NATO Special Operations Forces Medical Engagements and Partnering Course: Initial Curriculum Recommendations from the NSHQ SOFMEP Committee.

PubMed

Alderman, Shawn M; Arvidsson, C Jimmy; Boedecker, Ben H; Durck, Craig H; Ferguson, Jason L; Harreld, Chad E; House, John H; Irizarry, Daniel J; Oshiki, Michael S; Sanchack, Kristian E; Torres, John E

2012-01-01

Military partnering operations and military engagements with host nation civil infrastructure are fundamental missions for NATO Special Operations Forces (SOF) conducting military assistance operations. Unit medical advisors are frequently called upon to support partnering operations and execute medical engagements with host nation health systems. As a primary point of NATO SOF medical capability development and coordination, the NATO Special Operations Headquarters (NSHQ) sought to create a practical training opportunity in which medical advisors are taught how to prepare for, plan, and execute these complex military assistance operations. An international committee of SOF medical advisors, planners and teachers was assembled to research and develop the curriculum for the first NSHQ SOF Medical Engagement and Partnering (SOFMEP) course. The committee found no other venues offering the necessary training. Furthermore, a lack of a common operating language and inadequate outcome metrics were identified as sources of knowledge deficits that create confusion and inhibit process improvement. These findings provided the foundation of this committee?s curricular recommendations. The committee constructed operational definitions to improve understanding and promote dialogue between medical advisors and commanders. Active learning principles were used to construct a curriculum that engages learners and enhances retention of new material. This article presents the initial curriculum recommendations for the SOFMEP course, which is currently scheduled for October 2012. 2012.

Dietary Supplements for Musculoskeletal Pain: Science Versus Claims.

PubMed

Crawford, Cindy; Saldanha, Leila; Costello, Rebecca; Deuster, Patricia A

2018-01-01

Special Operations Forces (SOF) face unique challenges that manifest themselves both mentally and physically. The extremes of training and combat can affect the readiness to perform at peak levels, especially when confronted with musculoskeletal pain. Many SOF Operators turn to dietary supplements in hopes of gaining an edge. Although some supplements are now being marketed for pain, decisions to use these products need to be driven by information that is evidence based. We describe SOF-specific evidence-based recommendations for the use of dietary ingredients for pain that emerged from a rigorous scientific evaluation. These recommendations are compared with the label claims made in the commercial market by companies selling products to combat musculoskeletal pain. This information can be used by the SOF medical community to assist Operators in making informed decisions when considering or selecting dietary supplements for maintaining and optimizing performance. 2018.

A Theory of Special Operations: The Origin, Qualities, and Use of SOF

DTIC Science & Technology

2007-10-01

because rough men stand ready in the night to visit violence on those who would do us harm. — George Orwell Special Operations Forces (SOF) are small...induced by the gunpowder revolution and the industrial revolution , did not render all previous understandings of war irrelevant. They revolutionized ...for Counter-Terrorism Studies, The Fletcher School, Tufts University and JSOU Senior Fellow George Emile Irani Ph.D., International Relations

Navy Irregular Warfare and Counterterrorism Operations: Background and Issues for Congress

DTIC Science & Technology

2017-03-21

appropriation account. Regarding this funding request, DOD states that The Underwater Systems line item procures dry and wet combat submersibles...modifications, and field changes to the Dry Deck Shelter (DDS), and various systems and components for Special Operations Forces (SOF) Combat Diving...environments. The Dry Combat Submersibles (DCS) will provide the capability to insert and extract SOF and/or payloads into denied areas from strategic

2011 Special Operations Forces Industry Conference

DTIC Science & Technology

2011-05-19

to USSOCOM acquisition objectives and challenges . The Forum is designed to be an informative discussion, with audience participation, between... Challenge UNCLASSIFIED UNCLAS IF ED UNCLASSIFIED UNCLASSIFIED Acquisition Enterprise DOD and Service Labs, International Partners, Industry IR&D SOF...Experimentation • Mission – Support Concept & Solution Development for SOF Capability Gaps, Technology Thrust Areas & Warfighter Challenges • Objectives

Planning for success: desired characteristics of special operations surgeons, a pilot study.

PubMed

Campbell, Barrett H; Alderman, Shawn M

2012-01-01

Selection criteria for Special Operations Forces (SOF) physicians are often unclear to potential candidates without prior SOF experience. To date, no published career resource exists to guide the careers of physicians interested in becoming a SOF surgeon. Using a survey tool, desirable characteristics and personal attributes were identified that can be used to inform candidate career decisions and better prepare them for a future position in Special Operations. A descriptive, cross-sectional survey instrument was developed and distributed to current Army SOF Command Surgeons for further distribution to subordinate surgeons. RESULTS were analyzed as a cohort and by subordinate command. Respondents consisted of current SOF Surgeons. Uniformly, the individual characteristics most strongly desired are professionalism, being a team player, and leadership. Possessing or obtaining Airborne and Flight Surgeon qualifications prior to consideration for a surgeon position was highly desired. Residency training within Family Medicine or Emergency Medicine constituted the vast majority of specialty preference. Understanding which characteristics and attributes are desirable to current surgeons and commanders can aid physicians interested in SOF surgeon positions. Using this study and future studies can guide career planning and foster the selection of ideally trained physicians who will operate at the tip of the spear. The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government. 2012.

Special Operations Forces During the Dhofar Insurgency and in Afghanistan: A Comparative Study for German Special Operations Forces

DTIC Science & Technology

2011-04-28

rebels’ communist atheism formed unity among the counterinsurgents at the tactical level. The British SOF and the host nation’s indigenous forces...government that first had to be established and now develops its legitimacy. The communist atheism and the Sultan’s restrictive Media campaign

The Development of the Hungarian Special Operations Forces Between 2003 and 2009

DTIC Science & Technology

2011-03-01

also participated in the NATO SOF exercise “ Jackal Stone” in 2008 and 2009, along with the U.S. Task Force 1/10. These exercises provided the...exercise “ Jackal Stone” is another occasion where the 100 Ministry of Defense, Hungarian Defense Forces

What's in a Rash? Viral Exanthem Versus CBRNE Exposure: Teleconsultation Support for Two Special Forces Soldiers With Diffuse Rash in an Austere Environment.

PubMed

Lee, Howard D; Butterfield, Samuel; Maddry, Joseph; Powell, Douglas; Vasios, William N; Yun, Heather; Ferraro, David; Pamplin, Jeremy C

2018-01-01

Review clinical thought process and key principles for diagnosing weaponized chemical and biologic injuries. Clinical Context: Special Operation Forces (SOF) team deployed in an undisclosed, austere environment. Organic Expertise: Two SOF Soldiers with civilian EMT-Basic certification. Closest Medical Support: Mobile Forward Surgical Team (2 hours away); medical consults available by e-mail, phone, or video-teleconsultation. Earliest Evacuation: Earliest military evacuation from country 12-24 hours. With teleconsultation, patients departed to Germany as originally scheduled without need for Medical Evacuation. 2018.

Force of Choice: Optimizing Theater Special Operations Commands to Achieve Synchronized Effects

DTIC Science & Technology

2012-12-01

GCC Geographic Combatant Command GFM Global Force Management GSN Global SOF Network (aka EGSN) IA Interagency IATF Interagency Task Force...and through African partners.75 SOCOM NCR was chosen because it is a primary outgrowth of the SOCOM Interagency Task Force ( IATF ), and the...result, SOCOM established the IATF and Special Operations Support Teams (SOST). While the IATF remained at SOCOM Headquarters at MacDill AFB, the

Strike Operations: Contingency Operations with Light-Heavy-Special Operations Forces.

DTIC Science & Technology

1991-06-07

based on actual training exercises and contingency operations conducted by light, heavy, and SOF elements. This study concludes that light, heavy and... based on balanced develcopnt, security, neutralization and mobilization. The host goverrnmt inplements social, econcmic, and political programs which...as a mixed force. The doctrine, tactics, and techniques are applied to a likely contingency scenerio of a "Strike Operation" to provide a base model

Long-Term Counterinsurgency Strategy: Maximizing Special Operations and Airpower

DTIC Science & Technology

2010-02-01

operations forces possess a repertoire of capabilities and attributes which impart them with unique strategic utility. “That utility reposes most...flashlight), LTMs are employed in a similar role to cue aircrews equipped with Night Vision Devices (NVDs). Concurrently, employment of small laptop...Special Operations Forces (PSS-SOF) and Precision Fires Image Generator (PFIG) have brought similar benefit to the employment of GPS/INS targeted weapons

Advice from SOF on the Use of SOF for the Next Administration

DTIC Science & Technology

2016-10-01

diversity of the force via greater recruitment of minorities and women , and place an emphasis on their development, mentorship, and retention . Also...expected to have.” Others 5 pointed out that SOF are experts at marrying the lowest and highest levels of technology to produce unique...National Mission Force. Attendees understood the decision to open all SOF roles to women , but were sensitive to potential pressures to lower

Rethinking Heat Injury in the SOF Multipurpose Canine: A Critical Review.

PubMed

Baker, Janice L; Hollier, Paul J; Miller, Laura; Lacy, Ward A

2012-01-01

Heat injury is a significant concern of the Special Operations Forces Multipurpose Canine (SOF MPC). The unique athletic abilities and working environment of the SOF MPC differ from that of companion dogs or even conventional military working dogs. This should be considered in the prevention, diagnosis, and treatment of heat injury of the SOF MPC. A critical review of the literature on canine heat injury as it pertains to working dogs demonstrates limited scientific evidence on best practices for immediate clinical management of heat injury in SOF MPCs. A majority of management guidelines for heat injury in veterinary reference books and journals are based on review articles or professional opinion of the author vs. evidence from original research. In addition, guidelines are written primarily for companion animal populations vs. SOF MPCs and focus on measures to be undertaken in a clinical setting vs. point of injury. The phenomenon of ?circular referencing? is also prevalent in the heat injury literature. Current guidelines supported by review articles and textbooks often provide no citation or cite other review articles for clinical standards such as normal temperature ranges, treatment methods, and recurrence of heat injury. This ?circular referencing? phenomenon misrepresents anecdotal evidence and professional opinion as scientifically validated, reinforcing concepts and recommendations that are not truly supported by the evidence. Further study is needed to fully understand heat injury in SOF MPCs and how this applies to prevention, diagnosis and treatment guidelines. In order to provide SOF canine programs with best clinical advice and care, SOF Veterinarians must make clinical judgments based on evaluation of the most accurate and valid information possible. Clinical guidelines are fluid and should be reviewed regularly for relevance to the defined population in question. Clinical Guidelines should also be utilized as guiding principles in conjunction with clinical judgment vs. dictate a clinical protocol. SOF veterinarians as the veterinary support asset to SOF MPC programs should be clinically competent as well as versed in evidence based medicine practices to provide the cutting edge clinical support that is required to keep SOF MPCs operating in modern warfare environments. 2012.

