Too easily lead? Health effects of gasoline additives.

PubMed Central

Menkes, D B; Fawcett, J P

1997-01-01

Octane-enhancing constituents of gasoline pose a number of health hazards. This paper considers the relative risks of metallic (lead, manganese), aromatic (e.g., benzene), and oxygenated additives in both industrialized and developing countries. Technological advances, particularly in industrialized countries, have allowed the progressive removal of lead from gasoline and the increased control of exhaust emissions. The developing world, by contrast, has relatively lax environmental standards and faces serious public health problems from vehicle exhaust and the rapid increase in automobile use. Financial obstacles to the modernization of refineries and vehicle fleets compound this problem and the developing world continues to import large quantities of lead additives and other hazardous materials. Progress in decreasing environmental health problems depends both on the adoption of international public health standards as well as efforts to decrease dependence on the private automobile for urban transport. Images Figure 1. Figure 2. PMID:9171982

Progress in NTHMP Hazard Assessment

USGS Publications Warehouse

Gonzalez, F.I.; Titov, V.V.; Mofjeld, H.O.; Venturato, A.J.; Simmons, R.S.; Hansen, R.; Combellick, Rodney; Eisner, R.K.; Hoirup, D.F.; Yanagi, B.S.; Yong, S.; Darienzo, M.; Priest, G.R.; Crawford, G.L.; Walsh, T.J.

2005-01-01

The Hazard Assessment component of the U.S. National Tsunami Hazard Mitigation Program has completed 22 modeling efforts covering 113 coastal communities with an estimated population of 1.2 million residents that are at risk. Twenty-three evacuation maps have also been completed. Important improvements in organizational structure have been made with the addition of two State geotechnical agency representatives to Steering Group membership, and progress has been made on other improvements suggested by program reviewers. ?? Springer 2005.

Crack-cocaine use accelerates HIV disease progression in a cohort of HIV-positive drug users.

PubMed

Baum, Marianna K; Rafie, Carlin; Lai, Shenghan; Sales, Sabrina; Page, Bryan; Campa, Adriana

2009-01-01

HIV infection is prevalent among substance abusers. The effects of specific illicit drugs on HIV disease progression have not been established. We evaluated the relationship between substances of abuse and HIV disease progression in a cohort of HIV-1-positive active drug users. A prospective, 30-month, longitudinal study was conducted on 222 HIV-1 seropositive drug users in Miami, FL. History of illicit drug, alcohol, and medication use, CD4+ cell count, and viral load were performed every 6 months. Crack-cocaine users were 2.14 times [95% confidence interval (CI): 1.08 to 4.25, P = 0.029] more likely to present a decline of CD4 to

[Research progress in post-fire debris flow].

PubMed

Di, Xue-ying; Tao, Yu-zhu

2013-08-01

The occurrence of the secondary disasters of forest fire has significant impacts on the environment quality and human health and safety. Post-fire debris flow is one of the most hazardous secondary disasters of forest fire. To understand the occurrence conditions of post-fire debris flow and to master its occurrence situation are the critical elements in post-fire hazard assessment. From the viewpoints of vegetation, precipitation threshold and debris flow material sources, this paper elaborated the impacts of forest fire on the debris flow, analyzed the geologic and geomorphic conditions, precipitation and slope condition that caused the post-fire debris flow as well as the primary mechanisms of debris-flow initiation caused by shallow landslide or surface runoff, and reviewed the research progress in the prediction and forecast of post-fire debris flow and the related control measures. In the future research, four aspects to be focused on were proposed, i. e., the quantification of the relationships between the fire behaviors and environmental factors and the post-fire debris flow, the quantitative research on the post-fire debris flow initiation and movement processes, the mechanistic model of post-fire debris flow, and the rapid and efficient control countermeasures of post-fire debris flow.

Pollution prevention and the use of low-VOC/HAP coatings at wood furniture manufacturing facilities

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

Marshall, A.M.; Spaight, J.L.; Jones, J.W.

1999-10-01

Midwest Research Institute, under a cooperative agreement with the Air Pollution Prevention and Control Division of the US Environmental Protection Agency`s (EPA`s) National Risk Management Research Laboratory, is conducting a study to identify wood furniture and cabinet manufacturing facilities that have converted to low-volatile organic compound/hazardous air pollutant (VOC/HAP) coatings and to develop case studies for those facilities. This paper discusses the progress of the project and pollution prevention options at wood furniture manufacturing facilities and the regulatory requirements (e.g., the National Emissions Standards for Hazardous Air Pollutants (NESHAP) for Wood Furniture Manufacturing Operations) that these facilities face.

Organizing Hazards, Engineering Disasters? Improving the Recognition of Political-Economic Factors in the Creation of Disasters

ERIC Educational Resources Information Center

Freudenburg, William R.; Gramling, Robert; Laska, Shirley; Erikson, Kai T.

2008-01-01

Disaster studies have made important progress in recognizing the unequally distributed consequences of disasters, but there has been less progress in analyzing social factors that help create "natural" disasters. Even well-known patterns of hazard-creation tend to be interpreted generically--as representing "economic development" or…

Continuation of epidermal growth factor receptor tyrosine kinase inhibitor treatment prolongs disease control in non-small-cell lung cancers with acquired resistance to EGFR tyrosine kinase inhibitors

PubMed Central

Chen, Qi; Quan, Qi; Ding, Lingyu; Hong, Xiangchan; Zhou, Ningning; Liang, Ying; Wu, Haiying

2015-01-01

Objectives Patients with non-small-cell lung cancer (NSCLC) develop acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) after tumor regression. No approved targeted therapies are currently available after initial EGFR TKI treatment. This study investigated the efficacy of continuing EGFR TKI therapy with local treatments for patients with NSCLC and local progression or minimal/slow progression on TKI therapy. Materials and Methods Fifty-five patients with NSCLC treated with EGFR TKIs and developed acquired resistance to the drug were included. Initial response to target therapy, median progression free survival (PFS1), progression pattern, and first progression site were assessed. Median progression free survival to physician assessment progression (PFS2) and difference between PFS1 and PFS2 (PFS difference) were also recorded. Results and Conclusion PFS1 was 11.2 months, PFS2 was 20.3 months, and PFS difference was 8.3 months. Nineteen patients (34.5%) who manifested progression received local therapy, and 16 (28.6%) underwent rebiopsy after progression with six positive EGFR T790M mutations detected. Cox proportional hazards regression model showed that only the first line of treatment was significantly correlated with PFS difference. NSCLC patients with acquired resistance to EGFR TKIs could benefit from the same TKI therapy through months to years of disease control. PMID:26172562

Learn about the Hazardous Waste Electronic Manifest System (e-Manifest)

EPA Pesticide Factsheets

This webpage provides information on EPA's work toward developing a hazardous waste electronic manifest system. Information on the Hazardous Waste Electronic Manifest Establishment Act, progress on the project and frequent questions are available.

Environmental Hazards Assessment Program annual report, [June 1992--June 1993

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

Not Available

1993-10-01

This report, the Environment Hazards Assessment Program (EHAP) Annual Report, is the second of three reports that document activities under the EHAP grant and details progress made during the first year of the grant. The first year was devoted to the development of a working program implementation plan. During the developmental process some key objectives were achieved such as developing a Doctor of Philosophy degree program in Environmental Studies at MUSC (Medical University of South Carolina) and conducting the first Crossroads of Humanity series Round Table Forum. The PIP (Program Implementation Program) details the objectives, management and budgetary basis formore » the overall management and control of the grant over the next four years, the yearly program plans provide the monthly and day-to-day programmatic and budgetary control by which the PIP was developed.« less

A systematic assessment of the state of hazardous waste clean-up technologies. Quarterly technical progress report, April 1--June 30, 1993

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

Berg, M.T.; Reed, B.E.; Gabr, M.

1993-07-01

West Virginia University (WVU) and the US DOE Morgantown Energy Technology Center (METC) entered into a Cooperative Agreement on August 29, 1992 entitled ``Decontamination Systems Information and Research Programs.`` Stipulated within the Agreement is the requirement that WVU submit to METC a series of Technical Progress Report for Year 1 of the Agreement. This report reflects the progress and/or efforts performed on the following nine technical projects encompassed by the Year 1 Agreement for the period of April 1 through June 30, 1993: Systematic assessment of the state of hazardous waste clean-up technologies; site remediation technologies -- drain-enhanced soil flushingmore » (DESF) for organic contaminants removal; site remediation technologies -- in situ bioremediation of organic contaminants; excavation systems for hazardous waste sites; chemical destruction of polychlorinated biphenyls; development of organic sensors -- monolayer and multilayer self-assembled films for chemical sensors; Winfield lock and dam remediation; Assessments of Technologies for hazardous waste site remediation -- non-treatment technologies and pilot scale test facility implementation; and remediation of hazardous sites with stream reforming.« less

Unequal exposure to ecological hazards: environmental injustices in the Commonwealth of Massachusetts.

PubMed Central

Faber, Daniel R; Krieg, Eric J

2002-01-01

This study analyzes the social and geographic distribution of ecological hazards across 368 communities in the Commonwealth of Massachusetts. Combining census data with a variety of environmental data, we tested for and identified both income-based and racially based biases to the geographic distribution of 17 different types of environmentally hazardous sites and industrial facilities. We also developed a composite measure of cumulative exposure to compare the relative overall risks characteristic of each community. To the best of our knowledge, this point system makes this the first environmental justice study to develop a means for measuring and ranking cumulative exposure for communities. The study also controls for the intensity of hazards in each community by accounting for the area across which hazards are distributed. The findings indicate that ecologically hazardous sites and facilities are disproportionately located and concentrated in communities of color and working-class communities. The implication of this research for policymakers and citizen advocates is that cumulative exposure of residents to environmentally hazardous facilities and sites should receive greater consideration regarding community demographics and environmental health indicators. We conclude that the provision of additional resources for environmental monitoring and ranking, as well as yearly progress reports, is necessary for communities and state agencies to achieve equal access to clean and healthy environments for all residents. PMID:11929739

Cardioversion and subsequent quality of life and natural history of atrial fibrillation.

PubMed

Pokorney, Sean D; Kim, Sunghee; Thomas, Laine; Fonarow, Gregg C; Kowey, Peter R; Gersh, Bernard J; Mahaffey, Kenneth W; Peterson, Eric D; Piccini, Jonathan P

2017-03-01

Cardioversion is a class I procedure for patients with symptomatic atrial fibrillation (AF) pursuing rhythm control. There are few contemporary reports on quality of life and outcomes after cardioversion. Using the nationwide prospective ORBIT-AF registry, cardioversion patients were propensity matched 3:1 to noncardioverted patients and Cox proportional hazards modeling evaluated hospitalization at 1 year in those with and without cardioversion. Cardiovascular outcomes, AF progression, and quality of life were evaluated for the matched cohorts with and without cardioversion. Among 9,642 patients, 817 patients (8%) underwent 906 cardioversions during a median follow-up of 12 (interquartile range 6-18) months. Among matched cardioverted and noncardioverted patients, 1-year cardiovascular hospitalization rates were 43% vs 21% (adjusted hazard ratio 2.2, 95% CI 1.8-2.8, P<.001), and sinus rhythm at both first and second follow-ups was 36% vs 27% (P=.042), respectively. Findings were similar among first-time cardioversion patients. Matched cardioversion patients did not exhibit greater symptom improvement (34% vs 42%) or less symptomatic progression (15% vs 4%) by European Heart Rhythm Association scores. Cardioversion was associated with AF progression with an odds ratio of 1.6 (95% CI 1.2-2.2, P=.001) after cardioversion and 2.7 (P<.001) after first cardioversion vs matched noncardioversion patients. After cardioversion, only 18% of patients not previously on an antiarrhythmic started one, less than 5% underwent ablation, and 22% stopped their antiarrhythmic. Cardioversion was not associated with improved AF-related quality of life or less progression. Many patients who undergo cardioversion do not receive adjunctive rhythm control therapies. These findings may help to better inform therapeutic decision making. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Sunlight exposure and sun sensitivity associated with disability progression in multiple sclerosis.

PubMed

D'hooghe, M B; Haentjens, P; Nagels, G; Garmyn, M; De Keyser, J

2012-04-01

Sunlight and vitamin D have been inversely associated with the risk of multiple sclerosis (MS). We investigated sunlight exposure and sun sensitivity in relation to disability progression in MS. We conducted a survey among persons with MS, registered by the Flemish MS society, Belgium, and stratified data according to relapsing-onset and progressive-onset MS. We used Kaplan-Meier survival and Cox proportional hazard regression analyses with time to Expanded Disability Status Scale (EDSS) 6 as outcome measure. Hazard ratios for the time from onset and from birth were calculated for the potentially predictive variables, adjusting for age at onset, gender and immunomodulatory treatment. 704 (51.3%) of the 1372 respondents had reached EDSS 6. In relapsing-onset MS, respondents reporting equal or higher levels of sun exposure than persons of the same age in the last 10 years had a decreased risk of reaching EDSS 6. In progressive-onset MS, increased sun sensitivity was associated with an increased hazard of reaching EDSS 6. The association of higher sun exposure with a better outcome in relapsing-onset MS may be explained by either a protective effect or reverse causality. Mechanisms underlying sun sensitivity might influence progression in progressive-onset MS.

Elotuzumab Therapy for Relapsed or Refractory Multiple Myeloma.

PubMed

Lonial, Sagar; Dimopoulos, Meletios; Palumbo, Antonio; White, Darrell; Grosicki, Sebastian; Spicka, Ivan; Walter-Croneck, Adam; Moreau, Philippe; Mateos, Maria-Victoria; Magen, Hila; Belch, Andrew; Reece, Donna; Beksac, Meral; Spencer, Andrew; Oakervee, Heather; Orlowski, Robert Z; Taniwaki, Masafumi; Röllig, Christoph; Einsele, Hermann; Wu, Ka Lung; Singhal, Anil; San-Miguel, Jesus; Matsumoto, Morio; Katz, Jessica; Bleickardt, Eric; Poulart, Valerie; Anderson, Kenneth C; Richardson, Paul

2015-08-13

Elotuzumab, an immunostimulatory monoclonal antibody targeting signaling lymphocytic activation molecule F7 (SLAMF7), showed activity in combination with lenalidomide and dexamethasone in a phase 1b-2 study in patients with relapsed or refractory multiple myeloma. In this phase 3 study, we randomly assigned patients to receive either elotuzumab plus lenalidomide and dexamethasone (elotuzumab group) or lenalidomide and dexamethasone alone (control group). Coprimary end points were progression-free survival and the overall response rate. Final results for the coprimary end points are reported on the basis of a planned interim analysis of progression-free survival. Overall, 321 patients were assigned to the elotuzumab group and 325 to the control group. After a median follow-up of 24.5 months, the rate of progression-free survival at 1 year in the elotuzumab group was 68%, as compared with 57% in the control group; at 2 years, the rates were 41% and 27%, respectively. Median progression-free survival in the elotuzumab group was 19.4 months, versus 14.9 months in the control group (hazard ratio for progression or death in the elotuzumab group, 0.70; 95% confidence interval, 0.57 to 0.85; P<0.001). The overall response rate in the elotuzumab group was 79%, versus 66% in the control group (P<0.001). Common grade 3 or 4 adverse events in the two groups were lymphocytopenia, neutropenia, fatigue, and pneumonia. Infusion reactions occurred in 33 patients (10%) in the elotuzumab group and were grade 1 or 2 in 29 patients. Patients with relapsed or refractory multiple myeloma who received a combination of elotuzumab, lenalidomide, and dexamethasone had a significant relative reduction of 30% in the risk of disease progression or death. (Funded by Bristol-Myers Squibb and AbbVie Biotherapeutics; ELOQUENT-2 ClinicalTrials.gov number, NCT01239797.).

Using Base Rate of Low Scores to Identify Progression from Amnestic Mild Cognitive Impairment to Alzheimer's Disease.

PubMed

Oltra-Cucarella, Javier; Sánchez-SanSegundo, Miriam; Lipnicki, Darren M; Sachdev, Perminder S; Crawford, John D; Pérez-Vicente, José A; Cabello-Rodríguez, Luis; Ferrer-Cascales, Rosario

2018-05-10

To investigate the implications of obtaining one or more low scores on a battery of cognitive tests on diagnosing mild cognitive impairment (MCI). Observational longitudinal study. Alzheimer's Disease Neuroimaging Initiative. Normal controls (NC, n = 280) and participants with MCI (n = 415) according to Petersen criteria were reclassified using the Jak/Bondi criteria and number of impaired tests (NIT) criteria. Diagnostic statistics and hazard ratios of progression to Alzheimer's disease (AD) were compared according to diagnostic criteria. The NIT criteria were a better predictor of progression to AD than the Petersen or Jak/Bondi criteria, with optimal sensitivity, specificity, and positive and negative predictive value. Considering normal variability in cognitive test performance when diagnosing MCI may help identify individuals at greatest risk of progression to AD with greater certainty. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Implementing a resource management program for accreditation process at the medical laboratory.

PubMed

Yenice, Sedef

2009-03-01

To plan for and provide adequate resources to meet the mission and goals of a medical laboratory in compliance with the requirements for laboratory accreditation by Joint Commission International. The related policies and procedures were developed based on standard requirements for resource management. Competency assessment provided continuing education and performance feedback to laboratory employees. Laboratory areas were designed for the efficient and safe performance of laboratory work. A physical environment was built up where hazards were controlled and personnel activities were managed to reduce the risk of injuries. An Employees Occupational Safety and Health Program (EOSHP) was developed to address all types of hazardous materials and wastes. Guidelines were defined to verify that the methods would produce accurate and reliable results. An active resource management program will be an effective way of assuring that systems are in control and continuous improvement is in progress.

Solar paint: From synthesis to printing

DOE PAGES

Zhou, Xiaojing; Belcher, Warwick; Dastoor, Paul

2014-11-13

Water-based polymer nanoparticle dispersions (solar paint) offer the prospect of addressing two of the main challenges associated with printing large area organic photovoltaic devices; namely, how to control the nanoscale architecture of the active layer and eliminate the need for hazardous organic solvents during device fabrication. We review progress in the field of nanoparticulate organic photovoltaic (NPOPV) devices and future prospects for large-scale manufacturing of solar cells based on this technology.

Solar paint: From synthesis to printing

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

Zhou, Xiaojing; Belcher, Warwick; Dastoor, Paul

Water-based polymer nanoparticle dispersions (solar paint) offer the prospect of addressing two of the main challenges associated with printing large area organic photovoltaic devices; namely, how to control the nanoscale architecture of the active layer and eliminate the need for hazardous organic solvents during device fabrication. We review progress in the field of nanoparticulate organic photovoltaic (NPOPV) devices and future prospects for large-scale manufacturing of solar cells based on this technology.

Subjective cognitive concerns and neuropsychiatric predictors of progression to the early clinical stages of Alzheimer disease.

PubMed

Donovan, Nancy J; Amariglio, Rebecca E; Zoller, Amy S; Rudel, Rebecca K; Gomez-Isla, Teresa; Blacker, Deborah; Hyman, Bradley T; Locascio, Joseph J; Johnson, Keith A; Sperling, Reisa A; Marshall, Gad A; Rentz, Dorene M

2014-12-01

To examine neuropsychiatric and neuropsychological predictors of progression from normal to early clinical stages of Alzheimer disease (AD). From a total sample of 559 older adults from the Massachusetts Alzheimer's Disease Research Center longitudinal cohort, 454 were included in the primary analysis: 283 with clinically normal cognition (CN), 115 with mild cognitive impairment (MCI), and 56 with subjective cognitive concerns (SCC) but no objective impairment, a proposed transitional group between CN and MCI. Two latent cognitive factors (memory-semantic, attention-executive) and two neuropsychiatric factors (affective, psychotic) were derived from the Alzheimer's Disease Centers' Uniform Data Set neuropsychological battery and Neuropsychiatric Inventory brief questionnaire. Factors were analyzed as predictors of time to progression to a worse diagnosis using a Cox proportional hazards regression model with backward elimination. Covariates included baseline diagnosis, gender, age, education, prior depression, antidepressant medication, symptom duration, and interaction terms. Higher/better memory-semantic factor score predicted lower hazard of progression (hazard ratio [HR] = 0.4 for 1 standard deviation [SD] increase, p <0.0001), and higher/worse affective factor score predicted higher hazard (HR = 1.3 for one SD increase, p = 0.01). No other predictors were significant in adjusted analyses. Using diagnosis as a sole predictor of transition to MCI, the SCC diagnosis carried a fourfold risk of progression compared with CN (HR = 4.1, p <0.0001). These results identify affective and memory-semantic factors as significant predictors of more rapid progression from normal to early stages of cognitive decline and highlight the subgroup of cognitively normal elderly with SCC as those with elevated risk of progression to MCI. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Down to Earth with an electric hazard from space

USGS Publications Warehouse

Love, Jeffrey J.; Bedrosian, Paul A.; Schultz, Adam

2017-01-01

In reaching across traditional disciplinary boundaries, solid-Earth geophysicists and space physicists are forging new collaborations to map magnetic-storm hazards for electric-power grids. Future progress in evaluation storm time geoelectric hazards will come primarily through monitoring, surveys, and modeling of related data.

High serum bicarbonate level within the normal range prevents the progression of chronic kidney disease in elderly chronic kidney disease patients

PubMed Central

2013-01-01

Background Metabolic acidosis leads to chronic kidney disease (CKD) progression. The guidelines recommend a lower limit of serum bicarbonate level, but no upper limit. For serum bicarbonate level to be clinically useful as a therapeutic target marker, it is necessary to investigate the target serum bicarbonate level within the normal range to prevent CKD progression. Methods One hundred and thirteen elderly CKD patients, whose serum bicarbonate level was controlled within the normal range, were enrolled in this retrospective cohort study in Ibaraki, Japan. Outcome was defined as a decrease of 25% or more in estimated glomerular filtration rate (eGFR) or starting dialysis. We used Cox proportional hazard models adjusted for patients’ characteristics to examine the association between serum bicarbonate level and the outcome. Results Female patients were 36.3%: average age (SD), 70.4 (6.6) years; eGFR, 25.7 (13.6) ml/min/1.73 m2; serum bicarbonate level, 27.4 (3.2) mEq/l. Patients with the lowest quartile of serum bicarbonate levels [23.4 (1.8) mEq/l] showed a high risk of CKD progression compared with patients with high serum bicarbonate levels [28.8 (2.3) mEq/l]: adjusted hazard ratio (HR), 3.511 (95% CI, 1.342-9.186). A 1 mEq/l increase in serum bicarbonate level was associated with a low risk of CKD progression: adjusted HR, 0.791 [95% confidence interval (CI), 0.684-0.914]. Conclusions In elderly CKD patients, our findings suggest that serum bicarbonate level is independently associated with CKD progression, and that a high serum bicarbonate level is associated with a low risk of CKD progression. A high target serum bicarbonate level within the normal range may be effective for preventing CKD progression. PMID:23298330

Progress Towards the Remote Sensing of Aircraft Icing Hazards

NASA Technical Reports Server (NTRS)

Reehorst, Andrew; Brinker, David; Politovich, Marcia; Serke, David; Ryerson, Charles; Pazmany, Andrew; Solheim, Fredrick

2009-01-01

NASA has teamed with the FAA, DoD, industry, and academia for research into the remote detection and measurement of atmospheric conditions leading to aircraft icing hazards. The ultimate goal of this effort is to provide pilots, controllers, and dispatchers sufficient information to allow aircraft to avoid or minimize their exposure to the hazards of in-flight icing. Since the hazard of in-flight icing is the outcome of aircraft flight through clouds containing supercooled liquid water and strongly influenced by the aircraft s speed and configuration and by the length of exposure, the hazard cannot be directly detected, but must be inferred based upon the measurement of conducive atmospheric conditions. Therefore, icing hazard detection is accomplished through the detection and measurement of liquid water in regions of measured sub-freezing air temperatures. The icing environment is currently remotely measured from the ground with a system fusing radar, lidar, and multifrequency microwave radiometer sensors. Based upon expected ice accretion severity for the measured environment, a resultant aircraft hazard is then calculated. Because of the power, size, weight, and view angle constraints of airborne platforms, the current ground-based solution is not applicable for flight. Two current airborne concepts are based upon the use of either multifrequency radiometers or multifrequency radar. Both ground-based and airborne solutions are required for the future since groundbased systems can provide hazard detection for all aircraft in airport terminal regions while airborne systems will be needed to provide equipped aircraft with flight path coverage between terminal regions.

Occupational characteristics and the progression of carotid artery intima-media thickness and plaque over 9 years: the Multi-Ethnic Study of Atherosclerosis (MESA)

PubMed Central

Fujishiro, Kaori; Diez Roux, Ana V; Landsbergis, Paul; Kaufman, Joel D; Korcarz, Claudia E; Stein, James H

2015-01-01

Objectives The role of occupation in the development of cardiovascular disease (CVD) remains a topic of research because few studies have examined longitudinal associations, and because occupation can be an indicator of socioeconomic position (SEP) and a proxy for hazard exposure. This study examines associations of occupational category as an SEP marker and selected occupational exposures with progression of the subclinical carotid artery disease. Methods A community-based, multiethnic sample (n=3109, mean age=60.2) provided subclinical CVD measures at least twice at three data collection points (mean follow-up=9.4 years). After accounting for demographic characteristics, SEP, and traditional CVD risk factors, we modelled common carotid intima-media thickness, carotid plaque scores, and carotid plaque shadowing as a function of occupational category, physical hazard exposure, physical activity on the job, interpersonal stress, job control and job demands. These job characteristics were derived from the Occupational Resource Network (O*NET). Random coefficient models were used to account for repeated measures and time-varying covariates. Results There were a few statistically significant associations at baseline. After all covariates were included in the model, men in management, office/sales, service and blue-collar jobs had 28–44% higher plaque scores than professionals at baseline (p=0.001). Physically hazardous jobs were positively associated with plaque scores among women (p=0.014). However, there were no significant longitudinal associations between any of the occupational characteristics and any of the subclinical CVD measures. Conclusions There was little evidence that the occupational characteristics examined in this study accelerated the progression of subclinical CVD. PMID:25217203

Outcome and prognostic factors for osteosarcoma of the maxilla, mandible, or calvarium in dogs: 183 cases (1986-2012).

PubMed

Selmic, Laura E; Lafferty, Mary H; Kamstock, Debra A; Garner, Alana; Ehrhart, Nicole P; Worley, Deanna R; Withrow, Stephen J; Lana, Susan E

2014-10-15

To describe the biological behavior, clinical outcome, and prognostic factors of osteosarcoma of the maxilla, mandible, or calvarium in dogs. Retrospective case series. 183 client-owned dogs with osteosarcoma of the maxilla, mandible, or calvarium. Medical records for dogs treated for osteosarcoma of the maxilla, mandible, or calvarium from 1986 through 2012 were reviewed. Dogs with a histopathologic diagnosis of osteosarcoma and treated for a primary tumor arising from these bones of the head were included. Mean age was 9.3 years, and body weight was 31.8 kg (70.0 lb). Most dogs (124/183 [67.8%]) were purebred, and the most common primary tumor site was the maxilla (80 [43.7%]). Treatments included palliative medical treatment only (11/183 [6.0%]), coarsely fractionated radiation therapy (RT; 12 [6.6%]), fractionated or stereotactic RT (18 [9.8%]), surgery (135 [73.8%]), and both surgery and fractionated RT (7 [3.8%]). Eighty-three (45.4%) dogs received adjuvant chemotherapy. Local recurrence or progression occurred in 80 of 156 (51.3%) dogs, and 60 of 156 (38.5%) dogs developed distant metastases. Median survival time for all dogs was 239 days. Dogs that underwent surgery had a median survival time of 329 days. Histologically tumor-free surgical margins were associated with significantly decreased hazards of progression or recurrence (hazard ratio [HR], 0.4) and death (HR, 0.5). Dogs with osteosarcoma of the calvarium had a significantly greater hazard of local recurrence or progression (HR, 2.0). In this study, tumor excision in dogs with histologically tumor-free margins resulted in better local control and longer survival time than did other treatment types.

Impact of Hypertriglyceridemia on Carotid Stenosis Progression under Normal Low-Density Lipoprotein Cholesterol Levels.

PubMed

Kitagami, Masayuki; Yasuda, Ryuta; Toma, Naoki; Shiba, Masato; Nampei, Mai; Yamamoto, Yoko; Nakatsuka, Yoshinari; Sakaida, Hiroshi; Suzuki, Hidenori

2017-08-01

Dyslipidemia is a well-known risk factor for carotid stenosis progression, but triglycerides have attracted little attention. The aim of this study was to assess if serum triglycerides affect progression of carotid stenosis in patients with well-controlled low-density lipoprotein cholesterol (LDL-C) levels. This is a retrospective study in a single hospital consisting of 71 Japanese patients with internal carotid artery stenosis greater than or equal to 50% and normal serum LDL-C levels who underwent angiographic examination with or without the resultant carotid artery stenting or endarterectomy from 2007 to 2011, and were subsequently followed up for 4 years. Clinical factors including fasting serum triglyceride values were compared between the progression (≥10% increase in degree of carotid stenosis on ultrasonography) and the nonprogression groups. During 4 years, 15 patients (21.1%) had carotid stenosis progression on either side. Cox regression analysis demonstrated that symptomatic cases (hazard ratio [HR], 4.327; P = .019), coexisting intracranial arteriosclerotic stenosis (HR, 5.341; P = .005), and hypertriglyceridemia (HR, 6.228; P = .011) were associated with subsequent progression of carotid stenosis. Kaplan-Meier plots demonstrated that the progression-free survival rate was significantly higher in patients without hypertriglyceridemia and intracranial arteriosclerotic stenosis at baseline. Among patients with moderate to severe carotid stenosis and well-controlled LDL-C, hypertriglyceridemia was an important risk factor for progression of carotid stenosis irrespective of surgical treatments. It would be worthwhile to test if triglyceride-lowering medications suppress carotid stenosis progression. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Risk of Visual Field Progression in Glaucoma Patients with Progressive Retinal Nerve Fiber Layer Thinning: A 5-Year Prospective Study.

PubMed

Yu, Marco; Lin, Chen; Weinreb, Robert N; Lai, Gilda; Chiu, Vivian; Leung, Christopher Kai-Shun

2016-06-01

To investigate whether progressive retinal nerve fiber layer (RNFL) thinning is predictive of progressive visual field (VF) loss in glaucoma. Prospective study. A total of 139 primary open-angle glaucoma patients (240 eyes) followed up for ≥5 years. Retinal nerve fiber layer imaging and VF testing were performed at ∼4-month intervals. Progressive RNFL thinning was determined by event analysis (Guided Progression Analysis [GPA]) and trend analysis (Trend-based Progression Analysis [TPA]) of serial registered RNFL thickness maps. VF progression was detected according to the Early Manifest Glaucoma Trial (EMGT) ("likely progression") and pointwise linear regression (PLR) criteria (≥3 contiguous locations with sensitivity change <0 decibels [dB]/year at P < 0.01). Hazard ratios (HRs) for predicting VF progression were calculated by Cox proportional hazard modeling with progressive RNFL thinning as a time-dependent covariate. The specificity of GPA/TPA for detection of RNFL changes was determined by the proportion of eyes with significant RNFL thinning/thickening in 25 normal subjects followed weekly for 8 consecutive weeks and the proportion with significant RNFL thickening in the glaucoma group. The HRs of VF progression. A total of 65 (27.1%) and 117 eyes (48.8%) had progressive RNFL thinning based on GPA and TPA, respectively, and 30 (12.5%) and 39 eyes (16.3%) had VF progression per the EMGT and PLR criteria, respectively, during follow-up. Eyes with progressive RNFL thinning had lower VF survival estimates and a faster decline of visual field index than eyes without. Progressive RNFL thinning predicted the development of VF progression with HRs of 8.44 (95% confidence interval, 3.30-21.61) (EMGT criteria) and 5.11 (2.51-10.42) (PLR criteria) for TPA and 3.95 (1.74-8.93) (EMGT criteria) and 3.81 (1.83-7.92) (PLR criteria) for GPA after controlling for baseline covariates. The specificities of GPA and TPA were 100% (83.4%-100.0%) in the normal group and 81.7% (76.2%-86.4%) and 84.2% (78.9%-88.6%), respectively, in the glaucoma group. Progressive RNFL thinning determined by GPA and TPA is predictive of detectable functional decline in glaucoma. This finding underscores the significance of detecting progressive RNFL thinning and its relevance to initiate or augment treatment for glaucoma patients. Regulatory authorities may consider progressive RNFL thinning as an outcome measure in clinical trials for evaluation of glaucoma treatment. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

High concentrations of AGE-LDL and oxidized LDL in circulating immune complexes are associated with progression of retinopathy in type 1 diabetes.

PubMed

Lopes-Virella, Maria F; Baker, Nathaniel L; Hunt, Kelly J; Lyons, Timothy J; Jenkins, Alicia J; Virella, Gabriel

2012-06-01

To determine whether immunocomplexes (ICs) containing advanced glycation end product (AGE)-LDL (AGE-LDL) and oxidized LDL (oxLDL) contribute to the development of retinopathy over a 16-year period in subjects with type 1 diabetes. Levels of AGE-LDL and oxLDL in ICs were measured in 517 patients of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) cohort. Retinopathy was assessed by stereoscopic fundus photography. Cox proportional hazards models were used to assess the effect of AGE-LDL-ICs and oxLDL-ICs on retinopathy progression. In unadjusted models, higher baseline levels of AGE-LDL-ICs and oxLDL-ICs significantly predicted progression of diabetic retinopathy outcomes. After adjustment by study-design variables (treatment group, retinopathy cohort, duration of type 1 diabetes, and baseline albumin excretion rate [AER], hemoglobin A(1c) (HbA(1c)), and Early Treatment Diabetic Retinopathy Study [ETDRS] score), one SD increase in IC levels was associated with 47% (hazard ratio [HR] 1.47 [95% CI 1.19-1.81]; AGE-LDL-IC) and 45% (1.45 [1.17-1.80]; oxLDL-IC) increased risk of developing proliferative diabetic retinopathy (PDR) and 37% (1.37 [1.12-1.66]; to both ICs) increased risk of progressing to severe nonproliferative retinopathy. Analyses were stratified by retinopathy cohort because results differed between primary and secondary cohorts. For AGE-LDL-ICs, HR for progression to PDR was 2.38 (95% CI 1.30-4.34) in the primary cohort and attenuated in the secondary cohort (1.29 [1.03-1.62]). Similar results were observed for oxLDL-ICs. Increased levels of AGE-LDL and oxLDL in ICs are associated with increased risk for progression to advanced retinopathy in patients with type 1 diabetes, indicating that the antibody response to modified LDL plays a significant role in retinopathy progression.

A Model to Guide Development of Environmental Final Governing Standards for Overseas United States Department of Defense Installations

DTIC Science & Technology

2014-03-28

four sub-sections were included into “System” because none of them address limits of contaminates or chemicals in the water. 24 The Hazardous...maximum contaminant levels (MCL) of chemicals, stricter emission standards, stricter control limits, greater minimum separation distances, prohibited...0.37 Indonesia Strugglers 52.29 -0.40 Malaysia Progressives 62.51 0.34 Mongolia Regressives 45.37 -0.21 Myanmar Strugglers 52.72 -1.09 Nepal

Cost-effectiveness analysis of dose-dense versus standard intravenous chemotherapy for ovarian cancer: An economic analysis of results from the Gynecologic Oncology Group protocol 262 randomized controlled trial.

PubMed

Seagle, Brandon-Luke L; Shahabi, Shohreh

2017-04-01

To determine the cost-effectiveness of dose-dense versus standard intravenous adjuvant chemotherapy for ovarian cancer using results from the no-bevacizumab cohort of the Gynecologic Oncology Group protocol 262 (GOG-262) randomized controlled trial, which reported a smaller absolute progression-free survival (PFS) benefit than the prior Japanese trial. A three-state Markov decision model from a healthcare system perspective with a 21day cycle length and 28month time-horizon was used to calculate incremental cost-effectiveness ratio (ICER) values per progression-free life-year saved (PFLYS) using results from GOG-262. Costs of chemotherapy, complications, and surveillance were from Medicare or institutional data. PFS, discontinuation, and complication rates were from GOG-262. Time-dependent transition probabilities and within-cycle corrections were used. One-way and probabilistic sensitivity analyses were performed. The model produces standard and dose-dense cohorts with 84.3% and 68.3% progression event proportions at 28months, matching GOG-262 rates at the trial's median follow-up. With a median PFS of 10.3months after standard chemotherapy and a hazard ratio for progression of 0.62 after dose-dense therapy, the ICER for dose-dense chemotherapy is $8074.25 (95% confidence interval: $7615.97-$10,207.16) per PFLYS. ICER estimates are sensitive only to the hazard ratio estimate but do not exceed $100,000 per PFLYS. 99.8% of ICER estimates met a more stringent willingness-to-pay of $50,000 per PFLYS. The willingness-to-pay value at which there is a 90% probability of dose-dense treatment being cost-effective is $12,000 per PFLYS. Dose-dense adjuvant chemotherapy is robustly cost-effective for advanced ovarian cancer from a healthcare system perspective based on results from GOG-262. Copyright © 2017 Elsevier Inc. All rights reserved.

Genome-wide Association Study Implicates PARD3B-based AIDS Restriction

PubMed Central

Nelson, George W.; Lautenberger, James A.; Chinn, Leslie; McIntosh, Carl; Johnson, Randall C.; Sezgin, Efe; Kessing, Bailey; Malasky, Michael; Hendrickson, Sher L.; Pontius, Joan; Tang, Minzhong; An, Ping; Winkler, Cheryl A.; Limou, Sophie; Le Clerc, Sigrid; Delaneau, Olivier; Zagury, Jean-François; Schuitemaker, Hanneke; van Manen, Daniëlle; Bream, Jay H.; Gomperts, Edward D.; Buchbinder, Susan; Goedert, James J.; Kirk, Gregory D.; O'Brien, Stephen J.

2011-01-01

Background. Host genetic variation influences human immunodeficiency virus (HIV) infection and progression to AIDS. Here we used clinically well-characterized subjects from 5 pretreatment HIV/AIDS cohorts for a genome-wide association study to identify gene associations with rate of AIDS progression. Methods.  European American HIV seroconverters (n = 755) were interrogated for single-nucleotide polymorphisms (SNPs) (n = 700,022) associated with progression to AIDS 1987 (Cox proportional hazards regression analysis, co-dominant model). Results.  Association with slower progression was observed for SNPs in the gene PARD3B. One of these, rs11884476, reached genome-wide significance (relative hazard = 0.3; P =3. 370 × 10−9) after statistical correction for 700,022 SNPs and contributes 4.52% of the overall variance in AIDS progression in this study. Nine of the top-ranked SNPs define a PARD3B haplotype that also displays significant association with progression to AIDS (hazard ratio, 0.3; P = 3.220 × 10−8). One of these SNPs, rs10185378, is a predicted exonic splicing enhancer; significant alteration in the expression profile of PARD3B splicing transcripts was observed in B cell lines with alternate rs10185378 genotypes. This SNP was typed in European cohorts of rapid progressors and was found to be protective for AIDS 1993 definition (odds ratio, 0.43, P = .025). Conclusions. These observations suggest a potential unsuspected pathway of host genetic influence on the dynamics of AIDS progression. PMID:21502085

On the importance of accounting for competing risks in pediatric cancer trials designed to delay or avoid radiotherapy: I. Basic concepts and first analyses.

PubMed

Tai, Bee-Choo; Grundy, Richard G; Machin, David

2010-04-01

In trials designed to delay or avoid irradiation among children with malignant brain tumor, although irradiation after disease progression is an important event, patients who have disease progression may decline radiotherapy (RT), or those without disease progression may opt for elective RT. To accurately describe the cumulative need for RT in such instances, it is crucial to account for these distinct events and to evaluate how each contributes to the delay or advancement of irradiation via a competing risks analysis. We describe the summary of competing events in such trials using competing risks methods based on cumulative incidence functions and Gray's test. The results obtained are contrasted with standard survival methods based on Kaplan-Meier curves, cause-specific hazard functions and log-rank test. The Kaplan-Meier method overestimates all event-specific rates. The cause-specific hazard analysis showed reduction in hazards for all events (A: RT after progression; B: no RT after progression; C: elective RT) among children with ependymoma. For event A, a higher cumulative incidence was reported for ependymoma. Although Gray's test failed to detect any difference (p = 0.331) between histologic subtypes, the log-rank test suggested marginal evidence (p = 0.057). Similarly, for event C, the log-rank test found stronger evidence of reduction in hazard among those with ependymoma (p = 0.005) as compared with Gray's test (p = 0.086). To evaluate treatment differences, failing to account for competing risks using appropriate methodology may lead to incorrect interpretations.

Diabetes mellitus and Parkinson disease.

PubMed

Pagano, Gennaro; Polychronis, Sotirios; Wilson, Heather; Giordano, Beniamino; Ferrara, Nicola; Niccolini, Flavia; Politis, Marios

2018-05-08

To investigate whether diabetes mellitus is associated with Parkinson-like pathology in people without Parkinson disease and to evaluate the effect of diabetes mellitus on markers of Parkinson pathology and clinical progression in drug-naive patients with early-stage Parkinson disease. We compared 25 patients with Parkinson disease and diabetes mellitus to 25 without diabetes mellitus, and 14 patients with diabetes mellitus and no Parkinson disease to 14 healthy controls (people with no diabetes mellitus or Parkinson disease). The clinical diagnosis of diabetes mellitus was confirmed by 2 consecutive fasting measurements of serum glucose levels >126 mL/dL. Over a 36-month follow-up period, we then investigated in the population with Parkinson disease whether the presence of diabetes mellitus was associated with faster motor progression or cognitive decline. The presence of diabetes mellitus was associated with higher motor scores ( p < 0.01), lower striatal dopamine transporter binding ( p < 0.05), and higher tau CSF levels ( p < 0.05) in patients with Parkinson disease. In patients with diabetes but without Parkinson disease, the presence of diabetes mellitus was associated with lower striatal dopamine transporter binding ( p < 0.05) and higher tau ( p < 0.05) and α-synuclein ( p < 0.05) CSF levels compared to healthy controls. At the Cox survival analysis in the population of patients with Parkinson disease, the presence of diabetes mellitus was associated with faster motor progression (hazard ratio = 4.521, 95% confidence interval = 1.468-13.926; p < 0.01) and cognitive decline (hazard ratio = 9.314, 95% confidence interval = 1.164-74.519; p < 0.05). Diabetes mellitus may predispose toward a Parkinson-like pathology, and when present in patients with Parkinson disease, can induce a more aggressive phenotype. © 2018 American Academy of Neurology.

Effectiveness and cost-effectiveness of erlotinib versus gefitinib in first-line treatment of epidermal growth factor receptor-activating mutation-positive non-small-cell lung cancer patients in Hong Kong.

PubMed

Lee, Vivian W Y; Schwander, Bjoern; Lee, Victor H F

2014-06-01

To compare the effectiveness and cost-effectiveness of erlotinib versus gefitinib as first-line treatment of epidermal growth factor receptor-activating mutation-positive non-small-cell lung cancer patients. DESIGN. Indirect treatment comparison and a cost-effectiveness assessment. Hong Kong. Those having epidermal growth factor receptor-activating mutation-positive non-small-cell lung cancer. Erlotinib versus gefitinib use was compared on the basis of four relevant Asian phase-III randomised controlled trials: one for erlotinib (OPTIMAL) and three for gefitinib (IPASS; NEJGSG; WJTOG). The cost-effectiveness assessment model simulates the transition between the health states: progression-free survival, progression, and death over a lifetime horizon. The World Health Organization criterion (incremental cost-effectiveness ratio <3 times of gross domestic product/capita:

Preventing the progression to type 2 diabetes mellitus in adults at high risk: a systematic review and network meta-analysis of lifestyle, pharmacological and surgical interventions.

PubMed

Stevens, John W; Khunti, Kamlesh; Harvey, Rebecca; Johnson, Maxine; Preston, Louise; Woods, Helen Buckley; Davies, Melanie; Goyder, Elizabeth

2015-03-01

Individuals with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) have an increased risk of progression to Type 2 diabetes mellitus. The objective of this review was to quantify the effectiveness of lifestyle, pharmacological and surgical interventions in reducing the progression to Type 2 diabetes mellitus in people with IFG or IGT. A systematic review was carried out. A network meta-analysis (NMA) of log-hazard ratios was performed. Results are presented as hazard ratios and the probabilities of treatment rankings. 30 studies were included in the NMA. There was a reduced hazard of progression to Type 2 diabetes mellitus associated with all interventions versus standard lifestyle advice; glipizide, diet plus pioglitazone, diet plus exercise plus metformin plus rosiglitazone, diet plus exercise plus orlistat, diet plus exercise plus pedometer, rosiglitazone, orlistat and diet plus exercise plus voglibose produced the greatest effects. Lifestyle and some pharmacological interventions are beneficial in reducing the risk of progression to Type 2 diabetes mellitus. Lifestyle interventions require significant behaviour changes that may be achieved through incentives such as the use of pedometers. Adverse events and cost of pharmacological interventions should be taken into account when considering potential risks and benefits. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Enzalutamide in metastatic prostate cancer before chemotherapy.

PubMed

Beer, Tomasz M; Armstrong, Andrew J; Rathkopf, Dana E; Loriot, Yohann; Sternberg, Cora N; Higano, Celestia S; Iversen, Peter; Bhattacharya, Suman; Carles, Joan; Chowdhury, Simon; Davis, Ian D; de Bono, Johann S; Evans, Christopher P; Fizazi, Karim; Joshua, Anthony M; Kim, Choung-Soo; Kimura, Go; Mainwaring, Paul; Mansbach, Harry; Miller, Kurt; Noonberg, Sarah B; Perabo, Frank; Phung, De; Saad, Fred; Scher, Howard I; Taplin, Mary-Ellen; Venner, Peter M; Tombal, Bertrand

2014-07-31

Enzalutamide is an oral androgen-receptor inhibitor that prolongs survival in men with metastatic castration-resistant prostate cancer in whom the disease has progressed after chemotherapy. New treatment options are needed for patients with metastatic prostate cancer who have not received chemotherapy, in whom the disease has progressed despite androgen-deprivation therapy. In this double-blind, phase 3 study, we randomly assigned 1717 patients to receive either enzalutamide (at a dose of 160 mg) or placebo once daily. The coprimary end points were radiographic progression-free survival and overall survival. The study was stopped after a planned interim analysis, conducted when 540 deaths had been reported, showed a benefit of the active treatment. The rate of radiographic progression-free survival at 12 months was 65% among patients treated with enzalutamide, as compared with 14% among patients receiving placebo (81% risk reduction; hazard ratio in the enzalutamide group, 0.19; 95% confidence interval [CI], 0.15 to 0.23; P<0.001). A total of 626 patients (72%) in the enzalutamide group, as compared with 532 patients (63%) in the placebo group, were alive at the data-cutoff date (29% reduction in the risk of death; hazard ratio, 0.71; 95% CI, 0.60 to 0.84; P<0.001). The benefit of enzalutamide was shown with respect to all secondary end points, including the time until the initiation of cytotoxic chemotherapy (hazard ratio, 0.35), the time until the first skeletal-related event (hazard ratio, 0.72), a complete or partial soft-tissue response (59% vs. 5%), the time until prostate-specific antigen (PSA) progression (hazard ratio, 0.17), and a rate of decline of at least 50% in PSA (78% vs. 3%) (P<0.001 for all comparisons). Fatigue and hypertension were the most common clinically relevant adverse events associated with enzalutamide treatment. Enzalutamide significantly decreased the risk of radiographic progression and death and delayed the initiation of chemotherapy in men with metastatic prostate cancer. (Funded by Medivation and Astellas Pharma; PREVAIL ClinicalTrials.gov number, NCT01212991.).

Efficacy and Safety of Trabectedin or Dacarbazine for Metastatic Liposarcoma or Leiomyosarcoma After Failure of Conventional Chemotherapy: Results of a Phase III Randomized Multicenter Clinical Trial.

PubMed

Demetri, George D; von Mehren, Margaret; Jones, Robin L; Hensley, Martee L; Schuetze, Scott M; Staddon, Arthur; Milhem, Mohammed; Elias, Anthony; Ganjoo, Kristen; Tawbi, Hussein; Van Tine, Brian A; Spira, Alexander; Dean, Andrew; Khokhar, Nushmia Z; Park, Youn Choi; Knoblauch, Roland E; Parekh, Trilok V; Maki, Robert G; Patel, Shreyaskumar R

2016-03-10

This multicenter study, to our knowledge, is the first phase III trial to compare trabectedin versus dacarbazine in patients with advanced liposarcoma or leiomyosarcoma after prior therapy with an anthracycline and at least one additional systemic regimen. Patients were randomly assigned in a 2:1 ratio to receive trabectedin or dacarbazine intravenously every 3 weeks. The primary end point was overall survival (OS), secondary end points were disease control-progression-free survival (PFS), time to progression, objective response rate, and duration of response-as well as safety and patient-reported symptom scoring. A total of 518 patients were enrolled and randomly assigned to either trabectedin (n = 345) or dacarbazine (n = 173). In the final analysis of PFS, trabectedin administration resulted in a 45% reduction in the risk of disease progression or death compared with dacarbazine (median PFS for trabectedin v dacarbazine, 4.2 v 1.5 months; hazard ratio, 0.55; P < .001); benefits were observed across all preplanned subgroup analyses. The interim analysis of OS (64% censored) demonstrated a 13% reduction in risk of death in the trabectedin arm compared with dacarbazine (median OS for trabectedin v dacarbazine, 12.4 v 12.9 months; hazard ratio, 0.87; P = .37). The safety profiles were consistent with the well-characterized toxicities of both agents, and the most common grade 3 to 4 adverse effects were myelosuppression and transient elevation of transaminases in the trabectedin arm. Trabectedin demonstrates superior disease control versus conventional dacarbazine in patients who have advanced liposarcoma and leiomyosarcoma after they experience failure of prior chemotherapy. Because disease control in advanced sarcomas is a clinically relevant end point, this study supports the activity of trabectedin for patients with these malignancies. © 2015 by American Society of Clinical Oncology.

Anaesthetic techniques for risk of malignant tumour recurrence.

PubMed

Cakmakkaya, Ozlem S; Kolodzie, Kerstin; Apfel, Christian C; Pace, Nathan Leon

2014-11-07

Surgery remains a mainstay of treatment for malignant tumours; however, surgical manipulation leads to a significant systemic release of tumour cells. Whether these cells lead to metastases is largely dependent on the balance between aggressiveness of the tumour cells and resilience of the body. Surgical stress per se, anaesthetic agents and administration of opioid analgesics perioperatively can compromise immune function and might shift the balance towards progression of minimal residual disease. Regional anaesthesia techniques provide perioperative pain relief; they therefore reduce the quantity of systemic opioids and of anaesthetic agents used. Additionally, regional anaesthesia techniques are known to prevent or attenuate the surgical stress response. In recent years, the potential benefit of regional anaesthesia techniques for tumour recurrence has received major attention and has been discussed many times in the literature. In preparing this review, we aimed to summarize the current evidence systematically and comprehensively. To establish whether anaesthetic technique (general anaesthesia versus regional anaesthesia or a combination of the two techniques) influences the long-term prognosis for individuals with malignant tumours. We searched The Cochrane Library (2013, Issue 12), PubMed (1950 to 15 December 2013), EMBASE (1974 to 15 December 2013), BIOSIS (1926 to 15 December 2013) and Web of Science (1965 to 15 December 2013). We handsearched relevant websites and conference proceedings and reference lists of cited articles. We applied no language restrictions. We included all randomized controlled trials or controlled clinical trials that investigated the effects of general versus regional anaesthesia on the risk of malignant tumour recurrence in patients undergoing resection of primary malignant tumours. Comparisons of interventions consisted of (1) general anaesthesia alone versus general anaesthesia combined with one or more regional anaesthetic techniques; (2) general anaesthesia combined with one or more regional anaesthetic techniques versus one or more regional anaesthetic techniques; and (3) general anaesthesia alone versus one or more regional anaesthetic techniques. Primary outcomes included (1) overall survival, (2) progression-free survival and (3) time to tumour progression. Two review authors independently scanned the titles and abstracts of identified reports and extracted study data.All primary outcome variables are time-to-event data. If the individual trial report provided summary statistics with odds ratios, relative risks or Kaplan-Meier curves, extracted data enabled us to calculate the hazard ratio using the hazard ratio calculating spreadsheet. To assess risk of bias, we used the standard methodological procedures expected by The Cochrane Collaboration. We included four studies with a total of 746 participants. All studies included adult patients undergoing surgery for primary tumour resection. Two studies enrolled male and female participants undergoing major abdominal surgery for cancer. One study enrolled male participants undergoing surgery for prostate cancer, and one study male participants undergoing surgery for colon cancer. Follow-up time ranged from nine to 17 years. All four studies compared general anaesthesia alone versus general anaesthesia combined with epidural anaesthesia and analgesia. All four studies are secondary data analyses of previously conducted prospective randomized controlled trials.Of the four included studies, only three contributed to the outcome of overall survival, and two each to the outcomes of progression-free survival and time to tumour progression. In our meta-analysis, we could not find an advantage for either study group for the outcomes of overall survival (hazard ratio (HR) 1.03, 95% confidence interval (CI) 0.86 to 1.24) and progression-free survival (HR 0.88, 95% CI 0.56 to 1.38). For progression-free survival, the level of inconsistency was high. Pooled data for time to tumour progression showed a slightly favourable outcome for the control group (general anaesthesia alone) compared with the intervention group (epidural and general anaesthesia) (HR 1.50, 95% CI 1.00 to 2.25).Quality of evidence was graded low for overall survival and very low for progression-free survival and time to tumour progression. The outcome of overall survival was downgraded for serious imprecision and serious indirectness. The outcomes of progression-free survival and time to tumour progression were also downgraded for serious inconsistency and serious risk of bias, respectively.Reporting of adverse events was sparse, and data could not be analysed. Currently, evidence for the benefit of regional anaesthesia techniques on tumour recurrence is inadequate. An encouraging number of prospective randomized controlled trials are ongoing, and it is hoped that their results, when reported, will add evidence for this topic in the near future.

SIRFLOX: Randomized Phase III Trial Comparing First-Line mFOLFOX6 (Plus or Minus Bevacizumab) Versus mFOLFOX6 (Plus or Minus Bevacizumab) Plus Selective Internal Radiation Therapy in Patients With Metastatic Colorectal Cancer.

PubMed

van Hazel, Guy A; Heinemann, Volker; Sharma, Navesh K; Findlay, Michael P N; Ricke, Jens; Peeters, Marc; Perez, David; Robinson, Bridget A; Strickland, Andrew H; Ferguson, Tom; Rodríguez, Javier; Kröning, Hendrik; Wolf, Ido; Ganju, Vinod; Walpole, Euan; Boucher, Eveline; Tichler, Thomas; Shacham-Shmueli, Einat; Powell, Alex; Eliadis, Paul; Isaacs, Richard; Price, David; Moeslein, Fred; Taieb, Julien; Bower, Geoff; Gebski, Val; Van Buskirk, Mark; Cade, David N; Thurston, Kenneth; Gibbs, Peter

2016-05-20

SIRFLOX was a randomized, multicenter trial designed to assess the efficacy and safety of adding selective internal radiation therapy (SIRT) using yttrium-90 resin microspheres to standard fluorouracil, leucovorin, and oxaliplatin (FOLFOX)-based chemotherapy in patients with previously untreated metastatic colorectal cancer. Chemotherapy-naïve patients with liver metastases plus or minus limited extrahepatic metastases were randomly assigned to receive either modified FOLFOX (mFOLFOX6; control) or mFOLFOX6 plus SIRT (SIRT) plus or minus bevacizumab. The primary end point was progression-free survival (PFS) at any site as assessed by independent centralized radiology review blinded to study arm. Between October 2006 and April 2013, 530 patients were randomly assigned to treatment (control, 263; SIRT, 267). Median PFS at any site was 10.2 v 10.7 months in control versus SIRT (hazard ratio, 0.93; 95% CI, 0.77 to 1.12; P = .43). Median PFS in the liver by competing risk analysis was 12.6 v 20.5 months in control versus SIRT (hazard ratio, 0.69; 95% CI, 0.55 to 0.90; P = .002). Objective response rates (ORRs) at any site were similar (68.1% v 76.4% in control v SIRT; P = .113). ORR in the liver was improved with the addition of SIRT (68.8% v 78.7% in control v SIRT; P = .042). Grade ≥ 3 adverse events, including recognized SIRT-related effects, were reported in 73.4% and 85.4% of patients in control versus SIRT. The addition of SIRT to FOLFOX-based first-line chemotherapy in patients with liver-dominant or liver-only metastatic colorectal cancer did not improve PFS at any site but significantly delayed disease progression in the liver. The safety profile was as expected and was consistent with previous studies. © 2016 by American Society of Clinical Oncology.

The effects of AST-120 on chronic kidney disease progression in the United States of America: a post hoc subgroup analysis of randomized controlled trials.

PubMed

Schulman, Gerald; Berl, Tomas; Beck, Gerald J; Remuzzi, Giuseppe; Ritz, Eberhard; Shimizu, Miho; Shobu, Yuko; Kikuchi, Mami

2016-09-30

The orally administered spherical carbon adsorbent AST-120 is used on-label in Asian countries to slow renal disease progression in patients with progressive chronic kidney disease (CKD). Recently, two multinational, randomized, double-blind, placebo-controlled, phase 3 trials (Evaluating Prevention of Progression in Chronic Kidney Disease [EPPIC] trials) examined AST-120's efficacy in slowing CKD progression. This study assessed the efficacy of AST-120 in the subgroup of patients from the United States of America (USA) in the EPPIC trials. In the EPPIC trials, 2035 patients with moderate to severe CKD were studied, of which 583 were from the USA. The patients were randomly assigned to two groups of equal size that were treated with AST-120 or placebo (9 g/day). The primary end point was a composite of dialysis initiation, kidney transplantation, or serum creatinine doubling. The Kaplan-Meier curve for the time to achieve the primary end point in the placebo-treated patients from the USA was similar to that projected before the study. The per protocol subgroup analysis of the population from the USA which included patients with compliance rates of ≥67 % revealed a significant difference between the treatment groups in the time to achieve the primary end point (Hazard Ratio, 0.74; 95 % Confidence Interval, 0.56-0.97). This post hoc subgroup analysis of EPPIC study data suggests that treatment with AST-120 might delay the time to primary end point in CKD patients from the USA. A further randomized controlled trial in progressive CKD patients in the USA is necessary to confirm the beneficial effect of adding AST-120 to standard therapy regimens. ClinicalTrials.gov NCT00500682 ; NCT00501046 .

Relation of physical activity time to incident disability in community dwelling adults with or at risk of knee arthritis: prospective cohort study.

PubMed

Dunlop, Dorothy D; Song, Jing; Semanik, Pamela A; Sharma, Leena; Bathon, Joan M; Eaton, Charles B; Hochberg, Marc C; Jackson, Rebecca D; Kwoh, C Kent; Mysiw, W Jerry; Nevitt, Michael C; Chang, Rowland W

2014-04-29

To investigate whether objectively measured time spent in light intensity physical activity is related to incident disability and to disability progression. Prospective multisite cohort study from September 2008 to December 2012. Baltimore, Maryland; Columbus, Ohio; Pittsburgh, Pennsylvania; and Pawtucket, Rhode Island, USA. Disability onset cohort of 1680 community dwelling adults aged 49 years or older with knee osteoarthritis or risk factors for knee osteoarthritis; the disability progression cohort included 1814 adults. Physical activity was measured by accelerometer monitoring. Disability was ascertained from limitations in instrumental and basic activities of daily living at baseline and two years. The primary outcome was incident disability. The secondary outcome was progression of disability defined by a more severe level (no limitations, limitations to instrumental activities only, 1-2 basic activities, or ≥3 basic activities) at two years compared with baseline. Greater time spent in light intensity activities had a significant inverse association with incident disability. Less incident disability and less disability progression were each significantly related to increasing quartile categories of daily time spent in light intensity physical activities (hazard ratios for disability onset 1.00, 0.62, 0.47, and 0.58, P for trend=0.007; hazard ratios for progression 1.00, 0.59, 0.50, and 0.53, P for trend=0.003) with control for socioeconomic factors (age, sex, race/ethnicity, education, income) and health factors (comorbidities, depressive symptoms, obesity, smoking, lower extremity pain and function, and knee assessments: osteoarthritis severity, pain, symptoms, prior injury). This finding was independent of time spent in moderate-vigorous activities. These prospective data showed an association between greater daily time spent in light intensity physical activities and reduced risk of onset and progression of disability in adults with osteoarthritis of the knee or risk factors for knee osteoarthritis. An increase in daily physical activity time may reduce the risk of disability, even if the intensity of that additional activity is not increased.

Monitoring the Hazards of Silicic Volcanoes with Remote Sensing

NASA Technical Reports Server (NTRS)

Fink, Jonathan; Wessels, Rick; Eisinger, Chris; Ramsey, Michael; Hellman, Melanie; Kuhn, Sally

2004-01-01

This report details the final progress on the Solid Earth and Natural Hazards project: Monitoring of Hazards of Silicic Volcanoes with Remote Sensing (SENH99-0000-0159). The original award went to Arizona State University (ASU) with Dr. Jonathan Fink as the P.I. and Dr. Michael Ramsey as the Co-I. In May 2000, Dr. Ramsey left ASU to take a tenure-track faculty position at the University of Pittsburgh. The principle investigators and NASA Headquarters agreed to split the grant award at the HQ level and therefore avoid the double overhead charges that would arise from a university subcontract. The objectives of the science were divided, and coordinated yearly progress reports have been submitted from each University. This report details the final progress on work carried out at Arizona State. A report by Dr. Ramsey at the University of Pittsburgh has already been submitted. The work from both institutions is closely related and this report will reflect that connection.

A phase 3 randomized controlled trial of the efficacy and safety of atrasentan in men with metastatic hormone-refractory prostate cancer.

PubMed

Carducci, Michael A; Saad, Fred; Abrahamsson, Per-Anders; Dearnaley, David P; Schulman, Claude C; North, Scott A; Sleep, Darryl J; Isaacson, Jeffrey D; Nelson, Joel B

2007-11-01

The objective of this study was to evaluate the efficacy and safety of atrasentan (Xinlay), a selective endothelin-A receptor antagonist, in patients with metastatic hormone-refractory prostate cancer (HRPC). This multinational, double-blind, placebo-controlled trial enrolled 809 men with metastatic HRPC. Patients were randomized 1:1 to receive either atrasentan 10 mg per day or placebo. The primary endpoint was time to disease progression (TTP), which was determined according to radiographic and clinical measures. Analyses of overall survival and changes in biomarkers also were performed. Atrasentan did not reduce the risk of disease progression relative to placebo (hazards ratio, 0.89; 95% confidence interval, 0.76-1.04; P = .136). Most patients progressed radiographically at the first 12-week bone scan without concomitant clinical progression. In exploratory analyses, increases from baseline to final bone alkaline phosphatase (BAP) and prostate-specific antigen (PSA) levels were significantly lower with atrasentan treatment (P < .05 for each). The median time to BAP progression (>/=50% increase from nadir) was twice as long with atrasentan treatment (505 days vs 254 days; P < .01). The delay in time to PSA progression did not reach statistical significance. Atrasentan generally was tolerated well, and the most common adverse events associated with treatment were headache, rhinitis, and peripheral edema, reflecting the vasodilatory and fluid-retention properties of endothelin-A receptor antagonism. Atrasentan did not delay disease progression in men with metastatic HRPC despite evidence of biologic effects on PSA and BAP as markers of disease burden.

Effective tree hazard control on forested recreation sites...losses and protection costs evaluated

Treesearch

Lee A. Paine

1967-01-01

Effectiveness of hazard control was evaluated by analyzing data on tree failures, accidents, and control costs on California recreation sites. Results indicate that reduction of limb hazard in oaks and bole hazard in conifers is the most effective form of control. Least effective is limb hazard reduction in conifers. After hazard control goals or control budgets have...

Exercise capacity and progression from prehypertension to hypertension.

PubMed

Faselis, Charles; Doumas, Michael; Kokkinos, John Peter; Panagiotakos, Demosthenes; Kheirbek, Raya; Sheriff, Helen M; Hare, Katherine; Papademetriou, Vasilios; Fletcher, Ross; Kokkinos, Peter

2012-08-01

Prehypertension is likely to progress to hypertension. The rate of progression is determined mostly by age and resting blood pressure but may also be attenuated by increased fitness. A graded exercise test was performed in 2303 men with prehypertension at the Veterans Affairs Medical Centers in Washington, DC. Four fitness categories were defined, based on peak metabolic equivalents (METs) achieved. We assessed the association between exercise capacity and rate of progression to hypertension (HTN). The median follow-up period was 7.8 years (mean (± SD) 9.2±6.1 years). The incidence rate of progression from prehypertension to hypertension was 34.4 per 1000 person-years. Exercise capacity was a strong and independent predictor of the rate of progression. Compared to the High-Fit individuals (>10.0 METs), the adjusted risk for developing HTN was 66% higher (hazard ratio, 1.66; 95% CI, 1.2 to 2.2; P=0.001) for the Low-Fit and, similarly, 72% higher (hazard ratio, 1.72; 95% CI, 1.2 to 2.3; P=0.001) for the Least-Fit individuals, whereas it was only 36% for the Moderate-Fit (hazard ratio, 1.36; 95% CI, 0.99 to 1.80; P=0.056). Significant predictors for the progression to HTN were also age (19% per 10 years), resting systolic blood pressure (16% per 10 mm Hg), body mass index (15.3% per 5 U), and type 2 diabetes mellitus (2-fold). In conclusion, an inverse, S-shaped association was shown between exercise capacity and the rate of progression from prehypertension to hypertension in middle-aged and older male veterans. The protective effects of fitness were evident when exercise capacity exceeded 8.5 METs. These findings emphasize the importance of fitness in the prevention of hypertension.

78 FR 38730 - Announcement of Funding Awards for Lead-Based Paint Hazard Control, and Lead Hazard Reduction...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-27

... Awards for Lead-Based Paint Hazard Control, and Lead Hazard Reduction Demonstration Grant Programs for... (OHHLHC) Lead-Based Paint Hazard Control, and Lead Hazard Reduction Demonstration Grant Program Notices of... Grants.gov on December 3, 2012, and amended on January 18, 2013, for the Lead Based Paint Hazard Control...

14 CFR 417.413 - Hazard areas.

Code of Federal Regulations, 2014 CFR

2014-01-01

... controls during public access. A launch operator must establish procedural controls that prevent hazardous... that system hazard controls are in place that prevent initiation of a hazardous event. Hazard controls... devices or other restraints on system actuation switches or other controls to eliminate the possibility of...

14 CFR 417.413 - Hazard areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... controls during public access. A launch operator must establish procedural controls that prevent hazardous... that system hazard controls are in place that prevent initiation of a hazardous event. Hazard controls... devices or other restraints on system actuation switches or other controls to eliminate the possibility of...

14 CFR 417.413 - Hazard areas.

Code of Federal Regulations, 2011 CFR

2011-01-01

... controls during public access. A launch operator must establish procedural controls that prevent hazardous... that system hazard controls are in place that prevent initiation of a hazardous event. Hazard controls... devices or other restraints on system actuation switches or other controls to eliminate the possibility of...

Using SAR and GPS for Hazard Management and Response: Progress and Examples from the Advanced Rapid Imaging and Analysis (ARIA) Project

NASA Astrophysics Data System (ADS)

Owen, S. E.; Simons, M.; Hua, H.; Yun, S. H.; Agram, P. S.; Milillo, P.; Sacco, G. F.; Webb, F.; Rosen, P. A.; Lundgren, P.; Milillo, G.; Manipon, G. J. M.; Moore, A. W.; Liu, Z.; Polet, J.; Cruz, J.

2014-12-01

ARIA is a joint JPL/Caltech project to automate synthetic aperture radar (SAR) and GPS imaging capabilities for scientific understanding, hazard response, and societal benefit. We have built a prototype SAR and GPS data system that forms the foundation for hazard monitoring and response capability, as well as providing imaging capabilities important for science studies. Together, InSAR and GPS have the ability to capture surface deformation in high spatial and temporal resolution. For earthquakes, this deformation provides information that is complementary to seismic data on location, geometry and magnitude of earthquakes. Accurate location information is critical for understanding the regions affected by damaging shaking. Regular surface deformation measurements from SAR and GPS are useful for monitoring changes related to many processes that are important for hazard and resource management such as volcanic deformation, groundwater withdrawal, and landsliding. Observations of SAR coherence change have a demonstrated use for damage assessment for hazards such as earthquakes, tsunamis, hurricanes, and volcanic eruptions. These damage assessment maps can be made from imagery taken day or night and are not affected by clouds, making them valuable complements to optical imagery. The coherence change caused by the damage from hazards (building collapse, flooding, ash fall) is also detectable with intelligent algorithms, allowing for rapid generation of damage assessment maps over large areas at fine resolution, down to the spatial scale of single family homes. We will present the progress and results we have made on automating the analysis of SAR data for hazard monitoring and response using data from the Italian Space Agency's (ASI) COSMO-SkyMed constellation of X-band SAR satellites. Since the beginning of our project with ASI, our team has imaged deformation and coherence change caused by many natural hazard events around the world. We will present progress on our data system technology that enables rapid and reliable production of imagery. Lastly, we participated in the March 2014 FEMA exercise based on a repeat of the 1964 M9.2 Alaska earthquake, providing simulated data products for use in this hazards response exercise. We will present lessons learned from this and other simulation exercises.

St. Louis Area Earthquake Hazards Mapping Project - December 2008-June 2009 Progress Report

USGS Publications Warehouse

Williams, R.A.; Bauer, R.A.; Boyd, O.S.; Chung, J.; Cramer, C.H.; Gaunt, D.A.; Hempen, G.L.; Hoffman, D.; McCallister, N.S.; Prewett, J.L.; Rogers, J.D.; Steckel, P.J.; Watkins, C.M.

2009-01-01

This report summarizes the mission, the project background, the participants, and the progress of the St. Louis Area Earthquake Hazards Mapping Project (SLAEHMP) for the period from December 2008 through June 2009. During this period, the SLAEHMP held five conference calls and two face-to-face meetings in St. Louis, participated in several earthquake awareness public meetings, held one outreach field trip for the business and government community, collected and compiled new borehole and digital elevation data from partners, and published a project summary.

Developmental Neurotoxicity Testing: A Path Forward

EPA Science Inventory

Great progress has been made over the past 40 years in understanding the hazards of exposure to a small number of developmental neurotoxicants. Lead, PCBs, and methylmercury are all good examples of science-based approaches to characterizing the hazard to the developing nervous s...

The Association of Statin Use with Age-Related Macular Degeneration Progression: The Age-Related Eye Disease Study 2 Report Number 9.

PubMed

Al-Holou, Shaza N; Tucker, William R; Agrón, Elvira; Clemons, Traci E; Cukras, Catherine; Ferris, Frederick L; Chew, Emily Y

2015-12-01

To evaluate the association of statin use with progression of age-related macular degeneration (AMD). Preplanned, prospective cohort study within a controlled clinical trial of oral supplementation for age-related eye diseases. Age-Related Eye Disease Study 2 (AREDS2) participants, aged 50 to 85 years. Factors, including age, gender, smoking status, aspirin use, and history of diabetes, hypertension, heart disease, angina, and stroke-all known to be associated with statin use-were included in a logistic regression model to estimate propensity scores for each participant. Age-adjusted proportional hazards regression models, with and without propensity score matching, were performed to evaluate the association of statin use with progression to late AMD. Analyses adjusting for the competing risk of death were also performed. Baseline and annual stereoscopic fundus photographs were assessed centrally by masked graders for the development of late AMD, either neovascular AMD or geographic atrophy (GA). Of the 3791 participants (2462 with bilateral large drusen and 1329 with unilateral late AMD at baseline), 1659 (43.8%) were statin users. The overall analysis, with no matching of propensity scores and no adjustment for death as a competing risk, showed that statin use was not associated with progression to late AMD (hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.83-1.41; P = 0.56). When matched for propensity scores and adjusted for death as a competing risk, the result was not statistically significant (HR, 0.81; 95% CI, 0.55-1.20; P = 0.29). Furthermore, subgroup analyses of persons with or without late AMD at baseline and the various components of late AMD (neovascular AMD, central GA, or any GA) also showed no statistically significant association of statin use with progression to AMD. Statin use was not statistically significantly associated with progression to late AMD in the AREDS2 participants, and these findings are consistent with findings in the majority of previous studies. Statins have been demonstrated to reduce the risk of cardiovascular disease, but our data do not provide evidence of a beneficial effect on slowing AMD progression. Published by Elsevier Inc.

