the Network of Geophysical Observatories, is utilized to calculate customized versions of the auroral electrojet indices, AE, AL, and AU. MANGO is part of an effort to enhance data services available to users of the Heliophysics VxOs, specifically for the Virtual Magnetospheric Observatory (VMO). The MANGO value-added service package is composed of a set of IDL routines that decompose ground magnetic field observations to isolate secular, diurnal, and disturbance variations of magnetic field disturbance, station-by-station. Each MANGO subroutine has been written in modular fashion to allow "plug and play"-style flexibility and each has been designed to account for failure modes and noisy data so that the programs will run to completion producing as much derived data as possible. The capabilities of the MANGO service package will be demonstrated through their application to the study of auroral electrojet current flow during magnetic substorms. Traditionally, the AE indices are calculated by using data from about twelve ground stations located at northern auroral zone latitudes spread longitudinally around the world. Magnetogram data are corrected for secular variation prior to calculating the standard version of the indices but the data are not corrected for diurnal variations. A custom version of the AE indices will be created by using the MANGO routines including a step to subtract diurnal curves from the magnetic field data at each station. The custom AE indices provide more accurate measures of auroral electrojet activity due to isolation of the sunstorm electrojet magnetic field signiture. The improvements in the accuracy of the custom AE indices over the tradition indices are largest during the northern hemisphere summer when the range of diurnal variation reaches its maximum.

Peridomestic Aedes malayensis and Aedes albopictus are capable vectors of arboviruses in cities.

PubMed

Mendenhall, Ian H; Manuel, Menchie; Moorthy, Mahesh; Lee, Theodore T M; Low, Dolyce H W; Missé, Dorothée; Gubler, Duane J; Ellis, Brett R; Ooi, Eng Eong; Pompon, Julien

2017-06-01

Dengue and chikungunya are global re-emerging mosquito-borne diseases. In Singapore, sustained vector control coupled with household improvements reduced domestic mosquito populations for the past 45 years, particularly the primary vector Aedes aegypti. However, while disease incidence was low for the first 30 years following vector control implementation, outbreaks have re-emerged in the past 15 years. Epidemiological observations point to the importance of peridomestic infection in areas not targeted by control programs. We investigated the role of vectors in peri-domestic areas. We carried out entomological surveys to identify the Aedes species present in vegetated sites in highly populated areas and determine whether mosquitoes were present in open-air areas frequented by people. We compared vector competence of Aedes albopictus and Aedes malayensis with Ae. aegypti after oral infection with sympatric dengue serotype 2 and chikungunya viruses. Mosquito saliva was tested for the presence of infectious virus particles as a surrogate for transmission following oral infection. We identified Aedes albopictus and Aedes malayensis throughout Singapore and quantified their presence in forested and opened grassy areas. Both Ae. albopictus and Ae. malayensis can occupy sylvatic niches and were highly susceptible to both arboviruses. A majority of saliva of infected Ae. malayensis contained infectious particles for both viruses. Our study reveals the prevalence of competent vectors in peri-domestic areas, including Ae. malayensis for which we established the vector status. Epidemics can be driven by infection foci, which are epidemiologically enhanced in the context of low herd immunity, selective pressure on arbovirus transmission and the presence of infectious asymptomatic persons, all these conditions being present in Singapore. Learning from Singapore's vector control success that reduced domestic vector populations, but has not sustainably reduced arboviral incidence, we suggest including peri-domestic vectors in the scope of vector management.

Is balance exercise training as effective as aerobic exercise training in fibromyalgia syndrome?

PubMed

Duruturk, Neslihan; Tuzun, Emine Handan; Culhaoglu, Belde

2015-05-01

The aim was to compare the effect of aerobic and balance exercises on pain severity, myalgic score, quality of life, exercise capacity and balance in fibromyalgia syndrome (FMS). A total of 33 females diagnosed with FMS by the American College of Rheumatology criteria were recruited in this randomised controlled study and allocated to aerobic exercise (AE) or balance exercise (BE) groups. Exercises were performed three times a week, for 6 weeks on a treadmill or with a Tetrax interactive balance system (TIBS). Outcome measures were characterised by myalgic score, visual analogue scale, Fibromyalgia Impact Questionnaire (FIQ), exercise testing, Timed Up-Go (TUG) and TIBS measurements. Comparisons from baseline to 6 weeks were evaluated using Wilcoxon test. Mann-Whitney U test was used to compare differences between groups. Effect sizes were also calculated. Improvements in pain, myalgic score and FIQ were found in both groups (p < 0.05). While comparing groups, myalgic score was significant (p = 0.02, d = -1.77), the value was higher in AE. Exercise duration, Borg scale, resting blood pressures (RBP) and maximal heart rate were significant in AE. In BE, Borg scale, exercise duration was significant (p < 0.05). While comparing groups, diastolic RBP (p = 0.04, d = -0.92), exercise duration (p = 0.00, d = -1.64) were significant, with higher values in AE. TUG significantly changed in groups (p < 0.05, d ≥ -1.22). Stability scores, eyes open while standing on elastic pads (p = 0.00, d = -0.98) and head back (p = 0.03, d = -0.74), were significant, with higher values in BE. This study showed that BE provided some improvements in FMS, but AE training led to greater gains. BE training should be included in comprehensive programs.

Role of Aedes aegypti (Linnaeus) and Aedes albopictus (Skuse) in local dengue epidemics in Taiwan.

PubMed

Tsai, Pui-Jen; Teng, Hwa-Jen

2016-11-09

Aedes mosquitoes in Taiwan mainly comprise Aedes albopictus and Ae. aegypti. However, the species contributing to autochthonous dengue spread and the extent at which it occurs remain unclear. Thus, in this study, we spatially analyzed real data to determine spatial features related to local dengue incidence and mosquito density, particularly that of Ae. albopictus and Ae. aegypti. We used bivariate Moran's I statistic and geographically weighted regression (GWR) spatial methods to analyze the globally spatial dependence and locally regressed relationship between (1) imported dengue incidences and Breteau indices (BIs) of Ae. albopictus, (2) imported dengue incidences and BI of Ae. aegypti, (3) autochthonous dengue incidences and BI of Ae. albopictus, (4) autochthonous dengue incidences and BI of Ae. aegypti, (5) all dengue incidences and BI of Ae. albopictus, (6) all dengue incidences and BI of Ae. aegypti, (7) BI of Ae. albopictus and human population density, and (8) BI of Ae. aegypti and human population density in 348 townships in Taiwan. In the GWR models, regression coefficients of spatially regressed relationships between the incidence of autochthonous dengue and vector density of Ae. aegypti were significant and positive in most townships in Taiwan. However, Ae. albopictus had significant but negative regression coefficients in clusters of dengue epidemics. In the global bivariate Moran's index, spatial dependence between the incidence of autochthonous dengue and vector density of Ae. aegypti was significant and exhibited positive correlation in Taiwan (bivariate Moran's index = 0.51). However, Ae. albopictus exhibited positively significant but low correlation (bivariate Moran's index = 0.06). Similar results were observed in the two spatial methods between all dengue incidences and Aedes mosquitoes (Ae. aegypti and Ae. albopictus). The regression coefficients of spatially regressed relationships between imported dengue cases and Aedes mosquitoes (Ae. aegypti and Ae. albopictus) were significant in 348 townships in Taiwan. The results indicated that local Aedes mosquitoes do not contribute to the dengue incidence of imported cases. The density of Ae. aegypti positively correlated with the density of human population. By contrast, the density of Ae. albopictus negatively correlated with the density of human population in the areas of southern Taiwan. The results indicated that Ae. aegypti has more opportunities for human-mosquito contact in dengue endemic areas in southern Taiwan. Ae. aegypti, but not Ae. albopictus, and human population density in southern Taiwan are closely associated with an increased risk of autochthonous dengue incidence.

Cytopathology whole slide images and virtual microscopy adaptive tutorials: A software pilot

PubMed Central

Van Es, Simone L.; Pryor, Wendy M.; Belinson, Zack; Salisbury, Elizabeth L.; Velan, Gary M.

2015-01-01

Background: The constant growth in the body of knowledge in medicine requires pathologists and pathology trainees to engage in continuing education. Providing them with equitable access to efficient and effective forms of education in pathology (especially in remote and rural settings) is important, but challenging. Methods: We developed three pilot cytopathology virtual microscopy adaptive tutorials (VMATs) to explore a novel adaptive E-learning platform (AeLP) which can incorporate whole slide images for pathology education. We collected user feedback to further develop this educational material and to subsequently deploy randomized trials in both pathology specialist trainee and also medical student cohorts. Cytopathology whole slide images were first acquired then novel VMATs teaching cytopathology were created using the AeLP, an intelligent tutoring system developed by Smart Sparrow. The pilot was run for Australian pathologists and trainees through the education section of Royal College of Pathologists of Australasia website over a period of 9 months. Feedback on the usability, impact on learning and any technical issues was obtained using 5-point Likert scale items and open-ended feedback in online questionnaires. Results: A total of 181 pathologists and pathology trainees anonymously attempted the three adaptive tutorials, a smaller proportion of whom went on to provide feedback at the end of each tutorial. VMATs were perceived as effective and efficient E-learning tools for pathology education. User feedback was positive. There were no significant technical issues. Conclusion: During this pilot, the user feedback on the educational content and interface and the lack of technical issues were helpful. Large scale trials of similar online cytopathology adaptive tutorials were planned for the future. PMID:26605119

ITMS: Individualized Teaching Material System: Adaptive Integration of Web Pages Distributed in Some Servers.

ERIC Educational Resources Information Center

Mitsuhara, Hiroyuki; Kurose, Yoshinobu; Ochi, Youji; Yano, Yoneo

The authors developed a Web-based Adaptive Educational System (Web-based AES) named ITMS (Individualized Teaching Material System). ITMS adaptively integrates knowledge on the distributed Web pages and generates individualized teaching material that has various contents. ITMS also presumes the learners' knowledge levels from the states of their…

Designing Structured Interviews for Educational Research. ERIC/AE Digest.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Assessment and Evaluation, Washington, DC.

This digest reviews the basic building blocks of a structured interview, points out some of the pitfalls in interviewing, and suggests ways for researchers to avoid these difficulties to produce questions that have the best possibility of generating reliable and accurate data on the topics of interest. The data collection instrument is a document…

Theoretical Development, Factorial Validity, and Reliability of the Online Graduate Mentoring Scale

ERIC Educational Resources Information Center

Crawford, Linda M.; Randolph, Justus J.; Yob, Iris M.

2014-01-01

In this study, we sought to confirm the theoretical framework underlying an Online Graduate Mentoring Scale by establishing the scale's factorial validity and reliability. Analysis of data received from doctoral students and alumni/ae of the College of Education of one large, online, accredited university reduced the initial theoretical…

Towards a global system of vigilance and surveillance in unrelated donors of haematopoietic progenitor cells for transplantation.

PubMed

Shaw, B E; Chapman, J; Fechter, M; Foeken, L; Greinix, H; Hwang, W; Phillips-Johnson, L; Korhonen, M; Lindberg, B; Navarro, W H; Szer, J

2013-11-01

Safety of living donors is critical to the success of blood, tissue and organ transplantation. Structured and robust vigilance and surveillance systems exist as part of some national entities, but historically no global systems are in place to ensure conformity, harmonisation and the recognition of rare adverse events (AEs). The World Health Assembly has recently resolved to require AE/reaction (AE/R) reporting both nationally and globally. The World Marrow Donor Association (WMDA) is an international organisation promoting the safety of unrelated donors and progenitor cell products for use in haematopoietic progenitor cell (HPC) transplantation. To address this issue, we established a system for collecting, collating, analysing, distributing and reacting to serious adverse events and reactions (SAE/R) in unrelated HPC donors. The WMDA successfully instituted this reporting system with 203 SAE/R reported in 2011. The committee generated two rapid reports, reacting to specific SAE/R, resulting in practice changing policies. The system has a robust governance structure, formal feedback to the WMDA membership and transparent information flows to other agencies, specialist physicians and transplant programs and the general public.

AE activity during transient beta drops in high poloidal beta discharges

NASA Astrophysics Data System (ADS)

Huang, J.; Gong, X. Z.; Ren, Q. L.; Ding, S. Y.; Qian, J. P.; Pan, C. K.; Li, G. Q.; Heidbrink, W. W.; Garofalo, A. M.; McClenaghan, J.

2016-10-01

Enhanced AE activity has been observed during transient beta drops in high poloidal beta DIII-D discharges with internal transport barriers (ITBs). These drops in beta are believed to be caused by n=1 external kink modes. In some discharges, beta recovers within 200 ms but, in others, beta stays suppressed. A typical discharge has βP 3, qmin 3, and q95 12. The drop in beta affects both fast ions and thermal particles, and a drop is also observed in the density and rotation. The enhanced AE activity follows the instability that causes the beta drop, is largest at the lowest beta, and subsides as beta recovers. MHD stability analysis is planned. A database study of the plasma conditions associated with the collapse will be also presented. Supported in part by the US Department of Energy under DE-FC02-04ER54698, DE-AC05-06OR23100, and by the National Natural Science Foundation of China 11575249, and the National Magnetic Confinement Fusion Program of China No. 2015GB110005.

Weak Larval Competition Between Two Invasive Mosquitoes Aedes koreicus and Aedes albopictus (Diptera: Culicidae).

PubMed

Baldacchino, Frédéric; Arnoldi, Daniele; Lapère, Charlotte; Rosà, Roberto; Montarsi, Fabrizio; Capelli, Gioia; Rizzoli, Annapaola

2017-09-01

Aedes (Hulecoeteomyia) koreicus (Edwards) and Aedes (Stegomyia) albopictus (Skuse) are two invasive mosquito species well established in northeastern Italy, and these two species may co-occur in artificial larval habitats such as tires, buckets, drums, and catch basins. Because Ae. albopictus has been shown experimentally to be a superior competitor to several mosquito species, we investigated larval competition between Ae. koreicus and Ae. albopictus using two diet levels (low level and high level) and 10 Ae. albopictus: Ae. koreicus density combination levels (30:0, 60:0, 15:15, 30:30, 10:20, 20:10, 20:40, 40:20, 0:60, and 0:30). A multivariate analysis (MANOVA) demonstrated a significant effect of the density combination on Ae. koreicus survivorship, female development time, and female wing length considered simultaneously in low-level diet and high-level diet treatments. Pairwise comparisons across low-level diet treatments showed a significant reduction of Ae. koreicus survivorship in 20:10 combination treatments (i.e. 20 Ae. albopictus and 10 Ae. koreicus larvae) compared to 10:20, 20:40, and 30:30 combination treatments, while no difference was detected for Ae. albopictus between density combination treatments. Furthermore, Ae. albopictus developed faster than Ae. koreicus regardless of diet and density combination treatments. Our results show weak larval competition between Ae. koreicus and Ae. albopictus with a slight advantage of the latter species. On the other hand, the presence of Ae. albopictus seems to favor the emergence of larger Ae. koreicus females. We suggest that factors such as habitats preferences or seasonal distributions may be determinant for the invasion success of Ae. koreicus. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Anti-PD-L1 atezolizumab-Induced Autoimmune Diabetes: a Case Report and Review of the Literature.

PubMed

Hickmott, Laura; De La Peña, Hugo; Turner, Helen; Ahmed, Fathelrahman; Protheroe, Andrew; Grossman, Ashley; Gupta, Avinash

2017-04-01

Programmed cell death-1 and programmed death ligand 1 (PD-1/PD-L1) inhibitors trigger an immune-mediated anti-tumour response by promoting the activation of cytotoxic T lymphocytes. Although proven to be highly effective in the treatment of several malignancies they can induce significant immune-related adverse events (irAEs) including endocrinopathies, most commonly hypophysitis and thyroid dysfunction, and rarely autoimmune diabetes. Here we present the first case report of a patient with a primary diagnosis of urothelial cancer developing PD-L1 inhibitor-induced autoimmune diabetes. A euglycemic 57 year old male presented to clinic with dehydration after the fifth cycle of treatment with the novel PD-L1 inhibitor atezolizumab. Blood tests demonstrated rapid onset hyperglycaemia (BM 24 mmol/L), ketosis and a low C-peptide level (0.65 ng/mL) confirming the diagnosis of type 1 diabetes. He responded well to insulin therapy and was discharged with stable blood glucose levels. Due to the widening use of PD-1/PD-L1 inhibitors in cancer treatment clinicians need to be aware of this rare yet treatable irAE. Given the morbidity and mortality associated with undiagnosed autoimmune diabetes we recommend routine HbA1c and plasma glucose testing in all patients prior to and during treatment with PD-1/PD-L1 inhibitors until more evidence has accumulated on identifying those patients with a pre-treatment risk of such irAEs.

VOLUMETRIC LEAK DETECTION IN LARGE UNDERGROUND STORAGE TANKS - VOLUME II: APPENDICES A-E

EPA Science Inventory

The program of experiments conducted at Griffiss Air Force Base was devised to expand the understanding of large underground storage tank behavior as it impacts the performance of volumetric leak detection testing. The report addresses three important questions about testing the ...

Joint Services Electronics Program Progress Report.

DTIC Science & Technology

1982-09-30

method has been successfully applied to scattering by submerged targets and to partially buried targets I0 . Other applications of our computational...The AES analyzer will enable us to detect possible contaminants on the sub- strate surface prior to MBR groqh as we have already done and to deter

Distribution of vectors, transmission indices and microfilaria rates of subperiodic Wuchereria bancrofti in relation to village ecotypes in Samoa.

PubMed

Samarawickrema, W A; Kimura, E; Spears, G F; Penaia, L; Sone, F; Paulson, G S; Cummings, R F

1987-01-01

Aedes polynesiensis and Ae. samoanus biting densities and Wuchereria bancrofti infection and infective rates were studied in 47 villages throughout the islands of Samoa Upolu, Manono and Savaii during 1978-79, and microfilaria (mf) rates were surveyed in 28 of the villages. The mf rate was correlated with both infection and infective rates of Ae. polynesiensis in Upolu, but not of Ae. samoanus. In Upolu, Ae. polynesiensis was apparently the major vector. It was relatively more abundant in more cultivated and populated areas, along the northern coast of Upolu, except Apia town area. In Savaii, Ae. samoanus predominated over Ae. polynesiensis except in "plantation" villages. Relatively high biting densities and rates of infection and infectivity indicated that Ae. samoanus was not less important than Ae. polynesiensis as a vector in Savaii. Ae. samoanus preferred natural vegetation, in contrast to Ae. polynesiensis which was found near human habitations in cultivated land. There was no difference between the biting densities of Ae. polynesiensis in "coastal" and "inland" villages, indicating that crab holes (numerous only in some coastal villages) may not influence the density of Ae. polynesiensis. Higher mf rates were associated with villages where Ae. polynesiensis, rather than Ae. samoanus, was dominant, indicating that Ae. polynesiensis was generally a more efficient vector. In the former villages, the difference in mf rates between males and females was smaller than in the latter, probably reflecting a difference in biting habits of the vectors. Ae. polynesiensis infections were recorded in plantations over 2 km from any village, suggesting that both habitats were foci of transmission.

Efficacy of the FIFA 11+ Injury Prevention Program in the Collegiate Male Soccer Player

PubMed Central

Silvers-Granelli, Holly; Mandelbaum, Bert; Adeniji, Ola; Insler, Stephanie; Bizzini, Mario; Pohlig, Ryan; Junge, Astrid; Snyder-Mackler, Lynn; Dvorak, Jiri

2016-01-01

Background The Fédération Internationale de Football Association (FIFA) 11+ program has been shown to be an effective injury prevention program in the female soccer cohort, but there is a paucity of research to demonstrate its efficacy in the male population. Hypothesis To examine the efficacy of the FIFA 11+ program in men's collegiate United States National Collegiate Athletic Association (NCAA) Division I and Division II soccer. Study Design Randomized controlled trial; Level of evidence, 1. Methods Before the commencement of the fall 2012 season, every NCAA Division I and Division II men's collegiate soccer team (N = 396) was solicited to participate in this research study. Human ethics review board approval was obtained through Quorum Review IRB. Sixty-five teams were randomized: 34 to the control group (CG; 850 players) and 31 to the intervention group (IG; 675 players). Four teams in the IG did not complete the study, reducing the number for analysis to 61. The FIFA 11+ injury prevention program served as the intervention and was utilized weekly. Athlete-exposures (AEs), compliance, and injury data were recorded using a secure Internet-based system. Results In the CG, 665 injuries (mean ± SD, 19.56 ± 11.01) were reported for 34 teams, which corresponded to an incidence rate (IR) of 15.04 injuries per 1000 AEs. In the IG, 285 injuries (mean ± SD, 10.56 ± 3.64) were reported for 27 teams, which corresponded to an IR of 8.09 injuries per 1000 AEs. Total days missed because of injury were significantly higher for the CG (mean ± SD, 13.20 ± 26.6 days) than for the IG (mean ± SD, 10.08 ± 14.68 days) (P = .007). There was no difference for time loss due to injury based on field type (P = .341). Conclusion The FIFA 11+ significantly reduced injury rates by 46.1% and decreased time loss to injury by 28.6% in the competitive male collegiate soccer player (rate ratio, 0.54 [95% CI, 0.49-0.59]; P < .0001) (number needed to treat = 2.64). PMID:26378030

Genome-Wide Identification and Expression Analysis of the UGlcAE Gene Family in Tomato.

PubMed

Ding, Xing; Li, Jinhua; Pan, Yu; Zhang, Yue; Ni, Lei; Wang, Yaling; Zhang, Xingguo

2018-05-27

The UGlcAE has the capability of interconverting UDP-d-galacturonic acid and UDP-d-glucuronic acid, and UDP-d-galacturonic acid is an activated precursor for the synthesis of pectins in plants. In this study, we identified nine UGlcAE protein-encoding genes in tomato. The nine UGlcAE genes that were distributed on eight chromosomes in tomato, and the corresponding proteins contained one or two trans-membrane domains. The phylogenetic analysis showed that SlUGlcAE genes could be divided into seven groups, designated UGlcAE1 to UGlcAE6 , of which the UGlcAE2 were classified into two groups. Expression profile analysis revealed that the SlUGlcAE genes display diverse expression patterns in various tomato tissues. Selective pressure analysis indicated that all of the amino acid sites of SlUGlcAE proteins are undergoing purifying selection. Fifteen stress-, hormone-, and development-related elements were identified in the upstream regions (0.5 kb) of these SlUGlcAE genes. Furthermore, we investigated the expression patterns of SlUGlcAE genes in response to three hormones (indole-3-acetic acid (IAA), gibberellin (GA), and salicylic acid (SA)). We detected firmness, pectin contents, and expression levels of UGlcAE family genes during the development of tomato fruit. Here, we systematically summarize the general characteristics of the SlUGlcAE genes in tomato, which could provide a basis for further function studies of tomato UGlcAE genes.

The signatures of acoustic emission waveforms from fatigue crack advancing in thin metallic plates

NASA Astrophysics Data System (ADS)

Yeasin Bhuiyan, Md; Giurgiutiu, Victor

2018-01-01

The acoustic emission (AE) waveforms from a fatigue crack advancing in a thin metallic plate possess diverse and complex spectral signatures. In this article, we analyze these waveform signatures in coordination with the load level during cyclic fatigue. The advancing fatigue crack may generate numerous AE hits while it grows under fatigue loading. We found that these AE hits can be sorted into various groups based on their AE waveform signatures. Each waveform group has a particular time-domain signal pattern and a specific frequency spectrum. This indicates that each group represents a certain AE event related to the fatigue crack growth behavior. In situ AE-fatigue experiments were conducted to monitor the fatigue crack growth with simultaneous measurement of AE signals, fatigue loading, and optical crack growth measurement. An in situ microscope was installed in the load-frame of the mechanical testing system (MTS) to optically monitor the fatigue crack growth and relate the AE signals with the crack growth measurement. We found the AE signal groups at higher load levels (75%-85% of maximum load) were different from the AE signal groups that happened at lower load levels (below 60% of load level). These AE waveform groups are highly related to the fatigue crack-related AE events. These AE signals mostly contain the higher frequency peaks (100 kHz, 230 kHz, 450 kHz, 550 kHz). Some AE signal groups happened as a clustered form that relates a sequence of small AE events within the fatigue crack. They happened at relatively lower load level (50%-60% of the maximum load). These AE signal groups may be related to crack friction and micro-fracture during the friction process. These AE signals mostly contain the lower frequency peaks (60 kHz, 100 kHz, 200 kHz). The AE waveform based analysis may give us comprehensive information of the metal fatigue.

AECM-4; Proceedings of the 4th International Symposium on Acoustic Emission from Composite Materials, Seattle, WA, July 27-31, 1992

NASA Astrophysics Data System (ADS)

Various papers on AE from composite materials are presented. Among the individual topics addressed are: acoustic analysis of tranverse lamina cracking in CFRP laminates under tensile loading, characterization of fiber failure in graphite-epoxy (G/E) composites, application of AE in the study of microfissure damage to composite used in the aeronautic and space industries, interfacial shear properties and AE behavior of model aluminum and titanium matrix composites, amplitude distribution modelling and ultimate strength prediction of ASTM D-3039 G/E tensile specimens, AE prefailure warning system for composite structural tests, characterization of failure mechanisms in G/E tensile tests specimens using AE data, development of a standard testing procedure to yield an AE vs. strain curve, benchmark exercise on AE measurements from carbon fiber-epoxy composites. Also discussed are: interpretation of optically detected AE signals, acoustic emission monitoring of fracture process of SiC/Al composites under cyclic loading, application of pattern recognition techniques to acousto-ultrasonic testing of Kevlar composite panels, AE for high temperature monitoring of processing of carbon/carbon composite, monitoring the resistance welding of thermoplastic composites through AE, plate wave AE composite materials, determination of the elastic properties of composite materials using simulated AE signals, AE source location in thin plates using cross-correlation, propagation of flexural mode AE signals in Gr/Ep composite plates.

National Dam Safety Program. Lindys Lake Dam (NJ00201), Passaic River Basin, Branch of West Brook, Passaic County, New Jersey. Phase 1 Inspection Report.

DTIC Science & Technology

1980-02-01

shallow ground moraine over rock. The downstream channel is described as swamp. The rock is described on Geologic Overlay Sheet 22, as hornblende granite ...DAM 410-04’ hqa Scale: I" =I Mite LEGEND: PRECAMBRIAN gh Mostly Hornblende Granite and Gneiss. hqa Hyperstene-Quartz- And esine.-Gneiss. GEOLOGIC MAP L...A.J. 0o2o/) S CZ6 -§&S5 /,r/ C,4 7-1 ,4V-etaoe Dep4e&/LaL L* rt~~~c~~t4’A aeS’ OP~ ~ A AI 3CD PS?7V7,/ & zAer ’, ! v’.’:7- z - 6 c ,, ,, ,,g

KSC-2012-4238

NASA Image and Video Library

2012-08-03

CAPE CANAVERAL, Fla. – Inside the Space Life Sciences Laboratory, or SLSL, at NASA’s Kennedy Space Center in Florida, radish plants are being harvested in a plant growth chamber. The plants were grown under red and blue LED lights. The plant experiment at Kennedy is part of the Advanced Exploration Systems, or AES, program in NASA’s Human Exploration and Operations Mission Directorate. This plant experiment studies the effects of different types of lighting on plants such as radishes and leaf lettuce. Results of these studies will help provide information on how to grow food sources for deep space exploration missions. AES projects pioneer new approaches for rapidly developing prototype systems, demonstrating key capabilities and validating operational concepts for future human missions beyond Earth orbit. Photo credit: NASA/Frank Ochoa-Gonzales

KSC-2012-4241

NASA Image and Video Library

2012-08-03

CAPE CANAVERAL, Fla. – Inside the Space Life Sciences Laboratory, or SLSL, at NASA’s Kennedy Space Center in Florida, radish plants were harvested from a plant growth chamber. The plants were grown under red and blue LED lights. The plant experiment at Kennedy is part of the Advanced Exploration Systems, or AES, program in NASA’s Human Exploration and Operations Mission Directorate. This plant experiment studies the effects of different types of lighting on plants such as radishes and leaf lettuce. Results of these studies will help provide information on how to grow food sources for deep space exploration missions. AES projects pioneer new approaches for rapidly developing prototype systems, demonstrating key capabilities and validating operational concepts for future human missions beyond Earth orbit. Photo credit: NASA/Frank Ochoa-Gonzales

Natural Resources Research Program. An Assessment of the National Economic Effects of the U.S. Army Corps of Engineers Recreation Program

DTIC Science & Technology

1994-06-01

Propst Michigan State University Qý-94-25006IH~IIUAlAE ’TIC Z-"’,". JAUG 7 IE 94 Approved For Public Release; Distribution Is Unlimited ’MC QtYU"y fI’jc...Vicksburg, MS. V 1 Introduction The U.S. Army Corps of Engineers (CE) manages over 460 water resomrce development projects throughout the United

[Adverse events in general and digestive surgery departments in Spanish hospitals].

PubMed

Aranaz-Andrés, Jesús M; Ruiz-López, Pedro; Aibar-Remón, Carlos; Requena-Puche, Juana; Agra-Varela, Yolanda; Limón-Ramírez, Ramón; Gea-Velázquez de Castro, María Teresa; Miralles-Bueno, Juan José; Júdez-Legaristi, Diego

2007-11-01

To determine the incidence of patients with adverse events (AE) in Spanish general surgery units, describe the immediate causes of AE, identify avoidable AE, and determine the impact of these events. We performed a retrospective cohort study of a randomized stratified sample of 24 hospitals. Six of the hospitals were small (fewer than 200 beds), 13 were medium-sized (between 200 and 499 beds) and five were large (500 or more beds). Patients admitted for more than 24 hours to the selected hospitals and who were discharged between the 4th and 10th of June 2005 were included. AE detected during hospitalization and those occurring as a consequence of previous admissions in the same hospital were analyzed. The incidence of patients with AE associated with medical care was 10.5% (76/735; 95%CI: 8.1%-12.5%). The presence of intrinsic risk factors increased the risk of AE (14.8% vs 7.2%; P=.001). Likewise, 16.2% of patients with an extrinsic risk factor had an AE compared with 7.0% of those without these risk factors (P< .001). Comorbidity influenced the occurrence of AE (33.7% of AE vs. 2.2% without comorbidity; P< .001). The severity of the AE was related to ASA risk (P=.036). AE were related to nosocomial infection (41.7%), procedures (27.1%) and medication (24%). A total of 31.3% of the AE were mild, 39.6% were moderate, and 29.2% were severe. Preventable AE accounted for 36.5%. AE caused an additional 527 days of stay (6.3 additional days of stay per patient), of which 216 were due to preventable AE. Patients in general and digestive surgery units have an increased risk of AE. Risk factors for these events are age, comorbidity, and the use of external devices. A substantial number of AE are related to nosocomial infection (especially surgical wound infection) and to surgical procedures. AE have an important impact on patients and a considerable proportion of these events are preventable. AE have strong health, social and economic repercussions and until recently have constituted a silent epidemic in Spain. Consequently, study of these events should be a public health priority.

Statin Adverse Effects: A Review of the Literature and Evidence for a Mitochondrial Mechanism

PubMed Central

Golomb, Beatrice A.; Evans, Marcella A.

2009-01-01

HMG-CoA reductase inhibitors (statins) are a widely used class of drug, and like all medications have potential for adverse effects (AEs). Here we review the statin AE literature, first focusing on muscle AEs as the most reported problem both in the literature and by patients. Evidence regarding the statin muscle AE mechanism, dose effect, drug interactions, and genetic predisposition is examined. We hypothesize, and provide evidence, that the demonstrated mitochondrial mechanisms for muscle AEs have implications to other nonmuscle AEs in patients treated with statins. In meta-analyses of randomized controlled trials (RCTs), muscle AEs are more frequent with statins than with placebo. A number of manifestations of muscle AEs have been reported, with rhabdomyolysis the most feared. AEs are dose dependent, and risk is amplified by drug interactions that functionally increase statin potency, often through inhibition of the cytochrome P450 (CYP)3A4 system. An array of additional risk factors for statin AEs are those that amplify (or reflect) mitochondrial or metabolic vulnerability, such as metabolic syndrome factors, thyroid disease, and genetic mutations linked to mitochondrial dysfunction. Converging evidence supports a mitochondrial foundation for muscle AEs associated with statins, and both theoretical and empirical considerations suggest that mitochondrial dysfunction may also underlie many non-muscle statin AEs. Evidence from RCTs and studies of other designs indicates existence of additional statin-associated AEs, such as cognitive loss, neuropathy, pancreatic and hepatic dysfunction, and sexual dysfunction. Physician awareness of statin AEs is reportedly low even for the AEs most widely reported by patients. Awareness and vigilance for AEs should be maintained to enable informed treatment decisions, treatment modification if appropriate, improved quality of patient care, and reduced patient morbidity. PMID:19159124

Relationships Among Adverse Events, Disease Characteristics, and Demographics in Treatment of Postherpetic Neuralgia With Gastroretentive Gabapentin

PubMed Central

Slattum, Patricia W.; Bucior, Iwona; Nalamachu, Srinivas

2015-01-01

Objectives: To characterize risk factors for occurrence of adverse events (AEs) and treatment discontinuations due to AEs for improving safety and tolerability of treatment of postherpetic neuralgia (PHN). Methods: Patients with PHN (n=556) received 1800 mg once-daily gastroretentive gabapentin (G-GR) in 2 phase 3 and 1 phase 4 study. Safety assessments included the incidence and severity of AEs and analysis of discontinuations due to AEs. Multivariable, logistic regression analyses examined predictors of AE reporting and discontinuations due to AEs. Results: In total, 53.2% of patients reported any AE, and 12.9% discontinued because of AEs. Both AE incidence and treatment discontinuations decreased rapidly during the 2-week titration to sustained, low levels. The probability to report any AE was 0.6 for females versus 0.4 for males, whereas there were no differences in probabilities for age (less than 75 vs. 75 y and older) and race (nonwhite vs. white). Consistent with this, only female sex was a significant (P=0.0006) predictor of AE reporting. Experiencing moderate (P≤0.0001) or severe (P=0.0006) AEs, but not patient demographics, was predictive of treatment discontinuations. The probability of discontinuation due to moderate AEs was 0.4 and 0.5 for severe AEs. Discussion: The tolerability of G-GR was not affected by patient age, but was affected by AE severity. Although being female was predictive of reporting AEs, it did not influence treatment discontinuation. Given that PHN is a disease for which the risk and duration of PHN increases with age and with being female, G-GR appears to be a well-suited treatment option for PHN. PMID:25811794

The Epidemiology of High Ankle Sprains in National Collegiate Athletic Association Sports.

PubMed

Mauntel, Timothy C; Wikstrom, Erik A; Roos, Karen G; Djoko, Aristarque; Dompier, Thomas P; Kerr, Zachary Y

2017-07-01

Ankle sprains are among the most common injuries experienced by collegiate athletes. The type of ankle sprain is rarely differentiated in epidemiological studies. This differentiation is necessary, as each ankle sprain type has a unique injury mechanism and recovery period. High ankle sprains commonly result in long recovery periods. Thus, a further examination of the epidemiology of high ankle sprains is warranted. To describe the epidemiology of high ankle sprains in National Collegiate Athletic Association (NCAA) sports during the 2009/2010-2014/2015 academic years. Descriptive epidemiology study. NCAA Injury Surveillance Program high ankle sprain data and athlete-exposures (AEs) from 25 sports were evaluated. Certified athletic trainers recorded sport-related injury, event, and AE data during team-sanctioned events. High ankle sprain injury rates per 10,000 AEs were calculated. Percentage distributions were calculated for the amount of time lost from sport and percentage of recurrent injuries. Injury rate ratios (RRs) and 95% CIs compared injury rates by event type, participation restriction time, and sex. 95% CIs not containing 1.00 were considered statistically significant. The overall high ankle sprain injury rate was 1.00 per 10,000 AEs. Overall, 56.7% of high ankle sprain injuries occurred during competitions, and 9.8% of high ankle sprain injuries were recurrent. Men's football (2.42/10,000 AEs), wrestling (2.11/10,000 AEs), and ice hockey (1.19/10,000 AEs) had the highest high ankle sprain injury rates. In sex-comparable sports, men had higher injury rates (RR, 1.77; 95% CI, 1.28-2.44). Player contact was the most common injury mechanism (60.4%), and 69.0% of injuries resulted in ≥1 day of participation restriction, with 47.1% resulting in ≥7 days of participation restriction and 15.8% resulting in >21 days of participation restriction. High ankle sprains resulted in significant participation restriction time from sport participation. The majority of high ankle sprain injuries resulted from player contact and were observed in contact/collision sports. The large proportion of high ankle sprains resulting from player contact, specifically in male contact sports, is worthy of further investigation. The enhanced understanding of the epidemiology of high ankle sprains provided in our study will aid clinicians in developing targeted injury prevention strategies to mitigate the negative consequences of these injuries.

Validating Automated Essay Scoring for Online Writing Placement

ERIC Educational Resources Information Center

Ramineni, Chaitanya

2013-01-01

In this paper, I describe the design and evaluation of automated essay scoring (AES) models for an institution's writing placement program. Information was gathered on admitted student writing performance at a science and technology research university in the northeastern United States. Under timed conditions, first-year students (N = 879) were…

Track-Before-Declare Methods in IR Image Sequences

DTIC Science & Technology

1992-09-01

processing methods of this type, known as track- before-declare (TBD), and sometimes by the misleading term track - before - detect , have been employed in systems...Electronic Systems, Vol. AES-il, No. 6. November 1975. 8. A. Corbeil, J. DiDomizio, Track - Before - Detect Development and Demonstration Program, Phase

Power Consumption and Calculation Requirement Analysis of AES for WSN IoT.

PubMed

Hung, Chung-Wen; Hsu, Wen-Ting

2018-05-23

Because of the ubiquity of Internet of Things (IoT) devices, the power consumption and security of IoT systems have become very important issues. Advanced Encryption Standard (AES) is a block cipher algorithm is commonly used in IoT devices. In this paper, the power consumption and cryptographic calculation requirement for different payload lengths and AES encryption types are analyzed. These types include software-based AES-CB, hardware-based AES-ECB (Electronic Codebook Mode), and hardware-based AES-CCM (Counter with CBC-MAC Mode). The calculation requirement and power consumption for these AES encryption types are measured on the Texas Instruments LAUNCHXL-CC1310 platform. The experimental results show that the hardware-based AES performs better than the software-based AES in terms of power consumption and calculation cycle requirements. In addition, in terms of AES mode selection, the AES-CCM-MIC64 mode may be a better choice if the IoT device is considering security, encryption calculation requirement, and low power consumption at the same time. However, if the IoT device is pursuing lower power and the payload length is generally less than 16 bytes, then AES-ECB could be considered.