Oxygen Toxicity and Special Operations Forces Diving: Hidden and Dangerous

PubMed Central

Wingelaar, Thijs T.; van Ooij, Pieter-Jan A. M.; van Hulst, Rob A.

2017-01-01

In Special Operations Forces (SOF) closed-circuit rebreathers with 100% oxygen are commonly utilized for covert diving operations. Exposure to high partial pressures of oxygen (PO2) could cause damage to the central nervous system (CNS) and pulmonary system. Longer exposure time and higher PO2 leads to faster development of more serious pathology. Exposure to a PO2 above 1.4 ATA can cause CNS toxicity, leading to a wide range of neurologic complaints including convulsions. Pulmonary oxygen toxicity develops over time when exposed to a PO2 above 0.5 ATA and can lead to inflammation and fibrosis of lung tissue. Oxygen can also be toxic for the ocular system and may have systemic effects on the inflammatory system. Moreover, some of the effects of oxygen toxicity are irreversible. This paper describes the pathophysiology, epidemiology, signs and symptoms, risk factors and prediction models of oxygen toxicity, and their limitations on SOF diving. PMID:28790955

Association of prospective lower extremity musculoskeletal injury and musculoskeletal, balance, and physiological characteristics in Special Operations Forces.

PubMed

Keenan, Karen A; Wohleber, Meleesa F; Perlsweig, Katherine A; Baldwin, Thomas M; Caviston, Michael; Lovalekar, Mita; Connaboy, Christopher; Nindl, Bradley C; Beals, Kim

2017-11-01

Previous research has examined lower extremity (LE) musculoskeletal injury (MSI) patterns and risk factors in Special Operations Forces (SOF) trainees, conventional military personnel, and athletes; however, it is unclear if SOF have the same patterns/risk factors. This study aimed to determine the association of musculoskeletal, balance, and physiological characteristics with LE MSI in SOF. Cohort study. A total of 726 Air Force (N=140), Navy Sea, Air, and Land (N=301), and Special Warfare Combatant Crewmen (N=285) SOF (age=25.72±4.77years, height=178.34±6.63cm, weight=84.28±9.03kg) participated in laboratory testing, including: LE muscular strength and flexibility; balance; body composition; anaerobic power/capacity; and aerobic capacity. Medical charts were reviewed for LE MSI 365days following laboratory testing. Participants were assigned by injury status and laboratory data stratified by tertile. Chi-square statistics were calculated to determine the frequency of LE MSI across tertiles for each characteristic. There was a significant association between LE MSI and: ankle inversion strength (weaker side: Χ(2)=17.703; stronger side: Χ(2)=18.911; p≤0.001); ankle eversion/inversion strength ratio (lower side: Χ(2)=13.456; higher side: Χ(2)=16.885; p≤0.001); hamstring flexibility (less flexible: Χ(2)=19.930; more flexible Χ(2)=15.185; p≤0.001); gastrocnemius-soleus flexibility (less flexible: Χ(2)=7.889, p=0.019); dynamic balance asymmetry (Χ(2)=7.444, p=0.024); Vestibular and Preference ratios (Χ(2)=9.124, p=0.010 and Χ(2)=6.572, p=0.037, respectively); and aerobic capacity (Χ(2)=13.935, p=0.001). Characteristics associated with LE MSI are unique in SOF. Human performance program initiatives should include efforts to optimize ankle strength and flexibility, maintain moderate hamstring flexibility, expand dynamic balance strategies, and maximize aerobic capacity to reduce LE MSI risk. Copyright © 2017 Sports Medicine Australia. All rights reserved.

9/11 and Canadian Special Operations Forces: How 40 Selected Men Indelibly Influenced the Future of the Force

DTIC Science & Technology

2013-05-23

Terrorism strategy/plan and an unresolved dialogue surrounding special operations aviation (SO Avn ) deficiencies are but two specific examples of...Regiment-like sister unit (the Canadian Special Operations Regiment (CSOR)) is created, an expanded SO Avn capability is formed (427 Special Operations...an adequate SO Avn Squadron under command, maturing CJIRU and CSOR sister units and lately a small but effective SOF training organization.127

Smart Power and U.S. National Strategy

DTIC Science & Technology

2013-08-01

COIN strategy being used in Afghanistan a “fran- chise business and the variations among the franchises is enormous.”327 The strategy being followed...ment—i.e. force rotation and regeneration while sustaining an operational presence—at a high operational tempo and maintaining SOF-unique quali- ties...Admiral Olson’s views regarding USSOCOM’s growth in force and the increased operational tempo issues. Congressional support is being sought for

Understanding USSOCOM and US Marine Corps Roles in Crisis Response and Limited Contingency Operations

DTIC Science & Technology

2013-04-15

are required. For example exploring MAGTF deployments on Littoral Combat Ships or building GCE , LCE, and ACE units that support company level ...objective raids that is likely due to the level of training and in the case of peace enforcement it is likely due to the regional focus of SOF...formed the SOF units and task forces over this period. The inherent “jointness” of USSOCOM is apparent at the lowest tactical level which contrasts

Building Coalitions for Humanitarian Operations -- Operation Provide Comfort

DTIC Science & Technology

1992-04-15

When notified of his new appointment, General Shalilkashvili was the Deputy Commander of United States Army Europe (USAREUR). He arrived at the...refugees. EUCOM selected Air Force Major General James L. Jamerson as the commander of JTF-PC. General Jamerson was serving as the Deputy Commander of U.S...located with JTF-PC headquarters. AFFOR was under the command of Air Force Brigadier General James L. Hobson, Jr. The SOF forces were under the

Proper Employment of Special Operations Forces: Geographic Combatant Command Planner Considerations for Special Operations Forces Employment

DTIC Science & Technology

2010-04-01

October 2008, in Figure 2-1 below. TACON Best Practices 1) For the respective commanders to jointly determine the required tasks and organize the... organization . 2) Provide the gaining commander of the TACON force the requisite expertise to effectively plan and exercise TACON of the force. We sometimes...the TACON of SOF is given to an organization other than the parent organization . As changes occur, a plan may change requiring a shift in end state

U.S. Special Operations Forces (SOF): Background and Issues for Congress

DTIC Science & Technology

2016-04-08

platforms to include AC-130U, AC-130W, U-28, MQ-1, MQ-9, C-145, C-146 as well as small unmanned aerial systems ( SUAS ), Combat Aviation Advisors, medical...forces can operate in small groups and have the ability to quickly deploy from Navy ships, submarines and aircraft , overseas bases, and forward-based...given greater responsibility for planning and conducting worldwide counterterrorism operations. U.S. Special Operations Command (USSOCOM) has about

On the Job Education: An Alternative for Special Operations Forces Officers

DTIC Science & Technology

2010-04-01

flexibility of the ACSC OLMP has great advantages to support the alternative education for SOF majors. The OLMP executes the entire curriculum every...AIR COMMAND AND STAFF COLLEGE AIR UNIVERSITY ON THE JOB EDUCATION : AN ALTERNATIVE FOR SPECIAL OPERATIONS FORCES OFFICERS by...relatively low compared to conventional officers. Conventional officers have educational institutions at the major level that prepare them to understand

U.S. Special Operations Forces (SOF): Background and Issues for Congress

DTIC Science & Technology

2017-01-06

Defense. The Assistant Secretary of Defense for Special Operations and Low Intensity Conflict ( ASD /SOLIC), a member of the Office of the Secretary of...Defense for Policy (OSD-P), provides civilian oversight over USSOCOM activities. The current ASD /SOLIC is Mr. Michael Lumpkin, a former Navy SEAL...supports U.S. European Command; CCSA is the Army;  Special Operations Command Central (SOCCENT), MacDill Air Force Base, FL; supports U.S

Choosing to Win: How Sof Can Better Select Partners for Capacity Building

DTIC Science & Technology

2014-06-01

countries will yield the best results when SOF are employed to build capacity. This thesis uses two RAND reports—What Works Best When Building...environment, planners will be forced to make difficult decisions about which countries will yield the best results when SOF are employed to build...deliberate planning, global posture, global force management, and nuclear weapons planning.20 The GEF also directs the combatant commanders to

Coast Guard SOF

DTIC Science & Technology

2006-02-01

Forces units into known Viet Cong (VC) strongholds, participating in direct action raids on VC junk bases, conducting psychological operations, and...and General McClure established the Army’s Psychological Warfare Cen- ter and 10th Special Forces Group in 1952.62 President Kennedy’s interest in...counterinsurgency warfare paved the way for the “Green Beret,” for which Army Special Forces renamed the Psychological Warfare Center the JFK Special

Public health foodborne illness case study during a Special Operations Forces deployment to South America.