Propensity Score–Matched Analysis of Comprehensive Local Therapy for Oligometastatic Non-Small Cell Lung Cancer That Did Not Progress After Front-Line Chemotherapy

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

Sheu, Tommy; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Heymach, John V.

2014-11-15

Purpose: To retrospectively analyze factors influencing survival in patients with non-small cell lung cancer presenting with ≤3 synchronous metastatic lesions. Methods and Materials: We identified 90 patients presenting between 1998 and 2012 with non-small cell lung cancer and ≤3 metastatic lesions who had received at least 2 cycles of chemotherapy followed by surgery or radiation therapy before disease progression. The median number of chemotherapy cycles before comprehensive local therapy (CLT) (including concurrent chemoradiation as first-line therapy) was 6. Factors potentially affecting overall (OS) or progression-free survival (PFS) were evaluated with Cox proportional hazards regression. Propensity score matching was used to assessmore » the efficacy of CLT. Results: Median follow-up time was 46.6 months. Benefits in OS (27.1 vs 13.1 months) and PFS (11.3 months vs 8.0 months) were found with CLT, and the differences were statistically significant when propensity score matching was used (P ≤ .01). On adjusted analysis, CLT had a statistically significant benefit in terms of OS (hazard ratio, 0.37; 95% confidence interval, 0.20-0.70; P ≤ .01) but not PFS (P=.10). In an adjusted subgroup analysis of patients receiving CLT, favorable performance status (hazard ratio, 0.43; 95% confidence interval, 0.22-0.84; P=.01) was found to predict improved OS. Conclusions: Comprehensive local therapy was associated with improved OS in an adjusted analysis and seemed to favorably influence OS and PFS when factors such as N status, number of metastatic lesions, and disease sites were controlled for with propensity score–matched analysis. Patients with favorable performance status had improved outcomes with CLT. Ultimately, prospective, randomized trials are needed to provide definitive evidence as to the optimal treatment approach for this patient population.« less

Propensity score-matched analysis of comprehensive local therapy for oligometastatic non-small cell lung cancer that did not progress after front-line chemotherapy.

PubMed

Sheu, Tommy; Heymach, John V; Swisher, Stephen G; Rao, Ganesh; Weinberg, Jeffrey S; Mehran, Reza; McAleer, Mary Frances; Liao, Zhongxing; Aloia, Thomas A; Gomez, Daniel R

2014-11-15

To retrospectively analyze factors influencing survival in patients with non-small cell lung cancer presenting with ≤3 synchronous metastatic lesions. We identified 90 patients presenting between 1998 and 2012 with non-small cell lung cancer and ≤3 metastatic lesions who had received at least 2 cycles of chemotherapy followed by surgery or radiation therapy before disease progression. The median number of chemotherapy cycles before comprehensive local therapy (CLT) (including concurrent chemoradiation as first-line therapy) was 6. Factors potentially affecting overall (OS) or progression-free survival (PFS) were evaluated with Cox proportional hazards regression. Propensity score matching was used to assess the efficacy of CLT. Median follow-up time was 46.6 months. Benefits in OS (27.1 vs 13.1 months) and PFS (11.3 months vs 8.0 months) were found with CLT, and the differences were statistically significant when propensity score matching was used (P ≤ .01). On adjusted analysis, CLT had a statistically significant benefit in terms of OS (hazard ratio, 0.37; 95% confidence interval, 0.20-0.70; P ≤ .01) but not PFS (P=.10). In an adjusted subgroup analysis of patients receiving CLT, favorable performance status (hazard ratio, 0.43; 95% confidence interval, 0.22-0.84; P=.01) was found to predict improved OS. Comprehensive local therapy was associated with improved OS in an adjusted analysis and seemed to favorably influence OS and PFS when factors such as N status, number of metastatic lesions, and disease sites were controlled for with propensity score-matched analysis. Patients with favorable performance status had improved outcomes with CLT. Ultimately, prospective, randomized trials are needed to provide definitive evidence as to the optimal treatment approach for this patient population. Copyright © 2014 Elsevier Inc. All rights reserved.

Hazards in volcanic arcs

NASA Astrophysics Data System (ADS)

Sparks, S. R.

2008-12-01

Volcanic eruptions in arcs are complex natural phenomena, involving the movement of magma to the Earth's surface and interactions with the surrounding crust during ascent and with the surface environment during eruption, resulting in secondary hazards. Magma changes its properties profoundly during ascent and eruption and many of the underlying processes of heat and mass transfer and physical property changes that govern volcanic flows and magmatic interactions with the environment are highly non-linear. Major direct hazards include tephra fall, pyroclastic flows from explosions and dome collapse, volcanic blasts, lahars, debris avalanches and tsunamis. There are also health hazards related to emissions of gases and very fine volcanic ash. These hazards and progress in their assessment are illustrated mainly from the ongoing eruption of the Soufriere Hills volcano. Montserrat. There are both epistemic and aleatory uncertainties in the assessment of volcanic hazards, which can be large, making precise prediction a formidable objective. Indeed in certain respects volcanic systems and hazardous phenomena may be intrinsically unpredictable. As with other natural phenomena, predictions and hazards inevitably have to be expressed in probabilistic terms that take account of these uncertainties. Despite these limitations significant progress is being made in the ability to anticipate volcanic activity in volcanic arcs and, in favourable circumstances, make robust hazards assessments and predictions. Improvements in monitoring ground deformation, gas emissions and seismicity are being combined with more advanced models of volcanic flows and their interactions with the environment. In addition more structured and systematic methods for assessing hazards and risk are emerging that allow impartial advice to be given to authorities during volcanic crises. There remain significant issues of how scientific advice and associated uncertainties are communicated to provide effective mitigation during volcanic crises.

Combined diabetes-renal multifactorial intervention in patients with advanced diabetic nephropathy: Proof-of-concept.

PubMed

Fogelfeld, Leon; Hart, Peter; Miernik, Jadwiga; Ko, Jocelyn; Calvin, Donna; Tahsin, Bettina; Adhami, Anwar; Mehrotra, Rajeev; Fogg, Louis

2017-03-01

To evaluate efficacy of a multifactorial-multidisciplinary approach in delaying CKD 3-4 progression to ESRD. Two-year proof-of-concept stratified randomized control trial conducted in an outpatient clinic of a large public hospital system. This intervention, led by a team of endocrinologists, nephrologists, nurse practitioners, and registered dietitians, integrated intensive diabetes-renal care with behavioral/dietary and pharmacological interventions. 120 low-income adults with T2DM and CKD 3-4 enrolled; 58% male, 55% African American, 23% Hispanic. Primary outcome was progression rate from CKD 3-4 to ESRD. Fewer intervention (13%) than control (28%) developed ESRD, p<0.05. Intervention had greater albumin/creatinine ratio (ACR) decrease (62% vs. 42%, p<0.05) and A1C<7% attainment (50% vs. 30%, p<0.05) and trended toward better lipid/blood pressure control (p=NS). Significant differences between 25 ESRD and 95 ESRD-free patients were baseline eGFR (28 vs. 40ml/min/1.73m 2 ), annual eGFR decline (15 vs. 3ml/min/year), baseline ACR (2362 vs. 1139mg/g), final ACR (2896 vs. 1201mg/g), and final A1C (6.9 vs. 7.8%). In multivariate Cox analysis, receiving the intervention reduced hazard ratio to develop ESRD (0.125, CI 0.029-0.54) as did higher baseline eGFR (0.69, CI 0.59-0.80). Greater annual eGFR decline increased hazard ratio (1.59, CI 1.34-1.87). The intervention delayed ESRD. Improved A1C and ACR plus not-yet-identified variables may have influenced better outcomes. Multifactorial-multidisciplinary care may serve as a CKD 3-4 treatment paradigm. Copyright © 2017 Elsevier Inc. All rights reserved.

76 FR 45600 - Order of Succession for the Office of Healthy Homes and Lead Hazard Control

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-29

... Office of Healthy Homes and Lead Hazard Control AGENCY: Office of Healthy Homes and Lead Hazard Control... Healthy Homes and Lead Hazard Control for the Department of Housing and Urban Development designates the Order of Succession for the Office of Healthy Homes and Lead Hazard Control. This Order of Succession...

SETAC Pellston WorkshopTM: Environmental hazard and risk assessment approaches for endocrine-active chemicals (EHRA)

EPA Science Inventory

Suspected endocrine disrupting substances (EDS) are now being evaluated by several regulatory authorities. A debate is in progress about whether or not EDS can be adequately assessed by following the standard approach involving identification of intrinsic hazards, prediction of e...

Guidance Manual for Integrating Hazardous Material Control and Management into System Acquisition Programs

DTIC Science & Technology

1993-04-01

34 in the remainder of this "• IPS. Ensure that system safety, Section refer to the DoD format paragraph health hazards, and environmental for the...hazardous materials is controlled in the manner which protects human health and the environment at the least cost. Hazardous Material Control and Management...of hazardous materials is controlled in a manner which protects human health and the environment at the least cost. Hazardous Material Control and

Post hoc analysis of Japanese patients from the placebo-controlled PREVAIL trial of enzalutamide in patients with chemotherapy-naive, metastatic castration-resistant prostate cancer-updated results.

PubMed

Kimura, Go; Ueda, Takeshi

2017-03-01

A post hoc analysis of interim results from PREVAIL, a Phase III, double-blind, placebo-controlled trial of men with metastatic castration-resistant prostate cancer, demonstrated that the treatment effects, safety and pharmacokinetics of enzalutamide in Japanese patients were generally consistent with those of the overall population. A recent longer term analysis of PREVAIL demonstrated continued benefit of enzalutamide treatment over placebo. Here, we report results from a post hoc analysis of Japanese patients enrolled in PREVAIL at the prespecified number of deaths for the final analysis. In Japanese patients, enzalutamide reduced the risk of death by 35% (hazard ratio, 0.65; 95% confidence interval, 0.28-1.51) and the risk of investigator-assessed radiographic progression or death by 60% (hazard ratio, 0.40; 95% confidence interval, 0.18-0.90). These results show that treatment effects and safety in Japanese patients in the final analysis of PREVAIL continued to be generally consistent with those of the overall population. © The Author 2016. Published by Oxford University Press.

Post hoc analysis of Japanese patients from the placebo-controlled PREVAIL trial of enzalutamide in patients with chemotherapy-naive, metastatic castration-resistant prostate cancer—updated results

PubMed Central

Ueda, Takeshi

2017-01-01

Abstract A post hoc analysis of interim results from PREVAIL, a Phase III, double-blind, placebo-controlled trial of men with metastatic castration-resistant prostate cancer, demonstrated that the treatment effects, safety and pharmacokinetics of enzalutamide in Japanese patients were generally consistent with those of the overall population. A recent longer term analysis of PREVAIL demonstrated continued benefit of enzalutamide treatment over placebo. Here, we report results from a post hoc analysis of Japanese patients enrolled in PREVAIL at the prespecified number of deaths for the final analysis. In Japanese patients, enzalutamide reduced the risk of death by 35% (hazard ratio, 0.65; 95% confidence interval, 0.28–1.51) and the risk of investigator-assessed radiographic progression or death by 60% (hazard ratio, 0.40; 95% confidence interval, 0.18–0.90). These results show that treatment effects and safety in Japanese patients in the final analysis of PREVAIL continued to be generally consistent with those of the overall population. PMID:28003320

Stage progression and need for renal replacement therapy in a renal protection programme in Colombia. A cohort study.

PubMed

Yepes Delgado, Carlos Enrique; Pérez Dávila, Sara; Montoya Jaramillo, Marcela; Orrego Orozco, Beatriz Elena

Due to the global burden represented by chronic kidney disease (CKD), the World Health Organization encouraged the implementation of renal protection programmes (RPP) to affect its incidence through prevention and control measures. To assess the effectiveness of a Colombian RPP in terms of its effect on the stage progression of CKD and the need for renal replacement therapy (RRT). An analytical study that monitored 2cohorts of patients diagnosed with CKD. The study compares the behaviour of clinical and renal impairment indicators from patients exposed to a RPP with that of patients following conventional treatment (CT). The population of both intervention groups was considered when determining the sample size. The incidence rate was calculated as well as patient survival (Kaplan Meier). In addition, a multivariate analysis (Cox) was used to calculate the influence that exposure to the RPP had on the outcomes of the patients following the RPP and those following CT. The patients exposed to the RPP took longer to advance to the next CKD stage and require RRT. The incidence rate for progression is higher for the patients following CT (0.050, IC 95%: 0.040-0.064) compared to those in the RPP (0.034, IC 95%: 0.030-0.039). The ratio of incidence rates was 1.480 (IC 95% 1.21-1.90). The hazard of progression was lower for the RPP (HR: 0.855, IC 95%: 0.74- 0.98), as was the hazard of requiring RRT (HR: 0.797, IC 95%: 0.606-1.049). The RPP is a secondary prevention strategy against CKD which has an effect on the stage progression of CKD and the need for RRT. Early patient detection has a positive effect on the outcomes studied. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

PRELIMINARY ANALYSIS OF HAZARDOUS AIR POLLUTANT EMISSION INVENTORIES FROM THREE MAJOR URBAN AREAS

EPA Science Inventory

The paper reports EPA/AEERL's progress on emissions inventory evaluation and improvement under a hazardous air pollutant (HAP) emissions research program in support of the Urban Area Source Program required under Title III of the Clean Air Act Amendments of 1990 (CAAA). he paper ...

76 FR 57024 - Notice of Teleconference of the Chronic Hazard Advisory Panel on Phthalates and Phthalate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-15

... Product Safety Improvement Act of 2008 (CPSIA) (Pub. L. 110- 314). The CHAP will discuss its progress... CONSUMER PRODUCT SAFETY COMMISSION Notice of Teleconference of the Chronic Hazard Advisory Panel on Phthalates and Phthalate Substitutes AGENCY: Consumer Product Safety Commission. ACTION: Notice of...

Carotid Atherosclerosis Progression and Risk of Cardiovascular Events in a Community in Taiwan.

PubMed

Chen, Pei-Chun; Jeng, Jiann-Shing; Hsu, Hsiu-Ching; Su, Ta-Chen; Chien, Kuo-Liong; Lee, Yuan-Teh

2016-05-12

The authors investigated the association between progression of carotid atherosclerosis and incidence of cardiovascular disease in a community cohort in Taiwan. Data has rarely been reported in Asian populations. Study subjects were 1,398 participants who underwent ultrasound measures of common carotid artery intima-media thickness (IMT) and extracranial carotid artery plaque score at both 1994-1995 and 1999-2000 surveys. Cox proportional hazards model was used to assess the risk of incident cardiovascular disease. During a median follow-up of 13 years (1999-2013), 71 strokes and 68 coronary events occurred. The 5-year individual IMT change was not associated with development of cardiovascular events in unadjusted and adjusted models. Among subjects without plaque in 1994-1995, we observed elevated risk associated with presence of new plaque (plaque score >0 in 1999-2000) in a dose-response manner in unadjusted and age- and sex- adjusted models. The associations attenuated and became statistically non-significant after controlling for cardiovascular risk factors (hazard ratio [95% confidence interval] for plaque score >2 vs. 0: stroke, 1.61 [0.79-3.27], coronary events, 1.13 [0.48-2.69]). This study suggested that carotid plaque formation measured by ultrasound is associated increased risk of developing cardiovascular disease, and cardiovascular risk factors explain the associations to a large extent.

21 CFR 123.6 - Hazard analysis and Hazard Analysis Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2013 CFR

2013-04-01

... identified food safety hazards, including as appropriate: (i) Critical control points designed to control... control points designed to control food safety hazards introduced outside the processing plant environment... Control Point (HACCP) plan. 123.6 Section 123.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF...

21 CFR 123.6 - Hazard analysis and Hazard Analysis Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... identified food safety hazards, including as appropriate: (i) Critical control points designed to control... control points designed to control food safety hazards introduced outside the processing plant environment... Control Point (HACCP) plan. 123.6 Section 123.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF...

21 CFR 123.6 - Hazard analysis and Hazard Analysis Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2014 CFR

2014-04-01

... identified food safety hazards, including as appropriate: (i) Critical control points designed to control... control points designed to control food safety hazards introduced outside the processing plant environment... Control Point (HACCP) plan. 123.6 Section 123.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF...

Modelling the dynamics and hazards of explosive eruptions: Where we are now, and confronting the next challenges (Sergey Soloviev Medal Lecture)

NASA Astrophysics Data System (ADS)

Neri, Augusto

2017-04-01

Understanding of explosive eruption dynamics and assessment of their hazards continue to represent challenging issues to the present-day volcanology community. This is largely due to the complex and diverse nature of the phenomena, and the variability and unpredictability of volcanic processes. Nevertheless, important and continuing progress has been made in the last few decades in understanding fundamental processes and in forecasting the occurrences of these phenomena, thanks to significant advances in field, experimental and theoretical modeling investigations. For over four decades, for example, volcanologists have made major progress in the description of the nature of explosive eruptions, considerably aided by the development, improvement, and application of physical-mathematical models. Integral steady-state homogeneous flow models were first used to investigate the different controlling mechanisms and to infer the genesis and evolution of the phenomena. Through continuous improvements and quantum-leap developments, a variety of transient, 3D, multiphase flow models of volcanic phenomena now can implement state-of-the-art formulations of the underlying physics, new-generation analytical and experimental data, as well as high-performance computational techniques. These numerical models have proved to be able to provide key insights in the understanding of the dynamics of explosive eruptions (e.g. convective plumes, collapsing columns, pyroclastic density currents, short-lived explosions, etc.), as well as to represent a valuable tool in the quantification of potential eruptive scenarios and associated hazards. Simplified models based on a reduction of the system complexity have been also proved useful, combined with Monte Carlo and statistical methods, to generate quantitative probabilistic hazard maps at different space and time scales, some including the quantification of important sources of uncertainty. Nevertheless, the development of physical models able to accurately replicate, within acceptable statistical uncertainty, the evolution of explosive eruptions remains a challenging goal still to be achieved. Testing of the developed models versus large-scale experimental data and well-measured real events, real-time assimilation of observational data to forecast the process nature and evolution, as well as the quantification of the uncertainties affecting our system and modelling representations appear key next steps to further progress volcanological research and its essential contribution to the mitigation of volcanic risk.

Should we use standard survival models or the illness-death model for interval-censored data to investigate risk factors of chronic kidney disease progression?

PubMed

Boucquemont, Julie; Metzger, Marie; Combe, Christian; Stengel, Bénédicte; Leffondre, Karen

2014-01-01

In studies investigating risk factors of chronic kidney disease (CKD) progression, one may be interested in estimating factors effects on both a fall of glomerular filtration rate (GFR) below a specific level (i.e., a CKD stage) and death. Such studies have to account for the fact that GFR is measured at intermittent visit only, which implies that progression to the stage of interest is unknown for patients who die before being observed at that stage. Our objective was to compare the results of an illness-death model that handles this uncertainty, with frequently used survival models. This study included 1,519 patients from the NephroTest cohort with CKD stages 1-4 at baseline (69% males, 59±15 years, median protein/creatinine ratio [PCR] 27.4 mg/mmol) and subsequent annual measures of GFR (follow-up time 4.3±2.7 years). Each model was used to estimate the effects of sex, age, PCR, and GFR at baseline on the hazards of progression to CKD stage 5 (GFR<15 mL/min/1.73 m2, n = 282 observed) and death (n = 168). For progression to stage 5, there were only minor differences between results from the different models. The differences between results were higher for the hazard of death before or after progression. Our results also suggest that previous findings on the effect of age on end-stage renal disease are more likely due to a strong impact of age on death than to an effect on progression. The probabilities of progression were systematically under-estimated with the survival model as compared with the illness-death model. This study illustrates the advantages of the illness-death model for accurately estimating the effects of risk factors on the hazard of progression and death, and probabilities of progression. It avoids the need to choose arbitrary time-to-event and time-to-censoring, while accounting for both interval censoring and competition by death, using a single analytical model.

The impact of the new biology on radiation risks in space

NASA Technical Reports Server (NTRS)

Dicello, John F.

2003-01-01

Radiation is considered to be one of three or four major hazards for personnel in space and has emerged as the most critical issue to be resolved for long-term missions, both orbital and interplanetary. Space habitats are stressful and dangerous environments. Health and medical consequences arising from microgravity, stress, and trauma include weakened immune systems, increased viral activity, and loss of bone mass. The greatest risks from radiation are generally assumed to be cancers and possibly damage to the central nervous system. Synergistic effects arising from the other environmental hazards along with abscopal and exogenic factors are likely. Space programs represent an exceptional opportunity for examining the biological consequences of low-dose exposures of humans to radiation at every level of progression. Although astronauts are a relatively small population, they are healthy, physically active volunteers who undergo extensive testing and medical examinations before, during, and after protracted exposures with periodic follow-up examinations. The radiation environments along with other hazards are likewise monitored and documented. Extensive international research programs are in progress. Seven years ago the U.S. National Aeronautics and Space Administration established the National Space Biomedical Research Institute through a cooperative agreement with a consortium of research and academic institutions in order to address radiation issues through a concerted, programmatic effort. Advanced technologies are rapidly being incorporated into these programs to determine the significance of new biological data and to evaluate the interplay among the different medical hazards. Programmatic in vivo and in vitro studies of the processes leading to carcinogenesis are in progress. Drugs and dietary supplements are being examined at the cellular and in vivo levels to assess their potential as dose-modifying agents. The infrastructure of this new approach, recent results, and research in progress are reviewed and discussed.

Associations of Coffee, Tea, and Caffeine Intake with Coronary Artery Calcification and Cardiovascular Events.

PubMed

Miller, P Elliott; Zhao, Di; Frazier-Wood, Alexis C; Michos, Erin D; Averill, Michelle; Sandfort, Veit; Burke, Gregory L; Polak, Joseph F; Lima, Joao A C; Post, Wendy S; Blumenthal, Roger S; Guallar, Eliseo; Martin, Seth S

2017-02-01

Coffee and tea are 2 of the most commonly consumed beverages in the world. The association of coffee and tea intake with coronary artery calcium and major adverse cardiovascular events remains uncertain. We examined 6508 ethnically diverse participants with available coffee and tea data from the Multi-Ethnic Study of Atherosclerosis. Intake for each was classified as never, occasional (<1 cup per day), and regular (≥1 cup per day). A coronary artery calcium progression ratio was derived from mixed effect regression models using loge(calcium score+1) as the outcome, with coefficients exponentiated to reflect coronary artery calcium progression ratio versus the reference. Cox proportional hazards analyses were used to evaluate the association between beverage intake and incident cardiovascular events. Over a median follow-up of 5.3 years for coronary artery calcium and 11.1 years for cardiovascular events, participants who regularly drank tea (≥1 cup per day) had a slower progression of coronary artery calcium compared with never drinkers after multivariable adjustment. This correlated with a statistically significant lower incidence of cardiovascular events for ≥1 cup per day tea drinkers (adjusted hazard ratio 0.71; 95% confidence interval 0.53-0.95). Compared with never coffee drinkers, regular coffee intake (≥1 cup per day) was not statistically associated with coronary artery calcium progression or cardiovascular events (adjusted hazard ratio 0.97; 95% confidence interval 0.78-1.20). Caffeine intake was marginally inversely associated with coronary artery calcium progression. Moderate tea drinkers had slower progression of coronary artery calcium and reduced risk for cardiovascular events. Future research is needed to understand the potentially protective nature of moderate tea intake. Published by Elsevier Inc.

Abiraterone plus Prednisone in Metastatic, Castration-Sensitive Prostate Cancer.

PubMed

Fizazi, Karim; Tran, NamPhuong; Fein, Luis; Matsubara, Nobuaki; Rodriguez-Antolin, Alfredo; Alekseev, Boris Y; Özgüroğlu, Mustafa; Ye, Dingwei; Feyerabend, Susan; Protheroe, Andrew; De Porre, Peter; Kheoh, Thian; Park, Youn C; Todd, Mary B; Chi, Kim N

2017-07-27

Abiraterone acetate, a drug that blocks endogenous androgen synthesis, plus prednisone is indicated for metastatic castration-resistant prostate cancer. We evaluated the clinical benefit of abiraterone acetate plus prednisone with androgen-deprivation therapy in patients with newly diagnosed, metastatic, castration-sensitive prostate cancer. In this double-blind, placebo-controlled, phase 3 trial, we randomly assigned 1199 patients to receive either androgen-deprivation therapy plus abiraterone acetate (1000 mg daily, given once daily as four 250-mg tablets) plus prednisone (5 mg daily) (the abiraterone group) or androgen-deprivation therapy plus dual placebos (the placebo group). The two primary end points were overall survival and radiographic progression-free survival. After a median follow-up of 30.4 months at a planned interim analysis (after 406 patients had died), the median overall survival was significantly longer in the abiraterone group than in the placebo group (not reached vs. 34.7 months) (hazard ratio for death, 0.62; 95% confidence interval [CI], 0.51 to 0.76; P<0.001). The median length of radiographic progression-free survival was 33.0 months in the abiraterone group and 14.8 months in the placebo group (hazard ratio for disease progression or death, 0.47; 95% CI, 0.39 to 0.55; P<0.001). Significantly better outcomes in all secondary end points were observed in the abiraterone group, including the time until pain progression, next subsequent therapy for prostate cancer, initiation of chemotherapy, and prostate-specific antigen progression (P<0.001 for all comparisons), along with next symptomatic skeletal events (P=0.009). These findings led to the unanimous recommendation by the independent data and safety monitoring committee that the trial be unblinded and crossover be allowed for patients in the placebo group to receive abiraterone. Rates of grade 3 hypertension and hypokalemia were higher in the abiraterone group. The addition of abiraterone acetate and prednisone to androgen-deprivation therapy significantly increased overall survival and radiographic progression-free survival in men with newly diagnosed, metastatic, castration-sensitive prostate cancer. (Funded by Janssen Research and Development; LATITUDE ClinicalTrials.gov number, NCT01715285 .).

Relation of physical activity time to incident disability in community dwelling adults with or at risk of knee arthritis: prospective cohort study

PubMed Central

Song, Jing; Semanik, Pamela A; Sharma, Leena; Bathon, Joan M; Eaton, Charles B; Hochberg, Marc C; Jackson, Rebecca D; Kwoh, C Kent; Mysiw, W Jerry; Nevitt, Michael C; Chang, Rowland W

2014-01-01

Objective To investigate whether objectively measured time spent in light intensity physical activity is related to incident disability and to disability progression. Design Prospective multisite cohort study from September 2008 to December 2012. Setting Baltimore, Maryland; Columbus, Ohio; Pittsburgh, Pennsylvania; and Pawtucket, Rhode Island, USA. Participants Disability onset cohort of 1680 community dwelling adults aged 49 years or older with knee osteoarthritis or risk factors for knee osteoarthritis; the disability progression cohort included 1814 adults. Main outcome measures Physical activity was measured by accelerometer monitoring. Disability was ascertained from limitations in instrumental and basic activities of daily living at baseline and two years. The primary outcome was incident disability. The secondary outcome was progression of disability defined by a more severe level (no limitations, limitations to instrumental activities only, 1-2 basic activities, or ≥3 basic activities) at two years compared with baseline. Results Greater time spent in light intensity activities had a significant inverse association with incident disability. Less incident disability and less disability progression were each significantly related to increasing quartile categories of daily time spent in light intensity physical activities (hazard ratios for disability onset 1.00, 0.62, 0.47, and 0.58, P for trend=0.007; hazard ratios for progression 1.00, 0.59, 0.50, and 0.53, P for trend=0.003) with control for socioeconomic factors (age, sex, race/ethnicity, education, income) and health factors (comorbidities, depressive symptoms, obesity, smoking, lower extremity pain and function, and knee assessments: osteoarthritis severity, pain, symptoms, prior injury). This finding was independent of time spent in moderate-vigorous activities. Conclusion These prospective data showed an association between greater daily time spent in light intensity physical activities and reduced risk of onset and progression of disability in adults with osteoarthritis of the knee or risk factors for knee osteoarthritis. An increase in daily physical activity time may reduce the risk of disability, even if the intensity of that additional activity is not increased. PMID:24782514

Geotechnical applications of LiDAR pertaining to geomechanical evaluation and hazard identification

NASA Astrophysics Data System (ADS)

Lato, Matthew J.

Natural hazards related to ground movement that directly affect the safety of motorists and highway infrastructure include, but are not limited to, rockfalls, rockslides, debris flows, and landslides. This thesis specifically deals with the evaluation of rockfall hazards through the evaluation of LiDAR data. Light Detection And Ranging (LiDAR) is an imaging technology that can be used to delineate and evaluate geomechanically-controlled hazards. LiDAR has been adopted to conduct hazard evaluations pertaining to rockfall, rock-avalanches, debris flows, and landslides. Characteristics of LiDAR surveying, such as rapid data acquisition rates, mobile data collection, and high data densities, pose problems to traditional CAD or GIS-based mapping methods. New analyses methods, including tools specifically oriented to geomechanical analyses, are needed. The research completed in this thesis supports development of new methods, including improved survey techniques, innovative software workflows, and processing algorithms to aid in the detection and evaluation of geomechanically controlled rockfall hazards. The scientific research conducted between the years of 2006-2010, as presented in this thesis, are divided into five chapters, each of which has been published by or is under review by an international journal. The five research foci are: (i) geomechanical feature extraction and analysis using LiDAR data in active mining environments; (ii) engineered monitoring of rockfall hazards along transportation corridors: using mobile terrestrial LiDAR; (iii) optimization of LiDAR scanning and processing for automated structural evaluation of discontinuities in rockmasses; (iv) location orientation bias when using static LiDAR data for geomechanical analysis; and (v) evaluating roadside rockmasses for rockfall hazards from LiDAR data: optimizing data collection and processing protocols. The research conducted pertaining to this thesis has direct and significant implications with respect to numerous engineering projects that are affected by geomechanical stability issues. The ability to efficiently and accurately map discontinuities, detect changes, and standardize roadside geomechanical stability analyses from remote locations will fundamentally change the state-of-practice of geotechnical investigation workflows and repeatable monitoring. This, in turn, will lead to earlier detection and definition of potential zones of instability, will allow for progressive monitoring and risk analysis, and will indicate the need for pro-active slope improvement and stabilization.

78 FR 60755 - Hazardous Materials: Enhanced Enforcement Procedures-Resumption of Transportation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-02

.... Summary of MAP-21 and Final Rule V. Summary Review of Amendments VI. Regulatory Analyses and Notices A.... Executive Summary On July 6, 2012, the President signed the Moving Ahead for Progress in the 21st Century Act, or the MAP-21, which included the Hazardous Materials Transportation Safety Improvement Act of...

78 FR 30258 - Hazardous Materials: Enhanced Enforcement Procedures-Resumption of Transportation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-22

... 21st Century Act, or the MAP-21, which included the Hazardous Materials Transportation Safety... 6, 2012, the President signed the Moving Ahead for Progress in the 21st Century Act, or the MAP-21... This NPRM In MAP-21 Congress directed the Secretary to address certain transportation matters related...

77 FR 19306 - Announcement of Funding Awards: Office of Healthy Homes and Lead Hazard Control Grant Programs...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

... Federal Register notice published on May 18, 2011 for Lead Based Paint Hazard Control and Lead Hazard... Based Paint Hazard Control Grant Program A total of $43,206,000 was awarded to 22 grantees for the Lead Based Paint Hazard Control Grant Program and an additional $1,999,971 was awarded to 20 out of the 29...

77 FR 19305 - Announcement of Funding Awards: Office of Healthy Homes and Lead Hazard Control Grant Programs...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

... Federal Register notice published on September 9, 2010 for Lead Based Paint Hazard Control and Lead Hazard... follows: 1. Lead Based Paint Hazard Control Grant Program A total of $69,700,000 was awarded to 29 grantees for the Lead Based Paint Hazard Control Grant Program and an additional $2,388,637 was awarded to...

Innovative hazard detection and avoidance strategy for autonomous safe planetary landing

NASA Astrophysics Data System (ADS)

Jiang, Xiuqiang; Li, Shuang; Tao, Ting

2016-09-01

Autonomous hazard detection and avoidance (AHDA) is one of the key technologies for future safe planetary landing missions. In this paper, we address the latest progress on planetary autonomous hazard detection and avoidance technologies. First, the innovative autonomous relay hazard detection and avoidance strategy adopted in Chang'e-3 lunar soft landing mission and its flight results are reported in detail. Second, two new conceptual candidate schemes of hazard detection and avoidance are presented based on the Chang'e-3 AHDA system and the latest developing technologies for the future planetary missions, and some preliminary testing results are also given. Finally, the related supporting technologies for the two candidate schemes above are analyzed.

Environmental Hazards Assessment Program. Quarterly report, July--September 1995

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

NONE

This report describes activities and reports on progress for the first quarter (July--September) of the fourth year of the grant to support the Environmental Hazards Assessment Program (EHAP) at the Medical University of South Carolina. It reports progress against the grant objectives and the Program Implementation Plan published at the end of the first year of the grant. The objectives of EHAP stated in the proposal to DOE are to: (1) develop a holistic, national basis for risk assessment, risk management, and risk communication that recognizes the direct impact of environmental hazards on the health and well-being of all; (2)more » develop a pool of talented scientists and experts in cleanup activities, especially in human health aspects; and (3) identify needs and develop programs addressing the critical shortage of well-educated, highly-skilled technical and scientific personnel to address the health-oriented aspects of environmental restoration and waste management.« less

Systemic treatment in advanced biliary cancers: A multicenter Australian analysis and review.

PubMed

Brungs, Daniel; Aghmesheh, Morteza; Sjoquist, Katrin; Goldstein, David

2017-10-01

While first-line palliative chemotherapy (CT1) improves survival and quality of life in advanced biliary cancer (ABC), there is no randomized evidence to support second-line chemotherapy (CT2) in ABC. We aim to explore to role of CT2 in ABC. We performed a retrospective review of all patients who received one or more lines of chemotherapy for ABC at four Australian cancer centers between 2008 and 2011. A Cox proportional hazard model was developed to determine the impact of clinicopathologic variables on overall survival (OS) from time of progression on CT1. We identified 73 patients who received palliative chemotherapy for ABC. Twenty-five patients (34%) received two or more lines of chemotherapy. Patients with a preserved performance status on progression on first-line chemotherapy (CT1) were more likely to receive second-line chemotherapy (CT2) (P < 0.001). Disease control rate with CT2 was 36%, and mean progression-free survival was 3.2 months (95% confidence interval 1.5-4.9 months). The following variables were significant in the univariate analysis of OS from time of progression on CT1: lines of chemotherapy (P = 0.0001), Eastern Cooperative Oncology Group performance status at progression on CT1 (P < 0.0001) and disease control with CT1 (P = 0.027). Lines of chemotherapy received and performance status remained significant in the multivariate analysis for OS from progression on CT1. Second-line chemotherapy is feasible in a subset of patients with ABC. Even after accounting for confounding variables, CT2 appears to increase OS in ABC, although we are unable to exclude other unmeasured factors such as tumor biology. These findings warrant further evaluation with prospective trials. © 2016 John Wiley & Sons Australia, Ltd.

Risk factors for progression to invasive carcinoma in patients with borderline ovarian tumors.

PubMed

Song, Taejong; Lee, Yoo-Young; Choi, Chel Hun; Kim, Tae-Joong; Lee, Jeong-Won; Bae, Duk-Soo; Kim, Byoung-Gie

2014-09-01

The aim of this study was to identify risk factors for progression to invasive carcinoma in patients with borderline ovarian tumors (BOTs). We performed a retrospective review of all patients treated and followed for BOTs between 1996 and 2011. Multivariate Cox proportional hazards model analysis was performed to identify independent risk factors for progression to invasive carcinoma. A total of 364 patients were identified. During the median follow-up of 53.8 months, 31 patients (8.5%) developed recurrent disease: 12 (3.3%) had recurrent disease with progression to invasive carcinoma, and 19 (5.2%) had recurrent disease with borderline histology. Disease-related deaths (7/364; 1.7%) were observed only in patients with progression to invasive carcinoma. The multivariate analysis showed that independent risk factors for progression to invasive carcinoma were advanced disease stage (hazard ratio [HR], 5.59; P = 0.005), age 65 years or older (HR, 5.13; P = 0.037), and the presence of microinvasion (HR, 3.71; P = 0.047). These 3 factors were also independently related to overall survival. Although patients with BOTs have an excellent prognosis, the risk of progression to invasive carcinoma and thereby death remains. Therefore, physicians should pay closer attention to BOT patients with these risk factors (ie, advanced disease stage, old age, and microinvasion), and more careful surveillance for progression to invasive carcinoma is needed.

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

PubMed

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

2015-11-01

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

Interaction between GFR and Risk Factors for Morbidity and Mortality in African Americans with CKD

PubMed Central

Lea, Janice; McClellan, William M.

2013-01-01

Summary Background and objectives The African American Study of Kidney Disease Trial identified risk factors for CKD progression and suggested that GFR level may modify the association between these risk factors and CKD progression or death. Design, setting, participants, & measurements Enrollment in the African American Study of Kidney Disease Trial occurred between June of 1995 and September of 2001, with median follow-up of 48.6 months. Among 1094 patients with hypertensive kidney disease in the trial, this study tested whether the association between six previously identified risk factors for CKD progression (or death) and a composite clinical outcome (progression of CKD, ESRD, or death) depends on level of GFR. Multivariate Cox regression was used to control for other baseline risk factors. Results After controlling for baseline risk factors, only proteinuria was more closely associated with the composite clinical outcome at lower levels of GFR (P value for interaction term=0.002); increased hazards of the clinical composite outcome associated with a doubling of proteinuria ranged from 30% (95% confidence interval=21%–39%) with a GFR of 50 to 55% (95% confidence interval=40%–72%) with a GFR of 25. Conclusions The magnitude of the association between proteinuria and CKD progression, ESRD, or death in the African American Study of Kidney Disease Trial cohort depends on the level of GFR; proteinuria is a stronger independent predictor of the composite clinical outcome at lower levels of GFR. This finding reinforces that African Americans with proteinuria and lower GFR represent a population at particularly high risk for adverse outcomes. PMID:23085727

Concerns related to Safety Management of Engineered Nanomaterials in research environment

NASA Astrophysics Data System (ADS)

Groso, A.; Meyer, Th

2013-04-01

Since the rise of occupational safety and health research on nanomaterials a lot of progress has been made in generating health effects and exposure data. However, when detailed quantitative risk analysis is in question, more research is needed, especially quantitative measures of workers exposure and standards to categorize toxicity/hazardousness data. In the absence of dose-response relationships and quantitative exposure measurements, control banding (CB) has been widely adopted by OHS community as a pragmatic tool in implementing a risk management strategy based on a precautionary approach. Being in charge of health and safety in a Swiss university, where nanomaterials are largely used and produced, we are also faced with the challenge related to nanomaterials' occupational safety. In this work, we discuss the field application of an in-house risk management methodology similar to CB as well as some other methodologies. The challenges and issues related to the process will be discussed. Since exact data on nanomaterials hazardousness are missing for most of the situations, we deduce that the outcome of the analysis for a particular process is essentially the same with a simple methodology that determines only exposure potential and the one taking into account the hazardousness of ENPs. It is evident that when reliable data on hazardousness factors (as surface chemistry, solubility, carcinogenicity, toxicity etc.) will be available, more differentiation will be possible in determining the risk for different materials. On the protective measures side, all CB methodologies are inclined to overprotection side, only that some of them suggest comprehensive protective/preventive measures and others remain with basic advices. The implementation and control of protective measures in research environment will also be discussed.

Tulane/Xavier University Hazardous Materials in Aquatic Environments of the Mississippi River Basin. Quarterly progress report, January 1, 1995--March 31, 1995

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

NONE

1995-05-01

This progress report covers activities for the period January 1 - March 31, 1995 on project concerning `Hazardous Materials in Aquatic Environments of the Mississippi River Basin.` The following activities are each summarized by bullets denoting significant experiments/findings: biotic and abiotic studies on the biological fate, transport and ecotoxicity of toxic and hazardous waste in the Mississippi River Basin; assessment of mechanisms of metal-induced reproductive toxicity in quatic species as a biomarker of exposure; hazardous wastes in aquatic environments: biological uptake and metabolism studies; ecological sentinels of aquatic contamination in the lower Mississippi River system; bioremediation of selected contaminants inmore » aquatic environments of the Mississippi River Basin; a sensitive rapid on-sit immunoassay for heavy metal contamination; pore-level flow, transport, agglomeration and reaction kinetics of microorganism; biomarkers of exposure and ecotoxicity in the Mississippi River Basin; natural and active chemical remediation of toxic metals, organics and radionuclides in the aquatic environment; expert geographical information systems for assessing hazardous wastes in aquatic environments; enhancement of environmental education; and a number of just initiated projects including fate and transport of contaminants in aquatic environments; photocatalytic remediation; radionuclide fate and modeling from Chernobyl.« less

78 FR 69604 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-20

... Manufacturing Practice and Hazard Analysis and Risk- Based Preventive Controls for Human Food; Extension of... Hazard Analysis and Risk- Based Preventive Controls for Human Food'' and its information collection... Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for Human Food.'' IV. How To...

Research and Evaluations of the Health Aspects of Disasters, Part IX: Risk-Reduction Framework.

PubMed

Birnbaum, Marvin L; Daily, Elaine K; O'Rourke, Ann P; Loretti, Alessandro

2016-06-01

A disaster is a failure of resilience to an event. Mitigating the risks that a hazard will progress into a destructive event, or increasing the resilience of a society-at-risk, requires careful analysis, planning, and execution. The Disaster Logic Model (DLM) is used to define the value (effects, costs, and outcome(s)), impacts, and benefits of interventions directed at risk reduction. A Risk-Reduction Framework, based on the DLM, details the processes involved in hazard mitigation and/or capacity-building interventions to augment the resilience of a community or to decrease the risk that a secondary event will develop. This Framework provides the structure to systematically undertake and evaluate risk-reduction interventions. It applies to all interventions aimed at hazard mitigation and/or increasing the absorbing, buffering, or response capacities of a community-at-risk for a primary or secondary event that could result in a disaster. The Framework utilizes the structure provided by the DLM and consists of 14 steps: (1) hazards and risks identification; (2) historical perspectives and predictions; (3) selection of hazard(s) to address; (4) selection of appropriate indicators; (5) identification of current resilience standards and benchmarks; (6) assessment of the current resilience status; (7) identification of resilience needs; (8) strategic planning; (9) selection of an appropriate intervention; (10) operational planning; (11) implementation; (12) assessments of outputs; (13) synthesis; and (14) feedback. Each of these steps is a transformation process that is described in detail. Emphasis is placed on the role of Coordination and Control during planning, implementation of risk-reduction/capacity building interventions, and evaluation. Birnbaum ML , Daily EK , O'Rourke AP , Loretti A . Research and evaluations of the health aspects of disasters, part IX: Risk-Reduction Framework. Prehosp Disaster Med. 2016;31(3):309-325.

A framework for profiling the characteristics of risk governance in natural hazard contexts

NASA Astrophysics Data System (ADS)

Walker, G.; Tweed, F.; Whittle, R.

2014-01-01

Over recent decades there have been moves away from traditional forms of government towards broader practices of "governance". These moves are as relevant to the handling of natural hazards as they are to other societal concerns. Key characteristics of such changes include the emergence of multi-level governance processes, shifts away from the exercise of centralised authority towards the involvement and collaboration of a multiplicity of actors, the creation of new forms of authority and control, and changing distributions of responsibilities between the state and other actors. However, the extent to which these shifts have taken place across the varied national contexts in Europe and can be observed specifically in relation to the governance of natural hazards is not at all clear. Such developments may also be evaluated in different ways; where some might see progressive reforms, others might see damaging undermining of established arrangements. In this paper, we propose a risk governance profiling framework that can be used to draw out the key characteristics of the ways in which natural hazards are governed in a particular governance setting. The framework can be flexibly applied in relation to a specific hazard and national, regional or local context, and enables qualitative profiling across a spectrum of eight key governance characteristics. Past trends and likely future changes can also be represented. We discuss the formulation of this framework as well as giving examples of profiles for different hazards in different parts of Europe. We suggest ways in which comparisons can be made between governance profiles, providing a stimulus and focus for debate and discussion around the trends of change in governance practice that have been, and are continuing, to take place.

78 FR 16189 - Transportation of Agricultural Commodities

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-14

... 32934, respectively, of the Moving Ahead for Progress in the 21st Century Act (MAP-21). Although prior statutory exemptions involving agriculture are unchanged, some of these exemptions overlap with MAP-21... HM Hazardous Materials HOS Hours of Service MAP-21 Moving Ahead for Progress in the 21st Century Act...

Notification: EPA Progress on Meeting Resource Conservation and Recovery Act Statutory Mandate for Minimum Frequency of Inspections at Hazardous Waste Disposal Facilities

EPA Pesticide Factsheets

Project #OPE-FY15-0018, January 20, 2015. The EPA OIG plans to begin preliminary research on EPA’s progress in meeting minimum inspection requirements under the RCRA at treatment, storage and disposal facilities (TSDFs).

The Association of Statin Use with Age-Related Macular Degeneration Progression The Age-Related Eye Disease Study 2 Report Number 9

PubMed Central

Al-Holou, Shaza N.; Tucker, William R.; Agrón, Elvira; Clemons, Traci E.; Cukras, Catherine; Ferris, Frederick L.; Chew, Emily Y.

2015-01-01

Objective/purpose To evaluate the association of statin use with progression of age-related macular degeneration (AMD). Design Preplanned, prospective cohort study within a controlled clinical trial of oral supplementation for age-related eye diseases. Subjects Age-Related Eye Disease Study 2 participants, aged 50 to 85 years. Methods Factors, including age, gender, smoking status, aspirin use, and history of diabetes, hypertension, heart disease, angina, and stroke, all known to be associated with statin use, were included in a logistic regression model to estimate propensity scores for each participant. Age-adjusted proportional hazards regression models, with and without propensity score matching, were performed to evaluate the association of statin use with progression to late AMD. Analyses were also performed adjusting for the competing risk of death. Main Outcome Measures Baseline and annual stereoscopic fundus photographs were assessed centrally by masked graders for the development of late AMD, either neovascular AMD or geographic atrophy (GA). Results Of the 3791 participants (2462 with bilateral large drusen and 1329 with unilateral late AMD at baseline), 1659 (43.8%) were statin users. The overall analysis, with no matching of propensity scores and no adjustment for death as a competing risk, showed that statin use was not associated with progression to late AMD (hazard ratios [HR] of 1.08, 95% confidence intervals [CI] of 0.83–1.41, P=0.56). When matched for propensity scores and adjusted for death as a competing risk, the result was not statistically significant with HR: 0.81, 95% CI: 0.55–1.20, P=0.29. Further subgroup analyses of persons with or without late AMD at baseline to the various components of late AMD (neovascular, central geographic atrophy, or any geographic atrophy) also showed no statistically significant association of statin use with progression to AMD. Conclusions Statin use was not statistically significantly associated with the progression to late AMD in the AREDS2 participants, and these findings are consistent with the findings in the majority of previous studies. Statins have been demonstrated to reduce the risks of cardiovascular disease, but our data do not provide evidence of a beneficial effect on slowing AMD progression. PMID:26435335

Heavy Metal Risk Management: Case Analysis

PubMed Central

Kim, Ji Ae; Lee, Seung Ha; Choi, Seung Hyun; Jung, Ki Kyung; Park, Mi Sun; Jeong, Ji Yoon; Hwang, Myung Sil; Yoon, Hae Jung; Choi, Dal Woong

2012-01-01

To prepare measures for practical policy utilization and the control of heavy metals, hazard control related institutions by country, present states of control by country, and present states of control by heavy metals were examined. Hazard control cases by heavy metals in various countries were compared and analyzed. In certain countries (e.g., the U.S., the U.K., and Japan), hazardous substances found in foods (e.g., arsenic, lead, cadmium, and mercury) are controlled. In addition, the Joint FAO/WHO Expert Committee on Food Additives (JECFA) recommends calculating the provisional tolerable weekly intake (PTWI) of individual heavy metals instead of the acceptable daily intake (ADI) to compare their pollution levels considering their toxicity accumulated in the human body. In Korea, exposure assessments have been conducted, and in other countries, hazardous substances are controlled by various governing bodies. As such, in Korea and other countries, diverse food heavy metal monitoring and human body exposure assessments are conducted, and reducing measures are prepared accordingly. To reduce the danger of hazardous substances, many countries provide leaflets and guidelines, develop hazardous heavy metal intake recommendations, and take necessary actions. Hazard control case analyses can assist in securing consumer safety by establishing systematic and reliable hazard control methods. PMID:24278603

78 FR 24691 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

... Manufacturing Practice and Hazard Analysis and Risk- Based Preventive Controls for Human Food; Extension of... Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for Human Food'' that appeared in... Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for Human Food'' with a 120-day...

Association of the HLA-B*52 allele with non-progression to AIDS in Brazilian HIV-1-infected individuals.

PubMed

Teixeira, S L M; de Sá, N B R; Campos, D P; Coelho, A B; Guimarães, M L; Leite, T C N F; Veloso, V G; Morgado, M G

2014-04-01

Several human leukocyte antigen (HLA) class I alleles are associated with the susceptibility to human immunodeficiency virus-1 (HIV-1) infection and/or AIDS progression. Of these, the HLA-B alleles are considered the strongest genetic determinant of disease outcome. We evaluated the influence of the HLA-B alleles on AIDS progression among HIV-1-positive individuals from Rio de Janeiro, Brazil, who were categorized as rapid progressors (RPs), typical progressors (TPs) or long-term non-progressors (LTNPs). In this study, significant differences in HLA-B allele frequencies were observed among the three progression groups for the B*48, B*49 and B*52 alleles. After controlling for other factors associated with AIDS progression, the presence of the B*52 allele was shown to be a significant protective factor (hazard ratio (HR) 0.49 (95% confidence interval (CI) 0.27-0.90) P<0.03). Although no direct association was observed between the presence of the B*27 or B*57 allele and the LTNP profile compared with the TP or RP groups, the adjusted model confirmed that these alleles are protective factors against AIDS progression (HR 0.62 (95% CI 0.38-0.99) P<0.05), as previously described. These data corroborate the existence of significant differences in HLA-B allele frequencies among the distinct AIDS progression profiles and further elucidate the role of HLA alleles in the outcome of HIV infections in diverse populations.

Coffee and tea consumption in relation to prostate cancer prognosis

PubMed Central

Geybels, Milan S.; Neuhouser, Marian L.; Wright, Jonathan L.; Stott-Miller, Marni; Stanford, Janet L.

2013-01-01

Background Bioactive compounds found in coffee and tea may delay the progression of prostate cancer. Methods We investigated associations of pre-diagnostic coffee and tea consumption with risk of prostate cancer recurrence/progression. Study participants were men diagnosed with prostate cancer in 2002–2005 in King County, Washington, USA. We assessed the usual pattern of coffee and tea consumption two years before diagnosis date. Prostate cancer outcome events were identified using a detailed follow-up survey. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results The analysis of coffee intake in relation to prostate cancer recurrence/progression included 630 patients with a median follow-up of 6.4 years, during which 140 prostate cancer recurrence/progression events were recorded. Approximately 61% of patients consumed at least one cup of coffee per day. Coffee consumption was associated with a reduced risk of prostate cancer recurrence/progression; the adjusted HR for ≥4 cups/day versus ≤1 cup/week was 0.41 (95% CI: 0.20, 0.81; P for trend = 0.01). Approximately 14% of patients consumed one or more cups of tea per day, and tea consumption was unrelated to prostate cancer recurrence/progression. Conclusion Results indicate that pre-diagnostic coffee consumption is associated with a lower risk of prostate cancer recurrence/progression. This finding will require replication in larger studies. PMID:23907772

Progression rate from new-onset pre-hypertension to hypertension in Korean adults.

PubMed

Kim, Soo Jeong; Lee, Jakyoung; Nam, Chung Mo; Jee, Sun Ha; Park, Il Soo; Lee, Kyung Jong; Lee, Soon Young

2011-01-01

There are limited studies conducted in Asia to investigate the progression rate to hypertension (HTN). This study was done to estimate the progression rate of new-onset pre-HTN (PreHTN) to HTN during an 8-year follow-up period, and to compare the impact of PreHTN on progression to HTN. A total of 49,228 participants, aged 30 to 54 years with new-onset PreHTN at baseline (1994-1996) from a biennial national medical exam were enrolled and followed up every 2 years until 2004. The incidence rate recorded at each interval and the cumulative incidence rate of HTN were analyzed. Hazard ratio of high-normal and high blood pressure (BP) in men and women was calculated. The cumulative incidence rate for high-normal BP was 27.6% and 26.4% at 2-year follow-up, increased to respectively 64.1% and 55.8% in men and women at the 8-year follow-up. Compared to optimal BP, hazard ratios for men with high-normal BP across all age groups were 3- to 4-fold higher at 2-year, and 2- to 3-fold higher at 8-year follow-up. Hazard ratios for women were about 6-fold higher at 2-year and around 4-fold higher at 8-year follow-up. New PreHTN was a significant predisposing factor for future HTN, in young adults and the effect is more prominent in women.

Prolonged Effect of Intensive Therapy on the Risk of Retinopathy Complications in Patients With Type 1 Diabetes Mellitus

PubMed Central

2009-01-01

Objective To examine the persistence of the original treatment effects 10 years after the Diabetes Control and Complications Trial (DCCT) in the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study. In the DCCT, intensive therapy aimed at near-normal glycemia reduced the risk of microvascular complications of type 1 diabetes mellitus compared with conventional therapy. Methods Retinopathy was evaluated by fundus photography in 1211 subjects at EDIC year 10. Further 3-step progression on the Early Treatment Diabetic Retinopathy Study scale from DCCT closeout was the primary outcome. Results After 10 years of EDIC follow-up, there was no significant difference in mean glycated hemoglobin levels (8.07% vs 7.98%) between the original treatment groups. Nevertheless, compared with the former conventional treatment group, the former intensive group had significantly lower incidences from DCCT close of further retinopathy progression and proliferative retinopathy or worse (hazard reductions, 53%-56%; P<.001). The risk (hazard) reductions at 10 years of EDIC were attenuated compared with the 70% to 71% over the first 4 years of EDIC (P<.001). The persistent beneficial effects of former intensive therapy were largely explained by the difference in glycated hemoglobin levels during DCCT. Conclusion The persistent difference in diabetic retinopathy between former intensive and conventional therapy (“metabolic memory”) continues for at least 10 years but may be waning. PMID:19064853

Advancing Health and Environmental Disease Tracking: A 5-Year Follow-Up Study

PubMed Central

Litt, Jill S.; Wismann, Andrea; Resnick, Beth; Dawson, Rebecca Smullin; Hano, Mary; Burke, Thomas A.

2007-01-01

Objectives. Our goal was to gain an understanding of the extent to which environmental public health tracking (EPHT) has progressed since the release of the 2000 Pew Environmental Health Commission report examining the nation’s EPHT infrastructure. Methods. As a follow-up to the Pew Commission report, we conducted a telephone survey of state practitioners in an effort to assess EPHT trends and changes in state-level capacities and activities over the past several years. Results. We found that new and enhanced federal–state partnerships; improved surveillance, data analysis, and communication capacities; and enhanced support of tracking personnel have provided a foundation for progress in the area of EPHT. Also, the Centers for Disease Control and Prevention’s support of EPHT has strengthened the national environmental public health infrastructure and capacity to track environmental hazards, exposures, and health. Conclusions. Improved funding, data access, and translation of data to prevention activities are critical to sustaining progress in EPHT and developing the evidence base necessary for assessing the longer-term impacts and efficacy of EPHT and related environmental health improvements. PMID:17267714

Environmental hazards assessment program. Annual report, July 1, 1994--June 30, 1995

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

NONE

1995-07-31

This report describes activities and reports on progress for the third year of the DOE grant to support the Environmental Hazards Assessment Program (EHAP). It reports progress against grant objectives and the Program Implementation Plan published at the end of the first year of the grant. As the program has evolved, more projects have been funded and many existing projects have become more complex. Thus, to accomplish better the objectives over the years and retain a solid focus on the total mission, we have reorganized the grant effort from three to five majoe elements: Public and professional outreach; Clinical programs;more » Science programs; Information systems; and, Program management.« less

Variable impact on mortality of AIDS-defining events diagnosed during combination antiretroviral therapy: not all AIDS-defining conditions are created equal.

PubMed

Mocroft, Amanda; Sterne, Jonathan A C; Egger, Matthias; May, Margaret; Grabar, Sophie; Furrer, Hansjakob; Sabin, Caroline; Fatkenheuer, Gerd; Justice, Amy; Reiss, Peter; d'Arminio Monforte, Antonella; Gill, John; Hogg, Robert; Bonnet, Fabrice; Kitahata, Mari; Staszewski, Schlomo; Casabona, Jordi; Harris, Ross; Saag, Michael

2009-04-15

The extent to which mortality differs following individual acquired immunodeficiency syndrome (AIDS)-defining events (ADEs) has not been assessed among patients initiating combination antiretroviral therapy. We analyzed data from 31,620 patients with no prior ADEs who started combination antiretroviral therapy. Cox proportional hazards models were used to estimate mortality hazard ratios for each ADE that occurred in >50 patients, after stratification by cohort and adjustment for sex, HIV transmission group, number of antiretroviral drugs initiated, regimen, age, date of starting combination antiretroviral therapy, and CD4+ cell count and HIV RNA load at initiation of combination antiretroviral therapy. ADEs that occurred in <50 patients were grouped together to form a "rare ADEs" category. During a median follow-up period of 43 months (interquartile range, 19-70 months), 2880 ADEs were diagnosed in 2262 patients; 1146 patients died. The most common ADEs were esophageal candidiasis (in 360 patients), Pneumocystis jiroveci pneumonia (320 patients), and Kaposi sarcoma (308 patients). The greatest mortality hazard ratio was associated with non-Hodgkin's lymphoma (hazard ratio, 17.59; 95% confidence interval, 13.84-22.35) and progressive multifocal leukoencephalopathy (hazard ratio, 10.0; 95% confidence interval, 6.70-14.92). Three groups of ADEs were identified on the basis of the ranked hazard ratios with bootstrapped confidence intervals: severe (non-Hodgkin's lymphoma and progressive multifocal leukoencephalopathy [hazard ratio, 7.26; 95% confidence interval, 5.55-9.48]), moderate (cryptococcosis, cerebral toxoplasmosis, AIDS dementia complex, disseminated Mycobacterium avium complex, and rare ADEs [hazard ratio, 2.35; 95% confidence interval, 1.76-3.13]), and mild (all other ADEs [hazard ratio, 1.47; 95% confidence interval, 1.08-2.00]). In the combination antiretroviral therapy era, mortality rates subsequent to an ADE depend on the specific diagnosis. The proposed classification of ADEs may be useful in clinical end point trials, prognostic studies, and patient management.

Bedtime misalignment and progression of breast cancer.

PubMed

Hahm, Bong-Jin; Jo, Booil; Dhabhar, Firdaus S; Palesh, Oxana; Aldridge-Gerry, Arianna; Bajestan, Sepideh N; Neri, Eric; Nouriani, Bita; Spiegel, David; Zeitzer, Jamie M

2014-03-01

Disruption of circadian rhythms, which frequently occurs during night shift work, may be associated with cancer progression. The effect of chronotype (preference for behaviors such as sleep, work, or exercise to occur at particular times of day, with an associated difference in circadian physiology) and alignment of bedtime (preferred vs. habitual), however, have not yet been studied in the context of cancer progression in women with breast cancer. Chronotype and alignment of actual bedtime with preferred chronotype were examined using the Morningness-Eveningness Scale (MEQ) and sleep-wake log among 85 women with metastatic breast cancer. Their association with disease-free interval (DFI) was retrospectively examined using the Cox proportional hazards model. Median DFI was 81.9 months for women with aligned bedtimes ("going to bed at preferred bedtime") (n = 72), and 46.9 months for women with misaligned bedtimes ("going to bed later or earlier than the preferred bedtime") (n = 13) (log rank p = 0.001). In a multivariate Cox proportional hazard model, after controlling for other significant predictors of DFI, including chronotype (morning type/longer DFI; HR = 0.539, 95% CI = 0.320-0.906, p = 0.021), estrogen receptor (ER) status at initial diagnosis (negative/shorter DFI; HR = 2.169, 95% CI = 1.124-4.187, p = 0.028) and level of natural-killer cell count (lower levels/shorter DFI; HR = 1.641, 95% CI = 1.000-2.695, p = 0.050), misaligned bedtimes was associated with shorter DFI, compared to aligned bedtimes (HR = 3.180, 95% CI = 1.327-7.616, p = 0.018). Our data indicate that a misalignment of bedtime on a daily basis, an indication of circadian disruption, is associated with more rapid breast cancer progression as measured by DFI. Considering the limitations of small sample size and study design, a prospective study with a larger sample is necessary to explore their causal relationship and underlying mechanisms.

The influence of background diabetic retinopathy in the second eye on rates of progression of diabetic retinopathy between 2005 and 2010.

PubMed

Scanlon, Peter H; Stratton, Irene M; Histed, Mark; Chave, Steve J; Aldington, Stephen J

2013-08-01

The Gloucestershire Diabetic Eye Screening Programme offers annual digital photographic screening for diabetic retinopathy to a countywide population of people with diabetes. This study was designed to investigate progression of diabetic retinopathy in this programme of the English NHS Diabetic Eye Screening Programme. Mydriatic digital retinal photographs of people with diabetes screened on at least 2 occasions between 2005 and 2010 were graded and included in this study if the classification at first screening was no DR (R0), background DR in one (R1a) or both eyes (R1b). Times to detection of referable diabetic retinopathy (RDR) comprising maculopathy (M1), preproliferative (R2) or proliferative retinopathy (R3) were analysed using survival models. Data were available on 19 044 patients, 56% men, age at screening 66 (57-74) years (median, 25th, 75th centile). A total of 8.3% of those with R1a and 28.2% of those with R1b progressed to any RDR, hazard ratios 2.9 [2.5-3.3] and 11.3 [10.0-12.8]. Similarly 7.1% and 0.11% of those with R1a progressed to M1 and R3, hazard ratios 2.7 [2.3-3.2] and 1.6 [0.5-5.0], compared to 21.8% and 1.07% of those with R1b, hazard ratio 9.1 [7.8-10.4] and 15.0 [7.1-31.5]. The risk of progression is significantly higher for those with background DR in both eyes than those with background retinopathy in only one or in neither eye. © 2013 The Authors Acta Ophthalmologica © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by Blackwell Publishing Ltd.

Randomized, Double-Blind, Placebo-Controlled Phase III Trial of Apatinib in Patients With Chemotherapy-Refractory Advanced or Metastatic Adenocarcinoma of the Stomach or Gastroesophageal Junction.

PubMed

Li, Jin; Qin, Shukui; Xu, Jianming; Xiong, Jianping; Wu, Changping; Bai, Yuxian; Liu, Wei; Tong, Jiandong; Liu, Yunpeng; Xu, Ruihua; Wang, Zhehai; Wang, Qiong; Ouyang, Xuenong; Yang, Yan; Ba, Yi; Liang, Jun; Lin, Xiaoyan; Luo, Deyun; Zheng, Rongsheng; Wang, Xin; Sun, Guoping; Wang, Liwei; Zheng, Leizhen; Guo, Hong; Wu, Jingbo; Xu, Nong; Yang, Jianwei; Zhang, Honggang; Cheng, Ying; Wang, Ningju; Chen, Lei; Fan, Zhining; Sun, Piaoyang; Yu, Hao

2016-05-01

There is currently no standard treatment strategy for patients with advanced metastatic gastric cancer experiencing progression after two or more lines of chemotherapy. We assessed the efficacy and safety of apatinib, a novel vascular endothelial growth factor receptor 2 tyrosine kinase inhibitor, in patients with advanced gastric or gastroesophageal junction adenocarcinoma for whom at least two lines of prior chemotherapy had failed. This was a randomized, double-blind, placebo-controlled phase III trial. Patients from 32 centers in China with advanced gastric or gastroesophageal junction adenocarcinoma, for whom two or more prior lines of chemotherapy had failed, were enrolled. Patients were randomly assigned to oral apatinib 850 mg or placebo once daily. The primary end points were overall (OS) and progression-free survival (PFS). Between January 2011 and November 2012, 267 patients were enrolled. Median OS was significantly improved in the apatinib group compared with the placebo group (6.5 months; 95% CI, 4.8 to 7.6 v 4.7 months; 95% CI, 3.6 to 5.4; P = .0149; hazard ratio, 0.709; 95% CI, 0.537 to 0.937; P = .0156). Similarly, apatinib significantly prolonged median PFS compared with placebo (2.6 months; 95% CI, 2.0 to 2.9 v 1.8 months; 95% CI, 1.4 to 1.9; P < .001; hazard ratio, 0.444; 95% CI, 0.331 to 0.595; P < .001). The most common grade 3 to 4 nonhematologic adverse events were hand-foot syndrome, proteinuria, and hypertension. These data show that apatinib treatment significantly improved OS and PFS with an acceptable safety profile in patients with advanced gastric cancer refractory to two or more lines of prior chemotherapy. © 2016 by American Society of Clinical Oncology.

Sildenafil citrate as a medical expulsive therapy for distal ureteric stones: A randomised double-blind placebo-controlled study.

PubMed

Shokeir, Ahmed A; Tharwat, Mohamed A; Abolazm, Ahmed Elhussein; Harraz, Ahmed

2016-03-01

To study the effect of sildenafil citrate on spontaneous passage of distal ureteric stones (DUS). This was a randomised double-blinded placebo-controlled study of 100 patients with DUS. Inclusion criteria were: male, age 18-65 years, normal renal function, and a single radiopaque unilateral DUS of 5-10 mm. Patients were randomly allocated into two equal groups, one that received placebo and the other that received 50 mg sildenafil citrate once daily. Both investigators and patients were masked to the type of treatment. Patients self-administered the medication until spontaneous passage of the DUS. In patients where there was uncontrolled pain, fever, an increase in serum creatinine of >1.8 mg/dL, progressive hydronephrosis or no further progress after 4 weeks, a decision was taken for further treatment. In all, 47 and 49 patients were available for analysis in both the placebo and sildenafil citrate groups; respectively. Both groups were comparable for age and stone characteristics. Spontaneous expulsion occurred in 19 of 47 patients (40.4%) in the placebo group and in 33 of 49 (67.3%) in the sildenafil citrate group (P = 0.014). The mean time to stone expulsion was significantly shorter in the sildenafil citrate group (P < 0.001). A multivariable Cox proportional hazards model showed that receiving sildenafil citrate was the only independent factor that had a significant impact on stone passage with a hazard ratio of 2.7 (95% confidence interval 1.5-4.8; P < 0.001). Sildenafil citrate enhances spontaneous passage of 5-10 mm DUS.

The international workshop on wave hindcasting and forecasting and the coastal hazards symposium

NASA Astrophysics Data System (ADS)

Breivik, Øyvind; Swail, Val; Babanin, Alexander V.; Horsburgh, Kevin

2015-05-01

Following the 13th International Workshop on Wave Hindcasting and Forecasting and 4th Coastal Hazards Symposium in October 2013 in Banff, Canada, a topical collection has appeared in recent issues of Ocean Dynamics. Here, we give a brief overview of the history of the conference since its inception in 1986 and of the progress made in the fields of wind-generated ocean waves and the modelling of coastal hazards before we summarize the main results of the papers that have appeared in the topical collection.

Enzalutamide in Japanese patients with chemotherapy-naïve, metastatic castration-resistant prostate cancer: A post-hoc analysis of the placebo-controlled PREVAIL trial.

PubMed

Kimura, Go; Yonese, Junji; Fukagai, Takashi; Kamba, Tomomi; Nishimura, Kazuo; Nozawa, Masahiro; Mansbach, Hank; Theeuwes, Ad; Beer, Tomasz M; Tombal, Bertrand; Ueda, Takeshi

2016-05-01

To evaluate the treatment effects, safety and pharmacokinetics of enzalutamide in Japanese patients. This was a post-hoc analysis of the phase 3, double-blind, placebo-controlled PREVAIL trial. Asymptomatic or mildly symptomatic chemotherapy-naïve patients with metastatic castration-resistant prostate cancer progressing on androgen deprivation therapy were randomized one-to-one to 160 mg/day oral enzalutamide or placebo until discontinuation on radiographic progression or skeletal-related event and initiation of subsequent antineoplastic therapy. Coprimary end-points were centrally assessed radiographic progression-free survival and overall survival. Secondary end-points were investigator-assessed radiographic progression-free survival, time to initiation of chemotherapy, time to prostate-specific antigen progression, prostate-specific antigen response (≥50% decline) and time to skeletal-related event. Of 1717 patients, 61 were enrolled in Japan (enzalutamide, n = 28; placebo, n = 33); hazard ratios (95% confidence interval) of 0.30 for centrally assessed radiographic progression-free survival (0.03-2.95), 0.59 for overall survival (0.20-1.8), 0.46 for time to chemotherapy (0.22-0.96) and 0.36 for time to prostate-specific antigen progression (0.17-0.75) showed the treatment benefit of enzalutamide over the placebo. Prostate-specific antigen responses were observed in 60.7% of enzalutamide-treated men versus 21.2% of placebo-treated men. Plasma concentrations of enzalutamide were higher in Japanese patients: the geometric mean ratio of Japanese/non-Japanese patients was 1.126 (90% confidence interval 1.018-1.245) at 13 weeks. Treatment-related adverse events grade ≥3 occurred in 3.6% of enzalutamide- and 6.1% of placebo-treated Japanese patients. Treatment effects and safety in Japanese patients were generally consistent with the overall results from PREVAIL. © 2016 The Authors. International Journal of Urology published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Urological Association.

The Forum of the International HCH and Pesticides Association--a platform for international cooperation.

PubMed

Vijgen, John; Aliyeva, Gulchohra; Weber, Roland

2013-04-01

The unsustainable life cycle management of pesticides in the last 60 years has created large pesticide stockpiles. The two major working areas of the International HCH and Pesticide Association (IHPA; www.ihpa.info ) address a part of these legacies and are shortly introduced here: (1) The assessment and support of the management of the worlds single largest POPs stockpile: the globally dumped 4 to 7 million tonnes hexachlorocyclohexane (HCH) wastes from lindane production, and (2) the support for the management of the obsolete pesticides legacy in Eastern Europe, the Caucasus and Central Asia (EECCA) countries of ~240,000 t, leaving these pesticides in unregulated storages without adequate safety control being a huge risk to the environment and human health. The integrative approach IHPA takes-promoting international cooperation and the exchange of knowledge and experiences-is shortly explained. IHPA has developed various supporting tools for its work: the IHPA web page and newsletter informing on the threats and challenges, but also on the progresses of managing pesticide stockpiles; the joint GIZ-PAN-IHPA exhibition on awareness of the pesticide stockpile challenge; and the 'International HCH and Pesticides Forum' as most important tool to progress the integrative work and mission of IHPA. Finally, a summary of the 11th International HCH and Pesticides Forum held in Gabala, Azerbaijan is given which brought together more than 120 scientists, policy-makers, non-governmental and international organisations, industry and students from more than 40 countries to progress the obsolete pesticides and hazardous chemical waste challenge in EECCA countries. The event finished with adoption of 'Gabala Declaration', which aims to mobilise efforts of all stakeholders for prevention and elimination of POPs, obsolete pesticides, and hazardous chemical waste in the region.

Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin’s lymphoma: a systematic review

PubMed Central

Herbst, Christine; Rehan, Fareed A.; Brillant, Corinne; Bohlius, Julia; Skoetz, Nicole; Schulz, Holger; Monsef, Ina; Specht, Lena; Engert, Andreas

2010-01-01

Combined modality treatment (CMT) of chemotherapy followed by localized radiotherapy is standard treatment for patients with early stage Hodgkin’s lymphoma. However, the role of radiotherapy has been questioned recently and some clinical study groups advocate chemotherapy only for this indication. We thus performed a systematic review with meta-analysis of randomized controlled trials comparing chemotherapy alone with CMT in patients with early stage Hodgkin’s lymphoma with respect to response rate, tumor control and overall survival (OS). We searched Medline, EMBASE and the Cochrane Library as well as conference proceedings from January 1980 to February 2009 for randomized controlled trials comparing chemotherapy alone versus the same chemotherapy regimen plus radiotherapy. Progression free survival and similar outcomes were analyzed together as tumor control. Effect measures used were hazard ratios for OS and tumor control as well as relative risks for complete response (CR). Meta-analyses were performed using RevMan5. Five randomized controlled trials involving 1,245 patients were included. The hazard ratio (HR) was 0.41 (95% confidence interval (CI) 0.25 to 0.66) for tumor control and 0.40 (95% CI 0.27 to 0.59) for OS for patients receiving CMT compared to chemotherapy alone. CR rates were similar between treatment groups. In sensitivity analyses another 6 trials were included that did not fulfill the inclusion criteria of our protocol but were considered relevant to the topic. These trials underlined the results of the main analysis. In conclusion, adding radiotherapy to chemotherapy improves tumor control and OS in patients with early stage Hodgkin’s lymphoma. PMID:19951972

Robots, systems, and methods for hazard evaluation and visualization

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

Nielsen, Curtis W.; Bruemmer, David J.; Walton, Miles C.

A robot includes a hazard sensor, a locomotor, and a system controller. The robot senses a hazard intensity at a location of the robot, moves to a new location in response to the hazard intensity, and autonomously repeats the sensing and moving to determine multiple hazard levels at multiple locations. The robot may also include a communicator to communicate the multiple hazard levels to a remote controller. The remote controller includes a communicator for sending user commands to the robot and receiving the hazard levels from the robot. A graphical user interface displays an environment map of the environment proximatemore » the robot and a scale for indicating a hazard intensity. A hazard indicator corresponds to a robot position in the environment map and graphically indicates the hazard intensity at the robot position relative to the scale.« less

Radiation Effects and Protection for Moon and Mars Missions

NASA Technical Reports Server (NTRS)

Parnell, Thomas A.; Watts, John W., Jr.; Armstrong, Tony W.

1998-01-01

Manned and robotic missions to the Earth's moon and Mars are exposed to a continuous flux of Galactic Cosmic Rays (GCR) and occasional, but intense, fluxes of Solar Energetic Particles (SEP). These natural radiations impose hazards to manned exploration, but also present some constraints to the design of robotic missions. The hazards to interplanetary flight crews and their uncertainties have been studied recently by a National Research Council Committee (Space Studies Board 1996). Considering the present uncertainty estimates, thick spacecraft shielding would be needed for manned missions, some of which could be accomplished with onboard equipment and expendables. For manned and robotic missions, the effects of radiation on electronics, sensors, and controls require special consideration in spacecraft design. This paper describes the GCR and SEP particle fluxes, secondary particles behind shielding, uncertainties in radiobiological effects and their impact on manned spacecraft design, as well as the major effects on spacecraft equipment. The principal calculational tools and considerations to mitigate the radiation effects are discussed, and work in progress to reduce uncertainties is included.

Investigation of injury/illness data at a nuclear facility. Part II

DOE PAGES

Cournoyer, Michael E.; Garcia, Vincent E.; Sandoval, Arnold N.; ...

2015-07-01

At Los Alamos National Laboratory (LANL), there are several nuclear facilities, accelerator facilities, radiological facilities, explosives sites, moderate- and high-hazard non-nuclear facilities, biosciences laboratory, etc. The Plutonium Science and Manufacturing Directorate (ADPSM) provides special nuclear material research, process development, technology demonstration, and manufacturing capabilities. ADPSM manages the LANL Plutonium Facility. Within the Radiological Control Area at TA-55 (PF-4), chemical and metallurgical operations with plutonium and other hazardous materials are performed. LANL Health and Safety Programs investigate injury and illness data. In this study, statistically significant trends have been identified and compared for LANL, ADPSM, and PF-4 injury/illness cases. A previouslymore » described output metric is used to measures LANL management progress towards meeting its operational safety objectives and goals. Timelines are used to determine trends in Injury/Illness types. Pareto Charts are used to prioritize causal factors. The data generated from analysis of Injury/Illness data have helped identify and reduce the number of corresponding causal factors.« less

Volcanic hazards on the Island of Hawaii

USGS Publications Warehouse

Mullineaux, Donal Ray; Peterson, Donald W.

1974-01-01

Volcanic hazards on the Island of Hawaii have been determined to be chiefly products of eruptions: lava flows, falling fragments, gases, and particle-and-gas clouds. Falling fragments and particle-and-gas clouds can be substantial hazards to life, but they are relatively rare. Lava flows are the chief hazard to property; they are frequent and cover broad areas. Rupture, subsidence, earthquakes, and sea waves (tsunamis) caused by eruptions are minor hazards; those same events caused by large-scale crustal movements, however, are major hazards to both life and property. Volcanic hazards are greatest on Mauna Loa and Kilauea, and the risk is highest along the rift zones of those volcanoes. The hazards are progressively less severe on Hualalai, Mauna Kea, and Kohala volcanoes. Some risk from earthquakes extends across the entire island, and the risk from tsunamis is high all along the coast. The island has been divided into geographic zones of different relative risk for each volcanic hazard, and for all those hazards combined. Each zone is assigned a relative risk for that area as a whole; the degree of risk varies within the zones, however, and in some of them the risk decreases gradationally across the entire zone. Moreover, the risk in one zone may be locally as great or greater than that at some points in the zone of next higher overall risk. Nevertheless, the zones can be highly useful for land-use planning. Planning decisions to which the report is particularly applicable include the selection of kinds of structures and kinds of land use that are appropriate for the severity and types of hazards present. For example, construction of buildings that can resist a lava flow is generally not feasible, but it is both feasible and desirable to build structures that can resist falling rock fragments, earthquakes, and tsunamis in areas where risk from those hazards is relatively high. The report can also be used to select sites where overall risk is relatively low, to identify sites where either overall risk or risk from some specific hazard is relatively high, and to identify areas in which there is a threat to lives as well as to property. The report further can serve as a basis for warning persons about hazards in areas most likely to be affected by volcanic eruptions. Perhaps most important, however, the report provides basic information needed for zoning to control future land use.

Estrogen receptor (α and β) but not androgen receptor expression is correlated with recurrence, progression and survival in post prostatectomy T3N0M0 locally advanced prostate cancer in an urban Greek population

PubMed Central

Megas, Georgios; Chrisofos, Michael; Anastasiou, Ioannis; Tsitlidou, Aida; Choreftaki, Theodosia; Deliveliotis, Charalampos

2015-01-01

The objective of this study was to evaluate the expression of estrogen receptors (ER(α) and ER(β)) and androgen receptors (ARs) as prognostic factors for biochemical recurrence, disease progression and survival in patients with pT3N0M0 prostate cancer (PCa) in an urban Greek population. A total of 100 consecutive patients with pT3N0M0 PCa treated with radical prostatectomy participated in the study. The mean age and follow-up were 64.2 and 6 years, respectively. The HSCORE was used for semi-quantitative analysis of the immunoreactivity of the receptors. The prognostic value of the ER(α) and ER(β) and AR was assessed in terms of recurrence, progression, and survival. AR expression was not associated with any of the above parameters; however, both ERs correlated with the prognosis. A univariate Cox regression analysis showed that ER(α) positive staining was significantly associated with a greater hazard for all outcomes. Increased ER(β) staining was significantly associated with a lower hazard for all outcomes in the univariate analysis. When both ER HSCORES were used for the analysis, it was found that patients with high ER(α) or low ER(β) HSCORES compared with patients with negatively stained ER(α) and >1.7 hSCORE ER(β) had 6.03, 10.93, and 10.53 times greater hazard for biochemical disease recurrence, progression of disease and death, respectively. Multiple Cox proportional hazard analyses showed that the age, preoperative prostate specific antigen, Gleason score and ERs were independent predictors of all outcomes. ER expression is an important prognosticator after radical prostatectomy in patients with pT3N0M0 PCa. By contrast, AR expression has limited prognostic value. PMID:25219910

Estrogen receptor (α and β) but not androgen receptor expression is correlated with recurrence, progression and survival in post prostatectomy T3N0M0 locally advanced prostate cancer in an urban Greek population.

PubMed

Megas, Georgios; Chrisofos, Michael; Anastasiou, Ioannis; Tsitlidou, Aida; Choreftaki, Theodosia; Deliveliotis, Charalampos

2015-01-01

The objective of this study was to evaluate the expression of estrogen receptors (ER(α) and ER(β)) and androgen receptors (ARs) as prognostic factors for biochemical recurrence, disease progression and survival in patients with pT3N0M0 prostate cancer (PCa) in an urban Greek population. A total of 100 consecutive patients with pT3N0M0 PCa treated with radical prostatectomy participated in the study. The mean age and follow-up were 64.2 and 6 years, respectively. The HSCORE was used for semi-quantitative analysis of the immunoreactivity of the receptors. The prognostic value of the ER(α) and ER(β) and AR was assessed in terms of recurrence, progression, and survival. AR expression was not associated with any of the above parameters; however, both ERs correlated with the prognosis. A univariate Cox regression analysis showed that ER(α) positive staining was significantly associated with a greater hazard for all outcomes. Increased ER(β) staining was significantly associated with a lower hazard for all outcomes in the univariate analysis. When both ER HSCORES were used for the analysis, it was found that patients with high ER(α) or low ER(β) HSCORES compared with patients with negatively stained ER(α) and >1.7 hSCORE ER(β) had 6.03, 10.93, and 10.53 times greater hazard for biochemical disease recurrence, progression of disease and death, respectively. Multiple Cox proportional hazard analyses showed that the age, preoperative prostate specific antigen, Gleason score and ERs were independent predictors of all outcomes. ER expression is an important prognosticator after radical prostatectomy in patients with pT3N0M0 PCa. By contrast, AR expression has limited prognostic value.

76 FR 45592 - Delegation of Authority for the Office of Healthy Homes and Lead Hazard Control

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-29

... the Office of Healthy Homes and Lead Hazard Control AGENCY: Office of the Secretary, HUD. ACTION... of 1992, the Office of Healthy Homes and Lead Hazard Control (OHHLHC) is authorized to develop, demonstrate, and promote measures to correct lead-based paint-related health and safety hazards in the home...

76 FR 56362 - National Oil and Hazardous Substances Pollution Contingency Plan National Priorities List

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-13

... and Hazardous Substances Pollution Contingency Plan National Priorities List AGENCY: Environmental... protection, Air pollution control, Chemicals, Hazardous Waste, Hazardous substances, Intergovernmental relations, Penalties, Reporting and recordkeeping requirements, Superfund, Water pollution control, Water...

76 FR 42055 - National Oil and Hazardous Substances Pollution Contingency Plan; National Priorities List

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-18

... protection, Air pollution control, Chemicals, Hazardous Waste, Hazardous substances, Intergovernmental relations, Penalties, Reporting and recordkeeping requirements, Superfund, Water pollution control, Water... and Hazardous Substances Pollution Contingency Plan; National Priorities List AGENCY: Environmental...

21 CFR 120.8 - Hazard Analysis and Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

...: (i) Critical control points designed to control food hazards that are reasonably likely to occur and could be introduced inside the processing plant environment; and (ii) Critical control points designed... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Hazard Analysis and Critical Control Point (HACCP...

21 CFR 120.8 - Hazard Analysis and Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2012 CFR

2012-04-01

...: (i) Critical control points designed to control food hazards that are reasonably likely to occur and could be introduced inside the processing plant environment; and (ii) Critical control points designed... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Hazard Analysis and Critical Control Point (HACCP...

21 CFR 120.8 - Hazard Analysis and Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2013 CFR

2013-04-01

...: (i) Critical control points designed to control food hazards that are reasonably likely to occur and could be introduced inside the processing plant environment; and (ii) Critical control points designed... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Hazard Analysis and Critical Control Point (HACCP...

21 CFR 120.8 - Hazard Analysis and Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2014 CFR

2014-04-01

...: (i) Critical control points designed to control food hazards that are reasonably likely to occur and could be introduced inside the processing plant environment; and (ii) Critical control points designed... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Hazard Analysis and Critical Control Point (HACCP...

21 CFR 120.8 - Hazard Analysis and Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

...: (i) Critical control points designed to control food hazards that are reasonably likely to occur and could be introduced inside the processing plant environment; and (ii) Critical control points designed... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Hazard Analysis and Critical Control Point (HACCP...

24 CFR 35.1330 - Interim controls.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Interim controls. 35.1330 Section... Lead-Paint Hazard Evaluation and Hazard Reduction Activities § 35.1330 Interim controls. Interim controls of lead-based paint hazards identified in a risk assessment shall be conducted in accordance with...

76 FR 56294 - National Oil and Hazardous Substances Pollution Contingency Plan National Priorities List

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-13

... and Hazardous Substances Pollution Contingency Plan National Priorities List AGENCY: Environmental... pollution control, Chemicals, Hazardous Waste, Hazardous substances, Intergovernmental relations, Penalties, Reporting and recordkeeping requirements, Superfund, Water pollution control, Water supply. Authority: 33 U...

Next-Generation Sequencing-Based Detection of Circulating Tumour DNA After Allogeneic Stem Cell Transplantation for Lymphoma

PubMed Central

Herrera, Alex F.; Kim, Haesook T.; Kong, Katherine A.; Faham, Malek; Sun, Heather; Sohani, Aliyah R.; Alyea, Edwin P.; Carlton, Victoria E.; Chen, Yi-Bin; Cutler, Corey S.; Ho, Vincent T.; Koreth, John; Kotwaliwale, Chitra; Nikiforow, Sarah; Ritz, Jerome; Rodig, Scott J.; Soiffer, Robert J.; Antin, Joseph H.; Armand, Philippe

2016-01-01

Summary Next-generation sequencing (NGS)-based circulating tumour DNA (ctDNA) detection is a promising monitoring tool for lymphoid malignancies. We evaluated whether the presence of ctDNA was associated with outcome after allogeneic haematopoietic stem cell transplantation (HSCT) in lymphoma patients. We studied 88 patients drawn from a phase 3 clinical trial of reduced-intensity conditioning HSCT in lymphoma. Conventional restaging and collection of peripheral blood samples occurred at pre-specified time points before and after HSCT and were assayed for ctDNA by sequencing of the immunoglobulin or T-cell receptor genes. Tumour clonotypes were identified in 87% of patients with adequate tumour samples. Sixteen of 19 (84%) patients with disease progression after HSCT had detectable ctDNA prior to progression at a median of 3.7 months prior to relapse/progression. Patients with detectable ctDNA 3 months after HSCT had inferior progression-free survival (PFS) (2-year PFS 58% versus 84% in ctDNA-negative patients, p=0.033). In multivariate models, detectable ctDNA was associated with increased risk of progression/death (Hazard ratio 3.9, p=0.003) and increased risk of relapse/progression (Hazard ratio 10.8, p=0.0006). Detectable ctDNA is associated with an increased risk of relapse/progression, but further validation studies are necessary to confirm these findings and determine the clinical utility of NGS-based minimal residual disease monitoring in lymphoma patients after HSCT. PMID:27711974

Handbook on Bird Management and Control.

DTIC Science & Technology

1980-03-01

strike hazard ...................... 70 FIGURE 10. Sample application of sharp projections ........ 80 FIGURE 11. Plans for a low profile pigeon trap...particularly with Domestic Pigeons , Starlings, and House Sparrows, can reduce most of the hazards mentioned in this chapter. 4.2. HEALTH HAZARDS 4.2.1...damage, pest bird control, hazardous bird control, bird biology t behavior, altering the concept, altering the situation, exclusion, repulsion, removal

Low-Risk Lifestyle, Coronary Calcium, Cardiovascular Events, and Mortality: Results From MESA

PubMed Central

Ahmed, Haitham M.; Blaha, Michael J.; Nasir, Khurram; Jones, Steven R.; Rivera, Juan J.; Agatston, Arthur; Blankstein, Ron; Wong, Nathan D.; Lakoski, Susan; Budoff, Matthew J.; Burke, Gregory L.; Sibley, Christopher T.; Ouyang, Pamela; Blumenthal, Roger S.

2013-01-01

Unhealthy lifestyle habits are a major contributor to coronary artery disease. The purpose of the present study was to investigate the associations of smoking, weight maintenance, physical activity, and diet with coronary calcium, cardiovascular events, and mortality. US participants who were 44–84 years of age (n = 6,229) were followed in the Multi-Ethnic Study of Atherosclerosis from 2000 to 2010. A lifestyle score ranging from 0 to 4 was created using diet, exercise, body mass index, and smoking status. Coronary calcium was measured at baseline and a mean of 3.1 (standard deviation, 1.3) years later to assess calcium progression. Participants who experienced coronary events or died were followed for a median of 7.6 (standard deviation, 1.5) years. Participants with lifestyle scores of 1, 2, 3, and 4 were found to have mean adjusted annual calcium progressions that were 3.5 (95% confidence interval (CI): 0.0, 7.0), 4.2 (95% CI: 0.6, 7.9), 6.8 (95% CI: 2.0, 11.5), and 11.1 (95% CI: 2.2, 20.1) points per year slower, respectively, relative to the reference group (P = 0.003). Unadjusted hazard ratios for death by lifestyle score were as follows: for a score of 1, the hazard ratio was 0.79 (95% CI: 0.61, 1.03); for a score of 2, the hazard ratio was 0.61 (95% CI: 0.46, 0.81); for a score of 3, the hazard ratio was 0.49 (95% CI: 0.32, 0.75); and for a score of 4, the hazard ratio was 0.19 (95% CI: 0.05, 0.75) (P < 0.001 by log-rank test). In conclusion, a combination of regular exercise, healthy diet, smoking avoidance, and weight maintenance was associated with lower coronary calcium incidence, slower calcium progression, and lower all-cause mortality over 7.6 years. PMID:23733562

75 FR 14361 - Notification, Documentation, and Recordkeeping Requirements for Inspected Establishments

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-25

... establishment's process control plans, that is, its Hazard Analysis and Critical Control Point plans. DATES... control plans, i.e., its Hazard Analysis and Critical Control Point (HACCP) plans; and (3) make the recall... systematic prevention of biological, chemical, and physical hazards. HACCP plans are establishment-developed...

75 FR 58423 - Notice of Funding Availability for HUD's Fiscal Year (FY) 2010 Lead-Based Paint Hazard Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

... Availability for HUD's Fiscal Year (FY) 2010 Lead-Based Paint Hazard Control Grant Program and Lead Hazard Reduction Demonstration Grant Program; Technical Correction AGENCY: Office of Healthy Homes and Lead Hazard...://www.Grants.gov its Notice of Funding Availability (NOFA) for HUD's FY2010 Lead-Based Paint Hazard...

Exploring eye movements in patients with glaucoma when viewing a driving scene.

PubMed

Crabb, David P; Smith, Nicholas D; Rauscher, Franziska G; Chisholm, Catharine M; Barbur, John L; Edgar, David F; Garway-Heath, David F

2010-03-16

Glaucoma is a progressive eye disease and a leading cause of visual disability. Automated assessment of the visual field determines the different stages in the disease process: it would be desirable to link these measurements taken in the clinic with patient's actual function, or establish if patients compensate for their restricted field of view when performing everyday tasks. Hence, this study investigated eye movements in glaucomatous patients when viewing driving scenes in a hazard perception test (HPT). The HPT is a component of the UK driving licence test consisting of a series of short film clips of various traffic scenes viewed from the driver's perspective each containing hazardous situations that require the camera car to change direction or slow down. Data from nine glaucomatous patients with binocular visual field defects and ten age-matched control subjects were considered (all experienced drivers). Each subject viewed 26 different films with eye movements simultaneously monitored by an eye tracker. Computer software was purpose written to pre-process the data, co-register it to the film clips and to quantify eye movements and point-of-regard (using a dynamic bivariate contour ellipse analysis). On average, and across all HPT films, patients exhibited different eye movement characteristics to controls making, for example, significantly more saccades (P<0.001; 95% confidence interval for mean increase: 9.2 to 22.4%). Whilst the average region of 'point-of-regard' of the patients did not differ significantly from the controls, there were revealing cases where patients failed to see a hazard in relation to their binocular visual field defect. Characteristics of eye movement patterns in patients with bilateral glaucoma can differ significantly from age-matched controls when viewing a traffic scene. Further studies of eye movements made by glaucomatous patients could provide useful information about the definition of the visual field component required for fitness to drive.

Exploring Eye Movements in Patients with Glaucoma When Viewing a Driving Scene

PubMed Central

Crabb, David P.; Smith, Nicholas D.; Rauscher, Franziska G.; Chisholm, Catharine M.; Barbur, John L.; Edgar, David F.; Garway-Heath, David F.

2010-01-01

Background Glaucoma is a progressive eye disease and a leading cause of visual disability. Automated assessment of the visual field determines the different stages in the disease process: it would be desirable to link these measurements taken in the clinic with patient's actual function, or establish if patients compensate for their restricted field of view when performing everyday tasks. Hence, this study investigated eye movements in glaucomatous patients when viewing driving scenes in a hazard perception test (HPT). Methodology/Principal Findings The HPT is a component of the UK driving licence test consisting of a series of short film clips of various traffic scenes viewed from the driver's perspective each containing hazardous situations that require the camera car to change direction or slow down. Data from nine glaucomatous patients with binocular visual field defects and ten age-matched control subjects were considered (all experienced drivers). Each subject viewed 26 different films with eye movements simultaneously monitored by an eye tracker. Computer software was purpose written to pre-process the data, co-register it to the film clips and to quantify eye movements and point-of-regard (using a dynamic bivariate contour ellipse analysis). On average, and across all HPT films, patients exhibited different eye movement characteristics to controls making, for example, significantly more saccades (P<0.001; 95% confidence interval for mean increase: 9.2 to 22.4%). Whilst the average region of ‘point-of-regard’ of the patients did not differ significantly from the controls, there were revealing cases where patients failed to see a hazard in relation to their binocular visual field defect. Conclusions/Significance Characteristics of eye movement patterns in patients with bilateral glaucoma can differ significantly from age-matched controls when viewing a traffic scene. Further studies of eye movements made by glaucomatous patients could provide useful information about the definition of the visual field component required for fitness to drive. PMID:20300522

The identification and classification of skin irritation hazard by a human patch test.

PubMed

Basketter, D A; Whittle, E; Griffiths, H A; York, M

1994-08-01

There exist various regulatory instruments the purpose of which is to ensure that the intrinsic toxic hazards associated with substances and preparations are identified. In the context of identification of skin irritation potential, the method is normally the Draize test. Guidance notes provided by the OECD and the EEC expect that corrosive substances will have been screened out by a variety of methods. Substances or preparations which cause a sufficient degree of skin irritation will be classified as skin irritants. The primary motivation behind the present work was to introduce the concept that it is possible to assess the hazard potential of a substance or preparation to produce skin irritation in a human study. In the example presented here, 20% sodium lauryl sulfate (SLS) has been chosen as the positive control. With the protocol currently devised, occluded patch treatment with 20% SLS for up to 4 hr produces an irritant response in just over half of the panel. An irritant response is taken as a clinically evident and significant increase in erythema, oedema or dryness--a minimum of a+ reaction on the ICDRG scale. At such a level of response with the positive control (both in terms of intensity and in proportion of the panel), it is then possible to judge and/or to determine statistically, whether the test material has produced a level of skin irritation which is similar to, greater, or lower than the positive control. In this way a human patch test protocol can form a fundamental component of a strategy for the replacement of animals in determination of skin irritation and corrosion potential. By use of a careful and progressive protocol and by comparison of test data against a positive control it is both possible and practical to classify substances and preparations in terms of their skin irritation potential using that endpoint in the species of concern, man.

Hazard banding in compliance with the new Globally Harmonised System (GHS) for use in control banding tools.

PubMed

Arnone, Mario; Koppisch, Dorothea; Smola, Thomas; Gabriel, Stefan; Verbist, Koen; Visser, Remco

2015-10-01

Many control banding tools use hazard banding in risk assessments for the occupational handling of hazardous substances. The outcome of these assessments can be combined with advice for the required risk management measures (RMMs). The Globally Harmonised System of Classification and Labelling of Chemicals (GHS) has resulted in a change in the hazard communication elements, i.e. Hazard (H) statements instead of Risk-phrases. Hazard banding schemes that depend on the old form of safety information have to be adapted to the new rules. The purpose of this publication is to outline the rationales for the assignment of hazard bands to H statements under the GHS. Based on this, this publication proposes a hazard banding scheme that uses the information from the safety data sheets as the basis for assignment. The assignment of hazard bands tiered according to the severity of the underlying hazards supports the important principle of substitution. Additionally, the set of assignment rules permits an exposure-route-specific assignment of hazard bands, which is necessary for the proposed route-specific RMMs. Ideally, all control banding tools should apply the same assignment rules. This GHS-compliant hazard banding scheme can hopefully help to establish a unified hazard banding strategy in the various control banding tools. Copyright © 2015 Elsevier Inc. All rights reserved.

Stereotactic radiosurgery of World Health Organization grade II and III intracranial meningiomas: treatment results on the basis of a 22-year experience.

PubMed

Pollock, Bruce E; Stafford, Scott L; Link, Michael J; Garces, Yolanda I; Foote, Robert L

2012-02-15

A study was undertaken to define the variables associated with tumor control and survival after single-session stereotactic radiosurgery (SRS) for patients with atypical and malignant intracranial meningiomas. Fifty patients with World Health Organization (WHO) grade II (n = 37) or grade III (n = 13) meningiomas underwent SRS from 1990 to 2008. Most tumors were located in the falx/parasagittal region or cerebral convexities (n = 35, 70%). Twenty patients (40%) had progressing tumors despite prior external beam radiation therapy (EBRT) (median dose, 54.0 grays [Gy]). The median treatment volume was 14.6 cm(3) ; the median tumor margin dose was 15.0 Gy. Seven patients (14%) received concurrent EBRT (median dose, 50.4 Gy). Follow-up (median, 38 months) was censored at last evaluation (n = 28) or death (n = 22). Tumor grade correlated with disease-specific survival (DSS) (hazard ratio [HR], 3.4; P = .008), local tumor control (HR, 2.4; P = .02), and progression-free survival (PFS) (HR, 2.6; P = .02) on univariate analysis, but not on multivariate analysis. Multivariate analysis showed that having failed EBRT and tumor volume >14.6 cm(3) were negative predictors of DSS and local control (HR, 3.0; P = .02 and HR, 4.4; P = .01; HR, 3.3; P = .001 and HR, 2.3; P = .02;, respectively). Having failed EBRT was a negative predictor of PFS (HR, 3.5; P = .002). Thirteen patients (26%) had radiation-related complications at a median of 6 months after radiosurgery. Tumor progression despite prior EBRT and larger tumor volume are negative predictors of tumor control and survival for patients having SRS for WHO grade II and III intracranial meningiomas. Copyright © 2011 American Cancer Society.

An evaluation of HIV elite controller definitions within a large seroconverter cohort collaboration.

PubMed

Olson, Ashley D; Meyer, Laurence; Prins, Maria; Thiebaut, Rodolphe; Gurdasani, Deepti; Guiguet, Marguerite; Chaix, Marie-Laure; Amornkul, Pauli; Babiker, Abdel; Sandhu, Manjinder S; Porter, Kholoud

2014-01-01

Understanding the mechanisms underlying viral control is highly relevant to vaccine studies and elite control (EC) of HIV infection. Although numerous definitions of EC exist, it is not clear which, if any, best identify this rare phenotype. We assessed a number of EC definitions used in the literature using CASCADE data of 25,692 HIV seroconverters. We estimated proportions maintaining EC of total ART-naïve follow-up time, and disease progression, comparing to non-EC. We also examined HIV-RNA and CD4 values and CD4 slope during EC and beyond (while ART naïve). Most definitions classify ∼ 1% as ECs with median HIV-RNA 43-903 copies/ml and median CD4>500 cells/mm(3). Beyond EC status, median HIV-RNA levels remained low, although often detectable, and CD4 values high but with strong evidence of decline for all definitions. Median % ART-naïve time as EC was ≥ 92% although overlap between definitions was low. EC definitions with consecutive HIV-RNA measurements <75 copies/ml with follow-up ≥ six months, or with 90% of measurements <400 copies/ml over ≥ 10 year follow-up preformed best overall. Individuals thus defined were less likely to progress to endpoint (hazard ratios ranged from 12.5-19.0 for non-ECs compared to ECs). ECs are rare, less likely to progress to clinical disease, but may eventually lose control. We suggest definitions requiring individuals to have consecutive undetectable HIV-RNA measurements for ≥ six months or otherwise with >90% of measurements <400 copies/ml over ≥ 10 years be used to define this phenotype.

Controlling organic chemical hazards in food manufacturing: a hazard analysis critical control points (HACCP) approach.

PubMed

Ropkins, K; Beck, A J

2002-08-01

Hazard analysis by critical control points (HACCP) is a systematic approach to the identification, assessment and control of hazards. Effective HACCP requires the consideration of all hazards, i.e., chemical, microbiological and physical. However, to-date most 'in-place' HACCP procedures have tended to focus on the control of microbiological and physical food hazards. In general, the chemical component of HACCP procedures is either ignored or limited to applied chemicals, e.g., food additives and pesticides. In this paper we discuss the application of HACCP to a broader range of chemical hazards, using organic chemical contaminants as examples, and the problems that are likely to arise in the food manufacturing sector. Chemical HACCP procedures are likely to result in many of the advantages previously identified for microbiological HACCP procedures: more effective, efficient and economical than conventional end-point-testing methods. However, the high costs of analytical monitoring of chemical contaminants and a limited understanding of formulation and process optimisation as means of controlling chemical contamination of foods are likely to prevent chemical HACCP becoming as effective as microbiological HACCP.

Hazards to Early Development: The Biological Embedding of Early Life Adversity.

PubMed

Nelson, Charles A

2017-10-11

The number of children under 18 years of age has increased worldwide over the past decade. This growth spurt is due, in part, to remarkable progress in child survival. Alas, surviving early hazards, like prematurity or infectious disease, does not guarantee that children's development will not be compromised by other hazards as they grow older. Throughout the world, children continue to be confronted with a large number of biological and psychosocial challenges that greatly limit their developmental potential. The focus of this article is how such adverse experiences impact the developing brain. Copyright © 2017 Elsevier Inc. All rights reserved.

(Hydrogeology of hazardous waste, Sede Boker Campus, Ben-Gurion University, Israel)

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

Stow, S.H.

1990-03-29

This trip report describes progress made by the International Commission on the Hydrogeology of Hazardous Waste in preparing a document on hydrogeologic and environmental issues associated with siting of hazardous waste disposal facilities. This document follows the successful completion of a commission report on siting of facilities for subsurface disposal of liquid wastes. Also contained in this trip report are descriptions of water and waste management activities throughout the southern part of Israel. Water availability and the need to protect the country's limited water supplies from contamination resulting from waste disposal are issues of paramount importance to Israel.

21 CFR 123.6 - Hazard analysis and Hazard Analysis Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Hazard analysis and Hazard Analysis Critical Control Point (HACCP) plan. 123.6 Section 123.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... processor shall have and implement a written HACCP plan whenever a hazard analysis reveals one or more food...

21 CFR 123.6 - Hazard analysis and Hazard Analysis Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Hazard analysis and Hazard Analysis Critical Control Point (HACCP) plan. 123.6 Section 123.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... processor shall have and implement a written HACCP plan whenever a hazard analysis reveals one or more food...

78 FR 11611 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-19

... Manufacturing Practice and Hazard Analysis and Risk- Based Preventive Controls for Human Food; Extension of... Analysis and Risk-Based Preventive Controls for Human Food.'' FOR FURTHER INFORMATION CONTACT: Domini Bean... Practice and Hazard Analysis and Risk-Based Preventive Controls for Human Food'' with a 120-day comment...

Hazard Analysis for Pneumatic Flipper Suitport/Z-1 Manned Evaluation, Chamber B, Building 32. Revision: Basic

NASA Technical Reports Server (NTRS)

2012-01-01

One of the characteristics of an effective safety program is the recognition and control of hazards before mishaps or failures occur. Conducting potentially hazardous tests necessitates a thorough hazard analysis in order to protect our personnel from injury and our equipment from damage. The purpose of this hazard analysis is to define and address the potential hazards and controls associated with the Z1 Suit Port Test in Chamber B located in building 32, and to provide the applicable team of personnel with the documented results. It is imperative that each member of the team be familiar with the hazards and controls associated with his/her particular tasks, assignments, and activities while interfacing with facility test systems, equipment, and hardware. The goal of this hazard analysis is to identify all hazards that have the potential to harm personnel and/or damage facility equipment, flight hardware, property, or harm the environment. This analysis may also assess the significance and risk, when applicable, of lost test objectives when substantial monetary value is involved. The hazards, causes, controls, verifications, and risk assessment codes have been documented on the hazard analysis work sheets in appendix A of this document. The preparation and development of this report is in accordance with JPR 1700.1, JSC Safety and Health Handbook.

The NHLBI LAM Registry: Prognostic physiological and radiological biomarkers emerge from a 15-year prospective longitudinal analysis.

PubMed

Gupta, Nishant; Lee, Hye-Seung; Ryu, Jay H; Taveira-DaSilva, Angelo M; Beck, Gerald J; Lee, Jar-Chi; McCarthy, Kevin; Finlay, Geraldine A; Brown, Kevin K; Ruoss, Stephen J; Avila, Nilo A; Moss, Joel; McCormack, Francis X

2018-06-22

The natural history of lymphangioleiomyomatosis is mainly derived from retrospective cohort analyses and remains incompletely understood. A National Institutes of Health LAM Registry was established to define the natural history and identify prognostic biomarkers that can help guide management and decision-making in patients with LAM. A linear mixed effects model was employed to compute the rate of decline of FEV1, and identify variables impacting FEV1 decline among 217 registry patients who enrolled from 1998-2001. Prognostic variables associated with progression to death/lung transplantation were identified using a Cox proportional hazard model. Mean annual decline of FEV1 was 89±53 ml/year, and remained remarkably constant regardless of baseline lung function. FEV1 decline was more rapid in those with greater cyst profusion on CT scan (p=0.02), and in premenopausal subjects (118ml/year) compared to postmenopausal subjects (74ml/year), (p=0.003). There were 26 deaths and 43 lung transplants during the evaluation period. Estimated 5-, 10-, 15-, and 20-year transplant-free survival rates were 95%, 85%, 75%, and 64%, respectively. Postmenopausal status (hazard ratio 0.30, p=0.0002) and higher baseline FEV1 (hazard ratio 0.97, p=0.008) or DLCO (hazard ratio 0.97, p=0.001) were independently associated with a lower risk of progression to death or lung transplantation. The median transplant-free survival in patients with LAM is greater than 20 years. Menopausal status as well as structural and physiological markers of disease severity significantly affect the rate of decline of FEV1 and progression to death or lung transplantation in LAM. Copyright © 2018. Published by Elsevier Inc.

Hazard Analysis for Building 34 Vacuum Glove Box Assembly

NASA Technical Reports Server (NTRS)

Meginnis, Ian

2014-01-01

One of the characteristics of an effective safety program is the recognition and control of hazards before mishaps or failures occur. Conducting potentially hazardous tests necessitates a thorough hazard analysis in order to prevent injury to personnel, and to prevent damage to facilities and equipment. The primary purpose of this hazard analysis is to define and address the potential hazards and controls associated with the Building 34 Vacuum Glove Box Assembly, and to provide the applicable team of personnel with the documented results. It is imperative that each member of the team be familiar with the hazards and controls associated with his/her particular tasks, assignments and activities while interfacing with facility test systems, equipment and hardware. In fulfillment of the stated purposes, the goal of this hazard analysis is to identify all hazards that have the potential to harm personnel, damage the facility or its test systems or equipment, test articles, Government or personal property, or the environment. This analysis may also assess the significance and risk, when applicable, of lost test objectives when substantial monetary value is involved. The hazards, causes, controls, verifications, and risk assessment codes have been documented on the hazard analysis work sheets in Appendix A of this document. The preparation and development of this report is in accordance with JPR 1700.1, "JSC Safety and Health Handbook" and JSC 17773 Rev D "Instructions for Preparation of Hazard Analysis for JSC Ground Operations".

Comparing counselling models for the hazardous use of alcohol at the Swedish National Alcohol Helpline: study protocol for a randomised controlled trial.

PubMed

Säfsten, Eleonor; Forsell, Yvonne; Ramstedt, Mats; Galanti, Maria Rosaria

2017-06-06

Hazardous and harmful consumption of alcohol is a leading cause of preventable disease and premature deaths. Modifying the amount and pattern of risky alcohol consumption conveys substantial benefits to individuals and to society at large. Telephone helplines provide a feasible alternative to face-to-face counselling in order to increase the reach of brief interventions aiming at modifying the hazardous and harmful use of alcohol. However, there is a lack of studies on the implementation and evaluation of population-based telephone services for the prevention and treatment of alcohol misuse. A randomised controlled trial was designed to compare a brief, structured intervention to usual care within the Swedish National Alcohol Helpline (SAH), concerning their effectiveness on decreasing the hazardous use of alcohol. Between May 2015 and December 2017, about 300 callers are to be individually randomised with a 1:1 ratio to a brief, structured intervention (n = 150) or to usual care (n = 150). The brief, structured intervention consists of the delivery of a self-help booklet followed by one proactive call from SAH counsellors to monitor and give feedback about the client's progression. Callers assigned to usual care receive telephone counselling according to existing practice, i.e., motivational interviewing in a tailored and client-driven combination of proactive and reactive calls. The primary outcome is defined as a change from a higher to a lower AUDIT risk-level category between baseline and follow-up. General linear modeling will be used to calculate risk ratios of the outcome events. The primary analysis will follow an intention-to-treat (ITT) approach. The trial is designed to evaluate the effectiveness in decreasing the hazardous and harmful consumption of alcohol of a brief, structured intervention compared to usual care when delivered at the SAH. The results of the study will be used locally to improve the effectiveness of the service provided at the SAH. Additionally, they will expand the evidence base about optimal counselling models in population-based telephone services for alcohol misuse prevention and treatment. ISRCNT.com, ID: ISRCTN13160878 . Retrospectively registered on 18 January 2016.

Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma.

PubMed

Mok, Tony S; Wu, Yi-Long; Thongprasert, Sumitra; Yang, Chih-Hsin; Chu, Da-Tong; Saijo, Nagahiro; Sunpaweravong, Patrapim; Han, Baohui; Margono, Benjamin; Ichinose, Yukito; Nishiwaki, Yutaka; Ohe, Yuichiro; Yang, Jin-Ji; Chewaskulyong, Busyamas; Jiang, Haiyi; Duffield, Emma L; Watkins, Claire L; Armour, Alison A; Fukuoka, Masahiro

2009-09-03

Previous, uncontrolled studies have suggested that first-line treatment with gefitinib would be efficacious in selected patients with non-small-cell lung cancer. In this phase 3, open-label study, we randomly assigned previously untreated patients in East Asia who had advanced pulmonary adenocarcinoma and who were nonsmokers or former light smokers to receive gefitinib (250 mg per day) (609 patients) or carboplatin (at a dose calculated to produce an area under the curve of 5 or 6 mg per milliliter per minute) plus paclitaxel (200 mg per square meter of body-surface area) (608 patients). The primary end point was progression-free survival. The 12-month rates of progression-free survival were 24.9% with gefitinib and 6.7% with carboplatin-paclitaxel. The study met its primary objective of showing the noninferiority of gefitinib and also showed its superiority, as compared with carboplatin-paclitaxel, with respect to progression-free survival in the intention-to-treat population (hazard ratio for progression or death, 0.74; 95% confidence interval [CI], 0.65 to 0.85; P<0.001). In the subgroup of 261 patients who were positive for the epidermal growth factor receptor gene (EGFR) mutation, progression-free survival was significantly longer among those who received gefitinib than among those who received carboplatin-paclitaxel (hazard ratio for progression or death, 0.48; 95% CI, 0.36 to 0.64; P<0.001), whereas in the subgroup of 176 patients who were negative for the mutation, progression-free survival was significantly longer among those who received carboplatin-paclitaxel (hazard ratio for progression or death with gefitinib, 2.85; 95% CI, 2.05 to 3.98; P<0.001). The most common adverse events were rash or acne (in 66.2% of patients) and diarrhea (46.6%) in the gefitinib group and neurotoxic effects (69.9%), neutropenia (67.1%), and alopecia (58.4%) in the carboplatin-paclitaxel group. Gefitinib is superior to carboplatin-paclitaxel as an initial treatment for pulmonary adenocarcinoma among nonsmokers or former light smokers in East Asia. The presence in the tumor of a mutation of the EGFR gene is a strong predictor of a better outcome with gefitinib. (ClinicalTrials.gov number, NCT00322452.) 2009 Massachusetts Medical Society

Evaluating hazardous air pollutants in Australia.

PubMed

Hinwood, A L; Di Marco, P N

2002-12-27

Hazardous air pollutants (HAPS) have been evaluated for their health and environmental significance on a targeted and campaign basis in Australia until recently. Individual States and Territories have been undertaking targeted monitoring studies and have numerous control strategies aimed at controlling HAPS emissions with the focus largely on volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs) and selected heavy metals, with some limited work on exposure assessment. There has been little evaluation of the potential health or environmental effects of the monitored concentrations of these substances and few toxicological or epidemiological studies have been conducted-none in the community setting in Australia. Moreover, there has not been an agreed method for assessing risks from HAPS in ambient air, with different jurisdictions utilising different international benchmarks. Recently, the National Environmental Health (EnHealth) Council commenced developing a risk assessment methodology, which is being used in the development of ambient air quality guidelines for selected HAPS in Western Australia. In 1999, the Commonwealth Government established the Living Cities-Toxics Program, designed to assess the state of knowledge on HAPS in Australia with the aims of identifying and prioritising HAPS, identifying information gaps and informing the development of national air quality standards and national management strategies. The Commonwealth Government commenced a number of projects in 2000 to progress these aims.

The demands and benefits of ergonomics in Sri Lankan apparel industry: A case study at MAS holdings.

PubMed

Abeysekera, John; Illankoon, Prasanna

2016-10-17

Apparel exports bring in sizeable foreign income to Sri Lanka. To protect and promote this industry is a paramount need. This can be carried out by applying Human Factors/Ergonomics (HFE) which has proved to control negative effects at work places. This paper reports a case study which describes the demands and benefits of HFE in MAS Holdings which owns a large share of the apparel industry in Sri Lanka. The study consisted of walk through observation survey, a questionnaire survey and ergonomic work place analysis followed by a training programme to selected employees in three companies. Positive responses to questionnaires revealed good ergonomic practices in the work places surveyed. Ergonomically unfit chairs and potential hazards e.g. exposure to noise and hot environment were detected. It is seen that MAS have introduced strategies originated by Toyota Production System viz. 5S, Kaizen, six sigma etc., which are in fact ergonomic methods. A progressive project MAS boast of viz. 'MAS Operating System' (MOS) empowers training and development to employees. MAS Holdings has adequately realized the benefits of applying HFE as evident by the number of awards received. Relevant companies were advised to take appropriate corrective measures to control the potential hazards.

Pregnancy and HIV Disease Progression in an Early Infection Cohort from Five African Countries.

PubMed

Wall, Kristin M; Rida, Wasima; Haddad, Lisa B; Kamali, Anatoli; Karita, Etienne; Lakhi, Shabir; Kilembe, William; Allen, Susan; Inambao, Mubiana; Yang, Annie H; Latka, Mary H; Anzala, Omu; Sanders, Eduard J; Bekker, Linda-Gail; Edward, Vinodh A; Price, Matt A

2017-03-01

Understanding associations between pregnancy and HIV disease progression is critical to provide appropriate counseling and care to HIV-positive women. From 2006 to 2011, women less than age 40 with incident HIV infection were enrolled in an early HIV infection cohort in Kenya, Rwanda, South Africa, Uganda, and Zambia. Time-dependent Cox models evaluated associations between pregnancy and HIV disease progression. Clinical progression was defined as a single CD4 measurement <200 cells/μl, percent CD4 <14%, or category C event, with censoring at antiretroviral (ART) initiation for reasons other than prevention of mother-to-child transmission (PMTCT). Immunologic progression was defined as two consecutive CD4s ≤350 cells/μl or a single CD4 ≤350 cells/μl followed by non-PMTCT ART initiation. Generalized estimating equations assessed changes in CD4 before and after pregnancy. Among 222 women, 63 experienced clinical progression during 783.5 person-years at risk (8.0/100). Among 205 women, 87 experienced immunologic progression during 680.1 person-years at risk (12.8/100). The association between pregnancy and clinical progression was adjusted hazard ratio [aHR] = 0.7; 95% confidence interval (CI): 0.2, 1.8. The association between pregnancy and immunologic progression was aHR = 1.7; 95% CI: 0.9, 3.3. Models controlled for age; human leukocyte antigen alleles A*03:01, B*45, B*57; CD4 set point; and HIV-1 subtype. CD4 measurements before versus after pregnancies were not different. In this cohort, pregnancy was not associated with increased clinical or immunologic HIV progression. Similarly, we did not observe meaningful deleterious associations of pregnancy with CD4s. Our findings suggest that HIV-positive women may become pregnant without harmful health effects occurring during the pregnancy. Evaluation of longer-term impact of pregnancy on progression is warranted.

Pregnancy and HIV Disease Progression in an Early Infection Cohort from Five African Countries

PubMed Central

Rida, Wasima; Haddad, Lisa B.; Kamali, Anatoli; Karita, Etienne; Lakhi, Shabir; Kilembe, William; Allen, Susan; Inambao, Mubiana; Yang, Annie H.; Latka, Mary H.; Anzala, Omu; Sanders, Eduard J.; Bekker, Linda-Gail; Edward, Vinodh A.; Price, Matt A.

2017-01-01

Background: Understanding associations between pregnancy and HIV disease progression is critical to provide appropriate counseling and care to HIV-positive women. Methods: From 2006 to 2011, women less than age 40 with incident HIV infection were enrolled in an early HIV infection cohort in Kenya, Rwanda, South Africa, Uganda, and Zambia. Time-dependent Cox models evaluated associations between pregnancy and HIV disease progression. Clinical progression was defined as a single CD4 measurement <200 cells/μl, percent CD4 <14%, or category C event, with censoring at antiretroviral (ART) initiation for reasons other than prevention of mother-to-child transmission (PMTCT). Immunologic progression was defined as two consecutive CD4s ≤350 cells/μl or a single CD4 ≤350 cells/μl followed by non-PMTCT ART initiation. Generalized estimating equations assessed changes in CD4 before and after pregnancy. Results: Among 222 women, 63 experienced clinical progression during 783.5 person-years at risk (8.0/100). Among 205 women, 87 experienced immunologic progression during 680.1 person-years at risk (12.8/100). The association between pregnancy and clinical progression was adjusted hazard ratio [aHR] = 0.7; 95% confidence interval (CI): 0.2, 1.8. The association between pregnancy and immunologic progression was aHR = 1.7; 95% CI: 0.9, 3.3. Models controlled for age; human leukocyte antigen alleles A*03:01, B*45, B*57; CD4 set point; and HIV-1 subtype. CD4 measurements before versus after pregnancies were not different. Conclusions: In this cohort, pregnancy was not associated with increased clinical or immunologic HIV progression. Similarly, we did not observe meaningful deleterious associations of pregnancy with CD4s. Our findings suggest that HIV-positive women may become pregnant without harmful health effects occurring during the pregnancy. Evaluation of longer-term impact of pregnancy on progression is warranted. PMID:27893488

Childhood Lead Poisoning: Conservative Estimates of the Social and Economic Benefits of Lead Hazard Control

PubMed Central

Gould, Elise

2009-01-01

Background This study is a cost–benefit analysis that quantifies the social and economic benefits to household lead paint hazard control compared with the investments needed to minimize exposure to these hazards. Objectives This research updates estimates of elevated blood lead levels among a cohort of children ≤ 6 years of age and compiles recent research to determine a range of the costs of lead paint hazard control ($1–$11 billion) and the benefits of reduction attributed to each cohort for health care ($11–$53 billion), lifetime earnings ($165–$233 billion), tax revenue ($25–$35 billion), special education ($30–$146 million), attention deficit–hyperactivity disorder ($267 million), and the direct costs of crime ($1.7 billion). Results Each dollar invested in lead paint hazard control results in a return of $17–$221 or a net savings of $181–269 billion. Conclusions There are substantial returns to investing in lead hazard control, particularly targeted at early intervention in communities most likely at risk. Given the high societal costs of inaction, lead hazard control appears to be well worth the price. PMID:19654928

Reduced volatile organic compound (VOC) ammunition coatings. Progress report, October 1994-September 1995

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

Duncan, J.L.

1996-05-01

Production requirements and film thickness limitations typically require that ammunition coating systems consist of a single film. This single film must provide the corrosion resistance of a primer plus such properties as color, gloss, and solvent resistance that are required of a topcoat, a compromise at best. Federal and local regulations resulting from the Clean Air Act and its amendments restrict the amount of VOC emitted during the application of protective coatings, and regulations on worker safety restrict exposure to hazardous materials such as chromates. These materials also generate hazardous wastes and the associated high disposal costs. This report summarizesmore » progress in developing ammunition coatings that perform as well as or better than current systems, but at reduced VOC levels with chromate-free pigmentation.« less

14 CFR 417.409 - System hazard controls.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., or system must account for static and dynamic loads, environmental stresses, and expected wear; (3... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false System hazard controls. 417.409 Section 417... OF TRANSPORTATION LICENSING LAUNCH SAFETY Ground Safety § 417.409 System hazard controls. (a) General...

A hazard control system for robot manipulators

NASA Technical Reports Server (NTRS)

Carter, Ruth Chiang; Rad, Adrian

1991-01-01

A robot for space applications will be required to complete a variety of tasks in an uncertain, harsh environment. This fact presents unusual and highly difficult challenges to ensuring the safety of astronauts and keeping the equipment they depend on from becoming damaged. The systematic approach being taken to control hazards that could result from introducing robotics technology in the space environment is described. First, system safety management and engineering principles, techniques, and requirements are discussed as they relate to Shuttle payload design and operation in general. The concepts of hazard, hazard category, and hazard control, as defined by the Shuttle payload safety requirements, is explained. Next, it is shown how these general safety management and engineering principles are being implemented on an actual project. An example is presented of a hazard control system for controlling one of the hazards identified for the Development Test Flight (DTF-1) of NASA's Flight Telerobotic Servicer, a teleoperated space robot. How these schemes can be applied to terrestrial robots is discussed as well. The same software monitoring and control approach will insure the safe operation of a slave manipulator under teleoperated or autonomous control in undersea, nuclear, or manufacturing applications where the manipulator is working in the vicinity of humans or critical hardware.

Risk Assessment Using the Three Dimensions of Probability (Likelihood), Severity, and Level of Control

NASA Technical Reports Server (NTRS)

Watson, Clifford

2010-01-01

Traditional hazard analysis techniques utilize a two-dimensional representation of the results determined by relative likelihood and severity of the residual risk. These matrices present a quick-look at the Likelihood (Y-axis) and Severity (X-axis) of the probable outcome of a hazardous event. A three-dimensional method, described herein, utilizes the traditional X and Y axes, while adding a new, third dimension, shown as the Z-axis, and referred to as the Level of Control. The elements of the Z-axis are modifications of the Hazard Elimination and Control steps (also known as the Hazard Reduction Precedence Sequence). These steps are: 1. Eliminate risk through design. 2. Substitute less risky materials for more hazardous materials. 3. Install safety devices. 4. Install caution and warning devices. 5. Develop administrative controls (to include special procedures and training.) 6. Provide protective clothing and equipment. When added to the twodimensional models, the level of control adds a visual representation of the risk associated with the hazardous condition, creating a tall-pole for the least-well-controlled failure while establishing the relative likelihood and severity of all causes and effects for an identified hazard. Computer modeling of the analytical results, using spreadsheets and threedimensional charting gives a visual confirmation of the relationship between causes and their controls

Risk Assessment Using the Three Dimensions of Probability (Likelihood), Severity, and Level of Control

NASA Technical Reports Server (NTRS)

Watson, Clifford C.

2011-01-01

Traditional hazard analysis techniques utilize a two-dimensional representation of the results determined by relative likelihood and severity of the residual risk. These matrices present a quick-look at the Likelihood (Y-axis) and Severity (X-axis) of the probable outcome of a hazardous event. A three-dimensional method, described herein, utilizes the traditional X and Y axes, while adding a new, third dimension, shown as the Z-axis, and referred to as the Level of Control. The elements of the Z-axis are modifications of the Hazard Elimination and Control steps (also known as the Hazard Reduction Precedence Sequence). These steps are: 1. Eliminate risk through design. 2. Substitute less risky materials for more hazardous materials. 3. Install safety devices. 4. Install caution and warning devices. 5. Develop administrative controls (to include special procedures and training.) 6. Provide protective clothing and equipment. When added to the two-dimensional models, the level of control adds a visual representation of the risk associated with the hazardous condition, creating a tall-pole for the least-well-controlled failure while establishing the relative likelihood and severity of all causes and effects for an identified hazard. Computer modeling of the analytical results, using spreadsheets and three-dimensional charting gives a visual confirmation of the relationship between causes and their controls.

Risk Presentation Using the Three Dimensions of Likelihood, Severity, and Level of Control

NASA Technical Reports Server (NTRS)

Watson, Clifford

2010-01-01

Traditional hazard analysis techniques utilize a two-dimensional representation of the results determined by relative likelihood and severity of the residual risk. These matrices present a quick-look at the Likelihood (Y-axis) and Severity (X-axis) of the probable outcome of a hazardous event. A three-dimensional method, described herein, utilizes the traditional X and Y axes, while adding a new, third dimension, shown as the Z-axis, and referred to as the Level of Control. The elements of the Z-axis are modifications of the Hazard Elimination and Control steps (also known as the Hazard Reduction Precedence Sequence). These steps are: 1. Eliminate risk through design. 2. Substitute less risky materials for more hazardous materials. 3. Install safety devices. 4. Install caution and warning devices. 5. Develop administrative controls (to include special procedures and training.) 6. Provide protective clothing and equipment. When added to the two-dimensional models, the level of control adds a visual representation of the risk associated with the hazardous condition, creating a tall-pole for the leastwell-controlled failure while establishing the relative likelihood and severity of all causes and effects for an identified hazard. Computer modeling of the analytical results, using spreadsheets and three-dimensional charting gives a visual confirmation of the relationship between causes and their controls.

Risk assessment in infrastructure in educational institution: A study in Malaysia

NASA Astrophysics Data System (ADS)

Rasdan Ismail, Ahmad; Adilah Hamzah, Noor; Kamilah Makhtar, Nor; Azhar Mat Daud, Khairul; Zulkarnaen Khidzir, Nik; Husna Che Hassan, Nurul; Arifpin Mansor, Muhamad

2017-10-01

This particular study was conducted to assess the hazard exposure in education institution and to highlight the possible risk level available. The assessment utilised is Hazard Identification, Risk Assessment and Risk Control (HIRARC). There was a 2008’s form in order to determine the risk level of the hazard. There were over 111 of education institutions were selected around Malaysia to perform this assessment. Area chosen for each institution was office, playing field, canteen, classroom, toilet and drainage. By referring HIRARC Guideline 2008, the determination of risk rank is measure based on the formula likelihood multiply severity and the rank need to refer from risk matrix standard. There are several hazard have be found and shows the high, medium and low of risk level. The higher level of risk was discussed in the study which is hazard found in playing field and hazard in office. There several hazard that need to be control by education management to avoid increase of case accident in Education Sector, Malaysia. As conclusion, the exposure hazard among the staff and educators is high and further action and control are needed. Further study need to explore the best recommendation for control measure of the hazard exposed by education institution.

Next-generation sequencing-based detection of circulating tumour DNA After allogeneic stem cell transplantation for lymphoma.

PubMed

Herrera, Alex F; Kim, Haesook T; Kong, Katherine A; Faham, Malek; Sun, Heather; Sohani, Aliyah R; Alyea, Edwin P; Carlton, Victoria E; Chen, Yi-Bin; Cutler, Corey S; Ho, Vincent T; Koreth, John; Kotwaliwale, Chitra; Nikiforow, Sarah; Ritz, Jerome; Rodig, Scott J; Soiffer, Robert J; Antin, Joseph H; Armand, Philippe

2016-12-01

Next-generation sequencing (NGS)-based circulating tumour DNA (ctDNA) detection is a promising monitoring tool for lymphoid malignancies. We evaluated whether the presence of ctDNA was associated with outcome after allogeneic haematopoietic stem cell transplantation (HSCT) in lymphoma patients. We studied 88 patients drawn from a phase 3 clinical trial of reduced-intensity conditioning HSCT in lymphoma. Conventional restaging and collection of peripheral blood samples occurred at pre-specified time points before and after HSCT and were assayed for ctDNA by sequencing of the immunoglobulin or T-cell receptor genes. Tumour clonotypes were identified in 87% of patients with adequate tumour samples. Sixteen of 19 (84%) patients with disease progression after HSCT had detectable ctDNA prior to progression at a median of 3·7 months prior to relapse/progression. Patients with detectable ctDNA 3 months after HSCT had inferior progression-free survival (PFS) (2-year PFS 58% vs. 84% in ctDNA-negative patients, P = 0·033). In multivariate models, detectable ctDNA was associated with increased risk of progression/death (Hazard ratio 3·9, P = 0·003) and increased risk of relapse/progression (Hazard ratio 10·8, P = 0·0006). Detectable ctDNA is associated with an increased risk of relapse/progression, but further validation studies are necessary to confirm these findings and determine the clinical utility of NGS-based minimal residual disease monitoring in lymphoma patients after HSCT. © 2016 John Wiley & Sons Ltd.

Home safety measures and the risk of unintentional injury among young children: a multicentre case–control study

PubMed Central

LeBlanc, John C.; Pless, I. Barry; King, W. James; Bawden, Harry; Bernard-Bonnin, Anne-Claude; Klassen, Terry; Tenenbein, Milton

2006-01-01

Background Young children may sustain injuries when exposed to certain hazards in the home. To better understand the relation between several childproofing strategies and the risk of injuries to children in the home, we undertook a multicentre case–control study in which we compared hazards in the homes of children with and without injuries. Methods We conducted this case-control study using records from 5 pediatric hospital emergency departments for the 2-year period 1995–1996. The 351 case subjects were children aged 7 years and less who presented with injuries from falls, burns or scalds, ingestions or choking. The matched control subjects were children who presented during the same period with acute non-injury-related conditions. A home visitor, blinded to case-control status, assessed 19 injury hazards at the children's homes. Results Hazards found in the homes included baby walkers (21% of homes with infants), no functioning smoke alarm (17% of homes) and no fire extinguisher (51% of homes). Cases did not differ from controls in the mean proportion of home hazards. After controlling for siblings, maternal education and employment, we found that cases differed from controls for 5 hazards: the presence of a baby walker (odds ratio [OR] 9.0, 95% confidence interval [CI] 1.1–71.0), the presence of choking hazards within a child's reach (OR 2.0, 95% CI 1.0–3.7), no child-resistant lids in bathroom (OR 1.6, 95% CI 1.0–2.5), no smoke alarm (OR 3.2, 95% CI 1.4–7.7) and no functioning smoke alarm (OR 1.7, 95% CI 1.0–2.8). Interpretation Homes of children with injuries differed from those of children without injuries in the proportions of specific hazards for falls, choking, poisoning and burns, with a striking difference noted for the presence of a baby walker. In addition to counselling parents about specific hazards, clinicians should consider that the presence of some hazards may indicate an increased risk for home injuries beyond those directly related to the hazard found. Families with any home hazard may be candidates for interventions to childproof against other types of home hazards. PMID:16998079

Effects of CCR5-delta32 and CCR2-64I alleles on disease progression of perinatally HIV-1-infected children: an international meta-analysis.

PubMed

Ioannidis, John P A; Contopoulos-Ioannidis, Despina G; Rosenberg, Philip S; Goedert, James J; De Rossi, Anita; Espanol, Teresa; Frenkel, Lisa; Mayaux, Marie-Jeanne; Newell, Marie-Louise; Pahwa, Savita G; Rousseau, Christine; Scarlatti, Gabriella; Sei, Shizuko; Sen, Luisa; O'Brien, Thomas R

2003-07-25

Among perinatally infected children, the effects of certain alleles of the CCR5 and CCR2 genes on the rate of disease progression remain unclear. We addressed the effects of CCR5-delta32 and CCR2-64I in an international meta-analysis. Genotype data were contributed from 10 studies with 1317 HIV-1-infected children (7263 person-years of follow-up). Time-to-event analyses were performed stratified by study and racial group. Endpoints included progression to clinical AIDS, death, and death after the diagnosis of clinical AIDS. The time-dependence of the genetic effects was specifically investigated. There was large heterogeneity in the observed rates of disease progression between different cohorts. For progression to clinical AIDS, both CCR5-delta32 and CCR2-64I showed overall non-significant trends for protection [hazard ratios 0.84, 95% confidence interval (CI) 0.58-1.23; and 0.87, 95% CI 0.67-1.14, respectively]. However, analyses of survival showed statistically significant time-dependence. No deaths occurred among CCR5-delta32 carriers in the first 3 years of life, whereas there was no protective effect (hazard ratio 0.95; 95% CI 0.43-2.10) in later years (P=0.01 for the time-dependent model). For CCR2-64I, the hazard ratio for death was 0.69 (95% CI 0.39-1.21) in the first 6 years of life and 2.56 (95% CI 1.26-5.20) in subsequent years (P<0.01 for the time-dependent model). CCR5-delta32 and CCR2-64I offered no clear protection after clinical AIDS had developed. The CCR5-delta32 and CCR2-64I alleles are associated with a decreased risk of death among perinatally infected children, but only for the first years of life.

Idiopathic Pulmonary Fibrosis: The Association between the Adaptive Multiple Features Method and Fibrosis Outcomes.

PubMed

Salisbury, Margaret L; Lynch, David A; van Beek, Edwin J R; Kazerooni, Ella A; Guo, Junfeng; Xia, Meng; Murray, Susan; Anstrom, Kevin J; Yow, Eric; Martinez, Fernando J; Hoffman, Eric A; Flaherty, Kevin R

2017-04-01

Adaptive multiple features method (AMFM) lung texture analysis software recognizes high-resolution computed tomography (HRCT) patterns. To evaluate AMFM and visual quantification of HRCT patterns and their relationship with disease progression in idiopathic pulmonary fibrosis. Patients with idiopathic pulmonary fibrosis in a clinical trial of prednisone, azathioprine, and N-acetylcysteine underwent HRCT at study start and finish. Proportion of lung occupied by ground glass, ground glass-reticular (GGR), honeycombing, emphysema, and normal lung densities were measured by AMFM and three radiologists, documenting baseline disease extent and postbaseline change. Disease progression includes composite mortality, hospitalization, and 10% FVC decline. Agreement between visual and AMFM measurements was moderate for GGR (Pearson's correlation r = 0.60, P < 0.0001; mean difference = -0.03 with 95% limits of agreement of -0.19 to 0.14). Baseline extent of GGR was independently associated with disease progression when adjusting for baseline Gender-Age-Physiology stage and smoking status (hazard ratio per 10% visual GGR increase = 1.98, 95% confidence interval [CI] = 1.20-3.28, P = 0.008; and hazard ratio per 10% AMFM GGR increase = 1.36, 95% CI = 1.01-1.84, P = 0.04). Postbaseline visual and AMFM GGR trajectories were correlated with postbaseline FVC trajectory (r = -0.30, 95% CI = -0.46 to -0.11, P = 0.002; and r = -0.25, 95% CI = -0.42 to -0.06, P = 0.01, respectively). More extensive baseline visual and AMFM fibrosis (as measured by GGR densities) is independently associated with elevated hazard for disease progression. Postbaseline change in AMFM-measured and visually measured GGR densities are modestly correlated with change in FVC. AMFM-measured fibrosis is an automated adjunct to existing prognostic markers and may allow for study enrichment with subjects at increased disease progression risk.

Aberrant Expression of the Cell Polarity Regulator aPKCλ/ι is Associated With Disease Progression in Cervical Intraepithelial Neoplasia (CIN): A Possible Marker for Predicting CIN Prognosis.

PubMed

Mizushima, Taichi; Asai-Sato, Mikiko; Akimoto, Kazunori; Nagashima, Yoji; Taguri, Masataka; Sasaki, Kazunori; Nakaya, Masa-aki; Asano, Ryoko; Tokinaga, Aya; Kiyono, Tohru; Hirahara, Fumiki; Ohno, Shigeo; Miyagi, Etsuko

2016-03-01

Atypical protein kinase C λ/ι (aPKCλ/ι) is a regulator of epithelial cellular polarity. It is also overexpressed in several cancers and functions in cell proliferation and invasion. Therefore, we hypothesized that aPKCλ/ι may be involved in development and progression of cervical intraepithelial neoplasia (CIN), the precancerous disease of cervical cancer induced by human papillomavirus. To do this, we investigated the relationship between aPKCλ/ι expression and CIN. aPKCλ/ι expression level and subcellular localization were assessed in 192 CIN biopsy samples and 13 normal epithelial samples using immunohistochemistry. aPKCλ/ι overexpression (normal epithelium, 7.7%; CIN1, 41.7%; CIN2/3, 76.4%) and aPKCλ/ι nuclear localization (normal epithelium, 0.0%; CIN1, 36.9%; CIN2/3, 78.7%) were higher in CIN samples than normal samples (P<0.05), suggesting that CIN grade is related to aPKCλ/ι overexpression and nuclear localization. Then, 140 CIN cases were retrospectively analyzed for 4-yr cumulative disease progression and regression rates using the Cox proportional hazards model. CIN1 cases with aPKCλ/ι overexpression or aPKCλ/ι nuclear localization had a higher progression rate than CIN1 cases with normal aPKCλ/ι expression levels or cytoplasmic localization (62.5% vs. 9.7% and 63.1% vs. 9.4%, respectively; P<0.001). Multivariate analysis indicated that human papillomavirus types 16 and 18, aPKCλ/ι overexpression (hazard ratio=4.26; 95% confidence interval, 1.50-12.1; P=0.007), and aPKCλ/ι nuclear localization (hazard ratio=3.59; 95% confidence interval, 1.24-10.4; P=0.019) were independent risk factors for CIN1 progression. In conclusion, aPKCλ/ι could be useful for the therapeutic management of patients with CIN, particularly those with non-human papillomavirus 16/18 types.

Maternal outcomes after HAART for the prevention of mother-to-child transmission in HIV-infected women in Brazil.

PubMed

Pilotto, Jose H; Velasque, Luciane S; Friedman, Ruth K; Moreira, Ronaldo I; Veloso, Valdilea G; Grinsztejn, Beatriz; Morgado, Mariza G; Watts, D Heather; Currier, Judith S; Hoffman, Risa M

2011-01-01

Information is lacking on outcomes in HIV-infected Brazilian women with CD4(+) T-cell counts >200 cells/mm(3) who initiate HAART for the prevention of mother-to-child transmission, and discontinue after delivery. Clinical event rates after postpartum HAART discontinuation were calculated for all WHO stage 2-3 events, as well as for HIV progression warranting HAART re-initiation, defined by a WHO stage 4 event and/or CD4(+) T-cell decrease to ≤200 cells/mm(3). Predictors of the WHO stage 2-3 events and HIV progression outcomes were evaluated with Cox's proportional hazards models. A total of 120 women were followed for a mean of 1.5 years after delivery. Overall, 26 women had 30 events as follows: 20 developed WHO stage 2-3 events, yielding an incidence rate of 13/100 person-years (PY; 95% CI 8-20); 10 developed HIV progression requiring HAART re-initiation (incidence ratio 6/100 PY, 95% CI 3-11). Among progressors, a single woman developed a WHO stage 4 clinical event and the remainder had CD4(+) T-cell decreases. Women who had baseline CD4(+) T-cell counts between 200-500 cells/mm(3) had a hazard ratio for WHO stage 2-3 events of 2.5 compared to women with baseline ≥500 cells/mm(3) (95% CI 1.0-6.3; P=0.05). The only significant predictor of HIV progression was baseline CD4(+) T-cell count (hazard ratio 0.99, 95% CI 0.98-0.99; P=0.02). In this observational study, a baseline CD4(+) T-cell count <500 cells/mm(3) was associated with an increased risk of postpartum WHO stage 2-3 clinical events and HIV disease progression. Randomized studies are needed to further evaluate the effect of postpartum treatment discontinuation on maternal health.

Health span approximates life span among many supercentenarians: compression of morbidity at the approximate limit of life span.

PubMed

Andersen, Stacy L; Sebastiani, Paola; Dworkis, Daniel A; Feldman, Lori; Perls, Thomas T

2012-04-01

We analyze the relationship between age of survival, morbidity, and disability among centenarians (age 100-104 years), semisupercentenarians (age 105-109 years), and supercentenarians (age 110-119 years). One hundred and four supercentenarians, 430 semisupercentenarians, 884 centenarians, 343 nonagenarians, and 436 controls were prospectively followed for an average of 3 years (range 0-13 years). The older the age group, generally, the later the onset of diseases, such as cancer, cardiovascular disease, dementia, and stroke, as well as of cognitive and functional decline. The hazard ratios for these individual diseases became progressively less with older and older age, and the relative period of time spent with disease was lower with increasing age group. We observed a progressive delay in the age of onset of physical and cognitive function impairment, age-related diseases, and overall morbidity with increasing age. As the limit of human life span was effectively approached with supercentenarians, compression of morbidity was generally observed.

Health Span Approximates Life Span Among Many Supercentenarians: Compression of Morbidity at the Approximate Limit of Life Span

PubMed Central

Andersen, Stacy L.; Sebastiani, Paola; Dworkis, Daniel A.; Feldman, Lori

2012-01-01

We analyze the relationship between age of survival, morbidity, and disability among centenarians (age 100–104 years), semisupercentenarians (age 105–109 years), and supercentenarians (age 110–119 years). One hundred and four supercentenarians, 430 semisupercentenarians, 884 centenarians, 343 nonagenarians, and 436 controls were prospectively followed for an average of 3 years (range 0–13 years). The older the age group, generally, the later the onset of diseases, such as cancer, cardiovascular disease, dementia, and stroke, as well as of cognitive and functional decline. The hazard ratios for these individual diseases became progressively less with older and older age, and the relative period of time spent with disease was lower with increasing age group. We observed a progressive delay in the age of onset of physical and cognitive function impairment, age-related diseases, and overall morbidity with increasing age. As the limit of human life span was effectively approached with supercentenarians, compression of morbidity was generally observed. PMID:22219514

Conceptual Development of a National Volcanic Hazard Model for New Zealand

NASA Astrophysics Data System (ADS)

Stirling, Mark; Bebbington, Mark; Brenna, Marco; Cronin, Shane; Christophersen, Annemarie; Deligne, Natalia; Hurst, Tony; Jolly, Art; Jolly, Gill; Kennedy, Ben; Kereszturi, Gabor; Lindsay, Jan; Neall, Vince; Procter, Jonathan; Rhoades, David; Scott, Brad; Shane, Phil; Smith, Ian; Smith, Richard; Wang, Ting; White, James D. L.; Wilson, Colin J. N.; Wilson, Tom

2017-06-01

We provide a synthesis of a workshop held in February 2016 to define the goals, challenges and next steps for developing a national probabilistic volcanic hazard model for New Zealand. The workshop involved volcanologists, statisticians, and hazards scientists from GNS Science, Massey University, University of Otago, Victoria University of Wellington, University of Auckland, and University of Canterbury. We also outline key activities that will develop the model components, define procedures for periodic update of the model, and effectively articulate the model to end-users and stakeholders. The development of a National Volcanic Hazard Model is a formidable task that will require long-term stability in terms of team effort, collaboration and resources. Development of the model in stages or editions that are modular will make the process a manageable one that progressively incorporates additional volcanic hazards over time, and additional functionalities (e.g. short-term forecasting). The first edition is likely to be limited to updating and incorporating existing ashfall hazard models, with the other hazards associated with lahar, pyroclastic density currents, lava flow, ballistics, debris avalanche, and gases/aerosols being considered in subsequent updates.

An Analysis of U.S. Army Health Hazard Assessments During the Acquisition of Military Materiel

DTIC Science & Technology

2010-06-03

GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S...administrative controls and the use of personal protective equipment (PPE) (Milz, Conrad, & Soule , 2003). Engineering controls can eliminate hazards through...facilitate hazard free designs or conditions (Milz, Conrad, & Soule , 2003). Engineering control measures can serve to 7 minimize hazards where they

Evansville Area Earthquake Hazards Mapping Project (EAEHMP) - Progress Report, 2008

USGS Publications Warehouse

Boyd, Oliver S.; Haase, Jennifer L.; Moore, David W.