Differential Adverse Event Profiles Associated with BCG as a Preventive Tuberculosis Vaccine or Therapeutic Bladder Cancer Vaccine Identified by Comparative Ontology-Based VAERS and Literature Meta-Analysis

PubMed Central

Xie, Jiangan; Codd, Christopher; Mo, Kevin; He, Yongqun

2016-01-01

M. bovis strain Bacillus Calmette–Guérin (BCG) has been the only licensed live attenuated vaccine against tuberculosis (TB) for nearly one century and has also been approved as a therapeutic vaccine for bladder cancer treatment since 1990. During its long time usage, different adverse events (AEs) have been reported. However, the AEs associated with the BCG preventive TB vaccine and therapeutic cancer vaccine have not been systematically compared. In this study, we systematically collected various BCG AE data mined from the US VAERS database and PubMed literature reports, identified statistically significant BCG-associated AEs, and ontologically classified and compared these AEs related to these two types of BCG vaccine. From 397 VAERS BCG AE case reports, we identified 64 AEs statistically significantly associated with the BCG TB vaccine and 14 AEs with the BCG cancer vaccine. Our meta-analysis of 41 peer-reviewed journal reports identified 48 AEs associated with the BCG TB vaccine and 43 AEs associated with the BCG cancer vaccine. Among all identified AEs from VAERS and literature reports, 25 AEs belong to serious AEs. The Ontology of Adverse Events (OAE)-based ontological hierarchical analysis indicated that the AEs associated with the BCG TB vaccine were enriched in immune system (e.g., lymphadenopathy and lymphadenitis), skin (e.g., skin ulceration and cyanosis), and respiratory system (e.g., cough and pneumonia); in contrast, the AEs associated with the BCG cancer vaccine mainly occurred in the urinary system (e.g., dysuria, pollakiuria, and hematuria). With these distinct AE profiles detected, this study also discovered three AEs (i.e., chills, pneumonia, and C-reactive protein increased) shared by the BCG TB vaccine and bladder cancer vaccine. Furthermore, our deep investigation of 24 BCG-associated death cases from VAERS identified the important effects of age, vaccine co-administration, and immunosuppressive status on the final BCG-associated death outcome. PMID:27749923

Prospective comparison of two models of integrating early infant male circumcision with maternal child health services in Kenya: The Mtoto Msafi Mbili Study

PubMed Central

Adera, Fredrick; Mackesy-Amiti, Mary Ellen; Adipo, Timothy; Nordstrom, Sherry K.; Mehta, Supriya D.; Jaoko, Walter; Langi, F. L. Fredrik G.; Obiero, Walter; Obat, Edmon; Otieno, Fredrick O.; Young, Marisa R.

2017-01-01

As countries scale up adult voluntary medical male circumcision (VMMC) for HIV prevention, they are looking ahead to long term sustainable strategies, including introduction of early infant male circumcision (EIMC). To address the lack of evidence regarding introduction of EIMC services in sub-Saharan African settings, we conducted a simultaneous, prospective comparison of two models of EIMC service delivery in Homa Bay County, Kenya. In one division a standard delivery package (SDP) was introduced and included health facility-based provision of EIMC services with community engagement for client referral versus in a different division a standard package plus (SDPplus) that included community-delivered EIMC services. Babies 1–60 days old were eligible for EIMC. A representative sample of mothers and fathers of baby boys at 16 health facilities was surveyed. We examined differences between mothers and fathers in the SDP and SDPplus divisions and identified factors associated with EIMC uptake. We report adjusted prevalence ratios (aPR). Of 1660 mothers interviewed, 1501 (89%) gave approval to contact the father, and 1259 fathers (84%) were interviewed. The proportion of babies circumcised was slightly greater in the SDPplus division than the SDP division (27.3% vs 23.7%), but the difference was not significant (p = 0.08). In adjusted analyses, however, the prevalence of babies being circumcised was greater in the SDPplus division (aPR = 1.23, 95% CI:1.04–1.45) and the factors associated with a baby being circumcised were the mother having received information about EIMC (during pregnancy, aPR = 4.81, 95% CI: 2.21–3.42), having discussed circumcision with the father if married or cohabiting (aPR = 5.39, 95% CI: 3.31–8.80) or being single (aPR = 5.67, 95% CI: 3.31–9.69), perceiving herself to be living with HIV (aPR = 1.39, 95% CI: 1.15–1.67), or having a post-secondary education (aPR = 1.33, 95% CI: 1.04–1.69), and the father being Muslim (aPR = 1.85, 95% CI: 1.29–2.65) or circumcised (aPR = 1.34, 95% CI: 1.13–1.59). The median age of 2117 babies circumcised was 8 days (IQR: 1–36), and the median weight was 3.6 kg (IQR: 3.2–4.4). There were 6 moderate adverse events (AEs) (0.28%); 5 severe AEs (0.24%), all involving an injury to the glans penis, requiring hospitalization and corrective surgery; and one death probably related to the procedure. There were no AEs among the 365 procedures performed outside health facilities. Information and education campaigns must reach members of the general population, especially men and fathers, who are influential to the EIMC decision. Serious AEs using the Mogen clamp are rare, but do occur and require efficient, reliable emergency back-up. Our results can assist countries considering scale-up of EIMC services for HIV prevention as their adult VMMC programs mature. PMID:28880904

Fatigue crack monitoring with coupled piezoelectric film acoustic emission sensors

NASA Astrophysics Data System (ADS)

Zhou, Changjiang

Fatigue-induced cracking is a commonly seen problem in civil infrastructures reaching their original design life. A number of high-profile accidents have been reported in the past that involved fatigue damage in structures. Such incidences often happen without prior warnings due to lack of proper crack monitoring technique. In order to detect and monitor the fatigue crack, acoustic emission (AE) technique, has been receiving growing interests recently. AE can provide continuous and real-time monitoring data on damage progression in structures. Piezoelectric film AE sensor measures stress-wave induced strain in ultrasonic frequency range and its feasibility for AE signal monitoring has been demonstrated recently. However, extensive work in AE monitoring system development based on piezoelectric film AE sensor and sensor characterization on full-scale structures with fatigue cracks, have not been done. A lack of theoretical formulations for understanding the AE signals also hinders the use of piezoelectric film AE sensors. Additionally, crack detection and source localization with AE signals is a very important area yet to be explored for this new type of AE sensor. This dissertation presents the results of both analytical and experimental study on the signal characteristics of surface stress-wave induced AE strain signals measured by piezoelectric film AE sensors in near-field and an AE source localization method based on sensor couple theory. Based on moment tensor theory, generalized expression for AE strain signal is formulated. A special case involving the response of piezoelectric film AE sensor to surface load is also studied, which could potentially be used for sensor calibration of this type of sensor. A new concept of sensor couple theory based AE source localization technique is proposed and validated with both simulated and experimental data from fatigue test and field monitoring. Two series of fatigue tests were conducted to perform fatigue crack monitoring on large-scale steel test specimens using piezoelectric film AE sensors. Continuous monitoring of fatigue crack growth in steel structures is demonstrated in these fatigue test specimens. The use of piezoelectric film AE sensor for field monitoring of existing fatigue crack is also demonstrated in a real steel I-girder bridge located in Maryland. The sensor couple theory based AE source localization is validated using a limited number of piezoelectric film AE sensor data from both fatigue test specimens and field monitoring bridge. Through both laboratory fatigue test and field monitoring of steel structures with active fatigue cracks, the signal characteristics of piezoelectric film AE sensor have been studied in real-world environment.

An Optimal Image-Based Method for Identification of Acoustic Emission (AE) Sources in Plate-Like Structures Using a Lead Zirconium Titanate (PZT) Sensor Array.

PubMed

Yan, Gang; Zhou, Li

2018-02-21

This paper proposes an innovative method for identifying the locations of multiple simultaneous acoustic emission (AE) events in plate-like structures from the view of image processing. By using a linear lead zirconium titanate (PZT) sensor array to record the AE wave signals, a reverse-time frequency-wavenumber (f-k) migration is employed to produce images displaying the locations of AE sources by back-propagating the AE waves. Lamb wave theory is included in the f-k migration to consider the dispersive property of the AE waves. Since the exact occurrence time of the AE events is usually unknown when recording the AE wave signals, a heuristic artificial bee colony (ABC) algorithm combined with an optimal criterion using minimum Shannon entropy is used to find the image with the identified AE source locations and occurrence time that mostly approximate the actual ones. Experimental studies on an aluminum plate with AE events simulated by PZT actuators are performed to validate the applicability and effectiveness of the proposed optimal image-based AE source identification method.

An Optimal Image-Based Method for Identification of Acoustic Emission (AE) Sources in Plate-Like Structures Using a Lead Zirconium Titanate (PZT) Sensor Array

PubMed Central

Zhou, Li

2018-01-01

This paper proposes an innovative method for identifying the locations of multiple simultaneous acoustic emission (AE) events in plate-like structures from the view of image processing. By using a linear lead zirconium titanate (PZT) sensor array to record the AE wave signals, a reverse-time frequency-wavenumber (f-k) migration is employed to produce images displaying the locations of AE sources by back-propagating the AE waves. Lamb wave theory is included in the f-k migration to consider the dispersive property of the AE waves. Since the exact occurrence time of the AE events is usually unknown when recording the AE wave signals, a heuristic artificial bee colony (ABC) algorithm combined with an optimal criterion using minimum Shannon entropy is used to find the image with the identified AE source locations and occurrence time that mostly approximate the actual ones. Experimental studies on an aluminum plate with AE events simulated by PZT actuators are performed to validate the applicability and effectiveness of the proposed optimal image-based AE source identification method. PMID:29466310

15 CFR Appendix B to Part 30 - AES Filing Codes

Code of Federal Regulations, 2013 CFR

2013-01-01

... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false AES Filing Codes B Appendix B to Part..., DEPARTMENT OF COMMERCE FOREIGN TRADE REGULATIONS Pt. 30, App. B Appendix B to Part 30—AES Filing Codes Part I... Manifest Use Only by AES Carriers) AE Shipment information filed through AES (See §§ 30.50 through 30.58...

15 CFR Appendix B to Part 30 - AES Filing Codes

Code of Federal Regulations, 2012 CFR

2012-01-01

... 15 Commerce and Foreign Trade 1 2012-01-01 2012-01-01 false AES Filing Codes B Appendix B to Part..., DEPARTMENT OF COMMERCE FOREIGN TRADE REGULATIONS Pt. 30, App. B Appendix B to Part 30—AES Filing Codes Part I... Manifest Use Only by AES Carriers) AE Shipment information filed through AES (See §§ 30.50 through 30.58...

The Influence of Short-Term Adventure-Based Experiences on Levels of Resilience

ERIC Educational Resources Information Center

Ewert, Alan; Yoshino, Aiko

2011-01-01

This exploratory study investigated the impact of participation in a three-week adventure education (AE) expedition upon levels of resilience of university students. Resilience is considered to be a dynamic process of positive adaptation to significant threat or adversity and may be an important variable to study as college students often live…

Atopic and nonatopic eczema in adolescence: is there a difference?

PubMed

Johansson, E K; Ballardini, N; Bergström, A; Kull, I; Wahlgren, C-F

2015-10-01

There is limited information on clinical manifestations of atopic eczema (AE) and non-AE in teenagers. To describe the characteristics of adolescent eczema in the general population and to identify potential differences between AE and non-AE in teenagers. Overall, 3108 teenagers were included from the population-based BAMSE cohort and 2529 of these teenagers provided blood samples for analysis of specific IgE. At age 16 years, the teenagers answered questionnaires regarding the symptoms of eczema, asthma and rhinitis for the previous year. The prevalence of eczema in adolescence was 9·6% (n = 297). More girls than boys had eczema (12·5% vs. 6·5%; P < 0·001). The age at onset was usually within the first 2 years of life (48·8%), but onset in adolescence was also common (25·6%). Eczema was mild in 72·7% of cases, moderate in 16·8% and severe in 10·4%. Body folds were most frequently affected (73·4%). More than half of the teenagers with eczema had AE (59%). The teenagers with AE had more severe and more chronic eczema. Onset in infancy was most common in AE and onset in adolescence was most common in non-AE. There were no major differences in location or seasonal variance between AE and non-AE in adolescence. AE is more common than non-AE among teenagers. More than one in four teenagers with eczema has moderate-to-severe disease. Onset in adolescence is common, especially for non-AE. AE in adolescence has an earlier onset and is more chronic and more severe than non-AE. © 2015 British Association of Dermatologists.

A preliminary observation of the adverse effects of phenobarbital among patients with convulsive epilepsy in rural West China.

PubMed

Si, Yang; Liu, Ling; Tian, Linyu; Mu, Jie; Chen, Deng; Chen, Tao; Deng, Ying; He, Jun; Li, You; He, Li; Zhou, Dong

2016-01-01

This study explored the adverse effect (AE) profile of phenobarbital (PB) among patients with active convulsive epilepsy (ACE) from resource-poor areas. Patients with ACE were enrolled into an epilepsy management project in rural West China. Information was obtained from monthly follow-up questionnaires. The demographic and clinical features of the patients with AE were firstly described. After that, the occurrence rate was estimated for each subtype of AE at three different severity levels (mild, moderate, and serious). Survival analysis was used to determine the potential risk factors of AEs. A total of 7231 patients (3780 men) were included in the present cohort. During the follow-up time period (average 33.4months), the most common AEs were drowsiness (moderate: 4.4%, serious: 0.68%), dizziness (moderate: 3.7%, serious: 0.5%), and headache (moderate: 2.9%, serious: 0.41%). In the confirmed AE groups (moderate and serious severity levels), the symptoms tended to be transient, with durations of less than 3months. Polytherapy was an independent risk factor for AEs and had an increasing risk when the severity of the AE increased (Hazard Ratio 1.12, 1.55, and 2.52 for mild AE, moderate AE, and serious AE, respectively). Receiving a high dosage of PB (>180mg/day) indicated a slightly elevated risk (Hazard Ratio 1.22 and 1.27 for mild AE and moderate AE, respectively). Phenobarbital demonstrates overall tolerability, and serious AEs were not common. Patients receiving a high dose of PB or polytherapy are at increased risk of developing AEs. Copyright © 2015 Elsevier Inc. All rights reserved.

Prevalence of injuries in Wushu competition during the 1st Asian Martial Arts Games 2009.

PubMed

Yiemsiri, Pichet; Wanawan, Amarin

2014-02-01

To determine the prevalence and characteristic of injuries in Wushu Competition during the IP' Asian MartialArts Games 2009. Sixty international athletes (38 males) participating in Wushu Competition during the 1st Asian Martial Arts Games 2009. Injuries were recorded on injury report forms to document any injuries seen and treatment provided by tournament physician during competitions. The injury forms described the athlete s causes, type, site, and severity of the injuries. There were 60 international athletes the average age were 22.49 +/- 3.75 years. The prevalence ofinjuries was 228.07/ 1000 athlete exposure (AE). The prevalence in males andfemales was 161.76/1000 AE and 326.09/1000 AE, respectively. The most common injured body parts in males were lower extremities 102.94/1000 AE, followed by head and face injuries 58.82/1000 AE. The most common injured body parts in females were lower extremities 282.61/1000 AE. The most common types of injuries in males were contusions 58.82/1000 AE, concussion 29.41/1000 AE and strain-sprain 29.41/1000 AE. In females the most common type of injury were contusion 195.65/1000 AEfollowed by strain-sprain 130.43/1000 AE. The most common mechanism of injury in males werereceiving a punch 58.82/1000 AE, receiving a kick 44.12/1000 AE and delivering a kick 44.12/1000 AE. Meanwhile, in females common mechanisms were receiving a kick 152.17/1000 AE followed by delivering a kick 130.43/1000 AE. High prevalence of injuries in Wushu competition during the 1" Asian MartialArts Games 2009 revealedfemale injuries were higher than male and had a higher prevalence compared with Muay Thai or Taekwondo competitions.

PFC Emissions from Detected Versus Nondetected Anode Effects in the Aluminum Industry

NASA Astrophysics Data System (ADS)

Wong, David S.; Fraser, Paul; Lavoie, Pascal; Kim, Jooil

2015-02-01

Perfluorinated carbon compounds (PFCs) CF4 and C2F6 are potent greenhouse gases that are generated in aluminum reduction cells during events known as anode effects (AEs). Since the 1990s, the aluminum industry has made considerable progress in reducing PFCs from conventionally defined and detected AEs. However in recent years, the industry has noted the presence of unaccounted PFCs that are generated outside the conventional AE definition. Two additional AE categories have been proposed, namely low-voltage, propagating AEs (LVP-AEs) and nonpropagating AEs (NP-AEs) that relate to continuous, background levels of PFC emissions. These unaccounted PFC phenomena may help explain the recent discrepancy between industry accounting and atmospheric measurements of global PFC emissions. Estimates from AGAGE, a global network of atmospheric observatories, suggest as much as 50% underaccounting of PFCs by the aluminum industry in the 2006-2010 period. The following work reviews this discrepancy and the potential role played by LVP-AEs and NP-AEs.

Role of Cl−–HCO3 − exchanger AE3 in intracellular pH homeostasis in cultured murine hippocampal neurons, and in crosstalk to adjacent astrocytes

PubMed Central

Salameh, Ahlam I.; Hübner, Christian A.

2016-01-01

Key points A polymorphism of human AE3 is associated with idiopathic generalized epilepsy. Knockout of AE3 in mice lowers the threshold for triggering epileptic seizures. The explanations for these effects are elusive.Comparisons of cells from wild‐type vs. AE3–/– mice show that AE3 (present in hippocampal neurons, not astrocytes; mediates HCO3 – efflux) enhances intracellular pH (pHi) recovery (decrease) from alkali loads in neurons and, surprisingly, adjacent astrocytes.During metabolic acidosis (MAc), AE3 speeds initial acidification, but limits the extent of pHi decrease in neurons and astrocytes.AE3 speeds re‐alkalization after removal of MAc in neurons and astrocytes, and speeds neuronal pHi recovery from an ammonium prepulse‐induced acid load.We propose that neuronal AE3 indirectly increases acid extrusion in (a) neurons via Cl– loading, and (b) astrocytes by somehow enhancing NBCe1 (major acid extruder). The latter would enhance depolarization‐induced alkalinization of astrocytes, and extracellular acidification, and thereby reduce susceptibility to epileptic seizures. Abstract The anion exchanger AE3, expressed in hippocampal (HC) neurons but not astrocytes, contributes to intracellular pH (pHi) regulation by facilitating the exchange of extracellular Cl– for intracellular HCO3 –. The human AE3 polymorphism A867D is associated with idiopathic generalized epilepsy. Moreover, AE3 knockout (AE3–/–) mice are more susceptible to epileptic seizure. The mechanism of these effects has been unclear because the starting pHi in AE3–/– and wild‐type neurons is indistinguishable. The purpose of the present study was to use AE3–/– mice to investigate the role of AE3 in pHi homeostasis in HC neurons, co‐cultured with astrocytes. We find that the presence of AE3 increases the acidification rate constant during pHi recovery from intracellular alkaline loads imposed by reducing [CO2]. The presence of AE3 also speeds intracellular acidification during the early phase of metabolic acidosis (MAc), not just in neurons but, surprisingly, in adjacent astrocytes. Additionally, AE3 contributes to braking the decrease in pHi later during MAc in both neurons and astrocytes. Paradoxically, AE3 enhances intracellular re‐alkalization after MAc removal in neurons and astrocytes, and pHi recovery from an ammonium prepulse‐induced acid load in neurons. The effects of AE3 knockout on astrocytic pHi homeostasis in MAc‐related assays require the presence of neurons, and are consistent with the hypothesis that the AE3 knockout reduces functional expression of astrocytic NBCe1. These findings suggest a new type of neuron–astrocyte communication, based on the expression of AE3 in neurons, which could explain how AE3 reduces seizure susceptibility. PMID:27353306

Role of Cl- -HCO3- exchanger AE3 in intracellular pH homeostasis in cultured murine hippocampal neurons, and in crosstalk to adjacent astrocytes.

PubMed

Salameh, Ahlam I; Hübner, Christian A; Boron, Walter F

2017-01-01

A polymorphism of human AE3 is associated with idiopathic generalized epilepsy. Knockout of AE3 in mice lowers the threshold for triggering epileptic seizures. The explanations for these effects are elusive. Comparisons of cells from wild-type vs. AE3 -/- mice show that AE3 (present in hippocampal neurons, not astrocytes; mediates HCO 3 - efflux) enhances intracellular pH (pH i ) recovery (decrease) from alkali loads in neurons and, surprisingly, adjacent astrocytes. During metabolic acidosis (MAc), AE3 speeds initial acidification, but limits the extent of pH i decrease in neurons and astrocytes. AE3 speeds re-alkalization after removal of MAc in neurons and astrocytes, and speeds neuronal pH i recovery from an ammonium prepulse-induced acid load. We propose that neuronal AE3 indirectly increases acid extrusion in (a) neurons via Cl - loading, and (b) astrocytes by somehow enhancing NBCe1 (major acid extruder). The latter would enhance depolarization-induced alkalinization of astrocytes, and extracellular acidification, and thereby reduce susceptibility to epileptic seizures. The anion exchanger AE3, expressed in hippocampal (HC) neurons but not astrocytes, contributes to intracellular pH (pH i ) regulation by facilitating the exchange of extracellular Cl - for intracellular HCO 3 - . The human AE3 polymorphism A867D is associated with idiopathic generalized epilepsy. Moreover, AE3 knockout (AE3 -/- ) mice are more susceptible to epileptic seizure. The mechanism of these effects has been unclear because the starting pH i in AE3 -/- and wild-type neurons is indistinguishable. The purpose of the present study was to use AE3 -/- mice to investigate the role of AE3 in pH i homeostasis in HC neurons, co-cultured with astrocytes. We find that the presence of AE3 increases the acidification rate constant during pH i recovery from intracellular alkaline loads imposed by reducing [CO 2 ]. The presence of AE3 also speeds intracellular acidification during the early phase of metabolic acidosis (MAc), not just in neurons but, surprisingly, in adjacent astrocytes. Additionally, AE3 contributes to braking the decrease in pH i later during MAc in both neurons and astrocytes. Paradoxically, AE3 enhances intracellular re-alkalization after MAc removal in neurons and astrocytes, and pH i recovery from an ammonium prepulse-induced acid load in neurons. The effects of AE3 knockout on astrocytic pH i homeostasis in MAc-related assays require the presence of neurons, and are consistent with the hypothesis that the AE3 knockout reduces functional expression of astrocytic NBCe1. These findings suggest a new type of neuron-astrocyte communication, based on the expression of AE3 in neurons, which could explain how AE3 reduces seizure susceptibility. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

Angiographic embolization in the treatment of intrahepatic arterial bleeding in patients with blunt abdominal trauma.

PubMed

Kong, Ya-Lin; Zhang, Hong-Yi; He, Xiao-Jun; Zhao, Gang; Liu, Cheng-Li; Xiao, Mei; Zhen, Yu-Ying

2014-04-01

Angiographic embolization (AE) as an adjunct non-operative treatment of intrahepatic arterial bleeding has been widely used. The present study aimed to evaluate the efficacy of selective AE in patients with hepatic trauma. Seventy patients with intrahepatic arterial bleeding after blunt abdominal trauma who had undergone selective AE in 10 years at this institution were retrospectively reviewed. The criteria for selective AE included active extravasation on contrast-enhanced CT, an episode of hypotension or a decrease in hemoglobin level during the non-operative treatment. The data of the patients included demographics, grade of liver injuries, mechanism of blunt abdominal trauma, associated intra-abdominal injuries, indications for AE, angiographic findings, type of AE, and AE-related hepatobiliary complications. In the 70 patients, 32 (45.71%) had high-grade liver injuries. Extravazation during the early arterial phase mainly involved the right hepatic segments. Thirteen (18.57%) patients underwent embolization of intrahepatic branches and the extrahepatic trunk and these patients all developed AE-related hepatobiliary complications. In 19 patients with AE-related complications, 14 received minimally invasive treatment and recovered without severe sequelae. AE is an adjunct treatment for liver injuries. Selective and/or super-selective AE should be advocated to decrease the incidence and severity of AE-related hepatobiliary complications.

Statistical and Ontological Analysis of Adverse Events Associated with Monovalent and Combination Vaccines against Hepatitis A and B Diseases

PubMed Central

Xie, Jiangan; Zhao, Lili; Zhou, Shangbo; He, Yongqun

2016-01-01

Vaccinations often induce various adverse events (AEs), and sometimes serious AEs (SAEs). While many vaccines are used in combination, the effects of vaccine-vaccine interactions (VVIs) on vaccine AEs are rarely studied. In this study, AE profiles induced by hepatitis A vaccine (Havrix), hepatitis B vaccine (Engerix-B), and hepatitis A and B combination vaccine (Twinrix) were studied using the VAERS data. From May 2001 to January 2015, VAERS recorded 941, 3,885, and 1,624 AE case reports where patients aged at least 18 years old were vaccinated with only Havrix, Engerix-B, and Twinrix, respectively. Using these data, our statistical analysis identified 46, 69, and 82 AEs significantly associated with Havrix, Engerix-B, and Twinrix, respectively. Based on the Ontology of Adverse Events (OAE) hierarchical classification, these AEs were enriched in the AEs related to behavioral and neurological conditions, immune system, and investigation results. Twenty-nine AEs were classified as SAEs and mainly related to immune conditions. Using a logistic regression model accompanied with MCMC sampling, 13 AEs (e.g., hepatosplenomegaly) were identified to result from VVI synergistic effects. Classifications of these 13 AEs using OAE and MedDRA hierarchies confirmed the advantages of the OAE-based method over MedDRA in AE term hierarchical analysis. PMID:27694888

Storm drains as larval development and adult resting sites for Aedes aegypti and Aedes albopictus in Salvador, Brazil.

PubMed

Paploski, Igor Adolfo Dexheimer; Rodrigues, Moreno S; Mugabe, Vánio André; Kikuti, Mariana; Tavares, Aline S; Reis, Mitermayer Galvão; Kitron, Uriel; Ribeiro, Guilherme Sousa

2016-07-27

Dengue (DENV), Chikungunya (CHIKV), Zika (ZIKV), as well as yellow fever (YFV) viruses are transmitted to humans by Aedes spp. females. In Salvador, the largest urban center in north-eastern Brazil, the four DENV types have been circulating, and more recently, CHIKV and ZIKV have also become common. We studied the role of storm drains as Aedes larval development and adult resting sites in four neighbourhoods of Salvador, representing different socioeconomic, infrastructure and topographic conditions. A sample of 122 storm drains in the four study sites were surveyed twice during a 4-month period in 2015; in 49.0 % of the visits, the storm drains contained water. Adults and immatures of Aedes aegypti were captured in two of the four sites, and adults and immatures of Aedes albopictus were captured in one of these two sites. A total of 468 specimens were collected: 148 Ae. aegypti (38 adults and 110 immatures), 79 Ae. albopictus (48 adults and 31 immatures), and 241 non-Aedes (mainly Culex spp.) mosquitoes (42 adults and 199 immatures). The presence of adults or immatures of Ae. aegypti in storm drains was independently associated with the presence of non-Aedes mosquitoes and with rainfall of ≤ 50 mm during the preceding week. We found that in Salvador, one of the epicentres of the 2015 ZIKV outbreak, storm drains often accumulate water and serve as larval development sites and adult resting areas for both Ae. aegypti and Ae. albopictus. Vector control campaigns usually overlook storm drains, as most of the effort to prevent Ae. agypti reproduction is directed towards containers in the domicile environment. While further studies are needed to determine the added contribution of storm drains for the maintenance of Aedes spp. populations, we advocate that vector control programs incorporate actions directed at storm drains, including regular inspections and use of larvicides, and that human and capital resources are mobilized to modify storm drains, so that they do not serves as larval development sites for Aedes (and other) mosquitoes.

Characterization of Adverse Events Detected in a Large Health Care Delivery System Using an Enhanced Global Trigger Tool over a Five-Year Interval

PubMed Central

Kennerly, Donald A; Kudyakov, Rustam; da Graca, Briget; Saldaña, Margaret; Compton, Jan; Nicewander, David; Gilder, Richard

2014-01-01

Objective To report 5 years of adverse events (AEs) identified using an enhanced Global Trigger Tool (GTT) in a large health care system. Study Setting Records from monthly random samples of adults admitted to eight acute care hospitals from 2007 to 2011 with lengths of stay ≥3 days were reviewed. Study Design We examined AE incidence overall and by presence on admission, severity, stemming from care provided versus omitted, preventability, and category; and the overlap with commonly used AE-detection systems. Data Collection Professional nurse reviewers abstracted 9,017 records using the enhanced GTT, recording triggers and AEs. Medical record/account numbers were matched to identify overlapping voluntary reports or AHRQ Patient Safety Indicators (PSIs). Principal Findings Estimated AE rates were as follows: 61.4 AEs/1,000 patient-days, 38.1 AEs/100 discharges, and 32.1 percent of patients with ≥1 AE. Of 1,300 present-on-admission AEs (37.9 percent of total), 78.5 percent showed NCC-MERP level F harm and 87.6 percent were “preventable/possibly preventable.” Of 2,129 hospital-acquired AEs, 63.3 percent had level E harm, 70.8 percent were “preventable/possibly preventable”; the most common category was “surgical/procedural” (40.5 percent). Voluntary reports and PSIs captured <5 percent of encounters with hospital-acquired AEs. Conclusions AEs are common and potentially amenable to prevention. GTT-identified AEs are seldom caught by commonly used AE-detection systems. PMID:24628436

Seasonal Differences in Density But Similar Competitive Impact of Aedes albopictus (Skuse) on Aedes aegypti (L.) in Rio de Janeiro, Brazil

PubMed Central

Camara, Daniel Cardoso Portela; Codeço, Claudia Torres; Juliano, Steven A.; Lounibos, L. Philip; Riback, Thais Irene Souza; Pereira, Glaucio Rocha; Honorio, Nildimar Alves

2016-01-01

Previous studies have shown that the negative effects of density of Ae. albopictus on Ae. aegypti exceed those of Ae. aegypti on Ae. albopictus for population growth, adult size, survivorship, and developmental rate. This competitive superiority has been invoked to explain the displacement of Ae. aegypti by Ae. albopictus in the southeastern USA. In Brazil, these species coexist in many vegetated suburban and rural areas. We investigated a related, but less-well-studied question: do effects of Ae. albopictus on Ae. aegypti larval development and survival occur under field conditions at realistic densities across multiple seasons in Brazil? We conducted additive competition experiments in a vegetated area of Rio de Janeiro where these species coexist. We tested the hypothesis that Ae. aegypti (the focal species, at a fixed density) suffers negative effects on development and survivorship across a gradient of increasing densities of Ae. albopictus (the associate species) in three seasons. The results showed statistically significant effects of both season and larval density on Ae. aegypti survivorship, and significant effects of season on development rate, with no significant season-density interactions. Densities of Aedes larvae in these habitats differed among seasons by a factor of up to 7x. Overall, Spring was the most favorable season for Ae. aegypti survivorship and development. Results showed that under natural conditions the negative competitive effects of Ae. albopictus on Ae. aegypti were expressed primarily as lower survivorship. Coexistence between Ae. aegypti and Ae. albopictus in vegetated areas is likely affected by seasonal environmental differences, such as detrital resource levels or egg desiccation, which can influence competition between these species. Interactions between these Aedes are important in Brazil, where both species are well established and widely distributed and vector dengue, Zika and chikungunya viruses. PMID:27322537

Attitudes towards general practice and primary care: a survey of senior house officers in accident and emergency.

PubMed Central

Dale, J; Williams, S

1999-01-01

OBJECTIVES: The attitudes and knowledge of hospital based staff about the capabilities of general practice may be important obstacles to continuity of care and the quality of communication at the primary-secondary care interface. However, little research has sought to investigate such factors or how they change over time. The study aims to assess how senior house officers (SHOs) in accident and emergency (A&E) departments perceive general practice, and to test how attitudes change during their six months' tenure. METHODS: Questionnaires were sent to all A&E SHOs working in the 27 A&E departments in South Thames region. At the end of the first month and at the end of the sixth months SHOs were asked to respond using 100 mm visual analogue scales to statements about the quality of general practitioner (GP) services in their area and their attitudes towards treating primary care patients in A&E. RESULTS: After sending reminders, 135 (79%) SHOs responded to the questionnaire at the end of the first month, and 115 (67%) responded to the questionnaire at the end of the sixth month; 104 (61%) responded to both. Statements relating to GP accessibility within and outside normal working hours, perceptions of patients' satisfaction with GP services, GPs' effectiveness in educating patients about use of services, and the frustrations and lack of reward of treating primary care patients scored most negatively. The overall trend was for attitudes to become more negative during SHOs' period of employment in A&E, particularly for those intent on hospital specialist careers or those working within London hospitals. CONCLUSIONS: The findings indicate the extent to which attitudes become more entrenched over time. This may lead to care that is more hospital focused. These issues need to be addressed if quality improvement is to occur across the A&E-primary care interface. PMID:9918286

Safety of Acupuncture and Pharmacopuncture in 80,523 Musculoskeletal Disorder Patients: A Retrospective Review of Internal Safety Inspection and Electronic Medical Records.

PubMed

Kim, Me-Riong; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Ahn, Yong-Jun; Park, Ki Byung; Lee, Hwa Dong; Lee, Yoonmi; Kim, Sung Geun; Ha, In-Hyuk

2016-05-01

We investigated the range and frequency of significant adverse events (AEs) in use of pharmacopuncture and acupuncture using large-scale, single-center safety data as evidence supporting safety of acupuncture with pharmacopuncture, used extensively in Asia, is scarce. Status reports (nurse records in ambulatory and inpatient care units, and administrative event records) as a part of an internal audit at a Korean Medicine hospital specializing in the treatment of musculoskeletal disorders, patient complaints filed through the hospital website, and medical records of patients visiting from December, 2010 (inception of internal audit) to October, 2014 were retrospectively reviewed. A total 80,523 patients (5966 inpatients and 74,557 outpatients) visited during this period. Inpatients received an average 31.9 ± 20.7 acupuncture, 23.0 ± 15.6 pharmacopuncture, and 15.4 ± 11.3 bee venom pharmacopuncture sessions, and outpatients were administered 8.2 ± 12.2 acupuncture, 7.8 ± 11.5 pharmacopuncture, and 10.0 ± 12.3 bee venom sessions, respectively. AEs associated with acupuncture/pharmacopuncture were forgotten needle (n = 47), hypersensitivity to bee venom (n = 37), presyncopic episode (n = 4), pneumothorax (n = 4), and infection (n = 2). Most cases were mild requiring little or no additional intervention and leaving no sequelae. Although serious AEs including infection (n = 2) and anaphylaxis associated with bee venom treatment (n = 3) were also reported, incidence was rare at 0.002% in infection and 0.019% in anaphylaxis. Incidence of AEs associated with acupuncture/pharmacopuncture treatment was low, and most cases were not serious. Still, however rare, avoidable AEs can and should be prevented through education and corrective action. Further prospective studies on the effect of error reduction strategies on incidence of adverse effects are warranted.

Improving the healthcare response to domestic violence and abuse in sexual health clinics: feasibility study of a training, support and referral intervention

PubMed Central

Sohal, Alex Hardip; Pathak, Neha; Blake, Sarah; Apea, Vanessa; Berry, Judith; Bailey, Jayne; Griffiths, Chris; Feder, Gene

2018-01-01

Objectives Sexual health and gynaecological problems are the most consistent and largest physical health differences between abused and non-abused female populations. Sexual health services are well placed to identify and support patients experiencing domestic violence and abuse (DVA). Most sexual health professionals have had minimal DVA training despite English National Institute for Health and Care Excellence recommendations. We sought to determine the feasibility of an evidence-based complex DVA training intervention in female sexual health walk-in services (IRIS ADViSE: Identification and Referral to Improve Safety whilst Assessing Domestic Violence in Sexual Health Environments). Methods An adaptive mixed method pilot study in the female walk-in service of two sexual health clinics. Following implementation and evaluation at site 1, the intervention was refined before implementation at site 2. The intervention comprised electronic prompts, multidisciplinary training sessions, clinic materials and simple referral pathways to IRIS ADViSE advocate-educators (AEs). The pilot lasted 7 weeks at site 1 and 12 weeks at site 2. Feasibility outcomes were to assign a supportive DVA clinical lead, an IRIS ADViSE AE employed by a local DVA service provider, adapt electronic records, develop local referral pathways, assess whether enquiry, identification and referral rates were measurable. Results Both sites achieved all feasibility outcomes: appointing a supportive DVA clinical lead and IRIS ADViSE AE, establishing links with a local DVA provider, adapting electronic records, developing local referral pathways and rates of enquiry, identification and referral were found to be measurable. Site 1: 10% enquiry rate (n=267), 4% identification rate (n=16) and eight AE referrals. Site 2: 61% enquiry rate (n=1090), a 7% identification rate (n=79) and eight AE referrals. Conclusions IRIS ADViSE can be successfully developed and implemented in sexual health clinics. It fulfils the unmet need for DVA training. Longer-term evaluation is recommended. PMID:28724743

Assistant to the secretary of defense for nuclear and chemical and biological defense programs (ATSD(NCB)). Change 1

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

Kennedy, R.

1996-03-01

This Change 1 to DoD Directive 5134.8, dated June 8, 1994, is provided to DTIC. NOTE: In accordance with Section 904 of the DoD Authorization Act for FY 1996 (P.L. 104-106), this change redesignates the Assistant to the Secretary of Defense for Atomic Energy (ATSD(AE)) as the Assistant to the Secretary of Defense for Nuclear and Chemical and Biological Defense Programs (ATSD(NCB)).

Towards the effect of acoustic emission (AE) sensor positioning within AE signal parameters in sliding on bulk ultrafine-grained materials

NASA Astrophysics Data System (ADS)

Filippov, A. V.; Tarasov, S. Yu.; Podgornykh, O. A.; Chazov, P. A.; Shamarin, N. N.; Filippova, E. O.

2017-12-01

The effect of AE sensor positioning on the bulk ultrafine-grained materials used for sliding against steel ball has been investigated. Two versions of AE sensor positioning have been tested and showed the different attenuation levels. The experimentally obtained AE signal waveforms have been analyzed under the AE signal parameters such as a median frequency and AE energy. It was established that the AE sensor positioned on the sample supporting plate in the vicinity of the sample tested allowed redistribution of the signal energy from a low-frequency to high-frequency range as well as extending the median frequency range as compared to those obtained by mounting the sensor on the immobile sample holder.

Hypolipidemic effects of starch and γ-oryzanol from wx/ae double-mutant rice on BALB/c.KOR-Apoe(shl) mice.