PubMed

McCown, Michael; Grzeszak, Benjamin

2010-01-01

Although many public health articles have been published detailing foodborne illness outbreaks, a medical literature search revealed no articles that detail a case study or a specific response of a deployed U.S. military unit to a potential foodborne illness. This article describes a recent public health case study of a U.S. Special Operations Forces (SOF) team sickened while deployed to South America. It highlights public health factors which may affect U.S. personnel deployed or serving overseas and may serve as a guide for a deployed SOF medic to reference in response to a potential food- or waterborne illness outbreak. Eight food samples and five water samples were collected. The food samples were obtained from the host nation kitchen that provided food to the SOF team. The water samples were collected from the kitchen as well as from multiple sites on the host nation base. These samples were packaged in sterile containers, stored at appropriate temperatures, and submitted to a U.S. Army diagnostic laboratory for analysis. Laboratory results confirmed the presence of elevated aerobic plate counts (APCs) in the food prepared by the host nation and consumed by the SOF team. High APCs in food are the primary indicator of improper sanitation of food preparation surfaces and utensils. This case study concluded that poor kitchen sanitation, improper food storage, preparation, and/or holding were the probable conditions that led to the team?s symptoms. These results emphasize the importance of ensuring safe food and water for U.S. personnel serving overseas, especially in a deployment or combat setting. Contaminated food and/or water will negatively impact the health and availability of forces, which may lead to mission failure. The SOF medic must respond to potential outbreaks and be able to (1) critically inspect food preparation areas and accurately advise commanders in order to correct deficiencies and (2) perform food/water surveillance testing consistently throughout a deployment and at any time in response to a potential outbreak.

Androgens and Androgen Derivatives: Science, Myths, and Theories: Explored From a Special Operations Perspective.

PubMed

Givens, Melissa L; Deuster, Patricia

2015-01-01

Androgen use outside of legitimate medical therapy is a perceived concern that is drawing attention across military and specifically Special Operations Forces (SOF) communities. For leadership and the medical community to properly address the issue and relate to those individuals who are using or considering use, it will be crucial to understand the scope of the problem. Limited data suggest that the prevalence of androgen use may be increasing, and inferences made from the scientific literature suggest that SOF may be a population of concern. While risks of androgen use are well known, there are little data specific to military performance that can be applied to a rigorous risk:benefit analysis, allowing myths and poorly supported theories to perpetuate within the community. Further efforts to define the potential benefits balanced against the short- and long-term risks should be undertaken. Providers within the SOF community should arm themselves with information to engage androgen users and leadership in meaningful discussion regarding androgen use. 2015.

By Force or by Fraud: Optimizing U.S. Information Strategy With Deception

DTIC Science & Technology

2016-06-01

IV. CASE- STUDY ASSESSMENTS ........................................................................37 A. CASE 1 OVERVIEW: THE DHOFAR REBELLION, 1965...xvi SOF Special Operations Forces SOG Studies and Observations Group USIA United States Information Agency VC Viet Cong...The Development of Overt and Covert Propaganda Strategies,” Presidential Studies Quarterly 24, no. 2 (Spring 1994): 265. 6 Ibid. 4 USIA departments

Psychological Operations Exploitation of Foreign Internal Defense in order to Develop Enduring Strategic Partnerships

DTIC Science & Technology

2014-12-12

Role of the global Special Operation Forces (SOF) network in a resource constrained environment; that “needs to be there before the bang —in fact, to...prevent the bang !” USSOF needs to “be out there before the crisis.”29 This demonstrates that all USSOF and conventional forces, must persistently...52 Although this static is weighed favorably in line with the ability to simulate this

USSOCOM Research Topics 2011

DTIC Science & Technology

2010-01-01

Law and legal institutions G31. U.S. SOF training of foreign military/security forces “to enhance their capacity” in counterterrorism, COIN, and...engagement advice to SOF. G31. U.S. SOF training of foreign military/security forces “to enhance their capacity” in counterterrorism, COIN, and FID is a...AND SUBTITLE USSOCOM Research Topics 2011 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e

Design and skill assessment of an Operational Forecasting System for currents and sea level variability to the Santos Estuarine System - Brazil

NASA Astrophysics Data System (ADS)

Godoi Rezende Costa, C.; Castro, B. M.; Blumberg, A. F.; Leite, J. R. B., Sr.

2017-12-01

Santos City is subject to an average of 12 storm tide events per year. Such events bring coastal flooding able to threat human life and damage coastal infrastructure. Severe events have forced the interruption of ferry boat services and ship traffic through Santos Harbor, causing great impacts to Santos Port, the largest in South America, activities. Several studies have focused on the hydrodynamics of storm tide events but only a few of those studies have pursued an operational initiative to predict short term (< 3 days) sea level variability. The goals of this study are (i) to describe the design of an operational forecasting system built to predict sea surface elevation and currents in the Santos Estuarine System and (ii) to evaluate model performance in simulating observed sea surface elevation. The Santos Operational Forecasting System (SOFS) hydrodynamic module is based on the Stevens Institute Estuarine and Coastal Ocean Model (sECOM). The fully automated SOFS is designed to provide up to 71 h forecast of sea surface elevations and currents every day. The system automatically collects results from global models to run the SOFS nested into another sECOM based model for the South Brazil Bight (SBB). Global forecasting results used to force both models come from Mercator Ocean, released by Copernicus Marine Service, and from the Brazilian developments on the Regional Atmospheric Modeling System (BRAMS) stablished by the Center for Weather Forecasts and Climate Studies (with Portuguese acronym CPTEC). The complete routines task take about 8 hours of run time to finish. SOFS was able to hindcast a severe storm tide event that took place in Santos on August 21-22, 2016. Comparisons with observed sea level provided skills of 0.92 and maximum root mean square errors of 25 cm. The good agreement with observed data shows the potential of the designed system to predict storm tides and to support both human and assets protection.

Joint Special Operations University SOF-Power Workshop: A Way Forward for Special Operations Theory and Strategic Art

DTIC Science & Technology

2011-08-01

participants‘ particular points of view and may be helpful in researching, developing, testing, and explaining theory. The Secret War in Laos was...Jan 1985. Tse -Tung, Mao. On Guerrilla Warfare. Praeger, New York: 1961. The Use and Utility of Force; Force Fungibles Art, Robert J. and...Penguin Books, New York: 1968. Griffith, Samuel B., (BrigGen (Ret) USMC). On Guerrilla Warfare – Mao Tse -Tung. Praeger, New York: 1961

Zoonotic and infectious disease surveillance in Central America: Honduran feral cats positive for toxoplasma, trypanosoma, leishmania, rickettsia, and Lyme disease.

PubMed

McCown, Michael; Grzeszak, Benjamin

2010-01-01

A recent zoonotic and infectious disease field surveillance study in Honduras resulted in the discovery of Toxoplasma, Trypanosoma, Leishmania, Rickettsia, and Lyme disease with statistically high prevalence rates in a group of feral cats. All five diseases--Toxoplasmosis, Trypanosomiasis, Leishmaniasis, Rickettsiosis, and Lyme disease--were confirmed in this group of cats having close contact to local civilians and U.S. personnel. These diseases are infectious to other animals and are known to infect humans as well. In the austere Central and South American sites that Special Operations Forces (SOF) medics are deployed, the living conditions and close quarters are prime environments for the potential spread of infectious and zoonotic disease. This study?s findings, as with previous veterinary disease surveillance studies, emphasize the critical need for continual and aggressive surveillance for zoonotic and infectious disease present within animals in specific areas of operation (AO). The importance to SOF is that a variety of animals may be sentinels, hosts, or direct transmitters of disease to civilians and service members. These studies are value-added tools to the U.S. military, specifically to a deploying or already deployed unit. The SOF medic must ensure that this value-added asset is utilized and that the findings are applied to assure Operational Detachment-Alpha (SFOD-A) health and, on a bigger scale, U.S. military force health protection and local civilian health. © 2010.

Reexamining Ground SOF Command and Control: Does One Size Fit All

DTIC Science & Technology

2016-12-01

Case studies covering varying methods of employment of special operations forces in limited contingencies will be utilized. The case studies focus on ...operating environment, much like an open organization. This research examines three case studies including operation JUST CAUSE in Panama, RESTORE HOPE in... case studies , the HQ elements formed around existing homogenous commands and not a Theater Special Operations Command (TSOC) staff with limited

Prediction equation for estimating total daily energy requirements of special operations personnel.

PubMed

Barringer, N D; Pasiakos, S M; McClung, H L; Crombie, A P; Margolis, L M

2018-01-01

Special Operations Forces (SOF) engage in a variety of military tasks with many producing high energy expenditures, leading to undesired energy deficits and loss of body mass. Therefore, the ability to accurately estimate daily energy requirements would be useful for accurate logistical planning. Generate a predictive equation estimating energy requirements of SOF. Retrospective analysis of data collected from SOF personnel engaged in 12 different SOF training scenarios. Energy expenditure and total body water were determined using the doubly-labeled water technique. Physical activity level was determined as daily energy expenditure divided by resting metabolic rate. Physical activity level was broken into quartiles (0 = mission prep, 1 = common warrior tasks, 2 = battle drills, 3 = specialized intense activity) to generate a physical activity factor (PAF). Regression analysis was used to construct two predictive equations (Model A; body mass and PAF, Model B; fat-free mass and PAF) estimating daily energy expenditures. Average measured energy expenditure during SOF training was 4468 (range: 3700 to 6300) Kcal·d- 1 . Regression analysis revealed that physical activity level ( r  = 0.91; P  < 0.05) and body mass ( r  = 0.28; P  < 0.05; Model A), or fat-free mass (FFM; r  = 0.32; P  < 0.05; Model B) were the factors that most highly predicted energy expenditures. Predictive equations coupling PAF with body mass (Model A) and FFM (Model B), were correlated ( r  = 0.74 and r  = 0.76, respectively) and did not differ [mean ± SEM: Model A; 4463 ± 65 Kcal·d - 1 , Model B; 4462 ± 61 Kcal·d - 1 ] from DLW measured energy expenditures. By quantifying and grouping SOF training exercises into activity factors, SOF energy requirements can be predicted with reasonable accuracy and these equations used by dietetic/logistical personnel to plan appropriate feeding regimens to meet SOF nutritional requirements across their mission profile.