2009-01-01

Maps of surficial geology, deterministic and probabilistic seismic hazard, and liquefaction potential index have been prepared by various members of the Evansville Area Earthquake Hazard Mapping Project for seven quadrangles in the Evansville, Indiana, and Henderson, Kentucky, metropolitan areas. The surficial geologic maps feature 23 types of surficial geologic deposits, artificial fill, and undifferentiated bedrock outcrop and include alluvial and lake deposits of the Ohio River valley. Probabilistic and deterministic seismic hazard and liquefaction hazard mapping is made possible by drawing on a wealth of information including surficial geologic maps, water well logs, and in-situ testing profiles using the cone penetration test, standard penetration test, down-hole shear wave velocity tests, and seismic refraction tests. These data were compiled and collected with contributions from the Indiana Geological Survey, Kentucky Geological Survey, Illinois State Geological Survey, United States Geological Survey, and Purdue University. Hazard map products are in progress and are expected to be completed by the end of 2009, with a public roll out in early 2010. Preliminary results suggest that there is a 2 percent probability that peak ground accelerations of about 0.3 g will be exceeded in much of the study area within 50 years, which is similar to the 2002 USGS National Seismic Hazard Maps for a firm rock site value. Accelerations as high as 0.4-0.5 g may be exceeded along the edge of the Ohio River basin. Most of the region outside of the river basin has a low liquefaction potential index (LPI), where the probability that LPI is greater than 5 (that is, there is a high potential for liquefaction) for a M7.7 New Madrid type event is only 20-30 percent. Within the river basin, most of the region has high LPI, where the probability that LPI is greater than 5 for a New Madrid type event is 80-100 percent.

Venetoclax-Rituximab in Relapsed or Refractory Chronic Lymphocytic Leukemia.

PubMed

Seymour, John F; Kipps, Thomas J; Eichhorst, Barbara; Hillmen, Peter; D'Rozario, James; Assouline, Sarit; Owen, Carolyn; Gerecitano, John; Robak, Tadeusz; De la Serna, Javier; Jaeger, Ulrich; Cartron, Guillaume; Montillo, Marco; Humerickhouse, Rod; Punnoose, Elizabeth A; Li, Yan; Boyer, Michelle; Humphrey, Kathryn; Mobasher, Mehrdad; Kater, Arnon P

2018-03-22

Venetoclax inhibits BCL2, an antiapoptotic protein that is pathologically overexpressed and that is central to the survival of chronic lymphocytic leukemia cells. We evaluated the efficacy of venetoclax in combination with rituximab in patients with relapsed or refractory chronic lymphocytic leukemia. In this randomized, open-label, phase 3 trial, we randomly assigned 389 patients to receive venetoclax for up to 2 years (from day 1 of cycle 1) plus rituximab for the first 6 months (venetoclax-rituximab group) or bendamustine plus rituximab for 6 months (bendamustine-rituximab group). The trial design did not include crossover to venetoclax plus rituximab for patients in the bendamustine-rituximab group in whom progression occurred. The primary end point was investigator-assessed progression-free survival. After a median follow-up period of 23.8 months, the rate of investigator-assessed progression-free survival was significantly higher in the venetoclax-rituximab group (32 events of progression or death in 194 patients) than in the bendamustine-rituximab group (114 events in 195 patients); the 2-year rates of progression-free survival were 84.9% and 36.3%, respectively (hazard ratio for progression or death, 0.17; 95% confidence interval [CI], 0.11 to 0.25; P<0.001 by the stratified log-rank test). The benefit was maintained across all clinical and biologic subgroups, including the subgroup of patients with chromosome 17p deletion; the 2-year rate of progression-free survival among patients with chromosome 17p deletion was 81.5% in the venetoclax-rituximab group versus 27.8% in the bendamustine-rituximab group (hazard ratio, 0.13; 95% CI, 0.05 to 0.29), and the 2-year rate among those without chromosome 17p deletion was 85.9% versus 41.0% (hazard ratio, 0.19; 95% CI, 0.12 to 0.32). The benefit of venetoclax plus rituximab over bendamustine plus rituximab was confirmed by an independent review committee assessment of progression-free survival and other secondary efficacy end points. The rate of grade 3 or 4 neutropenia was higher in the venetoclax-rituximab group than in the bendamustine-rituximab group, but the rates of grade 3 or 4 febrile neutropenia and infections or infestations were lower with venetoclax than with bendamustine. The rate of grade 3 or 4 tumor lysis syndrome in the venetoclax-rituximab group was 3.1% (6 of 194 patients). Among patients with relapsed or refractory chronic lymphocytic leukemia, venetoclax plus rituximab resulted in significantly higher rates of progression-free survival than bendamustine plus rituximab. (Funded by Genentech and AbbVie; ClinicalTrials.gov number, NCT02005471 .).

Institutional Oversight of Occupational Health and Safety for Research Programs Involving Biohazards

PubMed Central

Dyson, Melissa C; Carpenter, Calvin B; Colby, Lesley A

2017-01-01

Research with hazardous biologic materials (biohazards) is essential to the progress of medicine and science. The field of microbiology has rapidly advanced over the years, partially due to the development of new scientific methods such as recombinant DNA technology, synthetic biology, viral vectors, and the use of genetically modified animals. This research poses a potential risk to personnel as well as the public and the environment. Institutions must have appropriate oversight and take appropriate steps to mitigate the risks of working with these biologic hazards. This article will review responsibilities for institutional oversight of occupational health and safety for research involving biologic hazards. PMID:28662748

Institutional Oversight of Occupational Health and Safety for Research Programs Involving Biohazards.

PubMed

Dyson, Melissa C; Carpenter, Calvin B; Colby, Lesley A

2017-06-01

Research with hazardous biologic materials (biohazards) is essential to the progress of medicine and science. The field of microbiology has rapidly advanced over the years, partially due to the development of new scientific methods such as recombinant DNA technology, synthetic biology, viral vectors, and the use of genetically modified animals. This research poses a potential risk to personnel as well as the public and the environment. Institutions must have appropriate oversight and take appropriate steps to mitigate the risks of working with these biologic hazards. This article will review responsibilities for institutional oversight of occupational health and safety for research involving biologic hazards.

Early detection and progression of decay in L-joints and lap-joints in a moderate decay hazard zone

Treesearch

Carol A. Clausen; Terry L. Highley; Daniel L. Lindner

2006-01-01

Accelerated test methods are needed to evaluate the initiation and progression of decay in wood exposed aboveground. The relationship between test conditions and initiation of decay, however, is poorly understood. Southern pine and maple L-joints and lap-joints were exposed aboveground in a configuration that encouraged water entrapment at the Valley View Experimental...

Hazardous materials in aquatic environments of the Mississippi River Basin. Quarterly progress report, July 1, 1995--September 30, 1995

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

NONE

1995-12-01

This report is the quarterly progress report for July through September 1995 for work done by Tulane and Xavier Universities under DOE contract number DE-FG01-93-EW53023. Accomplishments for various tasks including administrative activities, collaborative cluster projects, education projects, initiation projects, coordinated instrumentation facility, and an investigators` retreat are detailed in the report.

Self-reported levels of education and disability progression in multiple sclerosis.

PubMed

D'hooghe, M B; Haentjens, P; Van Remoortel, A; De Keyser, J; Nagels, G

2016-12-01

The purpose of our study is to investigate whether socioeconomic indicators such as education, financial concerns, employment, and living status are associated with disease progression in relapsing-onset and progressive-onset Multiple Sclerosis (MS). We performed a cross-sectional survey among individuals with MS, registered by the Flemish MS society and included socioeconomic indicators. A Cox proportional hazard regression was performed with the time from MS onset and from birth to reach an ambulatory disability milestone corresponding to Expanded Disability Status Scale (EDSS) 6 (requiring a cane) as outcome measure, adjusted for gender, age at MS onset, and immunomodulatory treatment. Among the participants with relapsing-onset MS, subjects reporting education for more than 12 years had a reduced risk of reaching EDSS 6 compared to subjects reporting education for less than 12 years [HR from onset 0.68 (95% CI 0.49-0.95); HR from birth 0.71 (95% CI 0.51-0.99)]. In progressive-onset MS, longer education was associated with an increased hazard to reach EDSS 6 [HR from onset 1.25 (95% CI 0.91-1.70); HR from birth 1.39 (95% CI 1.02-1.90)]. Our study shows an association of self-reported levels of education with disability progression in MS, with the highest level being protective in relapsing-onset MS. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Daratumumab, Lenalidomide, and Dexamethasone for Multiple Myeloma.

PubMed

Dimopoulos, Meletios A; Oriol, Albert; Nahi, Hareth; San-Miguel, Jesus; Bahlis, Nizar J; Usmani, Saad Z; Rabin, Neil; Orlowski, Robert Z; Komarnicki, Mieczyslaw; Suzuki, Kenshi; Plesner, Torben; Yoon, Sung-Soo; Ben Yehuda, Dina; Richardson, Paul G; Goldschmidt, Hartmut; Reece, Donna; Lisby, Steen; Khokhar, Nushmia Z; O'Rourke, Lisa; Chiu, Christopher; Qin, Xiang; Guckert, Mary; Ahmadi, Tahamtan; Moreau, Philippe

2016-10-06

Daratumumab showed promising efficacy alone and with lenalidomide and dexamethasone in a phase 1-2 study involving patients with relapsed or refractory multiple myeloma. In this phase 3 trial, we randomly assigned 569 patients with multiple myeloma who had received one or more previous lines of therapy to receive lenalidomide and dexamethasone either alone (control group) or in combination with daratumumab (daratumumab group). The primary end point was progression-free survival. At a median follow-up of 13.5 months in a protocol-specified interim analysis, 169 events of disease progression or death were observed (in 53 of 286 patients [18.5%] in the daratumumab group vs. 116 of 283 [41.0%] in the control group; hazard ratio, 0.37; 95% confidence interval [CI], 0.27 to 0.52; P<0.001 by stratified log-rank test). The Kaplan-Meier rate of progression-free survival at 12 months was 83.2% (95% CI, 78.3 to 87.2) in the daratumumab group, as compared with 60.1% (95% CI, 54.0 to 65.7) in the control group. A significantly higher rate of overall response was observed in the daratumumab group than in the control group (92.9% vs. 76.4%, P<0.001), as was a higher rate of complete response or better (43.1% vs. 19.2%, P<0.001). In the daratumumab group, 22.4% of the patients had results below the threshold for minimal residual disease (1 tumor cell per 10 5 white cells), as compared with 4.6% of those in the control group (P<0.001); results below the threshold for minimal residual disease were associated with improved outcomes. The most common adverse events of grade 3 or 4 during treatment were neutropenia (in 51.9% of the patients in the daratumumab group vs. 37.0% of those in the control group), thrombocytopenia (in 12.7% vs. 13.5%), and anemia (in 12.4% vs. 19.6%). Daratumumab-associated infusion-related reactions occurred in 47.7% of the patients and were mostly of grade 1 or 2. The addition of daratumumab to lenalidomide and dexamethasone significantly lengthened progression-free survival among patients with relapsed or refractory multiple myeloma. Daratumumab was associated with infusion-related reactions and a higher rate of neutropenia than the control therapy. (Funded by Janssen Research and Development; POLLUX ClinicalTrials.gov number, NCT02076009 .).

Pooled analysis of stereotactic ablative radiotherapy for primary renal cell carcinoma: A report from the International Radiosurgery Oncology Consortium for Kidney (IROCK).

PubMed

Siva, Shankar; Louie, Alexander V; Warner, Andrew; Muacevic, Alexander; Gandhidasan, Senthilkumar; Ponsky, Lee; Ellis, Rodney; Kaplan, Irving; Mahadevan, Anand; Chu, William; Swaminath, Anand; Onishi, Hiroshi; Teh, Bin; Correa, Rohann J; Lo, Simon S; Staehler, Michael

2018-03-01

Stereotactic ablative radiotherapy (SABR) is an emerging therapy for primary renal cell carcinoma. The authors assessed safety, efficacy, and survival in a multi-institutional setting. Outcomes between single-fraction and multifraction SABR were compared. Individual patient data sets from 9 International Radiosurgery Oncology Consortium for Kidney institutions across Germany, Australia, the United States, Canada, and Japan were pooled. Toxicities were recorded using Common Terminology Criteria for Adverse Events, version 4.0. Patient, tumor, and treatment characteristics were stratified according to the number of radiotherapy fractions (single vs multiple). Survival outcomes were examined using Kaplan-Meier estimates and Cox proportional-hazards regression. Of 223 patients, 118 received single-fraction SABR, and 105 received multifraction SABR. The mean patient age was 72 years, and 69.5% of patients were men. There were 83 patients with grade 1 and 2 toxicity (35.6%) and 3 with grade 3 and 4 toxicities (1.3%). The rates of local control, cancer-specific survival, and progression-free survival were 97.8%, 95.7%, and 77.4%, respectively, at 2 years; and they were 97.8%, 91.9%, and 65.4%, respectively, at 4 years. On multivariable analysis, tumors with a larger maximum dimension and the receipt of multifraction SABR were associated with poorer progression-free survival (hazard ratio, 1.16 [P < .01] and 1.13 [P = .02], respectively) and poorer cancer-specific survival (hazard ratio, 1.28 [P < .01] and 1.33 [P = .01], respectively). There were no differences in local failure between the single-fraction cohort (n = 1) and the multifraction cohort (n = 2; P = .60). The mean ( ± standard deviation) estimated glomerular filtration rate at baseline was 59.9 ± 21.9 mL per minute, and it decreased by 5.5 ± 13.3 mL per minute (P < .01). SABR is well tolerated and locally effective for treating patients who have primary renal cell carcinoma and has an acceptable impact on renal function. An interesting observation is that patients who receive single-fraction SABR appear to be less likely to progress distantly or to die of cancer. Cancer 2018;124:934-42. © 2017 American Cancer Society. © 2017 American Cancer Society.

75 FR 8239 - School Food Safety Program Based on Hazard Analysis and Critical Control Point Principles (HACCP...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-24

... 0584-AD65 School Food Safety Program Based on Hazard Analysis and Critical Control Point Principles... Safety Program Based on Hazard Analysis and Critical Control Point Principles (HACCP) was published on... of Management and Budget (OMB) cleared the associated information collection requirements (ICR) on...

Environmental and economic solutions: Pollution prevention technical assistance and the City of Los Angeles Hazardous and Toxic Materials Office

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

Toy-Chen, D.; Joyce, M.M.

1994-12-31

The City of Los Angeles faces a challenge to assist industrial facilities to minimize and manage hazardous materials in order to sustain the local economy and natural environment. Industrial facilities in Los Angeles County released into the environment or transferred off-site 103,442,074 tons of hazardous materials and waste in 1988. This enormous quantity of hazardous waste requires generators to be in compliance with several environmental regulatory agencies. The City of Los Angeles Hazardous and Toxic Materials (HTM) Office has increased the awareness, commitments, and implementation of hazardous waste at the source, the amount of toxic pollutants discharged into the City`smore » publicly owned treatment works, surface and groundwaters, soils and atmosphere can be substantially reduced. Quantifying hazardous waste minimization progress is extremely difficult and complex. However, the HTM Office anticipates that if the challenge of pollution prevention is successful, more businesses will decide to remain in the region and Los Angeles residents will feel convinced that industry is making good faith efforts to protect the environment. Pollution prevention is a long term solution for the hazardous waste crisis that society has only recently recognized.« less

Manpower Needs in Environmental Engineering

ERIC Educational Resources Information Center

Middlebrooks, E. J.; And Others

1974-01-01

Outlines manpower needs in both the public and private sectors in the areas of air pollution control, solid waste management, radiological hazard control, pesticide hazard control, and water pollution control. (GS)

1980 scrubber highlights: dry-process startups, dual-alkali progress highlight scrubber advances

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

Not Available

1981-06-01

A survey of electric utilities reports scrubbers on 13% of existing capacity and estimates 29% by 1990, but compliance with the New Source Performance Standards may raise the total even higher. Dry scrubbers at two Northern States Power installations show test performances that indicate sound design and report modest manpower requirements. Other utilities are ordering demonstration dry-scrubber units, although orders for wet scrubbers continue to do well. A new dual-alkali scrubber is performing well at three installations in terms of availability and sulfur-dioxide-removal efficiency. A full-scale utility dump site test will identify any hazardous materials in pollution control ash andmore » sludge wastes. (DCK)« less

Performance Analysis: Work Control Events Identified January - August 2010

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

De Grange, C E; Freeman, J W; Kerr, C E

2011-01-14

This performance analysis evaluated 24 events that occurred at LLNL from January through August 2010. The analysis identified areas of potential work control process and/or implementation weaknesses and several common underlying causes. Human performance improvement and safety culture factors were part of the causal analysis of each event and were analyzed. The collective significance of all events in 2010, as measured by the occurrence reporting significance category and by the proportion of events that have been reported to the DOE ORPS under the ''management concerns'' reporting criteria, does not appear to have increased in 2010. The frequency of reporting inmore » each of the significance categories has not changed in 2010 compared to the previous four years. There is no change indicating a trend in the significance category and there has been no increase in the proportion of occurrences reported in the higher significance category. Also, the frequency of events, 42 events reported through August 2010, is not greater than in previous years and is below the average of 63 occurrences per year at LLNL since 2006. Over the previous four years, an average of 43% of the LLNL's reported occurrences have been reported as either ''management concerns'' or ''near misses.'' In 2010, 29% of the occurrences have been reported as ''management concerns'' or ''near misses.'' This rate indicates that LLNL is now reporting fewer ''management concern'' and ''near miss'' occurrences compared to the previous four years. From 2008 to the present, LLNL senior management has undertaken a series of initiatives to strengthen the work planning and control system with the primary objective to improve worker safety. In 2008, the LLNL Deputy Director established the Work Control Integrated Project Team to develop the core requirements and graded elements of an institutional work planning and control system. By the end of that year this system was documented and implementation had begun. In 2009, training of the workforce began and as of the time of this report more than 50% of authorized Integration Work Sheets (IWS) use the activity-based planning process. In 2010, LSO independently reviewed the work planning and control process and confirmed to the Laboratory that the Integrated Safety Management (ISM) System was implemented. LLNL conducted a cross-directorate management self-assessment of work planning and control and is developing actions to respond to the issues identified. Ongoing efforts to strengthen the work planning and control process and to improve the quality of LLNL work packages are in progress: completion of remaining actions in response to the 2009 DOE Office of Health, Safety, and Security (HSS) evaluation of LLNL's ISM System; scheduling more than 14 work planning and control self-assessments in FY11; continuing to align subcontractor work control with the Institutional work planning and control system; and continuing to maintain the electronic IWS application. The 24 events included in this analysis were caused by errors in the first four of the five ISMS functions. The most frequent cause was errors in analyzing the hazards (Function 2). The second most frequent cause was errors occurring when defining the work (Function 1), followed by errors during the performance of work (Function 4). Interestingly, very few errors in developing controls (Function 3) resulted in events. This leads one to conclude that if improvements are made to defining the scope of work and analyzing the potential hazards, LLNL may reduce the frequency or severity of events. Analysis of the 24 events resulted in the identification of ten common causes. Some events had multiple causes, resulting in the mention of 39 causes being identified for the 24 events. The most frequent cause was workers, supervisors, or experts believing they understood the work and the hazards but their understanding was incomplete. The second most frequent cause was unclear, incomplete or confusing documents directing the work. Together, these two causes were mentioned 17 times and contributed to 13 of the events. All of the events with the cause of ''workers, supervisors, or experts believing they understood the work and the hazards but their understanding was incomplete'' had this error in the first two ISMS functions: define the work and analyze the hazard. This means that these causes result in the scope of work being ill-defined or the hazard(s) improperly analyzed. Incomplete implementation of these functional steps leads to the hazards not being controlled. The causes are then manifested in events when the work is conducted. The process to operate safely relies on accurately defining the scope of work. This review has identified a number of examples of latent organizational weakness in the execution of work control processes.« less

A randomized controlled trial of the effect of prednisone omission from a multidrug chemotherapy protocol on treatment outcome in dogs with peripheral nodal lymphomas.

PubMed

Childress, Michael O; Ramos-Vara, José A; Ruple, Audrey

2016-11-01

OBJECTIVE To determine the effect of prednisone omission from a multidrug chemotherapy protocol on outcome in dogs with peripheral nodal lymphomas. DESIGN Single-center, nonblinded, parallel-group, randomized, controlled trial. ANIMALS 40 client-owned dogs with a histopathologically confirmed diagnosis of peripheral nodal lymphoma and an expected survival time of > 4 weeks with treatment. PROCEDURES Treatment consisted of a combination of L-asparaginase, cyclophosphamide, doxorubicin, vincristine, and prednisone (L-CHOP) or an identical protocol except for the omission of prednisone (L-CHO). The primary outcome of interest was progression-free survival time. Veterinary caregivers and assessors of outcome were not blinded to treatment assignment. Treatment assignment was concealed from the owners of study dogs prior to enrollment, but was revealed after written informed consent was provided. RESULTS The trial was terminated early because of slow enrollment. The 40 dogs successfully enrolled in the study were randomly assigned to the L-CHOP (n = 18) or L-CHO (22) group; results for all 40 dogs were analyzed with respect to the primary outcome. Median progression-free survival time was 142.5 days for dogs receiving L-CHO and 292 days for dogs receiving L-CHOP (hazard ratio, 1.79; 95% confidence interval, 0.85 to 3.75). Serious adverse events were more common among dogs receiving L-CHO. However, this difference was not significant. CONCLUSIONS AND CLINICAL RELEVANCE The exclusion of prednisone from the L-CHOP protocol did not appear to result in improved progression-free survival time for dogs with peripheral nodal lymphomas. However, the present trial was likely underpowered to detect a clinically meaningful difference in progression-free survival time between groups.

Periostin promotes fibrosis and predicts progression in patients with idiopathic pulmonary fibrosis

PubMed Central

Naik, Payal K.; Bozyk, Paul D.; Bentley, J. Kelley; Popova, Antonia P.; Birch, Carolyn M.; Wilke, Carol A.; Fry, Christopher D.; White, Eric S.; Sisson, Thomas H.; Tayob, Nabihah; Carnemolla, Barbara; Orecchia, Paola; Flaherty, Kevin R.; Hershenson, Marc B.; Murray, Susan; Martinez, Fernando J.

2012-01-01

Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease without effective therapeutics. Periostin has been reported to be elevated in IPF patients relative to controls, but its sources and mechanisms of action remain unclear. We confirm excess periostin in lungs of IPF patients and show that IPF fibroblasts produce periostin. Blood was obtained from 54 IPF patients (all but 1 with 48 wk of follow-up). We show that periostin levels predict clinical progression at 48 wk (hazard ratio = 1.47, 95% confidence interval = 1.03–2.10, P < 0.05). Monocytes and fibrocytes are sources of periostin in circulation in IPF patients. Previous studies suggest that periostin may regulate the inflammatory phase of bleomycin-induced lung injury, but periostin effects during the fibroproliferative phase of the disease are unknown. Wild-type and periostin-deficient (periostin−/−) mice were anesthetized and challenged with bleomycin. Wild-type mice were injected with bleomycin and then treated with OC-20 Ab (which blocks periostin and integrin interactions) or control Ab during the fibroproliferative phase of disease, and fibrosis and survival were assessed. Periostin expression was upregulated quickly after treatment with bleomycin and remained elevated. Periostin−/− mice were protected from bleomycin-induced fibrosis. Instillation of OC-20 during the fibroproliferative phase improved survival and limited collagen deposition. Chimeric mouse studies suggest that hematopoietic and structural sources of periostin contribute to lung fibrogenesis. Periostin was upregulated by transforming growth factor-β in lung mesenchymal cells, and periostin promoted extracellular matrix deposition, mesenchymal cell proliferation, and wound closure. Thus periostin plays a vital role in late stages of pulmonary fibrosis and is a potential biomarker for disease progression and a target for therapeutic intervention. PMID:23043074

St. Louis Area Earthquake Hazards Mapping Project - A Progress Report-November 2008

USGS Publications Warehouse

Karadeniz, D.; Rogers, J.D.; Williams, R.A.; Cramer, C.H.; Bauer, R.A.; Hoffman, D.; Chung, J.; Hempen, G.L.; Steckel, P.H.; Boyd, O.L.; Watkins, C.M.; McCallister, N.S.; Schweig, E.

2009-01-01

St. Louis has experienced minor earthquake damage at least 12 times in the past 200 years. Because of this history and its proximity to known active earthquake zones, the St. Louis Area Earthquake Hazards Mapping Project (SLAEHMP) is producing digital maps that show variability of earthquake hazards, including liquefaction and ground shaking, in the St. Louis area. The maps will be available free via the internet. Although not site specific enough to indicate the hazard at a house-by-house resolution, they can be customized by the user to show specific areas of interest, such as neighborhoods or transportation routes. Earthquakes currently cannot be predicted, but scientists can estimate how strongly the ground is likely to shake as the result of an earthquake. Earthquake hazard maps provide one way of conveying such estimates. The U.S. Geological Survey (USGS), which produces earthquake hazard maps for the Nation, is working with local partners to develop detailed maps for urban areas vulnerable to strong ground shaking. These partners, which along with the USGS comprise the SLAEHMP, include the Missouri University of Science and Technology-Rolla (Missouri S&T), Missouri Department of Natural Resources (MDNR), Illinois State Geological Survey (ISGS), Saint Louis University, Missouri State Emergency Management Agency, and URS Corporation. Preliminary hazard maps covering a test portion of the 29-quadrangle St. Louis study area have been produced and are currently being evaluated by the SLAEHMP. A USGS Fact Sheet summarizing this project was produced and almost 1000 copies have been distributed at several public outreach meetings and field trips that have featured the SLAEHMP (Williams and others, 2007). In addition, a USGS website focusing on the SLAEHMP, which provides links to project results and relevant earthquake hazard information, can be found at: http://earthquake.usgs.gov/regional/ceus/urban_map/st_louis/index.php. This progress report summarizes the methodology and data used to generate these preliminary maps. For more details about many of the topics in this summary the reader is referred to the Karadeniz (2007) and Chung (2007) Ph.D. theses.

75 FR 45149 - Announcement of Funding Awards for Healthy Homes and Lead Hazard Control Grant Programs for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-02

... announced in a Federal Register notice published on May 22, 2009 for Lead Based Paint Hazard Control and... for the Lead Based Paint Hazard Control Grant Program under the Consolidated Appropriations Act, 2009... Tahoe, 1901 Airport Road, Suite 107, South Lake Tahoe, CA 96150, $1,500,000; State of Connecticut...

Health issues in the Arab American community. Commentary on the global epidemic of tobacco, a manufactured disease. What it looks like today and what's to come.

PubMed

Warner, Kenneth E

2007-01-01

An estimated 1.2 billion citizens of the world are smokers. In developing countries, half the males smoke. WHO projects a global smoking population of 1.6 billion by the end of the next two decades. Collectively, today the world's smokers annually consume nearly 1,000 cigarettes for every man, woman and child on the planet. Almost 5 million people die as a result of smoking, half during their productive working years, with half occurring in developing countries. Two decades hence, tobacco products will kill an estimated 10 million people every year, 70% of them in the world's poor nations. During the 20th century, smoking killed 100 million people. Without significant public health progress, cigarettes will claim the lives of an estimated one billion during the 21st century. Progress can be achieved, however, through the adoption and enforcement of effective tobacco control policies. Such policies are embedded in the Framework Convention on Tobacco Control, the world's first international health treaty. They include protecting nonsmokers from the hazards of secondhand smoke in all indoor workplaces and public places, banning tobacco advertising and sponsorship, raising tobacco taxes and eliminating the smuggling of untaxed cigarettes. The future health of the world's population rests on the success that will be achieved in global tobacco control.

Effect of pravastatin on survival in patients with advanced hepatocellular carcinoma. A randomized controlled trial

PubMed Central

Kawata, S; Yamasaki, E; Nagase, T; Inui, Y; Ito, N; Matsuda, Y; Inada, M; Tamura, S; Noda, S; Imai, Y; Matsuzawa, Y

2001-01-01

Chemotherapy is not effective for hepatocellular carcinoma (HCC). HMG-CoA redutase inhibitors have cytostatic activity for cancer cells, but their clinical usefulness is unknown. To investigate whether pravastatin, a potent HMG-CoA reductase inhibitor, prolongs survival in patients with advanced HCC, this randomized controlled trial was conducted between February 1990 and February 1998 at Osaka University Hospital. 91 consecutive patients <71 years old (mean age 62) with unresectable HCC were enroled in this study. 8 patients were withdrawn because of progressive liver dysfunction; 83 patients were randomized to standard treatment with or without pravastatin. All patients underwent transcatheter arterial embolization (TAE) followed by oral 5-FU 200 mg−1d for 2 months. Patients were then randomly assigned to control (n = 42) and pravastatin (n = 41) groups. Pravastatin was administered at a daily dose of 40 mg. The effect of pravastatin on tumour growth was assessed by ultrasonography. Primary endpoint was death due to progression of HCC. The duration of pravastatin administration was 16.5 ± 9.8 months (mean ± SD). No patients in either group were lost to follow-up. Median survival was 18 months in the pravastatin group versus 9 months in controls (P = 0.006). The Cox proportional hazards model showed that pravastatin was a significant factor contributing to survival. Pravastatin prolonged the survival of patients with advanced HCC, suggesting its value for adjuvant treatment. © 2001 Cancer Research Campaign http://www.bjcancer.com PMID:11286466

Participatory health impact assessment for the development of local government regulation on hazard control

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

Inmuong, Uraiwan, E-mail: uraiwan@kku.ac.t; Faculty of Public Health, Khon Kaen University, Thailand 123 Mittrapharb Road, Khon Kaen 40002; Rithmak, Panee, E-mail: panrit@kku.ac.t

The Thai Public Health Act 1992 required the Thai local governments to issue respective regulations to take control of any possible health-hazard related activities, both from commercial and noncommercial sources. Since 1999, there has been centrally decentralized of power to a new form of local government establishment, namely Sub-district Administrative Organization (SAO). The SAO is asmall-scale local governing structure while its legitimate function is for community services, including control of health impact related activities. Most elected SAO administrators and officers are new and less experience with any of public health code of practice, particularly on health-hazard control. This action researchmore » attempted to introduce and apply a participatory health impact assessment (HIA) tool for the development of SAO health-hazard control regulation. The study sites were at Ban Meang and Kok See SAOs, Khon Kaen Province, Thailand, while all intervention activities conducted during May 2005-April 2006. A set of cooperative activities between researchers and community representatives were planned and organized by; surveying and identifying place and service base locally causing local environmental health problems, organizing community participatory workshops for drafting and proposing the health-hazard control regulation, and appropriate practices for health-hazard controlling measures. This action research eventually could successfully enable the SAO administrators and officers understanding of local environmental-related health problem, as well as development of imposed health-hazard control regulation for local community.« less

Gaining power and precision by using model-based weights in the analysis of late stage cancer trials with substantial treatment switching.

PubMed

Bowden, Jack; Seaman, Shaun; Huang, Xin; White, Ian R

2016-04-30

In randomised controlled trials of treatments for late-stage cancer, it is common for control arm patients to receive the experimental treatment around the point of disease progression. This treatment switching can dilute the estimated treatment effect on overall survival and impact the assessment of a treatment's benefit on health economic evaluations. The rank-preserving structural failure time model of Robins and Tsiatis (Comm. Stat., 20:2609-2631) offers a potential solution to this problem and is typically implemented using the logrank test. However, in the presence of substantial switching, this test can have low power because the hazard ratio is not constant over time. Schoenfeld (Biometrika, 68:316-319) showed that when the hazard ratio is not constant, weighted versions of the logrank test become optimal. We present a weighted logrank test statistic for the late stage cancer trial context given the treatment switching pattern and working assumptions about the underlying hazard function in the population. Simulations suggest that the weighted approach can lead to large efficiency gains in either an intention-to-treat or a causal rank-preserving structural failure time model analysis compared with the unweighted approach. Furthermore, violation of the working assumptions used in the derivation of the weights only affects the efficiency of the estimates and does not induce bias or inflate the type I error rate. The weighted logrank test statistic should therefore be considered for use as part of a careful secondary, exploratory analysis of trial data affected by substantial treatment switching. ©2015 The Authors. Statistics inMedicine Published by John Wiley & Sons Ltd.

Daratumumab plus Bortezomib, Melphalan, and Prednisone for Untreated Myeloma.

PubMed

Mateos, María-Victoria; Dimopoulos, Meletios A; Cavo, Michele; Suzuki, Kenshi; Jakubowiak, Andrzej; Knop, Stefan; Doyen, Chantal; Lucio, Paulo; Nagy, Zsolt; Kaplan, Polina; Pour, Ludek; Cook, Mark; Grosicki, Sebastian; Crepaldi, Andre; Liberati, Anna M; Campbell, Philip; Shelekhova, Tatiana; Yoon, Sung-Soo; Iosava, Genadi; Fujisaki, Tomoaki; Garg, Mamta; Chiu, Christopher; Wang, Jianping; Carson, Robin; Crist, Wendy; Deraedt, William; Nguyen, Huong; Qi, Ming; San-Miguel, Jesus

2018-02-08

The combination of bortezomib, melphalan, and prednisone is a standard treatment for patients with newly diagnosed multiple myeloma who are ineligible for autologous stem-cell transplantation. Daratumumab has shown efficacy in combination with standard-of-care regimens in patients with relapsed or refractory multiple myeloma. In this phase 3 trial, we randomly assigned 706 patients with newly diagnosed multiple myeloma who were ineligible for stem-cell transplantation to receive nine cycles of bortezomib, melphalan, and prednisone either alone (control group) or with daratumumab (daratumumab group) until disease progression. The primary end point was progression-free survival. At a median follow-up of 16.5 months in a prespecified interim analysis, the 18-month progression-free survival rate was 71.6% (95% confidence interval [CI], 65.5 to 76.8) in the daratumumab group and 50.2% (95% CI, 43.2 to 56.7) in the control group (hazard ratio for disease progression or death, 0.50; 95% CI, 0.38 to 0.65; P<0.001). The overall response rate was 90.9% in the daratumumab group, as compared with 73.9% in the control group (P<0.001), and the rate of complete response or better (including stringent complete response) was 42.6%, versus 24.4% (P<0.001). In the daratumumab group, 22.3% of the patients were negative for minimal residual disease (at a threshold of 1 tumor cell per 10 5 white cells), as compared with 6.2% of those in the control group (P<0.001). The most common adverse events of grade 3 or 4 were hematologic: neutropenia (in 39.9% of the patients in the daratumumab group and in 38.7% of those in the control group), thrombocytopenia (in 34.4% and 37.6%, respectively), and anemia (in 15.9% and 19.8%, respectively). The rate of grade 3 or 4 infections was 23.1% in the daratumumab group and 14.7% in the control group; the rate of treatment discontinuation due to infections was 0.9% and 1.4%, respectively. Daratumumab-associated infusion-related reactions occurred in 27.7% of the patients. Among patients with newly diagnosed multiple myeloma who were ineligible for stem-cell transplantation, daratumumab combined with bortezomib, melphalan, and prednisone resulted in a lower risk of disease progression or death than the same regimen without daratumumab. The daratumumab-containing regimen was associated with more grade 3 or 4 infections. (Funded by Janssen Research and Development; ALCYONE ClinicalTrials.gov number, NCT02195479 .).

KSC-2013-4280

NASA Image and Video Library

2013-12-06

CAPE CANAVERAL, Fla. – Inside a control room at NASA’s Kennedy Space Center in Florida, engineers monitor the progress as the Project Morpheus prototype lander is being prepared for a tether test on a transportable launch platform positioned at the north end of the Shuttle Landing Facility. The tethered test will include lifting it 20 feet by crane, ascending another 10 feet, maneuvering backwards 10 feet, and then flying forward and descending to its original position, landing at the end of the tether. Testing of the prototype lander was performed at NASA’s Johnson Space Center in Houston in preparation for tethered and free flight testing at Kennedy. The landing facility will provide the lander with the kind of field necessary for realistic testing, complete with rocks, craters and hazards to avoid. Morpheus utilizes an autonomous landing and hazard avoidance technology, or ALHAT, payload that will allow it to navigate to clear landing sites amidst rocks, craters and other hazards during its descent. Project Morpheus is being managed under the Advanced Exploration Systems, or AES, Division in NASA’s Human Exploration and Operations Mission Directorate. The efforts in AES pioneer new approaches for rapidly developing prototype systems, demonstrating key capabilities and validating operational concepts for future human missions beyond Earth orbit. For more information on Project Morpheus, visit http://morpheuslander.jsc.nasa.gov. Photo credit: NASA/Daniel Casper

[Failure modes and effects analysis in the prescription, validation and dispensing process].

PubMed

Delgado Silveira, E; Alvarez Díaz, A; Pérez Menéndez-Conde, C; Serna Pérez, J; Rodríguez Sagrado, M A; Bermejo Vicedo, T

2012-01-01

To apply a failure modes and effects analysis to the prescription, validation and dispensing process for hospitalised patients. A work group analysed all of the stages included in the process from prescription to dispensing, identifying the most critical errors and establishing potential failure modes which could produce a mistake. The possible causes, their potential effects, and the existing control systems were analysed to try and stop them from developing. The Hazard Score was calculated, choosing those that were ≥ 8, and a Severity Index = 4 was selected independently of the hazard Score value. Corrective measures and an implementation plan were proposed. A flow diagram that describes the whole process was obtained. A risk analysis was conducted of the chosen critical points, indicating: failure mode, cause, effect, severity, probability, Hazard Score, suggested preventative measure and strategy to achieve so. Failure modes chosen: Prescription on the nurse's form; progress or treatment order (paper); Prescription to incorrect patient; Transcription error by nursing staff and pharmacist; Error preparing the trolley. By applying a failure modes and effects analysis to the prescription, validation and dispensing process, we have been able to identify critical aspects, the stages in which errors may occur and the causes. It has allowed us to analyse the effects on the safety of the process, and establish measures to prevent or reduce them. Copyright © 2010 SEFH. Published by Elsevier Espana. All rights reserved.

76 FR 35130 - Pipeline Safety: Control Room Management/Human Factors

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-16

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Parts...: Control Room Management/Human Factors AGENCY: Pipeline and Hazardous Materials Safety Administration... safety standards, risk assessments, and safety policies for natural gas pipelines and for hazardous...

Perspectives on the Application of Mechanistic Information in Chemical Hazard and Dose-Response Assessments

EPA Science Inventory

This overview summarizes several EPA Assessment publications reviewing approaches for applying mechanistic information in human health risk assessment and exploring opportunities for progress in this area.

Real-world effectiveness of everolimus-based therapy versus fulvestrant monotherapy in HR(+)/HER2(-) metastatic breast cancer.

PubMed

Hao, Yanni; Lin, Peggy L; Xie, Jipan; Li, Nanxin; Koo, Valerie; Ohashi, Erika; Wu, Eric Q; Rogerio, Jaqueline

2015-08-01

Assessing real-world effectiveness of everolimus-based therapy (EVE) versus fulvestrant monotherapy (FUL) among postmenopausal women with hormone receptor-positive (HR(+))/HER2(-) metastatic breast cancer (mBC) after progression on nonsteroidal aromatase inhibitor (NSAI). Medical charts of community-based patients who received EVE or FUL for mBC after NSAI were examined. Progression-free survival (PFS), time on treatment and time to chemotherapy were compared using Kaplan-Meier curves and Cox proportional hazards models adjusting for line of therapy and patient characteristics. 192 patients received EVE and 156 FUL. After adjusting for patient characteristics, EVE was associated with significantly longer PFS than FUL (hazard ratio: 0.71; p = 0.045). EVE was associated with better PFS than FUL among NSAI-refractory postmenopausal HR(+)/HER2(-) mBC patients.

An epigenetic signature of adhesion molecules predicts poor prognosis of ovarian cancer patients

PubMed Central

Chang, Ping-Ying; Liao, Yu-Ping; Wang, Hui-Chen; Chen, Yu-Chih; Huang, Rui-Lan; Wang, Yu-Chi; Yuan, Chiou-Chung; Lai, Hung-Cheng

2017-01-01

DNA methylation is a promising biomarker for cancer. The epigenetic effects of cell adhesion molecules may affect the therapeutic outcome and the present study examined their effects on survival in ovarian cancer. We integrated methylomics and genomics datasets in The Cancer Genome Atlas (n = 391) and identified 106 highly methylated adhesion-related genes in ovarian cancer tissues. Univariate analysis revealed the methylation status of eight genes related to progression-free survival. In multivariate Cox regression analysis, four highly methylated genes (CD97, CTNNA1, DLC1, HAPLN2) and three genes (LAMA4, LPP, MFAP4) with low methylation were significantly associated with poor progression-free survival. Low methylation of VTN was an independent poor prognostic factor for overall survival after adjustment for age and stage. Patients who carried any two of CTNNA1, DLC1 or MFAP4 were significantly associated with poor progression-free survival (hazard ratio: 1.59; 95% confidence interval: 1.23, 2.05). This prognostic methylation signature was validated in a methylomics dataset generated in our lab (n = 37, hazard ratio: 16.64; 95% confidence interval: 2.68, 103.14) and in another from the Australian Ovarian Cancer Study (n = 91, hazard ratio: 2.43; 95% confidence interval: 1.11, 5.36). Epigenetics of cell adhesion molecules is related to ovarian cancer prognosis. A more comprehensive methylomics of cell adhesion molecules is needed and may advance personalized treatment with adhesion molecule-related drugs. PMID:28881822

Addressing Control of Hazardous Energy (COHE) Requirements in a Laser Safety Program

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

Woods, Michael; /SLAC

OSHA regulation 29CFR1910.147 specifies control of hazardous energy requirements for 'the servicing and maintenance of machines and equipment in which the unexpected energization or start up of the machines or equipment, or release of stored energy could cause injury to employees.' Class 3B and Class 4 laser beams must be considered hazardous energy sources because of the potential for serious eye injury; careful consideration is therefore needed to safely de-energize these lasers. This paper discusses and evaluates control of hazardous energy principles in this OSHA regulation, in ANSI Z136.1 ''Safe Use of Lasers,'' and in ANSI Z244.1 ''Control of Hazardousmore » Energy, Lockout/Tagout and Alternative Methods.'' Recommendations are made for updating and improving CoHE (control of hazardous energy) requirements in these standards for their applicability to safe laser operations.« less

Preharvest food safety.

PubMed

Childers, A B; Walsh, B

1996-07-23

Preharvest food safety is essential for the protection of our food supply. The production and transport of livestock and poultry play an integral part in the safety of these food products. The goals of this safety assurance include freedom from pathogenic microorganisms, disease, and parasites, and from potentially harmful residues and physical hazards. Its functions should be based on hazard analysis and critical control points from producer to slaughter plant with emphasis on prevention of identifiable hazards rather than on removal of contaminated products. The production goal is to minimize infection and insure freedom from potentially harmful residues and physical hazards. The marketing goal is control of exposure to pathogens and stress. Both groups should have functional hazard analysis and critical control points management programs which include personnel training and certification of producers. These programs must cover production procedures, chemical usage, feeding, treatment practices, drug usage, assembly and transportation, and animal identification. Plans must use risk assessment principles, and the procedures must be defined. Other elements would include preslaughter certification, environmental protection, control of chemical hazards, live-animal drug-testing procedures, and identification of physical hazards.

Application of systems and control theory-based hazard analysis to radiation oncology.

PubMed

Pawlicki, Todd; Samost, Aubrey; Brown, Derek W; Manger, Ryan P; Kim, Gwe-Ya; Leveson, Nancy G

2016-03-01

Both humans and software are notoriously challenging to account for in traditional hazard analysis models. The purpose of this work is to investigate and demonstrate the application of a new, extended accident causality model, called systems theoretic accident model and processes (STAMP), to radiation oncology. Specifically, a hazard analysis technique based on STAMP, system-theoretic process analysis (STPA), is used to perform a hazard analysis. The STPA procedure starts with the definition of high-level accidents for radiation oncology at the medical center and the hazards leading to those accidents. From there, the hierarchical safety control structure of the radiation oncology clinic is modeled, i.e., the controls that are used to prevent accidents and provide effective treatment. Using STPA, unsafe control actions (behaviors) are identified that can lead to the hazards as well as causal scenarios that can lead to the identified unsafe control. This information can be used to eliminate or mitigate potential hazards. The STPA procedure is demonstrated on a new online adaptive cranial radiosurgery procedure that omits the CT simulation step and uses CBCT for localization, planning, and surface imaging system during treatment. The STPA procedure generated a comprehensive set of causal scenarios that are traced back to system hazards and accidents. Ten control loops were created for the new SRS procedure, which covered the areas of hospital and department management, treatment design and delivery, and vendor service. Eighty three unsafe control actions were identified as well as 472 causal scenarios that could lead to those unsafe control actions. STPA provides a method for understanding the role of management decisions and hospital operations on system safety and generating process design requirements to prevent hazards and accidents. The interaction of people, hardware, and software is highlighted. The method of STPA produces results that can be used to improve safety and prevent accidents and warrants further investigation.

American Indian Substance Use: The Hazards for Substance Use Initiation and Progression for Adolescents Aged 14 to 20 Years

ERIC Educational Resources Information Center

Novins, Douglas K.; Baron, Anna E.

2004-01-01

Objective: To describe the risks and risk factors for substance use initiation and progression among a large sample of American Indian (AI) adolescents. Method: Data came from surveys completed by 2,356 AI adolescents aged 14 to 20 years who participated in two or more consecutive waves of a longitudinal study between 1993 and 1996 (response rate…

Automated Hazard Analysis

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

Riddle, F. J.

2003-06-26

The Automated Hazard Analysis (AHA) application is a software tool used to conduct job hazard screening and analysis of tasks to be performed in Savannah River Site facilities. The AHA application provides a systematic approach to the assessment of safety and environmental hazards associated with specific tasks, and the identification of controls regulations, and other requirements needed to perform those tasks safely. AHA is to be integrated into existing Savannah River site work control and job hazard analysis processes. Utilization of AHA will improve the consistency and completeness of hazard screening and analysis, and increase the effectiveness of the workmore » planning process.« less

A joint frailty-copula model between tumour progression and death for meta-analysis.

PubMed

Emura, Takeshi; Nakatochi, Masahiro; Murotani, Kenta; Rondeau, Virginie

2017-12-01

Dependent censoring often arises in biomedical studies when time to tumour progression (e.g., relapse of cancer) is censored by an informative terminal event (e.g., death). For meta-analysis combining existing studies, a joint survival model between tumour progression and death has been considered under semicompeting risks, which induces dependence through the study-specific frailty. Our paper here utilizes copulas to generalize the joint frailty model by introducing additional source of dependence arising from intra-subject association between tumour progression and death. The practical value of the new model is particularly evident for meta-analyses in which only a few covariates are consistently measured across studies and hence there exist residual dependence. The covariate effects are formulated through the Cox proportional hazards model, and the baseline hazards are nonparametrically modeled on a basis of splines. The estimator is then obtained by maximizing a penalized log-likelihood function. We also show that the present methodologies are easily modified for the competing risks or recurrent event data, and are generalized to accommodate left-truncation. Simulations are performed to examine the performance of the proposed estimator. The method is applied to a meta-analysis for assessing a recently suggested biomarker CXCL12 for survival in ovarian cancer patients. We implement our proposed methods in R joint.Cox package.

HPV status and favourable outcome in vulvar squamous cancer.

PubMed

Wakeham, Katie; Kavanagh, Kim; Cuschieri, Kate; Millan, David; Pollock, Kevin G; Bell, Sarah; Burton, Kevin; Reed, Nicholas S; Graham, Sheila V

2017-03-01

It is universally accepted that high-risk human papillomavirus (HR-HPV) is the cause of cervical dysplasia and cancer. More recently, it has been shown that HPV is also a marker of clinical outcome in oropharyngeal cancer. However, contemporary information is lacking on both the prevalence of HPV infection in vulvar cancer (VSCC), its precursor lesion, vulvar intraepithelial neoplasia (VIN) and the influence of HPV-status on the prognosis of this malignancy. We have conducted a detailed population-based study to examine rates of progression of VIN to VSCC, type-specific HPV prevalence in vulvar disease and the influence of HPV status on clinical outcome in VSCC. We observed that the age at which women are diagnosed with VSCC is falling and there is a significant time gap between first diagnosis of VIN and progression to invasive disease. HR-HPV infection was detected in 87% (97/112) cases of VIN and 52% cases (32/62) of VSCC. The presence of HR-HPV in squamous intraepithelial lesion was associated with lower rates of progression to invasive cancer (hazard ratio, 0.22, p = 0.001). In the adjusted analysis, HR-HPV was associated with improved progression-free survival of VSCC compared to those with HPV negative tumours (hazard ratio, 0.32, p = 0.02). © 2016 UICC.

Sarcopenia is associated with incident albuminuria in patients with type 2 diabetes: A retrospective observational study.

PubMed

Bouchi, Ryotaro; Fukuda, Tatsuya; Takeuchi, Takato; Minami, Isao; Yoshimoto, Takanobu; Ogawa, Yoshihiro

2017-11-01

Sarcopenia, defined as age-related loss of skeletal muscle mass and function, increases the risk of albuminuria. However, it has still unknown whether sarcopenia could increase the risk for the progression of albuminuria. A total 238 patients with type 2 diabetes (mean age 64 ± 12 years; 39.2% women) were studied in the present retrospective observational study. The prevalence of sarcopenia was 17.6%. During the median follow-up period of 2.6 years, albuminuria was measured 5.8 ± 1.8 times, and progression of albuminuria was observed in 14.9% of patients with normoalbuminuria, as was 11.5% in those with microalbuminuria. Sarcopenia was significantly associated with both progression (hazard ratio 2.61, 95% confidence interval 1.08-6.31, P = 0.034) and regression (hazard ratio 0.23, 95% confidence interval 0.05-0.98, P = 0.048) of albuminuria by multivariate Cox regression analysis. The present data suggest that sarcopenia is an important determinant of both progression and regression of albuminuria in patients with type 2 diabetes. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Tobacco smoking increases the risk of high-grade dysplasia and cancer among patients with Barrett's esophagus.

PubMed

Coleman, Helen G; Bhat, Shivaram; Johnston, Brian T; McManus, Damian; Gavin, Anna T; Murray, Liam J

2012-02-01

Esophageal adenocarcinoma arises from Barrett's esophagus (BE); patients with this cancer have a poor prognosis. Identification of modifiable lifestyle factors that affect the risk of progression from BE to esophageal adenocarcinoma might prevent its development. We investigated associations among body size, smoking, and alcohol use with progression of BE to neoplasia. We analyzed data from patients with BE identified from the population-based Northern Ireland BE register, diagnosed between 1993 and 2005 with specialized intestinal metaplasia (n = 3167). Data on clinical, demographic, and lifestyle factors related to diagnosis of BE were collected from hospital case notes. We used the Northern Ireland Cancer Registry to identify which of these patients later developed esophageal adenocarcinoma, adenocarcinomas of the gastric cardia, or esophageal high-grade dysplasia. Cox proportional hazards models were used to associate lifestyle factors with risk of progression. By December 31, 2008, 117 of the patients with BE developed esophageal high-grade dysplasia or adenocarcinomas of the esophagus or gastric cardia. Current tobacco smoking was significantly associated with an increased risk of progression (hazard ratio = 2.03; 95% confidence interval, 1.29-3.17) compared with never smoking, and across all strata of smoking intensity. Alcohol consumption was not related to risk of progression. Measures of body size were infrequently reported in endoscopy reports, and body size was not associated with risk of progression. Smoking tobacco increases the risk of progression to cancer or high-grade dysplasia 2-fold among patients with BE, compared with patients with BE that have never smoked. Smoking cessation strategies should be considered for patients with BE. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

Feasibility and safety of extended adjuvant temozolomide beyond six cycles for patients with glioblastoma.

PubMed

Hsieh, S Yp; Chan, D Tm; Kam, M Km; Loong, H Hf; Tsang, W K; Poon, D Mc; Ng, S Cp; Poon, W S

2017-12-01

Temozolomide is the first chemotherapeutic agent proven effective for patients with newly diagnosed glioblastoma. The drug is well tolerated for its low toxicity. The current standard practice is concomitant chemoradiotherapy for 6 weeks followed by 6 cycles of adjuvant temozolomide. Some Caucasian studies have suggested that patients might benefit from extended adjuvant cycles of temozolomide (>6 cycles) to lengthen both progression-free survival and overall survival. In the present study, we compared differences in survival and toxicity profile between patients who received conventional 6-cycle temozolomide and those who received more than 6 cycles of temozolomide. Patients with newly diagnosed glioblastoma without progressive disease and completed concomitant chemoradiotherapy during a 4-year period were studied. Progression-free survival was compared using Kaplan-Meier survival curves. t Test, U test, and correlation were chosen accordingly to examine the impact of age, extent of resection, MGMT promoter methylation status and adjuvant cycles on progression-free survival. For factors with a P value of <0.05 in univariate analyses, Cox regression hazard model was adopted to determine the strongest factors related to progression-free survival. The median progression-free survival was 17.0 months for patients who received 6 cycles of temozolomide (n=7) and 43.4 months for those who received more than 6 cycles (n=7) [P=0.007, log-rank test]. Two patients in the former group and one in the latter group encountered grade 1 toxicity and recovered following dose adjustment. Cycles of adjuvant temozolomide were correlated with progression-free survival (P=0.016, hazard ratio=0.68). Extended cycles of temozolomide are safe and feasible for Chinese patients with disease responsive to temozolomide.

Effect of candesartan on progression and regression of retinopathy in type 2 diabetes (DIRECT-Protect 2): a randomised placebo-controlled trial.

PubMed

Sjølie, Anne Katrin; Klein, Ronald; Porta, Massimo; Orchard, Trevor; Fuller, John; Parving, Hans Henrik; Bilous, Rudy; Chaturvedi, Nish

2008-10-18

Diabetic retinopathy remains a leading cause of visual loss in people of working age. We examined whether candesartan treatment could slow the progression and, secondly, induce regression of retinopathy in people with type 2 diabetes. We did a randomised, double-blind, parallel-group, placebo-controlled trial in 309 centres worldwide. We recruited normoalbuminuric, normotensive, or treated hypertensive people with type 2 diabetes with mild to moderately severe retinopathy and assigned them to candesartan 16 mg once a day or placebo. After a month, the dose was doubled to 32 mg once per day. Investigators and patients were unaware of the treatment allocation status. Progression of retinopathy was the primary endpoint, and regression was a secondary endpoint. Analysis was by intention to treat. The trial is registered with ClinicalTrials.gov, number NCT00252694. 1905 participants (aged 37-75 years) were randomised to candesartan (n=951) or placebo (n=954). 161 (17%) patients in the candesartan group and 182 (19%) in the placebo group had progression of retinopathy by three steps or more on the Early Treatment Diabetic Retinopathy Study scale. The risk of progression of retinopathy was non-significantly reduced by 13% in patients on candesartan compared with those on placebo (hazard ratio [HR] 0.87, 95% CI 0.70-1.08, p=0.20). Regression on active treatment was increased by 34% (1.34, 1.08-1.68, p=0.009). HRs were not attenuated by adjustment for baseline risk factors or changes in blood pressure during the trial. An overall change towards less severe retinopathy by the end of the trial was observed in the candesartan group (odds 1.17, 95% CI 1.05-1.30, p=0.003). Adverse events did not differ between the treatment groups. Treatment with candesartan in type 2 diabetic patients with mild to moderate retinopathy might induce improvement of retinopathy.

Spill Prevention and Countermeasures Plan

DTIC Science & Technology

1984-08-01

THE DISCHARGE OF OiIL AND HAZARDOUS SUBSTANCES AT RMA. THE SPCC PLAN IDENTIFIES POTENTIAL SOURCES OF OIL AND HAZARDOUS SUBSTANCES AND THE MEASURES...Control and Countermeasure (SPCC) Plan is to prevent and control the discharge of oil and hazardous sub- stances at Rocky Mountain Arsenal (RYA). The...SPCC Plan identifies potential sources of oil and hazardous substances and the measures required to prevent an accidental discharge resulting from

Digital Semaphore: Tactical Implications of QR Code Optical Signaling for Fleet Communications

DTIC Science & Technology

2013-06-01

Emissions Control (EMCON) and Hazards of Electromagnetic Radiation to Ordnance (HERO) restrict the ability for Naval Vessels to communicate using...importance of visual communications methods is brought to light by discussing emissions control, hazards of electromagnetic radiation to ordnance , and...overview of emissions restrictions including Emissions Control (EMCON) and Hazards of Electromagnetic Radiation to Ordnance (HERO). Chapter VII is

Hazardous waste management in the Pacific basin

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

Cirillo, R.R.; Chiu, S.; Chun, K.C.

1994-11-01

Hazardous waste control activities in Asia and the Pacific have been reviewed. The review includes China (mainland, Hong Kong, and Taiwan), Indonesia, Korea, Malaysia, Papua New Guinea, the Philippines, Singapore, and Thailand. It covers the sources of hazardous waste, the government structure for dealing with hazardous waste, and current hazardous waste control activities in each country. In addition, the hazardous waste program activities of US government agencies, US private-sector organizations, and international organizations are reviewed. The objective of these reviews is to provide a comprehensive picture of the current hazardous waste problems and the waste management approaches being used tomore » address them so that new program activities can be designed more efficiently.« less

Prognostic importance of plasma total magnesium in a cohort of cats with azotemic chronic kidney disease.

PubMed

van den Broek, D Hendrik N; Chang, Yu-Mei; Elliott, Jonathan; Jepson, Rosanne E

2018-04-27

Hypomagnesemia is associated with increased mortality and renal function decline in humans with chronic kidney disease (CKD). Magnesium is furthermore inversely associated with fibroblast growth factor 23 (FGF23), an important prognostic factor in CKD in cats. However, the prognostic significance of plasma magnesium in cats with CKD is unknown. To explore associations of plasma total magnesium concentration (tMg) with plasma FGF23 concentration, all-cause mortality, and disease progression in cats with azotemic CKD. Records of 174 client-owned cats with IRIS stage 2-4 CKD. Cohort study. Cats with azotemic CKD were identified from the records of two London-based first opinion practices (1999-2013). Possible associations of baseline plasma tMg with FGF23 concentration and risks of death and progression were explored using, respectively, linear, Cox, and logistic regression. Plasma tMg (reference interval, 1.73-2.57 mg/dL) was inversely associated with plasma FGF23 when controlling for plasma creatinine and phosphate concentrations (partial correlation coefficient, -0.50; P < .001). Hypomagnesemia was observed in 12% (20/174) of cats, and independently associated with increased risk of death (adjusted hazard ratio, 2.74; 95% confidence interval [CI], 1.35-5.55; P = .005). The unadjusted associations of hypermagnesemia (prevalence, 6%; 11/174 cats) with survival (hazard ratio, 2.88; 95% CI, 1.54-5.38; P = .001), and hypomagnesemia with progressive CKD (odds ratio, 17.7; 95% CI, 2.04-154; P = .009) lost significance in multivariable analysis. Hypomagnesemia was associated with higher plasma FGF23 concentrations and increased risk of death. Measurement of plasma tMg augments prognostic information in cats with CKD, but whether these observations are associations or causations warrants further investigation. © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Helplessness/hopelessness, minimization and optimism predict survival in women with invasive ovarian cancer: a role for targeted support during initial treatment decision-making?

PubMed

Price, Melanie A; Butow, Phyllis N; Bell, Melanie L; deFazio, Anna; Friedlander, Michael; Fardell, Joanna E; Protani, Melinda M; Webb, Penelope M

2016-06-01

Women with advanced ovarian cancer generally have a poor prognosis but there is significant variability in survival despite similar disease characteristics and treatment regimens. The aim of this study was to determine whether psychosocial factors predict survival in women with ovarian cancer, controlling for potential confounders. The sample comprised 798 women with invasive ovarian cancer recruited into the Australian Ovarian Cancer Study and a subsequent quality of life study. Validated measures of depression, optimism, minimization, helplessness/hopelessness, and social support were completed 3-6 monthly for up to 2 years. Four hundred nineteen women (52.5 %) died over the follow-up period. Associations between time-varying psychosocial variables and survival were tested using adjusted Cox proportional hazard models. There was a significant interaction of psychosocial variables measured prior to first progression and overall survival, with higher optimism (adjusted hazard ratio per 1 standard deviation (HR) = 0.80, 95 % confidence interval (CI) 0.65-0.97), higher minimization (HR = 0.79, CI 0.66-0.94), and lower helplessness/hopelessness (HR = 1.40, CI 1.15-1.71) associated with longer survival. After disease progression, these variables were not associated with survival (optimism HR = 1.10, CI 0.95-1.27; minimization HR = 1.12, CI 0.95-1.31; and helplessness/hopelessness HR = 0.86, CI 0.74-1.00). Depression and social support were not associated with survival. In women with invasive ovarian cancer, psychosocial variables prior to disease progression appear to impact on overall survival, suggesting a preventive rather than modifying role. Addressing psychosocial responses to cancer and their potential impact on treatment decision-making early in the disease trajectory may benefit survival and quality of life.

Prediction of functional loss in glaucoma from progressive optic disc damage.

PubMed

Medeiros, Felipe A; Alencar, Luciana M; Zangwill, Linda M; Bowd, Christopher; Sample, Pamela A; Weinreb, Robert N

2009-10-01

To evaluate the ability of progressive optic disc damage detected by assessment of longitudinal stereophotographs to predict future development of functional loss in those with suspected glaucoma. The study included 639 eyes of 407 patients with suspected glaucoma followed up for an average of 8.0 years with annual standard automated perimetry visual field and optic disc stereophotographs. All patients had normal and reliable standard automated perimetry results at baseline. Conversion to glaucoma was defined as development of 3 consecutive abnormal visual fields during follow-up. Presence of progressive optic disc damage was evaluated by grading longitudinally acquired simultaneous stereophotographs. Other predictive factors included age, intraocular pressure, central corneal thickness, pattern standard deviation, and baseline stereophotograph grading. Hazard ratios for predicting visual field loss were obtained by extended Cox models, with optic disc progression as a time-dependent covariate. Predictive accuracy was evaluated using a modified R(2) index. Progressive optic disc damage had a hazard ratio of 25.8 (95% confidence interval, 16.0-41.7) and was the most important risk factor for development of visual field loss with an R(2) of 79%. The R(2)s for other predictive factors ranged from 6% to 26%. Presence of progressive optic disc damage on stereophotographs was a highly predictive factor for future development of functional loss in glaucoma. These findings suggest the importance of careful monitoring of the optic disc appearance and a potential role for longitudinal assessment of the optic disc as an end point in clinical trials and as a reference for evaluation of diagnostic tests in glaucoma.

Outcome of Molecular Targeted Agents Plus Chemotherapy for Second-Line Therapy of Metastatic Colorectal Cancer: A Meta-Analysis of Randomized Trials.

PubMed

Pei, Xueqing; Liu, Yu; Sun, Liwei; Zhang, Jun; Fang, Yuanyuan; Liao, Xin; Liu, Jian; Zhang, Cuntai; Yin, Tiejun

2016-12-01

The aim of this study was to evaluate the efficacy and toxicity of molecular targeted agents plus chemotherapy compared with chemotherapy alone as second-line therapy for patients with metastatic colorectal cancer (mCRC). We identified randomized controlled trials that compared molecular targeted agents plus chemotherapy with chemotherapy alone by searching the PubMed and Embase databases for articles published between January 2000 and September 2015. The outcome measures included progression-free survival, overall survival, objective response rate, and adverse events. Two investigators independently performed the information retrieval, screening, and data extraction. Stata 10.0 software was used to statistically analyze the extracted data. In accordance with our inclusion criteria, 11 trials, with a total of 7440 patients, were included in this meta-analysis through rounds of selection. We divided the biologic agents used into 3 subgroups based on the type of biologic agents-vascular endothelial growth factor (VEGF) inhibitor, epidermal growth factor receptor inhibitor, and other pathway inhibitors. Our results suggested that the regimen of a molecular targeted agent plus chemotherapy had a significant advantage in progression-free survival, overall survival, and objective response rate over chemotherapy alone (hazard ratio, 0.74; 95% confidence interval [CI], 0.70-0.78; hazard ratio, 0.88; 95% CI, 0.83-0.93; risk ratio, 2.24; 95% CI: 1.58-3.17, respectively). However, the rate of grade ≥ 3 adverse events was also higher in the combination therapy arm (risk ratio, 1.25; 95% CI, 1.17-1.33). Subgroup analysis showed that the combination of VEGF inhibitor with chemotherapy had a significant advantage in PFS, OS, and ORR over chemotherapy alone, but there was also a higher risk ratio in adverse events for this combination compared with the control group. In conclusion, a molecular targeted agent, especially VEGF inhibitor, plus chemotherapy is a worthwhile combination for patients with metastatic colorectal cancer as second-line therapy. However, more randomized controlled trials on a larger scale are needed for evaluating the value of epidermal growth factor receptor and other pathway inhibitors. Copyright © 2016 Elsevier Inc. All rights reserved.

Aptamer-Based Analysis: A Promising Alternative for Food Safety Control

PubMed Central

Amaya-González, Sonia; de-los-Santos-Álvarez, Noemí; Miranda-Ordieres, Arturo J.; Lobo-Castañón, Maria Jesús

2013-01-01

Ensuring food safety is nowadays a top priority of authorities and professional players in the food supply chain. One of the key challenges to determine the safety of food and guarantee a high level of consumer protection is the availability of fast, sensitive and reliable analytical methods to identify specific hazards associated to food before they become a health problem. The limitations of existing methods have encouraged the development of new technologies, among them biosensors. Success in biosensor design depends largely on the development of novel receptors with enhanced affinity to the target, while being stable and economical. Aptamers fulfill these characteristics, and thus have surfaced as promising alternatives to natural receptors. This Review describes analytical strategies developed so far using aptamers for the control of pathogens, allergens, adulterants, toxins and other forbidden contaminants to ensure food safety. The main progresses to date are presented, highlighting potential prospects for the future. PMID:24287543

The Hazard Analysis and Critical Control Points (HACCP) generic model for the production of Thai fermented pork sausage (Nham).

PubMed

Paukatong, K V; Kunawasen, S

2001-01-01

Nham is a traditional Thai fermented pork sausage. The major ingredients of Nham are ground pork meat and shredded pork rind. Nham has been reported to be contaminated with Salmonella spp., Staphylococcus aureus, and Listeria monocytogenes. Therefore, it is a potential cause of foodborne diseases for consumers. A Hazard Analysis and Critical Control Points (HACCP) generic model has been developed for the Nham process. Nham processing plants were observed and a generic flow diagram of Nham processes was constructed. Hazard analysis was then conducted. Other than microbial hazards, the pathogens previously found in Nham, sodium nitrite and metal were identified as chemical and physical hazards in this product, respectively. Four steps in the Nham process have been identified as critical control points. These steps are the weighing of the nitrite compound, stuffing, fermentation, and labeling. The chemical hazard of nitrite must be controlled during the weighing step. The critical limit of nitrite levels in the Nham mixture has been set at 100-200 ppm. This level is high enough to control Clostridium botulinum but does not cause chemical hazards to the consumer. The physical hazard from metal clips could be prevented by visual inspection of every Nham product during stuffing. The microbiological hazard in Nham could be reduced in the fermentation process. The critical limit of the pH of Nham was set at lower than 4.6. Since this product is not cooked during processing, finally, educating the consumer, by providing information on the label such as "safe if cooked before consumption", could be an alternative way to prevent the microbiological hazards of this product.

The Suitport's Progress

NASA Technical Reports Server (NTRS)

Cohen, Marc M.

1995-01-01

NASA-Ames Research Center developed the Suitport as an advanced space suit airlock to support a Space Station suit based on the AX-5 hard suit. Several third parties proposed their own variations of the Suitport on the moon and Mars. The Suitport recently found its first practical use as a terrestrial application in the NASA-Ames Hazmat vehicle for the clean-up of hazardous and toxic materials. In the Hazmat application, the Suitport offers substantial improvements over conventional hazard suits by eliminating the necessity to decontaminate before doffing the suit.

EVA Hazards due to TPS Inspection and Repair

NASA Technical Reports Server (NTRS)

Stewart, Christine E.

2007-01-01

Tile inspection and repair activities have implicit hazards associated with them. When an Extra Vehicular Activities (EVA) crewmember and associated hardware are added into the equation, additional hazards are introduced. Potential hazards to the Extravehicular Mobility Unit (EMU), the Orbiter or the crew member themselves are created. In order to accurately assess the risk of performing a TPS inspection or repair, an accurate evaluation of potential hazards and how adequately these hazards are controlled is essential. The EMU could become damaged due to sharp edges, protrusions, thermal extremes, molten metal or impact with the Orbiter. Tools, tethers and the presence of a crew member in the vicinity of the Orbiter Thermal Protection System (TPS) pose hazards to the Orbiter. Hazards such as additional tile or Reinforced Carbon-Carbon (RCC) damage from a loose tool, safety tethers, crewmember or arm impact are introduced. Additionally, there are hazards to the crew which should be addressed. Crew hazards include laser injury, electrical shock, inability to return to the airlock for EMU failures or Orbiter rapid safing scenarios, as well as the potential inadvertent release of a crew member from the arm/boom. The aforementioned hazards are controlled in various ways. Generally, these controls are addressed operationally versus by design, as the majority of the interfaces are to the Orbiter and the Orbiter design did not originally account for tile repair. The Shuttle Remote Manipulator System (SRMS), for instance, was originally designed to deploy experiments, and therefore has insufficient design controls for retention of the Orbiter Boom Sensor System (OBSS). Although multiple methods to repair the Orbiter TPS exist, the majority of the hazards are applicable no matter which specific repair method is being performed. TPS Inspection performed via EVA also presents some of the same hazards. Therefore, the hazards common to all TPS inspection or repair methods will be addressed.

An Analysis of U.S. Army Health Hazard Assessments During the Acquisition of Military Materiel

DTIC Science & Technology

2010-06-03

protective equipment (PPE) (Milz, Conrad, & Soule , 2003). Engineering controls can eliminate hazards through system design, substitution of hazardous...Milz, Conrad, & Soule , 2003). Engineering control measures can serve to 7 minimize hazards where they cannot be eliminated, with preference for...during the materiel acquisitions process, and (c) will evaluate a sample of the database for accuracy by comparing the data entries to original reports

Influence of potential sea level rise on societal vulnerability to hurricane storm-surge hazards, Sarasota County, Florida

USGS Publications Warehouse

Frazier, T.G.; Wood, N.; Yarnal, B.; Bauer, D.H.

2010-01-01

Although the potential for hurricanes under current climatic conditions continue to threaten coastal communities, there is concern that climate change, specifically potential increases in sea level, could influence the impacts of future hurricanes. To examine the potential effect of sea level rise on community vulnerability to future hurricanes, we assess variations in socioeconomic exposure in Sarasota County, FL, to contemporary hurricane storm-surge hazards and to storm-surge hazards enhanced by sea level rise scenarios. Analysis indicates that significant portions of the population, economic activity, and critical facilities are in contemporary and future hurricane storm-surge hazard zones. The addition of sea level rise to contemporary storm-surge hazard zones effectively causes population and asset (infrastructure, natural resources, etc) exposure to be equal to or greater than what is in the hazard zone of the next higher contemporary Saffir-Simpson hurricane category. There is variability among communities for this increased exposure, with greater increases in socioeconomic exposure due to the addition of sea level rise to storm-surge hazard zones as one progresses south along the shoreline. Analysis of the 2050 comprehensive land use plan suggests efforts to manage future growth in residential, economic and infrastructure development in Sarasota County may increase societal exposure to hurricane storm-surge hazards. ?? 2010 Elsevier Ltd.

Influence of potential sea level rise on societal vulnerability to hurricane storm-surge hazards, Sarasota County, Florida

USGS Publications Warehouse

Frazier, Tim G.; Wood, Nathan; Yarnal, Brent; Bauer, Denise H.