PubMed

Nakaya, Makoto; Shojo, Aiko; Hirai, Hiroaki; Matsumoto, Kenji; Kitamura, Shinichi

2013-01-01

waxy/amylose-extender (wx/ae) double-mutant japonica rice (Oryza sativa L.) produces resistant starch (RS) and a large amount of γ-oryzanol. Our previous study has shown the hypolipidemic effect of wx/ae brown rice on mice. To identify the functional constituents of the hypolipidemic activity in wx/ae rice, we prepared pure wx/ae starch and γ-oryzanol from wx/ae rice and investigated their effect on the lipid metabolism in BALB/c.KOR/Stm Slc-Apoe(shl) mice. The mice were fed for 3 weeks a diet containing non-mutant rice starch, non-mutant rice starch plus γ-oryzanol, wx/ae starch, or wx/ae starch plus γ-oryzanol. γ-Oryzanol by itself had no effect on the lipid metabolism, and wx/ae starch prevented an accumulation of triacylglycerol (TAG) in the liver. Interestingly, the combination of wx/ae starch plus γ-oryzanol not only prevented a TAG accumulation in the liver, but also partially suppressed the rise in plasma TAG concentration, indicating that wx/ae starch and γ-oryzanol could have a synergistic effect on the lipid metabolism.

A Retrospective Review of Adverse Events Related to Diabetic Foot Ulcers.

PubMed

Allen, Latricia; Powell-Cope, Gail; Mbah, Alfred; Bulat, Tatjana; Njoh, Eni

2017-06-01

The risk of adverse events (AEs) such as infection and amputation related to diabetic foot ulcers (DFUs) has been studied, but less is known about rate of other AEs such as falls. As part of a quality improvement project, AEs in veterans with diabetes mellitus (DM) with and without a DFU were examined. Demographic data including ICD-9 codes, AEs, and comorbidities for all patients with a diagnosis of DM and/or DFU treated between 2009 and 2014 at the James A. Haley Veterans' Hospital, Tampa, FL, were reviewed retrospectively utilizing the Corporate Data Warehouse (CDW) database. Identifiable protected health information data using patient scrambled social security numbers were collected from the CDW to allow the longitudinal data to be linked at the unique patient level. Descriptive statistics (eg, mean, standard deviation) were determined for demographics, AE, and comorbidities. Adjusted models of AE association with DM and DFU were analyzed using regression modeling via a statistical analysis system. The models were adjusted for age, race, gender, marital status, and comorbidities. Data extracted included individuals diagnosed with diabetes with a DFU (n = 3238, average age 66.0 ± 10.6 years) and diabetes without DFU (n= 41 324, average age 64.4 ± 11.5 years). Participants were mostly Caucasian in both the DFU and non-DFU cohorts (2655 [82.0%] and 32 269 [78.1%], respectively) and male (3129 [96.6%] and 39 580 [95.8%], respectively). The most common comorbidities in this population were peripheral vascular disease (PVD, 39.5%) and peripheral neuropathy (PN, 23.2%). PVD was more common in veterans with (39.5%) than without a DFU (9.2%). Compared to individuals with DM, those with DM and DFU were significantly more likely to experience an infection (OR = 9.43; 95% CI 8.54-10.4), undergo an amputation (OR = 7.40; 95% CI 6.16-8.89), or experience a fracture (OR = 3.65; 95% CI 2.59-5.15) or fall (OR = 2.26; 95% CI 1.96-2.60) (P <.01 for all variables). Although the increased risk of infection and amputation among persons with DFUs has been documented, less is known about the rate of falls and fractures. The current findings will serve as baseline data for future implementation trials to reduce DFU-associated AEs, and clinicians may want to consider expanding DFU patient education efforts to include fall risk.

Presenting numeric information with percentages and descriptive risk labels: A randomized trial

PubMed Central

Sinayev, Aleksandr; Peters, Ellen; Tusler, Martin; Fraenkel, Liana

2015-01-01

Background Previous research demonstrated that providing (vs. not providing) numeric information about medications’ adverse effects (AEs) increased comprehension and willingness to use medication, but left open the question about which numeric format is best. Objective To determine which of four tested formats (percentage, frequency, percentage+risk label, frequency+risk label) maximizes comprehension and willingness to use medication across age and numeracy levels. Design In a cross-sectional internet survey (N=368; American Life Panel, 5/15/08–6/18/08), respondents were presented with a hypothetical prescription medication for high cholesterol. AE likelihoods were described using one of four tested formats. Main outcome measures were risk comprehension (ability to identify AE likelihood from a table) and willingness to use the medication (7-point scale; not likely=0, very likely=6). Results The percentage+risk label format resulted in the highest comprehension and willingness to use the medication compared to the other three formats (mean comprehension in percentage + risk label format=95% vs mean across the other three formats = 81%; mean willingness= 3.3 vs 2.95, respectively). Comprehension differences between percentage and frequency formats were smaller among the less numerate. Willingness to use medication depended less on age and numeracy when labels were used. Limitations Generalizability is limited by use of a sample that was older, more educated, and better off financially than national averages. Conclusions Providing numeric AE-likelihood information in a percentage format with risk labels is likely to increase risk comprehension and willingness to use a medication compared to other numeric formats. PMID:25952743

Presenting Numeric Information with Percentages and Descriptive Risk Labels: A Randomized Trial.

PubMed

Sinayev, Aleksandr; Peters, Ellen; Tusler, Martin; Fraenkel, Liana

2015-11-01

Previous research demonstrated that providing (v. not providing) numeric information about the adverse effects (AEs) of medications increased comprehension and willingness to use medication but left open the question about which numeric format is best. The objective was to determine which of 4 tested formats (percentage, frequency, percentage + risk label, frequency + risk label) maximizes comprehension and willingness to use medication across age and numeracy levels. In a cross-sectional internet survey (N = 368; American Life Panel, 15 May 2008 to 18 June 2008), respondents were presented with a hypothetical prescription medication for high cholesterol. AE likelihoods were described using 1 of 4 tested formats. Main outcome measures were risk comprehension (ability to identify AE likelihood from a table) and willingness to use the medication (7-point scale; not likely = 0, very likely = 6). The percentage + risk label format resulted in the highest comprehension and willingness to use the medication compared with the other 3 formats (mean comprehension in percentage + risk label format = 95% v. mean across the other 3 formats = 81%; mean willingness = 3.3 v. 2.95, respectively). Comprehension differences between percentage and frequency formats were smaller among the less numerate. Willingness to use medication depended less on age and numeracy when labels were used. Generalizability is limited by the use of a sample that was older, more educated, and better off financially than national averages. Providing numeric AE-likelihood information in a percentage format with risk labels is likely to increase risk comprehension and willingness to use a medication compared with other numeric formats. © The Author(s) 2015.

Clustering of adolescent health concerns: a latent class analysis of school students in New Zealand.

PubMed

Noel, Hannah; Denny, Simon; Farrant, Bridget; Rossen, Fiona; Teevale, Tasileta; Clark, Terryann; Fleming, Terry; Bullen, Pat; Sheridan, Janie; Fortune, Sarah

2013-11-01

The aims of this study are to identify clinically meaningful groups of adolescents based on their engagement in high levels of risk behaviours or severe emotional health concerns and to describe the demographic characteristics of these groups in two populations of school students in New Zealand. A nationally representative sample of secondary school students was surveyed in 2007; alternative education (AE) students in Auckland and Northland were surveyed in 2009. A total of 9107 secondary school students and 335 AE students completed a youth health questionnaire using Internet tablets. Latent class analysis (LCA) was used to identify groups of students on the basis of distinct profiles of their risk behaviours and mental health concerns. The majority (80%) of students in secondary schools are 'healthy' and report few health concerns, 16% are considered 'risky' or 'distressed', and 4% report 'multiple' risk behaviour profiles or emotional health concerns. In AE, only 21% of students were considered 'healthy' with most featuring in the 'risky' or 'multiple' groups. Females were more likely to be 'distressed', whereas males were more likely to feature in the 'risky' or 'multiple' groups. Clinically-concerning health risk behaviours and emotional health concerns 'cluster' in up to 20% of students in secondary schools and up to 79% of students in AE. Gender, ethnic and socio-economic disparities are also observed. This highlights the importance of comprehensive psychosocial assessment and appropriate service provision, particularly for at-risk groups. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Immune checkpoint inhibitor-induced gastrointestinal and hepatic injury: pathologists' perspective.

PubMed

Karamchandani, Dipti M; Chetty, Runjan

2018-04-27

Immune checkpoint inhibitors (CPIs) are a relatively new class of 'miracle' dugs that have revolutionised the treatment and prognosis of some advanced-stage malignancies, and have increased the survival rates significantly. This class of drugs includes cytotoxic T lymphocyte antigen-4 inhibitors such as ipilimumab; programmed cell death protein-1 inhibitors such as nivolumab, pembrolizumab and avelumab; and programmed cell death protein ligand-1 inhibitors such as atezolizumab. These drugs stimulate the immune system by blocking the coinhibitory receptors on the T cells and lead to antitumoural response. However, a flip side of these novel drugs is immune-related adverse events (irAEs), secondary to immune-mediated process due to disrupted self-tolerance. The irAEs in the gastrointestinal (GI) tract/liver may result in diarrhoea, colitis or hepatitis. An accurate diagnosis of CPI-induced colitis and/or hepatitis is essential for optimal patient management. As we anticipate greater use of these drugs in the future given the significant clinical response, pathologists need to be aware of the spectrum of histological findings that may be encountered in GI and/or liver biopsies received from these patients, as well as differentiate them from its histopathological mimics. This present review discusses the clinical features, detailed histopathological features, management and the differential diagnosis of the luminal GI and hepatic irAEs that may be encountered secondary to CPI therapy. © 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.

Cabazitaxel for metastatic castration-resistant prostate cancer: safety data from the Spanish expanded access program.

PubMed

Castellano, Daniel; Antón Aparicio, Luis M; Esteban, Emilio; Sánchez-Hernández, Alfredo; Germà, Jose Ramón; Batista, Norberto; Maroto, Pablo; Pérez-Valderrama, Begoña; Luque, Raquel; Méndez-Vidal, María José

2014-09-01

Based on the TROPIC study results, cabazitaxel was approved for the management of metastatic castration-resistant prostate cancer (mCRPC) progressing on or after docetaxel. This multi-centre program provided early access to cabazitaxel to patients with mCRPC before its commercialization. Safety data from 153 Spanish patients receiving cabazitaxel 25 mg/m(2) i.v. Q3W, plus oral prednisone/prednisolone 10 mg daily, are reported. Median age of patients was 70 years (26.8% ≥ 75 years), 94.1 and 26.8% had bone and visceral metastasis, respectively. Most had an Eastern Cooperative Oncology Group ≤ 1 (88.9%) and had received a median of 8.0 cycles of last docetaxel treatment. The median of cabazitaxel cycles and cumulative dose were 6.0 (Interquartile range [IQR]: 4.0; 8.0) and 148.9 (IQR: 98.2; 201.4) mg/m(2), respectively. Adverse events (AEs) possibly related to cabazitaxel occurred in 143 (93.5%) patients. The most frequent grade ≥ 3 AEs were neutropenia (n = 25, 16.3%) and asthenia (n = 17, 11.1%). Febrile neutropenia and grade ≥ 3 diarrhea occurred in 5.2% of the patients each. There were five (3.3%) possibly treatment-related deaths, mainly infection-related. G-CSFs were used in 114 (74.5%) patients, generally as prophylaxis (n = 107; 69.9%). Grade ≥ 3 peripheral neuropathy and nail disorders were uncommon. Cabazitaxel administration, in a real-world setting, is tolerated by Spanish patients with mCRPC, and the AEs are manageable.

Anti-PD-L1 Treatment Induced Central Diabetes Insipidus.

PubMed

Zhao, Chen; Tella, Sri Harsha; Del Rivero, Jaydira; Kommalapati, Anuhya; Ebenuwa, Ifechukwude; Gulley, James; Strauss, Julius; Brownell, Isaac

2018-02-01

Immune checkpoint inhibitors, including anti-programmed cell death protein 1 (PD-1), anti-programmed cell death protein ligand 1 (PD-L1), and anti-cytotoxic T-lymphocyte antigen 4 (anti-CTLA4) monoclonal antibodies, have been widely used in cancer treatment. They are known to cause immune-related adverse events (irAEs), which resemble autoimmune diseases. Anterior pituitary hypophysitis with secondary hypopituitarism is a frequently reported irAE, especially in patients receiving anti-CTLA4 treatment. In contrast, posterior pituitary involvement, such as central diabetes insipidus (DI), is relatively rare and is unreported in patients undergoing PD-1/PD-L1 blockade. We describe a case of a 73-year-old man with Merkel cell carcinoma who received the anti-PD-L1 monoclonal antibody avelumab and achieved partial response. The patient developed nocturia, polydipsia, and polyuria 3 months after starting avelumab. Further laboratory testing revealed central DI. Avelumab was held and he received desmopressin for the management of central DI. Within 6 weeks after discontinuation of avelumab, the patient's symptoms resolved and he was eventually taken off desmopressin. The patient remained off avelumab and there were no signs or symptoms of DI 2 months after the discontinuation of desmopressin. To our knowledge, this is the first report of central DI associated with anti-PD-L1 immunotherapy. The patient's endocrinopathy was successfully managed by holding treatment with the immune checkpoint inhibitor. This case highlights the importance of early screening and appropriate management of hormonal irAEs in subjects undergoing treatment with immune checkpoint inhibitors to minimize morbidity and mortality. Copyright © 2017 Endocrine Society

Fatigue crack sizing in rail steel using crack closure-induced acoustic emission waves

NASA Astrophysics Data System (ADS)

Li, Dan; Kuang, Kevin Sze Chiang; Ghee Koh, Chan

2017-06-01

The acoustic emission (AE) technique is a promising approach for detecting and locating fatigue cracks in metallic structures such as rail tracks. However, it is still a challenge to quantify the crack size accurately using this technique. AE waves can be generated by either crack propagation (CP) or crack closure (CC) processes and classification of these two types of AE waves is necessary to obtain more reliable crack sizing results. As the pre-processing step, an index based on wavelet power (WP) of AE signal is initially established in this paper in order to distinguish between the CC-induced AE waves and their CP-induced counterparts. Here, information embedded within the AE signal was used to perform the AE wave classification, which is preferred to the use of real-time load information, typically adopted in other studies. With the proposed approach, it renders the AE technique more amenable to practical implementation. Following the AE wave classification, a novel method to quantify the fatigue crack length was developed by taking advantage of the CC-induced AE waves, the count rate of which was observed to be positively correlated with the crack length. The crack length was subsequently determined using an empirical model derived from the AE data acquired during the fatigue tests of the rail steel specimens. The performance of the proposed method was validated by experimental data and compared with that of the traditional crack sizing method, which is based on CP-induced AE waves. As a significant advantage over other AE crack sizing methods, the proposed novel method is able to estimate the crack length without prior knowledge of the initial crack length, integration of AE data or real-time load amplitude. It is thus applicable to the health monitoring of both new and existing structures.

Dysport (botulinum toxin type A) in routine therapeutic usage: a telephone needs assessment survey of European physicians to evaluate current awareness and adherence to product labeling changes.

PubMed

Hubble, Jean; Schwab, Joseph; Hubert, Catherine; Abbott, Chandra Coleman

2013-01-01

Botulinum neurotoxin type A is a well-established treatment for a number of conditions involving muscle hyperactivity. Dysport (Ipsen Ltd, Wrexham, United Kingdom) is a botulinum neurotoxin type A preparation that has been available for a number of therapeutic uses for over 20 years in the European Union (EU). This survey was part of the EU botulinum toxin risk management plan to identify potential educational needs of injectors by collecting data on their routine practice administration of Dysport and their awareness of potential adverse events (AEs) that are included in the current product labeling. Dysport-experienced injectors in 5 EU countries were surveyed via telephone about their experience of Dysport in patients with cervical dystonia, adult upper and lower limb spasticity, pediatric cerebral palsy, and blepharospasm/hemifacial spasm. The reconstitution dilution volume most often used was 2.5 mL per 500 U for all indications. The mean total dose ranged from 387 to 530 U for cervical dystonia, 508 to 773 U for upper limb spasticity, 600 to 832 U for lower limb spasticity, 375 to 700 U for pediatric cerebral palsy, and 54 to 213 U for blepharospasm/hemifacial spasm. The potential AEs most commonly mentioned by surveyed physicians were dysphagia for cervical dystonia, arm muscle weakness for upper limb spasticity, leg muscle weakness for lower limb spasticity, and pediatric cerebral palsy and ptosis for blepharospasm/hemifacial spasm. The results indicate that product-labeling recommendations are generally applied in clinical practice and that there is a good familiarity with potential AEs based on clinical condition. Nevertheless, the survey shows that experienced injectors do sometimes deviate from the manufacturers labeling recommendations, highlighting the importance of ongoing education.

Aesculin modulates bone metabolism by suppressing receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and transduction signals.

PubMed

Zhao, Xiao-Li; Chen, Lin-Feng; Wang, Zhen

2017-06-17

Aesculin (AES), a coumarin compound derived from Aesculus hippocasanum L, is reported to exert protective role against inflammatory diseases, gastric disease and cancer. However, direct effect of AES in bone metabolism is deficient. In this study, we examined the effects of AES on osteoclast (OC) differentiation in receptor activator of NF-κB ligand (RANKL)-induced RAW264.7 cells. AES inhibits the OC differentiation in both dose- and time-dependent manner within non-toxic concentrations, as analyzed by Tartrate Resistant Acid Phosphatase (TRAP) staining. The actin ring formation manifesting OC function is also decreased by AES. Moreover, expressions of osteoclastogenesis related genes Trap, Atp6v0d2, Cathepsin K and Mmp-9 are decreased upon AES treatment. Mechanistically, AES attenuates the activation of MAPKs and NF-κB activity upon RANKL induction, thus leading to the reduction of Nfatc1 mRNA expression. Moreover, AES inhibits Rank expression, and RANK overexpression markedly decreases AES's effect on OC differentiation and NF-κB activity. Consistently, AES protects against bone mass loss in the ovariectomized and dexamethasone treated rat osteoporosis model. Taken together, our data demonstrate that AES can modulate bone metabolism by suppressing osteoclastogenesis and related transduction signals. AES therefore could be a promising agent for the treatment of osteoporosis. Copyright © 2017 Elsevier Inc. All rights reserved.

A large scale laboratory cage trial of Aedes densonucleosis virus (AeDNV).

PubMed

Wise de Valdez, Megan R; Suchman, Erica L; Carlson, Jonathan O; Black, William C

2010-05-01

Aedes aegypti (L.) (Diptera: Culicidae) the primary vector of dengue viruses (DENV1-4), oviposit in and around human dwellings, including sites difficult to locate, making control of this mosquito challenging. We explored the efficacy and sustainability of Aedes Densonucleosis Virus (AeDNV) as a biocontrol agent for Ae. aegypti in and among oviposition sites in large laboratory cages (> 92 m3) as a prelude to field trials. Select cages were seeded with AeDNV in a single oviposition site (OPS) with unseeded OPSs established at varied distances. Quantitative real-time polymerase chain reaction was used to track dispersal and accumulation of AeDNV among OPSs. All eggs were collected weekly from each cage and counted. We asked: (1) Is AeDNV dispersed over varying distances and can it accumulate and persist in novel OPSs? (2) Are egg densities reduced in AeDNV treated populations? AeDNV was dispersed to and sustained in novel OPSs. Virus accumulation in OPSs was positively correlated with egg densities and proximity to the initial infection source affected the timing of dispersal and maintenance of viral titers. AeDNV did not significantly reduce Ae. aegypti egg densities. The current study documents that adult female Ae. aegypti oviposition behavior leads to successful viral dispersal from treated to novel containers in large-scale cages; however, the AeDNV titers reached were not sufficient to reduce egg densities.

Classifying Adverse Events in the Dental Office.

PubMed

Kalenderian, Elsbeth; Obadan-Udoh, Enihomo; Maramaldi, Peter; Etolue, Jini; Yansane, Alfa; Stewart, Denice; White, Joel; Vaderhobli, Ram; Kent, Karla; Hebballi, Nutan B; Delattre, Veronique; Kahn, Maria; Tokede, Oluwabunmi; Ramoni, Rachel B; Walji, Muhammad F

2017-06-30

Dentists strive to provide safe and effective oral healthcare. However, some patients may encounter an adverse event (AE) defined as "unnecessary harm due to dental treatment." In this research, we propose and evaluate two systems for categorizing the type and severity of AEs encountered at the dental office. Several existing medical AE type and severity classification systems were reviewed and adapted for dentistry. Using data collected in previous work, two initial dental AE type and severity classification systems were developed. Eight independent reviewers performed focused chart reviews, and AEs identified were used to evaluate and modify these newly developed classifications. A total of 958 charts were independently reviewed. Among the reviewed charts, 118 prospective AEs were found and 101 (85.6%) were verified as AEs through a consensus process. At the end of the study, a final AE type classification comprising 12 categories, and an AE severity classification comprising 7 categories emerged. Pain and infection were the most common AE types representing 73% of the cases reviewed (56% and 17%, respectively) and 88% were found to cause temporary, moderate to severe harm to the patient. Adverse events found during the chart review process were successfully classified using the novel dental AE type and severity classifications. Understanding the type of AEs and their severity are important steps if we are to learn from and prevent patient harm in the dental office.

Amygdala enlargement: temporal lobe epilepsy subtype or nonspecific finding?

PubMed Central

Reyes, Anny; Thesen, Thomas; Kuzniecky, Ruben; Devinsky, Orrin; McDonald, Carrie R.; Jackson, Graeme D.; Vaughan, David N.; Blackmon, Karen

2018-01-01

Objective Amygdala enlargement (AE) is observed in patients with temporal lobe epilepsy (TLE), which has led to the suggestion that it represents a distinct TLE subtype; however, it is unclear whether AE is found at similar rates in other epilepsy syndromes or in healthy controls, which would limit its value as a marker for focal epileptogenicity. Methods We compared rates of AE, defined quantitatively from high-resolution T1-weighted MRI, in a large multi-site sample of 136 patients with nonlesional localization related epilepsy (LRE), including TLE and extratemporal (exTLE) focal epilepsy, 34 patients with idiopathic generalized epilepsy (IGE), and 233 healthy controls (HCs). Results AE was found in all groups including HCs; however, the rate of AE was higher in LRE (18.4%) than in IGE (5.9%) and HCs (6.4%). Patients with unilateral LRE were further evaluated to compare rates of concordant ipsilateral AE in TLE and exTLE, with the hypothesis that rates of ipsilateral AE would be higher in TLE. Although ipsilateral AE was higher in TLE (19.4%) than exTLE (10.5%), this difference was not significant. Furthermore, among the 25 patients with unilateral LRE and AE, 13 (52%) had either bilateral AE or AE contralateral to seizure onset. Conclusion Results suggest that AE, as defined with MRI volumetry, may represent an associated feature of nonlesional localization related epilepsy with limited seizure onset localization value. PMID:28284051

Dimension Reduction With Extreme Learning Machine.

PubMed

Kasun, Liyanaarachchi Lekamalage Chamara; Yang, Yan; Huang, Guang-Bin; Zhang, Zhengyou

2016-08-01

Data may often contain noise or irrelevant information, which negatively affect the generalization capability of machine learning algorithms. The objective of dimension reduction algorithms, such as principal component analysis (PCA), non-negative matrix factorization (NMF), random projection (RP), and auto-encoder (AE), is to reduce the noise or irrelevant information of the data. The features of PCA (eigenvectors) and linear AE are not able to represent data as parts (e.g. nose in a face image). On the other hand, NMF and non-linear AE are maimed by slow learning speed and RP only represents a subspace of original data. This paper introduces a dimension reduction framework which to some extend represents data as parts, has fast learning speed, and learns the between-class scatter subspace. To this end, this paper investigates a linear and non-linear dimension reduction framework referred to as extreme learning machine AE (ELM-AE) and sparse ELM-AE (SELM-AE). In contrast to tied weight AE, the hidden neurons in ELM-AE and SELM-AE need not be tuned, and their parameters (e.g, input weights in additive neurons) are initialized using orthogonal and sparse random weights, respectively. Experimental results on USPS handwritten digit recognition data set, CIFAR-10 object recognition, and NORB object recognition data set show the efficacy of linear and non-linear ELM-AE and SELM-AE in terms of discriminative capability, sparsity, training time, and normalized mean square error.

Spectrometer Sensitivity Investigations on the Spectrometric Oil Analysis Program.

DTIC Science & Technology

1983-04-22

31 H. ACID DISSOLUTION METHOD (ADM) ........... 90 31 I. ANALYSIS OF SAMPLES............................ 31 jJ. PARTICLE TRANSPORT EFFICIENCY OF...THE ROTATING *DISK.................................... 32 I .K. A/E35U-3 ACID DISSOLUTION METHOD.................. 32 L. BURN TIME... ACID DISSOLUTION METHOD ......... ,...,....... 95 3. EFFECT OF BURN TIME ............ 95 4. DIRECT SAMPLE INTRODUCTION .......................... 95

76 FR 4089 - Proposed Information Collection; Comment Request; Automated Export System (AES) Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-24

.... Government policies that affect the economy. These data also enable U.S. businesses to develop practical... origin. Also, the equipment number field will be revised to require the container number for all... require a license. For shipments where the origin of the commodity is foreign, the country of origin will...

The Media/Social Studies Connection: Partnerships for Learning.

ERIC Educational Resources Information Center

Pearce, Vickie; Lassiter, Cathy

1992-01-01

Describes a high school project that won an award in the 1991 A&E (Arts and Entertainment) National Teacher Grant Competition. The program, which introduced art history into the U.S. studies curriculum, involved cooperative research, analysis of art in the local museum, group presentations, parental participation, and the production of a…

76 FR 17755 - Energy Conservation Program for Consumer Products: Decision and Order Granting 180-Day Extension...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-31

... standby mode and off mode energy consumption of those products. The petitioners demonstrated that meeting... energy consumption. 75 FR 64621. More specifically, this test procedure final rule included a standby... ae ) for gas or oil-fired furnaces or boilers and annual electric energy consumption (E e ) for...

Photothermal Spectroscopy Using a Pyroelectric Thin Film Detector.

DTIC Science & Technology

1983-09-16

FRD-fi34 291 PHOTOTHERNAL SPECTROSCOPYIJ SING A PYROELECTRIC THIN- I/IT, F FILM DETECTOR(J) INTERNATIONAL BUSINESS MACHINES CORP I SAN JOSE CALIF SAN...Coufal N01-1C01 9, PERFORMING3 ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT. TASK International Business Machines Corp. AE OKUI UBR San Jose

Dual-opioid therapy: changing the paradigm. Introduction.

PubMed

Nicholson, Bruce D

2012-03-01

Morphine sulfate and oxycodone hydrochloride are commonly used for pain management because of their pharmacologic profile, pharmacokinetics, and analgesic potency. However, opioids are associated with a significant adverse event (AE) burden that limits their use in both the acute and the chronic pain settings. Co-administration of opioids demonstrated synergistic analgesia and reduced side effects. Thus, dual-opioid therapy has the potential to enhance the positive analgesic benefits of opioids, while limiting the burden of opioid-related AEs. This symposium proceedings was based on presentations at the 13th World Congress on Pain in August 2010. This program will review the rationale for dual-opioid therapy based on preclinical findings and data from clinical studies showing the efficacy and tolerability profile of a dual-opioid formulation when used to treat acute postoperative pain. Wiley Periodicals, Inc.

KSC-2012-4242

NASA Image and Video Library

2012-08-03

CAPE CANAVERAL, Fla. – Inside the Space Life Sciences Laboratory, or SLSL, at NASA’s Kennedy Space Center in Florida, red leaf lettuce plants were harvested from a plant growth chamber. The plants were grown under red and blue LED lights. The plant experiment at Kennedy is part of the Advanced Exploration Systems, or AES, program in NASA’s Human Exploration and Operations Mission Directorate. This plant experiment studies the effects of different types of lighting on plants such as radishes and leaf lettuce. Results of these studies will help provide information on how to grow food sources for deep space exploration missions. AES projects pioneer new approaches for rapidly developing prototype systems, demonstrating key capabilities and validating operational concepts for future human missions beyond Earth orbit. Photo credit: NASA/Frank Ochoa-Gonzales

15 CFR 758.2 - Automated Export System (AES).

Code of Federal Regulations, 2014 CFR

2014-01-01

... 15 Commerce and Foreign Trade 2 2014-01-01 2014-01-01 false Automated Export System (AES). 758.2... CLEARANCE REQUIREMENTS § 758.2 Automated Export System (AES). The Census Bureau's Foreign Trade Statistics...) electronically using the Automated Export System (AES). In order to use AES, you must apply directly to the...

15 CFR 758.2 - Automated Export System (AES).

Code of Federal Regulations, 2013 CFR

2013-01-01

... 15 Commerce and Foreign Trade 2 2013-01-01 2013-01-01 false Automated Export System (AES). 758.2... CLEARANCE REQUIREMENTS § 758.2 Automated Export System (AES). The Census Bureau's Foreign Trade Statistics...) electronically using the Automated Export System (AES). In order to use AES, you must apply directly to the...

15 CFR 758.2 - Automated Export System (AES).

Code of Federal Regulations, 2012 CFR

2012-01-01

... 15 Commerce and Foreign Trade 2 2012-01-01 2012-01-01 false Automated Export System (AES). 758.2... CLEARANCE REQUIREMENTS § 758.2 Automated Export System (AES). The Census Bureau's Foreign Trade Statistics...) electronically using the Automated Export System (AES). In order to use AES, you must apply directly to the...

15 CFR 752.15 - Export clearance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... System (AES) record. The SED or AES record covering an export made under an SCL must be prepared in... EAR. (1) Item descriptions. Item descriptions on the SED or AES record must indicate specifically the... each shipment on the respective SED or AES record. (3) SCL number. The SED or AES record must include...

Acoustic Emission Parameters of Three Gorges Sandstone during Shear Failure

NASA Astrophysics Data System (ADS)

Xu, Jiang; Liu, Yixin; Peng, Shoujian

2016-12-01

In this paper, an experimental investigation of sandstone samples from the Three Gorges during shear failure was conducted using acoustic emission (AE) and direct shear tests. The AE count rate, cumulative AE count, AE energy, and amplitude of the sandstone samples were determined. Then, the relationships among the AE signals and shearing behaviors of the samples were analyzed in order to detect micro-crack initiation and propagation and reflect shear failure. The results indicated that both the shear strength and displacement exhibited a logarithmic relationship with the displacement rate at peak levels of stress. In addition, the various characteristics of the AE signals were apparent in various situations. The AE signals corresponded with the shear stress under different displacement rates. As the displacement rate increased, the amount of accumulative damage to each specimen decreased, while the AE energy peaked earlier and more significantly. The cumulative AE count primarily increased during the post-peak period. Furthermore, the AE count rate and amplitude exhibited two peaks during the peak shear stress period due to crack coalescence and rock bridge breakage. These isolated cracks later formed larger fractures and eventually caused ruptures.

Development of high temperature acoustic emission sensing system using fiber Bragg grating

NASA Astrophysics Data System (ADS)

Pang, Dandan; Sui, Qingmei; Wang, Ming; Guo, Dongmei; Sai, Yaozhang

2018-03-01

In some applications in structural health monitoring (SHM), the acoustic emission (AE) detection technology is used in the high temperature environment. In this paper, a high-temperature-resistant AE sensing system is developed based on the fiber Bragg grating (FBG) sensor. A novel high temperature FBG AE sensor is designed with a high signal-to-noise ratio (SNR) compared with the traditional FBG AE sensor. The output responses of the designed sensors with different sensing fiber lengths also are investigated both theoretically and experimentally. Excellent AE detection results are obtained using the proposed FBG AE sensing system over a temperature range from 25 ° to 200 °. The experimental results indicate that this FBG AE sensing system can well meet the application requirement in AE detecting areas at high temperature.

Differential Survivorship of Invasive Mosquito Species in South Florida Cemeteries: Do Site-Specific Microclimates Explain Patterns of Coexistence and Exclusion?

PubMed Central

LOUNIBOS, L. P.; O'MEARA, G. F.; JULIANO, S. A.; NISHIMURA, N.; ESCHER, R. L.; REISKIND, M. H.; CUTWA, M.; GREENE, K.

2010-01-01

Within 2 yr of the arrival of the invasive container mosquito Aedes albopictus (Skuse), the previously dominant invasive mosquito Aedes aegypti (L.) disappeared from many Florida cemeteries. At some cemeteries, however, Ae. aegypti populations seem stable despite Ae. albopictus invasion. We sought to understand this variation in the outcome (exclusion, coexistence) of this invasion, given that previous experiments show that Ae. albopictus is the superior larval competitor. We tested experimentally the hypothesis that climate-dependent egg survivorship differs between exclusion and coexistence cemeteries and that differences in invasion outcome are associated with microclimate. Viability of eggs oviposited in the laboratory and suspended in vases at six cemeteries was significantly greater for Ae. aegypti than for Ae. albopictus, and greater in 2001 than in 2006. Cemeteries differed significantly in egg survivorship of Ae. albopictus, but not of Ae. aegypti, which is consistent with the hypothesis that Ae. albopictus suffers site-specific, climate-driven egg mortality that mitigates the competitive superiority of larval Ae. albopictus. Principal component (PC) analysis of microclimate records from vases during the experiments yielded three PCs accounting for >96% of the variance in both years of experiments. Multivariate analysis of variance of the three PCs revealed significant microclimate differences among the six cemeteries and between exclusion versus coexistence cemeteries. Stepwise logistic regression of egg survivorship versus microclimate PCs yielded significant fits for both species, and twice as much variance explained for Ae. albopictus as for Ae. aegypti in both years. Higher mortalities in 2006 were associated with high average daily maximum temperatures in vases, with lethal thresholds for both species at ≈40°C. From 1990 to 2007, vase occupancy by Ae. albopictus increased and that by Ae. aegypti decreased, with increasing seasonal precipitation at one well-sampled cemetery. Results support the hypothesis that locally variable climate-driven mortality of Ae. albopictus eggs contributes to patterns of exclusion of, or coexistence with, Ae. aegypti. PMID:20852732

Types, frequencies, and burden of nonspecific adverse events of drugs: analysis of randomized placebo-controlled clinical trials.

PubMed

Mahr, Alfred; Golmard, Clara; Pham, Emilie; Iordache, Laura; Deville, Laure; Faure, Pierre

2017-07-01

Scarce studies analyzing adverse event (AE) data from randomized placebo-controlled clinical trials (RPCCTs) of selected illnesses suggested that a substantial proportion of collected AEs are unrelated to the drug taken. This study analyzed the nonspecific AEs occurring with active-drug exposure in RPCCTs for a large range of medical conditions. Randomized placebo-controlled clinical trials published in five prominent medical journals during 2006-2012 were searched. Only trials that evaluated orally or parenterally administered active drugs versus placebo in a head-to-head setting were selected. For AEs reported from ≥10 RPCCTs, Pearson's correlation coefficients (r) were calculated to determine the relationship between AE rates in placebo and active-drug recipients. Random-effects meta-analyses were used to compute proportions of nonspecific AEs, which were truncated at a maximum of 100%, in active-drug recipients. We included 231 trials addressing various medical domains or healthy participants. For the 88 analyzed AE variables, AE rates for placebo and active-drug recipients were in general strongly correlated (r > 0.50) or very strongly correlated (r > 0.80). The pooled proportions of nonspecific AEs for the active-drug recipients were 96.8% (95%CI: 95.5-98.1) for any AEs, 100% (97.9-100) for serious AEs, and 77.7% (72.7-83.2) for drug-related AEs. Results were similar for individual medical domains and healthy participants. The pooled proportion of nonspecificity of 82 system organ class and individual AE types ranged from 38% to 100%. The large proportion of nonspecific AEs reported in active-drug recipients of RPCCTs, including serious and drug-related AEs, highlights the limitations of clinical trial data to determine the tolerability of drugs. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Cutaneous, gastrointestinal, hepatic, endocrine, and renal side-effects of anti-PD-1 therapy.

PubMed

Hofmann, Lars; Forschner, Andrea; Loquai, Carmen; Goldinger, Simone M; Zimmer, Lisa; Ugurel, Selma; Schmidgen, Maria I; Gutzmer, Ralf; Utikal, Jochen S; Göppner, Daniela; Hassel, Jessica C; Meier, Friedegund; Tietze, Julia K; Thomas, Ioannis; Weishaupt, Carsten; Leverkus, Martin; Wahl, Renate; Dietrich, Ursula; Garbe, Claus; Kirchberger, Michael C; Eigentler, Thomas; Berking, Carola; Gesierich, Anja; Krackhardt, Angela M; Schadendorf, Dirk; Schuler, Gerold; Dummer, Reinhard; Heinzerling, Lucie M

2016-06-01

Anti-programmed cell death receptor-1 (PD-1) antibodies represent an effective treatment option for metastatic melanoma as well as for other cancer entities. They act via blockade of the PD-1 receptor, an inhibitor of the T-cell effector mechanisms that limit immune responses against tumours. As reported for ipilimumab, the anti-PD-1 antibodies pembrolizumab and nivolumab can induce immune-related adverse events (irAEs). These side-effects affect skin, gastrointestinal tract, liver, endocrine system and other organ systems. Since life-threatening and fatal irAEs have been reported, adequate diagnosis and management are essential. In total, 496 patients with metastatic melanoma from 15 skin cancer centers were treated with pembrolizumab or nivolumab; 242 side-effects were described in 138 patients. In 116 of the 138 patients, side-effects affected the skin, gastrointestinal tract, liver, endocrine, and renal system. Rare side-effects included diabetes mellitus, lichen planus, and pancreas insufficiency due to pancreatitis. Anti-PD1 antibodies can induce a plethora of irAEs. The knowledge of them will allow prompt diagnosis and improve the management resulting in decreased morbidity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Safety of human papillomavirus vaccines: a review.

PubMed

Stillo, Michela; Carrillo Santisteve, Paloma; Lopalco, Pier Luigi

2015-05-01

Between 2006 and 2009, two different human papillomavirus virus (HPV) vaccines were licensed for use: a quadrivalent (qHPVv) and a bivalent (bHPVv) vaccine. Since 2008, HPV vaccination programmes have been implemented in the majority of the industrialized countries. Since 2013, HPV vaccination has been part of the national programs of 66 countries including almost all countries in North America and Western Europe. Despite all the efforts made by individual countries, coverage rates are lower than expected. Vaccine safety represents one of the main concerns associated with the lack of acceptance of HPV vaccination both in the European Union/European Economic Area and elsewhere. Safety data published on bivalent and quadrivalent HPV vaccines, both in pre-licensure and post-licensure phase, are reviewed. Based on the latest scientific evidence, both HPV vaccines seem to be safe. Nevertheless, public concern and rumors about adverse events (AE) represent an important barrier to overcome in order to increase vaccine coverage. Passive surveillance of AEs is an important tool for detecting safety signals, but it should be complemented by activities aimed at assessing the real cause of all suspect AEs. Improved vaccine safety surveillance is the first step for effective communication based on scientific evidence.