Advance Force Operations: The Middleweight Force’s Essential Role in the Joint Operations

DTIC Science & Technology

2013-04-18

solution selected, the Marine Corps will have to invest in increasing the training and readiness standards of its expeditionary forces. If the Marine Corps...28 Limited common AFO training ………………………………………… 31 Inadequate resourcing…………………………………………………… 32 SOF is the solution...delta while the newly formed SEALs began in Vietnam as advisors training the South Vietnamese in combat diving, demolitions, and guerrilla/anti

Roles for SOF in a Staggering Nigeria

DTIC Science & Technology

2009-04-01

languages and approximately 350 ethno-linguistic groups, Nigeria can indubitably be dubbed a cultural patchwork. Three dominant groups, the Ibo, Yoruba ...critical factors ................................................................................................................ 4 A cultural patchwork...continue to be the U.S. military force of choice for operations and exercises within Africa.”10 Culturally attuned, experienced in working with

Special Operations Forces Language and Culture Needs Assessment: Cultural Awarenes and Knowledge Training

DTIC Science & Technology

2010-11-01

hours. Training must incorporate language, culture, norms, customs, etiquette , religion, etc as to how not offend the local ethnicities.” SOF Leader...consensus. The frequency of occurrence for each theme is presented in this report. Analysis of the focus group data followed the same protocol , except

Validity, Reliability, and Performance Determinants of a New Job-Specific Anaerobic Work Capacity Test for the Norwegian Navy Special Operations Command.

PubMed

Angeltveit, Andreas; Paulsen, Gøran; Solberg, Paul A; Raastad, Truls

2016-02-01

Operators in Special Operation Forces (SOF) have a particularly demanding profession where physical and psychological capacities can be challenged to the extremes. The diversity of physical capacities needed depend on the mission. Consequently, tests used to monitor SOF operators' physical fitness should cover a broad range of physical capacities. Whereas tests for strength and aerobic endurance are established, there is no test for specific anaerobic work capacity described in the literature. The purpose of this study was therefore to evaluate the reliability, validity, and to identify performance determinants of a new test developed for testing specific anaerobic work capacity in SOF operators. Nineteen active young students were included in the concurrent validity part of the study. The students performed the evacuation (EVAC) test 3 times and the results were compared for reliability and with performance in the Wingate cycle test, 300-m sprint, and a maximal accumulated oxygen deficit (MAOD) test. In part II of the study, 21 Norwegian Navy Special Operations Command operators conducted the EVAC test, anthropometric measurements, a dual x-ray absorptiometry scan, leg press, isokinetic knee extensions, maximal oxygen uptake test, and countermovement jump (CMJ) test. The EVAC test showed good reliability after 1 familiarization trial (intraclass correlation = 0.89; coefficient of variance = 3.7%). The EVAC test correlated well with the Wingate test (r = -0.68), 300-m sprint time (r = 0.51), and 300-m mean power (W) (r = -0.67). No significant correlation was found with the MAOD test. In part II of the study, height, body mass, lean body mass, isokinetic knee extension torque, maximal oxygen uptake, and maximal power in a CMJ was significantly correlated with performance in the EVAC test. The EVAC test is a reliable and valid test for anaerobic work capacity for SOF operators, and muscle mass, leg strength, and leg power seem to be the most important determinants of performance.

Implications Of The Security Cooperation Office Transition in Afghanistan For Special Operations Forces: An Abbreviated Report of the Study’s Primary Findings

DTIC Science & Technology

2017-01-01

for working in an interagency environment can lead to mission success. From the Iraq case study , one former U.S. Forces–Iraq official felt that...of six historical case studies in which the mission of special operations forces (SOF) in country transitioned over time to some level of inclusion...explanation of the methodology applied for case study selec- tion, as well as adopted interview protocols, are provided in the long- form version of

Role of Special Forces Liaison Elements in Future Multinational Operations

DTIC Science & Technology

2002-05-01

SOF simply with UW and the “old special-ops bugaboo of poor command and control and lack of coordination” that was displayed during Desert One, the...funding and allocating time for training and education in the areas of cultural, tactical, and technical expertise is not only a good investment for

Low stiffness floors can attenuate fall-related femoral impact forces by up to 50% without substantially impairing balance in older women.

PubMed

Laing, Andrew C; Robinovitch, Stephen N

2009-05-01

Low stiffness floors such as carpet appear to decrease hip fracture risk by providing a modest degree of force attenuation during falls without impairing balance. It is unknown whether other compliant floors can more effectively reduce impact loads without coincident increases in fall risk. We used a hip impact simulator to assess femoral neck force for four energy-absorbing floors (SmartCell, SofTile, Firm Foam, Soft Foam) compared to a rigid floor. We also assessed the influence of these floors on balance/mobility in 15 elderly women. We observed differences in the mean attenuation in peak femoral neck force provided by the SmartCell (24.5%), SofTile (47.2%), Firm Foam (76.6%), and Soft Foam (52.4%) floors. As impact velocity increased from 2 to 4m/s, force attenuation increased for SmartCell (from 17.3% to 33.7%) and SofTile (from 44.9% to 51.2%), but decreased for the Firm Foam (from 87.0% to 64.5%) and Soft Foam (from 66.1% to 37.9%) conditions. Regarding balance, there were no significant differences between the rigid, SmartCell, and SofTile floors in proportion of successful trials, Get Up and Go time, balance confidence or utility ratings. SofTile, Firm Foam, and Soft Foam caused significant increases (when compared to the rigid floor) in postural sway in the anterior-posterior and medial-lateral directions during standing. However, SmartCell increased sway only in the anterior-posterior direction. This study demonstrates that two commercially available compliant floors can attenuate femoral impact force by up to 50% while having only limited influence on balance in older women, and supports development of clinical trials to test their effectiveness in high-risk settings.

The Realities of War: Assessing the Operational Risk of Revoking the Combat Exclusion Policy

DTIC Science & Technology

2013-05-23

Grenade RSOI Reception , Staging, and Onward Integration SEAD Suppression of Enemy Air Defenses SOF Special Operations Forces vii TAA Tactical Assembly...Diego Garcia[,] brought rations, cots, tents, blankets, and medical supplies, as well as refrigerated trailers , reverse-osmosis water- purification...78 In all, Desert Dragon II enabled the reception , staging, and onward integration (RSOI) of such a significant amount of combat power that the

Special Operations Forces Language and Culture Needs Assessment: Language Resources And Self-Study

DTIC Science & Technology

2010-11-12

2007; Freitas & Levine, 2004; Tuzun, 2007). SOFLO should analyze and consider the cost-benefit of providing more instructors/tutors. “I would like...instructor is generally considered an effective training solution (Blunt, 2007; Freitas & Levine, 2004; Tuzun, 2007). Additionally, some SOF operators...Simulation and Education Conference: Orlando, Fl. Freitas , S., & Levene, M. (2004). An investigation of the use of simulations and video gaming for

The Use of Special Operations Forces in Support of American Strategic Security Strategies

DTIC Science & Technology

2013-01-28

Operations Command (USSOCOM) global threats have morphed. The world has evolved from a bi-polar conflict characterized by the Cold War through what may be...the community of nations and create a more stable and thus, prosperous, world . This paper sets the strategic context for future operations, defines...transported gamers into the world of SOF on daring missions to save humanity from rogue states and international terrorists. While each is entertaining

Airland Battle and SOF: A Proposal for an Interim Doctrine for Joint Special Operations

DTIC Science & Technology

1989-05-19

of having to expand forces and create a viable command, control, communications and intelligence (C31) framework while at 3 the same time developing ... technology , not doctrine, and force development and training that is still driven by the parochial differences between service components. This study does...Fondacaro, USA, 51 pages. This study offers the Aimy’s AirLand Battle doctrine as an interim doctrine for SOFgemployment pending the develop - ment of

We Will Find A Way: Understanding the Legacy of Canadian Special Operations Forces

DTIC Science & Technology

2012-02-01

and numerous contemporary English accounts conceded that the Canadian raiders “are well known to be the most dangerous enemy of any... reckoned...of the 1st Canadian Parachute Bat- talion, at great cost and personal sacrifice, pioneered a new innovative form of warfare and demonstrated agility...The MND quickly realized the strategic impact at a relatively low cost , that even a small SOF task force could achieve. As such, he pushed for

Establish Best Practices for Supervision of Instructors

DTIC Science & Technology

2012-09-01

633. Christen, W. L., & Murphy, T. J. (1987). Inservice training and peer evaluation: An integrated program for faculty development. NASSP...describes the current state of instructional supervision in Special Operations Forces (SOF) initial acquisition training (IAT) language schools. This...leadership and Command Language Program Managers (CLPMs) related to selection, training , and resourcing. Finally, specific recommendations are provided for

Liberating the Oppressed: Research Knowledge Differentials and Ethical Investigation in Special Operations Forces Clinical Science.

PubMed

Kemplin, Kate Rocklein; Bowling, F Young

Special Operations Forces (SOF) medics do not have preparation in research knowledge that enables them to independently initiate or generate their own studies. Thus, medics rely on evidence generated by others, who are removed from medics' practice environment. Here, salient literature on research self-efficacy and the genesis of institutional review boards (IRBs) are reviewed and interpreted for contextual applications to medics' practice and initiation of studies. More publications delving into research methods are warranted to promote medics' participation and initiation of selfdirected scientific investigation, in collaboration with research scientists. 2017.

U.S. Special Operations Forces (SOF): Background and Issues for Congress

DTIC Science & Technology

2013-09-18

are routinely among the best in their field. Among them are seasoned combat veterans who cut their teeth by participating in joint special...have participated in all of our Nation’s wars and contingency operations since it was activated in 1980. Included among the places that military and...Years Defense Program for such centers, to include estimates of contributions of nations participating in such centers. (5) Any other matters that

The Evolving Requirements of the Canadian Special Operations Forces: A Future Concept Paper

DTIC Science & Technology

2005-09-01

possess an unflappable personality, a courage that Ernest Hemingway de- scribed as “grace under pressure.” 4 In addition, tact and persuasive skills...skill sets that could be easily placed under the capabilities umbrella of special op- erations. As an example, a former American SOF officer advised...operators, wearing trendy wraparound sunglasses and Nike baseball caps, resulted in media hype and, hence, political and public attention. Unfortunate

Foreign Internal Defense. Does Air Force Special Operations Have What it Takes?,

DTIC Science & Technology

1993-12-01

airlanded additional Rangers to secure the area.1" The key capability for the Combat Talon is SOF mobility, but it can contribute in several other ways as...only) or C-5 Galaxy aircraft (fig. 6). Yet, the strategic airlift to bring helicopters into theater requires large capacity runways. In addition, after...in a Honduran operation. I wanted to do a helicopter operation out along the border as an exercise with the US rangers . In order to do that, I had to

Human Capital Management of Air Force SOF: Leadership Identification, Selection and Cultivation

DTIC Science & Technology

2017-12-01

MANAGEMENT OF AIR FORCE SOF: LEADERSHIP IDENTIFICATION, SELECTION AND CULTIVATION by Paul R. Andrews Jr. Brett A. Stitt December 2017...No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for... information . Send comments regarding this burden estimate or any other aspect of this collection of information , including suggestions for reducing this

Drug-induced liver injury secondary to testosterone prohormone dietary supplement use.