2010-01-01

Although the potential for hurricanes under current climatic conditions continue to threaten coastal communities, there is concern that climate change, specifically potential increases in sea level, could influence the impacts of future hurricanes. To examine the potential effect of sea level rise on community vulnerability to future hurricanes, we assess variations in socioeconomic exposure in Sarasota County, FL, to contemporary hurricane storm-surge hazards and to storm-surge hazards enhanced by sea level rise scenarios. Analysis indicates that significant portions of the population, economic activity, and critical facilities are in contemporary and future hurricane storm-surge hazard zones. The addition of sea level rise to contemporary storm-surge hazard zones effectively causes population and asset (infrastructure, natural resources, etc) exposure to be equal to or greater than what is in the hazard zone of the next higher contemporary Saffir–Simpson hurricane category. There is variability among communities for this increased exposure, with greater increases in socioeconomic exposure due to the addition of sea level rise to storm-surge hazard zones as one progresses south along the shoreline. Analysis of the 2050 comprehensive land use plan suggests efforts to manage future growth in residential, economic and infrastructure development in Sarasota County may increase societal exposure to hurricane storm-surge hazards.

75 FR 60457 - Underground Injection Control Program Hazardous Waste Injection Restrictions; Petition for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-30

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9208-4] Underground Injection Control Program Hazardous Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection Dow Chemical Company (DOW... Petition. SUMMARY: Notice is hereby given that an exemption to the land disposal restrictions under the...

78 FR 42776 - Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-17

... ENVIRONMENTAL PROTECTION AGENCY [FRL9834-8] Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection; Blanchard Refining... migration petition reissuance. SUMMARY: Notice is hereby given that a reissuance of an exemption to the land...

Pembrolizumab as Second-Line Therapy for Advanced Urothelial Carcinoma.

PubMed

Bellmunt, Joaquim; de Wit, Ronald; Vaughn, David J; Fradet, Yves; Lee, Jae-Lyun; Fong, Lawrence; Vogelzang, Nicholas J; Climent, Miguel A; Petrylak, Daniel P; Choueiri, Toni K; Necchi, Andrea; Gerritsen, Winald; Gurney, Howard; Quinn, David I; Culine, Stéphane; Sternberg, Cora N; Mai, Yabing; Poehlein, Christian H; Perini, Rodolfo F; Bajorin, Dean F

2017-03-16

Patients with advanced urothelial carcinoma that progresses after platinum-based chemotherapy have a poor prognosis and limited treatment options. In this open-label, international, phase 3 trial, we randomly assigned 542 patients with advanced urothelial cancer that recurred or progressed after platinum-based chemotherapy to receive pembrolizumab (a highly selective, humanized monoclonal IgG4κ isotype antibody against programmed death 1 [PD-1]) at a dose of 200 mg every 3 weeks or the investigator's choice of chemotherapy with paclitaxel, docetaxel, or vinflunine. The coprimary end points were overall survival and progression-free survival, which were assessed among all patients and among patients who had a tumor PD-1 ligand (PD-L1) combined positive score (the percentage of PD-L1-expressing tumor and infiltrating immune cells relative to the total number of tumor cells) of 10% or more. The median overall survival in the total population was 10.3 months (95% confidence interval [CI], 8.0 to 11.8) in the pembrolizumab group, as compared with 7.4 months (95% CI, 6.1 to 8.3) in the chemotherapy group (hazard ratio for death, 0.73; 95% CI, 0.59 to 0.91; P=0.002). The median overall survival among patients who had a tumor PD-L1 combined positive score of 10% or more was 8.0 months (95% CI, 5.0 to 12.3) in the pembrolizumab group, as compared with 5.2 months (95% CI, 4.0 to 7.4) in the chemotherapy group (hazard ratio, 0.57; 95% CI, 0.37 to 0.88; P=0.005). There was no significant between-group difference in the duration of progression-free survival in the total population (hazard ratio for death or disease progression, 0.98; 95% CI, 0.81 to 1.19; P=0.42) or among patients who had a tumor PD-L1 combined positive score of 10% or more (hazard ratio, 0.89; 95% CI, 0.61 to 1.28; P=0.24). Fewer treatment-related adverse events of any grade were reported in the pembrolizumab group than in the chemotherapy group (60.9% vs. 90.2%); there were also fewer events of grade 3, 4, or 5 severity reported in the pembrolizumab group than in the chemotherapy group (15.0% vs. 49.4%). Pembrolizumab was associated with significantly longer overall survival (by approximately 3 months) and with a lower rate of treatment-related adverse events than chemotherapy as second-line therapy for platinum-refractory advanced urothelial carcinoma. (Funded by Merck; KEYNOTE-045 ClinicalTrials.gov number, NCT02256436 .).

Exposure to ACEI/ARB and β-Blockers Is Associated with Improved Survival and Decreased Tumor Progression and Hospitalizations in Patients with Advanced Colon Cancer1

PubMed Central

Engineer, Diana R; Burney, Basil O; Hayes, Teresa G; Garcia, Jose M

2013-01-01

BACKGROUND: Advanced colon cancer is associated with weight loss and decreased survival. Studies suggest that angiotensin and β-adrenergic blockade decrease colon cancer progression and ameliorate weight loss. This study aims to determine whether exposure to β-adrenoceptor blockers (BBs), angiotensin-converting enzyme inhibitors (ACEIs), or angiotensin receptor blockers (ARBs) is associated with decreased mortality, tumor progression, number of hospitalizations, or weight loss in colorectal cancer. METHODS: Retrospective chart review included patients with advanced colorectal cancer. Survival, stage, hospitalization, cancer progression, cancer treatment, and body weight history were collected. RESULTS: Two hundred sixty-two of 425 new stage III to IV colorectal cancer cases reviewed met the study criteria. Those exposed to ACEI/ARB, BB, or both were more likely to have diabetes, hypertension, and stage III colorectal cancer. Adjusting for age, presence of hypertension and diabetes, and stage, ACEI/ARB + BB exposure was associated with decreased mortality compared to unexposed individuals [hazard ratio (HR) = 0.5, confidence interval (CI) = 0.29–0.85; Cox regression, P = .01]. Fewer total and cancer-related hospitalizations and decreased cancer progression in the ACEI/ARB + BB group versus the unexposed group (HR = 0.59, CI = 0.36–0.99, P = .047) were seen. Exposure did not affect weight changes; furthermore, body weight changes from both prediagnosis and at diagnosis to 6, 12, 18, and 24 months postdiagnosis predicted survival. CONCLUSIONS: We have observed an association between exposure to a combination of ACEI/ARB + BB and increased survival, decreased hospitalizations, and decreased tumor progression in advanced colorectal cancer. Future studies will be needed to replicate these results and generalize them to broader populations. Determination of causality will require a randomized controlled trial. PMID:24151534

An Introduction to Hazardous Material Management.

ERIC Educational Resources Information Center

Reinhardt, Peter A.; And Others

1987-01-01

Colleges must have a system to safely control the ordering, delivery, transport, storage, and use of hazardous material. Information on hazardous material management is excerpted from "Managing Hazardous Waste at Educational Institutions. (MLW)

Prediction and perception of hazards in professional drivers: Does hazard perception skill differ between safe and less-safe fire-appliance drivers?

PubMed

Crundall, David; Kroll, Victoria

2018-05-18

Can hazard perception testing be useful for the emergency services? Previous research has found emergency response drivers' (ERDs) to perform better than controls, however these studies used clips of normal driving. In contrast, the current study filmed footage from a fire-appliance on blue-light training runs through Nottinghamshire, and endeavoured to discriminate between different groups of EDRs based on experience and collision risk. Thirty clips were selected to create two variants of the hazard perception test: a traditional push-button test requiring speeded-responses to hazards, and a prediction test that occludes at hazard onset and provides four possible outcomes for participants to choose between. Three groups of fire-appliance drivers (novices, low-risk experienced and high-risk experienced), and age-matched controls undertook both tests. The hazard perception test only discriminated between controls and all FA drivers, whereas the hazard prediction test was more sensitive, discriminating between high and low-risk experienced fire appliance drivers. Eye movement analyses suggest that the low-risk drivers were better at prioritising the hazardous precursors, leading to better predictive accuracy. These results pave the way for future assessment and training tools to supplement emergency response driver training, while supporting the growing literature that identifies hazard prediction as a more robust measure of driver safety than traditional hazard perception tests. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effect of systematic ergonomic hazard identification and control implementation on musculoskeletal disorder and injury risk.

PubMed

Cantley, Linda F; Taiwo, Oyebode A; Galusha, Deron; Barbour, Russell; Slade, Martin D; Tessier-Sherman, Baylah; Cullen, Mark R

2014-01-01

This study aimed to examine the effect of an ergonomic hazard control (HC) initiative, undertaken as part of a company ergonomics standard, on worker injury risk. Using the company's ergonomic hazards database to identify jobs with and without ergonomic HC implementation and linking to individual job and injury histories, injury risk among person-jobs with HC implementation (the HC group) was compared to those without HC (NoHC group) using random coefficient models. Further analysis of the HC group was conducted to determine the effect of additional ergonomic hazards controlled on injury risk. Among 123 jobs at 17 plant locations, 347 ergonomic hazards were quantitatively identified during the study period. HC were implemented for 204 quantified ergonomic hazards in 84 jobs, impacting 10 385 persons (12 967 person-jobs). No HC were implemented for quantified ergonomic hazards in the remaining 39 jobs affecting 4155 persons (5046 person-jobs). Adjusting for age, sex, plant origin, and year to control for any temporal trend in injury risk, the relative risk (RR) for musculoskeletal disorder (MSD) was 0.85 and the RR for any injury or MSD was 0.92 in the HC compared to NoHC group. Among the HC group, each ergonomic hazard controlled was associated with risk reduction for MSD and acute injury outcomes (RR 0.93). Systematic ergonomic HC through participatory ergonomics, as part of a mandatory company ergonomics standard, is associated with MSD and injury risk reduction among workers in jobs with HC implemented.

Effect of glaucoma on eye movement patterns and laboratory-based hazard detection ability

PubMed Central

Black, Alex A.; Wood, Joanne M.

2017-01-01

Purpose The mechanisms underlying the elevated crash rates of older drivers with glaucoma are poorly understood. A key driving skill is timely detection of hazards; however, the hazard detection ability of drivers with glaucoma has been largely unexplored. This study assessed the eye movement patterns and visual predictors of performance on a laboratory-based hazard detection task in older drivers with glaucoma. Methods Participants included 30 older drivers with glaucoma (71±7 years; average better-eye mean deviation (MD) = −3.1±3.2 dB; average worse-eye MD = −11.9±6.2 dB) and 25 age-matched controls (72±7 years). Visual acuity, contrast sensitivity, visual fields, useful field of view (UFoV; processing speeds), and motion sensitivity were assessed. Participants completed a computerised Hazard Perception Test (HPT) while their eye movements were recorded using a desk-mounted Tobii TX300 eye-tracking system. The HPT comprises a series of real-world traffic videos recorded from the driver’s perspective; participants responded to road hazards appearing in the videos, and hazard response times were determined. Results Participants with glaucoma exhibited an average of 0.42 seconds delay in hazard response time (p = 0.001), smaller saccades (p = 0.010), and delayed first fixation on hazards (p<0.001) compared to controls. Importantly, larger saccades were associated with faster hazard responses in the glaucoma group (p = 0.004), but not in the control group (p = 0.19). Across both groups, significant visual predictors of hazard response times included motion sensitivity, UFoV, and worse-eye MD (p<0.05). Conclusions Older drivers with glaucoma had delayed hazard response times compared to controls, with associated changes in eye movement patterns. The association between larger saccades and faster hazard response time in the glaucoma group may represent a compensatory behaviour to facilitate improved performance. PMID:28570621

The road to effective tobacco control in China.

PubMed

Yang, Gonghuan; Wang, Yu; Wu, Yiqun; Yang, Jie; Wan, Xia

2015-03-14

The non-communicable disease burden in China is enormous, with tobacco use a leading risk factor for the major non-communicable diseases. The prevalence of tobacco use in men is one of the highest in the world, with more than 300 million smokers and 740 million non-smokers exposed to second-hand smoke. In the past decade public awareness of the health hazards of tobacco use and exposure to second-hand smoke has grown, social customs and habits have changed, aggressive tactics used by the tobacco industry have been revealed, and serious tobacco control policies have been actively promoted. In 2014, national legislators in China began actively considering national bans on smoking in public and work places and tobacco advertising. However, tobacco control in China has remained particularly difficult because of interference by the tobacco industry. Changes to the interministerial coordinating mechanism for implementation of the WHO Framework Convention on Tobacco Control are now crucial. Progress towards a tobacco-free world will be dependent on more rapid action in China. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

Kienhuis, Anne S., E-mail: anne.kienhuis@rivm.nl; RIKILT, Institute of Food Safety, Wageningen UR, PO Box 230, 6700 AE, Wageningen; Netherlands Toxicogenomics Centre

Hepatic systems toxicology is the integrative analysis of toxicogenomic technologies, e.g., transcriptomics, proteomics, and metabolomics, in combination with traditional toxicology measures to improve the understanding of mechanisms of hepatotoxic action. Hepatic toxicology studies that have employed toxicogenomic technologies to date have already provided a proof of principle for the value of hepatic systems toxicology in hazard identification. In the present review, acetaminophen is used as a model compound to discuss the application of toxicogenomics in hepatic systems toxicology for its potential role in the risk assessment process, to progress from hazard identification towards hazard characterization. The toxicogenomics-based parallelogram is usedmore » to identify current achievements and limitations of acetaminophen toxicogenomic in vivo and in vitro studies for in vitro-to-in vivo and interspecies comparisons, with the ultimate aim to extrapolate animal studies to humans in vivo. This article provides a model for comparison of more species and more in vitro models enhancing the robustness of common toxicogenomic responses and their relevance to human risk assessment. To progress to quantitative dose-response analysis needed for hazard characterization, in hepatic systems toxicology studies, generation of toxicogenomic data of multiple doses/concentrations and time points is required. Newly developed bioinformatics tools for quantitative analysis of toxicogenomic data can aid in the elucidation of dose-responsive effects. The challenge herein is to assess which toxicogenomic responses are relevant for induction of the apical effect and whether perturbations are sufficient for the induction of downstream events, eventually causing toxicity.« less

Genome-wide analysis of disease progression in age-related macular degeneration.

PubMed

Yan, Qi; Ding, Ying; Liu, Yi; Sun, Tao; Fritsche, Lars G; Clemons, Traci; Ratnapriya, Rinki; Klein, Michael L; Cook, Richard J; Liu, Yu; Fan, Ruzong; Wei, Lai; Abecasis, Gonçalo R; Swaroop, Anand; Chew, Emily Y; Weeks, Daniel E; Chen, Wei

2018-03-01

Family- and population-based genetic studies have successfully identified multiple disease-susceptibility loci for Age-related macular degeneration (AMD), one of the first batch and most successful examples of genome-wide association study. However, most genetic studies to date have focused on case-control studies of late AMD (choroidal neovascularization or geographic atrophy). The genetic influences on disease progression are largely unexplored. We assembled unique resources to perform a genome-wide bivariate time-to-event analysis to test for association of time-to-late-AMD with ∼9 million variants on 2721 Caucasians from a large multi-center randomized clinical trial, the Age-Related Eye Disease Study. To our knowledge, this is the first genome-wide association study of disease progression (bivariate survival outcome) in AMD genetic studies, thus providing novel insights to AMD genetics. We used a robust Cox proportional hazards model to appropriately account for between-eye correlation when analyzing the progression time in the two eyes of each participant. We identified four previously reported susceptibility loci showing genome-wide significant association with AMD progression: ARMS2-HTRA1 (P = 8.1 × 10-43), CFH (P = 3.5 × 10-37), C2-CFB-SKIV2L (P = 8.1 × 10-10) and C3 (P = 1.2 × 10-9). Furthermore, we detected association of rs58978565 near TNR (P = 2.3 × 10-8), rs28368872 near ATF7IP2 (P = 2.9 × 10-8) and rs142450006 near MMP9 (P = 0.0006) with progression to choroidal neovascularization but not geographic atrophy. Secondary analysis limited to 34 reported risk variants revealed that LIPC and CTRB2-CTRB1 were also associated with AMD progression (P < 0.0015). Our genome-wide analysis thus expands the genetics in both development and progression of AMD and should assist in early identification of high risk individuals.

Hazard Identification, Risk Assessment, and Control Measures as an Effective Tool of Occupational Health Assessment of Hazardous Process in an Iron Ore Pelletizing Industry.

PubMed

Rout, B K; Sikdar, B K

2017-01-01

With the growing numbers of iron ore pelletization industries in India, various impacts on environment and health in relation to the workplace will rise. Therefore, understanding the hazardous process is crucial in the development of effective control measures. Hazard Identification, Risk Assessment, and Control measures (HIRAC) acts as an effective tool of Occupational Health Assessment. The aim of the study was to identify all the possible hazards at different workplaces of an iron ore pelletizing industry, to conduct an occupational health risk assessment, to calculate the risk rating based on the risk matrix, and to compare the risk rating before and after the control measures. The research was a cross-sectional study done from March to December 2015 in an iron ore pelletizing industry located in Odisha, India. Data from the survey were collected by inspecting the workplace, responses of employees regarding possible hazards in their workplace, reviewing department procedure manual, work instructions, standard operating procedure, previous incident reports, material safety data sheet, first aid/injury register, and health record of employees. A total of 116 hazards were identified. Results of the paired-sample's t -test showed that mean risk rating differs before taking control measures (M = 9.13, SD = 5.99) and after taking control measures (M = 2.80, SD = 1.38) at the 0.0001 level of significance ( t = 12.6428, df = 115, N = 116, P < 0.0001, 95% CI for mean difference 5.34 to 7.32). On an average, risk reduction was about 6.33 points lower after taking control measures. The hazards having high-risk rating and above were reduced to a level considered As Low as Reasonably Practicable (ALARP) when the control measures were applied, thereby reducing the occurrence of injury or disease in the workplace.

Food Safety Evaluation Based on Near Infrared Spectroscopy and Imaging: A Review.

PubMed

Fu, Xiaping; Ying, Yibin

2016-08-17

In recent years, due to the increasing consciousness of food safety and human health, much progress has been made in developing rapid and nondestructive techniques for the evaluation of food hazards, food authentication, and traceability. Near infrared (NIR) spectroscopy and imaging techniques have gained wide acceptance in many fields because of their advantages over other analytical techniques. Following a brief introduction of NIR spectroscopy and imaging basics, this review mainly focuses on recent NIR spectroscopy and imaging applications for food safety evaluation, including (1) chemical hazards detection; (2) microbiological hazards detection; (3) physical hazards detection; (4) new technology-induced food safety concerns; and (5) food traceability. The review shows NIR spectroscopy and imaging to be effective tools that will play indispensable roles for food safety evaluation. In addition, on-line/real-time applications of these techniques promise to be a huge growth field in the near future.

WE-G-BRA-06: Application of Systems and Control Theory-Based Hazard Analysis to Radiotherapy

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

Pawlicki, T; Samost, A; Leveson, N

Purpose: The process of delivering radiation occurs in a complex socio-technical system heavily reliant on human operators. Furthermore, both humans and software are notoriously challenging to account for in traditional hazard analysis models. High reliability industries such as aviation have approached this problem through using hazard analysis techniques grounded in systems and control theory. The purpose of this work is to apply the Systems Theoretic Accident Model Processes (STAMP) hazard model to radiotherapy. In particular, the System-Theoretic Process Analysis (STPA) approach is used to perform a hazard analysis of a proposed on-line adaptive cranial radiosurgery procedure that omits the CTmore » Simulation step and uses only CBCT for planning, localization, and treatment. Methods: The STPA procedure first requires the definition of high-level accidents and hazards leading to those accidents. From there, hierarchical control structures were created followed by the identification and description of control actions for each control structure. Utilizing these control structures, unsafe states of each control action were created. Scenarios contributing to unsafe control action states were then identified and translated into system requirements to constrain process behavior within safe boundaries. Results: Ten control structures were created for this new CBCT-only process which covered the areas of hospital and department management, treatment design and delivery, and vendor service. Twenty three control actions were identified that contributed to over 80 unsafe states of those control actions resulting in over 220 failure scenarios. Conclusion: The interaction of people, hardware, and software are highlighted through the STPA approach. STPA provides a hierarchical model for understanding the role of management decisions in impacting system safety so that a process design requirement can be traced back to the hazard and accident that it is intended to mitigate. Varian Medical Systems, Inc.« less

Association between First Nations ethnicity and progression to kidney failure by presence and severity of albuminuria.

PubMed

Samuel, Susan M; Palacios-Derflingher, Luz; Tonelli, Marcello; Manns, Braden; Crowshoe, Lynden; Ahmed, Sofia B; Jun, Min; Saad, Nathalie; Hemmelgarn, Brenda R

2014-02-04

Despite a low prevalence of chronic kidney disease (estimated glomerular filtration rate [GFR]<60 mL/min per 1.73 m2), First Nations people have high rates of kidney failure requiring chronic dialysis or kidney transplantation. We sought to examine whether the presence and severity of albuminuria contributes to the progression of chronic kidney disease to kidney failure among First Nations people. We identified all adult residents of Alberta (age≥18 yr) for whom an outpatient serum creatinine measurement was available from May 1, 2002, to Mar. 31, 2008. We determined albuminuria using urine dipsticks and categorized results as normal (i.e., no albuminuria), mild, heavy or unmeasured. Our primary outcome was progression to kidney failure (defined as the need for chronic dialysis or kidney transplantation, or a sustained doubling of serum creatinine levels). We calculated rates of progression to kidney failure by First Nations status, by estimated GFR and by albuminuria category. We determined the relative hazard of progression to kidney failure for First Nations compared with non-First Nations participants by level of albuminuria and estimated GFR. Of the 1 816 824 participants we identified, 48 669 (2.7%) were First Nations. First Nations people were less likely to have normal albuminuria compared with non-First Nations people (38.7% v. 56.4%). Rates of progression to kidney failure were consistently 2- to 3-fold higher among First Nations people than among non-First Nations people, across all levels of albuminuria and estimated GFRs. Compared with non-First Nations people, First Nations people with an estimated GFR of 15.0-29.9 mL/min per 1.73 m2 had the highest risk of progression to kidney failure, with similar hazard ratios for those with normal and heavy albuminuria. Albuminuria confers a similar risk of progression to kidney failure for First Nations and non-First Nations people.

Lutein/zeaxanthin for the treatment of age-related cataract: AREDS2 randomized trial report no. 4.

PubMed

Chew, Emily Y; SanGiovanni, John Paul; Ferris, Frederick L; Wong, Wai T; Agron, Elvira; Clemons, Traci E; Sperduto, Robert; Danis, Ronald; Chandra, Suresh R; Blodi, Barbara A; Domalpally, Amitha; Elman, Michael J; Antoszyk, Andrew N; Ruby, Alan J; Orth, David; Bressler, Susan B; Fish, Gary E; Hubbard, George B; Klein, Michael L; Friberg, Thomas R; Rosenfeld, Philip J; Toth, Cynthia A; Bernstein, Paul

2013-07-01

Age-related cataract is a leading cause of visual impairment in the United States. The prevalence of age-related cataract is increasing, with an estimated 30.1 million Americans likely to be affected by 2020. To determine whether daily oral supplementation with lutein/zeaxanthin affects the risk for cataract surgery. The Age-Related Eye Disease Study 2 (AREDS2), a multicenter, double-masked clinical trial, enrolled 4203 participants, aged 50 to 85 years, at risk for progression to advanced age-related macular degeneration. Participants were randomly assigned to daily placebo; lutein/zeaxanthin, 10mg/2mg; omega-3 long-chain polyunsaturated fatty acids, 1 g; or a combination to evaluate the effects on the primary outcome of progression to advanced age-related macular degeneration. Cataract surgery was documented at annual study examination with the presence of pseudophakia or aphakia, or reported during telephone calls at 6-month intervals between study visits. Annual best-corrected visual acuity testing was performed. A secondary outcome of AREDS2 was to evaluate the effects of lutein/zeaxanthin on the subsequent need for cataract surgery. A total of 3159 AREDS2 participants were phakic in at least 1 eye and 1389 of 6027 study eyes underwent cataract surgery during the study, with median follow-up of 4.7 years. The 5-year probability of progression to cataract surgery in the no lutein/zeaxanthin group was 24%. For lutein/zeaxanthin vs no lutein/zeaxanthin, the hazard ratios for progression to cataract surgery was 0.96 (95% CI, 0.84-1.10; P = .54). For participants in the lowest quintile of dietary intake of lutein/zeaxanthin, the hazard ratio comparing lutein/zeaxanthin vs no lutein/zeaxanthin for progression to cataract surgery was 0.68 (95% CI, 0.48-0.96; P = .03). The hazard ratio for 3 or more lines of vision loss was 1.03 (95% CI, 0.93-1.13; P = .61 for lutein/zeaxanthin vs no lutein/zeaxanthin). Daily supplementation with lutein/zeaxanthin had no statistically significant overall effect on rates of cataract surgery or vision loss. clinicaltrials.gov Identifier: NCT00345176.

A 3-Month Jump-Landing Training Program: A Feasibility Study Using the RE-AIM Framework

PubMed Central

Aerts, Inne; Cumps, Elke; Verhagen, Evert; Mathieu, Niels; Van Schuerbeeck, Sander; Meeusen, Romain

2013-01-01

Context: Evaluating the translatability and feasibility of an intervention program has become as important as determining the effectiveness of the intervention. Objective: To evaluate the applicability of a 3-month jump-landing training program in basketball players, using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Design: Randomized controlled trial. Setting: National and regional basketball teams. Patients or Other Participants: Twenty-four teams of the second highest national division and regional basketball divisions in Flanders, Belgium, were randomly assigned (1:1) to a control group and intervention group. A total of 243 athletes (control group = 129, intervention group = 114), ages 15 to 41 years, volunteered. Intervention(s): All exercises in the intervention program followed a progressive development, emphasizing lower extremity alignment during jump-landing activities. Main Outcome Measure(s): The results of the process evaluation of the intervention program were based on the 5 dimensions of the RE-AIM framework. The injury incidence density, hazard ratios, and 95% confidence intervals were determined. Results: The participation rate of the total sample was 100% (reach). The hazard ratio was different between the intervention group and the control group (0.40 [95% confidence interval = 0.16, 0.99]; effectiveness). Of the 12 teams in the intervention group, 8 teams (66.7%) agreed to participate in the study (adoption). Eight of the participating coaches (66.7%) felt positively about the intervention program and stated that they had implemented the training sessions of the program as intended (implementation). All coaches except 1 (87.5%) intended to continue the intervention program the next season (maintenance). Conclusions: Compliance of the coaches in this coach-supervised jump-landing training program was high. In addition, the program was effective in preventing lower extremity injuries. PMID:23675788

The Effects of Di-(2-ethylhexyl)-phthalate Exposure on Fertilization and Embryonic Development In Vitro and Testicular Genomic Mutation In Vivo

PubMed Central

Gu, Yi-Hua; Liu, Miao; Xu, Yan; Yuan, Yao; Sun, Fei; Zhang, Hui-Qin; Shi, Hui-Juan

2012-01-01

The present study was undertaken to determine the reproductive hazards of Di-(2-ethylhexyl)-phthalate (DEHP) on mouse spermatozoa and embryos in vitro and genomic changes in vivo. Direct low-level DEHP exposure (1 μg/ml) on spermatozoa and embryos was investigated by in vitro fertilization (IVF) process, culture of preimplanted embryos in DEHP-supplemented medium and embryo transfer to achieve full term development. Big Blue® transgenic mouse model was employed to evaluate the mutagenesis of testicular genome with in vivo exposure concentration of DEHP (500 mg/kg/day). Generally, DEHP-treated spermatozoa (1 μg/ml, 30 min) presented reduced fertilization ability (P<0.05) and the resultant embryos had decreased developmental potential compared to DMSO controls (P<0.05). Meanwhile, the transferred 2-cell stage embryos derived from treated spermatozoa also exhibited decreased birth rate than that of control (P<0.05). When fertilized oocytes or 2-cell stage embryos were recovered by in vivo fertilization (without treatment) and then exposed to DEHP, the subsequent development proceed to blastocysts was different, fertilized oocytes were significantly affected (P<0.05) whereas developmental progression of 2-cell stage embryos was similar to controls (P>0.05). Testes of the Big Blue® transgenic mice treated with DEHP for 4 weeks indicated an approximately 3-fold increase in genomic DNA mutation frequency compared with controls (P<0.05). These findings unveiled the hazardous effects of direct low-level exposure of DEHP on spermatozoa's fertilization ability as well as embryonic development, and proved that in vivo DEHP exposure posed mutagenic risks in the reproductive organ – at least in testes, are of great concern to human male reproductive health. PMID:23226291

The effects of Di-(2-ethylhexyl)-phthalate exposure on fertilization and embryonic development in vitro and testicular genomic mutation in vivo.

PubMed

Huang, Xue-Feng; Li, Yan; Gu, Yi-Hua; Liu, Miao; Xu, Yan; Yuan, Yao; Sun, Fei; Zhang, Hui-Qin; Shi, Hui-Juan

2012-01-01

The present study was undertaken to determine the reproductive hazards of Di-(2-ethylhexyl)-phthalate (DEHP) on mouse spermatozoa and embryos in vitro and genomic changes in vivo. Direct low-level DEHP exposure (1 μg/ml) on spermatozoa and embryos was investigated by in vitro fertilization (IVF) process, culture of preimplanted embryos in DEHP-supplemented medium and embryo transfer to achieve full term development. Big Blue® transgenic mouse model was employed to evaluate the mutagenesis of testicular genome with in vivo exposure concentration of DEHP (500 mg/kg/day). Generally, DEHP-treated spermatozoa (1 μg/ml, 30 min) presented reduced fertilization ability (P<0.05) and the resultant embryos had decreased developmental potential compared to DMSO controls (P<0.05). Meanwhile, the transferred 2-cell stage embryos derived from treated spermatozoa also exhibited decreased birth rate than that of control (P<0.05). When fertilized oocytes or 2-cell stage embryos were recovered by in vivo fertilization (without treatment) and then exposed to DEHP, the subsequent development proceed to blastocysts was different, fertilized oocytes were significantly affected (P<0.05) whereas developmental progression of 2-cell stage embryos was similar to controls (P>0.05). Testes of the Big Blue® transgenic mice treated with DEHP for 4 weeks indicated an approximately 3-fold increase in genomic DNA mutation frequency compared with controls (P<0.05). These findings unveiled the hazardous effects of direct low-level exposure of DEHP on spermatozoa's fertilization ability as well as embryonic development, and proved that in vivo DEHP exposure posed mutagenic risks in the reproductive organ - at least in testes, are of great concern to human male reproductive health.

A 3-month jump-landing training program: a feasibility study using the RE-AIM framework.

PubMed

Aerts, Inne; Cumps, Elke; Verhagen, Evert; Mathieu, Niels; Van Schuerbeeck, Sander; Meeusen, Romain

2013-01-01

Evaluating the translatability and feasibility of an intervention program has become as important as determining the effectiveness of the intervention. To evaluate the applicability of a 3-month jump-landing training program in basketball players, using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Randomized controlled trial. National and regional basketball teams. Twenty-four teams of the second highest national division and regional basketball divisions in Flanders, Belgium, were randomly assigned (1:1) to a control group and intervention group. A total of 243 athletes (control group = 129, intervention group = 114), ages 15 to 41 years, volunteered. All exercises in the intervention program followed a progressive development, emphasizing lower extremity alignment during jump-landing activities. The results of the process evaluation of the intervention program were based on the 5 dimensions of the RE-AIM framework. The injury incidence density, hazard ratios, and 95% confidence intervals were determined. The participation rate of the total sample was 100% (reach). The hazard ratio was different between the intervention group and the control group (0.40 [95% confidence interval = 0.16, 0.99]; effectiveness). Of the 12 teams in the intervention group, 8 teams (66.7%) agreed to participate in the study (adoption). Eight of the participating coaches (66.7%) felt positively about the intervention program and stated that they had implemented the training sessions of the program as intended (implementation). All coaches except 1 (87.5%) intended to continue the intervention program the next season (maintenance). Compliance of the coaches in this coach-supervised jump-landing training program was high. In addition, the program was effective in preventing lower extremity injuries.

Common Genetic Variation in CYP17A1 and Response to Abiraterone Acetate in Patients with Metastatic Castration-Resistant Prostate Cancer

PubMed Central

Binder, Moritz; Zhang, Ben Y.; Hillman, David W.; Kohli, Rhea; Kohli, Tanvi; Lee, Adam; Kohli, Manish

2016-01-01

Treatment with abiraterone acetate and prednisone (AA/P) prolongs survival in metastatic castration-resistant prostate cancer (mCRPC) patients. We evaluated the genetic variation in CYP17A1 as predictive of response to AA/P. A prospective collection of germline DNA prior to AA/P initiation and follow-up of a mCRPC cohort was performed. Five common single-nucleotide polymorphisms (SNPs) in CYP17A1 identified using a haplotype-based tagging algorithm were genotyped. Clinical outcomes included biochemical response and time to biochemical progression on AA/P. Logistic regression was used to assess the association between tag SNPs and biochemical response. Proportional hazards regression was used to assess the association between tag SNPs and time to biochemical progression. Odds or hazard ratio per minor allele were estimated and p-values below 0.05 were considered statistically significant. Germline DNA was successfully genotyped for four tag SNPs in 87 patients. The median age was 73 years (54–90); the median prostate-specific antigen was 66 ng/dL (0.1–99.9). A single SNP, rs2486758, was associated with lower odds of experiencing a biochemical response (Odds ratio 0.22, 95% confidence interval 0.07–0.63, p = 0.005) and a shorter time to biochemical progression (Hazard ratio 2.23, 95% confidence interval 1.39–3.56, p < 0.001). This tag SNP located in the promoter region of CYP17A1 will need further validation as a predictive biomarker for AA/P therapy. PMID:27409606

76 FR 25376 - Occupational Exposure to Hazardous Chemicals in Laboratories Standard; Extension of the Office of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... describes: Standard operating procedures for using hazardous chemicals; hazard-control techniques; equipment...] Occupational Exposure to Hazardous Chemicals in Laboratories Standard; Extension of the Office of Management... collection requirements specified in the Standard on Occupational Exposure to Hazardous Chemicals in...

Association of Progression of Carotid Artery Wall Volume and Recurrent Transient Ischemic Attack or Stroke: A Magnetic Resonance Imaging Study.

PubMed

Lu, Mingming; Peng, Peng; Cui, Yuanyuan; Qiao, Huiyu; Li, Dongye; Cai, Jianming; Zhao, Xihai

2018-03-01

This study aimed to investigate the association between carotid plaque progression and subsequent recurrent events using magnetic resonance imaging. Sixty-three symptomatic patients with ipsilateral carotid atherosclerotic stenosis (30%-69% stenosis) determined by ultrasound underwent first and second carotid artery magnetic resonance imaging for carotid artery at baseline and ≥6 months after the first scan, respectively. All the patients had clinical follow-up after the second magnetic resonance scan for ≤5 years until the onset of recurrent transient ischemic attack or stroke. Presence/absence of carotid plaque compositional features, particularly intraplaque hemorrhage and fibrous cap rupture was identified. The annual progression of carotid wall volume between 2 magnetic resonance scans was measured. Univariate and multivariate Cox regression was used to calculate the hazard ratio and corresponding 95% confidence interval of carotid plaque features in discriminating recurrent events. Receiver-operating-characteristic-curve analysis was conducted to determine the area-under-the-curve of carotid plaque features in predicting recurrent events. Sixty-three patients (mean age: 66.5±10.0 years old; 54 males) were eligible for final statistics analysis. During a mean follow-up duration of 55.1±13.6 months, 14.3% of patients (n=9) experienced ipsilateral recurrent transient ischemic attack/stroke. The annual progression of carotid wall volume was significantly associated with recurrent events before (hazard ratio, 1.14 per 10 mm 3 ; 95% confidence interval, 1.02-1.27; P =0.019) and after (hazard ratio, 1.19 per 10 mm3; 95% confidence interval, 1.03-1.37; P =0.022) adjusted for confounding factors. In discriminating the recurrence of transient ischemia attack/stroke, receiver-operator curve analysis indicated that combined with annual progression of wall volume, there was a significant incremental improvement in the area-under-the-curve of intraplaque hemorrhage (area-under-the-curve: 0.69-0.81) and fibrous cap rupture (area-under-the-curve: 0.73-0.84). The annual progression of carotid wall volume is independently associated with recurrent ischemic cerebrovascular events, and this measurement has added value for intraplaque hemorrhage and fibrous cap rupture in predicting future events. © 2018 American Heart Association, Inc.

Hazardous and toxic waste management in Botswana: practices and challenges.

PubMed

Mmereki, Daniel; Li, Baizhan; Meng, Liu

2014-12-01

Hazardous and toxic waste is a complex waste category because of its inherent chemical and physical characteristics. It demands for environmentally sound technologies and know-how as well as clean technologies that simultaneously manage and dispose it in an environmentally friendly way. Nevertheless, Botswana lacks a system covering all the critical steps from importation to final disposal or processing of hazardous and toxic waste owing to limited follow-up of the sources and types of hazardous and toxic waste, lack of modern and specialised treatment/disposal facilities, technical know-how, technically skilled manpower, funds and capabilities of local institutions to take lead in waste management. Therefore, because of a lack of an integrated system, there are challenges such as lack of cooperation among all the stakeholders about the safe management of hazardous and toxic waste. Furthermore, Botswana does not have a systematic regulatory framework regarding monitoring and hazardous and toxic waste management. In addition to the absence of a systematic regulatory framework, inadequate public awareness and dissemination of information about hazardous and toxic waste management, slower progress to phase-out persistent and bio-accumulative waste, and lack of reliable and accurate information on hazardous and toxic waste generation, sources and composition have caused critical challenges to effective hazardous and toxic waste management. It is, therefore, important to examine the status of hazardous and toxic waste as a waste stream in Botswana. By default; this mini-review article presents an overview of the current status of hazardous and toxic waste management and introduces the main challenges in hazardous and toxic waste management. Moreover, the article proposes the best applicable strategies to achieve effective hazardous and toxic waste management in the future. © The Author(s) 2014.

14 CFR 417.415 - Post-launch and post-flight-attempt hazard controls.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Post-launch and post-flight-attempt hazard controls. 417.415 Section 417.415 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION... evidence; and (4) Ensuring public safety from hazardous debris, such as plans for recovery and salvage of...

Selected References on Asbestos: Its Nature, Hazards, Detection, and Control.

ERIC Educational Resources Information Center

National Education Association, Washington, DC.

This document provides teachers with sources of information about the nature, hazards, detection, and control of asbestos. Because many school buildings include asbestos-containing materials, teachers and other school personnel must be aware of the potential dangers to students and to themselves and take steps to have asbestos hazards contained or…

14 CFR 417.415 - Post-launch and post-flight-attempt hazard controls.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Post-launch and post-flight-attempt hazard controls. 417.415 Section 417.415 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION... evidence; and (4) Ensuring public safety from hazardous debris, such as plans for recovery and salvage of...

14 CFR 417.415 - Post-launch and post-flight-attempt hazard controls.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Post-launch and post-flight-attempt hazard controls. 417.415 Section 417.415 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION... evidence; and (4) Ensuring public safety from hazardous debris, such as plans for recovery and salvage of...

76 FR 28803 - Notice of Availability: Notice of Funding Availability (NOFA) for HUD's Fiscal Year (FY) 2011...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-18

...: Notice of Funding Availability (NOFA) for HUD's Fiscal Year (FY) 2011 Lead-Based Paint Hazard Control Grant Program and Lead Hazard Reduction Demonstration Grant Program and Amendment and Technical Corrections AGENCY: Office of Healthy Homes and Lead Hazard Control, HUD. ACTION: Notice of Availability and...

Occupational Health and the Visual Arts: An Introduction.

PubMed

Hinkamp, David; McCann, Michael; Babin, Angela R

2017-09-01

Occupational hazards in the visual arts often involve hazardous materials, though hazardous equipment and hazardous work conditions can also be found. Occupational health professionals are familiar with most of these hazards and are particularly qualified to contribute clinical and preventive expertise to these issues. Articles illustrating visual arts health issues were sought and reviewed. Literature sources included medical databases, unindexed art-health publications, and popular press articles. Few medical articles examine health issues in the visuals arts directly, but exposures to pigments, solvents, and other hazards found in the visual arts are well described. The hierarchy of controls is an appropriate model for controlling hazards and promoting safer visual art workplaces. The health and safety of those working in the visual arts can benefit from the occupational health approach. Sources of further information are available.

The Main Biological Hazards in Animal Biosafety Level 2 Facilities and Strategies for Control.

PubMed

Li, Xiao Yan; Xue, Kang Ning; Jiang, Jin Sheng; Lu, Xuan Cheng

2016-04-01

Concern about the biological hazards involved in microbiological research, especially research involving laboratory animals, has increased in recent years. Working in an animal biosafety level 2 facility (ABSL-2), commonly used for research on infectious diseases, poses various biological hazards. Here, the regulations and standards related to laboratory biosafety in China are introduced, the potential biological hazards present in ABSL-2 facilities are analyzed, and a series of strategies to control the hazards are presented. Copyright © 2016 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

PALLADIUM/MAGNESIUM CORROSION NANO-CELLS FOR PCB DECHLORINATION

EPA Science Inventory

Polychlorinated biphenyls (PCBs) are toxic and recalcitrant environment pollutants that are prevalent in nation's submarine sediments. PCBs bioaccumulate and progressively move up the food chain to reach humans posing serious health hazards. Today, fish consumption is a major rou...

AMBIENT AIR MONITORING STRATEGY

EPA Science Inventory

The Clean Air Act requires EPA to establish national ambient air quality standards and to regulate as necessary, hazardous air pollutants. EPA uses ambient air monitoring to determine current air quality conditions, and to assess progress toward meeting these standards and relat...

A novel sample size formula for the weighted log-rank test under the proportional hazards cure model.

PubMed

Xiong, Xiaoping; Wu, Jianrong

2017-01-01

The treatment of cancer has progressed dramatically in recent decades, such that it is no longer uncommon to see a cure or log-term survival in a significant proportion of patients with various types of cancer. To adequately account for the cure fraction when designing clinical trials, the cure models should be used. In this article, a sample size formula for the weighted log-rank test is derived under the fixed alternative hypothesis for the proportional hazards cure models. Simulation showed that the proposed sample size formula provides an accurate estimation of sample size for designing clinical trials under the proportional hazards cure models. Copyright © 2016 John Wiley & Sons, Ltd.

Hepatic Fibrosis Progression in HIV-Hepatitis C Virus Co-Infection--The Effect of Sex on Risk of Significant Fibrosis Measured by Aspartate-to-Platelet Ratio Index.

PubMed

Rollet-Kurhajec, Kathleen C; Moodie, Erica E M; Walmsley, Sharon; Cooper, Curtis; Pick, Neora; Klein, Marina B

2015-01-01

In Hepatitis C virus (HCV) mono-infection, male sex is associated with faster liver fibrosis progression but the effects of sex have not been well studied in HIV-HCV co-infected patients. We examined the influence of sex on progression to significant liver fibrosis in HIV-HCV co-infected adults receiving antiretroviral therapy (ART) using the aspartate aminotransferase-to-platelet ratio index (APRI) as a surrogate biomarker of liver fibrosis. We evaluated 308 HIV infected, HCV RNA positive participants of a Canadian multicentre prospective cohort receiving antiretrovirals and without significant liver fibrosis or end-stage liver disease at baseline. We used multivariate discrete-time proportional hazards models to assess the effect of sex on time to significant fibrosis (APRI≥1.5) adjusting for baseline age, alcohol use, cigarette smoking, HCV duration, and APRI and time-updated CD4 count and HIV RNA. Overall, 55 (18%) participants developed an APRI ≥ 1.5 over 544 person-years of at-risk follow-up time; 18 (21%) women (incidence rate (IR)=14.0/100 PY; 7.5-20.4) and 37 (17%) men (IR=8.9/100 PY; 6.0-11.8). Women had more favourable profiles with respect to traditional risk factors for liver disease progression (younger, shorter duration of HCV infection and less alcohol use). Despite this, female sex was associated with a greater than two-fold increased risk of fibrosis progression (adjusted hazard rate (HR) =2.23; 1.22-4.08). HIV-HCV co-infected women receiving antiretroviral therapy were at significantly greater risk of progressing to liver fibrosis as measured by APRI compared with men. Enhanced efforts to engage and treat co-infected women for HCV are needed.

Recovery of polyclonal immunoglobulins one year after autologous stem cell transplantation as a long-term predictor marker of progression and survival in multiple myeloma.

PubMed

González-Calle, Verónica; Cerdá, Seila; Labrador, Jorge; Sobejano, Eduardo; González-Mena, Beatriz; Aguilera, Carmen; Ocio, Enrique María; Vidriales, María Belén; Puig, Noemí; Gutiérrez, Norma Carmen; García-Sanz, Ramón; Alonso, José María; López, Rosa; Aguilar, Carlos; de Coca, Alfonso García; Hernández, Roberto; Hernández, José Mariano; Escalante, Fernando; Mateos, María-Victoria

2017-05-01

Immunoparesis or suppression of polyclonal immunoglobulins is a very common condition in newly diagnosed myeloma patients. However, the recovery of polyclonal immunoglobulins in the setting of immune reconstitution after autologous stem cell transplantation and its effect on outcome has not yet been explored. We conducted this study in a cohort of 295 patients who had undergone autologous transplantation. In order to explore the potential role of immunoglubulin recovery as a dynamic predictor of progression or survival after transplantation, conditional probabilities of progression-free survival and overall survival were estimated according to immunoglobulin recovery at different time points using a landmark approach. One year after transplant, when B-cell reconstitution is expected to be completed, among 169 patients alive and progression free, 88 patients (52%) showed immunoglobulin recovery and 81 (48%) did not. Interestingly, the group with immunoglobulin recovery had a significantly longer median progression-free survival than the group with persistent immunoparesis (median 60.4 vs. 27.9 months, respectively; Hazard Ratio: 0.45, 95%Confidence Interval: 0.31-0.66; P <0.001), and improved overall survival (11.3 vs. 7.3 years; Hazard Ratio: 0.45, 95%Confidence Interval: 0.27-0.74; P =0.002). Furthermore, the percentage of normal plasma cells detected by flow cytometry in the bone marrow assessed at day 100 after transplantation was associated with the immunoglobulin recovery at that time and may predict immunoglobulin recovery in the subsequent months: nine months and one year. In conclusion, the recovery of polyclonal immunoglobulins one year after autologous transplantation in myeloma patients is an independent long-term predictor marker for progression and survival. Copyright© Ferrata Storti Foundation.

Endothelial activation biomarkers increase after HIV-1 acquisition: plasma vascular cell adhesion molecule-1 predicts disease progression.

PubMed

Graham, Susan M; Rajwans, Nimerta; Jaoko, Walter; Estambale, Benson B A; McClelland, R Scott; Overbaugh, Julie; Liles, W Conrad

2013-07-17

We aimed to determine whether endothelial activation biomarkers increase after HIV-1 acquisition, and whether biomarker levels measured in chronic infection would predict disease progression and death in HIV-1 seroconverters. HIV-1-seronegative Kenyan women were monitored monthly for seroconversion, and followed prospectively after HIV-1 acquisition. Plasma levels of angiopoietin-1 and angiopoietin-2 (ANG-1, ANG-2) and soluble vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and E-selectin were tested in stored samples from pre-infection, acute infection, and two chronic infection time points. We used nonparametric tests to compare biomarkers before and after HIV-1 acquisition, and Cox proportional-hazards regression to analyze associations with disease progression (CD4 < 200 cells/μl, stage IV disease, or antiretroviral therapy initiation) or death. Soluble ICAM-1 and VCAM-1 were elevated relative to baseline in all postinfection periods assessed (P < 0.0001). Soluble E-selectin and the ANG-2:ANG-1 ratio increased in acute infection (P = 0.0001), and ANG-1 decreased in chronic infection (P = 0.0004). Among 228 participants followed over 1028 person-years, 115 experienced disease progression or death. Plasma VCAM-1 levels measured during chronic infection were independently associated with time to HIV progression or death (adjusted hazard ratio 5.36, 95% confidence interval 1.99-14.44 per log10 increase), after adjustment for set point plasma viral load, age at infection, and soluble ICAM-1 levels. HIV-1 acquisition was associated with endothelial activation, with sustained elevations of soluble ICAM-1 and VCAM-1 postinfection. Soluble VCAM-1 may be an informative biomarker for predicting the risk of HIV-1 disease progression, morbidity, and mortality.

Promoting early exposure monitoring for respirable crystalline silica: Taking the laboratory to the mine site

PubMed Central

Cauda, Emanuele; Miller, Arthur; Drake, Pamela

2017-01-01

The exposure to respirable crystalline silica (RCS) in the mining industry is a recognized occupational hazard. The assessment and monitoring of the exposure to RCS is limited by two main factors: (1) variability of the silica percent in the mining dust and (2) lengthy off-site laboratory analysis of collected samples. The monitoring of respirable dust via traditional or real-time techniques is not adequate. A solution for on-site quantification of RCS in dust samples is being investigated by the Office of Mine Safety and Health Research, a division of the National Institute for Occupational Safety and Health. The use of portable Fourier transform infrared analyzers in conjunction with a direct-on-filter analysis approach is proposed. The progress made so far, the necessary steps in progress, and the application of the monitoring solution to a small data set is presented. When developed, the solution will allow operators to estimate RCS immediately after sampling, resulting in timelier monitoring of RCS for self-assessment of compliance at the end of the shift, more effective engineering monitoring, and better evaluation of control technologies. PMID:26558490

The Prognostic Value of Histopathologic Lesions in Native Kidney Biopsy Specimens: Results from the Boston Kidney Biopsy Cohort Study.

PubMed

Srivastava, Anand; Palsson, Ragnar; Kaze, Arnaud D; Chen, Margaret E; Palacios, Polly; Sabbisetti, Venkata; Betensky, Rebecca A; Steinman, Theodore I; Thadhani, Ravi I; McMahon, Gearoid M; Stillman, Isaac E; Rennke, Helmut G; Waikar, Sushrut S

2018-06-04

Background Few studies have evaluated whether histopathologic lesions on kidney biopsy provide prognostic information beyond clinical and laboratory data. Methods We enrolled 676 individuals undergoing native kidney biopsy at three tertiary care hospitals into a prospective, observational cohort study. Biopsy specimens were adjudicated for semiquantitative scores in 13 categories of histopathology by two experienced renal pathologists. Proportional hazards models tested the association between histopathologic lesions and risk of kidney disease progression (≥40% eGFR decline or RRT). Results Mean baseline eGFR was 57.5±36.0 ml/min per 1.73 m 2 During follow-up (median, 34.3 months), 199 individuals suffered kidney disease progression. After adjustment for demographics, clinicopathologic diagnosis, and laboratory values, the following lesions (hazard ratio; 95% confidence interval) were independently associated with progression: inflammation in nonfibrosed interstitium (0.52; 0.32 to 0.83), moderate and severe versus minimal interstitial fibrosis/tubular atrophy (2.14; 1.24 to 3.69 and 3.42; 1.99 to 5.87, respectively), moderate and severe versus minimal global glomerulosclerosis (2.17; 1.36 to 3.45 and 3.31; 2.04 to 5.38, respectively), moderate and severe versus minimal arterial sclerosis (1.78; 1.15 to 2.74 and 1.64; 1.04 to 2.60, respectively), and moderate and severe versus minimal arteriolar sclerosis (1.63; 1.08 to 2.46 and 2.33; 1.42 to 3.83, respectively). An 11-point chronicity score derived from semiquantitative assessments of chronic lesions independently associated with higher risk of kidney disease progression (hazard ratio per one-point increase, 1.19; 95% confidence interval, 1.12 to 1.27). Conclusions Across a diverse group of kidney diseases, histopathologic lesions on kidney biopsy provide prognostic information, even after adjustment for proteinuria and eGFR. Copyright © 2018 by the American Society of Nephrology.

Effect of systematic ergonomic hazard identification and control implementation on musculoskeletal disorder and injury risk

PubMed Central

Cantley, Linda F; Taiwo, Oyebode A; Galusha, Deron; Barbour, Russell; Slade, Martin D; Tessier-Sherman, Baylah; Cullen, Mark R

2014-01-01

Objectives This study aimed to examine the effect of an ergonomic hazard control (HC) initiative, undertaken as part of a company ergonomics standard, on worker injury risk. Methods Using the company's ergonomic hazards database to identify jobs with and without ergonomic HC implementation and linking to individual job and injury histories, injury risk among person-jobs with HC implementation (the HC group) was compared to those without HC (NoHC group) using random coefficient models. Further analysis of the HC group was conducted to determine the effect of additional ergonomic hazards controlled on injury risk. Results Among 123jobs at 17 plant locations, 347 ergonomic hazards were quantitatively identified during the study period. HC were implemented for 204 quantified ergonomic hazards in 84 jobs, impacting 10 385 persons (12 967 person-jobs). No HC were implemented for quantified ergonomic hazards in the remaining 39 jobs affecting 4155 persons (5046 person-jobs). Adjusting for age, sex, plant origin, and year to control for any temporal trend in injury risk, the relative risk (RR) for musculoskeletal disorder (MSD) was 0.85 and the RR for any injury or MSD was 0.92 in the HC compared to NoHC group. Among the HC group, each ergonomic hazard controlled was associated with risk reduction for MSD and acute injury outcomes (RR 0.93). Conclusion Systematic ergonomic HC through participatory ergonomics, as part of a mandatory company ergonomics standard, is associated with MSD and injury risk reduction among workers in jobs with HC implemented. PMID:24142048

The morphological changes of mucous membrane of stomach and duodenum of contractor organization personnel, which works in radiation hazard conditions at the object Shelter of Chornobyl NPP.

PubMed

Sushko, V O; Nezgovorova, G A; Degtjarova, L V; Kolosynska, O O; Gromadska, V M

2015-12-01

Аim: The determination of morphological features of stomach and duodenum mucous of membrane (MM) damage at a personnel that works in radiation hazard conditions at the object of "Shelter" of Chornobyl NPP (OS) by the endoscopic monitoring with biopsy material inspection from a gastro-duodenal zone on the stages of check - in (InC) and the special medical control (SpC). the complex clinical-endoscopic and morphological examination with the biopsy of MM of stomach and duodenum in 126 workers of OS (man in the age from 20 to 59) was carried out. Doses of external radiation exposure were from 0,14 to 79,6 mSv, доза internal radiation exposure were from 0,1 to 3 mSv/Results: For the personnel of OS contract organisations differently directed pathomorphological changes of MM at InC and increase of frequency of their exposure at an inspection during SC, that generally correspond to chronic H.pylori-associated pangastritis with violation of microcirculation and trophism, disregeneration changes of epithelial layer. for the personnel of contract organizations, which participated in radiation hazard works on ОS a presence of chronic H.pylori-associated pangastritis with the increase of frequency of atrophic changes of MM (nonmetaplastic or metaplastic type) and development of erosive-ulcerous defects of gastro-duodenal zone was founded out.For workers, who had previous influence of ionizing irradiation the greater frequency of disregeneration (hyperplasia / intestinal metaplasia) changes of epithelium that accordingly promotes the risk of neoplasmes transformations was clarified.Providing of EGDFS (at a necessity with the biopsy of MM) is at InC and next stages of medical control for personnel, that executes radiation hazard works on ОS is the highly informative evidential and necessary method of inspection for determination of form and degree of pathological changes of overhead departments of gastrointestinal tract for warning of progress of disease and development of complications, maintenance of workers health and workability. V. O. Sushko, G. A. Nezgovorova, L. V. Degtjarova, O. O.Kolosynska, V. M.Gromadska.

Occupational Attainment as Risk Factor for Progression from Mild Cognitive Impairment to Alzheimer's Disease: A CREDOS Study.

PubMed

Myung, Woojae; Lee, Chunsoo; Park, Jin Hong; Woo, Sook-Young; Kim, Seonwoo; Kim, Sangha; Chung, Jae Won; Kang, Hyo Shin; Lim, Shinn-Won; Choi, Junbae; Na, Duk L; Kim, Seong Yoon; Lee, Jae-Hong; Han, Seol-Heui; Choi, Seong Hye; Kim, Sang Yun; Carroll, Bernard J; Kim, Doh Kwan

2017-01-01

High occupational attainment has been known as a marker of cognitive reserve. Previous studies in the general population have shown that high occupational attainment is associated with reduced risk of Alzheimer's disease (AD). However, few studies have assessed the effect of occupational attainment on the clinical course of mild cognitive impairment (MCI). In this study, we evaluated whether individuals with high occupational attainment show more frequent progression from MCI to AD. Participants (n = 961) with MCI were recruited from a nationwide, hospital-based multi-center cohort, and were followed for up to 60 months (median: 17.64, interquartile range [12.36, 29.28]). We used Cox regression for competing risks to analyze the effect of occupational attainment on development of AD, treating dementia other than AD as a competing risk. Among the 961 individuals with MCI, a total of 280 (29.1%) converted to dementia during the follow-up period. The risk of progression to AD was higher in the individuals with high occupational attainment after controlling for potential confounders (hazard ratio = 1.83, 95% confidence interval = 1.25-2.69, p = 0.002). High occupational attainment in individuals with MCI is an independent risk factor for higher progression rate of MCI to AD. This result suggests that the protective effect of high occupational attainment against cognitive decline disappears in the MCI stage, and that careful assessment of occupational history can yield important clinical information for prognosis in individuals with MCI.

A risk perception gap? Comparing expert, producer and consumer prioritization of food hazard controls.

PubMed

Hartmann, Christina; Hübner, Philipp; Siegrist, Michael

2018-06-01

Using a survey approach, the study examined how experts (i.e. food control representatives), producers (i.e. food industry representatives) and consumers prioritized control activities for 28 hazards related to food and other everyday items. The investigated hazards encompassed a wide range of safety issues, including health risks, consumer deception and poor food hygiene behaviour. The participants included 41 experts, 138 producers and 243 consumers from the German- and French-speaking parts of Switzerland. Based on detailed descriptions of the hazards, they were asked to rank these on a score sheet in terms of the perceived importance of monitoring by food control authorities. A between-group comparison of average rankings showed that consumers and experts differed significantly in relation to 17 of the 28 hazards. While the experts assigned higher priority to hazards related to everyday items such as nitrosamine in mascara and chromium VI in leather products, producers and consumers tended to prioritize products related to plant treatment and genetic modification of food and feeds. Producer and consumer rankings of the hazards were highly correlated (r = .96, p < .001). Rankings were also similar among participants from the two cultural regions (i.e. German and French-speaking parts of Switzerland). Copyright © 2018 Elsevier Ltd. All rights reserved.

Urine output on ICU entry is associated with hospital mortality in unselected critically ill patients.

PubMed

Zhang, Zhongheng; Xu, Xiao; Ni, Hongying; Deng, Hongsheng

2014-02-01

Urine output (UO) is routinely measured in the intensive care unit (ICU) but its prognostic value remains debated. The study aimed to investigate the association between day 1 UO and hospital mortality. Clinical data were abstracted from the Multiparameter Intelligent Monitoring in Intensive Care II (version 2.6) database. UO was recorded for the first 24 h after ICU entry, and was classified into three categories: UO >0.5, 0.3-0.5 and ≤0.3 ml/kg per hour. The primary endpoint was the hospital mortality. Four models were built to adjust for the hazards ratio of mortality. A total of 21,207 unselected ICU patients including 2,401 non-survivors and 18,806 survivors were included (mortality rate 11.3 %). Mortality rate increased progressively across UO categories: >0.5 (7.67 %), 0.3-0.5 (11.27 %) and ≤0.3 ml/kg/h (18.29 %), and this relationship remained statistically significant after rigorous control of confounding factors with the Cox proportional hazards regression model. With UO >0.5 as the referent group, the hazards ratios for UO 0.3-0.5 and UO ≤0.3 were 1.41 (95 % CI 1.29-1.54) and 1.52 (95 % CI 1.38-1.67), respectively. UO obtained on ICU entry is an independent predictor of mortality irrespective of diuretic use. It would be interesting to examine whether strategies to increase UO would improve clinical outcome.

49 CFR 107.1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS AND OIL TRANSPORTATION HAZARDOUS MATERIALS PROGRAM..., Pipeline and Hazardous Materials Safety Administration. Competent Authority means a national agency that is responsible, under its national law, for the control or regulation of some aspect of hazardous materials...

Best Practices for Validating Hazard Control

EPA Science Inventory

Provides information on the application of Hazard Assessment Critical Control Points analysis to manging building water quality, and information on molecular assay options for detecting pathogens in water.

Effectiveness of a Web-Based Intervention to Reduce Alcohol Consumption among French Hazardous Drinkers: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Guillemont, Juliette; Cogordan, Chloé; Nalpas, Bertrand; Nguyen-Thanh, Vi?t; Richard, Jean-Baptiste; Arwidson, Pierre

2017-01-01

This study aims to evaluate the effectiveness of a web-based intervention to reduce alcohol consumption among hazardous drinkers. A two-group parallel randomized controlled trial was conducted among adults identified as hazardous drinkers according to the Alcohol Use Disorders Identification Test. The intervention delivers personalized normative…

The Application of Software Safety to the Constellation Program Launch Control System

NASA Technical Reports Server (NTRS)

Kania, James; Hill, Janice

2011-01-01

The application of software safety practices on the LCS project resulted in the successful implementation of the NASA Software Safety Standard NASA-STD-8719.138 and CxP software safety requirements. The GOP-GEN-GSW-011 Hazard Report was the first report developed at KSC to identify software hazard causes and their controls. This approach can be applied to similar large software - intensive systems where loss of control can lead to a hazard.

Sensing and capture of toxic and hazardous gases and vapors by metal–organic frameworks

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

Wang, Hao; Lustig, William P.; Li, Jing

This review summaries recent progress in the luminescent detection and adsorptive removal of harmful gases and vapors by metal–organic frameworks, as well as the principles and strategies guiding the design of these materials.

40 CFR Appendix 1 to Part 3 - Priority Reports

Code of Federal Regulations, 2013 CFR

2013-07-01

...). Hazardous Air Pollutants Compliance Report Reports containing results from performance test, opacity tests, and visible emissions tests. Progress reports; periodic and immediate startup, shutdown, and... Owners report emissions data from stationary sources 51.211. Report For Initial Performance Test Report...

40 CFR Appendix 1 to Part 3 - Priority Reports

Code of Federal Regulations, 2014 CFR

2014-07-01

...). Hazardous Air Pollutants Compliance Report Reports containing results from performance test, opacity tests, and visible emissions tests. Progress reports; periodic and immediate startup, shutdown, and... Owners report emissions data from stationary sources 51.211. Report For Initial Performance Test Report...

Sensing and capture of toxic and hazardous gases and vapors by metal–organic frameworks

DOE PAGES

Wang, Hao; Lustig, William P.; Li, Jing

2018-01-01

This review summaries recent progress in the luminescent detection and adsorptive removal of harmful gases and vapors by metal–organic frameworks, as well as the principles and strategies guiding the design of these materials.

29 CFR 1910.147 - The control of hazardous energy (lockout/tagout).

Code of Federal Regulations, 2012 CFR

2012-07-01

... prohibitions of the outside employer's energy control program. (3) Group lockout or tagout. (i) When servicing... 29 Labor 5 2012-07-01 2012-07-01 false The control of hazardous energy (lockout/tagout). 1910.147... ADMINISTRATION, DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH STANDARDS General Environmental Controls...

29 CFR 1910.147 - The control of hazardous energy (lockout/tagout).

Code of Federal Regulations, 2013 CFR

2013-07-01

... prohibitions of the outside employer's energy control program. (3) Group lockout or tagout. (i) When servicing... 29 Labor 5 2013-07-01 2013-07-01 false The control of hazardous energy (lockout/tagout). 1910.147... ADMINISTRATION, DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH STANDARDS General Environmental Controls...

29 CFR 1910.147 - The control of hazardous energy (lockout/tagout).

Code of Federal Regulations, 2014 CFR

2014-07-01

... prohibitions of the outside employer's energy control program. (3) Group lockout or tagout. (i) When servicing... 29 Labor 5 2014-07-01 2014-07-01 false The control of hazardous energy (lockout/tagout). 1910.147... ADMINISTRATION, DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH STANDARDS General Environmental Controls...

46 CFR 111.70-3 - Motor controllers and motor-control centers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... pump, elevator, steering gear, or auxiliary that is vital to the vessel's propulsion system, except a... ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Motor Circuits, Controllers, and Protection § 111.70-3 Motor... operation is not hazardous. If automatic restart is hazardous, the motor controller must have low-voltage...

46 CFR 111.70-3 - Motor controllers and motor-control centers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... pump, elevator, steering gear, or auxiliary that is vital to the vessel's propulsion system, except a... ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Motor Circuits, Controllers, and Protection § 111.70-3 Motor... operation is not hazardous. If automatic restart is hazardous, the motor controller must have low-voltage...

46 CFR 111.70-3 - Motor controllers and motor-control centers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... pump, elevator, steering gear, or auxiliary that is vital to the vessel's propulsion system, except a... ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Motor Circuits, Controllers, and Protection § 111.70-3 Motor... operation is not hazardous. If automatic restart is hazardous, the motor controller must have low-voltage...

46 CFR 111.70-3 - Motor controllers and motor-control centers.

Code of Federal Regulations, 2014 CFR

2014-10-01

... pump, elevator, steering gear, or auxiliary that is vital to the vessel's propulsion system, except a... ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Motor Circuits, Controllers, and Protection § 111.70-3 Motor... operation is not hazardous. If automatic restart is hazardous, the motor controller must have low-voltage...

46 CFR 111.70-3 - Motor controllers and motor-control centers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... pump, elevator, steering gear, or auxiliary that is vital to the vessel's propulsion system, except a... ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Motor Circuits, Controllers, and Protection § 111.70-3 Motor... operation is not hazardous. If automatic restart is hazardous, the motor controller must have low-voltage...

Does Drinking to Cope Explain Links Between Emotion-Driven Impulse Control Difficulties and Hazardous Drinking? A Longitudinal Test

PubMed Central

Watkins, Laura E.; Franz, Molly R.; DiLillo, David; Gratz, Kim L.; Messman-Moore, Terri L.

2016-01-01

Difficulty controlling impulsive behaviors when experiencing negative emotions is a prominent risk factor for hazardous alcohol use, and prior research suggests that drinking to cope may mediate this association. The present study examines this possibility prospectively in a sample of 490 young adult women between the ages of 18 and 25. Participants completed measures of emotion-driven impulse control difficulties, drinking to cope, and hazardous alcohol use at six time points over the course of approximately 20 months (i.e., one assessment every four months). Multilevel structural equation modeling revealed that drinking to cope fully mediated the relationship between emotion-driven impulse control difficulties and hazardous alcohol use when examining these relationships between individuals and partially mediated this relation when examining these relationships within individuals. These findings suggest that drinking to cope is a key mechanism in the relationship between emotion-driven impulse control difficulties and hazardous drinking. Results highlight the importance of targeting both emotion dysregulation and drinking to cope when treating young women for alcohol use problems. PMID:26502334

A phase II randomized trial of Observation versus stereotactic ablative RadiatIon for OLigometastatic prostate CancEr (ORIOLE).

PubMed

Radwan, Noura; Phillips, Ryan; Ross, Ashley; Rowe, Steven P; Gorin, Michael A; Antonarakis, Emmanuel S; Deville, Curtiland; Greco, Stephen; Denmeade, Samuel; Paller, Channing; Song, Daniel Y; Diehn, Maximilian; Wang, Hao; Carducci, Michael; Pienta, Kenneth J; Pomper, Martin G; DeWeese, Theodore L; Dicker, Adam; Eisenberger, Mario; Tran, Phuoc T

2017-06-29

We describe a randomized, non-blinded Phase II interventional study to assess the safety and efficacy of stereotactic ablative radiotherapy (SABR) for hormone-sensitive oligometastatic prostate adenocarcinoma, and to describe the biology of the oligometastatic state using immunologic, cellular, molecular, and functional imaging correlates. 54 men with oligometastatic prostate adenocarcinoma will be accrued. The primary clinical endpoint will be progression at 6 months from randomization with the hypothesis that SABR to all metastases will forestall progression by disrupting the metastatic process. Secondary clinical endpoints will include local control at 6 months post-SABR, toxicity and quality of life, and androgen deprivation therapy (ADT)-free survival (ADT-FS). Further fundamental analysis of the oligometastatic state with be achieved through correlation with investigational 18 F-DCFPyL PET/CT imaging and measurement of circulating tumor cells, circulating tumor DNA, and circulating T-cell receptor repertoires, facilitating an unprecedented opportunity to characterize, in isolation, the effects of SABR on the dynamics of and immunologic response to oligometastatic disease. Patients will be randomized 2:1 to SABR or observation with minimization to balance assignment by primary intervention, prior hormonal therapy, and PSA doubling time. Progression after 6 months will be compared using Fisher's exact test. Hazard ratios and Kaplan-Meier estimates of progression free survival (PFS), ADT free survival (ADT-FS), time to locoregional progression (TTLP) and time to distant progression (TTDP) will be calculated based on an intention-to-treat. Local control will be assessed using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. Withdrawal from the study prior to 6 months will be counted as progression. Adverse events will be summarized by type and grade. Quality of life pre- and post- SABR will be measured by Brief Pain Inventory. The ORIOLE trial is the first randomized, non-blinded Phase II interventional study in the North America evaluating the safety and efficacy of SABR in oligometastatic hormone-sensitive prostate cancer. Leading-edge laboratory and imaging correlates will provide unique insight into the effects of SABR on the oligometastatic state. ClinicalTrials.gov Identifier: NCT02680587. URL of Registry: https://clinicaltrials.gov/show/NCT02680587 Date of Registration: 02/08/2016. Date of First Participant Enrollment: 05/23/2016.

Regulatory Exclusions and Alternative Standards for the Recycling of Materials, Solid Wastes and Hazardous Wastes

EPA Pesticide Factsheets

Determining the Level of Regulation for Hazardous Waste Recycling, Recycled Materials that are not Subject to RCRA Hazardous Waste Regulation, Materials Subject to Alternative Regulatory Controls, Materials Subject to Full Hazardous Waste Regulations.

Rates and Durability of Response to Salvage Radiation Therapy Among Patients With Refractory or Relapsed Aggressive Non-Hodgkin Lymphoma

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

Tseng, Yolanda D., E-mail: ydt2@uw.edu; Chen, Yu-Hui; Catalano, Paul J.

Purpose: To evaluate the response rate (RR) and time to local recurrence (TTLR) among patients who received salvage radiation therapy for relapsed or refractory aggressive non-Hodgkin lymphoma (NHL) and investigate whether RR and TTLR differed according to disease characteristics. Methods and Materials: A retrospective review was performed for all patients who completed a course of salvage radiation therapy between January 2001 and May 2011 at Brigham and Women's Hospital/Dana-Farber Cancer Institute. Separate analyses were conducted for patients treated with palliative and curative intent. Predictors of RR for each subgroup were assessed using a generalized estimating equation model. For patients treatedmore » with curative intent, local control (LC) and progression-free survival were estimated with the Kaplan-Meier method; predictors for TTLR were evaluated using a Cox proportional hazards regression model. Results: Salvage radiation therapy was used to treat 110 patients to 121 sites (76 curative, 45 palliative). Salvage radiation therapy was given as part of consolidation in 18% of patients treated with curative intent. Median dose was 37.8 Gy, with 58% and 36% of curative and palliative patients, respectively, receiving 39.6 Gy or higher. The RR was high (86% curative, 84% palliative). With a median follow-up of 4.8 years among living patients, 5-year LC and progression-free survival for curative patients were 66% and 34%, respectively. Refractory disease (hazard ratio 3.3; P=.024) and lack of response to initial chemotherapy (hazard ratio 4.3; P=.007) but not dose (P=.93) were associated with shorter TTLR. Despite doses of 39.6 Gy or higher, 2-year LC was only 61% for definitive patients with refractory disease or disease that did not respond to initial chemotherapy. Conclusions: Relapsed or refractory aggressive NHL is responsive to salvage radiation therapy, and durable LC can be achieved in some cases. However, refractory disease is associated with a shorter TTLR, suggesting that radiation dose escalation, addition of radiosensitizers, or a combination of both may be indicated in these patients.« less

Ribociclib as First-Line Therapy for HR-Positive, Advanced Breast Cancer.