Genetics and morphology of Aedes aegypti (Diptera: Culicidae) in septic tanks in Puerto Rico.

PubMed

Somers, Gerard; Brown, Julia E; Barrera, Roberto; Powell, Jeffrey R

2011-11-01

Dengue viruses, primarily transmitted by the mosquito Aedes aegypti (L.), affect an estimated 50-100 million people yearly. Traditional approaches to control mosquito population numbers, such as the use of pesticides, have had only limited success. Atypical mosquito behavior may be one reason why current vector control efforts have been less efficacious than expected. In Puerto Rico, for example, adult Ae. aegypti have been observed emerging from septic tanks. Interestingly, adults emerging from septic tanks are larger on average than adults collected from surface containers. To determine whether adults colonizing septic tanks constitute a separate Ae. aegypti population, we used 12 previously validated microsatellite loci to examine adult mosquitoes collected from both septic tanks and surface containers, but found no evidence to suggest genetic differentiation. Size differences between septic tank and surface mosquitoes were reduced when nutrient levels were held constant across experimental groups. Despite the absence of evidence suggesting a genetic difference between experimental groups in this study, Ae. aegypti emerging from septic tanks may still represent a more dangerous phenotype and should be given special consideration when developing vector control programs and designing public health interventions in the future.

Genetics and Morphology of Aedes aegypti (Diptera: Culicidae) in Septic Tanks in Puerto Rico

PubMed Central

SOMERS, GERARD; BROWN, JULIA E.; BARRERA, ROBERTO; POWELL, JEFFREY R.

2012-01-01

Dengue viruses, primarily transmitted by the mosquito Aedes aegypti (L.), affect an estimated 50–100 million people yearly. Traditional approaches to control mosquito population numbers, such as the use of pesticides, have had only limited success. Atypical mosquito behavior may be one reason why current vector control efforts have been less efficacious than expected. In Puerto Rico, for example, adult Ae. aegypti have been observed emerging from septic tanks. Interestingly, adults emerging from septic tanks are larger on average than adults collected from surface containers. To determine whether adults colonizing septic tanks constitute a separate Ae. aegypti population, we used 12 previously validated microsatellite loci to examine adult mosquitoes collected from both septic tanks and surface containers, but found no evidence to suggest genetic differentiation. Size differences between septic tank and surface mosquitoes were reduced when nutrient levels were held constant across experimental groups. Despite the absence of evidence suggesting a genetic difference between experimental groups in this study, Ae. aegypti emerging from septic tanks may still represent a more dangerous phenotype and should be given special consideration when developing vector control programs and designing public health interventions in the future. PMID:22238867

Rapid Aeroelastic Analysis of Blade Flutter in Turbomachines

NASA Technical Reports Server (NTRS)

Trudell, J. J.; Mehmed, O.; Stefko, G. L.; Bakhle, M. A.; Reddy, T. S. R.; Montgomery, M.; Verdon, J.

2006-01-01

The LINFLUX-AE computer code predicts flutter and forced responses of blades and vanes in turbomachines under subsonic, transonic, and supersonic flow conditions. The code solves the Euler equations of unsteady flow in a blade passage under the assumption that the blades vibrate harmonically at small amplitudes. The steady-state nonlinear Euler equations are solved by a separate program, then equations for unsteady flow components are obtained through linearization around the steady-state solution. A structural-dynamics analysis (see figure) is performed to determine the frequencies and mode shapes of blade vibrations, a preprocessor interpolates mode shapes from the structural-dynamics mesh onto the LINFLUX computational-fluid-dynamics mesh, and an interface code is used to convert the steady-state flow solution to a form required by LINFLUX. Then LINFLUX solves the linearized equations in the frequency domain to calculate the unsteady aerodynamic pressure distribution for a given vibration mode, frequency, and interblade phase angle. A post-processor uses the unsteady pressures to calculate generalized aerodynamic forces, response amplitudes, and eigenvalues (which determine the flutter frequency and damping). In comparison with the TURBO-AE aeroelastic-analysis code, which solves the equations in the time domain, LINFLUX-AE is 6 to 7 times faster.

Identifying and managing the adverse effects of immune checkpoint blockade

PubMed Central

Winer, Arthur; Bodor, J. Nicholas

2018-01-01

Immunotherapy has revolutionized the field of oncology. By inhibiting the cytotoxic T-lymphocyte-associated protein (CTLA-4) and programmed death-1 (PD-1) immune checkpoint pathways, multiple studies have demonstrated greatly improved survival in locally advanced and metastatic cancers including melanoma, renal, lung, gastric, and hepatocellular carcinoma. Trials in other malignancies are ongoing, and undoubtedly the number of drugs in this space will grow beyond the six currently approved by the Food and Drug Administration. However, by altering the immune response to fight cancer, a new class of side effects has emerged known as immune-related adverse events (irAEs). These adverse events are due to overactivation of the immune system in almost any organ of the body, and can occur at any point along a patient’s treatment course. irAEs such as endocrinopathies (thyroiditis), colitis, and pneumonitis may occur more commonly. However, other organs such as the liver, heart, or brain may also be affected by immune overactivation and any of these side effects may become life threatening. This review presents an approach to promptly recognize and manage these toxicities, to hopefully minimize morbidity and mortality from irAEs. PMID:29593893

Development of alcohol expectancies and early alcohol use in children and adolescents: A systematic review.

PubMed

Smit, Koen; Voogt, Carmen; Hiemstra, Marieke; Kleinjan, Marloes; Otten, Roy; Kuntsche, Emmanuel

2018-03-01

Developmental changes in alcohol expectancies (AE) have been proposed to lead to alcohol use initiation and later alcohol use in adolescence. This systematic review aims to provide longitudinal evidence of the development of AE and the relation of AE to alcohol outcomes from childhood to late adolescence (4-18 years old). A computer-assisted search of relevant articles identified 1602 studies, of which 43 studies (conducted between 1996 and 2016) were selected. First, negative AE decline and positive AE increase in early adolescence. Moreover, alcohol use (initiation) seems to strongly influence changes in AE. Second, AE predict alcohol use initiation and drinking patterns over time. Third, longitudinal predictors of AE could be divided into individual predictors (i.e., alcohol-related cognitions, psychopathology, and genetics) and environmental predictors (i.e., family, peer, and media influences). Lastly, the results indicated that AE function as mediators of the relations between the various individual and environmental predictors and adolescent's alcohol use. Alcohol expectancies form an important framework through which drinking behavior can be explained over time. Due to the diverse findings on the predictors of AE, future longitudinal studies should further clarify the factors that are essential in the development of AE and adolescent's later alcohol use. Copyright © 2018 Elsevier Ltd. All rights reserved.

Urinary adverse effects of pelvic radiotherapy

PubMed Central

Liberman, Daniel; Mehus, Brian

2014-01-01

Objective Radiation is an integral part of the treatment of many pelvic tumors. The cellular death induced by radiotherapy (RT) benefits cancer control but can also result in adverse effects (AEs) on the organ being treated or those adjacent to it. RT for cancers of the pelvis (bladder, prostate, rectum, uterus or cervix) can result in AEs in the urinary tract. While the acute urinary AEs of pelvic RT are well described, late AEs are less well characterized. The burden of treatment for late AEs may be large given the prevalence of tumors in the pelvis and the high utilization of RT to treat them. Review For prostate cancer, grade 1 and 2 urinary AEs following external beam radiation therapy (EBRT) are reported to occur in 20-43% and 7-19%, respectively, with a follow up of 10 years. Three-year cumulative risk for grade ≥2 urinary AEs is 28-30%. Following brachytherapy (BT), rates of urinary AEs at 5 years are reported to be 36%, 24%, 6.2% and 0.1% for Radiation Therapy Oncology Group (RTOG) grade 1, 2, 3, and 4, respectively. For bladder cancer, with a median follow-up of 5 years, 7-12% of patients who receive RT experience urinary AEs of grade 3 or more. For cervical cancer, there remains a 0.25% per year risk of severe AEs for at least 25 years following RT, and ureteral stricture is a well-described AE. For endometrial cancer, severe urinary AEs are rare, but at 13 years of follow up, patients report a significantly worse quality of life with respect to urinary function. In rectal cancer, preoperative RT has a lower risk of AEs than postoperative RT, and few urinary AEs are reported in the literature. Conclusions Urinary AEs can manifest long after RT, and there is a paucity of studies describing rates of these long-term AEs. It is important that the possible complications of RT are recognized by providers and properly communicated to patients so that they are able to make informed decisions about their cancer treatment. PMID:26813159

How can the curation of hands-on STEM activities power successful mobile apps and websites?

NASA Astrophysics Data System (ADS)

Porcello, D.; Peticolas, L. M.; Schwerin, T. G.

2015-12-01

The Lawrence Hall of Science (LHS) is University of California, Berkeley's public science center. Over the last decade, the Center for Technology Innovation at LHS has partnered with many institutions to establish a strong track record of developing successful technology solutions to support STEM teaching and learning within informal environments. Curation by subject-matter experts has been at the heart of many educational technology products from LHS and its partners that are directed at educators and families. This work includes: (1) popular digital libraries for inquiry-based activities at Howtosmile.org (NSF DRL #0735007) and NASA Earth and Space science education resources at NASAwavelength.org; and novel mobile apps like DIY Sun Science (NASA NNX10AE05G) and DIY Human Body (NIH 5R25OD010543) designed to scaffold exploration of STEM phenomena at home. Both NASA Wavelength and DIY Sun Science arose out of long-term collaborations with the Space Sciences Laboratory at UC Berkeley, Institute for Global Environmental Strategies (IGES), and other NASA-funded organizations, in partnership with NASA through cooperative agreements. This session will review the development, formative evaluation, and usage metrics for these two Earth and Space science-themed educational technology products directly relevant to the AGU community. Questions reviewed by presenters will include: What makes a good hands-on activity, and what essential information do educators depend on when searching for programming additions? What content and connections do families need to explore hands-on activities? How can technology help incorporate educational standards into the discovery process for learning experiences online? How do all these components drive the design and user experience of websites and apps that showcase STEM content?

77 FR 15098 - AES Hawaii, Inc.; Notice of Petition for Temporary Waiver

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-14

...] AES Hawaii, Inc.; Notice of Petition for Temporary Waiver Take notice that on March 5, 2012, pursuant... and Procedure, 18 CFR 292.205(c), AES Hawaii, Inc. (AES Hawaii) filed a Request for Temporary Waiver..., Hawaii. AES Hawaii makes such a request because of a forced boiler outage in the fourth quarter of 2011...

Evaluating the Validity and Applicability of Automated Essay Scoring in Two Massive Open Online Courses

ERIC Educational Resources Information Center

Reilly, Erin Dawna; Stafford, Rose Eleanore; Williams, Kyle Marie; Corliss, Stephanie Brooks

2014-01-01

The use of massive open online courses (MOOCs) to expand students' access to higher education has raised questions regarding the extent to which this course model can provide and assess authentic, higher level student learning. In response to this need, MOOC platforms have begun utilizing automated essay scoring (AES) systems that allow…

Lexical Knowledge in Instructed Language Learning: The Effects of Age and Exposure

ERIC Educational Resources Information Center

Miralpeix, Inmaculada

2007-01-01

The aim of this study is to analyse the possible effects of Age of Onset (AO), Cognitive Maturity (Age at Testing--AT) and Amount of Exposure (AE) on the productive vocabularies of learners of English as a Foreign Language (FL). Three groups of bilingual Catalan/Spanish students were tested towards the end of Secondary Education. The groups…

Large-Scale Assessment, Locally-Developed Measures, and Automated Scoring of Essays: Fishing for Red Herrings?

ERIC Educational Resources Information Center

Condon, William

2013-01-01

Automated Essay Scoring (AES) has garnered a great deal of attention from the rhetoric and composition/writing studies community since the Educational Testing Service began using e-rater[R] and the "Criterion"[R] Online Writing Evaluation Service as products in scoring writing tests, and most of the responses have been negative. While the…

Aligning Academic Offerings with Industry Needs and Facility Construction, While Making Space for Relevant Public Private Partnerships (P3s)

ERIC Educational Resources Information Center

Golich, Vicki L.; Haynes, Sandra; Hillhouse, Erin; Pfeifer, David

2018-01-01

Metropolitan State University of Denver (MSU Denver) has been educating students for Colorado's urban workforce for over fifty years. The following case study of MSU Denver's new Aerospace Engineering Sciences (AES) Building reveals the roles played by partnerships among universities, faculty, and local civic and industry leaders in creating new…

Programmed cell death-1 and programmed cell death ligand-1 antibodies-induced dysthyroidism.

PubMed

Jaafar, Jaafar; Fernandez, Eugenio; Alwan, Heba; Philippe, Jacques

2018-05-01

Monoclonal antibodies blocking the programmed cell death-1 (PD-1) or its ligand (PD-L1) are a group of immune checkpoints inhibitors (ICIs) with proven antitumor efficacy. However, their use is complicated by immune-related adverse events (irAEs), including endocrine adverse events (eAEs). We review the incidence, time to onset and resolution rate of dysthyroidism induced by PD-1/PD-L1 Ab, and the clinical, biological and radiological findings. We aim to discuss the potential mechanisms of PD-1/PD-L1 Ab-induced dysthyroidism, and to propose a management algorithm. We performed a literature search of available clinical trials regarding PD-1/PD-L1 Ab in the PubMed database. We selected all English language clinical trials that included at least 100 patients. We also present selected case series or reports, retrospective studies and reviews related to this issue. In patients treated with PD-1 Ab, hypothyroidism occurred in 2-10.1% and hyperthyroidism occurred in 0.9-7.8%. When thyroiditis was reported separately, it occurred in 0.34-2.6%. Higher rates were reported when PD-1 Ab were associated with other ICI or chemotherapy. The median time to onset of hyperthyroidism and hypothyroidism after PD-1 Ab initiation was 23-45 days and 2-3.5 months, respectively. Regarding PD-L1 Ab, hypothyroidism occurred in 0-10% and hyperthyroidism in 0.5-2% of treated patients. The average time to onset of dysthyroidism after PD-L1 Ab was variable and ranged from 1 day after treatment initiation to 31 months. Dysthyroidism occurs in up to 10% of patients treated with PD-1/PD-L1 Ab. Hypothyroidism and reversible destructive thyroiditis are the most frequent endocrine adverse events (eAE) in PD-1/PD-L1 treated patients. Immune and non-immune mechanisms are potentially involved, independently of the presence of thyroid antibodies. © 2018 The authors.

Cross-Mating Compatibility and Competitiveness among Aedes albopictus Strains from Distinct Geographic Origins - Implications for Future Application of SIT Programs in the South West Indian Ocean Islands.

PubMed

Damiens, David; Lebon, Cyrille; Wilkinson, David A; Dijoux-Millet, Damien; Le Goff, Gilbert; Bheecarry, Ambicadutt; Gouagna, Louis Clément

2016-01-01

The production of large numbers of males needed for a sustainable sterile insect technique (SIT) control program requires significant developmental and operational costs. This may constitute a significant economic barrier to the installation of large scale rearing facilities in countries that are undergoing a transition from being largely dependent on insecticide use to be in a position to integrate the SIT against Aedes albopictus. Alternative options available for those countries could be to rely on outsourcing of sterile males from a foreign supplier, or for one centralised facility to produce mosquitoes for several countries, thus increasing the efficiency of the mass-rearing effort. However, demonstration of strain compatibility is a prerequisite for the export of mosquitoes for transborder SIT applications. Here, we compared mating compatibility among Ae. albopictus populations originating from three islands of the South Western Indian Ocean, and assessed both insemination rates and egg fertility in all possible cross-mating combinations. Furthermore, competitiveness between irradiated and non-irradiated males from the three studied strains, and the subsequent effect on female fertility were also examined. Although morphometric analysis of wing shapes suggested phenoptypic differences between Ae. albopictus strains, perfect reproductive compatibility between them was observed. Furthermore, irradiated males from the different islands demonstrated similar levels of competitiveness and induced sterility when confronted with fertile males from any of the other island populations tested. In conclusion, despite the evidence of inter-strain differences based on male wing morphology, collectively, our results provide a new set of expectations for the use of a single candidate strain of mass-reared sterile males for area-wide scale application of SIT against Ae. albopictus populations in different islands across the South Western Indian Ocean. Cross-mating competitiveness tests such as those applied here are necessary to assess the quality of mass reared strains for the trans-border application of sterile male release programs.

Safety and Efficacy of Pembrolizumab in Advanced, Programmed Death Ligand 1-Positive Cervical Cancer: Results From the Phase Ib KEYNOTE-028 Trial.

PubMed

Frenel, Jean-Sebastien; Le Tourneau, Christophe; O'Neil, Bert; Ott, Patrick A; Piha-Paul, Sarina A; Gomez-Roca, Carlos; van Brummelen, Emilie M J; Rugo, Hope S; Thomas, Shari; Saraf, Sanatan; Rangwala, Reshma; Varga, Andrea

2017-12-20

Purpose The KEYNOTE-028 trial ( ClinicalTrials.gov identifier: NCT02054806) was designed to assess the safety and efficacy of pembrolizumab in 20 programmed death ligand 1-positive, advanced solid tumor cohorts. Here, we present the results from the cohort of patients with advanced cervical cancer. Methods Patients were treated with pembrolizumab 10 mg/kg every 2 weeks for up to 24 months. Response was assessed every 8 weeks for the first 6 months and every 12 weeks thereafter. The primary end point was overall response rate per Response Evaluation Criteria in Solid Tumors, version 1.1, by investigator review. Safety was a secondary end point. Results Twenty-four patients were enrolled in the cervical cancer cohort. The median age was 42 years (range, 26 to 62 years), 22 patients (92%) had received prior radiation therapy, and 15 patients (63%) had received two or more lines of therapy, including bevacizumab (10 of 24 patients), for advanced disease. At the data cutoff, median follow-up duration was 11.0 months (range, 1.3 to 32.2 months). Overall response rate was 17% (95% CI, 5% to 37%); four patients (17%) achieved a confirmed partial response, and three patients (13%) had stable disease. Median duration of response for the four patients who achieved a partial response was 5.4 months (4.1 to 7.5 months). Treatment related adverse events (AEs) were experienced by 18 patients (75%); only rash (n = 5; 21%) and pyrexia (n = 4; 17%) and occurred in ≥ 10% of patients. Five patients experienced grade 3 treatment-related AEs. No grade 4 treatment-related AEs or deaths were observed. Conclusion In patients with programmed death ligand 1-positive advanced cervical cancer, pembrolizumab demonstrated antitumor activity and exhibited a safety profile consistent with that seen in other tumor types.

Cross-Mating Compatibility and Competitiveness among Aedes albopictus Strains from Distinct Geographic Origins - Implications for Future Application of SIT Programs in the South West Indian Ocean Islands

PubMed Central

Damiens, David; Lebon, Cyrille; Wilkinson, David A.; Dijoux-Millet, Damien; Le Goff, Gilbert; Bheecarry, Ambicadutt; Gouagna, Louis Clément

2016-01-01

The production of large numbers of males needed for a sustainable sterile insect technique (SIT) control program requires significant developmental and operational costs. This may constitute a significant economic barrier to the installation of large scale rearing facilities in countries that are undergoing a transition from being largely dependent on insecticide use to be in a position to integrate the SIT against Aedes albopictus. Alternative options available for those countries could be to rely on outsourcing of sterile males from a foreign supplier, or for one centralised facility to produce mosquitoes for several countries, thus increasing the efficiency of the mass-rearing effort. However, demonstration of strain compatibility is a prerequisite for the export of mosquitoes for transborder SIT applications. Here, we compared mating compatibility among Ae. albopictus populations originating from three islands of the South Western Indian Ocean, and assessed both insemination rates and egg fertility in all possible cross-mating combinations. Furthermore, competitiveness between irradiated and non-irradiated males from the three studied strains, and the subsequent effect on female fertility were also examined. Although morphometric analysis of wing shapes suggested phenoptypic differences between Ae. albopictus strains, perfect reproductive compatibility between them was observed. Furthermore, irradiated males from the different islands demonstrated similar levels of competitiveness and induced sterility when confronted with fertile males from any of the other island populations tested. In conclusion, despite the evidence of inter-strain differences based on male wing morphology, collectively, our results provide a new set of expectations for the use of a single candidate strain of mass-reared sterile males for area-wide scale application of SIT against Ae. albopictus populations in different islands across the South Western Indian Ocean. Cross-mating competitiveness tests such as those applied here are necessary to assess the quality of mass reared strains for the trans-border application of sterile male release programs. PMID:27806056

Development of a thick film PZT foil sensor for use in structural health monitoring applications.

PubMed

Pickwell, Andrew J; Dorey, Robert A; Mba, David

2013-02-01

Acoustic emission (AE) monitoring is a technique of growing interest in the field of nondestructive testing (NDT). The use of AE devices to monitor the health of structural components is currently limited by the cost of AE equipment, which prohibits the permanent placement of AE devices on structures for the purposes of continuous monitoring and the monitoring of areas with limited access. Micro electromechanical systems (MEMS) can provide solutions to these problems. We present the manufacture of a 4.4-μm-thick lead zirconate titanate (PZT) film on a 110-μm-thick titanium foil substrate for use as an AE sensor. The thick-film sensor is benchmarked against commercially available AE sensors in static and dynamic monitoring applications. The thick-film AE device is found to perform well in the detection of AE in static applications. A low signal-to-noise ratio is found to prohibit the detection of AE in a dynamic application.

Proceedings of the AFOSR Special Conference on Prime-Power for High Energy Space Systems, Norfolk, Virginia, 22-25 February 1982. Volume I.

DTIC Science & Technology

1982-02-25

source both liquid and solid fuel combustion devices have been successfully demonstrated during various development programs . Nuclear reactor heat...U02 fuel in the core . Improving the heat pipe model to correlate more closely with the experimental data is a major concern in the development of...ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT, PROJECT. TASK Research & Development Associates (RDA) AREA &WKNT AE (X Rosslyn, VA 22209 61102F 2301

Correlation of Experimental and Theoretical Steady-State Spinning Motion for a Current Fighter Airplane Using Rotation-Balance Aerodynamic Data

DTIC Science & Technology

1978-07-01

were input into the computer program. The program was numerically intergrated with time by using a fourth-order Runge-Kutta integration algorithm with...equations of motion are numerically intergrated to provide time histories of the aircraft spinning motion. A.2 EQUATIONS DEFINING THE FORCE AND MOMENT...by Cy or Cn. 50 AE DC-TR-77-126 A . 4 where EQUATIONS FOR TRANSFERRING AERODYNAMIC DATA INPUTS TO THE PROPER HORIZONTAL CENTER OF GRAVITY

Comparisons of Field Tests with Simulations: Abrams Program Lessons Learned

DTIC Science & Technology

1990-03-01

observed field out conme. Thiirtv-.-ixI\\ (3(-) of thle com parisons resulted in complete iuj .muatchves: thatif -. S ~u,-VSII inever )in its J000...2.REPORT DAE j3 EOTTP ~ AE OEE IMairch 1990 I-Final Jul 87 - Oct 89 4. TitE AND SUBTMTE S . PUNOING NUMBWERS (Comparisons or Field Tests with...Simulations: Abrams Program Lessons Learned 6. AUTHOR( S ) lPaul 11. lDcvtz, Jill I[. Smith. John 11. Stickling 7. PERFORMING ORGANIZATION NAME( S ) AND AIDDRESS

Automatic Extraction of Drug Adverse Effects from Product Characteristics (SPCs): A Text Versus Table Comparison.

PubMed

Lamy, Jean-Baptiste; Ugon, Adrien; Berthelot, Hélène

2016-01-01

Potential adverse effects (AEs) of drugs are described in their summary of product characteristics (SPCs), a textual document. Automatic extraction of AEs from SPCs is useful for detecting AEs and for building drug databases. However, this task is difficult because each AE is associated with a frequency that must be extracted and the presentation of AEs in SPCs is heterogeneous, consisting of plain text and tables in many different formats. We propose a taxonomy for the presentation of AEs in SPCs. We set up natural language processing (NLP) and table parsing methods for extracting AEs from texts and tables of any format, and evaluate them on 10 SPCs. Automatic extraction performed better on tables than on texts. Tables should be recommended for the presentation of the AEs section of the SPCs.

Amygdala enlargement: Temporal lobe epilepsy subtype or nonspecific finding?

PubMed

Reyes, Anny; Thesen, Thomas; Kuzniecky, Ruben; Devinsky, Orrin; McDonald, Carrie R; Jackson, Graeme D; Vaughan, David N; Blackmon, Karen

2017-05-01

Amygdala enlargement (AE) is observed in patients with temporal lobe epilepsy (TLE), which has led to the suggestion that it represents a distinct TLE subtype; however, it is unclear whether AE is found at similar rates in other epilepsy syndromes or in healthy controls, which would limit its value as a marker for focal epileptogenicity. We compared rates of AE, defined quantitatively from high-resolution T1-weighted MRI, in a large multi-site sample of 136 patients with nonlesional localization related epilepsy (LRE), including TLE and extratemporal (exTLE) focal epilepsy, 34 patients with idiopathic generalized epilepsy (IGE), and 233 healthy controls (HCs). AE was found in all groups including HCs; however, the rate of AE was higher in LRE (18.4%) than in IGE (5.9%) and HCs (6.4%). Patients with unilateral LRE were further evaluated to compare rates of concordant ipsilateral AE in TLE and exTLE, with the hypothesis that rates of ipsilateral AE would be higher in TLE. Although ipsilateral AE was higher in TLE (19.4%) than exTLE (10.5%), this difference was not significant. Furthermore, among the 25 patients with unilateral LRE and AE, 13 (52%) had either bilateral AE or AE contralateral to seizure onset. Results suggest that AE, as defined with MRI volumetry, may represent an associated feature of nonlesional localization related epilepsy with limited seizure onset localization value. Copyright © 2017 Elsevier B.V. All rights reserved.

New antiarrhythmic agents for atrial fibrillation and atrial flutter: United States drug market response as an indicator of acceptance.

PubMed

LaPointe, Nancy M Allen; Pamer, Carol A; Kramer, Judith M

2003-10-01

To determine how well dofetilide and Betapace AF (sotalol, approved solely for atrial fibrillation and atrial flutter), with their detailed dosing and monitoring guidelines for safety, were accepted into clinical practice during the 2 calendar years after their introduction. We reviewed the number of new, refill, and total prescriptions of all antiarrhythmic agents in the United States from April 2000-December 2001 to assess use of dofetilide and Betapace AF in the drug market. Both were prescribed very infrequently throughout the study period. In addition, the infrequent reported use of these drugs for patients with atrial fibrillation and flutter indicated poor acceptance of these agents by prescribing physicians. We speculated that the restricted distribution and required educational program for dofetilide, as well as the availability of generic sotalol products, may have discouraged physicians from prescribing both dofetilide and Betapace AE CONCLUSION: A common goal for both the dofetilide risk-management program and the creation of a sotalol product indicated solely for atrial fibrillation and atrial flutter was to provide safer treatment for patients with these arrhythmias. Unfortunately, limited penetration of dofetilide and Betapace AF into the U.S. market suggests that drugs without a risk-management program or detailed dosing guidelines were more likely than dofetilide or Betapace AF to be selected for treatment of atrial fibrillation and atrial flutter.

Evaluating pulmonary function, aerobic capacity, and pediatric quality of life following a 10-week aerobic exercise training in school-aged asthmatics: a randomized controlled trial.

PubMed

Abdelbasset, Walid K; Alsubaie, Saud F; Tantawy, Sayed A; Abo Elyazed, Tamer I; Kamel, Dalia M

2018-01-01

It has been documented that aerobic exercise may increase pulmonary functions and aerobic capacity, but limited data has evaluated a child's satisfaction and pediatric quality of life (PQoL) with exercise training. This study aimed to investigate the effects of moderate-intensity exercise training on asthmatic school-aged children. This study included 38 school-aged children with asthma (23 males and 15 females) aged between 8-12 years. They were randomly assigned to two groups, aerobic exercise (AE) and conventional treatment (Con ttt) groups. The AE group received a program of moderate-intensity aerobic exercise for 10 weeks with asthma medications and the Con ttt group received only asthma medications without exercise intervention. A home respiratory exercise was recommended for the two groups. Aerobic capacity was investigated using maximal oxygen uptake (VO 2max ), 6-minute walk test (6MWT), and fatigue index. PQoL was evaluated using Pediatric Quality of Life Questionnaire (PQoLQ). Also, pulmonary function tests were performed, and the results recorded. The findings of this study showed significant improvements in pulmonary functions and VO 2max in the two groups; however, this improvement was significantly higher in the AE group than in the Con ttt group ( p <0.05). The 6MWT and fatigue index improved in the AE group ( p <0.05) but not in the Con ttt group ( p >0.05). All dimensions of PQoL significantly improved in the AE group ( p <0.05), but there was no significant improvement in the Con ttt group after the 10-week intervention period ( p >0.05). Ten weeks of physical exercise had beneficial effects on pulmonary functions, aerobic capacity, and PQoL in school-aged children with asthma. Effort and awareness should be dedicated to encouraging the active lifestyle among different populations, especially asthmatic children.

Enhancement of the BG-sentinel trap with varying number of mice for field sampling of male and female Aedes albopictus mosquitoes.

PubMed

Le Goff, Gilbert; Damiens, David; Payet, Laurent; Ruttee, Abdoul-Hamid; Jean, Frédéric; Lebon, Cyrille; Dehecq, Jean-Sébastien; Gouagna, Louis-Clément

2016-09-22

Trapping male mosquitoes in the field is essential for the development of area-wide vector control programs with a sterile insect technique (SIT) component. To determine the optimal temporal and spatial release strategy, an estimation of the wild population density and its temporal dynamics is essential. Among the traps available for such data collection, the BG-Sentinel trap developed by the Biogents company uses a combination of visual cues, convection currents and olfactory signals. Although in numerous cases, this trap has shown high efficiency in sampling Aedes albopictus, in some cases low capture rates of Ae. albopictus males were recorded for the BG-sentinel mosquito trap baited with synthetic attractants. The effects of modifying the BG-sentinel trap (by adding one mouse, two or three live mice to the trap) on the efficiency of trapping Ae. albopictus males and females was tested. The experiment was carried out in three distinct areas on La Réunion that have been selected for pilot field testing of the release of sterile male Ae. albopictus mosquitoes. The effect of four types of attractant (including the generic BG-Lure, one mouse or two to three mice) in baited BGS traps was tested with a Latin square design in order to control for the variability of different sampling positions and dates. At the three studied sites, the number of Ae. albopictus adults caught and the proportion of males per trap consistently increased with the number of mice present in the trap. The results from this study suggest that some new attractants derived from, or similar to, mouse odors could be developed and tested in combination with other existing attractive components, such as CO 2 and heat, in order to provide a reliable estimation method for Ae. albopictus adult male abundance in the wild.

Peridomestic Aedes malayensis and Aedes albopictus are capable vectors of arboviruses in cities

PubMed Central

Manuel, Menchie; Low, Dolyce H. W.; Missé, Dorothée; Gubler, Duane J.; Ellis, Brett R.; Ooi, Eng Eong; Pompon, Julien

2017-01-01

Background Dengue and chikungunya are global re-emerging mosquito-borne diseases. In Singapore, sustained vector control coupled with household improvements reduced domestic mosquito populations for the past 45 years, particularly the primary vector Aedes aegypti. However, while disease incidence was low for the first 30 years following vector control implementation, outbreaks have re-emerged in the past 15 years. Epidemiological observations point to the importance of peridomestic infection in areas not targeted by control programs. We investigated the role of vectors in peri-domestic areas. Methods We carried out entomological surveys to identify the Aedes species present in vegetated sites in highly populated areas and determine whether mosquitoes were present in open-air areas frequented by people. We compared vector competence of Aedes albopictus and Aedes malayensis with Ae. aegypti after oral infection with sympatric dengue serotype 2 and chikungunya viruses. Mosquito saliva was tested for the presence of infectious virus particles as a surrogate for transmission following oral infection. Results We identified Aedes albopictus and Aedes malayensis throughout Singapore and quantified their presence in forested and opened grassy areas. Both Ae. albopictus and Ae. malayensis can occupy sylvatic niches and were highly susceptible to both arboviruses. A majority of saliva of infected Ae. malayensis contained infectious particles for both viruses. Conclusions Our study reveals the prevalence of competent vectors in peri-domestic areas, including Ae. malayensis for which we established the vector status. Epidemics can be driven by infection foci, which are epidemiologically enhanced in the context of low herd immunity, selective pressure on arbovirus transmission and the presence of infectious asymptomatic persons, all these conditions being present in Singapore. Learning from Singapore’s vector control success that reduced domestic vector populations, but has not sustainably reduced arboviral incidence, we suggest including peri-domestic vectors in the scope of vector management. PMID:28650959

Epidemiology of 3825 injuries sustained in six seasons of National Collegiate Athletic Association men's and women's soccer (2009/2010-2014/2015).

PubMed

Roos, Karen G; Wasserman, Erin B; Dalton, Sara L; Gray, Aaron; Djoko, Aristarque; Dompier, Thomas P; Kerr, Zachary Y

2017-07-01

To describe the epidemiology of National Collegiate Athletic Association (NCAA) men's and women's soccer injuries during the 2009/2010-2014/2015 academic years. This descriptive epidemiology study used NCAA Injury Surveillance Program (NCAA-ISP) data during the 2009/2010-2014/2015 academic years, from 44 men's and 64 women's soccer programmes (104 and 167 team seasons of data, respectively). Non-time-loss injuries were defined as resulting in <24 h lost from sport. Injury counts, percentages and rates were calculated. Injury rate ratios (RRs) and injury proportion ratios (IPRs) with 95% CIs compared rates and distributions by sex. There were 1554 men's soccer and 2271 women's soccer injuries with injury rates of 8.07/1000 athlete exposures (AE) and 8.44/1000AE, respectively. Injury rates for men and women did not differ in competitions (17.53 vs 17.04/1000AE; RR=1.03; 95% CI 0.94 to 1.13) or practices (5.47 vs 5.69/1000AE; RR=0.96; 95% CI 0.88 to 1.05). In total, 47.2% (n=733) of men's soccer injuries and 47.5% (n=1079) of women's were non-time loss. Most injuries occurred to the lower extremity and were diagnosed as sprains. Women had higher concussion rates (0.59 vs 0.34/1000AE; RR=1.76; 95% CI 1.32 to 2.35) than men. Non-time-loss injuries accounted for nearly half of the injuries in men's and women's soccer. Sex differences were found in competition injuries, specifically for concussion. Further study into the incidence, treatment and outcome of non-time-loss injuries may identify a more accurate burden of these injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Age-Stage, Two-Sex Life Table Characteristics of Aedes albopictus and Aedes Aegypti in Penang Island, Malaysia.

PubMed

Maimusa, Hamisu A; Ahmad, Abu Hassan; Kassim, Nur Faeza A; Rahim, Junaid

2016-03-01

The life table developmental attributes of laboratory colonies of wild strains of Aedes albopictus and Aedes aegypti were analyzed and compared based on the age-stage, two-sex life table. Findings inclusive in this study are: adult preoviposition periods, total preoviposition period, mean intrinsic rate of increase (r), mean finite rate of increase (λ), net reproductive rates (R0), and mean generation time (T). The total preadult development time was 9.47 days for Ae. albopictus and 8.76 days for Ae. aegypti. The life expectancy was 19.01 days for Ae. albopictus and 19.94 days for Ae. aegypti. Mortality occurred mostly during the adult stage. The mean development time for each stage insignificantly correlated with temperature for Ae. albopictus (r  =  -0.208, P > 0.05) and (r  =  -0.312, P > 0.05) for Ae. aegypti. The population parameters suggest that Ae. albopictus and Ae. aegypti populations are r-strategists characterized by a high r, a large R0, and short T. This present study provides the first report to compare the life parameters of Ae. albopictus and Ae. aegypti strains from Penang island, Malaysia.

Characterization of Acoustic Emission Parameters During Testing of Metal Liner Reinforced with Fully Resin Impregnated CNG Cylinder

NASA Astrophysics Data System (ADS)

Kenok, R.; Jomdecha, C.; Jirarungsatian, C.

The aim of this paper is to study the acoustic emission (AE) parameters obtained from CNG cylinders during pressurization. AE from flaw propagation, material integrity, and pressuring of cylinder was the main objective for characterization. CNG cylinders of ISO 11439, resin fully wrapped type and metal liner type, were employed to test by hydrostatic stressing. The pressure was step increased until 1.1 time of operating pressure. Two AE sensors, resonance frequency of 150 kHz, were mounted on the cylinder wall to detect the AE throughout the testing. From the experiment results, AE can be detected from pressuring rate, material integrity, and flaw propagation from the cylinder wall. AE parameters including Amplitude, Count, Energy (MARSE), Duration and Rise time were analyzed to distinguish the AE data. The results show that the AE of flaw propagation was different in character from that of pressurization. Especially, AE detected from flaws of resin wrapped and metal liner was significantly different. To locate the flaw position, both the AE sensors can be accurately used to locate the flaw propagation in a linear pattern. The error was less than ±5 cm.

Amino-terminal enhancer of split gene AES encodes a tumor and metastasis suppressor of prostate cancer.

PubMed

Okada, Yoshiyuki; Sonoshita, Masahiro; Kakizaki, Fumihiko; Aoyama, Naoki; Itatani, Yoshiro; Uegaki, Masayuki; Sakamoto, Hiromasa; Kobayashi, Takashi; Inoue, Takahiro; Kamba, Tomomi; Suzuki, Akira; Ogawa, Osamu; Taketo, M Mark

2017-04-01

A major cause of cancer death is its metastasis to the vital organs. Few effective therapies are available for metastatic castration-resistant prostate cancer (PCa), and progressive metastatic lesions such as lymph nodes and bones cause mortality. We recently identified AES as a metastasis suppressor for colon cancer. Here, we have studied the roles of AES in PCa progression. We analyzed the relationship between AES expression and PCa stages of progression by immunohistochemistry of human needle biopsy samples. We then performed overexpression and knockdown of AES in human PCa cell lines LNCaP, DU145 and PC3, and determined the effects on proliferation, invasion and metastasis in culture and in a xenograft model. We also compared the PCa phenotypes of Aes/Pten compound knockout mice with those of Pten simple knockout mice. Expression levels of AES were inversely correlated with clinical stages of human PCa. Exogenous expression of AES suppressed the growth of LNCaP cells, whereas the AES knockdown promoted it. We also found that AES suppressed transcriptional activities of androgen receptor and Notch signaling. Notably, AES overexpression in AR-defective DU145 and PC3 cells reduced invasion and metastasis to lymph nodes and bones without affecting proliferation in culture. Consistently, prostate epithelium-specific inactivation of Aes in Pten flox/flox mice increased expression of Snail and MMP9, and accelerated growth, invasion and lymph node metastasis of the mouse prostate tumor. These results suggest that AES plays an important role in controlling tumor growth and metastasis of PCa by regulating both AR and Notch signaling pathways. © 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

Comparison of rates of reported adverse events associated with i.v. iron products in the United States.