PubMed

Hoedebecke, Kyle; Rerucha, Caitlyn; Maxwell, Kimberly; Butler, Jason

2013-01-01

Dietary supplementation has become progressively more prevalent, with over half of the American population reporting use of various products. An increased incidence of supplement use has been reported in the military especially within Special Operations Forces (SOF) where training regimens rival those of elite athletes. Federal regulations regarding dietary supplements are minimal, allowing for general advertisement to the public without emphasis on the potentially harmful side effects. Subsequent medical care for these negative effects causes financial burden on the military in addition to the unit?s loss of an Operator and potential mission compromise. This report reviews a case of an Operator diagnosed with drug-induced liver injury secondary to a testosterone prohormone supplement called Post Cycle II. Clinical situations like this emphasize the necessity that SOF Operators and clinicians be aware of the risks and benefits of these minimally studied substances. Providers should also be aware of the Human Performance Resource Center for Health Information and Natural Medicines Comprehensive Database supplement safety ratings as well as the Food and Drug Administration?s MedWatch and Natural Medicines WATCH, to which adverse reactions should be reported. 2013.

SOF Integration with Conventional Forces: A Doctrine Gap?

DTIC Science & Technology

2011-12-01

close tolerances, friction in an engine can be reduced considerably. However, there will always be energy lost in the system as heat. The goal is to...armed peshmerga. The combat power analysis favored the Iraqis on the ground. JSOTF planners only recourse was to rely on air power to close this gap . A...Approved for Public Release; Distribution is Unlimited SOF Integration with Conventional Forces: A Doctrine Gap ? A Monograph by MAJ Gregory M

Advising the Command: Best Practices from the Special Operations Advisory Experience in Afghanistan

DTIC Science & Technology

2015-01-01

in their spare time. They looked for opportunities to have lunch with Afghans and reportedly extended offers for dinner .18 The SMW ETT cultivated...extremely close relationships with their counterparts, in part by routinely eating with colleagues in the Afghan dining facility. They initiated the...October 21 and November 21, 2013. The practice is very much akin to that of Task Force (TF) 51, where Norwegian SOF operators eat daily meals with

Logistically Sustaining Afloat-Staged Special Operations Forces through an LPD-17 Class Single-Ship Seabase

DTIC Science & Technology

2007-03-01

simulation are analyzed using regression, statistical and marginal benefit techniques to show how the MOEs are affected by varying levels of the...being supported by the seabase increases. A large marginal benefit is realized in reducing a unit’s frequency and time spent in a balk state by...units. SOF units operate within the range of sea-based helicopter assets; therefore the risk of a ‘ bingo ’ (i.e., near empty) fuel state is nearly

The Strategic Rationale for Special Operations Forces Employment

DTIC Science & Technology

1991-06-07

the United States consider " second best strategies"O.- Since American popular opinion is generally against the ... language school 4ar SF soldiers. Some SF officers, varrant officers and noncommissioned officers, and all PSYOP and CA cfficers, study languaes at the vell...of SOF, and examines the effects of American political culture on the national security policy-making apparatus of the nation. The net result is

Accomplishing American Strategic Goals in the Middle East through Persistent Special Operations

DTIC Science & Technology

2011-06-01

LIST OF TABLES Table 1. Utility of SOF Vs . GPF in Various Conflicts ..................................................27 xii THIS PAGE...Headquarters and Support Company , 3 rd Battalion, 5 th Special Forces Group (Airborne) who have tirelessly stayed in the fight. xviii THIS... franchise industry by extending ties to regional extremist groups through financing and training. Al Qaeda Arabian Peninsula (AQAP) and Iranian influence

Female Genital Mutilation as a Concern for Special Operations and Tactical Emergency Medical Support Medics.

PubMed

Wittich, Arthur C

Female genital mutilation (FGM), frequently called female genital cutting or female circumcision, is the intentional disfigurement of the external genitalia in young girls and women for the purpose of reducing libido and ensuring premarital virginity. This traditional, nontherapeutic procedure to suppress libido and prevent sexual intercourse before marriage has been pervasive in Northern Africa, the Middle East, and the Arabian peninsula for over 2,500 years. FGM permanently destroys the genital anatomy while frequently causing multiple and serious complications. The International Federation of Gynecology and Obstetrics proposed a classification system of FGM according to the specific genital anatomy removed and the extensiveness of genital disfigurement. Although it has been ruled illegal in most countries, FGM continues to be performed worldwide. With African, Asian, and Middle Eastern immigration to the United States and Europe, western countries are experiencing FGM in regions where these immigrants have concentrated. As deployments of Special Operations Forces (SOF) increase to regions in which FGM is pervasive, and as African, Asian, and Middle Eastern immigration to the United States increases, SOF and Tactical Emergency Medical Support (TEMS) medics will necessarily be called upon to evaluate and treat complications resulting from FGM. The purpose of this article is to educate SOF/TEMS medical personnel about the history, geographic regions, classification of procedures, complications, and medical treatment of patients with FGM. 2017.

An evaluation of a pre-scaling gel (SofScale) on the ease of supragingival calculus removal.

PubMed

Smith, S R; Foyle, D M; Daniels, J

1994-09-01

SofScale is a pre-scaling gel, containing disodium EDTA and sodium lauryl sulphate, which is claimed to soften calculus and therefore facilitate its removal. 31 subjects were treated in a double blind randomised placebo controlled split mouth study to evaluate this product. Test or placebo gels were applied to the lingual surfaces of the mandibular teeth for 4 min and the time taken to complete the removal of supragingival calculus recorded. The operator recorded on which side the calculus was considered easier to remove and the patient indicated how comfortable the scaling had been. The mean calculus index was 1.99 for the SofScale group and 1.97 for the placebo. The mean time taken to complete scaling was 5.31 min for both groups. Using the Student t-test, there were no statistically significant differences (p > 0.7) between either the calculus index or time taken to complete the scaling between the groups. The operator did not consider SofScale to facilitate calculus removal and patients did not find calculus removal more comfortable when SofScale had been used. There was no increased sensitivity in the SofScale group following scaling. The results of this study do not support the use of SofScale as an adjunct to scaling.

Analyzing Sanctuary Management in the Sahel

DTIC Science & Technology

2015-06-12

Afghanistan and Iraq, but they often lack the specific skills required for the multicultural , multilingual, and multinational environment of the Sahel...article/2013/11/14/us-africa-usa-military-idUSBRE9AD1AA20131114. Arieff, Alexis. 2013. Crisis in Mali. Washington, DC: U.S. Library of Congress...2011. US Special Operations Forces (SOF): Background and Issues for Congress. Washington, DC: U.S. Library of Congress, Congressional Research Service

Organizing for Irregular Warfare: Implications for the Brigade Combat Team

DTIC Science & Technology

2007-12-01

suggestions to improve his beloved institution. xii THIS PAGE INTENTIONALLY LEFT BLANK 1 I. INTRODUCTION The Army ended up trying to fight...Secretary of Defense and supported by the Chairman of the Joint Chiefs of Staff, was improving Special Operations Forces (SOF) and general purpose...applicable to all three missions within the larger term of irregular warfare. This paper may interchange some terms due their associations from varying

Maritime SOF in the Littorals: Theoretical Principles for Successful Littoral Special Operations

DTIC Science & Technology

2016-06-01

10 5. How Will Maritime SOF Operate in the Littorals? ..................14 B. RESEARCH QUESTION...117 2. Future Research ...thank all the professors, researchers , and personnel at NPS for making this an excellent and unique learning experience. We have also received a lot

SOF Profession of Arms: A SOF Unique Requirement for Special Forces Officers Attending Intermediate Level Education

DTIC Science & Technology

2009-05-21

the State is critical to Huntington’s objective civilian control. Todor D. Tagarev21 wrote an article titled, "The Role of Military Education in...34Edward Preble papers." Library of Congress, August 25, 1801. Tagarev, Todor D. The Role ofMilitary Education in Harmonizing Civil Military

Functional Evaluation and Characterization of a Newly Developed Silicone Oil-Free Prefillable Syringe System

PubMed Central

Yoshino, Keisuke; Nakamura, Koji; Yamashita, Arisa; Abe, Yoshihiko; Iwasaki, Kazuhiro; Kanazawa, Yukie; Funatsu, Kaori; Yoshimoto, Tsuyoshi; Suzuki, Shigeru

2014-01-01

The functionality of a newly developed silicone oil-free (SOF) syringe system, of which the plunger stopper is coated by a novel coating technology (i-coating™), was assessed. By scanning electron microscopy observations and other analysis, it was confirmed that the plunger stopper surface was uniformly covered with the designed chemical composition. A microflow imaging analysis showed that the SOF system drastically reduced both silicone oil (SO) doplets and oil-induced aggregations in a model protein formulation, whereas a large number of subvisible particles and protein aggregations were formed when a SO system was used. Satisfactory container closure integrity (CCI) was confirmed by means of dye and microorganism penetration studies. Furthermore, no significant difference between the break loose and gliding forces was observed in the former, and stability studies revealed that the SOF system could perfectly show the aging independence in break loose force observed in the SO system. The results suggest that the introduced novel SOF system has a great potential and represents an alternative that can achieve very low subvisible particles, secure CCI, and the absence of a break loose force. In particular, no risk of SO-induced aggregation can bring additional value in the highly sensitive biotech drug market. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 103:1520–1528, 2014 PMID:24643749

Email Marketing for U.S. Army and Special Operations Forces (SOF) Recruiting

DTIC Science & Technology

2007-12-01

church. Users had the ability to read the church’s ministry goals and standpoint on religion . The site also contained podcasts of recent church...Cost vs. Time Table for Phone and Email The formula used in this model is: Y =CX The Decision Variables are listed below: X1= Phone Leads X2... Millennial Consumers. Consumer Behavior. United States. Molenaar, C. (2002). The Future of Marketing. Great Britain: Pearson Education

Considerations for Integrating Women into Closed Occupations in the U.S. Special Operations Forces

DTIC Science & Technology

2015-05-01

effectiveness of integration. Ideally, studies adopting an experimental design (using both test and control groups ) would be preferred, but sample sizes may...data -- a survey of SOF personnel and a series of focus group discussions -- collected by the research team regarding the potential challenges to... controlled positions. This report summarizes our research , analysis, and conclusions. We used a mixed-methods approach. We reviewed the current state of

The Global Special Operations Forces Network from a Partner-Nation Perspective

DTIC Science & Technology

2014-12-01

in networks vs . management of Networks. ................................80  Figure 17.  A national SOF network with SOCOM as the manager of networks...context and are asked in the natural course of things; there is no predetermination of question topics or wording. 10 descriptive section is the...struggles and challenges that occur naturally over time. As depicted in Figure 2, the network will constantly have to examine how it is evolving and, if

The effect of chiropractic treatment on the reaction and response times of special operation forces military personnel: study protocol for a randomized controlled trial.