PubMed

Hortobagyi, Gabriel N; Stemmer, Salomon M; Burris, Howard A; Yap, Yoon-Sim; Sonke, Gabe S; Paluch-Shimon, Shani; Campone, Mario; Blackwell, Kimberly L; André, Fabrice; Winer, Eric P; Janni, Wolfgang; Verma, Sunil; Conte, Pierfranco; Arteaga, Carlos L; Cameron, David A; Petrakova, Katarina; Hart, Lowell L; Villanueva, Cristian; Chan, Arlene; Jakobsen, Erik; Nusch, Arnd; Burdaeva, Olga; Grischke, Eva-Maria; Alba, Emilio; Wist, Erik; Marschner, Norbert; Favret, Anne M; Yardley, Denise; Bachelot, Thomas; Tseng, Ling-Ming; Blau, Sibel; Xuan, Fengjuan; Souami, Farida; Miller, Michelle; Germa, Caroline; Hirawat, Samit; O'Shaughnessy, Joyce

2016-11-03

The inhibition of cyclin-dependent kinases 4 and 6 (CDK4/6) could potentially overcome or delay resistance to endocrine therapy in advanced breast cancer that is positive for hormone receptor (HR) and negative for human epidermal growth factor receptor 2 (HER2). In this randomized, placebo-controlled, phase 3 trial, we evaluated the efficacy and safety of the selective CDK4/6 inhibitor ribociclib combined with letrozole for first-line treatment in 668 postmenopausal women with HR-positive, HER2-negative recurrent or metastatic breast cancer who had not received previous systemic therapy for advanced disease. We randomly assigned the patients to receive either ribociclib (600 mg per day on a 3-weeks-on, 1-week-off schedule) plus letrozole (2.5 mg per day) or placebo plus letrozole. The primary end point was investigator-assessed progression-free survival. Secondary end points included overall survival, overall response rate, and safety. A preplanned interim analysis was performed on January 29, 2016, after 243 patients had disease progression or died. Prespecified criteria for superiority required a hazard ratio of 0.56 or less with P<1.29×10 -5 . The duration of progression-free survival was significantly longer in the ribociclib group than in the placebo group (hazard ratio, 0.56; 95% CI, 0.43 to 0.72; P=3.29×10 -6 for superiority). The median duration of follow-up was 15.3 months. After 18 months, the progression-free survival rate was 63.0% (95% confidence interval [CI], 54.6 to 70.3) in the ribociclib group and 42.2% (95% CI, 34.8 to 49.5) in the placebo group. In patients with measurable disease at baseline, the overall response rate was 52.7% and 37.1%, respectively (P<0.001). Common grade 3 or 4 adverse events that were reported in more than 10% of the patients in either group were neutropenia (59.3% in the ribociclib group vs. 0.9% in the placebo group) and leukopenia (21.0% vs. 0.6%); the rates of discontinuation because of adverse events were 7.5% and 2.1%, respectively. Among patients receiving initial systemic treatment for HR-positive, HER2-negative advanced breast cancer, the duration of progression-free survival was significantly longer among those receiving ribociclib plus letrozole than among those receiving placebo plus letrozole, with a higher rate of myelosuppression in the ribociclib group. (Funded by Novartis Pharmaceuticals; ClinicalTrials.gov number, NCT01958021 .).

Developing a global tsunami propagation database and its application for coastal hazard assessments in China

NASA Astrophysics Data System (ADS)

Wang, N.; Tang, L.; Titov, V.; Newman, J. C.; Dong, S.; Wei, Y.

2013-12-01

The tragedies of the 2004 Indian Ocean and 2011 Japan tsunamis have increased awareness of tsunami hazards for many nations, including China. The low land level and high population density of China's coastal areas place it at high risk for tsunami hazards. Recent research (Komatsubara and Fujiwara, 2007) highlighted concerns of a magnitude 9.0 earthquake on the Nankai trench, which may affect China's coasts not only in South China Sea, but also in the East Sea and Yellow Sea. Here we present our work in progress towards developing a global tsunami propagation database that can be used for hazard assessments by many countries. The propagation scenarios are computed by using NOAA's MOST numerical model. Each scenario represents a typical Mw 7.5 earthquake with predefined earthquake parameters (Gica et al., 2008). The model grid was interpolated from ETOPO1 at 4 arc-min resolution, covering -80° to72°N and 0 to 360°E. We use this database for preliminary tsunami hazard assessment along China's coastlines.

Periodontal Pocket Depth, Hyperglycemia, and Progression of Chronic Kidney Disease: A Population-Based Longitudinal Study.

PubMed

Chang, Jia-Feng; Yeh, Jih-Chen; Chiu, Ya-Lin; Liou, Jian-Chiun; Hsiung, Jing-Ru; Tung, Tao-Hsin

2017-01-01

No large epidemiological study has been conducted to investigate the interaction and joint effects of periodontal pocket depth and hyperglycemia on progression of chronic kidney disease in patients with periodontal diseases. Periodontal pocket depth was utilized for the grading severity of periodontal disease in 2831 patients from January 2002 to June 2013. Progression of chronic kidney disease was defined as progression of color intensity in glomerular filtration rate and albuminuria grid of updated Kidney Disease-Improving Global Outcomes guidelines. Multivariable-adjusted hazard ratios (aHR) in various models were presented across different levels of periodontal pocket depth and hemoglobin A1c (HbA1c) in forest plots and 3-dimensional histograms. During 7621 person-years of follow-up, periodontal pocket depth and HbA1C levels were robustly associated with incremental risks for progression of chronic kidney disease (aHR 3.1; 95% confidence interval [CI], 2.0-4.6 for periodontal pocket depth >4.5 mm, and 2.5; 95% CI, 1.1-5.4 for HbA1C >6.5%, respectively). The interaction between periodontal pocket depth and HbA1C on progression of chronic kidney disease was strong (P <.01). Patients with higher periodontal pocket depth (>4.5 mm) and higher HbA1C (>6.5%) had the greatest risk (aHR 4.2; 95% CI, 1.7-6.8) compared with the lowest aHR group (periodontal pocket depth ≤3.8 mm and HbA1C ≤6%). Our study identified combined periodontal pocket depth and HbA1C as a valuable predictor of progression of chronic kidney disease in patients with periodontal diseases. While considering the interaction between periodontal diseases and hyperglycemia, periodontal survey and optimizing glycemic control are warranted to minimize the risk of worsening renal function. Copyright © 2016 Elsevier Inc. All rights reserved.

Fall Hazards Within Senior Independent Living: A Case-Control Study.

PubMed

Kim, Daejin; Portillo, Margaret

2018-01-01

The main purpose of this research was to identify significant relationships between environmental hazards and older adults' falling. Falls can present a major health risk to older persons. Identifying potential environmental hazards that increase fall risks can be effective for developing fall prevention strategies that can create safer residential environments for older adults. The research included a retrospective analysis of 449 fall incident reports in two case-control buildings. In the homes of 88 older adults residing in independent living, an observational study was conducted to identify environmental hazards using two assessment tools including Westmead Home Safety Assessment (WeHSA) and resident interviews. A fall history analysis indicated that falls occurred in the bathroom were significantly associated with hospitalization. The observational study revealed that the bathroom was the most common place for environmental hazards. The research showed, with increasing age and use of mobility assistive aids, there was a corresponding increase in the total number of environmental hazards. Home hazards were significantly and independently associated with the incidence rate of falls. In other words, the high fall rate building included more environmental hazards compared to the low fall rate building while controlling for residents' age and mobility. The current study provides empirical evidence of the link between environmental hazards and older adults' falling, which is useful for developing effective fall intervention design strategies.

Superior Treatment Response and In-field Tumor Control in Epidermal Growth Factor Receptor-mutant Genotype of Stage III Nonsquamous Non-Small cell Lung Cancer Undergoing Definitive Concurrent Chemoradiotherapy.

PubMed

Lim, Yu Jin; Chang, Ji Hyun; Kim, Hak-Jae; Keam, Bhumsuk; Kim, Tae Min; Kim, Dong-Wan; Paeng, Jin Chul; Kang, Keon Wook; Chung, June-Key; Jeon, Yoon Kyung; Chung, Doo Hyun; Wu, Hong-Gyun

2017-05-01

Although previous in vitro data have suggested a more radio-sensitive nature of epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) cell lines, the clinical behavior according to the EGFR mutational status has not been well-established. In this study, we performed a comparative outcome analysis of EGFR-mutant and wild-type locally advanced NSCLC with chemoradiotherapy (CRT). A total of 102 patients with stage III nonsquamous NSCLC undergoing primary CRT were identified. Clinicopathologic characteristics, including the degree of glucose uptake, were evaluated. Failure patterns considering the radiation field and survival outcomes were compared according to the EGFR mutational status. Pre- and post-CRT maximum standardized uptake values were significantly lower in EGFR-mutant tumors (P = .010 and .018, respectively). The overall response rate was higher in the EGFR-mutant group compared with the wild-type (89% vs. 64%, respectively; P = .023). The 3-year overall survival rate was better with the genetic alteration (68.0% vs. 47.4%, P = .046), but the statistical significance did not remain in multivariate analysis (hazard ratio, 0.68; 95% confidence interval, 0.30-1.55). Considering the tumor progression inside or outside the radiation field, the EGFR-mutant group showed longer in-field time to progression (P = .002), even after adjusting for other related baseline variables (hazard ratio, 0.27; 95% confidence interval, 0.11-0.71). The differential metabolic activity, failure patterns, and prognosis suggest the distinct nature of the EGFR-mutant tumors. EGFR mutational status needs to be considered for more precise curative-intent treatment strategies of locally advanced nonsquamous NSCLC. Copyright © 2017 Elsevier Inc. All rights reserved.

Oral fluoropyrimidine versus intravenous 5-fluorouracil for the treatment of advanced gastric and colorectal cancer: Meta-analysis.

PubMed

Zhang, Linlin; Xing, Xiaoli; Meng, Fanlu; Wang, Yan; Zhong, Diansheng

2018-01-01

5-Fluorouracil (5-Fu) is one of the most commonly prescribed antineoplastic agents against gastric and colorectal cancers. Continuous infusion would be the optimal way of its administration, however, may usually cause thrombosis, infection, and prolonged hospital stay. Oral fluoropyrimidines would be an attractive alternative, but their efficiency and toxicities for the treatment of gastric and colorectal cancer are still obscure as compared with infusion 5-Fu. Literature retrieval, trials selection and assessment, data collection, and statistic analysis were performed according to the Cochrane Handbook. The outcome measures were tumor response rate, progression-free survival, overall survival, and adverse effects. Twenty-nine randomized controlled trials, comprising totally 15 154 patients, were included. Meta-analysis showed similar overall outcome in terms of response rate (1.01; 95% confidence interval [CI], 0.92-1.12), progression-free survival (hazard ratio 1.00; 95%CI, 0.94-1.06), and overall survival (hazard ratio 0.96; 95%CI, 0.92-1.01) between oral fluoropyrimidine-based and intravenous 5-Fu-based regimens in gastric and colorectal cancer patients. The risk of grade 3/4 neutropenia, thrombocytopenia, and stomatitis was more prominent in intravenous 5-Fu-based regimens; while more frequent grade 3/4 hand-foot syndrome, diarrhea, and anorexia were detected in oral fluoropyrimidine-based regimens. Oral-fluoropyrimidines showed equivalent response and similar survival outcomes, but different toxicity profiles, as compared with intravenous 5-Fu. Thus, it would be a more convenient and adjustable alternative in treatment of advanced gastric and colorectal cancer. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Metabolic Tumor Volume as a Prognostic Imaging-Based Biomarker for Head-and-Neck Cancer: Pilot Results From Radiation Therapy Oncology Group Protocol 0522

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

Schwartz, David L., E-mail: david.schwartz@utsw.edu; Harris, Jonathan; Yao, Min

2015-03-15

Purpose: To evaluate candidate fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging biomarkers for head-and-neck chemoradiotherapy outcomes in the cooperative group trial setting. Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 0522 patients consenting to a secondary FDG-PET/CT substudy were serially imaged at baseline and 8 weeks after radiation. Maximum standardized uptake value (SUVmax), SUV peak (mean SUV within a 1-cm sphere centered on SUVmax), and metabolic tumor volume (MTV) using 40% of SUVmax as threshold were obtained from primary tumor and involved nodes. Results: Of 940 patients entered onto RTOG 0522, 74 were analyzable for this substudy. Neither high baselinemore » SUVmax nor SUVpeak from primary or nodal disease were associated with poor treatment outcomes. However, primary tumor MTV above the cohort median was associated with worse local-regional control (hazard ratio 4.01, 95% confidence interval 1.28-12.52, P=.02) and progression-free survival (hazard ratio 2.34, 95% confidence interval 1.02-5.37, P=.05). Although MTV and T stage seemed to correlate (mean MTV 6.4, 13.2, and 26.8 for T2, T3, and T4 tumors, respectively), MTV remained a strong independent prognostic factor for progression-free survival in bivariate analysis that included T stage. Primary MTV remained prognostic in p16-associated oropharyngeal cancer cases, although sample size was limited. Conclusion: High baseline primary tumor MTV was associated with worse treatment outcomes in this limited patient subset of RTOG 0522. Additional confirmatory work will be required to validate primary tumor MTV as a prognostic imaging biomarker for patient stratification in future trials.« less

Clinical outcomes in patients with metastatic renal cell carcinoma receiving everolimus or temsirolimus after sunitinib

PubMed Central

Iacovelli, Roberto; Cartenì, Giacomo; Milella, Michele; Berardi, Rossana; Di Lorenzo, Giuseppe; Verzoni, Elena; Rizzo, Mimma; Santoni, Matteo; Procopio, Giuseppe

2014-01-01

Introduction: There are little data on the clinical activity of temsirolimus (TM) and everolimus (EV) when used as second-line therapy after sunitinib (SU) in patients with metastatic renal cell carcinoma (mRCC). Methods: Patients with mRCC treated with EV or TM after SU were included in this retrospective analysis. Progression-free survival (PFS), time to sequence failure (TTSF) from the start of SU to disease progression with EV/TM and overall survival (OS) were estimated using Kaplan-Meier method and compared across groups using the log-rank test. Cox proportional hazards models were applied to investigate predictors of TTSF and OS. Results: In total, 89 patients (median age 60.0 years) were included. At baseline 43% were classified as MSKCC good-risk, 43% as intermediate-risk and 14% as poor-risk. Median OS was 36.3 months and median TTSF was 17.2 months. Sixty-five patients received SU-EV and 24 patients SU-TM. Median PFS after the second-line treatment was 4.3 months in the EV group and 3.5 months in the TM group (p = 0.63). Median TTSF was 17.0 and 18.9 months (p = 0.32) and the OS was 35.8 and 38.3 months (p = 0.73) with SU-EV and SU-TM, respectively. The prognostic role of initial MSKCC was confirmed by multivariable analysis (hazard ratio 1.76, 95% confidence interval 1.08–2.85. p = 0.023). Conclusions: This study did not show significant differences in terms of disease control and OS between EV and TM in the second-line setting. EV remains the preferred mTOR inhibitor for the treatment of mRCC patients resistant to prior tyrosine kinase inhibitor treatment. PMID:24678349

Cross Reference Index for Bioenvironmental Engineer and Military Public Health Offices

DTIC Science & Technology

1992-03-01

Food Recall AFR 161-42 DOD Hazardous Food and Nonprescription Drug Recall System Insects and Mite Pests in Food AGR-HB-655 Insects and Mite Pests in Food...Solution, 11 Hazard Communication, 12 Hazardous Energy Control, 21, 22 Hazardous Food Recall Program, 9 Hazardous Waste, 11, 26 Hazardous Materials...34Institutional Meat Purchase Specification" NAMPS "National Association of Meat Purveyor’s" DPSC Support DOD 4155.6 Subsistence Inspection Manual Hazardous

The impact of overall treatment time on outcomes in radiation therapy for non-small cell lung cancer.

PubMed

Chen, M; Jiang, G L; Fu, X L; Wang, L J; Qian, H; Chen, G Y; Zhao, S; Liu, T F

2000-04-01

A retrospective study was carried out to evaluate the impact of overall treatment time (OTT) on the results of radiation therapy for non-small cell lung cancer (NSCLC). From Jan. 1990 to Dec. 1996, 256 patients with stages I-IIIb NSCLC entered this analysis. All patients received definitive radiotherapy. Biologically effective dose (BED) was used to standardize the irradiation effects. The correlation between OTT and local progression-free survival was analyzed by linear-regression and Cox proportional hazard models. The prognostic variables for survival and distant metastasis were also briefly studied. OTT had been shortened in 64 patients because of an accelerated hyperfractioned irradiation, while OTT was prolonged i n 114 patients due to interruptions of irradiation courses. The main ca uses of interruption were machine breakdown or delayed preparations of c errobend block for boost fields (55%), holidays (11%) and treatment toxi city and side effects (34%). Patients tre ated with prolonged OTT (> 45 days) had significant poorer local progression-free survival than whom with OTT of

3 CFR 8658 - Proclamation 8658 of April 27, 2011. Workers Memorial Day, 2011

Code of Federal Regulations, 2012 CFR

2012-01-01

... hazards. In the four decades since those landmark laws were enacted, we have seen great progress in... full force of the law is brought to bear in cases where workers are put in harm's way. Many of our...

Systems Toxicology of Embryo Development (9th Copenhagen Workshop)

EPA Science Inventory

An important consideration for predictive toxicology is to identify developmental hazards utilizing mechanism-based in vitro assays (e.g., ToxCast) and in silico multiscale models. Steady progress has been made with agent-based models that recapitulate morphogenetic drivers for a...

Hazardous Waste Cleanup: Buckeye Caribbean Terminals Incorporated in Yabucoa, Puerto Rico

EPA Pesticide Factsheets

The Buckeye Caribbean Terminals, Inc. (formerly Shell Chemical Yabucoa, Inc.) is located on Road 901 about two miles east of the town of Yabucoa, Puerto Rico. Petroleum refining operations have been in progress at the site since May 1971.

SUPERFUND INNOVATIVE TECHNOLOGY EVALUATION PROGRAM: PROGRESS AND ACCOMPLISHMENTS - FISCAL YEAR 1991

EPA Science Inventory

The Superfund Innovative Technology Evaluation (SITE) program was the first major program for demonstrating and evaluating full-scale innovative treatment technologies at hazardous waste sites. Having concluded its fifth year, the SITE program is recognized as a leading advocate ...

Six Strategies for Chemical Waste Minimization in Laboratories.

ERIC Educational Resources Information Center

Matteson, Gary C.; Hadley, Cheri R.

1991-01-01

Guidelines are offered to research administrators for reducing the volume of hazardous laboratory waste. Suggestions include a chemical location inventory, a chemical reuse facility, progressive contracts with chemical suppliers, internal or external chemical recycling mechanisms, a "chemical conservation" campaign, and laboratory fees for…

Hazardous Waste Cleanup: Lenox China Incorporated in Pomona, New Jersey

EPA Pesticide Factsheets

Lenox China Inc. is a 56-acre site in a rural area located on Tilton Road on the outskirts of the Town of Pomona in southeastern New Jersey. The facility manufactures china giftware and dinnerware. The manufacturing process includes the progressive

Measuring disease progression in early Parkinson disease: the National Institutes of Health Exploratory Trials in Parkinson Disease (NET-PD) experience.

PubMed

Parashos, Sotirios A; Luo, Sheng; Biglan, Kevin M; Bodis-Wollner, Ivan; He, Bo; Liang, Grace S; Ross, G Webster; Tilley, Barbara C; Shulman, Lisa M

2014-06-01

Optimizing assessments of rate of progression in Parkinson disease (PD) is important in designing clinical trials, especially of potential disease-modifying agents. To examine the value of measures of impairment, disability, and quality of life in assessing progression in early PD. Inception cohort analysis of data from 413 patients with early, untreated PD who were enrolled in 2 multicenter, randomized, double-blind clinical trials. Participants were randomly assigned to 1 of 5 treatments (67 received creatine, 66 received minocycline, 71 received coenzyme Q10, 71 received GPI-1485, and 138 received placebo). We assessed the association between the rates of change in measures of impairment, disability, and quality of life and time to initiation of symptomatic treatment. Time between baseline assessment and need for the initiation of symptomatic pharmaceutical treatment for PD was the primary indicator of disease progression. After adjusting for baseline confounding variables with regard to the Unified Parkinson's Disease Rating Scale (UPDRS) Part II score, the UPDRS Part III score, the modified Rankin Scale score, level of education, and treatment group, we assessed the rate of change for the following measurements: the UPDRS Part II score; the UPDRS Part III score; the Schwab and England Independence Scale score (which measures activities of daily living); the Total Functional Capacity scale; the 39-item Parkinson's Disease Questionnaire, summary index, and activities of daily living subscale; and version 2 of the 12-item Short Form Health Survey Physical Summary and Mental Summary. Variables reaching the statistical threshold in univariate analysis were entered into a multivariable Cox proportional hazards model using time to symptomatic treatment as the dependent variable. More rapid change (ie, worsening) in the UPDRS Part II score (hazard ratio, 1.15 [95% CI, 1.08-1.22] for 1 scale unit change per 6 months), the UPDRS Part III score (hazard ratio, 1.09 [95% CI, 1.06-1.13] for 1 scale unit change per 6 months), and the Schwab and England Independence Scale score (hazard ratio, 1.29 [95% CI, 1.12-1.48] for 5 percentage point change per 6 months) was associated with earlier need for symptomatic therapy. AND RELEVANCE In early PD, the UPDRS Part II score and Part III score and the Schwab and England Independence Scale score can be used to measure disease progression, whereas the 39-item Parkinson's Disease Questionnaire and summary index, Total Functional Capacity scale, and the 12-item Short Form Health Survey Physical Summary and Mental Summary are not sensitive to change. clinicaltrials.gov Identifiers: NCT00063193 and NCT00076492.

Pembrolizumab as Second-Line Therapy for Advanced Urothelial Carcinoma

PubMed Central

Bellmunt, J.; de Wit, R.; Vaughn, D.J.; Fradet, Y.; Lee, J.-L.; Fong, L.; Vogelzang, N.J.; Climent, M.A.; Petrylak, D.P.; Choueiri, T.K.; Necchi, A.; Gerritsen, W.; Gurney, H.; Quinn, D.I.; Culine, S.; Sternberg, C.N.; Mai, Y.; Poehlein, C.H.; Perini, R.F.; Bajorin, D.F.

2017-01-01

BACKGROUND Patients with advanced urothelial carcinoma that progresses after platinum-based chemotherapy have a poor prognosis and limited treatment options. METHODS In this open-label, international, phase 3 trial, we randomly assigned 542 patients with advanced urothelial cancer that recurred or progressed after platinum-based chemotherapy to receive pembrolizumab (a highly selective, humanized monoclonal IgG4κ isotype antibody against programmed death 1 [PD-1]) at a dose of 200 mg every 3 weeks or the investigator’s choice of chemotherapy with paclitaxel, docetaxel, or vinflunine. The coprimary end points were overall survival and progression-free survival, which were assessed among all patients and among patients who had a tumor PD-1 ligand (PD-L1) combined positive score (the percentage of PD-L1–expressing tumor and infiltrating immune cells relative to the total number of tumor cells) of 10% or more. RESULTS The median overall survival in the total population was 10.3 months (95% confidence interval [CI], 8.0 to 11.8) in the pembrolizumab group, as compared with 7.4 months (95% CI, 6.1 to 8.3) in the chemotherapy group (hazard ratio for death, 0.73; 95% CI, 0.59 to 0.91; P=0.002). The median overall survival among patients who had a tumor PD-L1 combined positive score of 10% or more was 8.0 months (95% CI, 5.0 to 12.3) in the pembrolizumab group, as compared with 5.2 months (95% CI, 4.0 to 7.4) in the chemotherapy group (hazard ratio, 0.57; 95% CI, 0.37 to 0.88; P=0.005). There was no significant between-group difference in the duration of progression-free survival in the total population (hazard ratio for death or disease progression, 0.98; 95% CI, 0.81 to 1.19; P=0.42) or among patients who had a tumor PD-L1 combined positive score of 10% or more (hazard ratio, 0.89; 95% CI, 0.61 to 1.28; P =0.24). Fewer treatment-related adverse events of any grade were reported in the pembrolizumab group than in the chemotherapy group (60.9% vs. 90.2%); there were also fewer events of grade 3, 4, or 5 severity reported in the pembrolizumab group than in the chemotherapy group (15.0% vs. 49.4%). CONCLUSIONS Pembrolizumab was associated with significantly longer overall survival (by approximately 3 months) and with a lower rate of treatment-related adverse events than chemotherapy as second-line therapy for platinum-refractory advanced urothelial carcinoma. (Funded by Merck; KEYNOTE-045 ClinicalTrials.gov number, NCT02256436.) PMID:28212060

10 CFR 851.21 - Hazard identification and assessment.

Code of Federal Regulations, 2012 CFR

2012-01-01

.... Procedures must include methods to: (1) Assess worker exposure to chemical, physical, biological, or safety..., biological, and safety workplace hazards using recognized exposure assessment and testing methodologies and... hazards and the established controls within 90 days after identifying such hazards. The Head of DOE Field...

10 CFR 851.21 - Hazard identification and assessment.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... Procedures must include methods to: (1) Assess worker exposure to chemical, physical, biological, or safety..., biological, and safety workplace hazards using recognized exposure assessment and testing methodologies and... hazards and the established controls within 90 days after identifying such hazards. The Head of DOE Field...

10 CFR 851.21 - Hazard identification and assessment.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... Procedures must include methods to: (1) Assess worker exposure to chemical, physical, biological, or safety..., biological, and safety workplace hazards using recognized exposure assessment and testing methodologies and... hazards and the established controls within 90 days after identifying such hazards. The Head of DOE Field...

Near surface geophysics techniques and geomorphological approach to reconstruct the hazard cave map in historical and urban areas

NASA Astrophysics Data System (ADS)

Lazzari, M.; Loperte, A.; Perrone, A.

2010-03-01

This work, carried out with an integrated methodological approach, focuses on the use of near surface geophysics techniques, such as ground penetrating radar and electrical resistivity tomography (ERT), and geomorphological analysis, in order to reconstruct the cave distribution and geometry in a urban context and, in particular, in historical centres. The interaction during recent centuries between human activity (caves excavation, birth and growth of an urban area) and the characters of the natural environment were the reasons of a progressive increase in hazard and vulnerability levels of several sites. The reconstruction of a detailed cave map distribution is the first step to define the anthropic and geomorphological hazard in urban areas, fundamental basis for planning and assessing the risk.

An Integrative Research Framework to Unravel the Interplay of Natural Hazards and Vulnerabilities

NASA Astrophysics Data System (ADS)

Di Baldassarre, Giuliano; Nohrstedt, Daniel; Mârd, Johanna; Burchardt, Steffi; Albin, Cecilia; Bondesson, Sara; Breinl, Korbinian; Deegan, Frances M.; Fuentes, Diana; Lopez, Marc Girons; Granberg, Mikael; Nyberg, Lars; Nyman, Monika Rydstedt; Rhodes, Emma; Troll, Valentin; Young, Stephanie; Walch, Colin; Parker, Charles F.

2018-03-01

Climate change, globalization, urbanization, social isolation, and increased interconnectedness between physical, human, and technological systems pose major challenges to disaster risk reduction (DRR). Subsequently, economic losses caused by natural hazards are increasing in many regions of the world, despite scientific progress, persistent policy action, and international cooperation. We argue that these dramatic figures call for novel scientific approaches and new types of data collection to integrate the two main approaches that still dominate the science underpinning DRR: the hazard paradigm and the vulnerability paradigm. Building from these two approaches, here we propose a research framework that specifies the scope of enquiry, concepts, and general relations among phenomena. We then discuss the essential steps to advance systematic empirical research and evidence-based DRR policy action.

Elevated serum progastrin-releasing peptide (31-98) level is a predictor of short response duration after hormonal therapy in metastatic prostate cancer.

PubMed

Yashi, Masahiro; Nukui, Akinori; Kurokawa, Shinsuke; Ochi, Masanori; Ishikawa, Shinya; Goto, Kentaro; Kobayashi, Yutaka; Muraishi, Osamu; Tokue, Akihiko

2003-09-01

The neuroendocrine (NE) pathway has been attracting attention as a mechanism for the androgen-independent progression because the neuropeptide provokes tumor growth and inhibits apoptosis under androgen-deprived milieu in prostate cancer cells. On the basis that serum progastrin-releasing peptide (ProGRP) is elevated in patients with advanced disease stage, we examined the prognostic value of the neuropeptide. Serum ProGRP status was determined with an enzyme-linked immunosorbent assay (ELISA) in 460 men with benign and malignant prostatic diseases, chronic renal failure, and healthy controls. Seventy patients with metastatic prostate cancer including four patients (5.7%) with NE carcinoma who underwent hormonal therapy were enrolled in the prognostic analyses by Cox proportional hazards model. The serum status steadily shifted toward predominant expression of ProGRP with the progression of prostate cancer into metastatic and androgen-independent stages. Univariate analysis revealed that the deteriorated performance status (PS) and extent of bony disease (EOD), and high serum alkaline phosphatase (ALP), serum ProGRP, and nadir prostate-specific antigen (PSA) levels were associated with a lower progression-free survival (PFS) rate (P < 0.005). Multivariate analysis demonstrated that PS, serum ProGRP, and nadir PSA held an independent predictive value for PFS (P < 0.05), and all correlated with bone-related factors. Serum ProGRP was the most significant predictor among pre-treatment factors in this model (P = 0.0094). The neuropeptide precursor ProGRP is a distinct serum marker that is useful to know the NE milieu and provides prognostic information in patients with advanced prostate cancer. Standard therapy for metastatic prostate cancer may make progress when further studies will clarify the causative link between serum ProGRP level and androgen-independent disease progression. Copyright 2003 Wiley-Liss, Inc.

Seventeen-year follow-up of the prospective randomized Nordic CIS study: BCG monotherapy versus alternating therapy with mitomycin C and BCG in patients with carcinoma in situ of the urinary bladder.

PubMed

Kaasinen, Eero; Wijkström, Hans; Rintala, Erkki; Mestad, Oddvar; Jahnson, Staffan; Malmström, Per-Uno

2016-10-01

The aim of this study was to compare the long-term efficacy of BCG monotherapy to alternating therapy of mitomycin C (MMC) and BCG in patients with carcinoma in situ (CIS). Between 1992 and 1997, 321 patients with CIS were randomized from Finland, Norway and Sweden in a prospective multicenter trial into two treatment groups. The alternating therapy comprised six weekly instillations of MMC 40 mg followed by 10 instillations of BCG (Connaught 120 mg) or MMC alternating monthly for 1 year. BCG monotherapy followed the same 6 + 10 schedule. Stratification was done by nationality and CIS category. Primary endpoints were time to first recurrence and time to progression. Secondary endpoints were disease-specific mortality and overall survival. The main statistical methods were the proportional subdistribution hazards model and Cox proportional hazards model with the cumulative incidence and Kaplan-Meier analyses. The median follow-up time was 9.9 years (maximum 19.9 years) in the BCG group and 8.9 years (maximum 20.3 years) in the alternating group. The risk of recurrence was significantly lower in the BCG group than in the alternating group (49 vs 59% at 15 years, respectively; hazard ratio 0.74, 95% confidence interval 0.54-1.00, p = 0.048). There were no significant differences in the other endpoints. Patients who progressed after 2 years were particularly prone to dying from bladder carcinoma. Younger patients performed worse than older ones. BCG monotherapy including monthly maintenance was effective and better than the alternating therapy. The risk of dying from bladder carcinoma after progression was high.

Association of Pulse Wave Velocity With Chronic Kidney Disease Progression and Mortality: Findings From the CRIC Study (Chronic Renal Insufficiency Cohort).

PubMed

Townsend, Raymond R; Anderson, Amanda Hyre; Chirinos, Julio A; Feldman, Harold I; Grunwald, Juan E; Nessel, Lisa; Roy, Jason; Weir, Matthew R; Wright, Jackson T; Bansal, Nisha; Hsu, Chi-Yuan

2018-06-01

Patients with chronic kidney diseases (CKDs) are at risk for further loss of kidney function and death, which occur despite reasonable blood pressure treatment. To determine whether arterial stiffness influences CKD progression and death, independent of blood pressure, we conducted a prospective cohort study of CKD patients enrolled in the CRIC study (Chronic Renal Insufficiency Cohort). Using carotid-femoral pulse wave velocity (PWV), we examined the relationship between PWV and end-stage kidney disease (ESRD), ESRD or halving of estimated glomerular filtration rate, or death from any cause. The 2795 participants we enrolled had a mean age of 60 years, 56.4% were men, 47.3% had diabetes mellitus, and the average estimated glomerular filtration rate at entry was 44.4 mL/min per 1.73 m 2 During follow-up, there were 504 ESRD events, 628 ESRD or halving of estimated glomerular filtration rate events, and 394 deaths. Patients with the highest tertile of PWV (>10.3 m/s) were at higher risk for ESRD (hazard ratio [95% confidence interval], 1.37 [1.05-1.80]), ESRD or 50% decline in estimated glomerular filtration rate (hazard ratio [95% confidence interval], 1.25 [0.98-1.58]), or death (hazard ratio [95% confidence interval], 1.72 [1.24-2.38]). PWV is a significant predictor of CKD progression and death in people with impaired kidney function. Incorporation of PWV measurements may help define better the risks for these important health outcomes in patients with CKDs. Interventions that reduce aortic stiffness deserve study in people with CKD. © 2018 American Heart Association, Inc.

The Role and Quality of Software Safety in the NASA Constellation Program

NASA Technical Reports Server (NTRS)

Layman, Lucas; Basili, Victor R.; Zelkowitz, Marvin V.

2010-01-01

In this study, we examine software safety risk in the early design phase of the NASA Constellation spaceflight program. Obtaining an accurate, program-wide picture of software safety risk is difficult across multiple, independently-developing systems. We leverage one source of safety information, hazard analysis, to provide NASA quality assurance managers with information regarding the ongoing state of software safety across the program. The goal of this research is two-fold: 1) to quantify the relative importance of software with respect to system safety; and 2) to quantify the level of risk presented by software in the hazard analysis. We examined 154 hazard reports created during the preliminary design phase of three major flight hardware systems within the Constellation program. To quantify the importance of software, we collected metrics based on the number of software-related causes and controls of hazardous conditions. To quantify the level of risk presented by software, we created a metric scheme to measure the specificity of these software causes. We found that from 49-70% of hazardous conditions in the three systems could be caused by software or software was involved in the prevention of the hazardous condition. We also found that 12-17% of the 2013 hazard causes involved software, and that 23-29% of all causes had a software control. Furthermore, 10-12% of all controls were software-based. There is potential for inaccuracy in these counts, however, as software causes are not consistently scoped, and the presence of software in a cause or control is not always clear. The application of our software specificity metrics also identified risks in the hazard reporting process. In particular, we found a number of traceability risks in the hazard reports may impede verification of software and system safety.

30 CFR 46.11 - Site-specific hazard awareness training.

Code of Federal Regulations, 2011 CFR

2011-07-01

... environmental conditions, recognition and avoidance of hazards such as electrical and powered-haulage hazards, traffic patterns and control, and restricted areas; and warning and evacuation signals, evacuation and...

The investigation of tethered satellite system dynamics

NASA Technical Reports Server (NTRS)

Lorenzini, E.

1985-01-01

Progress in tethered satellite system dynamics research is reported. A retrieval rate control law with no angular feedback to investigate the system's dynamic response was studied. The initial conditions for the computer code which simulates the satellite's rotational dynamics were extended to a generic orbit. The model of the satellite thrusters was modified to simulate a pulsed thrust, by making the SKYHOOK integrator suitable for dealing with delta functions without loosing computational efficiency. Tether breaks were simulated with the high resolution computer code SLACK3. Shuttle's maneuvers were tested. The electric potential around a severed conductive tether with insulator, in the case of a tether breakage at 20 km from the Shuttle, was computed. The electrodynamic hazards due to the breakage of the TSS electrodynamic tether in a plasma are evaluated.

The hovercraft environment.

PubMed

Lovesey, E J

1970-06-01

In just over a decade the hovercraft has progressed from first prototype to a successful commercial form of transport which also has the ability to penetrate many environments hitherto virtually inaccessible to manned vehicles. Comparison with rival short range vehicles such as the helicopter and hydrofoil show that the hovercraft has become one of the most versatile forms of transport available. This versatility and ability to operate in unusual or extreme environments has been accompanied by the problems of control and of protection of the occupants of the hovercraft from the hazards associated with these environments. Several of these problems are discussed, together with their possible solutions. This article is based on a paper given to the Nederlands Vereniging Voor Ergonomie/Ergonomics Research Society joint conference at Noordwijk in Holland, 11-13 June, 1969.

Lower risk of progression from prediabetes to diabetes with health checkup with lifestyle education: Japan Ningen Dock study.

PubMed

Okada, R; Tsushita, K; Wakai, K; Ishizaka, Y; Kato, K; Wada, T; Watanabe, K

2017-08-01

To investigate whether the progression from prediabetes to diabetes is lower among those who undertake Ningen Dock (comprehensive health checkups with lifestyle education and doctor's consultation) than those who undertake basic mandatory occupational health checkups. Subjects aged 30-69 years with complete annual data from 2008 to 2012 for either Ningen Dock or basic health checkups were enrolled. Subjects with prediabetes (fasting plasma glucose 100-125 mg/dl or HbA1c 5.7-6.4%) at baseline were selected (14,928 in the comprehensive group and 10,433 in the basic group). The incidence of diabetes (fasting plasma glucose ≥ 126 mg/dl, HbA1c ≥ 6.5% or taking glucose-lowering drugs) and the reduction of risk factors were compared. After 4 years, 3226 cases of diabetes occurred among 25,361 subjects with prediabetes. The incidence of diabetes was lower in the comprehensive group than the basic group (2.9 vs. 3.8 cases/100 person-years, hazard ratio 0.75, 95% confidence interval 0.68-0.81 after adjustment). Moreover, more overweight subjects controlled their body mass index (16.2% vs. 13.2%) and more began a daily exercise habit (11.8% vs. 8.5%) in the comprehensive group than in the basic group. The incidence of diabetes was lower in subjects who could control their weight or start daily exercise at year 1 in the comprehensive group. Progression from prediabetes to diabetes was significantly lower in subjects undertaking a comprehensive health checkup with lifestyle education. Lifestyle education at health checkup for people with prediabetes might prevent progression to diabetes by reducing modifiable risk factors. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Administrative goals and safety standards for hazard control on forested recreation sites

Treesearch

Lee A. Paine

1973-01-01

For efficient control of tree hazard on recreation sites, a specific administrative goal must be selected. A safety standard designed to achieve the selected goal and a uniform hazard-rating procedure will then promote a consistent level of safety at an acceptable cost. Safety standards can be established with the aid of data for past years, and dollar evaluations are...

14 CFR 417.409 - System hazard controls.

Code of Federal Regulations, 2012 CFR

2012-01-01

... hazard as identified by the ground safety analysis and satisfy the requirements of this section. A launch... electrical power and signal circuits that interface with hazardous subsystems. (e) Propulsion systems. A...

14 CFR 417.409 - System hazard controls.

Code of Federal Regulations, 2013 CFR

2013-01-01

... hazard as identified by the ground safety analysis and satisfy the requirements of this section. A launch... electrical power and signal circuits that interface with hazardous subsystems. (e) Propulsion systems. A...

14 CFR 417.409 - System hazard controls.

Code of Federal Regulations, 2014 CFR

2014-01-01

... hazard as identified by the ground safety analysis and satisfy the requirements of this section. A launch... electrical power and signal circuits that interface with hazardous subsystems. (e) Propulsion systems. A...

14 CFR 417.409 - System hazard controls.

Code of Federal Regulations, 2011 CFR

2011-01-01

... hazard as identified by the ground safety analysis and satisfy the requirements of this section. A launch... electrical power and signal circuits that interface with hazardous subsystems. (e) Propulsion systems. A...

Association Between Breast Cancer Disease Progression and Workplace Productivity in the United States.

PubMed

Yin, Wesley; Horblyuk, Ruslan; Perkins, Julia Jane; Sison, Steve; Smith, Greg; Snider, Julia Thornton; Wu, Yanyu; Philipson, Tomas J

2017-02-01

Determine workplace productivity losses attributable to breast cancer progression. Longitudinal analysis linking 2005 to 2012 medical and pharmacy claims and workplace absence data in the US patients were commercially insured women aged 18 to 64 diagnosed with breast cancer. Productivity was measured as employment status and total quarterly workplace hours missed, and valued using average US wages. Six thousand four hundred and nine women were included. Breast cancer progression was associated with a lower probability of employment (hazard ratio [HR] = 0.65, P < 0.01) and increased workplace hours missed. The annual value of missed work was $24,166 for non-metastatic and $30,666 for metastatic patients. Thus, progression to metastatic disease is associated with an additional $6500 in lost work time (P < 0.05), or 14% of average US wages. Breast cancer progression leads to diminished likelihood of employment, increased workplace hours missed, and increased cost burden.

Mechanistic modeling of developmental defects through computational embryology (WC10th)

EPA Science Inventory

Abstract: An important consideration for 3Rs is to identify developmental hazards utilizing mechanism-based in vitro assays (e.g., ToxCast) and in silico predictive models. Steady progress has been made with agent-based models that recapitulate morphogenetic drivers for angiogen...

DEVELOPMENT OF QUANTITATIVE COMPARATIVE CYTOTOXICITY AND GENOTOXICITY ASSAYS FOR ENVIRONMENTAL HAZARDOUS CHEMICALS (R825956)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

33 CFR 334.230 - Potomac River.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 334.230 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.230 Potomac River. (a) Naval Surface Warfare... manned or unmanned watercraft. (ii) When hazardous operations are in progress, no person, or fishing or...

33 CFR 334.230 - Potomac River.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 334.230 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.230 Potomac River. (a) Naval Surface Warfare... manned or unmanned watercraft. (ii) When hazardous operations are in progress, no person, or fishing or...

33 CFR 334.230 - Potomac River.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 334.230 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.230 Potomac River. (a) Naval Surface Warfare... manned or unmanned watercraft. (ii) When hazardous operations are in progress, no person, or fishing or...

33 CFR 334.230 - Potomac River.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 334.230 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.230 Potomac River. (a) Naval Surface Warfare... manned or unmanned watercraft. (ii) When hazardous operations are in progress, no person, or fishing or...

LOCAL EM ESTIMATION OF THE HAZARD FUNCTION FOR INTERVAL CENSORED DATA. (R824757)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

Adjusted Indirect Comparison Using Propensity Score Matching of Osimertinib to Platinum-Based Doublet Chemotherapy in Patients with EGFRm T790M NSCLC Who Have Progressed after EGFR-TKI.

PubMed

Mann, Helen; Andersohn, Frank; Bodnar, Carolyn; Mitsudomi, Tetsuya; Mok, Tony S K; Yang, James Chih-Hsin; Hoyle, Christopher

2018-04-01

An adjusted indirect comparison was conducted to assess efficacy outcomes, particularly overall survival (OS), of osimertinib versus platinum-based doublet chemotherapy in patients with epidermal growth factor receptor-mutated (EGFRm) T790M mutation-positive non-small-cell lung cancer (NSCLC) who had progressed following an EGFR tyrosine kinase inhibitor (TKI). Analysis of treatment effect from two separate trials had the potential to more accurately estimate the magnitude of OS benefit due to absence of confounding due to treatment switching from the control arm to the osimertinib arm of the ongoing randomized control trial, AURA3. Two non-randomized individual datasets were compared: pooled patients from the AURA extension and AURA2 trials (osimertinib 80 mg, n = 405, with a confirmed T790M mutation using tissue samples), and patients from the control arm of the IMPRESS study (platinum-based doublet chemotherapy, n = 61, with a confirmed T790M mutation using plasma circulating tumour DNA [ctDNA]). A propensity score-based approach was used to account for differences in baseline demographics and disease characteristics. After adjustment for baseline differences between the two groups, osimertinib demonstrated a statistically significant improvement in progression-free survival (PFS) versus platinum-based doublet chemotherapy (hazard ratio [HR] = 0.278, 95% confidence interval [CI] 0.188-0.409, p < 0.0001; median PFS 10.9 vs. 5.3 months). Improvements were also observed for objective response rate (ORR) and disease control rate (DCR) (ORR: 64.3 vs. 33.3%; odds ratio [OR] = 5.31, 95% CI 2.47-11.40, p < 0.001; DCR: 92.1 vs. 75.0%; OR = 4.72, 95% CI 1.92-11.58, p < 0.001). Similar results were obtained for patients who received osimertinib as second-line treatment only. A statistically significant improvement in OS was observed for the osimertinib group (HR = 0.412, 95% CI 0.273-0.622, p < 0.0001). Median OS for osimertinib was not reached. In this indirect comparison, osimertinib showed a statistically significant improvement in efficacy outcomes versus platinum-based doublet chemotherapy in patients with EGFRm T790M NSCLC who had progressed after EGFR-TKI therapy.

A Competence-Based Science Learning Framework Illustrated Through the Study of Natural Hazards and Disaster Risk Reduction

NASA Astrophysics Data System (ADS)

Oyao, Sheila G.; Holbrook, Jack; Rannikmäe, Miia; Pagunsan, Marmon M.

2015-09-01

This article proposes a competence-based learning framework for science teaching, applied to the study of 'big ideas', in this case to the study of natural hazards and disaster risk reduction (NH&DRR). The framework focuses on new visions of competence, placing emphasis on nurturing connectedness and behavioral actions toward resilience and sustainability. The framework draws together competences familiarly expressed as cognitive knowledge and skills, plus dispositions and adds connectedness and action-related behaviors, and applies this by means of a progression shift associated with NH&DRR from abilities to capabilities. The target is enhanced scientific literacy approached through an education through science focus, amplified through the study of a big idea, promotion of sustained resilience in the face of disaster and the taking of responsibilities for behavioral actions. The framework is applied to a learning progression for each interrelated education dimension, thus serving as a guide for both the development of abilities and as a platform for stimulating student capabilities within instruction and assessment.

Volcanic hazards and their mitigation: progress and problems

USGS Publications Warehouse

Tilling, R.I.

1989-01-01

A review of hazards mitigation approaches and techniques indicates that significant advances have been made in hazards assessment, volcano monioring, and eruption forecasting. For example, the remarkable accuracy of the predictions of dome-building events at Mount St. Helens since June 1980 is unprecedented. Yet a predictive capability for more voluminous and explosive eruptions still has not been achieved. Studies of magma-induced seismicity and ground deformation continue to provide the most systematic and reliable data for early detection of precursors to eruptions and shallow intrusions. In addition, some other geophysical monitoring techniques and geochemical methods have been refined and are being more widely applied and tested. Comparison of the four major volcanic disasters of the 1980s (Mount St. Helens, U.S.A. (1980), El Chichon, Mexico (1982); Galunggung, Indonesia (1982); and Nevado del Ruiz, Colombia (1985)) illustrates the importance of predisaster geoscience studies, volcanic hazards assessments, volcano monitoring, contingency planning, and effective communications between scientists and authorities. -from Author

Role of hepatic resection for patients with carcinoid heart disease.

PubMed

Bernheim, Alain M; Connolly, Heidi M; Rubin, Joseph; Møller, Jacob E; Scott, Christopher G; Nagorney, David M; Pellikka, Patricia A

2008-02-01

To evaluate the effects of resection of hepatic carcinoid metastases on progression and prognosis of carcinoid heart disease. From our database of 265 consecutive patients diagnosed as having carcinoid heart disease from January 1, 1980, through December 31, 2005, we calculated survival from first diagnosis of cardiac involvement. Hepatic resection during follow-up was entered as a time-dependent covariable in a multivariable analysis. In patients with serial echocardiograms more than 1 year apart without intervening cardiac surgery, a previously validated cardiac severity score was calculated. A score increase that exceeded 25% was considered relevant progression. Hepatic resection was performed in 31 patients (12%) during follow-up. Five-year survival was significantly higher in these patients (86.5%; 95% confidence interval [CI], 73.5%-100.0%) than in patients without hepatic resection (29.0%; 95% CI, 23.3%-36.1%; univariable hazard ratio for hepatic resection, 0.25; 95% CI 0.12-0.53; P<.001). Hepatic resection remained strongly associated with improved prognosis in multivariable analysis (hazard ratio, 0.31; 95% CI, 0.14-0.66; P=.003). Among 77 patients (29%) with serial echocardiograms, 10 (13%) underwent hepatic resection during follow-up; resection was independently associated with decreased risk of cardiac progression (odds ratio, 0.29; 95% CI, 0.06-0.75; P=.03). Despite the limitations of this retrospective nonrandomized study, our data suggest that patients with carcinoid heart disease who undergo hepatic resection have decreased cardiac progression and improved prognosis. Eligible patients should be considered for hepatic surgery.

Three new genetic loci (R1210C in CFH, variants in COL8A1 and RAD51B) are independently related to progression to advanced macular degeneration.

PubMed

Seddon, Johanna M; Reynolds, Robyn; Yu, Yi; Rosner, Bernard

2014-01-01

To assess the independent impact of new genetic variants on conversion to advanced stages of AMD, controlling for established risk factors, and to determine the contribution of genes in predictive models. In this prospective longitudinal study of 2765 individuals, 777 subjects progressed to neovascular disease (NV) or geographic atrophy (GA) in either eye over 12 years. Recently reported genetic loci were assessed for their independent effects on incident advanced AMD after controlling for 6 established loci in 5 genes, and demographic, behavioral, and macular characteristics. New variants which remained significantly related to progression were then added to a final multivariate model to assess their independent effects. The contribution of genes to risk models was assessed using reclassification tables by determining risk within cross-classified quintiles for alternative models. THREE NEW GENETIC VARIANTS WERE SIGNIFICANTLY RELATED TO PROGRESSION: rare variant R1210C in CFH (hazard ratio (HR) 2.5, 95% confidence interval [CI] 1.2-5.3, P = 0.01), and common variants in genes COL8A1 (HR 2.0, 95% CI 1.1-3.5, P = 0.02) and RAD51B (HR 0.8, 95% CI 0.60-0.97, P = 0.03). The area under the curve statistic (AUC) was significantly higher for the 9 gene model (.884) vs the 0 gene model (.873), P = .01. AUC's for the 9 vs 6 gene models were not significantly different, but reclassification analyses indicated significant added information for more genes, with adjusted odds ratios (OR) for progression within 5 years per one quintile increase in risk score of 2.7, P<0.001 for the 9 vs 6 loci model, and OR 3.5, P<0.001 for the 9 vs. 0 gene model. Similar results were seen for NV and GA. Rare variant CFH R1210C and common variants in COL8A1 and RAD51B plus six genes in previous models contribute additional predictive information for advanced AMD beyond macular and behavioral phenotypes.

Three New Genetic Loci (R1210C in CFH, Variants in COL8A1 and RAD51B) Are Independently Related to Progression to Advanced Macular Degeneration

PubMed Central

Seddon, Johanna M.; Reynolds, Robyn; Yu, Yi; Rosner, Bernard

2014-01-01

Objectives To assess the independent impact of new genetic variants on conversion to advanced stages of AMD, controlling for established risk factors, and to determine the contribution of genes in predictive models. Methods In this prospective longitudinal study of 2765 individuals, 777 subjects progressed to neovascular disease (NV) or geographic atrophy (GA) in either eye over 12 years. Recently reported genetic loci were assessed for their independent effects on incident advanced AMD after controlling for 6 established loci in 5 genes, and demographic, behavioral, and macular characteristics. New variants which remained significantly related to progression were then added to a final multivariate model to assess their independent effects. The contribution of genes to risk models was assessed using reclassification tables by determining risk within cross-classified quintiles for alternative models. Results Three new genetic variants were significantly related to progression: rare variant R1210C in CFH (hazard ratio (HR) 2.5, 95% confidence interval [CI] 1.2–5.3, P = 0.01), and common variants in genes COL8A1 (HR 2.0, 95% CI 1.1–3.5, P = 0.02) and RAD51B (HR 0.8, 95% CI 0.60–0.97, P = 0.03). The area under the curve statistic (AUC) was significantly higher for the 9 gene model (.884) vs the 0 gene model (.873), P = .01. AUC’s for the 9 vs 6 gene models were not significantly different, but reclassification analyses indicated significant added information for more genes, with adjusted odds ratios (OR) for progression within 5 years per one quintile increase in risk score of 2.7, P<0.001 for the 9 vs 6 loci model, and OR 3.5, P<0.001 for the 9 vs. 0 gene model. Similar results were seen for NV and GA. Conclusions Rare variant CFH R1210C and common variants in COL8A1 and RAD51B plus six genes in previous models contribute additional predictive information for advanced AMD beyond macular and behavioral phenotypes. PMID:24498017

Is progression-free survival a more relevant endpoint than overall survival in first-line HR+/HER2- metastatic breast cancer?

PubMed

Forsythe, Anna; Chandiwana, David; Barth, Janina; Thabane, Marroon; Baeck, Johan; Shor, Anastasiya; Tremblay, Gabriel

2018-01-01

Hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-), metastatic breast cancer (MBC) accounts for 73% of all MBCs. Endocrine therapy (ET) is the basis of first-line (1L) therapy for patients with HR+/HER2- MBC. Novel therapies have demonstrated improvements in progression-free survival (PFS) compared to ET. The clinical relevance of PFS is being debated, as there is no proven direct correlation with overall survival (OS) benefit to date. We reviewed studies of HR+/HER2- MBC to assess PFS and other factors that influence OS and treatment response, and health-related quality of life (HRQoL). The Embase ® , Medline ® , and Cochrane databases were systematically searched to identify studies in adult women with HR+/HER2- MBC, published between January 2006 and January 2017, and written in English. Phase II and III randomized controlled trials (RCTs), observational, and retrospective studies were included. Seventy-nine RCTs were identified: 58 (73%) in the 1L+ setting and 21 (27%) in second-line or greater settings. PFS hazard ratios (HRs) were reported in 61 (77%) studies; 31 (39%) reported significant PFS improvements. OS was reported in 44 (41%) studies; 12 (15%) reported significant OS improvements. Significant improvements in both PFS and OS were reported in only 6 (8%) studies (1 Phase II; 5 Phase III). Patients with HER2- MBC received, on average, ≥5 lines of therapy, with no consistent treatment pathway. Baseline characteristics, prior therapies, and the type and number of post-progression therapies significantly impacted OS. PFS, response rates, and HRQoL decreased with each line of therapy (EuroQol 5 Dimensions: 0.78 1L vs. 0.70 post-progression). Few RCTs in HR+/HER2- MBC have demonstrated significant improvements in OS. Factors other than choice of 1L therapy impact OS, including post-progression therapies, which cannot be controlled in RCTs. This study emphasizes the importance of PFS improvement in 1L treatment of HR+/HER2- MBC.

76 FR 55908 - Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-09

... of an exemption to the land disposal restrictions, under the 1984 Hazardous and Solid Waste... Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection; Great Lakes... from the injection zone for as long as the waste remains hazardous. This final decision allows the...

78 FR 23246 - Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-18

... exemption to the land disposal Restrictions, under the 1984 Hazardous and Solid Waste [[Page 23247... Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection; BASF... from the injection zone for as long as the waste remains hazardous. This final decision allows the...

77 FR 26755 - Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... reissuance of an exemption to the land disposal Restrictions, under the 1984 Hazardous and Solid Waste... Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection; Diamond... from the injection zone for as long as the waste remains hazardous. This final decision allows the...

Progression of HPV infection to detectable cervical lesions or clearance in adult women: Analysis of the control arm of the VIVIANE study.

PubMed

Skinner, S Rachel; Wheeler, Cosette M; Romanowski, Barbara; Castellsagué, Xavier; Lazcano-Ponce, Eduardo; Del Rosario-Raymundo, M Rowena; Vallejos, Carlos; Minkina, Galina; Pereira Da Silva, Daniel; McNeil, Shelly; Prilepskaya, Vera; Gogotadze, Irina; Money, Deborah; Garland, Suzanne M; Romanenko, Viktor; Harper, Diane M; Levin, Myron J; Chatterjee, Archana; Geeraerts, Brecht; Struyf, Frank; Dubin, Gary; Bozonnat, Marie-Cécile; Rosillon, Dominique; Baril, Laurence

2016-05-15

The control arm of the phase III VIVIANE (Human PapillomaVIrus: Vaccine Immunogenicity ANd Efficacy; NCT00294047) study in women >25 years was studied to assess risk of progression from cervical HPV infection to detectable cervical intraepithelial neoplasia (CIN). The risk of detecting CIN associated with the same HPV type as the reference infection was analysed using Kaplan-Meier and multivariable Cox models. Infections were categorised depending upon persistence as 6-month persistent infection (6MPI) or infection of any duration. The 4-year interim analysis included 2,838 women, of whom 1,073 (37.8%) experienced 2,615 infections of any duration and 708 (24.9%) experienced 1,130 6MPIs. Infection with oncogenic HPV types significantly increased the risk of detecting CIN grade 2 or greater (CIN2+) versus non-oncogenic types. For 6MPI, the highest risk was associated with HPV-33 (hazard ratio [HR]: 31.9 [8.3-122.2, p < 0.0001]). The next highest risk was with HPV-16 (21.1 [6.3-70.0], p < 0.0001). Similar findings were seen for infections of any duration. Significant risk was also observed for HPV-18, HPV-31, and HPV-45. Concomitant HPV infection or CIN grade 1 or greater associated with a different oncogenic HPV type increased risk. Most women (79.3%) with an HPV infection at baseline cleared detectable infections of any duration, and 69.9% cleared a 6MPI. The risk of progression of HPV infection to CIN2+ in women >25 years in this study was similar to that in women 15-25 years in PATRICIA. © 2015 The Authors and GlaxoSmithKline. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

Progression of HPV infection to detectable cervical lesions or clearance in adult women: Analysis of the control arm of the VIVIANE study

PubMed Central

Wheeler, Cosette M.; Romanowski, Barbara; Castellsagué, Xavier; Lazcano‐Ponce, Eduardo; Rowena Del Rosario‐Raymundo, M.; Vallejos, Carlos; Minkina, Galina; Pereira Da Silva, Daniel; McNeil, Shelly; Prilepskaya, Vera; Gogotadze, Irina; Money, Deborah; Garland, Suzanne M.; Romanenko, Viktor; Harper, Diane M.; Levin, Myron J.; Chatterjee, Archana; Geeraerts, Brecht; Struyf, Frank; Dubin, Gary; Bozonnat, Marie‐Cécile; Rosillon, Dominique; Baril, Laurence

2016-01-01

The control arm of the phase III VIVIANE (Human PapillomaVIrus: Vaccine Immunogenicity ANd Efficacy; NCT00294047) study in women >25 years was studied to assess risk of progression from cervical HPV infection to detectable cervical intraepithelial neoplasia (CIN). The risk of detecting CIN associated with the same HPV type as the reference infection was analysed using Kaplan–Meier and multivariable Cox models. Infections were categorised depending upon persistence as 6‐month persistent infection (6MPI) or infection of any duration. The 4‐year interim analysis included 2,838 women, of whom 1,073 (37.8%) experienced 2,615 infections of any duration and 708 (24.9%) experienced 1,130 6MPIs. Infection with oncogenic HPV types significantly increased the risk of detecting CIN grade 2 or greater (CIN2+) versus non‐oncogenic types. For 6MPI, the highest risk was associated with HPV‐33 (hazard ratio [HR]: 31.9 [8.3–122.2, p < 0.0001]). The next highest risk was with HPV‐16 (21.1 [6.3–70.0], p < 0.0001). Similar findings were seen for infections of any duration. Significant risk was also observed for HPV‐18, HPV‐31, and HPV‐45. Concomitant HPV infection or CIN grade 1 or greater associated with a different oncogenic HPV type increased risk. Most women (79.3%) with an HPV infection at baseline cleared detectable infections of any duration, and 69.9% cleared a 6MPI. The risk of progression of HPV infection to CIN2+ in women >25 years in this study was similar to that in women 15–25 years in PATRICIA. PMID:26685704

Efficacy of Nucleot(s)ide Analogs Therapy in Patients with Unresectable HBV-Related Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.

PubMed

He, Lingling; Liu, Xiaoli; Zhao, Yalin; Zhang, Shuan; Jiang, Yuyong; Wang, Xianbo; Yang, Zhiyun

2017-01-01

Aim . To determine whether nucleot(s)ide analogs therapy has survival benefit for patients with HBV-related HCC after unresectable treatment. Method . A systematic search was conducted through seven electronic databases including PubMed, OVID, EMBASE, Cochrane Databases, Elsevier, Wiley Online Library, and BMJ Best Practice. All studies comparing NA combined with unresectable treatment versus unresectable treatment alone were considered for inclusion. The primary outcome was the overall survival (OS) after unresectable treatment for patients with HBV-related HCC. The secondary outcome was the progression-free survival (PFS). Results were expressed as hazard ratio (HR) for survival with 95% confidence intervals. Results . We included six studies with 994 patients: 409 patients in nucleot(s)ide analogs therapy group and 585 patients without antiviral therapy in control group. There were significant improvements for the overall survival (HR = 0.57; 95% CI = 0.47-0.70; p < 0.001) and progression-free survival (HR = 0.84; 95% CI = 0.71-0.99; p = 0.034) in the NA-treated group compared with the control group. Funnel plot showed that there was no significant publication bias in these studies. When it comes to antiviral drugs and operation method, it also showed benefit in NA-treated group. At the same time, overall mortality as well as mortality secondary to liver failure in NA-treated group was obviously lesser. Sensitivity analyses confirmed the robustness of the results. Conclusions . Nucleot(s)ide analogs therapy after unresectable treatment has potential beneficial effects in terms of overall survival and progression-free survival. NA therapy should be considered in clinical practice.

Driver Vigilance in Automated Vehicles: Hazard Detection Failures Are a Matter of Time.

PubMed

Greenlee, Eric T; DeLucia, Patricia R; Newton, David C

2018-06-01

The primary aim of the current study was to determine whether monitoring the roadway for hazards during automated driving results in a vigilance decrement. Although automated vehicles are relatively novel, the nature of human-automation interaction within them has the classic hallmarks of a vigilance task. Drivers must maintain attention for prolonged periods of time to detect and respond to rare and unpredictable events, for example, roadway hazards that automation may be ill equipped to detect. Given the similarity with traditional vigilance tasks, we predicted that drivers of a simulated automated vehicle would demonstrate a vigilance decrement in hazard detection performance. Participants "drove" a simulated automated vehicle for 40 minutes. During that time, their task was to monitor the roadway for roadway hazards. As predicted, hazard detection rate declined precipitously, and reaction times slowed as the drive progressed. Further, subjective ratings of workload and task-related stress indicated that sustained monitoring is demanding and distressing and it is a challenge to maintain task engagement. Monitoring the roadway for potential hazards during automated driving results in workload, stress, and performance decrements similar to those observed in traditional vigilance tasks. To the degree that vigilance is required of automated vehicle drivers, performance errors and associated safety risks are likely to occur as a function of time on task. Vigilance should be a focal safety concern in the development of vehicle automation.

The exponential rise of induced seismicity with increasing stress levels in the Groningen gas field and its implications for controlling seismic risk

NASA Astrophysics Data System (ADS)

Bourne, S. J.; Oates, S. J.; van Elk, J.

2018-06-01

Induced seismicity typically arises from the progressive activation of recently inactive geological faults by anthropogenic activity. Faults are mechanically and geometrically heterogeneous, so their extremes of stress and strength govern the initial evolution of induced seismicity. We derive a statistical model of Coulomb stress failures and associated aftershocks within the tail of the distribution of fault stress and strength variations to show initial induced seismicity rates will increase as an exponential function of induced stress. Our model provides operational forecasts consistent with the observed space-time-magnitude distribution of earthquakes induced by gas production from the Groningen field in the Netherlands. These probabilistic forecasts also match the observed changes in seismicity following a significant and sustained decrease in gas production rates designed to reduce seismic hazard and risk. This forecast capability allows reliable assessment of alternative control options to better inform future induced seismic risk management decisions.

49 CFR 176.89 - Control of transport vehicles.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 2 2014-10-01 2014-10-01 false Control of transport vehicles. 176.89 Section 176... Special Requirements for Transport Vehicles Loaded With Hazardous Materials and Transported on Board Ferry Vessels § 176.89 Control of transport vehicles. (a) A transport vehicle containing hazardous materials may...

49 CFR 176.89 - Control of transport vehicles.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 2 2013-10-01 2013-10-01 false Control of transport vehicles. 176.89 Section 176... Special Requirements for Transport Vehicles Loaded With Hazardous Materials and Transported on Board Ferry Vessels § 176.89 Control of transport vehicles. (a) A transport vehicle containing hazardous materials may...

49 CFR 176.89 - Control of transport vehicles.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 2 2012-10-01 2012-10-01 false Control of transport vehicles. 176.89 Section 176... Special Requirements for Transport Vehicles Loaded With Hazardous Materials and Transported on Board Ferry Vessels § 176.89 Control of transport vehicles. (a) A transport vehicle containing hazardous materials may...

49 CFR 176.89 - Control of transport vehicles.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Control of transport vehicles. 176.89 Section 176... Special Requirements for Transport Vehicles Loaded With Hazardous Materials and Transported on Board Ferry Vessels § 176.89 Control of transport vehicles. (a) A transport vehicle containing hazardous materials may...

49 CFR 176.89 - Control of transport vehicles.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Control of transport vehicles. 176.89 Section 176... Special Requirements for Transport Vehicles Loaded With Hazardous Materials and Transported on Board Ferry Vessels § 176.89 Control of transport vehicles. (a) A transport vehicle containing hazardous materials may...

Navy Occupational Health Information Management System (NOHIMS). Hazardous Materials Control Module. Users’ Manual

DTIC Science & Technology

1987-01-16

Occupational Health Information Management System (NOHIMS) 6 Hazardous Materials Control Module (HMC) User’s Manual 7. Author(s) 8. Performing Organization...Materials Control (HMC) module of the Naval Medical Command’s (NAVMED) Navy Occupational Health Information Management System (NOHIMS). After presenting

Radiotherapy for Tracheal-Bronchial Cystic Adenoid Carcinomas.

PubMed

Levy, A; Omeiri, A; Fadel, E; Le Péchoux, C

2018-01-01

Primary tracheal-bronchial adenoid cystic carcinoma (thoracic adenoid cystic carcinoma; TACC) is a rare and aggressive malignant tumour. Radiotherapy results have not been previously individualised in this setting. Records of 31 patients with TACC (74% tracheal and 26% bronchial) who received radiotherapy between February 1984 and September 2014 were retrospectively analysed. Surgical removal of the primary tumour was carried out for most (71%) patients, and 13/22 (59%) had R1 or R2 (1/22) margins. The mean tumour size was 4.1 cm, 10 (32%) had associated lymph node involvement and 13 (41%) had perineural invasion (PNI). Adjuvant and definitive radiotherapy were delivered for 22 (71%) and nine patients, respectively. The mean delivered dose was 62 Gy (40-70 Gy) and eight patients had a radiotherapy boost (mean 19 Gy, range 9-30 Gy, two with endobronchial brachytherapy). At a median follow-up of 5.7 years, the 5 year overall survival and progression-free survival (PFS) rates were 88% and 61%, respectively. There were three local relapses and 10 metastatic relapses (mean delay 3.2 years), resulting in 5 year local and metastatic relapse rates of 10% and 26%, respectively. The prognostic factors in the univariate analysis for both decreased overall survival and PFS were: age ≥50 years (hazard ratio 6.2 and 3.8) and the presence of PNI (hazard ratio 10.3 and 4.1); and for PFS only: a radiotherapy dose ≤ 60 Gy (hazard ratio 3.1). Late toxicities were: tracheotomy due to symptomatic tracheal stenosis (n = 5), G3 dyspnoea (n = 4), hypothyroidism (n = 5) and pericarditis (n = 4). Radiotherapy dose may affect local control and the presence of PNI should be considered as an adverse prognostic factor. TACC irradiation conferred good local control rates, when comparing these results with historical series. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

A Guide to the Application of Probability Risk Assessment Methodology and Hazard Risk Frequency Criteria as a Hazard Control for the Use of the Mobile Servicing System on the International Space Station

NASA Astrophysics Data System (ADS)

D'silva, Oneil; Kerrison, Roger

2013-09-01

A key feature for the increased utilization of space robotics is to automate Extra-Vehicular manned space activities and thus significantly reduce the potential for catastrophic hazards while simultaneously minimizing the overall costs associated with manned space. The principal scope of the paper is to evaluate the use of industry standard accepted Probability risk/safety assessment (PRA/PSA) methodologies and Hazard Risk frequency Criteria as a hazard control. This paper illustrates the applicability of combining the selected Probability risk assessment methodology and hazard risk frequency criteria, in order to apply the necessary safety controls that allow for the increased use of the Mobile Servicing system (MSS) robotic system on the International Space Station. This document will consider factors such as component failure rate reliability, software reliability, and periods of operation and dormancy, fault tree analyses and their effects on the probability risk assessments. The paper concludes with suggestions for the incorporation of existing industry Risk/Safety plans to create an applicable safety process for future activities/programs

Large randomized study of thymosin alpha 1, interferon alfa, or both in combination with dacarbazine in patients with metastatic melanoma.

PubMed

Maio, Michele; Mackiewicz, Andrzej; Testori, Alessandro; Trefzer, Uwe; Ferraresi, Virginia; Jassem, Jacek; Garbe, Claus; Lesimple, Thierry; Guillot, Bernard; Gascon, Pere; Gilde, Katalin; Camerini, Roberto; Cognetti, Francesco

2010-04-01

Thymosin alpha 1 (Talpha1) is an immunomodulatory polypeptide that enhances effector T-cell responses. In this large randomized study, we evaluated the efficacy and safety of combining Talpha1 with dacarbazine (DTIC) and interferon alfa (IFN-alpha) in patients with metastatic melanoma. Four hundred eighty-eight patients were randomly assigned to five treatment groups: DTIC+IFN-alpha+Talpha1 (1.6 mg); DTIC+IFN-alpha+Talpha1 (3.2 mg); DTIC+IFN-alpha+Talpha1 (6.4 mg); DTIC+Talpha1 (3.2 mg); DTIC+IFN-alpha (control group). The primary end point was best overall response at study end (12 months). Secondary end points included duration of response, overall survival (OS), and progression-free survival (PFS). Patients were observed for up to 24 months. Ten and 12 tumor responses were observed in the DTIC+IFN-alpha+Talpha1 (3.2 mg) and DTIC+Talpha1 (3.2 mg) groups, respectively, versus four in the control group, which was sufficient to reject the null hypothesis that P(0) < or = .05 (expected response rate of standard therapy) in these two arms. Duration of response ranged from 1.9 to 23.2 months in patients given Talpha1 and from 4.4 to 8.4 months in the control group. Median OS was 9.4 months in patients given Talpha1 versus 6.6 months in the control group (hazard ratio = 0.80; 9% CI, 0.63 to 1.02; P = .08). An increase in PFS was observed in patients given Talpha1 versus the control group (hazard ratio = 0.80; 95% CI, 0.63 to 1.01; P = .06). Addition of Talpha1 to DTIC and IFN-alpha did not lead to any additional toxicity. These results suggest Talpha1 has activity in patients with metastatic melanoma and provide rationale for further clinical evaluation of this agent.

Studies in geophysics: Active tectonics

NASA Technical Reports Server (NTRS)

1986-01-01

Active tectonics is defined within the study as tectonic movements that are expected to occur within a future time span of concern to society. Such movements and their associated hazards include earthquakes, volcanic eruptions, and land subsidence and emergence. The entire range of geology, geophysics, and geodesy is, to some extent, pertinent to this topic. The needs for useful forecasts of tectonic activity, so that actions may be taken to mitigate hazards, call for special attention to ongoing tectonic activity. Further progress in understanding active tectonics depends on continued research. Particularly important is improvement in the accuracy of dating techniques for recent geologic materials.

Serum cholesterol and risk of lower urinary tract symptoms progression: Results from the Reduction by Dutasteride of Prostate Cancer Events study.