PubMed

Bailie, George R

2012-02-15

An analysis of reported adverse events (AEs) among patients using i.v. iron products, including the newer agent ferumoxytol, is presented. All AE reports to the Food and Drug Administration (FDA) citing iron sucrose, ferric gluconate, high- and low-molecular-weight iron dextran products, or ferumoxytol from October 2009 through June 2010 were evaluated. The rates of various classifications of reported AEs were calculated on a per-unit-sold basis and, for comparison of products supplied in different unit sizes, also in terms of 100-mg dose equivalents (DEq) of iron. A total of 197 reported AEs were identified (a cumulative rate of 14.1 AEs per million units sold). The rates of all AE classifications combined ranged from 5.25 to 746 per million units sold for iron sucrose and ferumoxytol, respectively; using the other method of calculation, the rates ranged from 5.24 per million DEq (iron sucrose) to 147 per million DEq (ferumoxytol). Relative to iron sucrose and sodium ferric gluconate, ferumoxytol was associated with significantly elevated risks of death (odds ratio [OR], 475 and 156, respectively; p < 0.0001), serious nonfatal AEs (OR, 263 and 121, respectively; p < 0.0001), and all evaluated AE classifications combined (OR, 142 and 109, respectively; p < 0.05). Analysis of reports submitted to FDA revealed large differences among i.v. iron products in reported deaths, serious AEs, other major AEs, and other AEs. Iron sucrose and sodium ferric gluconate were associated with much lower rates of AEs per million units sold than iron dextran or ferumoxytol, which were associated with the highest rates of all reported AE classifications.

Updated Reported Distribution of Aedes (Stegomyia) aegypti and Aedes (Stegomyia) albopictus (Diptera: Culicidae) in the United States, 1995-2016.

PubMed

Hahn, Micah B; Eisen, Lars; McAllister, Janet; Savage, Harry M; Mutebi, John-Paul; Eisen, Rebecca J

2017-09-01

Aedes (Stegomyia) aegypti (L.) and Aedes (Stegomyia) albopictus (Skuse) are potential vectors of Zika, dengue, and chikungunya viruses in the United States. A Zika virus outbreak in Florida in the summer of 2016, driven by Ae. aegypti and resulting in > 200 locally acquired cases of human illness, underscored the need for up-to-date information on the geographic distribution of Ae. aegypti and Ae. albopictus in the United States. In early 2016, we conducted a survey and literature review to compile county records for presence of Ae. aegypti and Ae. albopictus in the United States from 1995 to 2016. Surveillance for these vectors was intensified across the United States during the summer and fall of 2016. At the end of 2016, we therefore conducted a follow-up survey of mosquito control agencies, university researchers, and state and local health departments to document new collection records for Ae. aegypti and Ae. albopictus. The repeated survey at the end of the year added Ae. aegypti collection records from 38 new counties and Ae. albopictus collection records from 127 new counties, representing a 21 and 10 percent increase, respectively, in the number of counties with reported presence of these mosquitoes compared with the previous report. Moreover, through our updated survey, 40 and 183 counties, respectively, added additional years of collection records for Ae. aegypti and Ae. albopictus from 1995 to 2016. Our findings underscore the continued need for systematic surveillance of Ae. aegypti and Ae. albopictus. Published by Oxford University Press on behalf of Entomological Society of America 2017. This work is written by US Government employees and is in the public domain in the US.

Acoustic Emission Characteristics of Red Sandstone Specimens Under Uniaxial Cyclic Loading and Unloading Compression

NASA Astrophysics Data System (ADS)

Meng, Qingbin; Zhang, Mingwei; Han, Lijun; Pu, Hai; Chen, Yanlong

2018-04-01

To explore the acoustic emission (AE) characteristics of rock materials during the deformation and failure process under periodic loads, a uniaxial cyclic loading and unloading compression experiment was conducted based on an MTS 815 rock mechanics test system and an AE21C acoustic emissions test system. The relationships among stress, strain, AE activity, accumulated AE activity and duration for 180 rock specimens under 36 loading and unloading rates were established. The cyclic AE evolutionary laws with rock stress-strain variation at loading and unloading stages were analyzed. The Kaiser and Felicity effects of rock AE activity were disclosed, and the impact of the significant increase in the scale of AE events on the Felicity effect was discussed. It was observed that the AE characteristics are closely related to the stress-strain properties of rock materials and that they are affected by the developmental state and degree of internal microcracks. AE events occur in either the loading or unloading stages if the strain is greater than zero. Evolutionary laws of AE activity agree with changes in rock strain. Strain deformation is accompanied by AE activity, and the density and intensity of AE events directly reflect the damage degree of the rock mass. The Kaiser effect exists in the linear elastic stage of rock material, and the Felicity effect is effective in the plastic yield and post-peak failure stages, which are divided by the elastic yield strength. This study suggests that the stress level needed to determine a significant increase in AE activity was 70% of the i + 1 peak stress. The Felicity ratio of rock specimens decreases with the growth of loading-unloading cycles. The cycle magnitude and variation of the Felicity effect, in which loading and unloading rates play a weak role, are almost consistent.

Safety and Efficacy of Durvalumab (MEDI4736), an Anti-Programmed Cell Death Ligand-1 Immune Checkpoint Inhibitor, in Patients With Advanced Urothelial Bladder Cancer.

PubMed

Massard, Christophe; Gordon, Michael S; Sharma, Sunil; Rafii, Saeed; Wainberg, Zev A; Luke, Jason; Curiel, Tyler J; Colon-Otero, Gerardo; Hamid, Omid; Sanborn, Rachel E; O'Donnell, Peter H; Drakaki, Alexandra; Tan, Winston; Kurland, John F; Rebelatto, Marlon C; Jin, Xiaoping; Blake-Haskins, John A; Gupta, Ashok; Segal, Neil H

2016-09-10

To investigate the safety and efficacy of durvalumab, a human monoclonal antibody that binds programmed cell death ligand-1 (PD-L1), and the role of PD-L1 expression on clinical response in patients with advanced urothelial bladder cancer (UBC). A phase 1/2 multicenter, open-label study is being conducted in patients with inoperable or metastatic solid tumors. We report here the results from the UBC expansion cohort. Durvalumab (MEDI4736, 10 mg/kg every 2 weeks) was administered intravenously for up to 12 months. The primary end point was safety, and objective response rate (ORR, confirmed) was a key secondary end point. An exploratory analysis of pretreatment tumor biopsies led to defining PD-L1-positive as ≥ 25% of tumor cells or tumor-infiltrating immune cells expressing membrane PD-L1. A total of 61 patients (40 PD-L1-positive, 21 PD-L1-negative), 93.4% of whom received one or more prior therapies for advanced disease, were treated (median duration of follow-up, 4.3 months). The most common treatment-related adverse events (AEs) of any grade were fatigue (13.1%), diarrhea (9.8%), and decreased appetite (8.2%). Grade 3 treatment-related AEs occurred in three patients (4.9%); there were no treatment-related grade 4 or 5 AEs. One treatment-related AE (acute kidney injury) resulted in treatment discontinuation. The ORR was 31.0% (95% CI, 17.6 to 47.1) in 42 response-evaluable patients, 46.4% (95% CI, 27.5 to 66.1) in the PD-L1-positive subgroup, and 0% (95% CI, 0.0 to 23.2) in the PD-L1-negative subgroup. Responses are ongoing in 12 of 13 responding patients, with median duration of response not yet reached (range, 4.1+ to 49.3+ weeks). Durvalumab demonstrated a manageable safety profile and evidence of meaningful clinical activity in PD-L1-positive patients with UBC, many of whom were heavily pretreated. © 2016 by American Society of Clinical Oncology.

Safety and Efficacy of Durvalumab (MEDI4736), an Anti–Programmed Cell Death Ligand-1 Immune Checkpoint Inhibitor, in Patients With Advanced Urothelial Bladder Cancer

PubMed Central

Massard, Christophe; Gordon, Michael S.; Sharma, Sunil; Rafii, Saeed; Wainberg, Zev A.; Luke, Jason; Curiel, Tyler J.; Colon-Otero, Gerardo; Hamid, Omid; Sanborn, Rachel E.; O’Donnell, Peter H.; Drakaki, Alexandra; Tan, Winston; Kurland, John F.; Rebelatto, Marlon C.; Jin, Xiaoping; Blake-Haskins, John A.; Gupta, Ashok

2016-01-01

Purpose To investigate the safety and efficacy of durvalumab, a human monoclonal antibody that binds programmed cell death ligand-1 (PD-L1), and the role of PD-L1 expression on clinical response in patients with advanced urothelial bladder cancer (UBC). Methods A phase 1/2 multicenter, open-label study is being conducted in patients with inoperable or metastatic solid tumors. We report here the results from the UBC expansion cohort. Durvalumab (MEDI4736, 10 mg/kg every 2 weeks) was administered intravenously for up to 12 months. The primary end point was safety, and objective response rate (ORR, confirmed) was a key secondary end point. An exploratory analysis of pretreatment tumor biopsies led to defining PD-L1–positive as ≥ 25% of tumor cells or tumor-infiltrating immune cells expressing membrane PD-L1. Results A total of 61 patients (40 PD-L1–positive, 21 PD-L1–negative), 93.4% of whom received one or more prior therapies for advanced disease, were treated (median duration of follow-up, 4.3 months). The most common treatment-related adverse events (AEs) of any grade were fatigue (13.1%), diarrhea (9.8%), and decreased appetite (8.2%). Grade 3 treatment-related AEs occurred in three patients (4.9%); there were no treatment-related grade 4 or 5 AEs. One treatment-related AE (acute kidney injury) resulted in treatment discontinuation. The ORR was 31.0% (95% CI, 17.6 to 47.1) in 42 response-evaluable patients, 46.4% (95% CI, 27.5 to 66.1) in the PD-L1–positive subgroup, and 0% (95% CI, 0.0 to 23.2) in the PD-L1–negative subgroup. Responses are ongoing in 12 of 13 responding patients, with median duration of response not yet reached (range, 4.1+ to 49.3+ weeks). Conclusion Durvalumab demonstrated a manageable safety profile and evidence of meaningful clinical activity in PD-L1–positive patients with UBC, many of whom were heavily pretreated. PMID:27269937

Epidemiology of National Collegiate Athletic Association Women's Gymnastics Injuries, 2009-2010 Through 2013-2014.

PubMed

Kerr, Zachary Y; Hayden, Ross; Barr, Megan; Klossner, David A; Dompier, Thomas P

2015-08-01

Recent injury-surveillance data for collegiate-level women's gymnastics are limited. In addition, researchers have not captured non-time-loss injuries (ie, injuries resulting in restriction of participation <1 day). To describe the epidemiology of National Collegiate Athletic Association (NCAA) women's gymnastics injuries during the 2009-2010 through 2013-2014 academic years. Descriptive epidemiology study. Aggregate injury and exposure data collected from 11 women's gymnastics programs providing 28 seasons of data. Collegiate student-athletes participating in women's gymnastics during the 2009-2010 through 2013-2014 academic years. Women's gymnastics data from the NCAA Injury Surveillance Program (ISP) during the 2009-2010 through 2013-2014 academic years were analyzed. Injury rates; injury rate ratios; injury proportions by body site, diagnosis, and apparatus; and injury proportion ratios were reported with 95% confidence intervals (CIs). The ISP captured 418 women's gymnastics injuries, a rate of 9.22/1000 athlete-exposures (AEs; 95% CI = 8.33, 10.10). The competition injury rate (14.49/1000 AEs) was 1.67 times the practice injury rate (8.69/1000 AEs; 95% CI = 1.27, 2.19). When considering time-loss injuries only, the injury rate during this study period (3.62/1000 AEs) was lower than rates reported in earlier NCAA ISP surveillance data. Commonly injured body sites were the ankle (17.9%, n = 75), lower leg/Achilles tendon (13.6%, n = 57), trunk (13.4%, n = 56), and foot (12.4%, n = 52). Common diagnoses were ligament sprain (20.3%, n = 85) and muscle/tendon strain (18.7%, n = 78). Overall, 12.4% (n = 52) of injuries resulted in time loss of more than 3 weeks. Of the 291 injuries reported while a student-athlete used an apparatus (69.6%), most occurred during the floor exercise (41.9%, n = 122) and on the uneven bars (28.2%, n = 82). We observed a lower time-loss injury rate for women's gymnastics than shown in earlier NCAA ISP surveillance data. Safety initiatives in women's gymnastics, such as "sting mats," padded equipment, and a redesigned vault table, may have contributed to minimizing the frequency and severity of injury.

Incidence of adverse events in Sweden during 2013–2016: a cohort study describing the implementation of a national trigger tool

PubMed Central

Nilsson, Lena; Borgstedt-Risberg, Madeleine; Soop, Michael; Nylén, Urban; Ålenius, Carina; Rutberg, Hans

2018-01-01

Objectives To describe the implementation of a trigger tool in Sweden and present the national incidence of adverse events (AEs) over a 4-year period during which an ongoing national patient safety initiative was terminated. Design Cohort study using retrospective record review based on a trigger tool methodology. Setting and participants Patients ≥18 years admitted to all somatic acute care hospitals in Sweden from 2013 to 2016 were randomised into the study. Primary and secondary outcome measures Primary outcome measure was the incidence of AEs, and secondary measures were type of injury, severity of harm, preventability of AEs, estimated healthcare cost of AEs and incidence of AEs in patients cared for in another type of unit than the one specialised for their medical needs (‘off-site’). Results In a review of 64 917 admissions, the average AE rates in 2014 (11.6%), 2015 (10.9%) and 2016 (11.4%) were significantly lower than in 2013 (13.1%). The decrease in the AE rates was seen in different age groups, in both genders and for preventable and non-preventable AEs. The decrease comprised only the least severe AEs. The types of AEs that decreased were hospital-acquired infections, urinary bladder distention and compromised vital signs. Patients cared for ‘off-site’ had 84% more preventable AEs than patients cared for in the appropriate units. The cost of increased length of stay associated with preventable AEs corresponded to 13%–14% of the total cost of somatic hospital care in Sweden. Conclusions The rate of AEs in Swedish somatic hospitals has decreased from 2013 to 2016. Retrospective record review can be used to monitor patient safety over time, to assess the effects of national patient safety interventions and analyse challenges to patient safety such as the increasing care of patients ‘off-site’. It was found that the economic burden of preventable AEs is high. PMID:29602858

Doing No Harm? Adverse Events in a Nation-Wide Cohort of Patients with Multidrug-Resistant Tuberculosis in Nigeria

PubMed Central

Avong, Yohanna Kamabi; Isaakidis, Petros; Hinderaker, Sven Gudmund; Van den Bergh, Rafael; Ali, Engy; Obembe, Bolajoko Oladunni; Ekong, Ernest; Adebamowo, Clement; Ndembi, Nicaise; Okuma, James; Osakwe, Adeline; Oladimeji, Olanrewaju; Akang, Gabriel; Obasanya, Joshua Olusegun; Eltayeb, Osman; Agbaje, Aderonke Vivian; Abimiku, Alash’le; Mensah, Charles Olalekan; Dakum, Patrick Sunday

2015-01-01

Background Adverse events (AEs) of second line anti-tuberculosis drugs (SLDs) are relatively well documented. However, the actual burden has rarely been described in detail in programmatic settings. We investigated the occurrence of these events in the national cohort of multidrug-resistant tuberculosis (MDR-TB) patients in Nigeria. Method This was a retrospective, observational cohort study, using pharmacovigilance data systematically collected at all MDR-TB treatment centers in Nigeria. Characteristics of AEs during the intensive phase treatment were documented, and risk factors for development of AEs were assessed. Results Four hundred and sixty patients were included in the analysis: 62% were male; median age was 33 years [Interquartile Range (IQR):28–42] and median weight was 51 kg (IQR: 45–59). Two hundred and three (44%) patients experienced AEs; four died of conditions associated with SLD AEs. Gastro-intestinal (n = 100), neurological (n = 75), ototoxic (n = 72) and psychiatric (n = 60) AEs were the most commonly reported, whereas ototoxic and psychiatric AEs were the most debilitating. Majority of AEs developed after 1–2 months of therapy, and resolved in less than a month after treatment. Some treatment centers were twice as likely to report AEs compared with others, highlighting significant inconsistencies in reporting at different treatment centers. Patients with a higher body weight had an increased risk of experiencing AEs. No differences were observed in risk of AEs between HIV-infected and uninfected patients. Similarly, age was not significantly associated with AEs. Conclusion Patients in the Nigerian MDR-TB cohort experienced a wide range of AEs, some of which were disabling and fatal. Early identification and prompt management as well as standardized reporting of AEs at all levels of healthcare, including the community is urgently needed. Safer regimens for drug-resistant TB with the shortest duration are advocated. PMID:25781958

Complete chloroplast genomes of Aegilops tauschii Coss. and Ae. cylindrica Host sheds light on plasmon D evolution.

PubMed

Gogniashvili, Mari; Jinjikhadze, Tamar; Maisaia, Inesa; Akhalkatsi, Maia; Kotorashvili, Adam; Kotaria, Nato; Beridze, Tengiz; Dudnikov, Alexander Ju

2016-11-01

Hexaploid wheat (Triticum aestivum L., genomes AABBDD) originated in South Caucasus by allopolyploidization of the cultivated Emmer wheat T. dicoccum (genomes AABB) with the Caucasian Ae. tauschii ssp strangulata (genomes DD). Genetic variation of Ae. tauschii is an important natural resource, that is why it is of particular importance to investigate how this variation was formed during Ae. tauschii evolutionary history and how it is presented through the species area. The D genome is also found in tetraploid Ae. cylindrica Host (2n = 28, CCDD). The plasmon diversity that exists in Triticum and Aegilops species is of great significance for understanding the evolution of these genera. In the present investigation the complete nucleotide sequence of plasmon D (chloroplast DNA) of nine accessions of Ae. tauschii and two accessions of Ae. cylindrica are presented. Twenty-eight SNPs are characteristic for both TauL1 and TauL2 accessions of Ae. tauschii using TauL3 as a reference. Four SNPs are additionally observed for TauL2 lineage. The longest (27 bp) indel is located in the intergenic spacer Rps15-ndhF of SSC. This indel can be used for simple determination of TauL3 lineage among Ae. tauschii accessions. In the case of Ae. cylindrica additionally 7 SNPs were observed. The phylogeny tree shows that chloroplast DNA of TauL1 and TauL2 diverged from the TauL3 lineage. TauL1 lineage is relatively older then TauL2. The position of Ae. cylindrica accessions on Ae. tauschii phylogeny tree constructed on chloroplast DNA variation data is intermediate between TauL1 and TauL2. The complete nucleotide sequence of chloroplast DNA of Ae. tauschii and Ae. cylindrica allows to refine the origin and evolution of D plasmon of genus Aegilops.

Experience of low-dose aminophylline use to relieve minor adverse effects of dipyridamole in patients undergoing stress myocardial perfusion imaging.

PubMed

Lin, Li-Fan; Cheng, Cheng-Yi; Hou, Cheng-Han; Ku, Chih-Hung; Tseng, Neng-Chuan; Shen, Daniel H Y

2014-06-01

Intravenous administration of aminophylline is widely adopted to reverse dipyridamole-related adverse effects (AEs) during stress myocardial perfusion imaging (MPI). The study aimed to investigate the efficacy of lower-dose aminophylline to relieve minor AEs. 2,250 consecutive patients undergoing dipyridamole-stressed MPI were enrolled. Information concerning AE occurrence and dosages of aminophylline was collected to evaluate the efficacy of lower-dose aminophylline. A logistic regression was used to determine independent predictors of dipyridamole-related AE occurrence. No severe AE was noted. Overall mild AE incidence was 37.0% (833/2,250 patients). Initial low-dose (25 mg) aminophylline relieved symptoms in 98.8% of patients with mild AEs (823/833 patients). An extra 25 mg aminophylline sufficed to reverse all such AEs. Mean body mass index (BMI) differed significantly between patients with and without any AE [25.6 vs 25.1 (P = .009)]. There was no significant difference between two subgroups in mean age, male gender prevalence, body height and weight, dipyridamole dose/BMI, or prevalence of significant perfusion defect(s) on MPI. Multivariable logistic regression demonstrated BMI remained the independent predictor of dipyridamole-related AE occurrence (odds ratio 1.028, 95% confidence interval 1.007-1.049, P = .01). Low-dose (≦50 mg, and usually 25 mg) aminophylline seems sufficient to relieve mild dipyridamole-related AEs during stress MPI.

Structural Integration as an Adjunct to Outpatient Rehabilitation for Chronic Nonspecific Low Back Pain: A Randomized Pilot Clinical Trial

PubMed Central

Jacobson, Eric E.; Meleger, Alec L.; Bonato, Paolo; Wayne, Peter M.; Langevin, Helene M.; Kaptchuk, Ted J.; Davis, Roger B.

2015-01-01

Structural Integration (SI) is an alternative method of manipulation and movement education. To obtain preliminary data on feasibility, effectiveness, and adverse events (AE), 46 outpatients from Boston area with chronic nonspecific low back pain (CNSLBP) were randomized to parallel treatment groups of SI plus outpatient rehabilitation (OR) versus OR alone. Feasibility data were acceptable except for low compliance with OR and lengthy recruitment time. Intent-to-treat data on effectiveness were analyzed by Wilcoxon rank sum, n = 23 per group. Median reductions in VAS Pain, the primary outcome, of −26 mm in SI + OR versus 0 in OR alone were not significantly different (P = 0.075). Median reductions in RMDQ, the secondary outcome, of −2 points in SI + OR versus 0 in OR alone were significantly different (P = 0.007). Neither the proportions of participants with nor the seriousness of AE were significantly different. SI as an adjunct to OR for CNSLBP is not likely to provide additional reductions in pain but is likely to augment short term improvements in disability with a low additional burden of AE. A more definitive trial is feasible, but OR compliance and recruitment might be challenging. This trial is registered with ClinicalTrials.gov (NCT01322399). PMID:25945112

Structural integration as an adjunct to outpatient rehabilitation for chronic nonspecific low back pain: a randomized pilot clinical trial.

PubMed

Jacobson, Eric E; Meleger, Alec L; Bonato, Paolo; Wayne, Peter M; Langevin, Helene M; Kaptchuk, Ted J; Davis, Roger B

2015-01-01

Structural Integration (SI) is an alternative method of manipulation and movement education. To obtain preliminary data on feasibility, effectiveness, and adverse events (AE), 46 outpatients from Boston area with chronic nonspecific low back pain (CNSLBP) were randomized to parallel treatment groups of SI plus outpatient rehabilitation (OR) versus OR alone. Feasibility data were acceptable except for low compliance with OR and lengthy recruitment time. Intent-to-treat data on effectiveness were analyzed by Wilcoxon rank sum, n = 23 per group. Median reductions in VAS Pain, the primary outcome, of -26 mm in SI + OR versus 0 in OR alone were not significantly different (P = 0.075). Median reductions in RMDQ, the secondary outcome, of -2 points in SI + OR versus 0 in OR alone were significantly different (P = 0.007). Neither the proportions of participants with nor the seriousness of AE were significantly different. SI as an adjunct to OR for CNSLBP is not likely to provide additional reductions in pain but is likely to augment short term improvements in disability with a low additional burden of AE. A more definitive trial is feasible, but OR compliance and recruitment might be challenging. This trial is registered with ClinicalTrials.gov (NCT01322399).

Effect of a combination of inulin and polyphenol-containing adzuki bean extract on intestinal fermentation in vitro and in vivo.

PubMed

Nagata, Ryuji; Echizen, Mao; Yamaguchi, Yukari; Han, Kyu-Ho; Shimada, Kenichiro; Ohba, Kiyoshi; Kitano-Okada, Tomoko; Nagura, Taizo; Uchino, Hirokatsu; Fukushima, Michihiro

2018-03-01

The effect of a combination of inulin (INU) and polyphenol-containing adzuki bean extract (AE) on intestinal fermentation was examined in vitro using fermenters for 48 h and in vivo using rats for 28 d. The total short-chain fatty acid concentrations in the fermenters were decreased by a combination of INU and AE, but the concentration in the INU + AE group was higher than the cellulose (CEL) and CEL + AE groups. The cecal propionate concentration was increased by a combination of INU and AE compared with their single supplement. The ammonia-nitrogen concentration in the fermenters and rat cecum was decreased by INU and AE. Cecal mucin levels were increased by INU and AE respectively. Therefore, our observations suggested that the combination of INU and AE might be a material of functional food that includes several healthy effects through intestinal fermentation.

Fatigue crack localization with near-field acoustic emission signals

NASA Astrophysics Data System (ADS)

Zhou, Changjiang; Zhang, Yunfeng

2013-04-01

This paper presents an AE source localization technique using near-field acoustic emission (AE) signals induced by crack growth and propagation. The proposed AE source localization technique is based on the phase difference in the AE signals measured by two identical AE sensing elements spaced apart at a pre-specified distance. This phase difference results in canceling-out of certain frequency contents of signals, which can be related to AE source direction. Experimental data from simulated AE source such as pencil breaks was used along with analytical results from moment tensor analysis. It is observed that the theoretical predictions, numerical simulations and the experimental test results are in good agreement. Real data from field monitoring of an existing fatigue crack on a bridge was also used to test this system. Results show that the proposed method is fairly effective in determining the AE source direction in thick plates commonly encountered in civil engineering structures.

Neurological adverse events of new generation sodium blocker antiepileptic drugs. Meta-analysis of randomized, double-blinded studies with eslicarbazepine acetate, lacosamide and oxcarbazepine.

PubMed

Zaccara, Gaetano; Giovannelli, Fabio; Maratea, Dario; Fadda, Valeria; Verrotti, Alberto

2013-09-01

Analysis of overall tolerability and neurological adverse effects (AEs) of eslicarbazepine acetate (ESL), lacosamide (LCM) and oxcarbazepine (OXC) from double-blind, placebo-controlled trials. Indirect comparisons of patients withdrawing because of AEs, and the incidence of some vestibulocerebellar AEs between these three antiepileptic dugs (AEDs). We searched MEDLINE for all randomized, double-blind, placebo-controlled trials investigating therapeutic effects of fixed oral doses of ESL, LCM and OXC in patients with drug resistant epilepsy. Withdrawal rate due to AEs, percentages of patients with serious AEs, and the proportion of patients experiencing any neurological AE, nausea and vomiting were assessed for their association with the experimental drug. Analyses were performed between recommended daily doses of each AED according to the approved summary of product characteristics (SPC). Risk differences were used to evaluate the association of any AE [99% confidence intervals (CIs)] or study withdrawals because of AEs (95% CIs) with the experimental drug. Indirect comparisons between withdrawal rate and AEs dizziness, coordination abnormal/ataxia and diplopia were estimated according to network meta-analysis (Net-MA). Eight randomized, placebo-controlled, double-blind trials (4 with ESL, 3 with LCM, and 1 with OXC) were included in our analysis. At high doses (OXC 1200mg, ESL 1200mg and LCM 400mg) there was an increased risk of AE-related study withdrawals compared to placebo for all drugs. Several AEs were associated with the experimental drug. Both number and frequency of AEs were dose-related. At high recommended doses, patients treated with OXC withdrew from the experimental treatment significantly more frequently than patients treated with ESL and LCM. Furthermore, the AEs coordination abnormal/ataxia and diplopia were significantly more frequently observed in patients treated with OXC compared to patients treated with LCM and ESL. The overall tolerability of AEDs and the incidence of several neurological AEs were clearly dose-dependent. Indirect comparisons between these AEDs, taking into account dose-effect, showed that OXC may be associated with more frequent neurological AEs than LCM and ESL. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Population dynamics of Aedes aegypti and dengue as influenced by weather and human behavior in San Juan, Puerto Rico.

PubMed

Barrera, Roberto; Amador, Manuel; MacKay, Andrew J

2011-12-01

Previous studies on the influence of weather on Aedes aegypti dynamics in Puerto Rico suggested that rainfall was a significant driver of immature mosquito populations and dengue incidence, but mostly in the drier areas of the island. We conducted a longitudinal study of Ae. aegypti in two neighborhoods of the metropolitan area of San Juan city, Puerto Rico where rainfall is more uniformly distributed throughout the year. We assessed the impacts of rainfall, temperature, and human activities on the temporal dynamics of adult Ae. aegypti and oviposition. Changes in adult mosquitoes were monitored with BG-Sentinel traps and oviposition activity with CDC enhanced ovitraps. Pupal surveys were conducted during the drier and wetter parts of the year in both neighborhoods to determine the contribution of humans and rains to mosquito production. Mosquito dynamics in each neighborhood was compared with dengue incidence in their respective municipalities during the study. Our results showed that: 1. Most pupae were produced in containers managed by people, which explains the prevalence of adult mosquitoes at times when rainfall was scant; 2. Water meters were documented for the first time as productive habitats for Ae. aegypti; 3. Even though Puerto Rico has a reliable supply of tap water and an active tire recycling program, water storage containers and discarded tires were important mosquito producers; 4. Peaks in mosquito density preceded maximum dengue incidence; and 5. Ae. aegypti dynamics were driven by weather and human activity and oviposition was significantly correlated with dengue incidence.

Population Dynamics of Aedes aegypti and Dengue as Influenced by Weather and Human Behavior in San Juan, Puerto Rico

PubMed Central

Barrera, Roberto; Amador, Manuel; MacKay, Andrew J.

2011-01-01

Previous studies on the influence of weather on Aedes aegypti dynamics in Puerto Rico suggested that rainfall was a significant driver of immature mosquito populations and dengue incidence, but mostly in the drier areas of the island. We conducted a longitudinal study of Ae. aegypti in two neighborhoods of the metropolitan area of San Juan city, Puerto Rico where rainfall is more uniformly distributed throughout the year. We assessed the impacts of rainfall, temperature, and human activities on the temporal dynamics of adult Ae. aegypti and oviposition. Changes in adult mosquitoes were monitored with BG-Sentinel traps and oviposition activity with CDC enhanced ovitraps. Pupal surveys were conducted during the drier and wetter parts of the year in both neighborhoods to determine the contribution of humans and rains to mosquito production. Mosquito dynamics in each neighborhood was compared with dengue incidence in their respective municipalities during the study. Our results showed that: 1. Most pupae were produced in containers managed by people, which explains the prevalence of adult mosquitoes at times when rainfall was scant; 2. Water meters were documented for the first time as productive habitats for Ae. aegypti; 3. Even though Puerto Rico has a reliable supply of tap water and an active tire recycling program, water storage containers and discarded tires were important mosquito producers; 4. Peaks in mosquito density preceded maximum dengue incidence; and 5. Ae. aegypti dynamics were driven by weather and human activity and oviposition was significantly correlated with dengue incidence. PMID:22206021

Population of Aedes sp in Highland of Wonosobo District and Its Competence as A Dengue Vector

NASA Astrophysics Data System (ADS)

Martini, Martini; Widjanarko, Bagoes; Hestiningsih, Retno; Purwantisari, Susiana; Yuliawati, Sri

2017-02-01

The increased cases of dengue fever have occurred in the highland of Wonosobo District, and the epidemic taken place in 2009 had 59.3 cases per 100,000 populations. This study aimed to describe of vector competence of the mosquitoes as a dengue vector in the highland of Wonosobo District, Central Java Province. The serial laboratory work was done to measure of vector competence complementary with vector bionomic study. The samples were 20 villages, which were located at Wonosobo sub district. Every village was observed about 15-20 houses. The observed variables were vector competition, bionomic and transovarial infection level, and titer of virus on the mosquitoes after injection. Immunohistochemistry or IHC methods were used to identify transovarial infection status. The number of Ae. aegypti and Ae. albopictus were almost similar and both were found indoors or outdoors. Based on HI and OI index, the larvae density in the highland was enough high than standard of the program. Transovarial infection was found on Ae. aegypti and Ae. albopictus. Environment parameters such as temperature and relative humidity fulfilled the optimum requirement to support the vectors’ life cycle. Transovarial infection has been proven, thus, it indicates that the local transmission has been occurred in this area. Titer of virus was also increasing after day per day. This indicate that the mosquitoes has the ability being vector. As used to do in other area, it is important to conduct breeding places elimination (PSN) indoors as well as outdoors, through active participation of the community in highland area.

Adaptor protein 1 B mu subunit does not contribute to the recycling of kAE1 protein in polarized renal epithelial cells.

PubMed

Almomani, Ensaf Y; Touret, Nicolas; Cordat, Emmanuelle

2018-04-13

Mutations in the gene encoding the kidney anion exchanger 1 (kAE1) can lead to distal renal tubular acidosis (dRTA). dRTA mutations reported within the carboxyl (C)-terminal tail of kAE1 result in apical mis-targeting of the exchanger in polarized renal epithelial cells. As kAE1 physically interacts with the μ subunit of epithelial adaptor protein 1 B (AP-1B), we investigated the role of heterologously expressed μ1B subunit of the AP-1B complex for kAE1 retention to the basolateral membrane in polarized porcine LLC-PK1 renal epithelial cells that are devoid of endogenous AP-1B. We confirmed the interaction and close proximity between kAE1 and μ1B using immunoprecipitation and proximity ligation assay, respectively. Expressing the human μ1B subunit in these cells decreased significantly the amount of cell surface kAE1 at the steady state, but had no significant effect on kAE1 recycling and endocytosis. We show that (i) heterologous expression of μ1B displaces the physical interaction of endogenous GAPDH with kAE1 WT supporting that both AP-1B and GAPDH proteins bind to an overlapping site on kAE1 and (ii) phosphorylation of tyrosine 904 within the potential YDEV interaction motif does not alter the kAE1/AP-1B interaction. We conclude that μ1B subunit is not involved in recycling of kAE1.

Structural and mutational analyses of Aes, an inhibitor of MalT in Escherichia coli.

PubMed

Schiefner, André; Gerber, Kinga; Brosig, Alexander; Boos, Winfried

2014-02-01

The acyl esterase Aes effectively inhibits the transcriptional activity of MalT-the central activator of maltose and maltodextrin utilizing genes in Escherichia coli. To provide better insight into the nature of the interaction between Aes and MalT, we determined two different crystal structures of Aes-in its native form and covalently modified by a phenylmethylsulfonyl moiety at its active site serine. Both structures show distinct space groups and were refined to a resolution of 1.8 Å and 2.3 Å, respectively. The overall structure of Aes resembles a canonical α/β-hydrolase fold, which is extended by a funnel-like cap structure that forms the substrate-binding site. The catalytic triad of Aes, comprising residues Ser165, His292, and Asp262, is located at the bottom of this funnel. Analysis of the crystal-packing contacts of the two different space groups as well as analytical size-exclusion chromatography revealed a homodimeric arrangement of Aes. The Aes dimer adopts an antiparallel contact involving both the hydrolase core and the cap, with its twofold axis perpendicular to the largest dimension of Aes. To identify the surface area of Aes that is responsible for the interaction with MalT, we performed a structure-based alanine-scanning mutagenesis to pinpoint Aes residues that are significantly impaired in MalT inhibition, but still exhibit wild-type expression and enzymatic activity. These residues map to a shallow slightly concave surface patch of Aes at the opposite site of the dimerization interface and indicate the surface area that interacts with MalT. Copyright © 2013 Wiley Periodicals, Inc.

Adverse events following cervical manipulative therapy: consensus on classification among Dutch medical specialists, manual therapists, and patients.

PubMed

Kranenburg, Hendrikus A; Lakke, Sandra E; Schmitt, Maarten A; Van der Schans, Cees P

2017-12-01

To obtain consensus-based agreement on a classification system of adverse events (AE) following cervical spinal manipulation. The classification system should be comprised of clear definitions, include patients' and clinicians' perspectives, and have an acceptable number of categories. Design : A three-round Delphi study. Participants : Thirty Dutch participants (medical specialists, manual therapists, and patients) participated in an online survey. Procedure : Participants inventoried AE and were asked about their preferences for either a three- or a four-category classification system. The identified AE were classified by two analysts following the International Classification of Functioning, Disability and Health (ICF), and the International Classification of Diseases and Related Health Problems (ICD-10). Participants were asked to classify the severity for all AE in relation to the time duration. Consensus occurred in a three-category classification system. There was strong consensus for 16 AE in all severities (no, minor, and major AE) and all three time durations [hours, days, weeks]. The 16 AE included anxiety, flushing, skin rash, fainting, dizziness, coma, altered sensation, muscle tenderness, pain, increased pain during movement, radiating pain, dislocation, fracture, transient ischemic attack, stroke, and death. Mild to strong consensus was reached for 13 AE. A consensus-based classification system of AE is established which includes patients' and clinicians' perspectives and has three categories. The classification comprises a precise description of potential AE in accordance with internationally accepted classifications. After international validation, clinicians and researchers may use this AE classification system to report AE in clinical practice and research.

Patient safety and adverse events related with obstetric care.

PubMed

Aibar, Laura; Rabanaque, María José; Aibar, Carlos; Aranaz, Jesús María; Mozas, Juan

2015-04-01

To determine the frequency and distribution of Adverse Events (AE) in obstetrics departments at Spanish hospitals. We present a retrospective cohort study including 816 women admitted to the obstetrics departments at 41 hospitals that took part in the National Adverse Effects Study in Spain (ENEAS) and an extension of this study in all hospitals located in two Autonomous Regions. To identify AE, nurses from each participating hospital examined all medical records, and completed a validated screening guide. A team of external reviewers evaluated the medical records of all women who met at least one of the criteria in the screening guide to verify all AE. The main outcome measure was the incidence of AE during hospitalization. The cumulative incidence of patients with obstetric care-related AE was 3.6% (95% CI 2.3-4.8). The most frequent AE were those related with surgical interventions or procedures (59.4%). None of the AE detected were considered severe. 36.7% of the AE lengthened the woman's hospital stay, and 13.3% led to hospital admission. Additional procedures were needed after 71.9% of the AE, and additional treatment was needed after 59.4%. 56.3% of the AE were considered preventable. Obstetric care is characterized by generally younger ages among patients, their low frequency of comorbidities and high expectations for successful outcomes of care. However, some factors can increase obstetric risk and favor the appearance of preventable incidents and AE. Systems are needed to detect preventable AE, and measures are needed to reduce risks or attenuate their consequences.