PubMed

DeVocht, James W; Smith, Dean L; Long, Cynthia R; Corber, Lance; Kane, Bridget; Jones, Thomas M; Goertz, Christine M

2016-09-20

Chiropractic care is commonly used to treat musculoskeletal conditions and has been endorsed by clinical practice guidelines as being evidence-based and cost-effective for the treatment of patients with low back pain. Gaps in the literature exist regarding the physiological outcomes of chiropractic treatment. Previous pilot work has indicated the possibility of improvements in response time following the application of chiropractic treatment. However, it is unknown whether or not chiropractic treatment is able to improve reaction and response times in specific populations of interest. One such population is the U.S. military special operation forces' (SOF) personnel. This study is a randomized controlled trial of 120 asymptomatic volunteer SOF personnel. All participants are examined by a study doctor of chiropractic (DC) for eligibility prior to randomization. The participants are randomly allocated to either a treatment group receiving four treatments of chiropractic manipulative therapy (CMT) over 2 weeks or to a wait-list control group. The wait-list group does not receive any treatment but has assessments at the same time interval as the treatment group. The outcome measures are simple reaction times for dominant hand and dominant foot, choice reaction time with prompts calling for either hand or either foot, response time using Fitts' law tasks for small movements involving eye-hand coordination, and brief whole body movements using the t-wall, a commercially available product. At the first visit, all five tests are completed so that participants can familiarize themselves with the equipment and protocol. Assessments at the second and the final visits are used for data analysis. SOF personnel are highly motivated and extremely physically fit individuals whose occupation requires reaction times that are as quick as possible during the course of their assigned duties. A goal of CMT is to maximize the functionality and integration of the neuromusculoskeletal systems. Therefore, chiropractic treatment may be able to optimize the capacity of the numerous components of those systems, resulting in improved reaction time. The objective of this study is to test the hypothesis that CMT improves reaction and response times in asymptomatic SOF personnel. ClinicalTrials.gov, NCT02168153 . Registered on 12 June 2014.

Building Special Operations Partnerships in Afghanistan and Beyond: Challenges and Best Practices from Afghanistan, Iraq, and Colombia

DTIC Science & Technology

2015-01-01

1990s: Drugs, Insurgency, and Terrorism and the Initiation of Plans Colombia and Patriota . . . . . . . . . . . . . . . . . . . . . . . . . . . 60... planning , intelligence collection, logistics, etc. Building Afghan SOF capability in these areas will require simpler operations and a lower operational...be withdrawn after 2014. This will give indigenous SOF units the opportunity to plan accordingly; will avoid fears of a sudden, dramatic reduction in

Air and Space Power Journal. Volume 16, Number 3, Fall 2002

DTIC Science & Technology

2002-01-01

undersea sensor grid. The prehostilities phase of any crisis is a prime period for special operations—especially in the ISR role. SOF operations...application abound: Adolf Hitler’s references to the Luftwaffe dur­ ing the reoccupation of the Rhineland in 1936 or the Munich crisis of 1938...Kennedy’s reliance on Strategic Air Command’s B-52s and missile force during the Cuban missile crisis of 1962, among others. Although the framework

Flattening the Learning Curve: SOF as the Supported Command in the Irregular Warfare Environment

DTIC Science & Technology

2012-06-01

Afghanistan and the Troubled Future of Unconventional Warfare (Annapolis: Naval Institute Press, 2006). 45 Hy Rothstein, A Tale of Two Wars – Why...In recognition that all future wars and conflicts will be engaged in in a joint manner, something must be done to ensure that GPF have a base...CODE A 13. ABSTRACT (maximum 200 words) When the United States commits forces to a war , overseas contingency operations, or any other large

Cost and Operational Effectiveness Analysis (COEA) for the Lightweight Water Purifier (LWP).

DTIC Science & Technology

1996-03-11

HIL- ENEME , CA 93043-4328 HQ USAF/XORD, 1480 AIRFORCE PENTAGON, WASH[NGTON, DC 20330-1480 HQ ACC/CEX (ATTN-: MR. FISHER), 129 ANDREWS ST, STE 102...2014 50 2015 50 2016 50 2017 50 2018 50 2019 50 2020 50 2021 50 2022 0 S50 50 1000ROWPU-yrs 4. Initial Deployment of the 600 GPH ROWPU for Special...OPERATIONS FORCES (SOF) 07/11/95 2014 2015 2016 2017 2018 2019 2020 1.0 RDT&E-FUNDED ELEMENTS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.01 DEVELOPMENT

Circadian Rhythm Phase Locking for Traveling Special Forces Operators: Using Light Exposure to Maintain Time Zone Entrainment

DTIC Science & Technology

a circadian phase through the use of controlled light exposures. Eleven male subjects from active duty SOF commands were flown from Guam (UTC 10:00...to Troy, NY (UTC -05:00; 9 hours) while wearing blue- light goggles and blue-blocking, orange-tinted glasses in a carefully-prescribed schedule...designed to maintain entrainment to the desired circadian time (UTC 10:00). Biochemical indices (dim- light melatonin onset) showed that no change in

Special Operations Forces Language Transformation Strategy Needs Assessment Project: Final Project Report

DTIC Science & Technology

2005-03-15

German (includes romance languages, etc.) CAT III/IV Language More difficult languages to acquire for native English speakers. Examples: Cantonese ...conversations on practical, social , and professional topics in my required AOR language. 52.9 62.1 51.9 51.9 52.0 SOF Language Transformation...67.6 85.7 77.2 67.5 71.9 73.1 63.6 67.6 63.0 I feel confident in my ability to participate in informal conversations on practical, social , and

OOD/OOP experience in the Science Operations Center part of the ground system for X ray Timing Explorer mission

NASA Technical Reports Server (NTRS)

Choudhary, Abdur Rahim

1994-01-01

The Science Operations Center (SOC) for the X-ray Timing Explorer (XTE) mission is an important component of the XTE ground system. Its mandate includes: (1) command and telemetry for the three XTE instruments, using CCSDS standards; (2) monitoring of the real-time science operations, reconfiguration of the experiment and the instruments, and real-time commanding to address the targets of opportunity (TOO) and alternate observations; and (3) analysis, processing, and archival of the XTE telemetry, and the timely delivery of the data products to the principal investigator (PI) teams and the guest observers (GO). The SOC has two major components: the science operations facility (SOF) that addresses the first two objectives stated above and the guest observer facility (GOF) that addresses the third. The SOF has subscribed to the object oriented design and implementation; while the GOF uses the traditional approach in order to take advantage of the existing software developed in support of previous missions. This paper details the SOF development using the object oriented design (OOD), and its implementation using the object oriented programming (OOP) in C++ under Unix environment on client-server architecture using Sun workstations. It also illustrates how the object oriented (OO) and the traditional approaches coexist in SOF and GOF, the lessons learned, and how the OOD facilitated the distributed software development collaboratively by four different teams. Details are presented for the SOF system, its major subsystems, its interfaces with the rest of the XTE ground data system, and its design and implementation approaches.

The SOF Experience in the Philippines and the Implications for Future Defense Strategy

DTIC Science & Technology

2016-12-07

developed communications products including leaflets that advertised rewards for information on local insurgents and the various programs that were...and intelligence (2) Conducting civil–military operations (CMO) (3) Conducting information operations ( IO ) PRISM 6, no. 3 FROM THE FIELD | 155 THE...FUTURE DEFENSE STRATEGY the development of an intelligence fusion cen- ter and campaign assessment products . At Fort Magsaysay, U.S. SOF helped establish

Transient particle emission measurement with optical techniques

NASA Astrophysics Data System (ADS)

Bermúdez, Vicente; Luján, José M.; Serrano, José R.; Pla, Benjamín

2008-06-01

Particulate matter is responsible for some respiratory and cardiovascular diseases. In addition, it is one of the most important pollutants of high-speed direct injection (HSDI) passenger car engines. Current legislation requires particulate dilution tunnels for particulate matter measuring. However for development work, dilution tunnels are expensive and sometimes not useful since they are not able to quantify real-time particulate emissions during transient operation. In this study, the use of a continuous measurement opacimeter and a fast response HFID is proven to be a good alternative to obtain instantaneous particle mass emissions during transient operation (due to particulate matter consisting mainly of soot and SOF). Some methods and correlations available from literature, but developed for steady conditions, are evaluated during transient operation by comparing with mini-tunnel measurements during the entire MVEG-A transient cycle. A new correlation was also derived from this evaluation. Results for soot and SOF (obtained from the new correlation proposed) are compared with soot and SOF captured with particulate filters, which have been separated by means of an SOF extraction method. Finally, as an example of ECU design strategies using these sort of correlations, the EGR valve opening is optimized during transient operation. The optimization is performed while simultaneously taking into account instantaneous fuel consumption, particulate emissions (calculated with the proposed correlation) and other regulated engine pollutants.