PubMed

Feng, Tom; Howard, Lauren E; Vidal, Adriana C; Moreira, Daniel M; Castro-Santamaria, Ramiro; Andriole, Gerald L; Freedland, Stephen J

2017-02-01

To determine if cholesterol is a risk factor for the development of lower urinary tract symptoms in asymptomatic men. A post-hoc analysis of the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study was carried out in 2323 men with baseline International Prostate Symptom Score <8 and not taking benign prostatic hyperplasia or cholesterol medications. Cox proportion models were used to test the association between cholesterol, high-density lipoprotein, low-density lipoprotein and the cholesterol : high-density lipoprotein ratio with incident lower urinary tract symptoms, defined as first report of medical treatment, surgery or two reports of an International Prostate Symptom Score >14. A total of 253 men (10.9%) developed incident lower urinary tract symptoms. On crude analysis, higher high-density lipoprotein was associated with a decreased lower urinary tract symptoms risk (hazard ratio 0.89, P = 0.024), whereas total cholesterol and low-density lipoprotein showed no association. After multivariable adjustment, the association between high-density lipoprotein and incident lower urinary tract symptoms remained significant (hazard ratio 0.89, P = 0.044), whereas no association was observed for low-density lipoprotein (P = 0.611). There was a trend for higher cholesterol to be linked with higher lower urinary tract symptoms risk, though this was not statistically significant (hazard ratio 1.04, P = 0.054). A higher cholesterol : high-density lipoprotein ratio was associated with increased lower urinary tract symptoms risk on crude (hazard ratio 1.11, P = 0.016) and adjusted models (hazard ratio 1.12, P = 0.012). Among asymptomatic men participating in the REDUCE study, higher cholesterol was associated with increased incident lower urinary tract symptoms risk, though the association was not significant. A higher cholesterol : high-density lipoprotein ratio was associated with increased incident lower urinary tract symptoms, whereas higher high-density lipoprotein was protective. These findings suggest dyslipidemia might play a role in lower urinary tract symptoms progression. © 2016 The Japanese Urological Association.

Serum Urate at Trial Entry and ALS Progression in EMPOWER

PubMed Central

O'Reilly, Éilis J.; Liu, Dawei; Johns, Donald R.; Cudkowicz, Merit E.; Paganoni, Sabrina; Schwarzschild, Michael A.; Leitner, Melanie; Ascherio, Alberto

2017-01-01

Objective Determine whether serum urate predicts ALS progression. Methods The study population comprised adult participants of EMPOWER (n=942), a phase III clinical trial to evaluate the efficacy of dexpramipexole to treat ALS. Urate was measured in blood samples collected during enrollment as part of the routine block chemistry. Outcomes Combined assessment of function and survival rank (CAFs), and time to death, by 12 months. Results In women there was not a significant relation between urate and outcomes. In men, outcomes improved with increasing urate (comparing highest to lowest urate quartile: CAFS was 53 points better with p for trend=0.04; and hazard ratio for death was 0.60 with p for trend=0.07), but with adjustment for body mass index (BMI) at baseline, a predictor of both urate levels and prognosis, associations were attenuated and no longer statistically significant. Overall, participants with urate levels equal to or above the median (5.1 mg/dL) appeared to have a survival advantage compared to those below (hazard ratio adjusted for BMI: 0.67; 95% confidence interval: 0.47 to 0.95). Conclusion These findings suggest that while the association between urate at baseline and ALS progression is partially explained by BMI, there may be an independent beneficial effect of urate. PMID:27677562

Marginal Structural Cox Models for Estimating the Association Between β-Interferon Exposure and Disease Progression in a Multiple Sclerosis Cohort

PubMed Central

Karim, Mohammad Ehsanul; Gustafson, Paul; Petkau, John; Zhao, Yinshan; Shirani, Afsaneh; Kingwell, Elaine; Evans, Charity; van der Kop, Mia; Oger, Joel; Tremlett, Helen

2014-01-01

Longitudinal observational data are required to assess the association between exposure to β-interferon medications and disease progression among relapsing-remitting multiple sclerosis (MS) patients in the “real-world” clinical practice setting. Marginal structural Cox models (MSCMs) can provide distinct advantages over traditional approaches by allowing adjustment for time-varying confounders such as MS relapses, as well as baseline characteristics, through the use of inverse probability weighting. We assessed the suitability of MSCMs to analyze data from a large cohort of 1,697 relapsing-remitting MS patients in British Columbia, Canada (1995–2008). In the context of this observational study, which spanned more than a decade and involved patients with a chronic yet fluctuating disease, the recently proposed “normalized stabilized” weights were found to be the most appropriate choice of weights. Using this model, no association between β-interferon exposure and the hazard of disability progression was found (hazard ratio = 1.36, 95% confidence interval: 0.95, 1.94). For sensitivity analyses, truncated normalized unstabilized weights were used in additional MSCMs and to construct inverse probability weight-adjusted survival curves; the findings did not change. Additionally, qualitatively similar conclusions from approximation approaches to the weighted Cox model (i.e., MSCM) extend confidence in the findings. PMID:24939980

Prognostic Value of [18F]-Fluoromethylcholine Positron Emission Tomography/Computed Tomography Before Stereotactic Body Radiation Therapy for Oligometastatic Prostate Cancer.

PubMed

Cysouw, Matthijs; Bouman-Wammes, Esther; Hoekstra, Otto; van den Eertwegh, Alfons; Piet, Maartje; van Moorselaar, Jeroen; Boellaard, Ronald; Dahele, Max; Oprea-Lager, Daniela

2018-06-01

To investigate the predictive value of [ 18 F]-fluoromethylcholine positron emission tomography/computed tomography (PET/CT)-derived parameters on progression-free survival (PFS) in oligometastatic prostate cancer patients treated with stereotactic body radiation therapy (SBRT). In [ 18 F]-fluoromethylcholine PET/CT scans of 40 consecutive patients with ≤4 metachronous metastases treated with SBRT we retrospectively measured the number of metastases, standardized uptake values (SUV mean , SUV max , SUV peak ), metabolically active tumor volume (MATV), and total lesion choline uptake. Partial-volume correction was applied using the iterative deconvolution Lucy-Richardson algorithm. Thirty-seven lymph node and 13 bone metastases were treated with SBRT. Thirty-three patients (82.5%) had 1 lesion, 4 (10%) had 2 lesions, and 3 (7.5%) had 3 lesions. After a median follow-up of 32.6 months (interquartile range, 35.5 months), the median PFS was 11.5 months (95% confidence interval 8.4-14.6 months). Having more than a single metastasis was a significant prognostic factor (hazard ratio 2.74; P = .03), and there was a trend in risk of progression for large MATV (hazard ratio 1.86; P = .10). No SUV or total lesion choline uptake was significantly predictive for PFS, regardless of partial-volume correction. All PET semiquantitative parameters were significantly correlated with each other (P ≤ .013). The number of choline-avid metastases was a significant prognostic factor for progression after [ 18 F]-fluormethylcholine PET/CT-guided SBRT for recurrent oligometastatic prostate cancer, and there seemed to be a trend in risk of progression for patients with large MATVs. The lesional level of [ 18 F]-fluoromethylcholine uptake was not prognostic for progression. Copyright © 2018 Elsevier Inc. All rights reserved.

SRD5A gene polymorphism in Japanese men predicts prognosis of metastatic prostate cancer with androgen-deprivation therapy.

PubMed

Shiota, Masaki; Fujimoto, Naohiro; Yokomizo, Akira; Takeuchi, Ario; Itsumi, Momoe; Inokuchi, Junichi; Tatsugami, Katsunori; Uchiumi, Takeshi; Naito, Seiji

2015-09-01

De novo androgen synthesis is thought to be involved in the progression to castration-resistant prostate cancer (CRPC) during androgen-deprivation therapy (ADT). During androgen synthesis, 5α-reductase encoded by SRD5A catalyses testosterone into more active dihydrotestosterone and may be involved in the progression to CRPC. Then, this study aimed to reveal the association between genetic variations in SRD5A and the prognosis in metastatic prostate cancer. We studied the polymorphisms rs518673 and rs166050 in SRD5A1, and rs12470143, rs523349, rs676033 and rs2208532 in SRD5A2 as well as the time to CRPC progression and overall survival in 104 patients with metastatic prostate cancer that had undergone primary ADT. The association between the polymorphisms and the progression to CRPC as well as overall survival was examined. Patients carrying the more active GG genotype in SRD5A2 rs523349 exhibited a higher risk of the progression (hazard ration [95% confidence interval], 1.93 [1.14-3.14], p=0.016) and death (hazard ration [95% confidence interval], 2.14 [1.16-3.76], p=0.016), compared with less active GC/CC genotypes in SRD5A2 rs523349. High 5α-reductase activity due to the polymorphism in SRD5A2 may contribute to resistance to ADT. Furthermore, SRD5A2 rs523349 polymorphism may be a promising biomarker for metastatic prostate cancer patients treated with primary ADT and a molecular target for advanced prostate cancer. Copyright © 2015 Elsevier Ltd. All rights reserved.

Everolimus plus exemestane in postmenopausal patients with HR(+) breast cancer: BOLERO-2 final progression-free survival analysis.

PubMed

Yardley, Denise A; Noguchi, Shinzaburo; Pritchard, Kathleen I; Burris, Howard A; Baselga, José; Gnant, Michael; Hortobagyi, Gabriel N; Campone, Mario; Pistilli, Barbara; Piccart, Martine; Melichar, Bohuslav; Petrakova, Katarina; Arena, Francis P; Erdkamp, Frans; Harb, Wael A; Feng, Wentao; Cahana, Ayelet; Taran, Tetiana; Lebwohl, David; Rugo, Hope S

2013-10-01

Effective treatments for hormone-receptor-positive (HR(+)) breast cancer (BC) following relapse/progression on nonsteroidal aromatase inhibitor (NSAI) therapy are needed. Initial Breast Cancer Trials of OraL EveROlimus-2 (BOLERO-2) trial data demonstrated that everolimus and exemestane significantly prolonged progression-free survival (PFS) versus placebo plus exemestane alone in this patient population. BOLERO-2 is a phase 3, double-blind, randomized, international trial comparing everolimus (10 mg/day) plus exemestane (25 mg/day) versus placebo plus exemestane in postmenopausal women with HR(+) advanced BC with recurrence/progression during or after NSAIs. The primary endpoint was PFS by local investigator review, and was confirmed by independent central radiology review. Overall survival, response rate, and clinical benefit rate were secondary endpoints. Final study results with median 18-month follow-up show that median PFS remained significantly longer with everolimus plus exemestane versus placebo plus exemestane [investigator review: 7.8 versus 3.2 months, respectively; hazard ratio = 0.45 (95% confidence interval 0.38-0.54); log-rank P < 0.0001; central review: 11.0 versus 4.1 months, respectively; hazard ratio = 0.38 (95% confidence interval 0.31-0.48); log-rank P < 0.0001] in the overall population and in all prospectively defined subgroups, including patients with visceral metastases, [corrected] and irrespective of age. The incidence and severity of adverse events were consistent with those reported at the interim analysis and in other everolimus trials. The addition of everolimus to exemestane markedly prolonged PFS in patients with HR(+) advanced BC with disease recurrence/progression following prior NSAIs. These results further support the use of everolimus plus exemestane in this patient population. ClinicalTrials.gov #NCT00863655.

Higher net acid excretion is associated with lower risk of kidney disease progression in patients with diabetes

PubMed Central

Scialla, Julia J.; Asplin, John; Dobre, Mirela; Chang, Alex; Lash, James; Hsu, Chi-yuan; Kallem, Radhakrishna R.; Hamm, L. Lee; Feldman, Harold I.; Chen, Jing; Appel, Lawrence; Anderson, Cheryl A. M.; Wolf, Myles

2017-01-01

Higher diet-dependent nonvolatile acid load is associated with faster chronic kidney disease (CKD) progression, but most studies have used estimated acid load or measured only components of the gold-standard, net acid excretion (NAE). Here we measured NAE as the sum of urine ammonium and titratable acidity in 24 hour urines from a random subset of 980 participants in the Chronic Renal Insufficiency Cohort (CRIC) Study. In multivariable models accounting for demographics, comorbidity and kidney function, higher NAE was significantly associated with lower serum bicarbonate (0.17 mEq/L lower serum bicarbonate per 10 mEq/day higher NAE), consistent with a larger acid load. Over a median of 6 years follow-up, higher NAE was independently associated with a significantly lower risk of the composite of end stage renal disease or halving of estimated glomerular filtration rate among diabetics (hazard ratio 0.88 per 10 mEq/day higher NAE), but not those without diabetes (hazard ratio 1.04 per 10 mEq/day higher NAE). For comparison, we estimated nonvolatile acid load as net endogenous acid production using self-reported food frequency questionnaires from 2,848 patients and dietary urine biomarkers from 3,385 patients. Higher net endogenous acid production based on biomarkers (urea nitrogen and potassium) was modestly associated with faster CKD progression consistent with prior reports, but only among those without diabetes. Results from the food frequency questionnaires were not associated with CKD progression in any group. Thus, disparate results obtained from analyses of nonvolatile acid load directly measured as NAE and estimated from diet, suggests a novel hypothesis, that the risk of CKD progression related to low NAE, or acid load, may be due to diet-independent changes in acid production in diabetes. PMID:27914710

Hearing Loss in Children With Asymptomatic Congenital Cytomegalovirus Infection

PubMed Central

Chung, Winnie; Flores, Marily; Blum, Peggy; Caviness, A. Chantal; Bialek, Stephanie R.; Grosse, Scott D.; Miller, Jerry A.; Demmler-Harrison, Gail

2017-01-01

OBJECTIVES: To assess the prevalence, characteristics, and risk of sensorineural hearing loss (SNHL) in children with congenital cytomegalovirus infection identified through hospital-based newborn screening who were asymptomatic at birth compared with uninfected children. METHODS: We included 92 case-patients and 51 controls assessed by using auditory brainstem response and behavioral audiometry. We used Kaplan–Meier survival analysis to estimate the prevalence of SNHL, defined as ≥25 dB hearing level at any frequency and Cox proportional hazards regression analyses to compare SNHL risk between groups. RESULTS: At age 18 years, SNHL prevalence was 25% (95% confidence interval [CI]: 17%–36%) among case-patients and 8% (95% CI: 3%–22%) in controls (hazard ratio [HR]: 4.0; 95% CI: 1.2–14.5; P = .02). Among children without SNHL by age 5 years, the risk of delayed-onset SNHL was not significantly greater for case-patients than for controls (HR: 1.6; 95% CI: 0.4–6.1; P = .5). Among case-patients, the risk of delayed-onset SNHL was significantly greater among those with unilateral congenital/early-onset hearing loss than those without (HR: 6.9; 95% CI: 2.5–19.1; P < .01). The prevalence of severe to profound bilateral SNHL among case-patients was 2% (95% CI: 1%–9%). CONCLUSIONS: Delayed-onset and progression of SNHL among children with asymptomatic congenital cytomegalovirus infection continued to occur throughout adolescence. However, the risk of developing SNHL after age 5 years among case-patients was not different than in uninfected children. Overall, 2% of case-patients developed SNHL that was severe enough for them to be candidates for cochlear implantation. PMID:28209771

Germline PARP4 mutations in patients with primary thyroid and breast cancers

PubMed Central

Ikeda, Yuji; Kiyotani, Kazuma; Yew, Poh Yin; Kato, Taigo; Tamura, Kenji; Yap, Kai-Lee; Nielsen, Sarah M.; Mester, Jessica L; Eng, Charis; Nakamura, Yusuke; Grogan, Raymon H.

2016-01-01

Germline mutations in the PTEN gene, which cause Cowden syndrome (CS), are known to be one of the genetic factors for primary thyroid and breast cancers, however, PTEN mutations are found in only a small subset of research participants with non-syndrome breast and thyroid cancers. In this study, we aimed to identify germline variants that may be related to genetic risk of primary thyroid and breast cancers. Genomic DNAs extracted from peripheral blood of 14 PTEN-wild-type female research participants with primary thyroid and breast cancers were analyzed by whole-exome sequencing. Gene-based case control association analysis using the information of 406 Europeans obtained from the 1000 Genomes Project database identified 34 genes possibly associated with the phenotype with P<1.0×10−3. Among them, rare variants in the PARP4 gene were detected at significant high frequency (odds ratio = 5.2, P = 1.0×10−5). The variants, G496V and T1170I, were found in 6 of the 14 study participants (43%) while their frequencies were only 0.5% in controls. Functional analysis using HCC1143 cell line showed that knockdown of PARP4 with siRNA significantly enhanced the cell proliferation, compared with the cells transfected with siControl (P = 0.02). Kaplan-Meier analysis using GEO, EGA and TCGA datasets showed poor progression-free survival (P = 0.006, Hazard ratio 0.71) and overall survival (P < 0.0001, Hazard ratio 0.79) in a PARP4 low-expression group, suggesting that PARP4 may function as a tumor suppression. In conclusion, we identified PARP4 as a possible susceptibility gene of primary thyroid and breast cancer. PMID:26699384

Hypothyroidism is a predictor of disability pension and loss of labor market income: a Danish register-based study.

PubMed

Thvilum, Marianne; Brandt, Frans; Brix, Thomas Heiberg; Hegedüs, Laszlo

2014-09-01

Hypothyroidism is associated with an increased somatic and psychiatric disease burden. Whether there are any socioeconomic consequences of hypothyroidism, such as early retirement or loss of income, remains unclarified. Our aim was to examine, compared with a matched control group, the risk of receiving disability pension (before the age of 60) and the effect on labor market income in patients diagnosed with hypothyroidism. This was an observational register-based cohort study. By record linkage between different Danish health registers, 1745 hypothyroid singletons diagnosed before the age of 60 were each matched with 4 non-hypothyroid controls and followed for a mean of 5 (range 1-31) years. Additionally, we included 277 same-sex twin pairs discordant for hypothyroidism. The risk of disability pension was evaluated by the Cox regression analysis. Changes in labor market income progression over 5 years were evaluated using a difference in difference model. With a hazard ratio of 2.24 (95% confidence interval = 1.73-2.89), individuals diagnosed with hypothyroidism had a significantly increased risk of disability pension. This remained significant when adjusting for educational level and comorbidity (hazard ratio = 1.89; 95% confidence interval = 1.42-2.51). In an analysis of labor market income, 2 years before compared with 2 years after the diagnosis of hypothyroidism, the hypothyroid individuals had on average a €1605 poorer increase than their euthyroid controls (P < .001). Essentially similar results were found in the twin population. A diagnosis of hypothyroidism before the age of 60 is associated with loss of labor market income and an 89% increased risk of receiving a disability pension.

Progressive and Accelerated Disability Onset by Race/Ethnicity and Education among Late Midlife and Older Adults

PubMed Central

Latham, Kenzie

2012-01-01

Objectives This study explores the pace of severe disability onset with an emphasis on the role of race/ethnicity and education. More specifically, this research examines whether race/ethnicity and educational attainment are independent predictors of progressive and accelerated disability onset. Methods Using the Health and Retirement Study (HRS) Waves 2–10 (1994–2010), a series of discrete-time Cox proportional hazards models with multiple competing events were created to ascertain whether respondents developed progressive or accelerated disability in subsequent waves. Results Black and Hispanic respondents were at an increased risk of developing progressive disability. Respondents without a high school degree were more likely to experience progressive or accelerated disability. Discussion Low educational attainment was a particularly strong predictor of accelerated disability onset and may represent an acute lack of resources over the life course. Race and ethnicity were important predictors of progressive disability onset, which may reflect racial/ethnic variations in the disabling process. PMID:22982972

Lenalidomide Maintenance After Autologous Stem-Cell Transplantation in Newly Diagnosed Multiple Myeloma: A Meta-Analysis.

PubMed

McCarthy, Philip L; Holstein, Sarah A; Petrucci, Maria Teresa; Richardson, Paul G; Hulin, Cyrille; Tosi, Patrizia; Bringhen, Sara; Musto, Pellegrino; Anderson, Kenneth C; Caillot, Denis; Gay, Francesca; Moreau, Philippe; Marit, Gerald; Jung, Sin-Ho; Yu, Zhinuan; Winograd, Benjamin; Knight, Robert D; Palumbo, Antonio; Attal, Michel

2017-10-10

Purpose Lenalidomide maintenance therapy after autologous stem-cell transplantation (ASCT) demonstrated prolonged progression-free survival (PFS) versus placebo or observation in several randomized controlled trials (RCTs) of patients with newly diagnosed multiple myeloma (NDMM). All studies had PFS as the primary end point, and none were powered for overall survival (OS) as a primary end point. Thus, a meta-analysis was conducted to better understand the impact of lenalidomide maintenance in this setting. Patients and Methods The meta-analysis was conducted using primary-source patient-level data and documentation from three RCTs (Cancer and Leukemia Group B 100104, Gruppo Italiano Malattie Ematologiche dell'Adulto RV-MM-PI-209, and Intergroupe Francophone du Myélome 2005-02) that met the following prespecified inclusion criteria: an RCT in patients with NDMM receiving ASCT followed by lenalidomide maintenance versus placebo or observation with patient-level data available and achieved database lock for primary efficacy analysis. Results Overall, 1,208 patients were included in the meta-analysis (605 patients in the lenalidomide maintenance group and 603 in the placebo or observation group). The median PFS was 52.8 months for the lenalidomide group and 23.5 months for the placebo or observation group (hazard ratio, 0.48; 95% CI, 0.41 to 0.55). At a median follow-up time of 79.5 months for all surviving patients, the median OS had not been reached for the lenalidomide maintenance group, whereas it was 86.0 months for the placebo or observation group (hazard ratio, 0.75; 95% CI, 0.63 to 0.90; P = .001). The cumulative incidence rate of a second primary malignancy before disease progression was higher with lenalidomide maintenance versus placebo or observation, whereas the cumulative incidence rates of progression, death, or death as a result of myeloma were all higher with placebo or observation versus lenalidomide maintenance. Conclusion This meta-analysis demonstrates a significant OS benefit and confirms the PFS benefit with lenalidomide maintenance after ASCT in patients with NDMM when compared with placebo or observation.

Approach-avoidance pattern of visual attention in hazardous drinkers with ambivalence.

PubMed

Lee, Saerom; Cho, Sungkun; Lee, Jang-Han

2014-03-01

Ambivalence toward alcohol often develops when hazardous drinkers try to quit or to control their drinking. The purpose of this study was to investigate the differences between hazardous drinkers with and without ambivalence toward alcohol in terms of their visual attention to alcohol-related pictures over time using an eye-tracker. The study included 20 hazardous drinkers with ambivalence and 21 hazardous drinkers without ambivalence. The eye movements of the participants were monitored while the participants conducted a free-viewing task in which 20 pairs of alcohol-related pictures and matched control pictures were presented. The results showed that the hazardous drinkers with ambivalence were more attentive to the alcohol-related pictures at first and were more attentive to the control pictures toward the end of the task. On the other hand, the hazardous drinkers without ambivalence were more attentive to the alcohol-related pictures from beginning to end. The findings of this study indicated that ambivalence toward alcohol resulted in the inclination to approach and then avoid alcohol in a consecutive sequence. The present results could be helpful in distinguishing hazardous drinkers who may have ambivalence toward alcohol and identifying the pattern of ambivalence more concretely. Additionally, further studies need to consider the time that is important to measure ambivalence toward alcohol. Copyright © 2013 Elsevier Ltd. All rights reserved.

Marijuana Use Is Not Associated With Progression to Advanced Liver Fibrosis in HIV/Hepatitis C Virus–coinfected Women

PubMed Central

Kelly, Erin M.; Dodge, Jennifer L.; Sarkar, Monika; French, Audrey L.; Tien, Phyllis C.; Glesby, Marshall J.; Golub, Elizabeth T.; Augenbraun, Michael; Plankey, Michael; Peters, Marion G.

2016-01-01

Background. Marijuana (hereafter “tetrahydrocannabinol [THC]”) use has been associated with liver fibrosis progression in retrospective analyses of patients with chronic hepatitis C (HCV). We studied long-term effects of THC on fibrosis progression in women coinfected with human immunodeficiency virus (HIV)/HCV enrolled in the Women's Interagency HIV Study (WIHS). Methods. Liver fibrosis was categorized according to FIB-4 scores as none, moderate, or significant. THC and alcohol use were quantified as average exposure per week. Associations between THC use and progression to significant fibrosis were assessed using Cox proportional hazards regression. Results. Among 575 HIV/HCV-coinfected women followed for a median of 11 (interquartile range, 6–17) years, 324 (56%) reported no THC use, 141 (25%) less than weekly use, 70 (12%) weekly use, and 40 (7%) daily use at WIHS entry. In univariable analysis, entry FIB-4 score (hazard ratio [HR], 2.26 [95% confidence interval {CI}, 1.88–2.73], P < .001), log HCV RNA (HR, 1.19 [95% CI, 1.02–1.38], P = .02), tobacco use (HR, 1.37 [95% CI, 1.02–1.85], P = .04), CD4+ count (risk per 100-cell increase: HR, 0.90 [95% CI, .86–.95], P < .001), and log HIV RNA (HR, 1.18 [95% CI, 1.05–1.32], P = .005) were associated with progression to significant fibrosis, as was cumulative alcohol use in follow-up (HR, 1.03 [95% CI, 1.02–1.04], P < .001). In multivariable analysis, entry FIB-4, entry CD4+ count, and cumulative alcohol use remained significant. Cumulative THC use was not associated with fibrosis progression (HR, 1.01 [95% CI, .92–1.10], P = .83). Conclusions. In this large cohort of HIV/HCV-coinfected women, THC was not associated with progression to significant liver fibrosis. Alcohol use was independently associated with liver fibrosis, and may better predict fibrosis progression in HIV/HCV-coinfected women. PMID:27225241

Survival benefit for patients with diffuse intrinsic pontine glioma (DIPG) undergoing re-irradiation at first progression: A matched-cohort analysis on behalf of the SIOP-E-HGG/DIPG working group.

PubMed

Janssens, Geert O; Gandola, Lorenza; Bolle, Stephanie; Mandeville, Henry; Ramos-Albiac, Monica; van Beek, Karen; Benghiat, Helen; Hoeben, Bianca; Morales La Madrid, Andres; Kortmann, Rolf-Dieter; Hargrave, Darren; Menten, Johan; Pecori, Emilia; Biassoni, Veronica; von Bueren, Andre O; van Vuurden, Dannis G; Massimino, Maura; Sturm, Dominik; Peters, Max; Kramm, Christof M

2017-03-01

Overall survival (OS) of patients with diffuse intrinsic pontine glioma (DIPG) is poor. The purpose of this study is to analyse benefit and toxicity of re-irradiation at first progression. At first progression, 31 children with DIPG, aged 2-16 years, underwent re-irradiation (dose 19.8-30.0 Gy) alone (n = 16) or combined with systemic therapy (n = 15). At initial presentation, all patients had typical symptoms and characteristic MRI features of DIPG, or biopsy-proven high-grade glioma. An interval of ≥3 months after upfront radiotherapy was required before re-irradiation. Thirty-nine patients fulfilling the same criteria receiving radiotherapy at diagnosis, followed by best supportive care (n = 20) or systemic therapy (n = 19) at progression but no re-irradiation, were eligible for a matched-cohort analysis. Median OS for patients undergoing re-irradiation was 13.7 months. For a similar median progression-free survival after upfront radiotherapy (8.2 versus 7.7 months; P = .58), a significant benefit in median OS (13.7 versus 10.3 months; P = .04) was observed in favour of patients undergoing re-irradiation. Survival benefit of re-irradiation increased with a longer interval between end-of-radiotherapy and first progression (3-6 months: 4.0 versus 2.7; P < .01; 6-12 months: 6.4 versus 3.3; P = .04). Clinical improvement with re-irradiation was observed in 24/31 (77%) patients. No grade 4-5 toxicity was recorded. On multivariable analysis, interval to progression (corrected hazard ratio = .27-.54; P < .01) and re-irradiation (corrected hazard ratio = .18-.22; P < .01) remained prognostic for survival. A risk score (RS), comprising 5 categories, was developed to predict survival from first progression (ROC: .79). Median survival ranges from 1.0 month (RS-1) to 6.7 months (RS-5). The majority of patients with DIPG, responding to upfront radiotherapy, do benefit of re-irradiation with acceptable tolerability. Copyright © 2017 Elsevier Ltd. All rights reserved.

Clinicopathological predictors for progression of chronic kidney disease in nephrosclerosis: a biopsy-based cohort study.

PubMed

Yamanouchi, Masayuki; Hoshino, Junichi; Ubara, Yoshifumi; Takaichi, Kenmei; Kinowaki, Keiichi; Fujii, Takeshi; Ohashi, Kenichi; Mise, Koki; Toyama, Tadashi; Hara, Akinori; Shimizu, Miho; Furuichi, Kengo; Wada, Takashi

2018-05-19

Biopsy-based studies on nephrosclerosis are lacking and the clinicopathological predictors for progression of chronic kidney disease (CKD) are not well established. We retrospectively assessed 401 patients with biopsy-proven nephrosclerosis in Japan. Progression of CKD was defined as new-onset end-stage renal disease, decrease of estimated glomerular filtration rate (eGFR) by  ≥50% or doubling of serum creatinine, and the sub-distribution hazard ratio (SHR) with 95% confidence interval (CI) for CKD progression was determined for various clinical and histological characteristics in competing risks analysis. The incremental value of pathological information for predicting CKD progression was assessed by calculating Harrell's C-statistics, the Akaike information criterion (AIC), net reclassification improvement and integrated discrimination improvement. During a median follow-up period of 5.3 years, 117 patients showed progression of CKD and 10 patients died before the defined kidney event. Multivariable sub-distribution hazards model identified serum albumin (SHR 0.48; 95% CI 0.35-0.67), hemoglobin A1c (SHR 0.71; 95% CI 0.54-0.94), eGFR (SHR 0.98; 95% CI 0.97-0.99), urinary albumin/creatinine ratio (UACR) (SHR 1.18; 95% CI 1.08-1.29), percentage of segmental/global glomerulosclerosis (%GS) (SHR 1.01; 95% CI 1.00-1.02) and interstitial fibrosis and tubular atrophy (IFTA) (SHR 1.52; 95% CI 1.20-1.92) as risk factors for CKD progression. The C-statistic of a model with only clinical variables was improved by adding %GS (0.790 versus 0.796, P < 0.01) and IFTA (0.790 versus 0.811, P < 0.01). The reclassification statistic was also improved after adding the biopsy data to the clinical data. The model including IFTA was superior, with the lowest AIC. The study implies that in addition to the traditional markers of eGFR and UACR, we may explore the markers of serum albumin and hemoglobin A1c, which are widely available but not routinely measured in patients with nephrosclerosis, and the biopsy data, especially the data on the severity of interstitial damage, for the better prediction of CKD progression in patients with nephrosclerosis.

Stereotactic Ablative Radiation Therapy for Pulmonary Metastases: Histology, Dose, and Indication Matter

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

Helou, Joelle; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Thibault, Isabelle

Purpose: To assess the association between colorectal cancer (CRC) histology, dose, and local failure (LF) after stereotactic ablative radiation therapy (SABR) for pulmonary metastases, and to describe subsequent cancer progression, change of systemic therapy (CST), survival, and their association with treatment indications. Methods and Materials: From a prospective SABR cohort, 180 pulmonary metastases in 120 patients were identified. Treatment indications were single metastasis, oligometastases, oligoprogression, and dominant areas of progression. Doses of 48 to 52 Gy/4 to 5 fractions were delivered. Since 2010 the dose for peripheral CRC metastases was increased to 60 Gy/4 fractions. Cumulative incidence function (CIF) was used tomore » report LF, progression probability, and CST. The Kaplan-Meier method estimated overall survival (OS). Univariate and multivariable analyses to assess variable associations were conducted. Results: Median follow-up was 22 months (interquartile range, 14-33 months). At 24 months, the CIF of LF was 23.6% (95% confidence interval [CI] 15.1%-33.3%) and 8.3% (95% CI 2.6%-18.6%), respectively, for CRC and non-CRC metastases (P<.001). This association remained significant after adjusting for confounders (subdistribution hazard ratio [SHR] 13.6, 95% CI 4.2-44.1, P<.001). Among CRC metastases, 56 and 45 received <60 Gy and 60 Gy, respectively. Delivering 60 Gy was independently associated with a lower hazard of LF (SHR 0.271, 95% CI 0.078-0.940, P=.040). At 12 months the CIF of progression was 41.67% (95% CI 21.69%-60.56%), 42.51% (95% CI 29.09%-55.29%), 62.96% (95% CI 41.25%-78.53%), and 78.57% (95% CI 42.20%-93.48%), respectively, for patients treated for single metastasis, oligometastases, oligoprogression, and dominant area of progression (P<.001). A CST was observed, respectively, in 4 (17%), 17 (31%), 12 (44%), and 10 (71%) patients with a median time of 13.1, 11.1, 8.4, and 8.4 months. Conclusion: Colorectal cancer lung metastases are associated with a higher hazard of LF and require higher SABR doses. Outcomes for patients with oligometastases and oligoprogression treated with SABR seem favorable. Prospective clinical trials are needed to confirm these benefits.« less

Prognostic Value of 68Ga-DOTANOC PET/CT SUVmax in Patients with Neuroendocrine Tumors of the Pancreas.

PubMed

Ambrosini, Valentina; Campana, Davide; Polverari, Giulia; Peterle, Chiara; Diodato, Stefania; Ricci, Claudio; Allegri, Vincenzo; Casadei, Riccardo; Tomassetti, Paola; Fanti, Stefano

2015-12-01

This study was performed to investigate the role of (68)Ga-DOTANOC SUVmax as a potential prognostic factor in patients with pancreatic neuroendocrine tumor (pNET). Among the patients who underwent (68)Ga-DOTANOC PET/CT, we retrospectively collected the data of those who had G1 or G2 pNET (2010 World Health Organization classification), presented with disease on PET/CT and CT, and had at least 6 mo of follow-up. Patients with multiple endocrine neoplasia were excluded. Overall, 43 patients were included. No significant differences in SUVmax were observed with respect to sex, tumor syndrome, stage, World Health Organization classification, or Ki-67. During follow-up (median, 20 mo), 11 patients (35.6%; median, 33 mo; interquartile range, 20-48 mo) had stable disease and 32 (74.4%; median, 19 mo; interquartile range, 14-26 mo) had progressive disease. SUVmax at 24 mo of follow-up was significantly higher (P = 0.022) in patients with stable disease than in patients with progressive disease. The best SUVmax cutoff ranged from 37.8 to 38.0. The major risk factors for progression included an SUVmax of no more than 37.8 (hazard ratio, 3.09; P = 0.003), a Ki-67 of more than 5% (hazard ratio, 2.89; P = 0.009), and medical therapy alone (hazard ratio, 2.36; P = 0.018). Advanced stage (IV) (P = 0.026), an SUVmax of less than 37.8 (P = 0.043), and medical therapy alone (P = 0.015) were also confirmed at multivariate analysis. Median progression-free survival was 23 mo. Significant differences in progression-free survival were observed in relationship to Ki-67 (median, 45 mo for Ki-67 ≤ 5% and 20 mo for Ki-67 > 5%; P = 0.005), SUVmax (<37.8 vs. >38.0: 16.0 vs. 27.0 mo; P = 0.002), and type of therapy (medical vs. peptide receptor radionuclide therapy: 16.0 vs. 26.0 mo; P = 0.014). (68)Ga-DOTANOC SUVmax is a relevant prognostic factor in patients with G1 and G2 pNET, and its routine use will improve disease characterization and management in these patients, who may present with atypical cases showing heterogeneous clinical behavior. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

MiRNA-181d Expression Significantly Affects Treatment Responses to Carmustine Wafer Implantation.

PubMed

Sippl, Christoph; Ketter, Ralf; Bohr, Lisa; Kim, Yoo Jin; List, Markus; Oertel, Joachim; Urbschat, Steffi

2018-05-26

Standard therapeutic protocols for glioblastoma, the most aggressive type of brain cancer, include surgery followed by chemoradiotherapy. Additionally, carmustine-eluting wafers can be implanted locally into the resection cavity. To evaluate microRNA (miRNA)-181d as a prognostic marker of responses to carmustine wafer implantation. A total of 80 glioblastoma patients (40/group) were included in a matched pair analysis. One group (carmustine wafer group) received concomitant chemoradiotherapy with carmustine wafer implantation (Stupp protocol). The second group (control group) received only concomitant chemoradiotherapy. All tumor specimens were subjected to evaluations of miRNA-181d expression, results were correlated with further individual clinical data. The Cancer Genome Atlas (TCGA) dataset of 149 patients was used as an independent cohort to validate the results. Patients in the carmustine wafer group with low miRNA-181d expression had significantly longer overall (hazard ratio [HR], 35.03, [95% confidence interval (CI): 3.50-350.23], P = .002) and progression-free survival (HR, 20.23, [95% CI: 2.19-186.86], P = .008) than patients of the same group with a high miRNA-181d expression. These correlations were not observed in the control group. The nonsignificance in the control group was confirmed in the independent TCGA dataset. The carmustine wafer group patients with low miRNA-181d expression also had a significantly longer progression-free (P = .049) and overall survival (OS) (P = .034), compared with control group patients. Gross total resection correlated significantly with longer OS (P = .023). MiRNA-181d expression significantly affects treatment responses to carmustine wafer implantation.

NIMBY AND THE HAZARDOUS AND TOXIC WASTE SITING DILEMMA: THE NEED FOR CONCEPT CLARIFICATION. (R823191)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

An Approach for Evaluating the Progress of Natural Attenuation in Groundwater (Web Conference)

EPA Science Inventory

Monitored Natural Attenuation (MNA) is widely applied to ground water contamination at hazardous waste sites. Under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), MNA is considered to be a remedy like any other remedy. When MNA has been select...

Supplemental Hazard Analysis and Risk Assessment - Hydrotreater

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

Lowry, Peter P.; Wagner, Katie A.

A supplemental hazard analysis was conducted and quantitative risk assessment performed in response to an independent review comment received by the Pacific Northwest National Laboratory (PNNL) from the U.S. Department of Energy Pacific Northwest Field Office (PNSO) against the Hydrotreater/Distillation Column Hazard Analysis Report issued in April 2013. The supplemental analysis used the hazardous conditions documented by the previous April 2013 report as a basis. The conditions were screened and grouped for the purpose of identifying whether additional prudent, practical hazard controls could be identified, using a quantitative risk evaluation to assess the adequacy of the controls and establish amore » lower level of concern for the likelihood of potential serious accidents. Calculations were performed to support conclusions where necessary.« less

Positron emission tomography response at the time of autologous stem cell transplantation predicts outcome of patients with relapsed and/or refractory Hodgkin’s lymphoma responding to prior salvage therapy

PubMed Central

Devillier, Raynier; Coso, Diane; Castagna, Luca; Brenot Rossi, Isabelle; Anastasia, Antonella; Chiti, Arturo; Ivanov, Vadim; Schiano, Jean Marc; Santoro, Armando; Chabannon, Christian; Balzarotti, Monica; Blaise, Didier; Bouabdallah, Reda

2012-01-01

Background High-dose chemotherapy followed by autologous stem cell transplantation is the standard treatment for relapsed and/or refractory Hodgkin’s lymphoma although half of patients relapse after transplantation. Predictive factors, such as relapse within 12 months, Ann-Arbor stage at relapse, and relapse in previously irradiated fields are classically used to identify patients with poor outcome. Recently, 18-fluorodeoxyglucose positron emission tomography has emerged as a new method for providing information to predict outcome. The aim of this study was to confirm the predictive value of positron emission tomography status after salvage therapy and to compare single versus tandem autologous stem cell transplantation in patients with relapsed and/or refractory Hodgkin’s lymphoma. Design and Methods We report a series of 111 consecutive patients with treatment-sensitive relapsed and/or treatment-refractory Hodgkin’s lymphoma who achieved complete (positron emission tomography-negative group) or partial remission (positron emission tomography-positive group) at positron emission tomography evaluation after salvage chemotherapy and who underwent single or tandem autologous stem cell transplantation. Results Five-year overall and progression-free survival rates were 81% and 64%, respectively. There were significant differences in 5-year progression-free survival (79% versus 23%; P<0.001) and 5-year overall survival (90% versus 55%, P=0.001) between the positron emission tomography-negative and -positive groups, respectively. A complete response, as determined by positron emission tomography evaluation, after salvage therapy predicted significantly better 5-year overall survival rates in both intermediate (91% versus 50%; P=0.029) and unfavorable (89% versus 58%; P=0.026) risk subgroup analyses. In the positron emission tomography-positive subgroup, tandem transplantation improved 5-year progression-free survival from 0% (in the single transplantation group) to 43% (P=0.034). Multivariate analysis showed that positron emission tomography status (hazard ratio: 5.26 [2.57–10.73]) and tandem transplantation (hazard ratio: 0.39 [0.19–0.78]) but not risk factors at relapse (hazard ratio: 1.77 [0.80–3.92]) significantly influenced progression-free survival, while only tomography status significantly influenced overall survival (hazard ratio: 4.03 [1.38–11.75]). Conclusions In patients with relapsed/refractory Hodgkin’s lymphoma responding to prior salvage therapy, positron emission tomography response at time of autologous stem cell transplantation favorably influences outcome and enables identification of patients requiring single or tandem transplantation. PMID:22271893

Integrated Geo Hazard Management System in Cloud Computing Technology

NASA Astrophysics Data System (ADS)

Hanifah, M. I. M.; Omar, R. C.; Khalid, N. H. N.; Ismail, A.; Mustapha, I. S.; Baharuddin, I. N. Z.; Roslan, R.; Zalam, W. M. Z.

2016-11-01

Geo hazard can result in reducing of environmental health and huge economic losses especially in mountainous area. In order to mitigate geo-hazard effectively, cloud computer technology are introduce for managing geo hazard database. Cloud computing technology and it services capable to provide stakeholder's with geo hazards information in near to real time for an effective environmental management and decision-making. UNITEN Integrated Geo Hazard Management System consist of the network management and operation to monitor geo-hazard disaster especially landslide in our study area at Kelantan River Basin and boundary between Hulu Kelantan and Hulu Terengganu. The system will provide easily manage flexible measuring system with data management operates autonomously and can be controlled by commands to collects and controls remotely by using “cloud” system computing. This paper aims to document the above relationship by identifying the special features and needs associated with effective geohazard database management using “cloud system”. This system later will use as part of the development activities and result in minimizing the frequency of the geo-hazard and risk at that research area.

Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes.

PubMed

Patel, Anushka; MacMahon, Stephen; Chalmers, John; Neal, Bruce; Billot, Laurent; Woodward, Mark; Marre, Michel; Cooper, Mark; Glasziou, Paul; Grobbee, Diederick; Hamet, Pavel; Harrap, Stephen; Heller, Simon; Liu, Lisheng; Mancia, Giuseppe; Mogensen, Carl Erik; Pan, Changyu; Poulter, Neil; Rodgers, Anthony; Williams, Bryan; Bompoint, Severine; de Galan, Bastiaan E; Joshi, Rohina; Travert, Florence

2008-06-12

In patients with type 2 diabetes, the effects of intensive glucose control on vascular outcomes remain uncertain. We randomly assigned 11,140 patients with type 2 diabetes to undergo either standard glucose control or intensive glucose control, defined as the use of gliclazide (modified release) plus other drugs as required to achieve a glycated hemoglobin value of 6.5% or less. Primary end points were composites of major macrovascular events (death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke) and major microvascular events (new or worsening nephropathy or retinopathy), assessed both jointly and separately. After a median of 5 years of follow-up, the mean glycated hemoglobin level was lower in the intensive-control group (6.5%) than in the standard-control group (7.3%). Intensive control reduced the incidence of combined major macrovascular and microvascular events (18.1%, vs. 20.0% with standard control; hazard ratio, 0.90; 95% confidence interval [CI], 0.82 to 0.98; P=0.01), as well as that of major microvascular events (9.4% vs. 10.9%; hazard ratio, 0.86; 95% CI, 0.77 to 0.97; P=0.01), primarily because of a reduction in the incidence of nephropathy (4.1% vs. 5.2%; hazard ratio, 0.79; 95% CI, 0.66 to 0.93; P=0.006), with no significant effect on retinopathy (P=0.50). There were no significant effects of the type of glucose control on major macrovascular events (hazard ratio with intensive control, 0.94; 95% CI, 0.84 to 1.06; P=0.32), death from cardiovascular causes (hazard ratio with intensive control, 0.88; 95% CI, 0.74 to 1.04; P=0.12), or death from any cause (hazard ratio with intensive control, 0.93; 95% CI, 0.83 to 1.06; P=0.28). Severe hypoglycemia, although uncommon, was more common in the intensive-control group (2.7%, vs. 1.5% in the standard-control group; hazard ratio, 1.86; 95% CI, 1.42 to 2.40; P<0.001). A strategy of intensive glucose control, involving gliclazide (modified release) and other drugs as required, that lowered the glycated hemoglobin value to 6.5% yielded a 10% relative reduction in the combined outcome of major macrovascular and microvascular events, primarily as a consequence of a 21% relative reduction in nephropathy. (ClinicalTrials.gov number, NCT00145925.) 2008 Massachusetts Medical Society

HAZBOT - A hazardous materials emergency response mobile robot

NASA Technical Reports Server (NTRS)

Stone, H. W.; Edmonds, G.

1992-01-01

The authors describe the progress that has been made towards the development of a mobile robot that can be used by hazardous materials emergency response teams to perform a variety of tasks including incident localization and characterization, hazardous material identification/classification, site surveillance and monitoring, and ultimately incident mitigation. In September of 1991, the HAZBOT II vehicle performed its first end-to-end demonstration involving a scenario in which the vehicle: navigated to the incident location from a distant (150-200 ft.) deployment site; entered a building through a door with thumb latch style handle and door closer; located and navigated to the suspected incident location (a chemical storeroom); unlocked and opened the storeroom's door; climbed over the storeroom's 12 in. high threshold to enter the storeroom; and located and identified a broken container of benzene.

HAZBOT - A hazardous materials emergency response mobile robot

NASA Astrophysics Data System (ADS)

Stone, H. W.; Edmonds, G.

The authors describe the progress that has been made towards the development of a mobile robot that can be used by hazardous materials emergency response teams to perform a variety of tasks including incident localization and characterization, hazardous material identification/classification, site surveillance and monitoring, and ultimately incident mitigation. In September of 1991, the HAZBOT II vehicle performed its first end-to-end demonstration involving a scenario in which the vehicle: navigated to the incident location from a distant (150-200 ft.) deployment site; entered a building through a door with thumb latch style handle and door closer; located and navigated to the suspected incident location (a chemical storeroom); unlocked and opened the storeroom's door; climbed over the storeroom's 12 in. high threshold to enter the storeroom; and located and identified a broken container of benzene.

Post hoc analyses of East Asian patients from the randomized placebo-controlled PREVAIL trial of enzalutamide in patients with chemotherapy-naïve, metastatic castration-resistant prostate cancer.

PubMed

Kim, Choung Soo; Choi, Young Deuk; Lee, Sang Eun; Lee, Hyun Moo; Ueda, Takeshi; Yonese, Junji; Fukagai, Takashi; Chiong, Edmund; Lau, Weber; Abhyankar, Sarang; Theeuwes, Ad; Tombal, Bertrand; Beer, Tomasz M; Kimura, Go

2017-07-01

Enzalutamide is an androgen receptor (AR) inhibitor that acts on different steps in the AR signaling pathway. In PREVAIL, an international, phase III, double-blind, placebo-controlled trial, enzalutamide significantly reduced the risk of radiographic progression by 81% (hazard ratio [HR], 0.19; P < .0001) and reduced the risk of death by 29% (HR, 0.71; P < .0001) compared with placebo in chemotherapy-naïve men with metastatic castration-resistant prostate cancer. To evaluate treatment effects, safety, and pharmacokinetics of enzalutamide in East Asian patients from the PREVAIL trial, we performed a post hoc analysis of the Japanese, Korean, and Singaporean patients. PREVAIL enrolled patients with asymptomatic or mildly symptomatic chemotherapy-naïve metastatic castration-resistant prostate cancer who had progressed on androgen deprivation therapy. During the study, patients received enzalutamide (160 mg/d) or placebo (1:1) until death or discontinuation because of radiographic progression or skeletal-related event and initiation of subsequent therapy. Centrally assessed radiographic progression-free survival (rPFS) and overall survival (OS) were coprimary endpoints. The secondary endpoints of the PREVAIL trial were investigator-assessed rPFS, time to initiation of chemotherapy, time to prostate-specific antigen (PSA) progression, and PSA response (≥50% decline). Of 1717 patients, 148 patients were enrolled at sites in East Asia (enzalutamide 73, placebo 75). Treatment effect of enzalutamide versus placebo was consistent with that for the overall population as indicated by the HRs (95% confidence interval) of 0.38 (0.10-1.44) for centrally assessed rPFS, 0.59 (0.29-1.23) for OS, 0.33 (0.19-0.60) for time to chemotherapy, and 0.32 (0.20-0.50) for time to PSA progression. In East Asian patients, PSA responses were observed in 68.5% and 14.7% of enzalutamide- and placebo-treated patients, respectively. The enzalutamide plasma concentration ratio (East Asian:non-Asian patients) was 1.12 (90% confidence interval, 1.05-1.20) at 13 weeks. Treatment-related adverse events grade ≥ 3 occurred in 1.4% and 2.7% of enzalutamide- and placebo-treated East Asian patients, respectively. Treatment effects and safety of enzalutamide in East Asian patients were generally consistent with those observed in the overall study population from PREVAIL. CLINICALTRIALS. NCT01212991.

EMERGENCY RESPONSE PROCEDURES FOR CONTROL OF HAZARDOUS SUBSTANCE RELEASES

EPA Science Inventory

Information is provided for selecting the best spill stabilization controls for hazardous substances regulated by the Comprehensive Enviromental Response, Compensation and Liability Act of 1980 (CERCLA). Information is also provided on the onsite assessment of spill severity, app...

Carbon Structure Hazard Control

NASA Technical Reports Server (NTRS)

Yoder, Tommy; Greene, Ben; Porter, Alan

2015-01-01

Carbon composite structures are widely used in virtually all advanced technology industries for a multitude of applications. The high strength-to-weight ratio and resistance to aggressive service environments make them highly desirable. Automotive, aerospace, and petroleum industries extensively use, and will continue to use, this enabling technology. As a result of this broad range of use, field and test personnel are increasingly exposed to hazards associated with these structures. No single published document exists to address the hazards and make recommendations for the hazard controls required for the different exposure possibilities from damaged structures including airborne fibers, fly, and dust. The potential for personnel exposure varies depending on the application or manipulation of the structure. The effect of exposure to carbon hazards is not limited to personnel, protection of electronics and mechanical equipment must be considered as well. The various exposure opportunities defined in this document include pre-manufacturing fly and dust, the cured structure, manufacturing/machining, post-event cleanup, and post-event test and/or evaluation. Hazard control is defined as it is applicable or applied for the specific exposure opportunity. The carbon exposure hazard includes fly, dust, fiber (cured/uncured), and matrix vapor/thermal decomposition products. By using the recommendations in this document, a high level of confidence can be assured for the protection of personnel and equipment.

29 CFR 1910.147 - The control of hazardous energy (lockout/tagout).

Code of Federal Regulations, 2010 CFR

2010-07-01

... pounds and having the general design and basic characteristics of being at least equivalent to a one... prohibitions of the outside employer's energy control program. (3) Group lockout or tagout. (i) When servicing... 29 Labor 5 2010-07-01 2010-07-01 false The control of hazardous energy (lockout/tagout). 1910.147...

29 CFR 1910.147 - The control of hazardous energy (lockout/tagout).

Code of Federal Regulations, 2011 CFR

2011-07-01

... pounds and having the general design and basic characteristics of being at least equivalent to a one... prohibitions of the outside employer's energy control program. (3) Group lockout or tagout. (i) When servicing... 29 Labor 5 2011-07-01 2011-07-01 false The control of hazardous energy (lockout/tagout). 1910.147...

78 FR 47701 - Agency Information Collection Activities; Proposed Collection; Comment Request; Procedures for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-06

... Fishery Products--21 CFR Part 123 (OMB Control Number 0910-0354)-- Extension FDA regulations in part 123 (21 CFR part 123) mandate the application of hazard analysis and critical control point (HACCP) principles to the processing of seafood. HACCP is a preventive system of hazard control designed to help...

75 FR 18211 - Agency Information Collection Activities; Proposed Collection; Comment Request; Procedures for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... Importing of Fish and Fishery Products--21 CFR Part 123 (OMB Control Number 0910-0354)-- Extension FDA regulations in part 123 (21 CFR part 123) mandate the application of hazard analysis and critical control point (HACCP) principles to the processing of seafood. HACCP is a preventive system of hazard control...

77 FR 70724 - Eligibility of the Republic of Korea To Export Poultry Products to the United States

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-27

...) official controls over condemned product; (8) a Hazard Analysis and Critical Control Point (HACCP) system...) Hazard Analysis and Critical Control Point (HACCP) Systems, (5) Chemical Residue Testing Programs, and (6) Microbiological Testing Programs. FSIS evaluates the information submitted to verify that the critical points in...

Volcanic Hazard Maps; the results and progress made by the IAVCEI Hazard Map working group

NASA Astrophysics Data System (ADS)

Calder, Eliza; Lindsay, Jan; Wright, Heather

2017-04-01

The IAVCEI Commission on Volcanic Hazards and Risk set up a working group on Hazard Maps in 2014. Since then, the group has led or co-organised three major workshops, and organized two thematic conference sessions. In particular we have initiated a series of workshops, named the "State of the Hazard Map" which we plan to continue (the first was held at COV8 (State of the Hazard Map 1) and second at COV9 (State of the Hazard Map 2) and the third will be held at IAVCEI General Assembly in Portland. The broad aim of these activities is to work towards an IAVCEI-endorsed considerations or guidelines document for volcanic hazard map generation. The workshops have brought together people from around the world working on volcanic hazard maps, and have had four primary objectives: 1) to review (and collect further data on) the diverse variety of methods and rationales currently used to develop maps; 2) to openly discuss approaches and experiences regarding how hazard maps are interpreted and used by different groups; 3) to discuss and prepare the IAVCEI Guidelines document; and lastly, 4) Discuss options for finalizing, publishing and disseminating the Guidelines document (e.g. wiki, report, open-source publication). This presentation will provide an update of the results and outcomes of those initiatives. This includes brief outcomes of the reviews undertaken, a survey that has been constructed in order to gather additional data, the planned structure for the guidelines documents and a summary of the key findings to date. The majority of the participants of these activities so far have come from volcano observatories or geological surveys, as these institutions commonly have primary responsibility for making operational hazard map. It is important however that others in the scientific community that work on quantification of volcanic hazard contribute to these guidelines. We therefore invite interested parties to become involved.

Exposure to Stress: Occupational Hazards in Hospitals

MedlinePlus

EXPOSURE TO STRESS Occupational Hazards in Hospitals DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health Exposure to Stress Occupational Hazards in Hospitals DEPARTMENT OF HEALTH AND ...

Post-Contamination Vapour Hazards from Military Vehicles Contaminated with Thickened and Unthickened GD

DTIC Science & Technology

1979-02-01

The residual vapour hazards from four types of military vehicles previously contaminated with either thickened or unthickened GD have been measured...magnitude of these hazards have been investigated and an assessment made of their relevance to contamination control. It was found that on permeable... contamination had been applied were ineffective in reducing the subsequent vapour hazard; the vapour hazard arising from thickened GD contamination was less

Dependent convergence: the importation of technological hazards by semiperipheral countries.

PubMed

Siqueira, C E; Levenstein, C

2000-01-01

This article complements the substantial body of literature produced over the last three decades on the export of hazards from developed countries to developing countries. After reviewing the central arguments proposed by this literature, the authors add to the debate by focusing on the role of national actors in the importation of these hazards, based on the experience of late 1970s' developments in the petrochemical industry in Brazil. The Brazilian case indicates that social struggles and/or interactions among actors in developing and developed nations determine to what extent hazardous technologies are imported without environmental controls and to what extent their hazardous effects are controlled by these nations. This study suggests that the future development of a more inclusive theory of export-import of hazardous technologies and products should take into account the dialectical relationship established between social actors internal to the exporting and importing countries.

Radar image and data fusion for natural hazards characterisation

USGS Publications Warehouse

Lu, Zhong; Dzurisin, Daniel; Jung, Hyung-Sup; Zhang, Jixian; Zhang, Yonghong

2010-01-01

Fusion of synthetic aperture radar (SAR) images through interferometric, polarimetric and tomographic processing provides an all - weather imaging capability to characterise and monitor various natural hazards. This article outlines interferometric synthetic aperture radar (InSAR) processing and products and their utility for natural hazards characterisation, provides an overview of the techniques and applications related to fusion of SAR/InSAR images with optical and other images and highlights the emerging SAR fusion technologies. In addition to providing precise land - surface digital elevation maps, SAR - derived imaging products can map millimetre - scale elevation changes driven by volcanic, seismic and hydrogeologic processes, by landslides and wildfires and other natural hazards. With products derived from the fusion of SAR and other images, scientists can monitor the progress of flooding, estimate water storage changes in wetlands for improved hydrological modelling predictions and assessments of future flood impacts and map vegetation structure on a global scale and monitor its changes due to such processes as fire, volcanic eruption and deforestation. With the availability of SAR images in near real - time from multiple satellites in the near future, the fusion of SAR images with other images and data is playing an increasingly important role in understanding and forecasting natural hazards.

Hazard perception skills of young drivers with Attention Deficit Hyperactivity Disorder (ADHD) can be improved with computer based driver training: An exploratory randomised controlled trial.

PubMed

Bruce, C R; Unsworth, C A; Dillon, M P; Tay, R; Falkmer, T; Bird, P; Carey, L M

2017-12-01

Young drivers with Attention Deficit Hyperactivity Disorder (ADHD) are at higher risk of road traffic injuries than their peers. Increased risk correlates with poor hazard perception skill. Few studies have investigated hazard perception training using computer technology with this group of drivers. *Determine the presence and magnitude of the between-group and within- subject change in hazard perception skills in young drivers with ADHD who receive Drive Smart training. *Determine whether training-facilitated change in hazard perception is maintained over time. This was a feasibility study, randomised control trial conducted in Australia. The design included a delayed treatment for the control group. Twenty-five drivers with a diagnosis of ADHD were randomised to the Immediate Intervention or Delayed Intervention group.The Immediate Intervention group received a training session using a computer application entitled Drive Smart. The Delayed Intervention group watched a documentary video initially (control condition), followed by the Drive Smart computer training session. The participant's hazard perception skill was measured using the Hazard Perception Test (HPT). After adjusting for baseline scores, there was a significant betweengroup difference in post-intervention HPT change scores in favour of the Immediate Intervention group. The magnitude of the effect was large. There was no significant within-group delayed intervention effect. A significant maintenance effect was found at 6-week follow-up for the Immediate Intervention group. The hazard perception skills of participants improved following training with large effect size and some maintenance of gain. A multimodal approach to training is indicated to facilitate maintenance. A full-scale trial is feasible. Copyright © 2017 Elsevier Ltd. All rights reserved.

The efficacy of anti-PD-1/PD-L1 therapy and its comparison with EGFR-TKIs for advanced non-small-cell lung cancer.

PubMed

Sheng, Zhixin; Zhu, Xu; Sun, Yanhua; Zhang, Yanxia

2017-08-22

To better understand the efficacy and safety of anti-PD-1/PD-L1 therapy (atezolizumab, pembrolizumab, nivolumab) in patients with previously treated advanced non-small-cell lung cancer (NSCLC). The Cochrane Controlled Trial Register, Embase, Medline, and the Science Citation Index were searched for prospective published reports of atezolizumab, pembrolizumab, nivolumab in previously treated patients with advanced NSCLC. Finally, we identified 14 prospective published reports including four trials of atezolizumab covering 542 subjects, three trials of pembrolizumab covering 1566 subjects, seven trials of nivolumab covering 1678 subjects. When compared to docetaxel, anti-PD-1/PD-L1 therapy could significantly improve overall survival (hazard ratio [HR] 0.67, P<0.001) and progression-free survival (HR 0.83, P=0.002) for previously treated patients with advanced NSCLC. Anti-PD-1/PD-L1 therapy produced an overall response rate of 19% in the 2374 evaluable patients. When using docetaxel as the common comparator, indirect comparison of anti-PD-1/PD-L1 therapy versus EGFR-TKIs showed progression-free survival benefit (HR 0.62, P<0.001) and overall survival benefit (HR 0.60, P<0.001) for those patients with EGFR wild-type. Meanwhile, for those EGFR mutant patients, indirect comparison indicated that anti-PD-1/PD-L1 therapy was inferior to EGFR-TKIs therapy in terms of progression-free survival (HR 3.20, P<0.001), but no survival difference (HR 1.30, P=0.18). Anti-PD-1/PD-L1 therapy could produce progression-free survival and overall survival improvement over docetaxel for patients with previously treated NSCLC. For EGFR wild-type patients, anti-PD-1/PD-L1 therapy seemed to prolong progression-free survival and overall survival when compared to EGFR-TKIs. Meanwhile, for these EGFR mutant patients, anti-PD-1/PD-L1 therapy was inferior to EGFR-TKIs therapy in terms of progression-free survival.

Excessive progression in weekly running distance and risk of running-related injuries: an association which varies according to type of injury.

PubMed

Nielsen, Rasmus Østergaard; Parner, Erik Thorlund; Nohr, Ellen Aagaard; Sørensen, Henrik; Lind, Martin; Rasmussen, Sten

2014-10-01

An explorative, 1-year prospective cohort study. Objective To examine whether an association between a sudden change in weekly running distance and running-related injury varies according to injury type. It is widely accepted that a sudden increase in running distance is strongly related to injury in runners. But the scientific knowledge supporting this assumption is limited. A volunteer sample of 874 healthy novice runners who started a self-structured running regimen were provided a global-positioning-system watch. After each running session during the study period, participants were categorized into 1 of the following exposure groups, based on the progression of their weekly running distance: less than 10% or regression, 10% to 30%, or more than 30%. The primary outcome was running-related injury. A total of 202 runners sustained a running-related injury. Using Cox regression analysis, no statistically significant differences in injury rates were found across the 3 exposure groups. An increased rate of distance-related injuries (patellofemoral pain, iliotibial band syndrome, medial tibial stress syndrome, gluteus medius injury, greater trochanteric bursitis, injury to the tensor fascia latae, and patellar tendinopathy) existed in those who progressed their weekly running distance by more than 30% compared with those who progressed less than 10% (hazard ratio = 1.59; 95% confidence interval: 0.96, 2.66; P = .07). Novice runners who progressed their running distance by more than 30% over a 2-week period seem to be more vulnerable to distance-related injuries than runners who increase their running distance by less than 10%. Owing to the exploratory nature of the present study, randomized controlled trials are needed to verify these results, and more experimental studies are needed to validate the assumptions. Still, novice runners may be well advised to progress their weekly distances by less than 30% per week over a 2-week period.

Occupational hazards among the abattoir workers associated with noncompliance to the meat processing and waste disposal laws in Malaysia

PubMed Central

Abdullahi, Auwalu; Hassan, Azmi; Kadarman, Norizhar; Junaidu, Yakubu Muhammad; Adeyemo, Olanike Kudrat; Lua, Pei Lin

2016-01-01

Purpose This study aims to investigate the occupational hazards among the abattoir workers associated with noncompliance to the meat processing and waste disposal laws in Terengganu State, Malaysia. Occupational hazards are the major source of morbidity and mortality among the animal workers due to exposure to many hazardous situations in their daily practices. Occupational infections mostly contracted by abattoir workers could be caused by iatrogenic or transmissible agents, including viruses, bacteria, fungi, and parasites and the toxins produced by these organisms. Materials and methods The methodology was based on a cross-sectional survey using cluster sampling technique in the four districts of Terengganu State, Malaysia. One hundred and twenty-one abattoir workers from five abattoirs were assessed using a validated structured questionnaire and an observation checklist. Results The mean and standard deviation of occupational hazards scores of the workers were 2.32 (2.721). Physical, chemical, biological, psychosocial, musculoskeletal, and ergonomics hazards were the major findings of this study. However, the highest prevalence of occupational hazards identified among the workers was injury by sharp equipment such as a knife (20.0%), noise exposure (17.0%), and due to offensive odor within the abattoir premises (12.0%). Conclusion The major occupational hazards encountered by the workers in the study area were physical, chemical, biological, psychosocial, musculoskeletal, and ergonomics hazards. To ensure proper control of occupational health hazards among the abattoir workers, standard design and good environmental hygiene must be taken into consideration all the time. Exposure control plan, which includes risk identification, risk characterization, assessment of workers at risk, risk control, workers’ education/training, and implementation of safe work procedures, should be implemented by the government and all the existing laws governing the abattoir operation in the country should be enforced. PMID:27471416

The application of hazard analysis and critical control points and risk management in the preparation of anti-cancer drugs.

PubMed

Bonan, Brigitte; Martelli, Nicolas; Berhoune, Malik; Maestroni, Marie-Laure; Havard, Laurent; Prognon, Patrice

2009-02-01

To apply the Hazard analysis and Critical Control Points method to the preparation of anti-cancer drugs. To identify critical control points in our cancer chemotherapy process and to propose control measures and corrective actions to manage these processes. The Hazard Analysis and Critical Control Points application began in January 2004 in our centralized chemotherapy compounding unit. From October 2004 to August 2005, monitoring of the process nonconformities was performed to assess the method. According to the Hazard Analysis and Critical Control Points method, a multidisciplinary team was formed to describe and assess the cancer chemotherapy process. This team listed all of the critical points and calculated their risk indexes according to their frequency of occurrence, their severity and their detectability. The team defined monitoring, control measures and corrective actions for each identified risk. Finally, over a 10-month period, pharmacists reported each non-conformity of the process in a follow-up document. Our team described 11 steps in the cancer chemotherapy process. The team identified 39 critical control points, including 11 of higher importance with a high-risk index. Over 10 months, 16,647 preparations were performed; 1225 nonconformities were reported during this same period. The Hazard Analysis and Critical Control Points method is relevant when it is used to target a specific process such as the preparation of anti-cancer drugs. This method helped us to focus on the production steps, which can have a critical influence on product quality, and led us to improve our process.

The effect of interior lead hazard controls on children's blood lead concentrations: a systematic evaluation.

PubMed Central

Haynes, Erin; Lanphear, Bruce P; Tohn, Ellen; Farr, Nick; Rhoads, George G

2002-01-01

Dust control is often recommended to prevent children's exposure to residential lead hazards, but the effect of these controls on children's blood lead concentrations is uncertain. We conducted a systematic review of randomized, controlled trials of low-cost, lead hazard control interventions to determine the effect of lead hazard control on children's blood lead concentration. Four trials met the inclusion criteria. We examined mean blood lead concentration and elevated blood lead concentrations (> or = 10 microg/dL, > or = 15 microg/dL, and > or = 20 microg/dL) and found no significant differences in mean change in blood lead concentration for children by random group assignment (children assigned to the intervention group compared with those assigned to the control group). We found no significant difference between the intervention and control groups in the percentage of children with blood lead > or = 10 microg/dL, 29% versus 32% [odds ratio (OR), 0.85; 95% confidence interval (CI), 0.56-1.3], but there was a significant difference in the percentage of children with blood lead > or = 15 microg/dL between the intervention and control groups, 6% versus 14% (OR, 0.40; 95% CI, 0.21-0.80) and in the percentage of children with blood lead > or = 20 microg/dL between the intervention and control groups, 2% versus 6% (OR, 0.29; 95% CI, 0.10-0.85). We conclude that although low-cost, interior lead hazard control was associated with 50% or greater reduction in the proportion of children who had blood lead concentrations exceeding 15 microg/dL and > or = 20 microg/dL, there was no substantial effect on mean blood lead concentration. PMID:11781171

The effect of interior lead hazard controls on children's blood lead concentrations: a systematic evaluation.

PubMed

Haynes, Erin; Lanphear, Bruce P; Tohn, Ellen; Farr, Nick; Rhoads, George G

2002-01-01

Dust control is often recommended to prevent children's exposure to residential lead hazards, but the effect of these controls on children's blood lead concentrations is uncertain. We conducted a systematic review of randomized, controlled trials of low-cost, lead hazard control interventions to determine the effect of lead hazard control on children's blood lead concentration. Four trials met the inclusion criteria. We examined mean blood lead concentration and elevated blood lead concentrations (> or = 10 microg/dL, > or = 15 microg/dL, and > or = 20 microg/dL) and found no significant differences in mean change in blood lead concentration for children by random group assignment (children assigned to the intervention group compared with those assigned to the control group). We found no significant difference between the intervention and control groups in the percentage of children with blood lead > or = 10 microg/dL, 29% versus 32% [odds ratio (OR), 0.85; 95% confidence interval (CI), 0.56-1.3], but there was a significant difference in the percentage of children with blood lead > or = 15 microg/dL between the intervention and control groups, 6% versus 14% (OR, 0.40; 95% CI, 0.21-0.80) and in the percentage of children with blood lead > or = 20 microg/dL between the intervention and control groups, 2% versus 6% (OR, 0.29; 95% CI, 0.10-0.85). We conclude that although low-cost, interior lead hazard control was associated with 50% or greater reduction in the proportion of children who had blood lead concentrations exceeding 15 microg/dL and > or = 20 microg/dL, there was no substantial effect on mean blood lead concentration.

Imaging growth and isocitrate dehydrogenase 1 mutation are independent predictors for diffuse low-grade gliomas

PubMed Central

Gozé, Catherine; Blonski, Marie; Le Maistre, Guillaume; Bauchet, Luc; Dezamis, Edouard; Page, Philippe; Varlet, Pascale; Capelle, Laurent; Devaux, Bertrand; Taillandier, Luc; Duffau, Hugues; Pallud, Johan

2014-01-01

Background We explored whether spontaneous imaging tumor growth (estimated by the velocity of diametric expansion) and isocitrate dehydrogenase 1 (IDH1) mutation (estimated by IDH1 immunoexpression) were independent predictors of long-term outcomes of diffuse low-grade gliomas in adults. Methods One hundred thirty-one adult patients with newly diagnosed supratentorial diffuse low-grade gliomas were retrospectively studied. Results Isocitrate dehydrogenase 1 mutations were present in 107 patients. The mean spontaneous velocity of diametric expansion was 5.40 ± 5.46 mm/y. During follow-up (mean, 70 ± 54.7 mo), 56 patients presented a malignant transformation and 23 died. The median malignant progression-free survival and the overall survival were significantly longer in cases of slow velocity of diametric expansion (149 and 198 mo, respectively) than in cases of fast velocity of diametric expansion (46 and 82 mo; P < .001 and P < .001, respectively) and in cases with IDH1 mutation (100 and 198 mo, respectively) than in cases without IDH1 mutation (72 mo and not reached; P = .028 and P = .001, respectively). In multivariate analyses, spontaneous velocity of diametric expansion and IDH1 mutation were independent prognostic factors for malignant progression-free survival (P < .001; hazard ratio, 4.23; 95% CI, 1.81–9.40 and P = .019; hazard ratio, 2.39; 95% CI, 1.19–4.66, respectively) and for overall survival (P < .001; hazard ratio, 26.3; 95% CI, 5.42–185.2 and P = .007; hazard ratio, 17.89; 95% CI, 2.15–200.1, respectively). Conclusions The spontaneous velocity of diametric expansion and IDH1 mutation status are 2 independent prognostic values that should be obtained at the beginning of the management of diffuse low-grade gliomas in adults. PMID:24847087

Vemurafenib for BRAF V600 mutated advanced melanoma: results of treatment beyond progression.

PubMed

Scholtens, A; Geukes Foppen, M H; Blank, C U; van Thienen, J V; van Tinteren, H; Haanen, J B

2015-03-01

Selective BRAF inhibition (BRAFi) by vemurafenib or dabrafenib has become approved standard treatment in BRAF V600 mutated advanced stage melanoma. While the response rate is high, the response duration is limited with a progression-free survival (PFS) of 5-6months. Our observation of accelerated disease progression within some patients after stopping vemurafenib treatment has fostered the idea of treatment beyond progression (BRAFi TBP). In this retrospective study, we analysed 70 metastatic melanoma patients, treated at our institute, who experienced progression after prior objective response upon treatment with vemurafenib. Thirty-five patients that continued treatment beyond progression are compared with 35 patients who stopped BRAFi treatment at disease progression. Median overall survival beyond documented progression was found to be 5.2months versus 1.4months (95% confidence interval (CI): 3.8-7.4 versus 0.6-3.4; Log-Rank p=0.002) in favour of BRAFi TBP. In the multivariate survival analysis, stopping treatment at disease progression was significantly associated with shorter survival (hazard ratio: 1.92; 95% CI: 1.04-3.55; p=0.04). Our results suggest that continuing vemurafenib treatment beyond progression may be beneficial in advanced melanoma patients, who prior to progression responded to vemurafenib. Copyright © 2015 Elsevier Ltd. All rights reserved.