Detritus Type Alters the Outcome of Interspecific Competition Between Aedes aegypti and Aedes albopictus (Diptera: Culicidae)

PubMed Central

MURRELL, EBONY G.; JULIANO, STEVEN A.

2008-01-01

Many studies of interspecific competition between Aedes albopictus (Skuse) and Aedes aegypti (L.) (Diptera: Culicidae) larvae show that Ae. albopictus are superior resource competitors to Ae. aegypti. Single-species studies indicate that growth and survival of Ae. albopictus and Ae. aegypti larvae are affected by the type of detritus present in containers, which presumably affects the amount and quality of microorganisms that the mosquito larvae consume. We tested whether different detritus types alter the intensity of larval competition by raising 10 different density/species combinations of Ae. albopictus and Ae. aegypti larvae under standard laboratory conditions, with one of four detritus types (oak, pine, grass, or insect) provided as a nutrient base. Intraspecific competitive effects on survival were present with all detritus types. Ae. albopictus survivorship was unaffected by interspecific competition in all treatments. Negative interspecific effects on Ae. aegypti survivorship were present with three of four detritus types, but absent with grass. Estimated finite rate of increase (λ’) was lower with pine detritus than with any other detritus type for both species. Furthermore, Ae. aegypti λ’ was negatively affected by high interspecific density in all detritus types except grass. Thus, our experiment confirms competitive asymmetry in favor of Ae. albopictus with oak, pine, or insect detritus, but also demonstrates that certain detritus types may eliminate interspecific competition among the larvae of these species, which may allow for stable coexistence. Such variation in competitive outcome with detritus type may help to account for observed patterns of coexistence/exclusion of Ae. albopictus and Ae. aegypti in the field. PMID:18533429

76 FR 27041 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-10

...., AES Ironwood, L.L.C., AES Laurel Mountain, LLC, AES Red Oak, L.L.C., AES Redondo Beach, L.L.C., Condo... Venture, L.P., Fox Energy Company, LLC, Birchwood Power Partners, L.P., Shady Hills Power Company, LLC...

Field and Wind Tunnel Testing on Natural Ventilation Cooling Effects on Three Navy Buildings.

DTIC Science & Technology

1984-12-01

ORGANIZATION NAME AND ADDRESS 10 PROGRAM ELEMENT. PROJECT, TASK NAVAL CIVIL ENGINEERING LABORATORY AE OEUI UBR Port Hueneme, CA 93043S02-13A 7Y/ 11I...base of pressure difference coefficients for a variety of buildings with spe- cific architechtural features. Values from this data base can be used to

32 CFR 240.7 - Recruitment program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... year of service to the DoD upon graduation for each year or partial year of scholarship they receive... incur a service obligation of a minimum of 4 years on active duty in that Service upon graduation. The... graduation shall be required to reimburse the United States pursuant to 10 U.S.C. 2200a(e) for payments made...

32 CFR 240.7 - Recruitment program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... year of service to the DoD upon graduation for each year or partial year of scholarship they receive... incur a service obligation of a minimum of 4 years on active duty in that Service upon graduation. The... graduation shall be required to reimburse the United States pursuant to 10 U.S.C. 2200a(e) for payments made...

32 CFR 240.7 - Recruitment program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... year of service to the DoD upon graduation for each year or partial year of scholarship they receive... incur a service obligation of a minimum of 4 years on active duty in that Service upon graduation. The... graduation shall be required to reimburse the United States pursuant to 10 U.S.C. 2200a(e) for payments made...

AE-C attitude determination and control prelaunch analysis and operations plan

NASA Technical Reports Server (NTRS)

Werking, R. D.; Headrick, R. D.; Manders, C. F.; Woolley, R. D.

1973-01-01

A description of attitude control support being supplied by the Mission and Data Operations Directorate is presented. Included are descriptions of the computer programs being used to support the missions for attitude determination, prediction, and control. In addition, descriptions of the operating procedures which will be used to accomplish mission objectives are provided.

Effectiveness of the area wide pest management program to control asian tiger mosquito in New Jersey: evidence from a household survey

USDA-ARS?s Scientific Manuscript database

Households’ behaviors can both mitigate and measure the spread of urban mosquito species. Beginning in 2009, an area-wide pest management (AWPM) project to control Ae. Albopictus was implemented in 6 areas in Monmouth and Mercer counties, NJ. Including other activities, the project focused on increa...

Efficacy of Ovitrap Colors and Patterns for Attracting Aedes albopictus (Diptera: Culicidae) at Suburban Field Sites in North Central Florida

USDA-ARS?s Scientific Manuscript database

We sought to visually enhance the attractiveness of a standard black ovitrap routinely used in surveillance of the Asian Tiger Mosquito, Aedes albopictus (Skuse), and now being used as lethal ovitraps in Ae. aegypti (L.) dengue control programs. Black plastic drinking cups (ovitraps) were visually ...

Association between mast cell chymase genotype and atopic eczema: comparison between patients with atopic eczema alone and those with atopic eczema and atopic respiratory disease.

PubMed

Tanaka, K; Sugiura, H; Uehara, M; Sato, H; Hashimoto-Tamaoki, T; Furuyama, J

1999-06-01

It has remained unclear whether genetic background of patients with atopic eczema (AE) alone is identical to that of patients with both AE and atopic respiratory disease. We aimed to assess whether there is a genetic difference between these two groups of AE patients. We determined the genotype with regard to an allelic polymorphism in the gene for mast cell chymase (MCC; a serine protease secreted from mast cells) in 169 AE patients. MCC genotype was significantly associated with pure AE patients who did not have a predisposition to atopic respiratory disease and whose serum IgE concentration was < 500 IU/mL. The distribution of MCC genotypes also differed significantly between the latter patients and those AE patients with bronchial asthma and a serum IgE concentration of > 2000 IU/mL. These results suggest that pure AE is associated with genetic variants of MCC, and that the genetic basis of pure AE differs from that of AE associated with atopic asthma.

Suppression of RND3 activity by AES downregulation promotes cancer cell proliferation and invasion.

PubMed

Xia, Hongwei; Li, Mingxing; Chen, Liang; Leng, Weibing; Yuan, Dandan; Pang, Xiaohui; Chen, Liu; Li, Ronghui; Tang, Qiulin; Bi, Feng

2013-05-01

Amino-terminal enhancer of split (AES) is a member of the Groucho/TLE family. Although it has no DNA-binding site, AES can regulate transcriptional activity by interacting with transcriptional factors. Emerging evidence indicates that AES may play an important role in tumor metastasis, but the molecular mechanism is still poorly understood. In this study, we found that knockdown of AES by RNA interference (RNAi) downregulated RND3 expression at the mRNA and protein levels in MDA-MB-231 and HepG2, two cancer cell lines. Furthermore, luciferase assays showed that overexpression of AES significantly enhanced RND3 promoter activity. Moreover, inhibition of AES both in MDA-MB-231 and HepG2 cells by RNAi significantly promoted cell proliferation, cell cycle progression and invasion, consistent with the effects of RNAi-mediated RND3 knockdown in these cells. For the first time, data are presented showing that alteration of the malignant behavior of cancer cells by AES is related to RND3 regulation, and these findings also provide new insights into the mechanism of AES action in regulating tumor malignancy.

Genetic effect of the Aegilops caudata plasmon on the manifestation of the Ae. cylindrica genome.

PubMed

Tsunewaki, Koichiro; Mori, Naoki; Takumi, Shigeo

2014-01-01

In the course of reconstructing Aegilops caudata from its own genome (CC) and its plasmon, which had passed half a century in common wheat (genome AABBDD), we produced alloplasmic Ae. cylindrica (genome CCDD) with the plasmon of Ae. caudata. This line, designated (caudata)-CCDD, was found to express male sterility in its second substitution backcross generation (SB2) of (caudata)-AABBCCDD pollinated three times with the Ae. cylindrica pollen. We repeatedly backcrossed these SB2 plants with the Ae. cylindrica pollen until the SB5 generation, and SB5F2 progeny were produced by self-pollination of the SB5 plants. Thirteen morphological and physiological characters, including pollen and seed fertilities, of the (caudata)-CCDD SB5F2 were compared with those of the euplasmic Ae. cylindrica. The results indicated that the male sterility expressed by (caudata)-CCDD was due to genetic incompatibility between the Ae. cylindrica genome and Ae. caudata plasmon that did not affect any other characters of Ae. cylindrica. Also, we report that the genome integrity functions in keeping the univalent transmission rate high.

AE characteristic for monitoring of fatigue crack in steel bridge members

NASA Astrophysics Data System (ADS)

Yoon, Dong-Jin; Jung, Juong-Chae; Park, Philip; Lee, Seung-Seok

2000-06-01

Acoustic emission technique was employed for the monitoring of crack activity in both steel bridge members and laboratory specimen. Laboratory experiment was carried out to identify AE characteristics of fatigue cracks for compact tension specimen. The relationship between a stress intensity factor and AE signals activity as well as conventional AE parameter analysis was discussed. A field test was also conducted on a railway bridge, which contain several fatigue cracks. Crack activities were investigated while in service with strain measurement. From the results, in the laboratory tests, the features of three parameters such as the length of crack growth, the AE energy, and the cumulative AE events, showed the almost same trend in their increase as the number of fatigue cycle increased. From the comparisons of peak amplitude and AE energy with stress intensity factor, it was verified that the higher stress intensity factors generated AE signals with higher peak amplitude and a large number of AE counts. In the field test, real crack propagation signals were captured and the crack activity was verified in two cases.

Human kidney anion exchanger 1 interacts with adaptor-related protein complex 1 {mu}1A (AP-1 mu1A)

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

Sawasdee, Nunghathai; Junking, Mutita; Ngaojanlar, Piengpaga

Research highlights: {yields} Trafficking defect of kAE1 is a cause of dRTA but trafficking pathway of kAE1 has not been clearly described. {yields} Adaptor-related protein complex 1 {mu}1A (AP-1 mu1A) was firstly reported to interact with kAE1. {yields} The interacting site for AP-1 mu1A on Ct-kAE1 was found to be Y904DEV907, a subset of YXXO motif. {yields} AP-1 mu1A knockdown showed a marked reduction of kAE1 on the cell membrane and its accumulation in endoplasmic reticulum. {yields} AP-1 mu1A has a critical role in kAE1 trafficking to the plasma membrane. -- Abstract: Kidney anion exchanger 1 (kAE1) mediates chloride (Cl{supmore » -}) and bicarbonate (HCO{sub 3}{sup -}) exchange at the basolateral membrane of kidney {alpha}-intercalated cells. Impaired trafficking of kAE1 leads to defect of the Cl{sup -}/HCO{sub 3}{sup -} exchange at the basolateral membrane and failure of proton (H{sup +}) secretion at the apical membrane, causing a kidney disease - distal renal tubular acidosis (dRTA). To gain a better insight into kAE1 trafficking, we searched for proteins physically interacting with the C-terminal region of kAE1 (Ct-kAE1), which contains motifs crucial for intracellular trafficking, by a yeast two-hybrid (Y2H) system. An adaptor-related protein complex 1 {mu}1A (AP-1 mu1A) subunit was found to interact with Ct-kAE1. The interaction between either Ct-kAE1 or full-length kAE1 and AP-1 mu1A were confirmed in human embryonic kidney (HEK) 293T by co-immunoprecipitation, affinity co-purification, co-localization, yellow fluorescent protein (YFP)-based protein fragment complementation assay (PCA) and GST pull-down assay. The interacting site for AP-1 mu1A on Ct-kAE1 was found to be Y904DEV907, a subset of YXXO motif. Interestingly, suppression of endogenous AP-1 mu1A in HEK 293T by small interfering RNA (siRNA) decreased membrane localization of kAE1 and increased its intracellular accumulation, suggesting for the first time that AP-1 mu1A is involved in the kAE1 trafficking of kidney {alpha}-intercalated cells.« less

Acoustic emission studies of large advanced composite rocket motor cases.

NASA Technical Reports Server (NTRS)

Robinson, E. Y.

1973-01-01

Acoustic emission (AE) patterns were measured during pressure testing of advanced composite rocket motor cases made of boron/epoxy and graphite/epoxy. Both accelerometers and high frequency AE transducers were used, and both frequency spectrum and amplitude distribution were studied. The AE patterns suggest that precursor emission might be used in certain cases to anticipate failure. The technique of hold-cycle AE monitoring was also evaluated and could become a valuable decision gate for test continuation/termination. Data presented show similarity of accelerometers and AE transducer responses despite the different frequency response, and suggest that structural AE phenomena are broadband.

Azathioprine Intolerance in Japanese Patients with Antineutrophil Cytoplasmic Antibody-associated Vasculitis

PubMed Central

Morishita, Michiko; Watanabe, Haruki; Yan, Minglu; Zeggar, Sonia; Hiramatsu, Sumie; Ohashi, Keiji; Miyawaki, Yoshia; Katsuyama, Eri; Katsuyama, Takayuki; Takano Narazaki, Mariko; Toyota Tatebe, Noriko; Sunahori Watanabe, Katsue; Kawabata, Tomoko; Sada, Ken-Ei; Wada, Jun

2017-01-01

Objective To assess the safety of azathioprine (AZA) in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Methods We retrospectively enrolled 67 consecutive AAV patients who had initiated AZA treatment from January 2006 to August 2014 at Okayama University Hospital. We evaluated the development of severe adverse events (AEs), AZA discontinuation due to total AEs (severe AEs included) within 1 year, and AZA-associated risk factors. Results The patients' median age was 70 years old. Forty-nine women and 18 men participated at the initiation of the study. Fifty-eight (87%) patients experienced AEs, and 36 experienced severe AEs (21 hepatic and 11 cytopenic severe AEs). Thirty-one (46%) patients discontinued treatment because of AEs. Abnormal hepatic laboratory test results at the treatment initiation were more frequent in patients with hepatic severe AEs and were associated with treatment discontinuation. The leukocyte and neutrophil counts at the treatment initiation were lower in the patients who discontinued treatment because of cytopenic AEs than in those who continued treatment. Only two patients experienced flare-ups during treatment. Conclusion The AE-associated AZA discontinuation rate in Japanese AAV patients was relatively high. AZA use warrants caution in patients with abnormal hepatic laboratory test results or low leukocyte or neutrophil counts. PMID:28674351

Impaired trafficking of human kidney anion exchanger (kAE1) caused by hetero-oligomer formation with a truncated mutant associated with distal renal tubular acidosis.

PubMed

Quilty, Janne A; Cordat, Emmanuelle; Reithmeier, Reinhart A F

2002-12-15

Autosomal dominant distal renal tubular acidosis (dRTA) has been associated with several mutations in the anion exchanger AE1 gene. The effect of an 11-amino-acid C-terminal dRTA truncation mutation (901 stop) on the expression of kidney AE1 (kAE1) and erythroid AE1 was examined in transiently transfected HEK-293 cells. Unlike the wild-type proteins, kAE1 901 stop and AE1 901 stop mutants exhibited impaired trafficking from the endoplasmic reticulum to the plasma membrane as determined by immunolocalization, cell-surface biotinylation, oligosaccharide processing and pulse-chase experiments. The 901 stop mutants were able to bind to an inhibitor affinity resin, suggesting that these mutant membrane proteins were not grossly misfolded. Co-expression of wild-type and mutant kAE1 or AE1 resulted in intracellular retention of the wild-type proteins in a pre-medial Golgi compartment. This dominant negative effect was due to hetero-oligomer formation of the mutant and wild-type proteins. Intracellular retention of kAE1 in the alpha-intercalated cells of the kidney would account for the impaired acid secretion into the urine characteristic of dRTA.

Antibiotics-related adverse events in the infectious diseases department of a French teaching hospital: a prospective study.

PubMed

Courjon, J; Pulcini, C; Cua, E; Risso, K; Guillouet, F; Bernard, E; Roger, P-M

2013-12-01

Antibiotics are a significant cause of adverse events (AE), but few studies have focused on prescriptions in hospitalized patients. In infectious diseases departments, the high frequency and diversity of antibiotics prescribed makes AE post-marketing monitoring easier. The aim of our study was to assess the incidence and type of AE in the infectious diseases department of a French teaching tertiary-care hospital. The main characteristics of each hospitalization, including all antibiotics prescribed and any significant AE were recorded prospectively in the medical dashboard of the department. We included all patients having suffered an AE due to systemic antibiotics between January 2008 and March 2011. Among the 3963 hospitalized patients, 2682 (68%) received an antibiotic and 151/2682 (5.6%) suffered an AE. Fifty-two (34%) AE were gastrointestinal disorders, 32 (21%) dermatological, 20 (13%) hepatobiliary, 16 (11%) renal and urinary disorders, 13 (9%) neurological and 11 (7%) blood disorders. Rifampin, fosfomycin, cotrimoxazole and linezolid were the leading causes of AE. Sixty-two percent of the antibiotics causing an AE were stopped and 38% were continued (including 11% with a dose modification). Patients suffering from AE had an increased length of stay (18 vs 10 days, P < 0.001). Our data could help choosing the safest antibiotic when several options are possible.

Epidemiology of tree-hole breeding mosquitoes in the tropical rainforest of Imo State, south-east Nigeria.

PubMed

Anosike, Jude C; Nwoke, Bertram E B; Okere, Anthony N; Oku, Ene E; Asor, Joe E; Emmy-Egbe, Ifeyinwa O; Adimike, Desmond A

2007-01-01

The study of tree-hole breeding mosquitoes was carried out in the tropical rainforest of Imo State Nigeria (two rural areas and two forest reserves in some parts of Orlu Senatorial Zone) between May-October 2002. Using standard entomological procedures, two macrohabitats (natural tree-holes and bamboo traps) and two microhabitats (leaf axils of cocoyams/pineapples and leaf axils of plantain/banana) were sampled for various mosquito species. Mosquitoes were recovered from all the various biotypes sampled. Types of mosquitoes species encountered, their relative abundance, as well as genera varied significantly during the study (p<0.05). Four genera of mosquitoes: Aedes, Culex, Anopheles and Toxorhynchites were recovered while 16 species of mosquitoes encountered include: Aedes aegypti, Ae. africanus, Ae. simpsoni, Ae. albopictus, Ae. stokesi, Ae. taylori, Ae. apicoargenteus, Culex quinquefasciatus, Cx. nebulosus, Cx. trigripes, Cx. decens, Anopheles gambiae, An. funiestus, An. coustani and Toxorhynchites viridibasis. Most of the mosquitoes showed oviposition preferences for one or more habitats. The presence of Ae. africanus, Ae. simpsoni and Ae. aegypti indicate that the study areas were at risk of yellow fever epidemic. The presence of Anopheles and Culex species ensured endemicity of malaria and filariasis, while the recovery of Ae. albopictus in this region suggests a possible outbreak of dengue fever in future if not properly controlled.

Structural insights into the metabolism of 2-chlorodibenzofuran by an evolved biphenyl dioxygenase

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

Kumar, Pravindra; Mohammadi, Mahmood; Dhindwal, Sonali

2012-06-28

The biphenyl dioxygenase of Burkholderia xenovorans LB400 (BphAE{sub LB400}) is a Rieske-type oxygenase that catalyzes the stereospecific oxygenation of many heterocyclic aromatics including dibenzofuran. In a previous work, we evolved BphAE{sub LB400} and obtained BphAE{sub RR41}. This variant metabolizes dibenzofuran and 2-chlorodibenzofuran more efficiently than BphAE{sub LB400}. However, the regiospecificity of BphAE{sub RR41} toward these substrates differs. Dibenzofuran is metabolized principally through a lateral dioxygenation whereas 2-chlorodibenzofuran is metabolized principally through an angular dioxygenation. In order to explain this difference, we examined the crystal structures of both substrate-bound forms of BphAE{sub RR41} obtained under anaerobic conditions. This structure analysis, inmore » combination with biochemical data for a Ser283Gly mutant provided evidences that the substrate is compelled to move after oxygen-binding in BphAE{sub RR41}:dibenzofuran. In BphAE{sub RR41}:2-chlorodibenzofuran, the chlorine atom is close to the side chain of Ser283. This contact is missing in the BphAE{sub RR41}:dibenzofuran, and strong enough in the BphAE{sub RR41}:2-chlorodibenzofuran to help prevent substrate movement during the catalytic reaction.« less

The effector gene xopAE of Xanthomonas euvesicatoria 85-10 is part of an operon and encodes an E3 ubiquitin ligase.

PubMed

Popov, Georgy; Majhi, Bharat Bhusan; Sessa, Guido

2018-05-21

The type III effector XopAE from the Xanthomonas euvesicatoria strain 85-10 ( Xe 85-10) was previously shown to inhibit plant immunity and enhance pathogen-induced disease symptoms. Evolutionary analysis of 60 xopAE alleles ( AEal ) revealed that the xopAE locus is conserved in multiple Xanthomonas species. The majority of xopAE alleles (55 out of 60) encodes a single ORF ( xopAE ), while in 5 alleles, including AEal 37 of the Xe 85-10 strain, a frame-shift splits the locus into two ORFs ( hpaF and a truncated xopAE ). To test whether the second ORF of AEal 37 ( xopAE 85-10 ) is translated, we examined expression of YFP fused downstream to truncated or mutant forms of the locus in Xanthomonas bacteria. YFP fluorescence was detected at maximal levels when the reporter was in proximity of an internal ribosome-binding site upstream to a rare ATT start codon in the xopAE 85-10 ORF, but severely reduced when these elements were abolished. In agreement with the notion that xopAE 85- 10 is a functional gene, its protein product was translocated into plant cells by the type III secretion system and translocation was dependent on its upstream ORF hpaF. Homology modeling predicted that XopAE 85-10 contains an E3 ligase XL-box domain at the C-terminus, and in vitro assays demonstrated that this domain displays mono-ubiquitination activity. Remarkably, the XL-box was essential for XopAE 85-10 to inhibit PAMP-induced gene expression in Arabidopsis protoplasts. Together, these results indicate that the xopAE 85-10 gene resides in a functional operon, which utilizes the alternative start codon ATT, and encodes a novel XL-box E3 ligase. Importance Xanthomonas bacteria utilize a type III secretion system to cause disease in many crops. This study provides insights into evolution, translocation and biochemical function of the XopAE type III secreted effector contributing to the understanding of Xanthomonas-host interactions. We establish XopAE as core effector of seven Xanthomonas species and elucidate evolution of the Xanthomonas euvesicatoria xopAE locus, which contains an operon encoding a truncated effector. Our findings indicate that this operon evolved from the split of a multi-domains gene into two ORFs that conserved the original domain function. Analysis of xopAE 85-10 translation provides the first evidence for translation initiation from an ATT codon in Xanthomonas Our data demonstrate that XopAE 85-10 is an XL-box E3 ubiquitin ligase and provide insights into structure and function of this effector family. Copyright © 2018 American Society for Microbiology.

Essentials for starting a pediatric clinical study (4): Clinical pediatric safety planning based on preclinical toxicity studies and pediatric pharmacovigilance guidance.

PubMed

Sheth, Neha

2009-01-01

Juvenile toxicology studies in animals provide useful information to guide monitoring of potential adverse effects in children especially on growth and development. In order to continue to gain knowledge and build upon these preclinical studies, recent experience has suggested that additional approaches for monitoring of safety concerns in the pediatric population may be required. Recently, pediatric guidance has become available from the health authorities which provide pharmacovigilance concepts as they specifically relate to drugs being developed for pediatric indications. Clinical trials are typically not robust enough to detect rare or delayed safety effects as the pediatric trials are relatively short-term. Furthermore, such long term or rare effects may not be detected via standard voluntary postmarketing surveillance. Safety monitoring of children with Juvenile Inflammatory Arthritis (JIA) taking nonsteroid anti-inflammatory drug (NSAID)s will be used as an example to describe a post-marketing risk management and pharmacovigilance program that serves to better evaluate safety data from various sources. The intent of this program is to identify adverse events (AE), including events with longer latency, which may be associated with NSAID use in a pediatric population. In this presentation, the 4 major components of the program are to be addressed. Such a program may serve as a model to proactively generate and monitor safety data in order to identify AEs that may be associated with new therapeutics for a pediatric population.

An audit of sports injuries in children attending an Accident & Emergency department.

PubMed

Boyce, S H; Quigley, M A

2003-08-01

To assess the incidence of attendance, type of injury, sport involved and management of sports injuries in children attending an Accident & Emergency (A&E) department. Children, aged between 5-16 years, presenting with an injury related to sport, were studied over a period of three months. 1858 children attended the A&E department during the three month period. 238 (12.8%) were classified as sports injuries. Boys (71%) were injured more frequently than girls (29%). Injury rates in boys peaked at 14 years whereas in girls a peak occurred earlier at 12 years. Football was the most common sport implicated in injuries (39%). Rollerblading (14%), Rugby (8%), Basketball (7%) and Physical Education at school (7%) were the next most frequently involved sports. Soft tissue injuries dominated (61%). The upper limb was the most common anatomical area injured (46%). Other injuries involved the lower limb (36%), head and neck (15%) and the trunk (3%). Injuries to the wrist were the most frequent presentation accounting for 30 fractures and 30 soft tissue injuries (25%). The majority of children were discharged from the A&E department after treatment (71%). 26% were reviewed at out-patient clinics and 3% required hospital admission. No children were referred for physiotherapy. Children participate in sport and can be injured. The majority of sports injuries presenting to an A&E department appear to be of a minor nature and could be managed with simple first aid techniques by parents, teachers and coaches at the scene or by attending primary care in the first instance. Supervision of children, participation in organised sport and the use of protection devices may help to prevent serious injury.

Challenges in demonstrating the effectiveness of multidisciplinary treatment on quality of life, participation and health care utilisation in patients with fibromyalgia: a randomised controlled trial.

PubMed

van Eijk-Hustings, Yvonne; Kroese, Mariëlle; Tan, Frans; Boonen, Annelies; Bessems-Beks, Monique; Landewé, Robert

2013-02-01

This study aimed to examine the effectiveness of a multidisciplinary intervention with aftercare (MD) compared to aerobic exercise (AE) and usual care (UC) in recently diagnosed patients with fibromyalgia (FM). In a Zelen-like design, eligible patients from the outpatient rheumatology clinics of three medical centres in the South of the Netherlands were consecutively recruited and pre-randomised to MD (n = 108), AE (n = 47) or UC (n = 48). MD consisted of a 12-week course of sociotherapy, physiotherapy, psychotherapy and creative arts therapy (three half days per week), followed by five aftercare meetings in 9 months. AE was given twice a week in a 12-week course. UC varied but incorporated at least education and lifestyle advice. Primary outcomes were health-related quality of life (HR-Qol), participation and health care utilisation. Secondary outcome was the Fibromyalgia Impact Questionnaire (FIQ). Total follow-up duration of the study was 21-24 months. As willingness to participate in AE was limited, this group has been analysed but interpretation of the data is considered arguable. Within the MD group, a statistically significantly improved HR-Qol and a statistically significant reduction in number of hours sick leave, number of contacts with general practitioners and number of contacts with medical specialists was found. Moreover, statistically significant improvements were found on the FIQ, which increased after the intervention. However, no statistically significant between-group differences were found at the endpoint of the study. MD seemed to yield positive effects, but firm conclusions with regard to effectiveness cannot be formulated due to small between-group differences and limitations of the study.

Reliability and validity of the self-report version of the apathy evaluation scale in first-episode Psychosis: Concordance with the clinical version at baseline and 12 months follow-up.

PubMed

Faerden, Ann; Lyngstad, Siv Hege; Simonsen, Carmen; Ringen, Petter Andreas; Papsuev, Oleg; Dieset, Ingrid; Andreassen, Ole A; Agartz, Ingrid; Marder, Stephen R; Melle, Ingrid

2018-05-31

Negative symptoms have traditionally been assessed based on clinicians' observations. The subjective experience of negative symptoms in people with psychosis may bring new insight. The Apathy Evaluation Scale (AES) is commonly used to study apathy in psychosis and has corresponding self-rated (AES-S) and clinician-rated (AES-C) versions. The aim of the present study was to determine the validity and reliability of the AES-S by investigating its concordance with the AES-C. Eighty-four first-episode (FEP) patients completed the shortened 12-item AES-S and AES-C at baseline (T1) and 12 months (T2). Concordance was studied by degree of correlation, comparison of mean scores, and change and difference between diagnostic groups. The Positive and Negative Symptom Scale (PANSS) was used to study convergent and discriminative properties. High concordance was found between AES-S and AES-C at both T1 and T2 regarding mean values, change from T1 to T2, and the proportion with high levels of apathy. Both versions indicated high levels of apathy in FEP, while associations with PANSS negative symptoms were weaker for AES-S than AES-C. Controlling for depression did not significantly alter results. We concluded that self-rated apathy in FEP patients is in concordance with clinician ratings, but in need of further study. Copyright © 2018. Published by Elsevier B.V.

Aloe-emodin (AE) nanoparticles suppresses proliferation and induces apoptosis in human lung squamous carcinoma via ROS generation in vitro and in vivo.

PubMed

Wu, Yuan-Yuan; Zhang, Jing-Hua; Gao, Jing-Hua; Li, Yong-Sheng

2017-08-26

Human lung squamous cell carcinoma is a deadly cancer for which present therapeutic strategies are inadequate. And traditional chemotherapy results in severe systemic toxicity. Compounds from living organisms often exert a biological activity, triggering several targets, which may be useful for the improvement of novel pharmaceuticals. Aloe-emodin (AE), a well-known natural compound, is a primary component of anthraquinones in Aloe vera and exhibits anti-proliferative and apoptotic effects on various tumor cells. However, the translational and clinical use of AE has been limited owing to its rapid degradation and poor bioavailability. To improve its efficacy, a poly (lactic-co-glycolic acid) based AE nanoparticle formulation (NanoAE) was prepared. Our study indicated that compared to the free AE, nanoAE significantly suppressed cancer cell proliferation, induced cell cycle arrest and apoptosis, evidenced by high cleavage of Caspase-3, poly (ADP-ribose) polymerase (PARP), Caspase-8 and Caspase-9. NanoAE enhanced reactive oxygen species (ROS) production, along with Mitogen-activated protein kinases (MAPKs) activation and PI3K/AKT inactivation. Cell proliferation, apoptosis and MAPKs and PI3K/AKT were dependent on ROS production in nanoAE-treated groups. In vivo, nanoAE exhibited inhibitory effects on the tumor growth with little toxicity. Together, our results indicated that nanoAE might be an effective treatment for human lung squamous cell carcinoma. Copyright © 2017. Published by Elsevier Inc.

Potential for dengue in South Africa: mosquito ecology with particular reference to Aedes aegypti.

PubMed

Kemp, A; Jupp, P G

1991-12-01

Observations on prevalence, geographical distribution, utilization of artificial larval habitats and anthropophilism were made on diurnal mosquitoes at selected localities along the coast of Natal and inland in the Transvaal to identify potential vectors of dengue in South Africa. Larval collections made in artificial containers on the ground, the exposure of bamboo pots as ovitraps in trees and collection of mosquitoes biting man showed the following species as the most likely candidates for vectors: Aedes aegypti, Ae. demeilloni, Ae. simpsoni, Ae. strelitziae, Ae. furcifer, Ae. cordellieri and Eretmapodites quinquevittatus. The bamboo pots showed that Ae. aegypti and Ae. simpsoni were the most widespread species, occurring at 11 of 12 localities. Aedes aegypti was the most prevalent species with mean pot index of 60.3 +/- 9.8% (SE) and abundance index of 0.43 +/- 0.15 (SE). Aedes aegypti was frequently present as larvae in artificial containers at indices of 11-83% (mean 56.8 +/- 5.6%, SE) and was the most anthropophilic species with average biting rates of 10-29 per man-hour at 7 localities. Although Ae. aegypti was abundant in the pots at Ndumu (northern Natal) and at Skukuza (eastern Transvaal), the local populations were poorly anthropophilic at these localities. At some localities, populations of Ae. demeilloni, Ae. simpsoni and Ae. strelitziae had average biting rates of 5.4-9.6 per man-hour. Aedes furcifer was collected for the first time at Durban, extending its distribution southward to latitude 29 degrees 53' S.

Alcohol expectancies and alcohol outcomes: effects of the use of protective behavioral strategies.

PubMed

Grazioli, Véronique S; Lewis, Melissa A; Garberson, Lisa A; Fossos-Wong, Nicole; Lee, Christine M; Larimer, Mary E

2015-05-01

Alcohol expectancies (AEs) are positively associated with drinking behaviors, whereas the use of protective behavioural strategies (PBS) is negatively related to alcohol outcomes among young adults. PBS have been shown to weaken relationships between some alcohol risk factors and alcohol outcomes. This study aimed to examine longitudinally the moderating effect of PBS on the relationships between AEs and alcohol outcomes among young adults. Participants (N = 188; 61.7% female) were U.S. young adults participating in a larger longitudinal study. Measures of PBS, AEs, alcohol use, and related consequences were used from the baseline and 12-month follow-up assessments. Negative binomial hurdle models found that PBS (total score) significantly moderated the relationship between positive AEs and consequences, such that among high school seniors endorsing higher positive AEs, those using more PBS in high school reported fewer negative consequences 1 year later. PBS (Manner of Drinking) also moderated the relationship between negative AEs and alcohol use, revealing the use of PBS in high school as having a protective function against later drinking among participants with high positive AEs. Last, PBS (Serious Harm Reduction) significantly moderated the associations between positive AEs and alcohol use and between negative AEs and consequences, such that participants with higher AEs and higher PBS use in high school were at greatest risk for drinking and experiencing negative consequences later. Overall, these findings suggest that PBS use may be protective by weakening relationships between positive AEs and alcohol outcomes. Limitations and future directions are discussed.

Increasing Lower Extremity Injury Rates Across the 2009-2010 to 2014-2015 Seasons of National Collegiate Athletic Association Football: An Unintended Consequence of the "Targeting" Rule Used to Prevent Concussions?

PubMed

Westermann, Robert W; Kerr, Zachary Y; Wehr, Peter; Amendola, Annuziato

2016-12-01

Sports-related concussions (SRCs) have gained increased societal interest in the past decade. The National Collegiate Athletic Association (NCAA) has implemented legislation and rule changes to decrease the incidence and risk of head injury impacts. The "targeting" rule forbids initiating contact with the crown of a helmet and targeting defenseless players in the head and neck area; however, there are concerns that this rule change has unintentionally led to an increased incidence of lower extremity injuries. The purpose of this study was to evaluate the change in lower extremity injury rates in NCAA football during the 2009-2010 to 2014-2015 seasons. We hypothesized that the lower extremity injury rate has increased across the time period. Descriptive epidemiology study. Sixty-eight NCAA football programs provided 153 team-seasons of data to the NCAA Injury Surveillance Program. Lower extremity injuries (ie, hip/groin, upper leg/thigh, knee, lower leg/Achilles, foot/toes) and SRCs sustained during NCAA football games were examined. We calculated injury rates per 1000 athlete-exposures (AEs) for lower extremity injuries and SRCs. Rate ratios (RRs) compared injury rates between the 2009-2010 to 2011-2012 and 2012-2013 to 2014-2015 seasons. Overall, 2400 lower extremity injuries were reported during the 2009-2010 to 2014-2015 seasons; most were to the knee (33.6%) and ankle (28.5%) and caused by player contact (59.2%). The lower extremity injury rate increased in 2012-2013 to 2014-2015 compared with 2009-2010 to 2011-2012 (23.55 vs 20.45/1000 AEs, respectively; RR, 1.15; 95% CI, 1.06-1.25). This finding was retained when restricted to injuries due to player contact (RR, 1.19; 95% CI, 1.07-1.32) but not for injuries due to noncontact/overuse (RR, 0.96; 95% CI, 0.80-1.14). When examining player contact injury rates by anatomic site, only ankle injuries had an increase (RR, 1.36; 95% CI, 1.13-1.64). The SRC rate also increased in 2012-2013 to 2014-2015 compared with 2009-2010 to 2011-2012 (3.52 vs 2.63/1000 AEs, respectively; RR, 1.34; 95% CI, 1.08-1.66). The lower extremity injury rate has increased in NCAA football athletes. Similarly, SRC rates have increased, although this may be caused by concurrent policies related to better education, identification, and management. Targeting rule changes may be contributing to increased rates of player contact-related ankle injuries. Alongside continued surveillance research to examine longitudinal time trends, more in-depth individual-level examinations of how targeting rule changes influence coaching and player behaviors are warranted. © 2016 The Author(s).

District-Wide PBIS Team Questions Related to Using the PBIS Framework to Transition Students with Challenging Behaviors from an Alternative School to a Neighborhood School

ERIC Educational Resources Information Center

Jolivette, Kristine; Swoszowski, Nicole C.; Josephs, Nikki L.; McDaniel, Sara C.; Ennis, Robin Parks

2012-01-01

Students with emotional and behavioral disorders (E/BD) and those with challenging behaviors are often served in alternative education (AE) settings due to behavior that interferes with their learning and the learning of others to a degree that warrants placement outside of the traditional, neighborhood school environment. Placement in AE…

Association appoints new RCN A&E Chair.

PubMed

1999-09-01

Lynda Holt, A&E Clinical Manager at Warwick Hospital has become Chair of the RCN A&E Nursing Association following the resignation of Karen Castille who has been seconded to the Department of Health (England) to work on the A&E modernisation programme.

Competence of Aedes aegypti, Ae. albopictus, and Culex quinquefasciatus Mosquitoes as Zika Virus Vectors, China.

PubMed

Liu, Zhuanzhuan; Zhou, Tengfei; Lai, Zetian; Zhang, Zhenhong; Jia, Zhirong; Zhou, Guofa; Williams, Tricia; Xu, Jiabao; Gu, Jinbao; Zhou, Xiaohong; Lin, Lifeng; Yan, Guiyun; Chen, Xiao-Guang

2017-07-01

In China, the prevention and control of Zika virus disease has been a public health threat since the first imported case was reported in February 2016. To determine the vector competence of potential vector mosquito species, we experimentally infected Aedes aegypti, Ae. albopictus, and Culex quinquefasciatus mosquitoes and determined infection rates, dissemination rates, and transmission rates. We found the highest vector competence for the imported Zika virus in Ae. aegypti mosquitoes, some susceptibility of Ae. albopictus mosquitoes, but no transmission ability for Cx. quinquefasciatus mosquitoes. Considering that, in China, Ae. albopictus mosquitoes are widely distributed but Ae. aegypti mosquito distribution is limited, Ae. albopictus mosquitoes are a potential primary vector for Zika virus and should be targeted in vector control strategies.

Acoustic emission characteristics of copper alloys under low-cycle fatigue conditions

NASA Technical Reports Server (NTRS)

Krampfner, Y.; Kawamoto, A.; Ono, K.; Green, A.