Organizational Design for USSOCOM Rapid Acquisition

DTIC Science & Technology

2017-03-31

cycle times, leaving operators at a strategic disadvantage. It seeks to understand how it can adapt and upgrade at the speed of the commercial market ...technologies at the speed of the commercial market . Despite SOF AT&L’s innovative approaches, it still finds itself leaving SOF operators potentially at a...how it can adapt to take advantage of technology advances and upgrade its technologies at the speed of the commercial market . Its goal is to adapt

Comparative study of a learning fuzzy PID controller and a self-tuning controller.

PubMed

Kazemian, H B

2001-01-01

The self-organising fuzzy controller is an extension of the rule-based fuzzy controller with an additional learning capability. The self-organising fuzzy (SOF) is used as a master controller to readjust conventional PID gains at the actuator level during the system operation, copying the experience of a human operator. The application of the self-organising fuzzy PID (SOF-PID) controller to a 2-link non-linear revolute-joint robot-arm is studied using path tracking trajectories at the setpoint. For the purpose of comparison, the same experiments are repeated by using the self-tuning controller subject to the same data supplied at the setpoint. For the path tracking experiments, the output trajectories of the SOF-PID controller followed the specified path closer and smoother than the self-tuning controller.

Cross-Cultural Competence and Small Groups: Why SOF Are the Way SOF Are

DTIC Science & Technology

2011-03-01

social brain hypothesis suggests that the ability of the brain to process social knowledge (as distinct from memory size) sets limits on the number...is the autobiographical account of the experi- ence of British soldier T. E. Lawrence. 83. The Jedburgh Operation consisted of 3-man international

Horizons, Helping Shape the Future of SOF. Issue 3, Fall 2009

DTIC Science & Technology

2009-01-01

OIL quickly through the SOF, conventional, and inter-agency communities . Samples of Success LLATs have collected on a variety of topics. This...with the broader SE community so they did not reside solely at one operating site. Mr. David Hilliard, a Boeing mechanic operator, retrieves a...said a 1SFG soldier. It was critical that every aspect of the story incorporated an Iraqi face, such as Tiba’s, to communicate and emphasize Tiba’s

The Health Clinic. School of the Future: Houston.

ERIC Educational Resources Information Center

Iscoe, Louise

The Hogg Foundation for Mental Health created the School of the Future (SoF) project to enable selected Texas schools to coordinate and implement school-based social and health services on their campuses and to demonstrate the effectiveness of this method of service delivery by evaluating the project. SoF operated in four urban sites in Texas,…

Piracy: The Best Business Model Available

DTIC Science & Technology

2013-11-01

9 3. SOF Hostage Rescue Missions .......................................... 15 4. Recent Evolution of Piracy...positive effect when the pirate enterprise has acted and taken American hostages . However, a course of action with more fundamental results should include...solutions to crimes committed on the seas. As will be discussed, proposed counter-piracy operations aimed at support structures may require SOF air

Beyond the Classroom: Experiences of a School-Based Services Project.

ERIC Educational Resources Information Center

Iscoe, Louise K.

The Hogg Foundation for Mental Health created the School of the Future (SoF) project to enable selected Texas schools to coordinate and implement school-based social and health services on their campuses and to demonstrate the effectiveness of this method of service delivery by evaluating the project. The SoF operated in four sites, each with a…

SOF Language Transformation Strategy Needs Assessment Project: SOF Operator Survey Report

DTIC Science & Technology

2004-10-01

CAT III/IV Language More difficult languages to acquire for native English speakers. Examples: Cantonese , Japanese, Arabic, Dari, Pashto, Turkish...simple conversations on familiar topics (M = 68.4) and less confident in their ability participate in informal conversations on practical, social , and...familiar topics (M = 59.6), and to participate in informal conversations on practical, social , and professional topics (M = 40.3) than personnel

Proceedings of the Ninth Annual Special Operations/Low Intensity Conflict (SO/LIC) Symposium and Exhibition, "National Security Strategy in Transition" The Critical Role of Special Operations Forces (SOF) in Preparing Now for an Uncertain Future.

DTIC Science & Technology

1998-02-19

Satan , and persons of color are non- human "mud people." Even with this in common; though, conflict continued over doctrinal minutiae among the var...200,000 copies of "The Turner Diaries" have been sold at gun shows and movement meetings over the years. They know that it is a bible to many in the...L /4kn BIA S AB U. 20 X = REPORTED SENSOR OUTPUT M C HANDOFF = FTS FOV __X-"BIAS )2 pdf (X) = 1 e 20A 2 J2% A Figure 4: FTS FOV defined in terms of

Special Operations Research Topics 2014

DTIC Science & Technology

2014-01-01

problems . I encourage SOF personnel to contribute their experiences and ideas to the SOF community by submitting your completed research on these...and rapid problem solving. While this can be very beneficial in high-stress, time-sensitive situations, it may not be conducive to the development...a perception that everything is important and all problems must be quickly solved. Not only does this imply that slowing down to think is a waste

21st Century SOF: Toward an American Theory of Special Operations

DTIC Science & Technology

2013-04-01

century order. However, non-state actors can also pursue destructive ends that contribute to disorder and instability. It is worth noting that other...JS O U R ep o rt 13 -1 21st C en tu ry S O F: To w a rd a n A m erica n Th eo ry o f S p ecia l O p eratio n s Ya rger 21st Century ...21st Century SOF: Toward an American Theory of Special Operations 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

The Dilemma for USSOCOM: Transitioning SOF-Peculiar to Service-Common

DTIC Science & Technology

2012-02-15

Operations-peculiar (SO-peculiar or SOF-peculiar) to Service-common, while the third implication suggests a lack of “ advertising ”, i.e. the need for a...Portfolio Management ( CPM ) system which seeks to optimize capability investments across the defense enterprise.59 Though CPMs are charged to identify...capabilities as Service-common. Collectively though they do offer several avenues in which SOCOM can “ advertise ” them, and whereby through mutual

Creating SOF Networks: The Role of NATO Special Operations as a Testing Ground for SOF Integration

DTIC Science & Technology

2011-06-01

technology and network structures on modern conflict. Vice Admiral Arthur Cebrowski, a pioneer in the concept of network centric warfare, outlined how...European populations have increased slightly over the past four decades with increased longevity , immigration, and the maturation of larger post WWII...demographers predict that European populations will steadily decrease during the next several decades as longevity and immigration will not be able to offset

Effects of Combat Deployment on Anthropometrics and Physiological Status of U.S. Army Special Operations Forces Soldiers.

PubMed

Farina, Emily K; Taylor, Jonathan C; Means, Gary E; Williams, Kelly W; Murphy, Nancy E; Margolis, Lee M; Pasiakos, Stefan M; Lieberman, Harris R; McClung, James P

2017-03-01

U.S. Army Special Operations Forces (SOF) soldiers deploy frequently and conduct military operations through special warfare and surgical strike capabilities. Tasks required to execute these capabilities may induce physical and mental stress and have the potential to degrade soldier physiological status. No investigations have longitudinally characterized whether combat deployment alters anthropometrics or biochemical markers of physiological status in a SOF population of frequent deployers. Effects of modern combat deployment on longitudinal changes in anthropometrics and physiological status of elite U.S. Army SOF soldiers (n = 50) were assessed. Changes in measures of body composition, grip strength, physiological status, and health behaviors from baseline to postdeployment were determined with paired t test and McNemar's statistic. Baseline measures were obtained between 4 and 8 weeks before deployment. Deployment length was a uniform duration of time between 3 and 6 months (all soldiers completed the same length of deployment). Post hoc analyses determined change in body mass within quartiles of baseline body mass with paired t test and associations between change in sex hormone-binding globulin (SHBG) and change in body mass with correlation coefficient. The study was approved by the Human Use Review Committee at the U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts. In response to deployment, increases in lean mass (77.1 ± 7.6 to 77.8 ± 7.5 kg), maximum grip strength (57.9 ± 7.2 to 61.6 ± 8.8 kg), and conduct of aerobic (156 ± 106 to 250 ± 182 minutes/week) and strength training (190 ± 101 to 336 ± 251 minutes/week) exercise were observed (p < 0.05). Increases in serum SHBG (35.42 ± 10.68 to 38.77 ± 12.26 nmol/L) and decreases in serum cortisol (443.2 ± 79.3 to 381.9 ± 111.6 nmol/L) were also observed (p < 0.05). Body mass changes were dependent on baseline body mass. Soldiers in the lowest quartile of baseline body mass increased body mass (75.6 ± 2.6 vs. 76.6 ± 2.8 kg, p = 0.03), as did those in the second quartile (81.6 ± 2.0 vs. 83.7 ± 3.5 kg, p = 0.02). Those in the third quartile also tended to increase body mass (89.2 ± 2.6 vs. 90.9 ± 3.3 kg, p = 0.05), while those in the upper quartile tended to decrease body mass (98.5 ± 3.6 vs. 96.7 kg, p = 0.06). Change in SHBG was inversely correlated with change in body mass (r = -0.33, p = 0.02). There were no changes in fat mass, body fat percentage, waist circumference, neck circumference, total testosterone, calculated bioavailable or free testosterone, high-sensitivity C-reactive protein, tumor necrosis factor-α, interleukin-1β, or interleukin-6. Inflammatory markers were skewed toward lower values. Overall, physiological status of elite SOF soldiers characterized by multiple prior deployments was minimally impacted by combat deployment, in the absence of major unit casualties. The majority experienced some adaptive changes, including increased lean mass, grip strength, time spent engaged in exercise, and decreased levels of the stress hormone cortisol. Mechanisms contributing to inverse correlations between change in SHBG and change in body mass may be further clarified. Future investigations may also more fully characterize the degradation and optimization of health and physiological status of SOF training and deployment cycles with in-theater data collection and repeated measures. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Causes of death in US Special Operations Forces in the global war on terrorism: 2001-2004.