Hepatic Fibrosis Progression in HIV-Hepatitis C Virus Co-Infection – The Effect of Sex on Risk of Significant Fibrosis Measured by Aspartate-to-Platelet Ratio Index

PubMed Central

Rollet-Kurhajec, Kathleen C.; Moodie, Erica E. M.; Walmsley, Sharon; Cooper, Curtis; Pick, Neora; Klein, Marina B.

2015-01-01

Background In Hepatitis C virus (HCV) mono-infection, male sex is associated with faster liver fibrosis progression but the effects of sex have not been well studied in HIV-HCV co-infected patients. We examined the influence of sex on progression to significant liver fibrosis in HIV-HCV co-infected adults receiving antiretroviral therapy (ART) using the aspartate aminotransferase-to-platelet ratio index (APRI) as a surrogate biomarker of liver fibrosis. Methods We evaluated 308 HIV infected, HCV RNA positive participants of a Canadian multicentre prospective cohort receiving antiretrovirals and without significant liver fibrosis or end-stage liver disease at baseline. We used multivariate discrete-time proportional hazards models to assess the effect of sex on time to significant fibrosis (APRI≥1.5) adjusting for baseline age, alcohol use, cigarette smoking, HCV duration, and APRI and time-updated CD4 count and HIV RNA. Results Overall, 55 (18%) participants developed an APRI ≥ 1.5 over 544 person-years of at-risk follow-up time; 18 (21%) women (incidence rate (IR)=14.0/100 PY; 7.5-20.4) and 37 (17%) men (IR=8.9/100 PY; 6.0-11.8). Women had more favourable profiles with respect to traditional risk factors for liver disease progression (younger, shorter duration of HCV infection and less alcohol use). Despite this, female sex was associated with a greater than two-fold increased risk of fibrosis progression (adjusted hazard rate (HR) =2.23; 1.22-4.08). Conclusions HIV-HCV co-infected women receiving antiretroviral therapy were at significantly greater risk of progressing to liver fibrosis as measured by APRI compared with men. Enhanced efforts to engage and treat co-infected women for HCV are needed. PMID:26090666

Cabozantinib versus Everolimus in Advanced Renal-Cell Carcinoma.

PubMed

Choueiri, Toni K; Escudier, Bernard; Powles, Thomas; Mainwaring, Paul N; Rini, Brian I; Donskov, Frede; Hammers, Hans; Hutson, Thomas E; Lee, Jae-Lyun; Peltola, Katriina; Roth, Bruce J; Bjarnason, Georg A; Géczi, Lajos; Keam, Bhumsuk; Maroto, Pablo; Heng, Daniel Y C; Schmidinger, Manuela; Kantoff, Philip W; Borgman-Hagey, Anne; Hessel, Colin; Scheffold, Christian; Schwab, Gisela M; Tannir, Nizar M; Motzer, Robert J

2015-11-05

Cabozantinib is an oral, small-molecule tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor (VEGFR) as well as MET and AXL, each of which has been implicated in the pathobiology of metastatic renal-cell carcinoma or in the development of resistance to antiangiogenic drugs. This randomized, open-label, phase 3 trial evaluated the efficacy of cabozantinib, as compared with everolimus, in patients with renal-cell carcinoma that had progressed after VEGFR-targeted therapy. We randomly assigned 658 patients to receive cabozantinib at a dose of 60 mg daily or everolimus at a dose of 10 mg daily. The primary end point was progression-free survival. Secondary efficacy end points were overall survival and objective response rate. Median progression-free survival was 7.4 months with cabozantinib and 3.8 months with everolimus. The rate of progression or death was 42% lower with cabozantinib than with everolimus (hazard ratio, 0.58; 95% confidence interval [CI] 0.45 to 0.75; P<0.001). The objective response rate was 21% with cabozantinib and 5% with everolimus (P<0.001). A planned interim analysis showed that overall survival was longer with cabozantinib than with everolimus (hazard ratio for death, 0.67; 95% CI, 0.51 to 0.89; P=0.005) but did not cross the significance boundary for the interim analysis. Adverse events were managed with dose reductions; doses were reduced in 60% of the patients who received cabozantinib and in 25% of those who received everolimus. Discontinuation of study treatment owing to adverse events occurred in 9% of the patients who received cabozantinib and in 10% of those who received everolimus. Progression-free survival was longer with cabozantinib than with everolimus among patients with renal-cell carcinoma that had progressed after VEGFR-targeted therapy. (Funded by Exelixis; METEOR ClinicalTrials.gov number, NCT01865747.).

Body Mass Index in Mild Cognitive Impairment According to Age, Sex, Cognitive Intervention, and Hypertension and Risk of Progression to Alzheimer's Disease.

PubMed

Joo, Soo Hyun; Yun, Se Hee; Kang, Dong Woo; Hahn, Chang Tae; Lim, Hyun Kook; Lee, Chang Uk

2018-01-01

Introduction: Mild cognitive impairment (MCI) is a prodromal stage of dementia. The association of body mass index (BMI) and progression to Alzheimer's disease (AD) in MCI subjects according to age, sex, and cognitive intervention remains unknown. We investigated the relationship between BMI and the risk of progression to AD in subjects with MCI, as well as the effect of BMI on progression to AD depending on age, sex, cognitive intervention, and chronic diseases. Methods: Three hundred and eighty-eight MCI subjects were followed for 36.3 ± 18.4 months, prospectively. They underwent neuropsychological testing more than twice during the follow-up period. The MCI subjects were categorized into underweight, normal weight, overweight, and obese subgroups. The associations between baseline BMI and progression to AD over the follow-up period were estimated using Cox proportional hazard regression models. Data were analyzed after stratification by age, sex, cognitive intervention, and chronic diseases. Results: After adjustment for the covariates, the underweight MCI group had a higher risk of progression to AD [hazard ratio (HR): 2.38, 95% confidence interval (CI): 1.17-4.82] relative to the normal weight group. After stratifying by age, sex, cognitive intervention, and chronic diseases, this effect remained significant among females (HR: 3.15, 95% CI: 1.40-7.10), the older elderly ≥75 years old (HR: 3.52, 95% CI: 1.42-8.72), the non-intervention group (HR: 3.06, 95%CI: 1.18-7.91), and the hypertensive group (HR: 4.71, 95% CI: 1.17-18.99). Conclusion: These data indicate that underweight could be a useful marker for identifying individuals at increased risk for AD in MCI subjects. This association is even stronger in females, older elderly subjects, the non-cognitive intervention group, and the hypertensive group.

Pre-cART Elevation of CRP and CD4+ T-Cell Immune Activation Associated With HIV Clinical Progression in a Multinational Case-Cohort Study.

PubMed

Balagopal, Ashwin; Asmuth, David M; Yang, Wei-Teng; Campbell, Thomas B; Gupte, Nikhil; Smeaton, Laura; Kanyama, Cecilia; Grinsztejn, Beatriz; Santos, Breno; Supparatpinyo, Khuanchai; Badal-Faesen, Sharlaa; Lama, Javier R; Lalloo, Umesh G; Zulu, Fatima; Pawar, Jyoti S; Riviere, Cynthia; Kumarasamy, Nagalingeswaran; Hakim, James; Li, Xiao-Dong; Pollard, Richard B; Semba, Richard D; Thomas, David L; Bollinger, Robert C; Gupta, Amita

2015-10-01

Despite the success of combination antiretroviral therapy (cART), a subset of HIV-infected patients who initiate cART develop early clinical progression to AIDS; therefore, some cART initiators are not fully benefitted by cART. Immune activation pre-cART may predict clinical progression in cART initiators. A case-cohort study (n = 470) within the multinational Prospective Evaluation of Antiretrovirals in Resource-Limited Settings clinical trial (1571 HIV treatment-naive adults who initiated cART; CD4 T-cell count <300 cells/mm; 9 countries) was conducted. A subcohort of 30 participants per country was randomly selected; additional cases were added from the main cohort. Cases [n = 236 (random subcohort 36; main cohort 200)] had clinical progression (incident WHO stage 3/4 event or death) within 96 weeks after cART initiation. Immune activation biomarkers were quantified pre-cART. Associations between biomarkers and clinical progression were examined using weighted multivariable Cox-proportional hazards models. Median age was 35 years, 45% were women, 49% black, 31% Asian, and 9% white. Median CD4 T-cell count was 167 cells per cubic millimeter. In multivariate analysis, highest quartile C-reactive protein concentration [adjusted hazard ratio (aHR), 2.53; 95% confidence interval (CI): 1.02 to 6.28] and CD4 T-cell activation (aHR, 5.18; 95% CI: 1.09 to 24.47) were associated with primary outcomes, compared with lowest quartiles. sCD14 had a trend toward association with clinical failure (aHR, 2.24; 95% CI: 0.96 to 5.21). Measuring C-reactive protein and CD4 T-cell activation may identify patients with CD4 T-cell counts <300 cells per cubic millimeter at risk for early clinical progression when initiating cART. Additional vigilance and symptom-based screening may be required in this subset of patients even after beginning cART.

Pre-cART Elevation of CRP and CD4+ T-cell Immune Activation Associated with HIV Clinical Progression in a Multinational Case-Cohort Study

PubMed Central

Balagopal, Ashwin; Asmuth, David M.; Yang, Wei-Teng; Campbell, Thomas B.; Gupte, Nikhil; Smeaton, Laura; Kanyama, Cecilia; Grinsztejn, Beatriz; Santos, Breno; Supparatpinyo, Khuanchai; Badal-Faesen, Sharlaa; Lama, Javier R.; Lalloo, Umesh G.; Zulu, Fatima; Pawar, Jyoti S; Riviere, Cynthia; Kumarasamy, Nagalingeswaran; Hakim, James; Li, Xiao-Dong; Pollard, Richard B.; Semba, Richard D.; Thomas, David L.; Bollinger, Robert C.; Gupta, Amita

2015-01-01

Background Despite the success of combination antiretroviral therapy (cART), a subset of HIV-infected patients who initiate cART develop early clinical progression to AIDS; therefore some cART initiators are not fully benefitted by cART. Immune activation pre-cART may predict clinical progression in cART initiators. Methods A case-cohort study (n=470) within the multinational Prospective Evaluation of Antiretrovirals in Resource-Limited Settings (PEARLS) clinical trial (1571 HIV treatment-naïve adults who initiated cART; CD4+ T cell count <300 cells/mm3; nine countries) was conducted. A subcohort of 30 participants/country was randomly selected; additional cases were added from the main cohort. Cases (n=236 [random subcohort–36; main cohort–200]) had clinical progression (incident WHO Stage 3/4 event or death) within 96 weeks following cART initiation. Immune activation biomarkers were quantified pre-cART. Associations between biomarkers and clinical progression were examined using weighted multivariable Cox-proportional hazards models. Results Median age was 35 years, 45% were women, 49% black, 31% Asian, and 9% white. Median CD4+ T-cell count was 167 cells/mm3. In multivariate analysis, highest quartile CRP concentration (adjusted hazards ratio [aHR] 2.53, 95%CI 1.02-6.28) and CD4+ T-cell activation (aHR 5.18, 95CI 1.09-24.47) were associated with primary outcomes, compared to lowest quartiles. sCD14 had a trend towards association with clinical failure (aHR 2.24, 95%CI 0.96–5.21). Conclusions Measuring CRP and CD4+ T-cell activation may identify patients with CD4+ T cell counts < 300 cells/mm3 at risk for early clinical progression when initiating cART. Additional vigilance and symptom-based screening may be required in this subset of patients even after beginning cART. PMID:26017661

40 CFR 68.67 - Process hazard analysis.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.67 Process hazard analysis. (a... potential for catastrophic consequences. (3) Engineering and administrative controls applicable to the... engineering and administrative controls; (5) Stationary source siting; (6) Human factors; and (7) A...

40 CFR 68.67 - Process hazard analysis.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.67 Process hazard analysis. (a... potential for catastrophic consequences. (3) Engineering and administrative controls applicable to the... engineering and administrative controls; (5) Stationary source siting; (6) Human factors; and (7) A...

40 CFR 68.67 - Process hazard analysis.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.67 Process hazard analysis. (a... potential for catastrophic consequences. (3) Engineering and administrative controls applicable to the... engineering and administrative controls; (5) Stationary source siting; (6) Human factors; and (7) A...

40 CFR 146.61 - Applicability

Code of Federal Regulations, 2010 CFR

2010-07-01

... INJECTION CONTROL PROGRAM: CRITERIA AND STANDARDS Criteria and Standards Applicable to Class I Hazardous Waste Injection Wells § 146.61 Applicability (a) This subpart establishes criteria and standards for underground injection control programs to regulate Class I hazardous waste injection wells. Unless otherwise...

75 FR 5536 - Pipeline Safety: Control Room Management/Human Factors, Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-03

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Parts...: Control Room Management/Human Factors, Correction AGENCY: Pipeline and Hazardous Materials Safety... following correcting amendments: PART 192--TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM...

A MULTI-LEVEL APPROACH TO LONG-TERM BEHAVIOR CHANGE: TEACHING PROPER USE OF A HOUSEHOLD HAZARDOUS WASTE FACILITY. (R825827)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

THE SUPERFUND INNOVATIVE TECHNOLOGY EVALUATION PROGRAM: PROGRESS AND ACCOMPLISHMENTS - FISCAL YEAR 1990 A FOURTH REPORT TO CONGRESS

EPA Science Inventory

The SITE Program was the first major program for demonstrating and evaluating fullscale innovative treatment technologies at hazardous waste sites. Having concluded its fourth year, the SITE Program is recognized as a leading advocate of innovative technology development and comm...

Adapting to wildfire: Rebuilding after home loss

Treesearch

Miranda H. Mockrin; Susan I. Stewart; Volker C. Radeloff; Roger B. Hammer; Patricia M. Alexandre

2015-01-01

Wildfire management now emphasizes fire-adapted communities that coexist with wildfires, although it is unclear how communities will progress to this goal. Hazards research suggests that response to wildfire - specifically, rebuilding after fire - may be a crucial opportunity for homeowner and community adaptation. We explore rebuilding after the 2010 Fourmile Canyon...

Removal of DNT from Wastewaters at Radford Army Ammunition Plant

DTIC Science & Technology

1991-03-31

appi~cable) U.S. Armty Corps of EngineersI ITEnvronenta Prgras, ic. ____________Toxic an’d Hazardous Material-, zec 6ý.. ADDPLSS (Crty, State. and... Peter Hartmann is RAAP’s Technical Analytical laboratory supervisor and is responsible for tracking analytical progress and ensuring timely completion

Sequential chemical-biological processes for the treatment of industrial wastewaters: review of recent progresses and critical assessment.

PubMed

Guieysse, Benoit; Norvill, Zane N

2014-02-28

When direct wastewater biological treatment is unfeasible, a cost- and resource-efficient alternative to direct chemical treatment consists of combining biological treatment with a chemical pre-treatment aiming to convert the hazardous pollutants into more biodegradable compounds. Whereas the principles and advantages of sequential treatment have been demonstrated for a broad range of pollutants and process configurations, recent progresses (2011-present) in the field provide the basis for refining assessment of feasibility, costs, and environmental impacts. This paper thus reviews recent real wastewater demonstrations at pilot and full scale as well as new process configurations. It also discusses new insights on the potential impacts of microbial community dynamics on process feasibility, design and operation. Finally, it sheds light on a critical issue that has not yet been properly addressed in the field: integration requires complex and tailored optimization and, of paramount importance to full-scale application, is sensitive to uncertainty and variability in the inputs used for process design and operation. Future research is therefore critically needed to improve process control and better assess the real potential of sequential chemical-biological processes for industrial wastewater treatment. Copyright © 2013 Elsevier B.V. All rights reserved.

Small mammal populations at hazardous waste disposal sites near Houston, Texas, USA

USGS Publications Warehouse

Robbins, C.S.

1990-01-01

Small mammals were trapped, tagged and recaptured in 0?45 ha plots at six hazardous industrial waste disposal sites to determine if populations, body mass and age structures were different from paired control site plots. Low numbers of six species of small mammals were captured on industrial waste sites or control sites. Only populations of hispid cotton rats at industrial waste sites and control sites were large enough for comparisons. Overall population numbers, age structure, and body mass of adult male and female cotton rats were similar at industrial waste sites and control sites. Populations of small mammals (particularly hispid cotton rats) may not suffice as indicators of environments with hazardous industrial waste contamination.

Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial.

PubMed

El-Khoury, Fabienne; Cassou, Bernard; Latouche, Aurélien; Aegerter, Philippe; Charles, Marie-Aline; Dargent-Molina, Patricia

2015-07-22

To assess the effectiveness of a two year exercise programme of progressive balance retraining in reducing injurious falls among women aged 75-85 at increased risk of falls and injuries and living in the community. Pragmatic multicentre, two arm, parallel group, randomised controlled trial. 20 study sites in 16 medium to large cities throughout France. 706 women aged 75-85, living in their own home, and with diminished balance and gait capacities, randomly allocated to the experimental intervention group (exercise programme, n=352) or the control group (no intervention, n=354). Weekly supervised group sessions of progressive balance training offered in community based premises for two years, supplemented by individually prescribed home exercises. A geriatrician blinded to group assignment classified falls into one of three categories (no consequence, moderate, severe) based on physical damage and medical care. The primary outcome was the rate of injurious falls (moderate and severe). The two groups were compared for rates of injurious falls with a "shared frailty" model. Other outcomes included the rates of all falls, physical functional capacities (balance and motor function test results), fear of falling (FES-I), physical activity level, and perceived health related quality of life (SF-36). Analysis was by intention to treat. There were 305 injurious falls in the intervention group and 397 in the control group (hazard ratio 0.81, 95% confidence interval 0.67 to 0.99). The difference in severe injuries (68 in intervention group v 87 in control group) was of the same order of magnitude (0.83, 0.60 to 1.16). At two years, women in the intervention group performed significantly better on all physical tests and had significantly better perception of their overall physical function than women in the control group. Among women who started the intervention (n=294), the median number of group sessions attended was 53 (interquartile range 16-71). Five injurious falls related to the intervention were recorded. A two year progressive balance retraining programme combining weekly group and individual sessions was effective in reducing injurious falls and in improving measured and perceived physical function in women aged 75-85 at risk of falling.Trial registration ClinicalTrials.gov (NCT00545350). © El-Khoury et al 2015.

Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial

PubMed Central

El-Khoury, Fabienne; Cassou, Bernard; Latouche, Aurélien; Aegerter, Philippe; Charles, Marie-Aline

2015-01-01

Objective To assess the effectiveness of a two year exercise programme of progressive balance retraining in reducing injurious falls among women aged 75-85 at increased risk of falls and injuries and living in the community. Design Pragmatic multicentre, two arm, parallel group, randomised controlled trial. Setting 20 study sites in 16 medium to large cities throughout France. Participants 706 women aged 75-85, living in their own home, and with diminished balance and gait capacities, randomly allocated to the experimental intervention group (exercise programme, n=352) or the control group (no intervention, n=354). Intervention Weekly supervised group sessions of progressive balance training offered in community based premises for two years, supplemented by individually prescribed home exercises. Outcome measures A geriatrician blinded to group assignment classified falls into one of three categories (no consequence, moderate, severe) based on physical damage and medical care. The primary outcome was the rate of injurious falls (moderate and severe). The two groups were compared for rates of injurious falls with a “shared frailty” model. Other outcomes included the rates of all falls, physical functional capacities (balance and motor function test results), fear of falling (FES-I), physical activity level, and perceived health related quality of life (SF-36). Analysis was by intention to treat. Results There were 305 injurious falls in the intervention group and 397 in the control group (hazard ratio 0.81, 95% confidence interval 0.67 to 0.99). The difference in severe injuries (68 in intervention group v 87 in control group) was of the same order of magnitude (0.83, 0.60 to 1.16). At two years, women in the intervention group performed significantly better on all physical tests and had significantly better perception of their overall physical function than women in the control group. Among women who started the intervention (n=294), the median number of group sessions attended was 53 (interquartile range 16-71). Five injurious falls related to the intervention were recorded. Conclusion A two year progressive balance retraining programme combining weekly group and individual sessions was effective in reducing injurious falls and in improving measured and perceived physical function in women aged 75-85 at risk of falling. Trial registration ClinicalTrials.gov (NCT00545350). PMID:26201510

Bi-Level Demand-Sensitive LED Street Lighting Systems

DTIC Science & Technology

2013-10-01

Hazards of Electromagnetic Radiation to Fuel HERO : Hazards of Electromagnetic Radiation to Ordnance ...we followed the following guidelines very strictly: 68 • For Hazards of Electromagnetic Radiation to Ordnance (HERO), RF device to be brought in...should be used at least 5 feet from ordnance /explosives. • For, Hazards of Electromagnetic Radiation to Personnel (HERP), HERP Controlled and

Atrial antitachycardia pacing and managed ventricular pacing in bradycardia patients with paroxysmal or persistent atrial tachyarrhythmias: the MINERVA randomized multicentre international trial.

PubMed

Boriani, Giuseppe; Tukkie, Raymond; Manolis, Antonis S; Mont, Lluis; Pürerfellner, Helmut; Santini, Massimo; Inama, Giuseppe; Serra, Paolo; de Sousa, João; Botto, Giovanni Luca; Mangoni, Lorenza; Grammatico, Andrea; Padeletti, Luigi

2014-09-14

Atrial fibrillation (AF) is a common comorbidity in bradycardia patients. Advanced pacemakers feature atrial preventive pacing and atrial antitachycardia pacing (DDDRP) and managed ventricular pacing (MVP), which minimizes unnecessary right ventricular pacing. We evaluated whether DDDRP and MVP might reduce mortality, morbidity, or progression to permanent AF when compared with standard dual-chamber pacing (Control DDDR). In a randomized, parallel, single-blind, multi-centre trial we enrolled 1300 patients with bradycardia and previous atrial tachyarrhythmias, in whom a DDDRP pacemaker had recently been implanted. History of permanent AF and third-degree atrioventricular block were exclusion criteria. After a 1-month run-in period, 1166 eligible patients, aged 74 ± 9 years, 50% females, were randomized to Control DDDR, DDDRP + MVP, or MVP. Analysis was intention-to-treat. The primary outcome, i.e. the 2-year incidence of a combined endpoint composed of death, cardiovascular hospitalizations, or permanent AF, occurred in 102/385 (26.5%) Control DDDR patients, in 76/383 (19.8%) DDDRP + MVP patients [hazard ratio (HR) = 0.74, 95% confidence interval 0.55-0.99, P = 0.04 vs. Control DDDR] and in 85/398 (21.4%) MVP patients (HR = 0.89, 95% confidence interval 0.77-1.03, P = 0.125 vs. Control DDDR). When compared with Control DDDR, DDDRP + MVP reduced the risk for AF longer than 1 day (HR = 0.66, 95% CI 0.52-0.85, P < 0.001), AF longer than 7 days (HR = 0.52, 95% CI 0.36-0.73, P < 0.001), and permanent AF (HR = 0.39, 95% CI 0.21-0.75, P = 0.004). In patients with bradycardia and atrial tachyarrhythmias, DDDRP + MVP is superior to standard dual-chamber pacing. The primary endpoint was significantly lowered through the reduction of the progression of atrial tachyarrhythmias to permanent AF. NCT00262119. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Cardiology.

Advanced Environmental Monitoring and Control Program: Strategic Plan

NASA Technical Reports Server (NTRS)

Schmidt, Gregory

1996-01-01

Human missions in space, from short-duration shuttle missions lasting no more than several days to the medium-to-long-duration missions planned for the International Space Station, face a number of hazards that must be understood and mitigated for the mission to be carried out safely. Among these hazards are those posed by the internal environment of the spacecraft itself; through outgassing of toxic vapors from plastics and other items, failures or off-nominal operations of spacecraft environmental control systems, accidental exposure to hazardous compounds used in experiments: all present potential hazards that while small, may accumulate and pose a danger to crew health. The first step toward mitigating the dangers of these hazards is understanding the internal environment of the spacecraft and the compounds contained within it. Future spacecraft will have integrated networks of redundant sensors which will not only inform the crew of hazards, but will pinpoint the problem location and, through analysis by intelligent systems, recommend and even implement a course of action to stop the problem. This strategic plan details strategies to determine NASA's requirements for environmental monitoring and control systems for future spacecraft, and goals and objectives for a program to answer these needs.

The impact of a home visitation programme on household hazards associated with unintentional childhood injuries: a randomised controlled trial.

PubMed

Odendaal, Willem; van Niekerk, Ashley; Jordaan, Esme; Seedat, Mohamed

2009-01-01

The continued high mortality and morbidity rates for unintentional childhood injuries remain a public health concern. This article reports on the influence of a home visitation programme (HVP) on household hazards associated with unintentional childhood injuries in a South African low-income setting. A randomised controlled trial (n=211 households) was conducted in a South African informal settlement. Community members were recruited and trained as paraprofessional visitors. Four intervention visits were conducted over 3 months, focusing on child development, and the prevention of burn, poison, and fall injuries. The HVP, a multi-component intervention, included educational inputs, provision of safety devices, and an implicit enforcement strategy. The intervention effect (IE) was measured with a standardised risk assessment index that compared post-intervention scores for intervention and control households. A significant reduction was observed in the hazards associated with electrical and paraffin appliances, as well as in hazards related to poisoning. Non-significant changes were observed for burn safety household practices and fall injury hazards. This study confirmed that a multi-component HVP effectively reduced household hazards associated with electrical and paraffin appliances and poisoning among children in a low-income South African setting.

The palm wine trade: occupational and health hazards.

PubMed

Mbuagbaw, L; Noorduyn, S G

2012-10-01

The palm wine trade is an important economic activity for many tropical rural areas worldwide. In West Africa, palm wine holds high sociocultural and traditional values. Wine tappers often climb very tall trees with rudimentary equipment to harvest palm sap and risk severe injuries in the event of a fall. Furthermore, the wine quickly ferments beyond the desired taste and alcohol content, reducing the market power of these tappers. Therefore, to maximize benefits or to enhance shelf life, a variety of components are added to the palm tree sap, introducing the possibility of deadly contaminants. This paper highlights the public health implications of uncontrolled palm wine production and the relative neglect of the wine tapper. We draw from the limited published literature and use Cameroon as a case study. The palm wine trade can be more productive and safe if tappers work in cooperatives to improve their market power. Public health authorities need to monitor the quality of this cheap and common source of alcohol and enact regulations to protect wine tappers from the current level of occupational hazards. There are varying levels of progress to control quality and ensure safety in different parts of the world. Legislation and collaboration with traditional structures may offer a framework for change.

Forest tree responses to extreme drought and some biotic events: Towards a selection according to hazard tolerance?

NASA Astrophysics Data System (ADS)

Bréda, Nathalie; Badeau, Vincent

2008-09-01

The aim of this paper is to illustrate how some extreme events could affect forest ecosystems. Forest tree response can be analysed using dendroecological methods, as tree-ring widths are strongly controlled by climatic or biotic events. Years with such events induce similar tree responses and are called pointer years. They can result from extreme climatic events like frost, a heat wave, spring water logging, drought or insect damage… Forest tree species showed contrasting responses to climatic hazards, depending on their sensitivity to water shortage or temperature hardening, as illustrated from our dendrochronological database. For foresters, a drought or a pest disease is an extreme event if visible and durable symptoms are induced (leaf discolouration, leaf loss, perennial organs mortality, tree dieback and mortality). These symptoms here are shown, lagging one or several years behind a climatic or biotic event, from forest decline cases in progress since the 2003 drought or attributed to previous severe droughts or defoliations in France. Tree growth or vitality recovery is illustrated, and the functional interpretation of the long lasting memory of trees is discussed. A coupled approach linking dendrochronology and ecophysiology helps in discussing vulnerability of forest stands, and suggests management advices in order to mitigate extreme drought and cope with selective mortality.

Subjective Sleep Quality Deteriorates Prior to Development of Painful Temporomandibular Disorder

PubMed Central

Sanders, Anne E.; Akinkugbe, Aderonke A.; Bair, Eric; Fillingim, Roger B.; Greenspan, Joel D.; Ohrbach, Richard; Dubner, Ronald; Maixner, William; Slade, Gary D.

2016-01-01

There is good evidence that poor sleep quality increases risk of painful temporomandibular disorder (TMD). However little is known about the course of sleep quality in the months preceding TMD onset, and whether the relationship is mediated by heightened sensitivity to pain. The Pittsburgh Sleep Quality Index was administered at enrollment into the OPPERA prospective cohort study. Thereafter the Sleep Quality Numeric Rating Scale was administered every three months to 2,453 participants. Sensitivity to experimental pressure pain and pinprick pain stimuli was measured at baseline and repeated during follow-up of incident TMD cases (n=220) and matched TMD-free controls (n=193). Subjective sleep quality deteriorated progressively, but only in those who subsequently developed TMD. A Cox proportional hazards model showed that risk of TMD was greater among participants whose sleep quality worsened during follow-up (adjusted hazard ratio=1.73, 95% confidence limits: 1.29, 2.32). This association was independent of baseline measures of sleep quality, psychological stress, somatic awareness, comorbid conditions, non-pain facial symptoms and demographics. Poor baseline sleep quality was not significantly associated with baseline pain sensitivity or with subsequent change in pain sensitivity. Furthermore the relationship between sleep quality and TMD incidence was not mediated via baseline pain sensitivity nor change in pain sensitivity. PMID:26902644

Maternal exposure to heatwave and preterm birth in Brisbane, Australia.

PubMed

Wang, J; Williams, G; Guo, Y; Pan, X; Tong, S

2013-12-01

To quantify the short-term effects of maternal exposure to heatwave on preterm birth. An ecological study. A population-based study in Brisbane, Australia. All pregnant women who had a spontaneous singleton live birth in Brisbane between November and March in 2000-2010 were studied. Daily data on pregnancy outcomes, meteorological factors, and ambient air pollutants were obtained. The Cox proportional hazards regression model with time-dependent variables was used to examine the short-term impact of heatwave on preterm birth. A series of cut-off temperatures and durations were used to define heatwave. Multivariable analyses were also performed to adjust for socio-economic factors, demographic factors, meteorological factors, and ambient air pollutants. Spontaneous preterm births. The adjusted hazard ratios (HRs) ranged from 1.13 (95% CI 1.03-1.24) to 2.00 (95% CI 1.37-2.91) by using different heatwave definitions, after controlling for demographic, socio-economic, and meteorological factors, and air pollutants. Heatwave was significantly associated with preterm birth: the associations were robust to the definitions of heatwave. The threshold temperatures, instead of duration, could be more likely to influence the evaluation of birth-related heatwaves. The findings of this study may have significant public health implications as climate change progresses. © 2013 RCOG.

SCI Hazard Report Methodology

NASA Technical Reports Server (NTRS)

Mitchell, Michael S.

2010-01-01

This slide presentation reviews the methodology in creating a Source Control Item (SCI) Hazard Report (HR). The SCI HR provides a system safety risk assessment for the following Ares I Upper Stage Production Contract (USPC) components (1) Pyro Separation Systems (2) Main Propulsion System (3) Reaction and Roll Control Systems (4) Thrust Vector Control System and (5) Ullage Settling Motor System components.

78 FR 48636 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Parts 1, 16, 106, 110... Manufacturing Practice and Hazard Analysis and Risk- Based Preventive Controls for Human Food; Extension of...-Based Preventive Controls for Human Food,'' that appeared in the Federal Register of January 16, 2013...

Safety Analysis of Soybean Processing for Advanced Life Support

NASA Technical Reports Server (NTRS)

Hentges, Dawn L.

1999-01-01

Soybeans (cv. Hoyt) is one of the crops planned for food production within the Advanced Life Support System Integration Testbed (ALSSIT), a proposed habitat simulation for long duration lunar/Mars missions. Soybeans may be processed into a variety of food products, including soymilk, tofu, and tempeh. Due to the closed environmental system and importance of crew health maintenance, food safety is a primary concern on long duration space missions. Identification of the food safety hazards and critical control points associated with the closed ALSSIT system is essential for the development of safe food processing techniques and equipment. A Hazard Analysis Critical Control Point (HACCP) model was developed to reflect proposed production and processing protocols for ALSSIT soybeans. Soybean processing was placed in the type III risk category. During the processing of ALSSIT-grown soybeans, critical control points were identified to control microbiological hazards, particularly mycotoxins, and chemical hazards from antinutrients. Critical limits were suggested at each CCP. Food safety recommendations regarding the hazards and risks associated with growing, harvesting, and processing soybeans; biomass management; and use of multifunctional equipment were made in consideration of the limitations and restraints of the closed ALSSIT.

A Subject Reference: Benefit-Cost Analysis of Toxic Substances, Hazardous Materials and Solid Waste Control (1977)

EPA Pesticide Factsheets

Discussion of methodological issues for conducting benefit-cost analysis and provides guidance for selecting and applying the most appropriate and useful mechanisms in benefit-cost analysis of toxic substances, hazardous materials, and solid waste control

HANDBOOK: CONTROL TECHNIQUES FOR HAZARDOUS AIR POLLUTANTS

EPA Science Inventory

This manual is a revision of the first (1986) edition of the Handbook: Control Technologies for Hazardous Air Pollutants, which incorporated information from numerous sources into a single, self-contained reference source focusing on the design and cost of VOC and partic...

10 CFR 835.901 - Radiation safety training.

Code of Federal Regulations, 2011 CFR

2011-01-01

....901(c) commensurate with the hazards in the area and the required controls: (1) Before being permitted... controls, by successful completion of an examination and performance demonstrations: (1) Before being... radiological hazards: (1) Risks of exposure to radiation and radioactive materials, including prenatal...

HANDBOOK: QUALITY ASSURANCE/QUALITY CONTROL (QA/QC) PROCEDURES FOR HAZARDOUS WASTE INCINERATION

EPA Science Inventory

Resource Conservation and Recovery Act regulations for hazardous waste incineration require trial burns by permit applicants. uality Assurance Project Plan (QAPjP) must accompany a trial burn plan with appropriate quality assurance/quality control procedures. uidance on the prepa...

33 CFR 153.101 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION CONTROL OF POLLUTION BY OIL AND HAZARDOUS SUBSTANCES, DISCHARGE REMOVAL General § 153.101 Purpose. The purpose of this... hazardous substances as required by the Federal Water Pollution Control Act, as amended (FWPCA); the...

33 CFR 153.101 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION CONTROL OF POLLUTION BY OIL AND HAZARDOUS SUBSTANCES, DISCHARGE REMOVAL General § 153.101 Purpose. The purpose of this... hazardous substances as required by the Federal Water Pollution Control Act, as amended (FWPCA); the...

33 CFR 153.101 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION CONTROL OF POLLUTION BY OIL AND HAZARDOUS SUBSTANCES, DISCHARGE REMOVAL General § 153.101 Purpose. The purpose of this... hazardous substances as required by the Federal Water Pollution Control Act, as amended (FWPCA); the...

33 CFR 153.101 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION CONTROL OF POLLUTION BY OIL AND HAZARDOUS SUBSTANCES, DISCHARGE REMOVAL General § 153.101 Purpose. The purpose of this... hazardous substances as required by the Federal Water Pollution Control Act, as amended (FWPCA); the...

33 CFR 153.101 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION CONTROL OF POLLUTION BY OIL AND HAZARDOUS SUBSTANCES, DISCHARGE REMOVAL General § 153.101 Purpose. The purpose of this... hazardous substances as required by the Federal Water Pollution Control Act, as amended (FWPCA); the...

Ambler - An autonomous rover for planetary exploration

NASA Technical Reports Server (NTRS)

Bares, John; Hebert, Martial; Kanade, Takeo; Krotkov, Eric; Mitchell, Tom

1989-01-01

The authors are building a prototype legged rover, called the Ambler (loosely an acronym for autonomous mobile exploration robot) and testing it on full-scale, rugged terrain of the sort that might be encountered on the Martian surface. They present an overview of their research program, focusing on locomotion, perception, planning, and control. They summarize some of the most important goals and requirements of a rover design and describe how locomotion, perception, and planning systems can satisfy these requirements. Since the program is relatively young (one year old at the time of writing) they identify issues and approaches and describe work in progress rather than report results. It is expected that many of the technologies developed will be applicable to other planetary bodies and to terrestrial concerns such as hazardous waste assessment and remediation, ocean floor exploration, and mining.

Efficacy, end points and eventualities: sumatriptan/naproxen versus butalbital/paracetamol/caffeine in the treatment of migraine.

PubMed

Fox, Anthony W

2012-09-01

Migraine is a widespread, relapsing, remittent syndrome. No animal model predicts whether test medications will be clinically useful. Using a modern, well-controlled, sophisticated study design, Derosier et al. demonstrates not only that a butalbital formulation has modest efficacy as an acute treatment for migraine but also that a sumatriptan-naproxen combination is superior. These conclusions are reached using a variety of internally consistent secondary efficacy end points. The primary end point chosen (highly conservative and fashionable in some academic circles) was a technical failure (and not a negative experimental finding). Migraine is intrinsically pleiomorphic: diverse treatment options help match patient with therapy. This study does not justify blanket bans on (admittedly hazardous) barbiturate therapies, and regulators should not impose end point conservatism to an extent that will stifle further progress.

Intergenerational Transmission of Reproductive Behavior during the Demographic Transition

PubMed Central

Jennings, Julia A.; Sullivan, Allison R.; Hacker, J. David

2012-01-01

New evidence from the Utah Population Database (UPDB) reveals that at the onset of the fertility transition, reproductive behavior was transmitted across generations--between women and their mothers, as well as between women and their husbands' family of origin. Age at marriage, age at last birth, and the number of children ever born are positively correlated in the data, most strongly among first-born daughters and among cohorts born later in the fertility transition. Intergenerational ties, including the presence of mothers and mothers-in-law, influenced the hazard of progressing to a next birth. The findings suggest that the practice of parity-dependent marital fertility control and inter-birth spacing behavior derived in part from the previous generation and that the potential for mothers and mothers-in-law to help in the rearing of children encouraged higher marital fertility. PMID:22530253

Alectinib versus Crizotinib in Untreated ALK-Positive Non-Small-Cell Lung Cancer.

PubMed

Peters, Solange; Camidge, D Ross; Shaw, Alice T; Gadgeel, Shirish; Ahn, Jin S; Kim, Dong-Wan; Ou, Sai-Hong I; Pérol, Maurice; Dziadziuszko, Rafal; Rosell, Rafael; Zeaiter, Ali; Mitry, Emmanuel; Golding, Sophie; Balas, Bogdana; Noe, Johannes; Morcos, Peter N; Mok, Tony

2017-08-31

Alectinib, a highly selective inhibitor of anaplastic lymphoma kinase (ALK), has shown systemic and central nervous system (CNS) efficacy in the treatment of ALK-positive non-small-cell lung cancer (NSCLC). We investigated alectinib as compared with crizotinib in patients with previously untreated, advanced ALK-positive NSCLC, including those with asymptomatic CNS disease. In a randomized, open-label, phase 3 trial, we randomly assigned 303 patients with previously untreated, advanced ALK-positive NSCLC to receive either alectinib (600 mg twice daily) or crizotinib (250 mg twice daily). The primary end point was investigator-assessed progression-free survival. Secondary end points were independent review committee-assessed progression-free survival, time to CNS progression, objective response rate, and overall survival. During a median follow-up of 17.6 months (crizotinib) and 18.6 months (alectinib), an event of disease progression or death occurred in 62 of 152 patients (41%) in the alectinib group and 102 of 151 patients (68%) in the crizotinib group. The rate of investigator-assessed progression-free survival was significantly higher with alectinib than with crizotinib (12-month event-free survival rate, 68.4% [95% confidence interval (CI), 61.0 to 75.9] with alectinib vs. 48.7% [95% CI, 40.4 to 56.9] with crizotinib; hazard ratio for disease progression or death, 0.47 [95% CI, 0.34 to 0.65]; P<0.001); the median progression-free survival with alectinib was not reached. The results for independent review committee-assessed progression-free survival were consistent with those for the primary end point. A total of 18 patients (12%) in the alectinib group had an event of CNS progression, as compared with 68 patients (45%) in the crizotinib group (cause-specific hazard ratio, 0.16; 95% CI, 0.10 to 0.28; P<0.001). A response occurred in 126 patients in the alectinib group (response rate, 82.9%; 95% CI, 76.0 to 88.5) and in 114 patients in the crizotinib group (response rate, 75.5%; 95% CI, 67.8 to 82.1) (P=0.09). Grade 3 to 5 adverse events were less frequent with alectinib (41% vs. 50% with crizotinib). As compared with crizotinib, alectinib showed superior efficacy and lower toxicity in primary treatment of ALK-positive NSCLC. (Funded by F. Hoffmann-La Roche; ALEX ClinicalTrials.gov number, NCT02075840 .).

[Introduction of hazard analysis and critical control points (HACCP) principles at the flight catering food production plant].

PubMed

Popova, A Yu; Trukhina, G M; Mikailova, O M

In the article there is considered the quality control and safety system implemented in the one of the largest flight catering food production plant for airline passengers and flying squad. The system for the control was based on the Hazard Analysis And Critical Control Points (HACCP) principles and developed hygienic and antiepidemic measures. There is considered the identification of hazard factors at stages of the technical process. There are presented results of the analysis data of monitoring for 6 critical control points over the five-year period. The quality control and safety system permit to decline food contamination risk during acceptance, preparation and supplying of in-flight meal. There was proved the efficiency of the implemented system. There are determined further ways of harmonization and implementation for HACCP principles in the plant.

77 FR 74275 - Pipeline Safety: Information Collection Activities

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-13

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket No.... These regulations require operators of hazardous liquid pipelines and gas pipelines to develop and... control room. Affected Public: Operators of both natural gas and hazardous liquid pipeline systems. Annual...

78 FR 12780 - Agency Information Collection Activities: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-25

... INFORMATION CONTACT: To request additional information about this ICR, Elizabeth Lemersal, Earthquake Hazards... . SUPPLEMENTARY INFORMATION: Title: Earthquake Hazards Program Research and Monitoring. OMB Control Number: 1028... findings are essential to fulfilling USGS's responsibility under the Earthquake Hazards Reduction Act to...

AN ADVANCED TOOL FOR APPLIED INTEGRATED SAFETY MANAGEMENT

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

Potts, T. Todd; Hylko, James M.; Douglas, Terence A.

2003-02-27

WESKEM, LLC's Environmental, Safety and Health (ES&H) Department had previously assessed that a lack of consistency, poor communication and using antiquated communication tools could result in varying operating practices, as well as a failure to capture and disseminate appropriate Integrated Safety Management (ISM) information. To address these issues, the ES&H Department established an Activity Hazard Review (AHR)/Activity Hazard Analysis (AHA) process for systematically identifying, assessing, and controlling hazards associated with project work activities during work planning and execution. Depending on the scope of a project, information from field walkdowns and table-top meetings are collected on an AHR form. The AHAmore » then documents the potential failure and consequence scenarios for a particular hazard. Also, the AHA recommends whether the type of mitigation appears appropriate or whether additional controls should be implemented. Since the application is web based, the information is captured into a single system and organized according to the >200 work activities already recorded in the database. Using the streamlined AHA method improved cycle time from over four hours to an average of one hour, allowing more time to analyze unique hazards and develop appropriate controls. Also, the enhanced configuration control created a readily available AHA library to research and utilize along with standardizing hazard analysis and control selection across four separate work sites located in Kentucky and Tennessee. The AHR/AHA system provides an applied example of how the ISM concept evolved into a standardized field-deployed tool yielding considerable efficiency gains in project planning and resource utilization. Employee safety is preserved through detailed planning that now requires only a portion of the time previously necessary. The available resources can then be applied to implementing appropriate engineering, administrative and personal protective equipment controls in the field.« less

Effects of HUD-supported lead hazard control interventions in housing on children's blood lead.

PubMed

Clark, Scott; Galke, Warren; Succop, Paul; Grote, Joann; McLaine, Pat; Wilson, Jonathan; Dixon, Sherry; Menrath, William; Roda, Sandy; Chen, Mei; Bornschein, Robert; Jacobs, David

2011-02-01

The Evaluation of the US Department of Housing and Urban Development Lead-Based Paint Hazard Control Grant Program studied the effectiveness of the housing intervention performed in reducing the blood lead of children at four post-intervention times (6-months, 1-year, 2-years, and 3-years). A repeat measures analysis showed that blood lead levels declined up to three-years post-intervention. The results at each successive collection time were significantly lower than at the previous post-intervention time except for the difference between the levels at two and three years. At two-years post-intervention, geometric mean blood lead levels were approximately 37% lower than at pre-intervention. Children with pre-intervention blood lead levels as low as 10 μg/dL experienced substantial declines in blood lead levels. Previous studies have found substantial improvements only if a child's pre-intervention blood lead level was above 20 μg/dL. Individual interior lead hazard control treatments as grouped by Interior Strategy were not a significant predictor of post-intervention blood lead levels. However, children living in dwellings where exterior lead hazard control interventions were done had lower blood lead levels at one-year post-intervention than those living in dwellings without the exterior interventions (all other factors being equal), but those differences were only significant when the mean exterior paint lead loading at pre-intervention was about the 90th percentile (7.0mg/cm(2)). This observation suggests that exterior lead hazard control can be an important component of a lead hazard control plan. Children who were six to eleven months of age at pre-intervention had a significant increase in blood lead at one-year post-intervention, probably due to other exposures. Copyright © 2010 Elsevier Inc. All rights reserved.

Effective cues for accelerating young drivers' time to transfer control following a period of conditional automation.

PubMed

Wright, Timothy J; Agrawal, Ravi; Samuel, Siby; Wang, Yuhua; Zilberstein, Shlomo; Fisher, Donald L

2018-07-01

During conditional automated driving, a transition from the automated driving suite to manual control requires the driver to take over control at a moment's notice. Thus, it is critical that a driver be made situationally aware as quickly as possible in those conditions where he or she may not be paying full attention. Recent research suggests that specific cues about upcoming hazards (e.g., "crosswalk ahead") can increase the drivers' situation awareness during these safety-critical take-over situations when compared with a general cue ("take over control"). The current study examines whether this increased situation awareness which occurs as a result of more specific cues translates into improved hazard mitigation performance within the same limited time window. Fifty-seven drivers were randomly assigned to one of five between-subjects conditions (one control condition and four experimental auditory cue conditions) that varied in the specificity of information provided about an upcoming hazard. The four experimental conditions included a period of conditional automated driving where the driver was engaged in a driving-irrelevant task and looked away from the forward roadway prior to a take-over request. Drivers in the fifth condition had no cue and drove manually throughout. The same six simulator scenarios were used in all five conditions to evaluate how well the driver mitigated a hazard. The average velocity, standard deviation of velocity, and average absolute acceleration were recorded along with the glance behaviors of drivers. In general, during the 4s prior to a latent hazard (following the alerting cues in the automated driving conditions), the more likely a driver was to glance towards a latent hazard, the more likely the driver was to reduce his or her speed. Moreover, analyses focusing solely on hazard mitigation behavior revealed patterns that mirrored the glance behavior results. Specifically, drivers that were presented with cues that described the environments in which hazards were likely to occur were more likely to demonstrate vehicle behaviors that were consistent with speed reductions (lower velocity, higher speed variability, and higher absolute acceleration) than were drivers who were presented general cues or cues about the identity of the upcoming hazards. Even in as little as 4s prior to a potential hazard, cues that inform the driver of the environment in which the hazard is likely to occur increase the likelihood that the driver mitigates the crash compared with drivers who are provided general information or threat identity information. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development and Validation of a Novel Platform-Independent Metastasis Signature in Human Breast Cancer

PubMed Central

Speers, Corey; Liu, Meilan; Wilder-Romans, Kari; Lawrence, Theodore S.; Pierce, Lori J.; Feng, Felix Y.

2015-01-01

Purpose The molecular drivers of metastasis in breast cancer are not well understood. Therefore, we sought to identify the biological processes underlying distant progression and define a prognostic signature for metastatic potential in breast cancer. Experimental design In vivo screening for metastases was performed using Chick Chorioallantoic Membrane assays in 21 preclinical breast cancer models. Expressed genes associated with metastatic potential were identified using high-throughput analysis. Correlations with biological function were determined using the Database for Annotation, Visualization and Integrated Discovery. Results We identified a broad range of metastatic potential that was independent of intrinsic breast cancer subtypes. 146 genes were significantly associated with metastasis progression and were linked to cancer-related biological functions, including cell migration/adhesion, Jak-STAT, TGF-beta, and Wnt signaling. These genes were used to develop a platform-independent gene expression signature (M-Sig), which was trained and subsequently validated on 5 independent cohorts totaling nearly 1800 breast cancer patients with all p-values < 0.005 and hazard ratios ranging from approximately 2.5 to 3. On multivariate analysis accounting for standard clinicopathologic prognostic variables, M-Sig remained the strongest prognostic factor for metastatic progression, with p-values < 0.001 and hazard ratios > 2 in three different cohorts. Conclusion M-Sig is strongly prognostic for metastatic progression, and may provide clinical utility in combination with treatment prediction tools to better guide patient care. In addition, the platform-independent nature of the signature makes it an excellent research tool as it can be directly applied onto existing, and future, datasets. PMID:25974184

A review on recent progress in observations, and health effects of bioaerosols.

PubMed

Humbal, Charmi; Gautam, Sneha; Trivedi, Ujwalkumar

2018-06-06

Bioaerosol is a particulate mixture of solid and semi-solid matter combined with biotic matter like pollens, microbes and their fragments. The present review stresses on a cumulative understanding of sources, components, quantification and distribution of bioaerosols with respect to size, and its significant impacts on human health. The present review will be instrumental in devising strategies to understand and manage bioaerosols and reducing their human exposure and associated health hazards. The present review aims explore the relationship between particle and associated biological agents responsible for behaviours like dispersal, total potential health hazards and toxicology level during exposure to bioaerosol. Copyright © 2018. Published by Elsevier Ltd.

Hazard Identification and Risk Assessment in Water Treatment Plant considering Environmental Health and Safety Practice

NASA Astrophysics Data System (ADS)

Falakh, Fajrul; Setiani, Onny

2018-02-01

Water Treatment Plant (WTP) is an important infrastructure to ensure human health and the environment. In its development, aspects of environmental safety and health are of concern. This paper case study was conducted at the Water Treatment Plant Company in Semarang, Central Java, Indonesia. Hazard identification and risk assessment is one part of the occupational safety and health program at the risk management stage. The purpose of this study was to identify potential hazards using hazard identification methods and risk assessment methods. Risk assessment is done using criteria of severity and probability of accident. The results obtained from this risk assessment are 22 potential hazards present in the water purification process. Extreme categories that exist in the risk assessment are leakage of chlorine and industrial fires. Chlorine and fire leakage gets the highest value because its impact threatens many things, such as industrial disasters that could endanger human life and the environment. Control measures undertaken to avoid potential hazards are to apply the use of personal protective equipment, but management will also be better managed in accordance with hazard control hazards, occupational safety and health programs such as issuing work permits, emergency response training is required, Very useful in overcoming potential hazards that have been determined.

Variable message fog hazard warning signs to control vehicle operating characteristics : interim report, Interstate 5, North Albany.

DOT National Transportation Integrated Search

1972-04-01

This project is aimed at determining the effectiveness of variable message signs in controlling traffic on an Interstate highway during periods of hazardous driving conditions such as fog, vehicle accidents, or congestion. : The effectiveness of the ...

Proposed Rule for Control of Hazardous Air Pollutants From Mobile Sources - 40 CFR Parts 59, 80, 85, and 86

EPA Pesticide Factsheets

A proposed rule to control gasoline, passenger vehicles, and portable gasoline containers (gas cans) that would significantly reduce emissions of benzene and other hazardous air pollutants (‘‘mobile source air toxics’’).

Engineered Nanomaterials, Sexy New Technology and Potential Hazards

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

Beaulieu, R A

Engineered nanomaterials enhance exciting new applications that can greatly benefit society in areas of cancer treatments, solar energy, energy storage, and water purification. While nanotechnology shows incredible promise in these and other areas by exploiting nanomaterials unique properties, these same properties can potentially cause adverse health effects to workers who may be exposed during work. Dispersed nanoparticles in air can cause adverse health effects to animals not merely due to their chemical properties but due to their size, structure, shape, surface chemistry, solubility, carcinogenicity, reproductive toxicity, mutagenicity, dermal toxicity, and parent material toxicity. Nanoparticles have a greater likelihood of lungmore » deposition and blood absorption than larger particles due to their size. Nanomaterials can also pose physical hazards due to their unusually high reactivity, which makes them useful as catalysts, but has the potential to cause fires and explosions. Characterization of the hazards (and potential for exposures) associated with nanomaterial development and incorporation in other products is an essential step in the development of nanotechnologies. Developing controls for these hazards are equally important. Engineered controls should be integrated into nanomaterial manufacturing process design according to 10CFR851, DOE Policy 456.1, and DOE Notice 456.1 as safety-related hardware or administrative controls for worker safety. Nanomaterial hazards in a nuclear facility must also meet control requirements per DOE standards 3009, 1189, and 1186. Integration of safe designs into manufacturing processes for new applications concurrent with the developing technology is essential for worker safety. This paper presents a discussion of nanotechnology, nanomaterial properties/hazards and controls.« less

Chemical Safety Alert: Fire Hazard from Carbon Adsorption Deodorizing Systems

EPA Pesticide Factsheets

Activated carbon systems used to adsorb vapors for odor control may pose a fire hazard when used for certain types of substances, such as crude sulfate turpentine. Facilities should take precautions and proper procedures to avoid or mitigate these hazards.

Changes to the Hazardous Waste Federal Regulations Through Part 266 and Part 266 Appendices - Federal Register Notice, February 21, 1991

EPA Pesticide Factsheets

Under this final rule, the Environmental Protection Agency (EPA) is expanding controls on hazardous waste combustion to regulate air emissions from the burning of hazardous waste in boilers and industrial furnaces.

A Cascading Storm-Flood-Landslide Guidance System: Development and Application in China

NASA Astrophysics Data System (ADS)

Zeng, Ziyue; Tang, Guoqiang; Long, Di; Ma, Meihong; Hong, Yang

2016-04-01

Flash floods and landslides, triggered by storms, often interact and cause cascading effects on human lives and property. Satellite remote sensing data has significant potential use in analysis of these natural hazards. As one of the regions continuously affected by severe flash floods and landslides, Yunnan Province, located in Southwest China, has a complex mountainous hydrometeorology and suffers from frequent heavy rainfalls from May through to late September. Taking Yunnan as a test-bed, this study proposed a Cascading Storm-Flood-Landslide Guidance System to progressively analysis and evaluate the risk of the multi-hazards based on multisource satellite remote sensing data. First, three standardized rainfall amounts (average daily amount in flood seasons, maximum 1h and maximum 6h amount) from the products of Topical Rainfall Measuring Mission (TRMM) Multi-satellite Precipitation Analysis (TMPA) were used as rainfall indicators to derive the StorM Hazard Index (SMHI). In this process, an integrated approach of the Analytic Hierarchy Process (AHP) and the Information-Entropy theory was adopted to determine the weight of each indicator. Then, land cover and vegetation cover data from the Moderate Resolution Imaging Spectroradiometer (MODIS) products, soil type from the Harmonized World Soil Database (HWSD) soil map, and slope from the Shuttle Radar Topography Mission (SRTM) data were add as semi-static geo-topographical indicators to derive the Flash Flood Hazard Index (FFHI). Furthermore, three more relevant landslide-controlling indicators, including elevation, slope angle and soil text were involved to derive the LandSlide Hazard Index (LSHI). Further inclusion of GDP, population and prevention measures as vulnerability indicators enabled to consecutively predict the risk of storm to flash flood and landslide, respectively. Consequently, the spatial patterns of the hazard indices show that the southeast of Yunnan has more possibility to encounter with storms than other parts, while the northeast of Yunnan are most susceptible to floods and landslides, which agrees with the distribution of observed flood and landslide events. Moreover, risks for the multi-hazards were classified into four categories. Results show a strong correlation between the distributions of flash flood prone and landslide-prone regions and also highlight the counties with high risk of storms (e.g., Funing and Malipo), flash floods (e.g., Gongshan and Yanjing) and landslides (e.g., Zhaotong and Luxi). Compared to other approaches, the Cascading Storm-Flood-Landslide Guidance System uses a straightforward yet useful indicator-based weighted linear combination method and could be a useful prototype in mapping characteristics of storm-triggered hazards for users at different administrative levels (e.g., catchment, town, county, province and even nation) in China.

Environmental Hazards Assessment Program annual report, July 1, 1993--June 30, 1994

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

Not Available

On June 23, 1992, the US Department of Energy (DOE) signed Assistance Instrument Number DE-FG01-92EW50625 with the Medical University of South Carolina (MUSC) to support the Environmental Hazards Assessment Program (EHAP). The objectives of the EHAP program stated in the proposal to DOE are to: (1) Develop a holistic, national basis for risk assessment, risk management, and risk communication which recognizes the direct impact of environmental hazards on the health and well-being of all. (2) Develop a pool of talented scientists and experts in cleanup activities, especially in human health aspects; and (3) Identify needs and develop programs addressing themore » critical shortage of well-educated, highly-skilled technical and scientific personnel to address the health oriented aspects of environmental restoration and waste management. This report describes activities and reports on progress for the second year of the grant.« less

Reducing Vulnerability of Coastal Communities to Coastal Hazards through Building Community Resilience

NASA Astrophysics Data System (ADS)

Bhj, Premathilake

2010-05-01

Reducing Vulnerability of Coastal Communities to Coastal Hazards through Building Community Resilience B H J Premathilake Coast Conservation Department Sri Lanka Email: bhjprem@yahoo.com This paper contains two parts; Part one describes the comprehensive approach adopted by our project to build social, economical, institutional and environmental resilience of the tsunami affected communities in Sri Lanka to cope with future natural disasters. Community development, Coastal resource management and Disaster management are the three pillars of this model and these were built simultaneously to bring the community into a higher level of resilience to coastal hazards. Second part describes the application of Coastal Community Resilience (CCR) Assessment framework to evaluate the progress achieved by the project in building overall resilience of the communities during its period. It further describes how to estimate the contribution of this specific project for the improved resilience status of the selected communities in a multi stakeholder environment.

MR imaging features associated with distant metastasis-free survival of patients with invasive breast cancer: a case-control study.

PubMed

Song, Sung Eun; Shin, Sung Ui; Moon, Hyeong-Gon; Ryu, Han Suk; Kim, Kwangsoo; Moon, Woo Kyung

2017-04-01

Preoperative breast magnetic resonance (MR) imaging features of primary breast cancers may have the potential to act as prognostic biomarkers by providing morphologic and kinetic features representing inter- or intra-tumor heterogeneity. Recent radiogenomic studies reveal that several radiologist-annotated image features are associated with genes or signal pathways involved in tumor progression, treatment resistance, and distant metastasis (DM). We investigate whether preoperative breast MR imaging features are associated with worse DM-free survival in patients with invasive breast cancer. Of the 3536 patients with primary breast cancers who underwent preoperative MR imaging between 2003 and 2009, 147 patients with DM were identified and one-to-one matched with control patients (n = 147) without DM according to clinical-pathologic variables. Three radiologists independently reviewed the MR images of 294 patients, and the association of DM-free survival with MR imaging and clinical-pathologic features was assessed using Cox proportional hazard models. Of MR imaging features, rim enhancement (hazard ratio [HR], 1.83 [95% confidence interval, CI 1.29, 2.51]; p = 0.001) and peritumoral edema (HR, 1.48 [95% CI 1.03, 2.11]; p = 0.032) were the significant features associated with worse DM-free survival. The significant MR imaging features, however, were different between breast cancer subtypes and stages. Preoperative breast MR imaging features of rim enhancement and peritumoral edema may be used as prognostic biomarkers that help predict DM risk in patients with breast cancer, thereby potentially enabling improved personalized treatment and monitoring strategies for individual patients.

Tree hazard control on recreation sites...estimating local budgets

Treesearch

Lee A. Paine

1967-01-01

Tree hazard control efforts on recreation sites are subject to budget and administrative restrictions. To make the most effective use of available control funds, priorities should be assigned to various classes of tree defects and a budget set up. With the method provided, local priorities are based on cost effectiveness. Some guide lines and a worksheet for planning a...

Satellite Detection of the Convection Generated Stresses in Earth

NASA Technical Reports Server (NTRS)

Liu, Han-Shou; Kolenkiewicz, Ronald; Li, Jin-Ling; Chen, Jiz-Hong

2003-01-01

We review research developments on satellite detection of the convection generated stresses in the Earth for seismic hazard assessment and Earth resource survey. Particular emphasis is laid upon recent progress and results of stress calculations from which the origin and evolution of the tectonic features on Earth's surface can be scientifically addressed. An important aspect of the recent research development in tectonic stresses relative to earthquakes is the implications for earthquake forecasting and prediction. We have demonstrated that earthquakes occur on the ring of fire around the Pacific in response to the tectonic stresses induced by mantle convection. We propose a systematic global assessment of the seismic hazard based on variations of tectonic stresses in the Earth as observed by satellites. This space geodynamic approach for assessing the seismic hazard is unique in that it can pinpoint the triggering stresses for large earthquakes without ambiguities of geological structures, fault geometries, and other tectonic properties. Also, it is distinct from the probabilistic seismic hazard assessment models in the literature, which are based only on extrapolations of available earthquake data.

Landslide modeling and forecasting—recent progress by the u.s. geological survey

USGS Publications Warehouse

Baum, Rex L.; Kean, Jason W.

2015-01-01

Landslide studies by the U.S. Geological Survey (USGS) are focused on two main objectives: scientific understanding and forecasting. The first objective is to gain better understanding of the physical processes involved in landslide initiation and movement. This objective is largely in support of the second objective, to develop predictive capabilities to answer the main hazard questions. Answers to the following six questions are needed to characterize the hazard from landslides: (1) Where will landslides occur? (2) What kind(s) of landslides will occur? (3) When will landslides occur? (4) How big will the landslides be? (5) How fast will the landslides travel? (6) How far will the landslides go? Although these questions are sometimes recast in different terms, such as frequency or recurrence rather than timing (when), the questions or their variants address the spatial, physical, and temporal aspects of landslide hazards. Efforts to develop modeling and forecasting capabilities by the USGS are primarily focused on specific landslide types that pose a high degree of hazard and show relatively high potential for predictability.

Risk factors for hazardous events in olfactory-impaired patients.

PubMed

Pence, Taylor S; Reiter, Evan R; DiNardo, Laurence J; Costanzo, Richard M

2014-10-01

Normal olfaction provides essential cues to allow early detection and avoidance of potentially hazardous situations. Thus, patients with impaired olfaction may be at increased risk of experiencing certain hazardous events such as cooking or house fires, delayed detection of gas leaks, and exposure to or ingestion of toxic substances. To identify risk factors and potential trends over time in olfactory-related hazardous events in patients with impaired olfactory function. Retrospective cohort study of 1047 patients presenting to a university smell and taste clinic between 1983 and 2013. A total of 704 patients had both clinical olfactory testing and a hazard interview and were studied. On the basis of olfactory function testing results, patients were categorized as normosmic (n = 161), mildly hyposmic (n = 99), moderately hyposmic (n = 93), severely hyposmic (n = 142), and anosmic (n = 209). Patient evaluation including interview, examination, and olfactory testing. Incidence of specific olfaction-related hazardous events (ie, burning pots and/or pans, starting a fire while cooking, inability to detect gas leaks, inability to detect smoke, and ingestion of toxic substances or spoiled foods) by degree of olfactory impairment. The incidence of having experienced any hazardous event progressively increased with degree of impairment: normosmic (18.0%), mildly hyposmic (22.2%), moderately hyposmic (31.2%), severely hyposmic (32.4%), and anosmic (39.2%). Over 3 decades there was no significant change in the overall incidence of hazardous events. Analysis of demographic data (age, sex, race, smoking status, and etiology) revealed significant differences in the incidence of hazardous events based on age (among 397 patients <65 years, 148 [37.3%] with hazardous event, vs 31 of 146 patients ≥65 years [21.3%]; P < .001), sex (among 278 women, 106 [38.1%] with hazardous event, vs 73 of 265 men [27.6%]; P = .009), and race (among 98 African Americans, 41 [41.8%] with hazardous event, vs 134 of 434 whites [30.9%]; P = .04). Increased level of olfactory impairment portends an increased risk of experiencing a hazardous event. Risk is further impacted by individuals' age, sex, and race. These results may assist health care practitioners in counseling patients on the risks associated with olfactory impairment.

40 CFR 63.9020 - What performance tests and other procedures must I use?

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Hydrochloric Acid Production...) If you use a caustic scrubber control device or a water scrubber control device, the design...

40 CFR 63.5715 - What operating limits must I meet?

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission Standards for Hazardous Air Pollutants for Boat Manufacturing Demonstrating Compliance for Open Molding Operations Controlled by Add-on Control Devices § 63.5715 What operating limits must I meet? (a) For open...

OSHA safety requirements and the general duty clause.

PubMed

Mills, Anne C; Chillock, Cynthia A; Edelman, Harold; Mills, Shannon E

2005-03-01

Dental offices and clinics are subject to the same general safety requirements as other workplaces. Current guidelines, inspections, education, and training focus on infectious disease as the major workplace hazard for dental health care personnel (DHCP). However, the Occupational Safety and Health Administration has cited an increasing variety and number of general safety hazards during inspections of dental offices. A review of the general safety requirements for personal protective equipment and fire safety as they relate to DHCP follows. The authors discuss the responsibility of both employers and employees to perform workplace hazard evaluation and to implement education, engineering controls, and work practice controls to minimize their exposure to recognized and emerging workplace hazards.

75 FR 56972 - Pipeline Safety: Control Room Management/Human Factors

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Parts... Factors AGENCY: Pipeline and Hazardous Materials Safety Administration (PHMSA); DOT. ACTION: Notice of...: Background There are roughly 170,000 miles of hazardous liquid pipelines, 295,000 miles of gas transmission...

AMERICAN HEALTHY HOMES SURVEY: A NATIONAL STUDY OF RESIDENTIAL RELATED HAZARDS

EPA Science Inventory

The US Environmental Protection Agency's (EPA) National Exposure Research Laboratory (NERL) and the US Department of Housing and Urban Development's (HUD) Office of Healthy Homes and Lead Hazard Control conducted a national survey of housing related hazards in US residences. The...

75 FR 53268 - National Oil and Hazardous Substances Pollution Contingency Plan; National Priorities List...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-31

... relations, Penalties, Reporting and recordkeeping requirements, Superfund, Water pollution control, Water... and Hazardous Substances Pollution Contingency Plan; National Priorities List: Deletion of the..., as amended, is an appendix of the National Oil and Hazardous Substances Pollution Contingency Plan...

An audit strategy for progression-free survival

PubMed Central

Dodd, Lori E.; Korn, Edward L.; Freidlin, Boris; Gray, Robert; Bhattacharya, Suman

2010-01-01

Summary In randomized clinical trials, the use of potentially subjective endpoints has led to frequent use of blinded independent central review (BICR) and event adjudication committees to reduce possible bias in treatment effect estimators based on local evaluations (LE). In oncology trials, progression-free survival (PFS) is one such endpoint. PFS requires image interpretation to determine whether a patient’s cancer has progressed, and BICR has been advocated to reduce the potential for endpoints to be biased by knowledge of treatment assignment. There is current debate, however, about the value of such reviews with time-to-event outcomes like PFS. We propose a BICR audit strategy as an alternative to a complete-case BICR to provide assurance of the presence of a treatment effect. We develop an auxiliary-variable estimator of the log-hazard ratio that is more efficient than simply using the audited (i.e., sampled) BICR data for estimation. Our estimator incorporates information from the LE on all the cases and the audited BICR cases, and is an asymptotically unbiased estimator of the log-hazard ratio from BICR. The estimator offers considerable efficiency gains that improve as the correlation between LE and BICR increases. A two-stage auditing strategy is also proposed and evaluated through simulation studies. The method is applied retrospectively to a large oncology trial that had a complete-case BICR, showing the potential for efficiency improvements. PMID:21210772

Cytogenetic clonal evolution in myelodysplastic syndromes is associated with inferior prognosis.

PubMed

Neukirchen, Judith; Lauseker, Michael; Hildebrandt, Barbara; Nolting, Ann-Christin; Kaivers, Jennifer; Kobbe, Guido; Gattermann, Norbert; Haas, Rainer; Germing, Ulrich

2017-12-01

The karyotype of bone marrow cells at the time of diagnosis is a strong prognostic parameter for overall survival as well as acute myeloid leukemia (AML) progression in patients with myelodysplastic syndromes (MDS). However, to the authors' knowledge, few data exist regarding the prognostic impact of cytogenetic clonal evolution during the course of MDS. The authors evaluated follow-up karyotype analyses in 549 patients from the Dusseldorf MDS Registry. Clonal evolution was detectable in 24% of the entire cohort and in 18% of 294 patients receiving best supportive care. The authors noted a clear adverse effect of clonal evolution on the risk of leukemic transformation (hazard ratio, 2.233; P = .036) and overall survival (hazard ratio, 3.677; P<.001). The authors also analyzed the prognostic influence of subclones detectable at the time of diagnosis. Again, such a finding was associated with a significantly shorter overall survival and a higher 5-year-probability of acute myeloid leukemia progression (30% vs 22%). The results of the current study support the belief that follow-up karyotype analyses should be performed, especially in patients with lower-risk and intermediate-risk MDS, to identify those patients who are at higher risk of disease progression and therefore might benefit from earlier or more intensive treatment. Cancer 2017;123:4608-4616. © 2017 American Cancer Society. © 2017 American Cancer Society.

Serum urate at trial entry and ALS progression in EMPOWER.

PubMed

O'Reilly, ÉIlis J; Liu, Dawei; Johns, Donald R; Cudkowicz, Merit E; Paganoni, Sabrina; Schwarzschild, Michael A; Leitner, Melanie; Ascherio, Alberto

2017-02-01

Our objective was to determine whether serum urate predicts ALS progression. A study population comprised adult participants of EMPOWER (n = 942), a phase III clinical trial to evaluate the efficacy of dexpramipexole to treat ALS. Urate was measured in blood samples collected during enrollment as part of the routine block chemistry. We measured outcomes by combined assessment of function and survival rank (CAFs), and time to death, by 12 months. Results showed that in females there was not a significant relation between urate and outcomes. In males, outcomes improved with increasing urate (comparing highest to lowest urate quartile: CAFS was 53 points better with p for trend = 0.04; and hazard ratio for death was 0.60 with p for trend = 0.07), but with adjustment for body mass index (BMI) at baseline, a predictor of both urate levels and prognosis, associations were attenuated and no longer statistically significant. Overall, participants with urate levels equal to or above the median (5.1 mg/dl) appeared to have a survival advantage compared to those below (hazard ratio adjusted for BMI: 0.67; 95% confidence interval 0.47-0.95). In conclusion, these findings suggest that while the association between urate at baseline and ALS progression is partially explained by BMI, there may be an independent beneficial effect of urate.

Expression of decoy receptor 3 in kidneys is associated with allograft survival after kidney transplant rejection.

PubMed

Weng, Shuo-Chun; Shu, Kuo-Hsiung; Wu, Ming-Ju; Wen, Mei-Chin; Hsieh, Shie-Liang; Chen, Nien-Jung; Tarng, Der-Cherng

2015-09-03

Decoy receptor 3 (DcR3) expression in kidneys has been shown to predict progression of chronic kidney disease. We prospectively investigated a cohort comprising 96 renal transplant recipients (RTRs) undergoing graft kidney biopsies. Computer-assisted quantitative immunohistochemical staining value of DcR3 in renal tubular epithelial cells (RTECs) was used to determine the predictive role of DcR3 in kidney disease progression. The primary end point was doubling of serum creatinine and/or graft failure. A multivariate Cox proportional hazards model was used to assess the risk of DcR3 expression in rejected kidney grafts toward the renal end point. In total, RTRs with kidney allograft rejection were evaluated and the median follow-up was 30.9 months. The greater expression of DcR3 immunoreactivity in RTECs was correlated with a higher rate of the histopathological concordance of acute T cell-mediated rejection. Compared with 65 non-progressors, 31 progressors had higher DcR3 expression (HDE) regardless of the traditional risk factors. Cox regression analysis showed HDE was significantly associated with the risk of renal end point with a hazard ratio of 3.19 (95% confidence interval, 1.40 to 7.27; P = 0.006) after adjusting for other variables. In repetitive biopsies, HDE in tissue showed rapid kidney disease progression due to persistent inflammation.