1975-01-01

The acoustic emission (AE) characteristics of pure copper, zirconium-copper, and several copper alloys were determined to develop nondestructive evaluation schemes of thrust chambers through AE techniques. The AE counts rms voltages, frequency spectrum, and amplitude distribution analysis evaluated AE behavior under fatigue loading conditions. The results were interpreted with the evaluation of wave forms, crack propagation characteristics, as well as scanning electron fractographs of fatigue-tested samples. AE signals at the beginning of a fatigue test were produced by a sample of annealed alloys. A sample of zirconium-containing alloys annealed repeatedly after each fatigue loading cycle showed numerous surface cracks during the subsequent fatigue cycle, emitting strong-burst AE signals. Amplitude distribution analysis exhibits responses that are characteristic of certain types of AE signals.

Competence of Aedes aegypti, Ae. albopictus, and Culex quinquefasciatus Mosquitoes as Zika Virus Vectors, China

PubMed Central

Liu, Zhuanzhuan; Zhou, Tengfei; Lai, Zetian; Zhang, Zhenhong; Jia, Zhirong; Zhou, Guofa; Williams, Tricia; Xu, Jiabao; Gu, Jinbao; Zhou, Xiaohong; Lin, Lifeng; Yan, Guiyun

2017-01-01

In China, the prevention and control of Zika virus disease has been a public health threat since the first imported case was reported in February 2016. To determine the vector competence of potential vector mosquito species, we experimentally infected Aedes aegypti, Ae. albopictus, and Culex quinquefasciatus mosquitoes and determined infection rates, dissemination rates, and transmission rates. We found the highest vector competence for the imported Zika virus in Ae. aegypti mosquitoes, some susceptibility of Ae. albopictus mosquitoes, but no transmission ability for Cx. quinquefasciatus mosquitoes. Considering that, in China, Ae. albopictus mosquitoes are widely distributed but Ae. aegypti mosquito distribution is limited, Ae. albopictus mosquitoes are a potential primary vector for Zika virus and should be targeted in vector control strategies. PMID:28430562

Acoustic emission during fatigue of porous-coated Ti-6Al-4V implant alloy.

PubMed

Kohn, D H; Ducheyne, P; Awerbuch, J

1992-01-01

Acoustic emission (AE) events and event intensities (e.g., event amplitude, counts, duration, and energy counts) were recorded and analyzed during fatigue loading of uncoated and porous-coated Ti-6Al-4V. AE source location, spatial filtering, event, and event intensity distributions were used to detect, monitor, analyze, and predict failures. AE provides the ability to spatially and temporally locate multiple fatigue cracks, in real time. Fatigue of porous-coated Ti-6Al-4V is governed by a sequential, multimode fracture process of: transverse fracture in the porous coating; sphere/sphere and sphere/substrate debonding; substrate fatigue crack initiation; slow and rapid substrate fatigue crack propagation. Because of the porosity of the coating, the different stages of fracture within the coating occur in a discontinuous fashion. Therefore, the AE events generated are intermittent and the onset of each mode of fracture in the porous coating can be detected by increases in AE event rate. Changes in AE event rate also correspond to changes in crack extension rate, and may therefore be used to predict failure. AE offers two distinct advantages over conventional optical and microscopic methods of analyzing fatigue cracks--it is more sensitive and it can determine the time history of damage progression. The magnitude of the AE event intensities increased with increasing stress. Failure mechanisms are best differentiated by analyzing AE event amplitudes. Intergranular fracture and microvoid coalescence generated the highest AE event amplitudes (100 dB), whereas, plastic flow and friction generated the lowest AE event amplitudes (55-65 dB). Fractures in the porous coating were characterized by AE event amplitudes of less than 80 dB.

The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada.

PubMed

Baker, G Ross; Norton, Peter G; Flintoft, Virginia; Blais, Régis; Brown, Adalsteinn; Cox, Jafna; Etchells, Ed; Ghali, William A; Hébert, Philip; Majumdar, Sumit R; O'Beirne, Maeve; Palacios-Derflingher, Luz; Reid, Robert J; Sheps, Sam; Tamblyn, Robyn

2004-05-25

Research into adverse events (AEs) has highlighted the need to improve patient safety. AEs are unintended injuries or complications resulting in death, disability or prolonged hospital stay that arise from health care management. We estimated the incidence of AEs among patients in Canadian acute care hospitals. We randomly selected 1 teaching, 1 large community and 2 small community hospitals in each of 5 provinces (British Columbia, Alberta, Ontario, Quebec and Nova Scotia) and reviewed a random sample of charts for nonpsychiatric, nonobstetric adult patients in each hospital for the fiscal year 2000. Trained reviewers screened all eligible charts, and physicians reviewed the positively screened charts to identify AEs and determine their preventability. At least 1 screening criterion was identified in 1527 (40.8%) of 3745 charts. The physician reviewers identified AEs in 255 of the charts. After adjustment for the sampling strategy, the AE rate was 7.5 per 100 hospital admissions (95% confidence interval [CI] 5.7- 9.3). Among the patients with AEs, events judged to be preventable occurred in 36.9% (95% CI 32.0%-41.8%) and death in 20.8% (95% CI 7.8%-33.8%). Physician reviewers estimated that 1521 additional hospital days were associated with AEs. Although men and women experienced equal rates of AEs, patients who had AEs were significantly older than those who did not (mean age [and standard deviation] 64.9 [16.7] v. 62.0 [18.4] years; p = 0.016). The overall incidence rate of AEs of 7.5% in our study suggests that, of the almost 2.5 million annual hospital admissions in Canada similar to the type studied, about 185 000 are associated with an AE and close to 70 000 of these are potentially preventable.

Expression of metastasis suppressor gene AES driven by a Yin Yang (YY) element in a CpG island promoter and transcription factor YY2.

PubMed

Kakizaki, Fumihiko; Sonoshita, Masahiro; Miyoshi, Hiroyuki; Itatani, Yoshiro; Ito, Shinji; Kawada, Kenji; Sakai, Yoshiharu; Taketo, M Mark

2016-11-01

We recently found that the product of the AES gene functions as a metastasis suppressor of colorectal cancer (CRC) in both humans and mice. Expression of amino-terminal enhancer of split (AES) protein is significantly decreased in liver metastatic lesions compared with primary colon tumors. To investigate its downregulation mechanism in metastases, we searched for transcriptional regulators of AES in human CRC and found that its expression is reduced mainly by transcriptional dysregulation and, in some cases, by additional haploidization of its coding gene. The AES promoter-enhancer is in a typical CpG island, and contains a Yin-Yang transcription factor recognition sequence (YY element). In human epithelial cells of normal colon and primary tumors, transcription factor YY2, a member of the YY family, binds directly to the YY element, and stimulates expression of AES. In a transplantation mouse model of liver metastases, however, expression of Yy2 (and therefore of Aes) is downregulated. In human CRC metastases to the liver, the levels of AES protein are correlated with those of YY2. In addition, we noticed copy-number reduction for the AES coding gene in chromosome 19p13.3 in 12% (5/42) of human CRC cell lines. We excluded other mechanisms such as point or indel mutations in the coding or regulatory regions of the AES gene, CpG methylation in the AES promoter enhancer, expression of microRNAs, and chromatin histone modifications. These results indicate that Aes may belong to a novel family of metastasis suppressors with a CpG-island promoter enhancer, and it is regulated transcriptionally. © 2016 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

Nomenclature and traceability debate for biosimilars: small-molecule surrogates lend support for distinguishable nonproprietary names.

PubMed

Chao, Jingdong; Skup, Martha; Alexander, Emily; Tundia, Namita; Macaulay, Dendy; Wu, Eric; Mulani, Parvez

2015-03-01

The purpose of the present study was to investigate the traceability of adverse events (AEs) for branded and generic drugs with identical nonproprietary names and to consider potential implications for the traceability of AEs for branded and biosimilar biologics. Adverse event reports in the Food and Drug Administration AE Reporting System (FAERS) were compared with those in a commercial insurance claims database (Truven Health MarketScan(®)) for 2 drugs (levetiracetam and enoxaparin sodium) with manufacturing or prescribing considerations potentially analogous to those of some biosimilars. Monthly rates of branded- and generic-attributed AEs were estimated pre- and post-generic entry. Post-entry branded-to-generic AE relative rate ratios were calculated. In FAERS, monthly AE rate ratios during the post-generic period showed a pattern in which AE rates for the branded products were greater than for the generic products. Differences in rates of brand- and generic-attributed AEs were statistically significant for both study drugs; the AE rate for the branded products peaked at approximately 10 times that of the generic levetiracetam products and approximately 4 times that of the generic enoxaparin sodium products. In contrast, monthly ratios for the MarketScan data were relatively constant over time. Use of the same nonproprietary name for generic and branded products may contribute to poor traceability of AEs reported in the FAERS database due to the significant misattribution of AEs to branded products (when those AEs were in fact associated with patient use of generic products). To ensure accurate and robust safety surveillance and traceability for biosimilar products in the United States, improved product identification mechanisms, such as related but distinguishable nonproprietary names for biosimilars and reference biologics, should be considered.

Worldwide, 3-Year, Post-Marketing Surveillance Experience with Tofacitinib in Rheumatoid Arthritis.

PubMed

Cohen, Stanley; Curtis, Jeffrey R; DeMasi, Ryan; Chen, Yan; Fan, Haiyun; Soonasra, Arif; Fleischmann, Roy

2018-06-01

Post-marketing surveillance (PMS) is an integral part of monitoring adverse events (AEs) following approval of new drugs. Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). An analysis of PMS reports was conducted to evaluate the safety of tofacitinib in a post-marketing setting. Worldwide tofacitinib PMS data received in the Pfizer safety database from November 6, 2012 (first marketing authorization of tofacitinib) to November 5, 2015 were analyzed. Serious AEs (SAEs) of interest were reviewed and reporting rates (RRs) were calculated by dividing the number of SAEs by the estimated 100 patient-years of exposure. Patient exposure was calculated based on estimated worldwide sales and an estimated daily regimen of tofacitinib 5 mg twice daily. During the 3-year reporting period, worldwide post-marketing exposure to tofacitinib since approval was estimated to be 34,223 patient-years. In total, 9291 case reports (82.9% non-serious) were received and 25,417 AEs, 102 fatal cases, and 4352 SAEs were reported. The RRs (per 100 patient-years) for SAEs of interest by Medical Dictionary for Regulatory Activities System Organ Class were 2.57 for infections, 0.91 for gastrointestinal disorders, 0.60 for respiratory disorders, 0.45 for neoplasms, 0.43 for cardiac disorders, and 0.12 for hepatobiliary disorders. Although there are limitations to these data, no new safety risks were revealed in this real-world setting compared with the safety profile identified in the tofacitinib RA clinical development program. Any risks identified through the tofacitinib development program and PMS will continue to be monitored through pharmacovigilance surveillance. Pfizer Inc.

Asking the right questions to get the right answers: using cognitive interviews to review the acceptability, comprehension and clinical meaningfulness of patient self-report adverse event items in oncology patients.

PubMed

Holch, Patricia; Warrington, Lorraine; Potrata, Barbara; Ziegler, Lucy; Hector, Ceri; Keding, Ada; Harley, Clare; Absolom, Kate; Morris, Carolyn; Bamforth, Leon; Velikova, Galina

Standardized reporting of treatment-related adverse events (AE) is essential in clinical trials, usually achieved by using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) reported by clinicians. Patient-reported adverse events (PRAE) may add value to clinician assessments, providing patient perspective on subjective toxicity. We developed an online patient symptom report and self-management system for real-time reporting and managing AE during cancer treatment integrated with electronic patient records (eRAPID). As part of this program we developed a patient version of the CTCAE (version 4.0), rephrasing terminology into a self-report format. We explored patient understanding of these items via cognitive interviews. Sixty patients (33 female, 27 male) undergoing treatment were purposively sampled by age, gender and tumor group (median age 61.5, range 35-84, 12 breast, 12 gynecological, 13 colorectal, 12 lung and 11 renal). Twenty-one PRAE items were completed on a touch-screen computer. Subsequent audio-recorded cognitive interviews and thematic analysis explored patients' comprehension of items via verbal probing techniques during three interview rounds (n = 20 patients/round). In total 33 item amendments were made; 29% related to question comprehension, 68% response option and 3% order effects. These amendments to phrasing and language improved patient understanding but maintained CTCAE grading and key medical information. Changes were endorsed by members of a patient advisory group (N = 11). Item adaptations resulted in a bank of consistently interpreted self-report AE items for use in future research program. In-depth analysis of items through cognitive interviews is an important step towards developing an internationally valid system for PRAE, thus improving patient safety and experiences during cancer treatment.

Delayed Ileal Pouch Anal Anastomosis Has a Lower 30-Day Adverse Event Rate: Analysis From the National Surgical Quality Improvement Program.

PubMed

Kochar, Bharati; Barnes, Edward L; Peery, Anne F; Cools, Katherine S; Galanko, Joseph; Koruda, Mark; Herfarth, Hans H

2018-04-25

Ulcerative colitis (UC) patients requiring colectomy often have a staged ileal pouch anal anastomosis (IPAA). There are no prospective data comparing timing of pouch creation. We aimed to compare 30-day adverse event rates for pouch creation at the time of colectomy (PTC) with delayed pouch creation (DPC). Using prospectively collected data from 2011-2015 through the National Surgical Quality Improvement Program, we conducted a cohort study including subjects aged ≥18 years with a postoperative diagnosis of UC. We assessed 30-day postoperative rates of unplanned readmissions, reoperations, and major and minor adverse events (AEs), comparing the stage of the surgery where the pouch creation took place. Using a modified Poisson regression model, we estimated risk ratios (RRs) with 95% confidence intervals (CIs) adjusting for age, sex, race, body mass index, smoking status, diabetes, albumin, and comorbidities. Of 2390 IPAA procedures, 1571 were PTC and 819 were DPC. In the PTC group, 51% were on chronic immunosuppression preoperatively, compared with 15% in the DPC group (P < 0.01). After controlling for confounders, patients who had DPC were significantly less likely to have unplanned reoperations (RR, 0.42; 95% CI, 0.24-0.75), major AEs (RR, 0.72; 95% CI, 0.52-0.99), and minor AEs (RR, 0.48; 95% CI, 0.32-0.73) than PTC. Patients undergoing delayed pouch creation were at lower risk for unplanned reoperations and major and minor adverse events compared with patients undergoing pouch creation at the time of colectomy. 10.1093/ibd/izy082_video1izy082.video15776112442001.

Do Parkinson's disease patients disclose their adverse events spontaneously?

PubMed

Perez-Lloret, Santiago; Rey, María Verónica; Fabre, Nelly; Ory, Fabienne; Spampinato, Umberto; Montastruc, Jean-Louis; Rascol, Olivier

2012-05-01

Underreporting of adverse drug reactions is common but has been rarely studied in Parkinson's disease (PD). To compare the prevalence of adverse events (AEs) in relation to antiparkinsonian drugs in PD patients using two different data collection methods: patient's spontaneous reporting versus a predefined investigator-driven structured interview. Secondary objectives were to assess factors related to spontaneous reporting and to compare the rate of AE reporting in PD patients with that of a group of non-parkinsonian post-stroke patients. Cross-sectional study. Ambulatory, cognitively intact PD or post-stroke outpatients. None. Patients were first asked by means of an an open question to disclose any unpleasant effects in connection with their current medications that had occurred during the previous week. Afterwards, a predefined questionnaire listing the most common AEs known to be related to antiparkinsonian drugs was used to question the same patients in a systematic manner about the presence of any AE during the same week. Chronological and semiological criteria were used to classify the reported AEs as "unrelated" or "possibly/plausibly related" to the antiparkinsonian treatment. A total of 203 PD and 52 post-stroke patients of comparable age and sex were recruited. Eighty-five PD and five post-stroke patients reported spontaneously at least one AE (42 vs. 10%, p < 0.01), while 203 PD and 47 post-stroke patients reported at least one AE following the structured questionnaire (100 vs. 90%, p < 0.001). In PD patients, there were a total of 112 spontaneously reported AEs as compared with 1,574 according to the structured questionnaire (7%). Spontaneous disclosure of AEs was associated with experiencing >2 AEs [OR = 1.2 (1.1-3.2)], logistic regression). Seventy-four percent of PD patients had ≥1 AE possibly/plausibly related to antiparkinsonian drugs. Results showed that only 7% of AEs were reported spontaneously by patients, thus underscoring the importance of systematically asking about AEs in PD patients.

The association of Aedes aegypti and Ae. albopictus in Allende, Nuevo León, Mexico.

PubMed

Mercado-Hernandez, Roberto; Aguilar-Gueta, Juan de Dios; Fernandez-Salas, Ildefoso; Earl, Paul R

2006-03-01

The recent appearance of Aedes Stegomyia albopictus (Skuse) in Nuevo León (NL) worries health officials. It is a vector of dengue fever in Asia and is more resistant to lower temperatures than Ae. aegypti. The objective of this study was to learn about some ecological parameters of Ae. albopictus and their association with Ae. aegypti, and other culicids in Allende, NL, Mexico, during 1999. Allende is a small town close to metropolitan Monterrey, which has 4 million inhabitants. The design was random with monthly sampling of 175 ovitraps. Chi-square analyses were performed with data of presence, absence, frequency, and relative abundances. During the study, the species Culex tarsalis (Coquillet), Cx. thriambus (Dyar), Cx. pipiens (Linnaeus), Cx. coronator (Dyar and Knab), Ae. albopictus, Ae. aegypti, Toxorhynchites rutilus (Coquillet), and Ae. triseriatus (Say) were found. April is the month for large numbers of mosquito species. September had the highest populations in positive ovitraps (66.67%), followed by July (63.27% of traps). Aedes aegypti was the most abundant (65.13%), followed by Ae. albopictus (19.71%). Both Ae. albopictus and Ae. aegypti were found from April until December. Aedes aegypti was more abundant than Ae. albopictus, except in August, when they were similar (chi2 = 0.197, P < 0.05). We found significant association between the presence of both species for every study month (chi2 = 9.837, P < 0.05), with a contingency coefficient of 0.247. September and November were the months having the most mosquitoes in this association. Only considering Ae. albopictus, more were found in ovitraps in July (34.6%), followed by September (33.3%). However, its presence was not significant throughout the year. Of 2 zones, in town and at the river, prevalence indicated that Ae. albopictus preferred the river. This mosquito is in its establishment phase in this area and requires further studies.

Human kidney anion exchanger 1 interacts with kinesin family member 3B (KIF3B)

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

Duangtum, Natapol; Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700; Junking, Mutita

Highlights: {yields} Impaired trafficking of kAE1 causes distal renal tubular acidosis (dRTA). {yields} The interaction between kAE1 and kinesin family member 3B (KIF3B) is reported. {yields} The co-localization between kAE and KIF3B was detected in human kidney tissues. {yields} A marked reduction of kAE1 on the cell membrane was observed when KIF3B was knockdown. {yields} KFI3B plays an important role in trafficking of kAE1 to the plasma membrane. -- Abstract: Impaired trafficking of human kidney anion exchanger 1 (kAE1) to the basolateral membrane of {alpha}-intercalated cells of the kidney collecting duct leads to the defect of the Cl{sup -}/HCO{sub 3}{supmore » -} exchange and the failure of proton (H{sup +}) secretion at the apical membrane of these cells, causing distal renal tubular acidosis (dRTA). In the sorting process, kAE1 interacts with AP-1 mu1A, a subunit of AP-1A adaptor complex. However, it is not known whether kAE1 interacts with motor proteins in its trafficking process to the plasma membrane or not. We report here that kAE1 interacts with kinesin family member 3B (KIF3B) in kidney cells and a dileucine motif at the carboxyl terminus of kAE1 contributes to this interaction. We have also demonstrated that kAE1 co-localizes with KIF3B in human kidney tissues and the suppression of endogenous KIF3B in HEK293T cells by small interfering RNA (siRNA) decreases membrane localization of kAE1 but increases its intracellular accumulation. All results suggest that KIF3B is involved in the trafficking of kAE1 to the plasma membrane of human kidney {alpha}-intercalated cells.« less

Energy efficiency analysis and implementation of AES on an FPGA

NASA Astrophysics Data System (ADS)

Kenney, David

The Advanced Encryption Standard (AES) was developed by Joan Daemen and Vincent Rjimen and endorsed by the National Institute of Standards and Technology in 2001. It was designed to replace the aging Data Encryption Standard (DES) and be useful for a wide range of applications with varying throughput, area, power dissipation and energy consumption requirements. Field Programmable Gate Arrays (FPGAs) are flexible and reconfigurable integrated circuits that are useful for many different applications including the implementation of AES. Though they are highly flexible, FPGAs are often less efficient than Application Specific Integrated Circuits (ASICs); they tend to operate slower, take up more space and dissipate more power. There have been many FPGA AES implementations that focus on obtaining high throughput or low area usage, but very little research done in the area of low power or energy efficient FPGA based AES; in fact, it is rare for estimates on power dissipation to be made at all. This thesis presents a methodology to evaluate the energy efficiency of FPGA based AES designs and proposes a novel FPGA AES implementation which is highly flexible and energy efficient. The proposed methodology is implemented as part of a novel scripting tool, the AES Energy Analyzer, which is able to fully characterize the power dissipation and energy efficiency of FPGA based AES designs. Additionally, this thesis introduces a new FPGA power reduction technique called Opportunistic Combinational Operand Gating (OCOG) which is used in the proposed energy efficient implementation. The AES Energy Analyzer was able to estimate the power dissipation and energy efficiency of the proposed AES design during its most commonly performed operations. It was found that the proposed implementation consumes less energy per operation than any previous FPGA based AES implementations that included power estimations. Finally, the use of Opportunistic Combinational Operand Gating on an AES cipher was found to reduce its dynamic power consumption by up to 17% when compared to an identical design that did not employ the technique.

Genetic structure of Aegilops cylindrica Host in its native range and in the United States of America.

PubMed

Gandhi, Harish T; Vales, M Isabel; Mallory-Smith, Carol; Riera-Lizarazu, Oscar

2009-10-01

Chloroplast and nuclear microsatellite markers were used to study genetic diversity and genetic structure of Aegilops cylindrica Host collected in its native range and in adventive sites in the USA. Our analysis suggests that Ae. cylindrica, an allotetraploid, arose from multiple hybridizations between Ae. markgrafii (Greuter) Hammer. and Ae. tauschii Coss. presumably along the Fertile Crescent, where the geographic distributions of its diploid progenitors overlap. However, the center of genetic diversity of this species now encompasses a larger area including northern Iraq, eastern Turkey, and Transcaucasia. Although the majority of accessions of Ae. cylindrica (87%) had D-type plastomes derived from Ae. tauschii, accessions with C-type plastomes (13%), derived from Ae. markgrafii, were also observed. This corroborates a previous study suggesting the dimaternal origin of Ae. cylindrica. Model-based and genetic distance-based clustering using both chloroplast and nuclear markers indicated that Ae. tauschii ssp. tauschii contributed one of its D-type plastomes and its D genome to Ae. cylindrica. Analysis of genetic structure using nuclear markers suggested that Ae. cylindrica accessions could be grouped into three subpopulations (arbitrarily named N-K1, N-K2, and N-K3). Members of the N-K1 subpopulation were the most numerous in its native range and members of the N-K2 subpopulation were the most common in the USA. Our analysis also indicated that Ae. cylindrica accessions in the USA were derived from a few founder genotypes. The frequency of Ae. cylindrica accessions with the C-type plastome in the USA (approximately 24%) was substantially higher than in its native range of distribution (approximately 3%) and all C-type Ae. cylindrica in the USA except one belonged to subpopulation N-K2. The high frequency of the C-type plastome in the USA may reflect a favorable nucleo-cytoplasmic combination.

A Pharmacovigilance Signaling System Based on FDA Regulatory Action and Post-Marketing Adverse Event Reports.

PubMed

Hoffman, Keith B; Dimbil, Mo; Tatonetti, Nicholas P; Kyle, Robert F

2016-06-01

Many serious drug adverse events (AEs) only manifest well after regulatory approval. Therefore, the development of signaling methods to use with post-approval AE databases appears vital to comprehensively assess real-world drug safety. However, with millions of potential drug-AE pairs to analyze, the issue of focus is daunting. Our objective was to develop a signaling platform that focuses on AEs with historically demonstrated regulatory interest and to analyze such AEs with a disproportional reporting method that offers broad signal detection and acceptable false-positive rates. We analyzed over 1500 US FDA regulatory actions (safety communications and drug label changes) from 2008 to 2015 to construct a list of eligible signal AEs. The FDA Adverse Event Reporting System (FAERS) was used to evaluate disproportional reporting rates, constrained by minimum case counts and confidence interval limits, of these selected AEs for 109 training drugs. This step led to 45 AEs that appeared to have a low likelihood of being added to a label by FDA, so they were removed from the signal eligible list. We measured disproportional reporting for the final group of eligible AEs on a test group of 29 drugs that were not used in either the eligible list construction or the training steps. In a group of 29 test drugs, our model reduced the number of potential drug-AE signals from 41,834 to 97 and predicted 73 % of individual drug label changes. The model also predicted at least one AE-drug pair label change in 66 % of all the label changes for the test drugs. By concentrating on AE types with already demonstrated interest to FDA, we constructed a signaling system that provided focus regarding drug-AE pairs and suitable accuracy with regard to the issuance of FDA labeling changes. We suggest that focus on historical regulatory actions may increase the utility of pharmacovigilance signaling systems.

Adverse events in vaccinations for travelers - a 1-year prospective survey in a travel clinic in Germany.

PubMed

Slesak, Günther; Fleck, Ralf; Scherbaum, Helmut; Blumenstock, Gunnar; Schäfer, Johannes

2018-01-01

The study goal was to assess and compare adverse events (AE) of current vaccinations for travelers under 'real-life conditions'. A prospective observational online questionnaire study was performed from May 2015 till April 2016 in a travel clinic in Germany. Online questionnaire links were sent 1 week after the first vaccination date. Severity was rated on a scale from 1 to 5 (minor to very severe AE). Of 1357 vaccinees 781 (57.6%) responded to the questionnaire, corresponding to 1415 vaccinations (1-7 simultaneous vaccinations). Responders were more often female (f:m = 1.29:1). Main age groups were 20-29 years old (36.1%). Most frequent vaccinations were against rabies (277; chick embryo cell vaccine (CEC): 97, human diploid cell vaccine (HDC): 180), yellow fever (250), typhoid fever (198), meningococcal meningitis (126) and Japanese encephalitis (104). A total of 217 vaccinees (27.8%) reported AE; 82 (10.5%) rated AE as more severe (grade 3: 61, grade 4: 18, grade 5: 3). No life-threatening AE was reported. Of 157 systemic AE the most frequent were: fatigue (75), headaches (46) and pyrexia (31). Of 94 local AE most frequently reported were pain (66), myalgia (25) and swelling (12). AE after single vaccinations were more often associated with rabies vaccine (OR 2.2; 1.2-4.2). AE increased with the number of simultaneous vaccinations (single vaccination: 24.1%, 88/365; 2 vaccinations: 26.6%, 73/274, ≥3 vaccinations: 39.4%, 56/142, χ2 = 12.24, P = 0.002, CCorr = 0.18), but more severe AE showed no association with the number of vaccinations (χ2 = 5.55, P = 0.06, CCorr = 0.12). Single and simultaneous vaccinations were overall well tolerated. AE were reported more frequently with rabies vaccinations in single vaccinations. Increased numbers of simultaneous vaccinations led to some incremental AE but not to more severe AE. Simultaneous vaccinations should be encouraged to reduce missed opportunities for immunizations.

Characterization of Aes nuclear foci in colorectal cancer cells

PubMed Central

Itatani, Yoshiro; Sonoshita, Masahiro; Kakizaki, Fumihiko; Okawa, Katsuya; Stifani, Stefano; Itoh, Hideaki; Sakai, Yoshiharu; Taketo, M. Mark

2016-01-01

Amino-terminal enhancer of split (Aes) is a member of Groucho/Transducin-like enhancer (TLE) family. Aes is a recently found metastasis suppressor of colorectal cancer (CRC) that inhibits Notch signalling, and forms nuclear foci together with TLE1. Although some Notch-associated proteins are known to form subnuclear bodies, little is known regarding the dynamics or functions of these structures. Here, we show that Aes nuclear foci in CRC observed under an electron microscope are in a rather amorphous structure, lacking surrounding membrane. Investigation of their behaviour during the cell cycle by time-lapse cinematography showed that Aes nuclear foci dissolve during mitosis and reassemble after completion of cytokinesis. We have also found that heat shock cognate 70 (HSC70) is an essential component of Aes foci. Pharmacological inhibition of the HSC70 ATPase activity with VER155008 reduces Aes focus formation. These results provide insight into the understanding of Aes-mediated inhibition of Notch signalling. PMID:26229111

Effects of Zika Virus Strain and Aedes Mosquito Species on Vector Competence.

PubMed

Ciota, Alexander T; Bialosuknia, Sean M; Zink, Steven D; Brecher, Matthew; Ehrbar, Dylan J; Morrissette, Madeline N; Kramer, Laura D

2017-07-01

In the Western Hemisphere, Zika virus is thought to be transmitted primarily by Aedes aegypti mosquitoes. To determine the extent to which Ae. albopictus mosquitoes from the United States are capable of transmitting Zika virus and the influence of virus dose, virus strain, and mosquito species on vector competence, we evaluated multiple doses of representative Zika virus strains in Ae. aegypti and Ae. albopictus mosquitoes. Virus preparation (fresh vs. frozen) significantly affected virus infectivity in mosquitoes. We calculated 50% infectious doses to be 6.1-7.5 log 10 PFU/mL; minimum infective dose was 4.2 log 10 PFU/mL. Ae. albopictus mosquitoes were more susceptible to infection than Ae. aegypti mosquitoes, but transmission efficiency was higher for Ae. aegypti mosquitoes, indicating a transmission barrier in Ae. albopictus mosquitoes. Results suggest that, although Zika virus transmission is relatively inefficient overall and dependent on virus strain and mosquito species, Ae. albopictus mosquitoes could become major vectors in the Americas.

Effects of Zika Virus Strain and Aedes Mosquito Species on Vector Competence

PubMed Central

Bialosuknia, Sean M.; Zink, Steven D.; Brecher, Matthew; Ehrbar, Dylan J.; Morrissette, Madeline N.; Kramer, Laura D.

2017-01-01

In the Western Hemisphere, Zika virus is thought to be transmitted primarily by Aedes aegypti mosquitoes. To determine the extent to which Ae. albopictus mosquitoes from the United States are capable of transmitting Zika virus and the influence of virus dose, virus strain, and mosquito species on vector competence, we evaluated multiple doses of representative Zika virus strains in Ae. aegypti and Ae. albopictus mosquitoes. Virus preparation (fresh vs. frozen) significantly affected virus infectivity in mosquitoes. We calculated 50% infectious doses to be 6.1–7.5 log10 PFU/mL; minimum infective dose was 4.2 log10 PFU/mL. Ae. albopictus mosquitoes were more susceptible to infection than Ae. aegypti mosquitoes, but transmission efficiency was higher for Ae. aegypti mosquitoes, indicating a transmission barrier in Ae. albopictus mosquitoes. Results suggest that, although Zika virus transmission is relatively inefficient overall and dependent on virus strain and mosquito species, Ae. albopictus mosquitoes could become major vectors in the Americas. PMID:28430564

General practitioners providing non-urgent care in emergency department: a natural experiment

PubMed Central

Uthman, Olalekan A; Walker, Clare; Lahiri, Sudakshina; Jenkinson, David; Adekanmbi, Victor; Robertson, Wendy; Clarke, Aileen

2018-01-01

Objective To examine whether care provided by general practitioners (GPs) to non-urgent patients in the emergency department differs significantly from care provided by usual accident and emergency (A&E) staff in terms of process outcomes and A&E clinical quality indicators. Design Propensity score matched cohort study. Setting GPs in A&E colocated within the University Hospitals Coventry and Warwickshire NHS Trust between May 2015 and March 2016. Participants Non-urgent attendances visits to the A&E department. Main outcomes Process outcomes (any investigation, any blood investigation, any radiological investigation, any intervention, admission and referrals) and A&E clinical indicators (spent 4 hours plus, left without being seen and 7-day reattendance). Results A total of 5426 patients seen by GPs in A&E were matched with 10 852 patients seen by emergency physicians (ratio 1:2). Compared with standard care in A&E, GPs in A&E significantly: admitted fewer patients (risk ratio (RR) 0.28, 95% CI 0.25 to 0.31), referred fewer patients to other specialists (RR 0.31, 95% CI 0.24 to 0.40), ordered fewer radiological investigations (RR 0.38, 95% CI 0.34 to 0.42), ordered fewer blood tests (0.57, 95% CI 0.52 to 0.61) and ordered fewer investigations (0.93, 95% CI 0.90 to 0.96). However, they intervened more, offered more primary care follow-up (RR 1.78, 95% CI 1.67 to 1.89) and referred more patients to outpatient and other A&E clinics (RR 2.29, 95% CI 2.10 to 2.49). Patients seen by GPs in A&E were on average less likely to spend 4 hours plus in A&E (RR 0.37, 95% CI 0.30 to 0.45) compared with standard care in A&E. There was no difference in reattendance after 7 days (RR 0.96, 95% CI 0.84 to 1.09). Conclusion GPs in A&E tended to manage self-reporting minor cases with fewer resources than standard care in A&E, without increasing reattendance rates. PMID:29748341

[Construction and pathogenic identification of aes-31 gene mutant of avian pathogenic Escherichia coli strain E058].

PubMed

Huan, Haixia; Zhang, Ke; Chen, Xiang; Gao, Song; Liu, Xiufan

2010-12-01

To find the primary function of aes-31 fragment through construction of defined mutation of Avian Pathogenic Escherichia coli strain E058 and animal experiments. The fragment of aes-31 was generated by PCR and cloned into pGEM-T-easy vector. A resultant suicide vector containing the aes-31 fragment named pMEG375-aes-31 was constructed and transformed to a receptor strain SM10. Then recombinant strain SM10 was hybridized with E058 strain in solid state. Mutant derivatives of strain E058 were generated by homologous recombination and were named E058 (delta aes-31). The 50% lethal dose (LD50) of E058 and E058 (delta aes-31) in commercial day-old chickens experimentally inoculated via intratrachea were 10(4.3) CFU and 10(3.5) CFU, respectively. The same way was used to inoculate with 10(8) CFU to obtain the pathogenic ability of E058 and E058 (delta aes-31) in 35-days-old SPF chickens. In the chicken challenge model,the mutant was tested to determine the individual function for virulence and persistence in 2-week-old SPF chicks. The pathogenicity test for E058 strain and E058 (delta aes-31) strain showed that the mutant had a higher mortality (75%) to 35-day-old specific pathogen-free (SPF) chicks than that of E058 (62.5%). In the chicken challenge model,there was no obviously CFUs difference in blood and lung in chicks of E058 group and E058 (delta aes-31) group 6 hours after inoculation. After 24 hours there was obvious CFUs difference in heart, liver, spleen, lung and blood in chicks of E058 group and E058 (delta aes-31) group. After 48 hours, there was also obvious CFUs difference in heart, liver and spleen in chicks of E058 group and E058 (delta aes-31) group E058 (delta aes-31) had a trend of increasing virulence in chicks. Aes-31 might be associated with negative regulatory gene for E058 virulence and its actual function needed further study.

The invaders: phylogeography of dengue and chikungunya viruses Aedes vectors, on the South West islands of the Indian Ocean.

PubMed

Delatte, H; Bagny, L; Brengue, C; Bouetard, A; Paupy, C; Fontenille, D

2011-10-01

Aedes albopictus and Aedes aegypti are the two main worldwide arbovirus vectors that have experienced invasion phases. Aedes aegypti is a pantropical species that spread centuries ago whereas Ae. albopictus started the main wave of invasion in the 1980s. Both species have been at various times on the different islands in Southwestern Indian Ocean (SWIO). This area provides an opportunity to examine the extent to which mosquitoes colonization patterns are influenced by different introductory events likely linked with human settlement and migration between the islands. To explore this hypothesis, we propose a CO1-based phylogeny using a large sampling of fresh Ae. albopictus, Ae. aegypti, and Ae. mascarensis, and 50-year-old dry specimens originating from different Indian Ocean islands. Our data allow us to hypothesize the existence of at least two waves of invasion for Ae. albopictus in the islands of SWIO. The first one most likely occurred several centuries ago with establishments in Madagascar, Mauritius and Reunion Island. The other one that appears to currently still on-going, reached almost all the islands of SWIO during the 1990s or later. The low genetic diversity found between the ancient invasive strain and the contemporary one, indicates with great certainty that Ae. albopictus is not indigenous to the islands of SWIO. Recently, in Madagascar, an invasive lineage of Ae. albopictus has expanded all over the island while Ae. aegypti populations have declined in urban areas. Three clusters of Aedes aegypti have been observed, two fitting with the wild form Ae. aegypti formosus and the other one fitting with the more domestic form Ae. ae. aegypti. Sequence of Ae. mascarensis, endemic to Mauritius suggest that this species might belong to Ae. aegypti species and on this basis we propose to classify it as a sub species or form of Ae. aegypti species. Given the increase of human population flux on these islands, the occurrence of these vectors and their ability to spread quickly are of high importance of arbovirus transmission and the epidemicity of the associated diseases in these islands. Copyright © 2011 Elsevier B.V. All rights reserved.

Clinical Features of Hereditary and Mast Cell-mediated Angioedema Focusing on the Differential Diagnosis in Japanese Patients.

PubMed

Ohsawa, Isao; Honda, Daisuke; Hisada, Atsuko; Inoshita, Hiroyuki; Onda-Tsueshita, Kisara; Mano, Satoshi; Sato, Nobuyuki; Nakamura, Yuya; Shimizu, Tatsuo; Gotoh, Hiromichi; Goto, Yoshikazu; Suzuki, Yusuke; Tomino, Yasuhiko

2018-02-01

Objective The present study was designed to identify the clinical characteristics that permit the differential diagnosis of hereditary angioedema (HAE) and mast cell-mediated angioedema (Mast-AE) during the first consultation. Methods The medical histories and laboratory data of 46 patients with HAE and 41 patients with Mast-AE were compared. Results The average age of onset in the HAE group (19.8±9.0 years) was significantly lower than that in the Mast-AE group (35.2±12.0 years). The incidence of familial angioedema (AE) in the HAE group (73.9%) was significantly higher than that in the Mast-AE group (9.7%). The frequency of history of AE in the extremities, larynx, or gastrointestinal tract was significantly higher in the HAE group. The frequency of AE episodes of the lips and eyelids was significantly lower in the HAE group. The serum C4 concentration and CH50 titer were lower than the normal limit in 91.3% and 45.6% of the patients in the HAE group, respectively; in Mast-AE group the serum C4 concentration and CH50 titer were significantly lower than the normal limit in 4.8% and 0% of the patients, the difference between the two groups was statistically significant. A C1-inhibitor (C1-INH) activity level of <50% was observed in all of the HAE patients, but none of the Mast-AE patients. The mean serum IgE titer in the HAE group (120.8±130.5 IU/mL) was significantly lower than that in the Mast-AE group (262.2±314.9 IU/mL). Conclusion The parameters within the patients' medical histories, such as the age at the onset of AE, a family history of AE, and the locations of past AE episodes are critical for the successful diagnosis of the disease. Measurements of the C4 and C1-INH activity are very useful for differential diagnosis of HAE from Mast-AE.

Functional characterization and modified rescue of novel AE1 mutation R730C associated with overhydrated cation leak stomatocytosis.

PubMed

Stewart, Andrew K; Kedar, Prabhakar S; Shmukler, Boris E; Vandorpe, David H; Hsu, Ann; Glader, Bertil; Rivera, Alicia; Brugnara, Carlo; Alper, Seth L

2011-05-01

We report the novel, heterozygous AE1 mutation R730C associated with dominant, overhydrated, cation leak stomatocytosis and well-compensated anemia. Parallel elevations of red blood cell cation leak and ouabain-sensitive Na(+) efflux (pump activity) were apparently unaccompanied by increased erythroid cation channel-like activity, and defined ouabain-insensitive Na(+) efflux pathways of nystatin-treated cells were reduced. Epitope-tagged AE1 R730C at the Xenopus laevis oocyte surface exhibited severely reduced Cl(-) transport insensitive to rescue by glycophorin A (GPA) coexpression or by methanethiosulfonate (MTS) treatment. AE1 mutant R730K preserved Cl(-) transport activity, but R730 substitution with I, E, or H inactivated Cl(-) transport. AE1 R730C expression substantially increased endogenous oocyte Na(+)-K(+)-ATPase-mediated (86)Rb(+) influx, but ouabain-insensitive flux was minimally increased and GPA-insensitive. The reduced AE1 R730C-mediated sulfate influx did not exhibit the wild-type pattern of stimulation by acidic extracellular pH (pH(o)) and, unexpectedly, was partially rescued by exposure to sodium 2-sulfonatoethyl methanethiosulfonate (MTSES) but not to 2-aminoethyl methanethiosulfonate hydrobromide (MTSEA) or 2-(trimethylammonium)ethyl methanethiosulfonate bromide (MTSET). AE1 R730E correspondingly exhibited acid pH(o)-stimulated sulfate uptake at rates exceeding those of wild-type AE1 and AE1 R730K, whereas mutants R730I and R730H were inactive and pH(o) insensitive. MTSES-treated oocytes expressing AE1 R730C and untreated oocytes expressing AE1 R730E also exhibited unprecedented stimulation of Cl(-) influx by acid pH(o). Thus recombinant cation-leak stomatocytosis mutant AE1 R730C exhibits severely reduced anion transport unaccompanied by increased Rb(+) and Li(+) influxes. Selective rescue of acid pH(o)-stimulated sulfate uptake and conferral of acid pH(o)-stimulated Cl(-) influx, by AE1 R730E and MTSES-treated R730C, define residue R730 as critical to selectivity and regulation of anion transport by AE1.

Aedes aegypti Rhesus glycoproteins contribute to ammonia excretion by larval anal papillae.

PubMed

Durant, Andrea C; Chasiotis, Helen; Misyura, Lidiya; Donini, Andrew

2017-02-15

In larval Aedes aegypti , transcripts of the Rhesus-like glycoproteins AeRh50-1 and AeRh50-2 have been detected in the anal papillae, sites of ammonia (NH 3 /NH 4 + ) excretion; however, these putative ammonia transporters have not been previously localized or functionally characterized. In this study, we show that the AeRh50s co-immunolocalize with apical V-type H + -ATPase as well as with basal Na + /K + -ATPase in the epithelium of anal papillae. The double-stranded RNA-mediated knockdown of AeRh50-1 and AeRh50-2 resulted in a significant reduction in AeRh50 protein abundance in the anal papillae, and this was coupled to decreased ammonia excretion. The knockdown of AeRh50-1 resulted in decreased hemolymph [NH 4 + ] and pH whereas knockdown of AeRh50-2 had no effect on these parameters. We conclude that the AeRh50s are important contributors to ammonia excretion at the anal papillae of larval A. aegypti , which may be the basis for their ability to inhabit areas with high ammonia levels. © 2017. Published by The Company of Biologists Ltd.

Clinical Characteristics, Treatments, and Prognosis of Atopic Eczema in the Elderly.

PubMed

Tanei, Ryoji

2015-05-18

Atopic eczema (AE) in the elderly is gradually increasing and has been added to the classification of AE in recent years. This investigation retrospectively analyzed 60 patients with elderly AE. Among the clinical characteristics, a male predominance, existence of several patterns of onset and clinical course, and associations with immunoglobulin (Ig)E-allergic-status and asthmatic complication were observed. The highest positive-rate and positive-score for serum-specific IgE against Dermatophagoides farinae were 83.8% and 2.65 in patients with IgE-allergic AE, and a lower incidence of lichenified eczema in the elbow and knee folds were observed. In terms of treatments and outcomes, clinical improvement and clinical remission were observed in 80.8% and 36.5% of cases, respectively, using standard treatments and combined therapy with oral corticosteroid in severe cases. As for complications and final prognosis, most elderly AE patients reached the end of life with AE, but patients with IgE-allergic AE showed significantly lower incidences of complications of malignancy and death from malignancy. These results indicate that AE in the elderly represents a new subgroup of AE with specific features.

Clinical Characteristics, Treatments, and Prognosis of Atopic Eczema in the Elderly

PubMed Central

Tanei, Ryoji

2015-01-01

Atopic eczema (AE) in the elderly is gradually increasing and has been added to the classification of AE in recent years. This investigation retrospectively analyzed 60 patients with elderly AE. Among the clinical characteristics, a male predominance, existence of several patterns of onset and clinical course, and associations with immunoglobulin (Ig)E-allergic-status and asthmatic complication were observed. The highest positive-rate and positive-score for serum-specific IgE against Dermatophagoides farinae were 83.8% and 2.65 in patients with IgE-allergic AE, and a lower incidence of lichenified eczema in the elbow and knee folds were observed. In terms of treatments and outcomes, clinical improvement and clinical remission were observed in 80.8% and 36.5% of cases, respectively, using standard treatments and combined therapy with oral corticosteroid in severe cases. As for complications and final prognosis, most elderly AE patients reached the end of life with AE, but patients with IgE-allergic AE showed significantly lower incidences of complications of malignancy and death from malignancy. These results indicate that AE in the elderly represents a new subgroup of AE with specific features. PMID:26239460

Environmentally induced acoustic emission from reinforced concrete

NASA Astrophysics Data System (ADS)

Pollock, Adrian A.; Gonzalez-Nunez, Miguel; Shokri, Tala

2011-04-01

A system is being developed to monitor in-service deterioration of reinforced concrete (RC) in highway bridges. The system includes the monitoring of acoustic emission (AE). To develop a preliminary understanding of AE source mechanisms and their causes while also getting closer to the challenges of separating relevant AE from noise, a 6ft long RC test article was monitored in the outdoors environment of a New Jersey summer. There were indications of daily swings in the AE rate, coinciding with the daily swings in temperature. However this correlation was not consistent or reproducible. As the monitoring was extended into the winter and the test site was buried in snow, the AE rate dropped drastically. It was concluded that temperature changes were instrumental in stimulating AE from this damaged concrete. Implications for the formulation of AE evaluation criteria are discussed. Also, the summer swings provoked consideration of the underlying stress field, the fractal nature of the heterogeneous material and the stochastic AE phenomenon. An analysis of calm time distributions yielded results similar to those found by Abe and Suzuki for earthquake time distributions. Analysis of this kind may help to differentiate relevant AE from some kinds of noise.

Phylogenetic and Temporal Dynamics of Human Immunodeficiency Virus Type 1 CRF01_AE in China

PubMed Central

Su, Xueli; Lu, Hongyan; Pang, Xinghuo; Yan, Hong; Feng, Xia; He, Xiong; Zeng, Yi

2013-01-01

To explore the epidemic history of HIV-1 CRF01_AE in China, 408 fragments of gag gene sequences of CRF01_AE sampled in 2002–2010 were determined from different geographical regions and risk populations in China. Phylogenetic analysis indicates that the CRF01_AE sequences can be grouped into four clusters, suggesting that at least four genetically independent CRF01_AE descendants are circulating in China, of which two were closely related to the isolates from Thailand and Vietnam. Cluster 1 has the most extensive distribution in China. In North China, cluster 1 and cluster 4 were mainly transmitted through homosexuality.The real substance of the recent HIV-1 epidemic in men who have sex with men(MSM) of North China is a rapid spread of CRF01_AE, or rather two distinctive natives CRF01_AE.The time of the most recent common ancestor (tMRCA) of four CRF01_AE clusters ranged from the years 1990.9 to 2003.8 in different regions of China. This is the first phylogenetic and temporal dynamics study of HIV-1 CRF01_AE in China. PMID:23365653

A Computer Scientist’s Evaluation of Publically Available Hardware Trojan Benchmarks

DTIC Science & Technology

2015-09-01

in the Verilog file round.v. This module represents the tenth round of the AES encryption process. This round is similar to previous rounds. It...the round keys used during the AES encryption process. Note that the last two round keys are not leaked, but we assume that the attacker either...undermine the effectiveness of a 128-bit AES encryption circuit. These circuits are labelled AES -T100 through AES -T2100. The naming convention

Mechanisms of Diagonal-Shear Failure in Reinforced Concrete Beams analyzed by AE-SiGMA

NASA Astrophysics Data System (ADS)

Ohno, Kentaro; Shimozono, Shinichiro; Sawada, Yosuke; Ohtsu, Masayasu

Serious shear failures in reinforced concrete (RC) structures were reported in the Hanshin-Awaji Earthquake. In particular, it was demonstrated that a diagonal-shear failure could lead to disastrous damage. However, mechanisms of the diagonal-shear failure in RC beams have not been completely clarified yet. In this study, the diagonal-shear failure in RC beams is investigated, applying acoustic emission (AE) method. To identify source mechanisms of AE signals, SiGMA (Simplified Green's functions for Moment tensor Analysis) procedure was applied. Prior to four-point bending tests of RC beams, theoretical waveforms were calculated to determine the optimal arrangement of AE sensors. Then, cracking mechanisms in experiments were investigated by applying the SiGMA procedure to AE waveforms. From results of the SiGMA analysis, dominant motions of micro-cracks are found to be of shear crack in all the loading stages. As the load increased, the number of tensile cracks increased and eventually the diagonal-shear failure occurred in the shear span. Prior to final failure, AE cluster of micro-cracks was intensely observed in the shear span. To classify AE sources into tensile and shear cracks, AE parameter analysis was also applied. As a result, most of AE hits are classified into tensile cracks. The difference between results obtained by the AE parameter analysis and by the SiGMA analysis is investigated and discussed.

Reporting of Cardiovascular Medical Device Adverse Events to Pharmaceuticals and Medical Devices Agency, Japan☆

PubMed Central

Handa, Nobuhiro; Ishii, Kensuke; Matsui, Yutaka; Ando, Yuki

2015-01-01

Background Marketing authorization holders (MAHs) are obligated to report adverse events (AEs) within 15 days (some cases 30 days) to the Pharmaceuticals and Medical Devices Agency (PMDA) of Japan. Methods To analyze the timeliness of AE reporting to the PMDA, 6610 reports for five categories of cardiovascular devices were retrieved. Two durations were calculated: (1) time from the date the AE occurred to that when the MAH captured it (DOC: days); and (2) time from the date of MAH capture to that of MAH report (DCR: days). Number of DOC > 15 days (DOC15) and delayed reports (DCR > 15 or 30 days) were also calculated. Results AEs included 9.2% deaths and 7.5% non-recoveries. DOC15 and delayed reports were 51.0% and 10.9%, respectively. By multivariate analysis, DOC15 was associated with foreign AE, device category, MAH, patient outcome, event category, and AE that had to be reported within 15 or 30 days (AE15/30). Delayed report was associated with device category, MAH, patient outcome, event category, and AE15/30. Comments Although Japanese MAHs complied with the obligation to report AEs, they often failed to share AEs with healthcare providers. Registry may be a potential solution, although the cooperation of healthcare providers to input data is essential. PMID:26501120

Inhibitory effects of low-dose aloe-emodin on the development of colorectal tumors in min mice.

PubMed

Shimpo, Kan; Chihara, Takeshi; Kaneko, Takaaki; Beppu, Hidehiko; Wakamatsu, Kazumasa; Shinzato, Masanori; Yukitake, Jun; Sonoda, Shigeru

2014-01-01

Aloe-emodin (AE), a natural anthraquinone compound, has been reported to exhibit anticancer activity in various cancer cell lines and anti-inflammatory effects in murine macrophages. In the present study, we investigated the cancer chemopreventive effects of AE in an Apc-deficient Min mouse model. In the first experiment, male Min mice were fed a basal diet or diets containing 5 ppm AE and 10 ppm AE for 12 weeks. The dietary administration of 5 ppm AE significantly reduced the number of colorectal tumors. In a second experiment, we investigated the effects of AE on colitis-related colon carcinogenesis in Min mouse treated with dextran sodium sulfate (DSS). Female Min mice were administered 1% DSS in their drinking water for 7 days. AE was given to mice in their diet at a dose of 5 or 50 ppm for 5 weeks. Feeding with AE significantly reduced the number of colorectal tumors. When proliferation of cells in normal-appearing colonic mucosa was assessed by monoclonal anti-rat Ki-67 antibody (MIB-5) immunohistochemistry in experiments 1 and 2, the AE treatment significantly decreased the mean MIB-5-labeling index. These results suggest that the dietary administration of low-dose AE may have chemopreventive effects against development of colorectal tumors in Min mice, possibly in part by reducing cell proliferation in colorectal mucosa.

Identification of putative cytochrome P450 monooxygenase genes from the small white butterfly, Pieris rapae (Lepidoptera: Pieridae), and their response to insecticides.

PubMed

Liu, Su; Zhang, Yu-Xing; Wang, Wen-Long; Cao, Ye; Li, Shuai; Zhang, Bang-Xian; Li, Shi-Guang

2018-05-01

The small white butterfly, Pieris rapae (Lepidoptera: Pieridae), is an important pest on Brassicaceae plants, causing heavy crop loss each year. Cytochrome P450 monooxygenase (CYP) is a superfamily of enzymes involved in the detoxification of various xenobiotic compounds, including insecticides. However, little is known about the role of CYP genes in P. rapae. In this study, we identified 63 CYP genes in P. rapae, and analyzed their phylogenetic relationships, exon-intron structures and genomic locations. Moreover, our insecticide-response transcription profiling showed that LD 5 doses of lambda-cyhalothrin, chlorantraniliprole, and abamectin significantly increased expression of five (CYP4M59, CYP6AE119, CYP6AE120, CYP6AE121, and CYP6BD18), three (CYP4AU1, CYP6AE120, and CYP6AW1), and five (CYP4L40, CYP4AU1, CYP6AE119, CYP6AW1, and CYP6BD19) CYP genes, respectively; and LD 20 doses of the three pesticides significantly upregulated six (CYP4M59, CYP6AE119, CYP6AE120, CYP6AE121, CYP4AU1, and CYP6BD18), six (CYP4G168, CYP4L40, CYP4AU1, CYP6AE120, CYP6AW1, and CYP6BD19), and five (CYP4L40, CYP4AU1, CYP6AB108, CYP6AE119, and CYP6BD19) genes, respectively. When we used LD 50 doses of the three insecticides, we reported significantly elevated expression levels of five (CYP4M59, CYP6AE119, CYP6AE120, CYP6BD17, and CYP6BD18), eight (CYP4G168, CYP4L40, CYP4AU1, CYP6AE120, CYP6AE121, CYP6AW1, CYP6BD18, and CYP6BD19), and six (CYP4L40, CYP4S34, CYP6AB108, CYP6AE119, CYP6AE120, and CYP6BD19) genes, respectively. Our expression analysis also revealed that five (CYP4G168, CYP4G169, CYP4S34, CYP6AW1, and CYP6CT3) and three (CYP4L40, CYP6AN33, and CYP6BD17) CYP genes were mainly expressed in the midgut and fat body, respectively, and one CYP gene (CYP6AE119) in the Malpighian tubules. This is the first large-scale report into the characterization of CYP genes in P. rapae. © 2018 Wiley Periodicals, Inc.

Adverse Effects (AEs) of Topical NSAIDs in Older Adults with Osteoarthritis (OA): a Systematic Review of the Literature

PubMed Central

Makris, UE.; Kohler, MJ.; Fraenkel, L.

2010-01-01

Objective To systematically review the literature on reported adverse effects (AEs) associated with topical NSAID use in older adults with osteoarthritis (OA). Methods A systematic search of Medline (1950 to November 2009), Scopus, Embase, Web of Science, Cochrane databases, Dissertation and American College of Rheumatology Meeting Abstracts was performed to identify original randomized controlled trials, case reports, observational studies, editorials or dissertations reporting AEs from topical NSAIDs in older adults with OA. Information was sought on study and participant characteristics, detailed recording of application site and systemic AEs as well as withdrawals due to AEs. Results The initial search yielded 953 articles of which 19 met eligibility criteria. Subjects receiving topical NSAIDs reported up to 39.3% application site AEs, and up to 17.5% systemic AEs. Five cases of warfarin potentiation with topical agents were reported; 1 resulting in gastrointestinal bleeding. In formal trials, the withdrawal rate from AEs ranged from 0-21% in the topical agents, 0-25% in the oral NSAIDs, and 0-16% in the placebo group. Conclusion In summary, although topical NSAIDs are safer than oral NSAIDs (fewer severe gastrointestinal AEs), a substantial proportion of older adults report systemic AEs with topical agents. Moreover, the withdrawal rate due to AEs with topical agents is comparable to that of oral NSAIDs. Given the safety profile and withdrawal rates described in this study, further data are needed to determine the incremental benefits of topical NSAIDs compared to other treatment modalities in older adults with OA. PMID:20360183

Detection of adverse events in general surgery using the " Trigger Tool" methodology.

PubMed

Pérez Zapata, Ana Isabel; Gutiérrez Samaniego, María; Rodríguez Cuéllar, Elías; Andrés Esteban, Eva María; Gómez de la Cámara, Agustín; Ruiz López, Pedro

2015-02-01

Surgery is one of the high-risk areas for the occurrence of adverse events (AE). The purpose of this study is to know the percentage of hospitalisation-related AE that are detected by the «Global Trigger Tool» methodology in surgical patients, their characteristics and the tool validity. Retrospective, observational study on patients admitted to a general surgery department, who underwent a surgical operation in a third level hospital during the year 2012. The identification of AE was carried out by patient record review using an adaptation of «Global Trigger Tool» methodology. Once an AE was identified, a harm category was assigned, including the grade in which the AE could have been avoided and its relation with the surgical procedure. The prevalence of AE was 36,8%. There were 0,5 AE per patient. 56,2% were deemed preventable. 69,3% were directly related to the surgical procedure. The tool had a sensitivity of 86% and a specificity of 93,6%. The positive predictive value was 89% and the negative predictive value 92%. Prevalence of AE is greater than the estimate of other studies. In most cases the AE detected were related to the surgical procedure and more than half were also preventable. The adapted «Global Trigger Tool» methodology has demonstrated to be highly effective and efficient for detecting AE in surgical patients, identifying all the serious AE with few false negative results. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

[Quantitative surface analysis of Pt-Co, Cu-Au and Cu-Ag alloy films by XPS and AES].

PubMed

Li, Lian-Zhong; Zhuo, Shang-Jun; Shen, Ru-Xiang; Qian, Rong; Gao, Jie

2013-11-01

In order to improve the quantitative analysis accuracy of AES, We associated XPS with AES and studied the method to reduce the error of AES quantitative analysis, selected Pt-Co, Cu-Au and Cu-Ag binary alloy thin-films as the samples, used XPS to correct AES quantitative analysis results by changing the auger sensitivity factors to make their quantitative analysis results more similar. Then we verified the accuracy of the quantitative analysis of AES when using the revised sensitivity factors by other samples with different composition ratio, and the results showed that the corrected relative sensitivity factors can reduce the error in quantitative analysis of AES to less than 10%. Peak defining is difficult in the form of the integral spectrum of AES analysis since choosing the starting point and ending point when determining the characteristic auger peak intensity area with great uncertainty, and to make analysis easier, we also processed data in the form of the differential spectrum, made quantitative analysis on the basis of peak to peak height instead of peak area, corrected the relative sensitivity factors, and verified the accuracy of quantitative analysis by the other samples with different composition ratio. The result showed that the analytical error in quantitative analysis of AES reduced to less than 9%. It showed that the accuracy of AES quantitative analysis can be highly improved by the way of associating XPS with AES to correct the auger sensitivity factors since the matrix effects are taken into account. Good consistency was presented, proving the feasibility of this method.

Adverse event assessment and reporting in trials of newer treatments for post-operative pain.

PubMed

Hoffer, D; Smith, S M; Parlow, J; Allard, R; Gilron, I

2016-08-01

Assessment and reporting of adverse events (AEs) in studies of perioperative interventions is critical given the potential for unintended and preventable iatrogenic morbidity and mortality. This focused review evaluated the quality of AE assessment and reporting in acute post-operative pain treatment trials. Since older analgesics (e.g., opioids, NSAIDs) already have a well-characterized safety profile, we concentrated on trials of pregabalin and gabapentin as a representative sample of studies where the perioperative safety profile was relatively unknown. We reviewed primary reports of trials of pregabalin and gabapentin for treatment of acute post-operative pain for: (1) adherence to the 10 recommendations from the 'CONSORT Extension for Harms,' (2) AE assessment method, (3) timing of AE assessment and reporting, and (4) assessment and reporting of AE severity. We identified 31 trials of pregabalin and 59 of gabapentin. The median number of CONSORT harms recommendations that were satisfied was 7 of 10. The most common (41%) method of AE assessment was direct questioning about specific AEs by investigators. However, AE assessment method was not described in 18% of trials. AE assessments were reported for specified perioperative time points in only 24% of trials. Of greatest concern, no AE data were reported whatsoever in 8 of the included publications. Considerable widespread improvements are needed in AE reporting for post-operative pain treatment trials. In addition to heightened awareness among clinical investigators, mandatory journal editorial policies may further facilitate improvements in safety assessment and reporting. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

What Do We Really Know About the Safety of Tai Chi?: A Systematic Review of Adverse Event Reports in Randomized Trials

PubMed Central

Wayne, Peter M.; Berkowitz, Danielle L.; Litrownik, Daniel E.; Buring, Julie E.; Yeh, Gloria Y.

2014-01-01

Objective Systematically review frequency and quality of adverse event (AE) reports in randomized clinical trials (RCTs) of Tai Chi (TC). Data Sources Electronic searches of PubMed/MEDLINE and additional databases from inception through March 2013 of English-language RCTs. Search terms were tai chi, taiji, tai chi chuan. Data were independently extracted by two investigators. Study Selection We included all available randomized controlled trials (RCTs) that were published in English and used Tai Chi as an intervention. Inclusion and exclusion of studies were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data Extraction Eligible RCTs were categorized with respect to AE reporting: 1) No mention of protocols for monitoring AEs or reports of AEs; 2) Reports of AEs either with or without explicit protocols for monitoring AEs. Data Synthesis 153 eligible RCTs were identified, most targeting older adults. Only 50 eligible trials (33%) included reporting of AEs, and of these, only 18 trials (12% overall) also reported an explicit AE monitoring protocol. Protocols varied with respect to rigor of systematic monitoring in both Tai Chi and comparison groups. Reported AEs were typically minor and expected, and primarily musculoskeletal related (e.g., knee and back pain); no intervention-related serious AEs were reported. Conclusions Tai Chi is unlikely to result in serious adverse events, but may be associated with minor musculoskeletal aches and pains. However, poor and inconsistent reporting of AEs greatly limits the conclusions that can be drawn regarding the safety of Tai Chi. PMID:24878398

Aqueous Extract of Pomegranate Alone or in Combination with Citalopram Produces Antidepressant-Like Effects in an Animal Model of Menopause: Participation of Estrogen Receptors

PubMed Central

Valdés-Sustaita, Brenda; López-Rubalcava, Carolina; González-Trujano, María Eva; García-Viguera, Cristina

2017-01-01

It has been reported that the aqueous extract of pomegranate (AE-PG) has polyphenols with estrogenic-like activities. The present work determines if AE-PG alone or in combination with the selective serotonin reuptake inhibitor, citalopram, has antidepressant-like effects. It was also analyzed the participation of estrogen receptors (ER). AE-PG (0.1, 1.0, 10, or 100 mg/kg) was evaluated in ovariectomized female Wistar rats subjected to the forced swimming test. The effects induced by AE-PG were compared with those of citalopram (2.5, 5.0, 10, and 20.0 mg/kg) and 17β-estradiol (E2; 2.5 5.0, and 10 μg/rat). Likewise, the combination of suboptimal doses of AE-PG (0.1 mg/kg) plus citalopram (2.5 mg/kg) was evaluated. To determine if ER participates in the antidepressant-like action of pomegranate, the estrogen antagonist tamoxifen (15 mg/kg) was administered with AE-PG (1 mg/kg). AE-PG produced antidepressant-like actions with a similar behavioral profile induced by citalopram and E2. Suboptimal doses of citalopram plus AE-PG produced antidepressant-like effects. Tamoxifen was able to block AE-PG’s antidepressant-like actions. These results confirm the participation of ER in AE-PG’s antidepressant-like effects. Furthermore, the additive effects observed with the combined treatment of AE-PG plus citalopram could be advantageous in the treatment of depressive disorders, such as menopause. PMID:29257042

77 FR 276 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-04

... Energy Storage, LLC, AES ES Westover, LLC, AES Ironwood, L.L.C., AES Red Oak, L.L.C., AES Laurel Mountain... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings 1 Take notice... Energy Marketing Company, Ameren Energy Generating Company, Electric Energy Inc., AmerenEnergy Medina...

75 FR 3456 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-21

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings 1 January 12... Eastern Energy, LP, AES Energy Storage, LLC, AEE 2 LLC, AES CREATIVE RESOURCES LP, AES IRONWOOD LLC, AES.... submits letter notifying FERC that they sell electric energy at market-based rates at wholesale and do not...

Pembrolizumab-induced myasthenia gravis: A fatal case report.

PubMed

March, Katherine L; Samarin, Michael J; Sodhi, Amik; Owens, Ryan E

2018-03-01

Purpose Pembrolizumab, a monoclonal antibody which inhibits the programmed cell death 1 receptor, has been shown to efficaciously enhance pre-existing immune responses to malignancies. However, safety concerns must also be considered as pembrolizumab use has been associated with several life-threatening immune-related adverse events (irAEs). We report a fatal case of pembrolizumab-induced myasthenia gravis in a patient with no prior myasthenia gravis history. Case report A 63-year-old male presented with right eyelid drooping, puffiness, blurred vision, and shortness of breath two weeks after an initial infusion of pembrolizumab. He was subsequently diagnosed with new onset acetylcholine-receptor positive myasthenia gravis. Despite aggressive treatment with corticosteroids, pyridostigmine, intravenous immunoglobulin, and plasmapheresis, the patient clinically deteriorated and ultimately expired from acute respiratory failure after a 12-day hospitalization. Discussion Current package labeling for pembrolizumab warns against various irAEs associated with its use including pneumonitis, colitis, and endocrinopathies. To date, only one case of new onset myasthenia gravis and two case reports of myasthenia gravis exacerbation have been identified. This case further highlights the mortality risk associated with development of irAEs. Conclusion While rare, evidence for the development of MG associated with pembrolizumab is growing. Prompt recognition of symptoms and discontinuation of pembrolizumab is necessary to help improve prognosis.

Endocrine-related adverse events associated with immune checkpoint blockade and expert insights on their management.

PubMed

Sznol, Mario; Postow, Michael A; Davies, Marianne J; Pavlick, Anna C; Plimack, Elizabeth R; Shaheen, Montaser; Veloski, Colleen; Robert, Caroline

2017-07-01

Agents that modulate immune checkpoint proteins, such as cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed death receptor-1 (PD-1), have become a mainstay in cancer treatment. The clinical benefit afforded by immune checkpoint inhibitors can be accompanied by immune-related adverse events (irAE) that affect the skin, gastrointestinal tract, liver, and endocrine system. The types of irAEs associated with immune checkpoint inhibitors are generally consistent across tumor types. Immune-related endocrine events can affect the pituitary, thyroid, and adrenal glands, as well as other downstream target organs. These events are unique when compared with other irAEs because the manifestations are often irreversible. Immune-related endocrine events are typically grade 1/2 in severity and often present with non-specific symptoms, making them difficult to diagnose. The mechanisms underlying immune-related target organ damage in select individuals remain mostly undefined. Management includes close patient monitoring, appropriate laboratory testing for endocrine function, replacement of hormones, and consultation with an endocrinologist when appropriate. An awareness of the symptoms and management of immune-related endocrine events may aid in the safe and appropriate use of immune checkpoint inhibitors in clinical practice. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Safety of human papillomavirus vaccines: a review

PubMed Central

Stillo, Michela; Carrillo Santisteve, Paloma; Lopalco, Pier Luigi

2015-01-01

Introduction: Between 2006 and 2009, two different human papillomavirus virus (HPV) vaccines were licensed for use: a quadrivalent (qHPVv) and a bivalent (bHPVv) vaccine. Since 2008, HPV vaccination programmes have been implemented in the majority of the industrialized countries. Since 2013, HPV vaccination has been part of the national programs of 66 countries including almost all countries in North America and Western Europe. Despite all the efforts made by individual countries, coverage rates are lower than expected. Vaccine safety represents one of the main concerns associated with the lack of acceptance of HPV vaccination both in the European Union/European Economic Area and elsewhere. Areas covered: Safety data published on bivalent and quadrivalent HPV vaccines, both in pre-licensure and post-licensure phase, are reviewed. Expert opinion: Based on the latest scientific evidence, both HPV vaccines seem to be safe. Nevertheless, public concern and rumors about adverse events (AE) represent an important barrier to overcome in order to increase vaccine coverage. Passive surveillance of AEs is an important tool for detecting safety signals, but it should be complemented by activities aimed at assessing the real cause of all suspect AEs. Improved vaccine safety surveillance is the first step for effective communication based on scientific evidence. PMID:25689872

Insecticide Resistance and Metabolic Mechanisms Involved in Larval and Adult Stages of Aedes aegypti Insecticide-Resistant Reference Strains from Cuba.

PubMed

Bisset, Juan Andrés; Rodríguez, María Magdalena; French, Leydis; Severson, David W; Gutiérrez, Gladys; Hurtado, Daymi; Fuentes, Ilario

2014-12-01

Studies were conducted to compare levels of insecticide resistance and to determine the metabolic resistance mechanisms in larval and adult stages of Aedes aegypti from Cuba. Three insecticide-resistant reference strains of Ae. aegypti from Cuba were examined. These strains were derived from a Santiago de Cuba strain isolated in 1997; it was previously subjected to a strong selection for resistance to temephos (SAN-F6), deltamethrin (SAN-F12), and propoxur (SAN-F13) and routinely maintained in the laboratory under selection pressure up to the present time, when the study was carried out. In addition, an insecticide-susceptible strain was used for comparison. The insecticide resistance in larvae and adults was determined using standard World Health Organization methodologies. Insecticide resistance mechanisms were determined by biochemical assays. The esterases (α EST and β EST) and mixed function oxidase (MFO) activities were significantly higher in adults than in the larvae of the three resistant strains studied. The association of resistance level with the biochemical mechanism for each insecticide was established for each stage. The observed differences between larval and adult stages of Ae. aegypti in their levels of insecticide resistance and the biochemical mechanisms involved should be included as part of monitoring and surveillance activities in Ae. aegypti vector control programs.

Post-marketing surveillance of the safety and effectiveness of tacrolimus in 3,267 Japanese patients with rheumatoid arthritis.

PubMed

Takeuchi, Tsutomu; Kawai, Shinichi; Yamamoto, Kazuhiko; Harigai, Masayoshi; Ishida, Kota; Miyasaka, Nobuyuki

2014-01-01

A post-marketing surveillance (PMS) program was implemented to assess the safety and effectiveness of tacrolimus (TAC) in Japanese rheumatoid arthritis (RA) patients and to identify risk factors related to adverse drug reactions (ADRs). Patients were registered centrally and monitored for all adverse events (AEs) for 24 weeks. Effectiveness was evaluated using the Disease Activity Score 28-CRP (DAS28-CRP). Data from 3,172 patients (mean age 62.2 years) were evaluated in the safety analysis. Of the safety population, 78.5 %were female and 25.9 % were in Steinbrocker's functional class 3 or 4. TAC was prescribed as monotherapy in 52.5 % and the most common concomitant disease modifying antirheumatic drug (DMARD) was methotrexate, used in 28.9 % of the patients. The incidence of AEs, serious AEs (SAEs), ADRs and serious ADRs were 41.2, 6.4, 36.0, and 4.9 %, respectively. The most frequent serious ADR category was infections and infestations. Age ≥ 65 years, concurrent renal dysfunction, and concurrent diabetes mellitus were identified as significant risk factors for ADR. Based on EULAR response criteria, 65.4 % of the patients showed moderate or good response. The results demonstrate that TAC is well tolerated by Japanese patients with active RA, including those receiving concomitant methotrexate, in the real world.

Efficacy and Safety of Canagliflozin, a Sodium-Glucose Cotransporter 2 Inhibitor, as Add-on to Insulin in Patients With Type 1 Diabetes.

PubMed

Henry, Robert R; Thakkar, Payal; Tong, Cindy; Polidori, David; Alba, Maria

2015-12-01

This study assessed the efficacy and safety of canagliflozin, a sodium-glucose cotransporter 2 inhibitor, as add-on to insulin in adults with type 1 diabetes. This 18-week, double-blind, phase 2 study randomized 351 patients (HbA1c 7.0-9.0% [53-75 mmol/mol]) on multiple daily insulin injections or continuous subcutaneous insulin infusion to canagliflozin 100 or 300 mg or placebo. The primary end point was the proportion of patients achieving at week 18 both HbA1c reduction from baseline of ≥0.4% (≥4.4 mmol/mol) and no increase in body weight. Other end points included changes in HbA1c, body weight, and insulin dose, as well as hypoglycemia incidence. Safety was assessed by adverse event (AE) reports. More patients had both HbA1c reduction ≥0.4% and no increase in body weight with canagliflozin 100 and 300 mg versus placebo at week 18 (36.9%, 41.4%, 14.5%, respectively; P < 0.001). Both canagliflozin doses provided reductions in HbA1c, body weight, and insulin dose versus placebo over 18 weeks. The incidence of hypoglycemia was similar across groups; severe hypoglycemia rates were low (1.7-6.8%). Overall incidence of AEs was 55.6%, 67.5%, and 54.7% with canagliflozin 100 and 300 mg and placebo; discontinuation rates were low (0.9-1.3%). Increased incidence of ketone-related AEs (5.1%, 9.4%, 0%), including the specific AE of diabetic ketoacidosis (DKA) (4.3%, 6.0%, 0%), was seen with canagliflozin 100 and 300 mg versus placebo. Canagliflozin provided reductions in HbA1c, body weight, and insulin dose with no increase in hypoglycemia, but increased rates of ketone-related AEs, including DKA, in adults with type 1 diabetes inadequately controlled with insulin. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Improving the healthcare response to domestic violence and abuse in sexual health clinics: feasibility study of a training, support and referral intervention.

PubMed

Sohal, Alex Hardip; Pathak, Neha; Blake, Sarah; Apea, Vanessa; Berry, Judith; Bailey, Jayne; Griffiths, Chris; Feder, Gene

2018-03-01

Sexual health and gynaecological problems are the most consistent and largest physical health differences between abused and non-abused female populations. Sexual health services are well placed to identify and support patients experiencing domestic violence and abuse (DVA). Most sexual health professionals have had minimal DVA training despite English National Institute for Health and Care Excellence recommendations. We sought to determine the feasibility of an evidence-based complex DVA training intervention in female sexual health walk-in services (IRIS ADViSE: Identification and Referral to Improve Safety whilst Assessing Domestic Violence in Sexual Health Environments). An adaptive mixed method pilot study in the female walk-in service of two sexual health clinics. Following implementation and evaluation at site 1, the intervention was refined before implementation at site 2. The intervention comprised electronic prompts, multidisciplinary training sessions, clinic materials and simple referral pathways to IRIS ADViSE advocate-educators (AEs). The pilot lasted 7 weeks at site 1 and 12 weeks at site 2. Feasibility outcomes were to assign a supportive DVA clinical lead, an IRIS ADViSE AE employed by a local DVA service provider, adapt electronic records, develop local referral pathways, assess whether enquiry, identification and referral rates were measurable. Both sites achieved all feasibility outcomes: appointing a supportive DVA clinical lead and IRIS ADViSE AE, establishing links with a local DVA provider, adapting electronic records, developing local referral pathways and rates of enquiry, identification and referral were found to be measurable. Site 1: 10% enquiry rate (n=267), 4% identification rate (n=16) and eight AE referrals. Site 2: 61% enquiry rate (n=1090), a 7% identification rate (n=79) and eight AE referrals. IRIS ADViSE can be successfully developed and implemented in sexual health clinics. It fulfils the unmet need for DVA training. Longer-term evaluation is recommended. © 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.

Uncertainty Measurement for Trace Element Analysis of Uranium and Plutonium Samples by Inductively Coupled Plasma-Atomic Emission Spectrometry (ICP-AES) and Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

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

Gallimore, David L.

2012-06-13

The measurement uncertainty estimatino associated with trace element analysis of impurities in U and Pu was evaluated using the Guide to the Expression of Uncertainty Measurement (GUM). I this evalution the uncertainty sources were identified and standard uncertainties for the components were categorized as either Type A or B. The combined standard uncertainty was calculated and a coverage factor k = 2 was applied to obtain the expanded uncertainty, U. The ICP-AES and ICP-MS methods used were deveoped for the multi-element analysis of U and Pu samples. A typical analytical run consists of standards, process blanks, samples, matrix spiked samples,more » post digestion spiked samples and independent calibration verification standards. The uncertainty estimation was performed on U and Pu samples that have been analyzed previously as part of the U and Pu Sample Exchange Programs. Control chart results and data from the U and Pu metal exchange programs were combined with the GUM into a concentration dependent estimate of the expanded uncertainty. Comparison of trace element uncertainties obtained using this model was compared to those obtained for trace element results as part of the Exchange programs. This process was completed for all trace elements that were determined to be above the detection limit for the U and Pu samples.« less