PubMed

Holcomb, John; Caruso, James; McMullin, Neil; Wade, Charles E; Pearse, Lisa; Oetjen-Gerdes, Lynne; Champion, Howard R; Lawnick, Mary; Farr, Warner; Rodriguez, Sammy; Butler, Frank

2007-01-01

Effective combat trauma management strategies depend on an understanding of the epidemiology of death on the battlefield, resulting in evidence-based equipment, training, and research requirements. All Special Operations Forces (SOF) fatalities (combat and noncombat) in Operation Iraqi Freedom/Operation Enduring Freedom (OEF/OIF) from October 2001 until November 2004 were reviewed. All available autopsy and treatment records and photographs were used. In most cases, the immediate tactical situation was unknown. The review was performed by a multidisciplinary group including forensic pathologists, an SOF combat medic, and trauma surgeons. Fatalities were classified as having wounds that were either nonsurvivable or potentially survivable with existing training, equipment, and expertise on the battlefield. A structured review was performed evaluating the need for new equipment, training, or research requirements. Results were compared to autopsy data from Vietnam and modern civilian trauma center data. The study was approved by the Institutional Review Boards of the Armed Forces Institute of Pathology and the US Army Institute of Surgical Research. During the study period, 82 SOF fatalities were identified. Autopsies were performed on 77 Soldiers. Five casualties died secondary to aircraft crash, their bodies were not recovered from the ocean. For the purposes of this study they were considered nonsurvivable. Eighty-five percent (n = 70) of the fatalities sustained wounds that were nonsurvivable, while the remaining 15% (n = 12) had wounds that were potentially survivable. Injury Severity Score (ISS) was higher in the nonsurvivable group (p < 0.05). Truncal hemorrhage accounted for 47% of deaths while extremity hemorrhage accounted for 33%. One casualty was noted at autopsy to have a tension pneumothorax as well as multiple sources of internal hemorrhage, one suffered an airway death, while another died of sepsis 56 days after injury. Of those casualties deemed to be nonsurvivable, there were 31 patients with 40 Abbreviated Injury Score (AIS) 6 injuries (p = .0011), and 53 patients with 104 AIS 5 injuries. Among the 12 deaths deemed to be potentially survivable, there were only 8 AIS 5 injuries. Deaths were largely caused by explosions (n = 35), gunshot wounds (n = 23), and aircraft accidents (n = 19). No new training or equipment needs were identified for 53% of the potentially survivable deaths while improved methods of truncal hemorrhage control need to be developed for the remainder. The review panel concluded that 85% of the deaths would not have been prevented at a civilian Level I facility. Available records, in most cases, did not contain information about the use of body armor, time to death after injury, or the ongoing tactical situation. The majority of deaths on the modern battlefield are nonsurvivable. Current results are not different from previous conflicts. In Vietnam, reported potentially preventable death rates range from 5% to 35% and civilian data reports potentially preventable death rates ranging from 12% to 22%. Military munitions cause multiple lethal injuries. Current trauma training and equipment is sufficient to care for 53% of the potentially survivable deaths. Improved methods of intravenous or intracavitary noncompressible hemostasis combined with rapid surgery are required for the remaining 47% of the decedents.

Unreviewed Disposal Question Evaluation: Impact of New Information since 2008 PA on Current Low-Level Solid Waste Operations

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

Flach, G.; Smith, F.; Hamm, L.

2014-10-06

Solid low-level waste disposal operations are controlled in part by an E-Area Low-Level Waste Facility (ELLWF) Performance Assessment (PA) that was completed by the Savannah River National Laboratory (SRNL) in 2008 (WSRC 2008). Since this baseline analysis, new information pertinent to disposal operations has been identified as a natural outcome of ongoing PA maintenance activities and continuous improvement in model simulation techniques (Flach 2013). An Unreviewed Disposal Question (UDQ) Screening (Attachment 1) has been initiated regarding the continued ability of the ELLWF to meet Department of Energy (DOE) Order 435.1 performance objectives in light of new PA items and datamore » identified since completion of the original UDQ Evaluation (UDQE). The present UDQE assesses the ability of Solid Waste (SW) to meet performance objectives by estimating the influence of new information items on a recent sum-of-fractions (SOF) snapshot for each currently active E-Area low-level waste disposal unit. A final SOF, as impacted by this new information, is projected based on the assumptions that the current disposal limits, Waste Information Tracking System (WITS) administrative controls, and waste stream composition remain unchanged through disposal unit operational closure (Year 2025). Revision 1 of this UDQE addresses the following new PA items and data identified since completion of the original UDQE report in 2013: New K d values for iodine, radium and uranium; Elimination of cellulose degradation product (CDP) factors; Updated radionuclide data; Changes in transport behavior of mobile radionuclides; Potential delay in interim closure beyond 2025; and Component-in-grout (CIG) plume interaction correction. Consideration of new information relative to the 2008 PA baseline generally indicates greater confidence that PA performance objectives will be met than indicated by current SOF metrics. For SLIT9, the previous prohibition of non-crushable containers in revision 0 of this UDQE has rendered the projected final SOF for SLIT9 less than the WITS Admin Limit. With respect to future disposal unit operations in the East Slit Trench Group, consideration of new information for Slit Trench#14 (SLIT14) reduced the current SOF for the limiting All-Pathways 200-1000 year period (AP2) by an order of magnitude and by one quarter for the Beta-Gamma 12-100 year period (BG2) pathway. On the balance, updates to K{sub d} values and dose factors and elimination of CDP factors (generally favorable) more than compensated for the detrimental impact of a more rigorous treatment of plume dispersion. These observations suggest that future operations in the East Slit Trench Group can be conducted with higher confidence using current inventory limits, and that limits could be increased if desired for future low-level waste disposal units. The same general conclusion applies to future ST’s in the West Slit Trench Group based on the Impacted Final SOFs for existing ST’s in that area.« less

C-130 Advanced Technology Center wing box conceptual design/cost study

NASA Technical Reports Server (NTRS)

Whitehead, R. S.; Foreman, C. R.; Silva, K.

1992-01-01

A conceptual design was developed by Northrop/LTV for an advanced C-130 Center Wing Box (CWB) which could meet the severe mission requirements of the SOF C-130 aircraft. The goals for the advanced technology CWB relative to the current C-130H CWB were: (1) the same acquisition cost; (2) lower operating support costs; (3) equal or lower weight; (4) a 30,000 hour service life for the SOF mission; and (5) minimum impact on the current maintenance concept. Initially, the structural arrangement, weight, external and internal loads, fatigue spectrum, flutter envelope and design criteria for the SOF C-130 aircraft CWB were developed. An advanced materials assessment was then conducted to determine the suitability of advanced materials for a 1994 production availability and detailed trade studies were performed on candidate CWB conceptual designs. Finally, a life-cycle cost analysis was performed on the advanced CWB. The study results showed that a hybrid composite/metallic CWB could meet the severe SOF design requirements, reduce the CWB weight by 14 pct., and was cost effective relative to an all metal beefed up C-130H CWB.

The OSS Model and the Future of the SOF Warrior

DTIC Science & Technology

2011-11-01

The OSS Model and the Future of the SOF Warrior 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) 5d. PROJECT NUMBER...5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) Joint Special Operations University,7701 Tampa Point...Boulevard,MacDill AFB,FL,33621 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME( S ) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S

SOF in Unlit Spaces: Understanding the World’s Dark Spots in the Context of SOF Operational Planning

DTIC Science & Technology

2013-05-23

incident in 1993. Moreover, entering 52 Bowden, Mark, Killing Pablo: The Hunt for The World’s Greatest Outlaw , New York: Atlantic Monthly Press...D.C.: Congressional Research Service, 2013. Bowden, Mark. Killing Pablo: The Hunt for The World’s Greatest Outlaw . New York: Atlantic Monthly Press...CARL), this monograph would seriously lack abundant documentation. His meticulous hunt for sources fed the bulk of this monograph’s references. I

Ketones and Human Performance.

PubMed

Scott, Jonathan M; Deuster, Patricia A

Everyone is seeking nutritional strategies that might benefit performance. One approach receiving much attention is ketones, or ketosis. Ketones are very simple compounds made of hydrogen, carbon, and oxygen, and ketosis is a metabolic state whereby the body uses predominantly ketones. Ketosis can be achieved by fasting for longer than 72 hours or by following a very lowcarbohydrate, high-fat diet (ketogenic diet) for several days to weeks. Alternatively, ketone supplements purportedly induce ketosis rapidly and do not require strict adherence to any specific type of diet; however, much of the touted benefits are anecdotal. A potential role for ketosis as a performance enhancer was first introduced in 1983 with the idea that chronic ketosis without caloric restriction could preserve submaximal exercise capability by sparing glycogen or conserving the limited carbohydrate stores. Few human studies on the effects of a ketogenic diet on performance have yielded positive results, and most studies have yielded equivocal or null results, and a few negative results. Many questions about ketones relevant to Special Operations Forces (SOF) remain unanswered. At present, a ketogenic diet and/or a ketone supplement do not appear confer performance benefits for SOF. Instead, Operators should engage with their unit dietitian to develop individualized nutritional strategies based on unique mission requirements. The authors review the concept of a ketogenic diet, describe some potential benefits and risks of ketosis, review the performance literature and how to measure ketone status, and then summarize the landscape in 2017. 2017.

Real-World Single-Center Experience with Sofosbuvir-Based Regimens for the Treatment of Chronic Hepatitis C Genotype 1 Patients

PubMed Central

Shin, Hyun Phil; Burman, Blaire; Kozarek, Richard A.; Zeigler, Amy; Wang, Chia; Lee, Houghton; Zehr, Troy; Edwards, Alicia M.; Siddique, Asma

2017-01-01

Background/Aims The approval of sofosbuvir (SOF), a direct-acting antiviral, has revolutionized the treatment of chronic hepatitis C virus (HCV). Methods We assessed the sustained virological response (SVR) of SOF-based regimens in a real-world single-center setting for the treatment of chronic HCV genotype 1 (G1) patients. This was a retrospective review of chronic HCV G1 adult patients treated with a SOF-based regimen at Virginia Mason Medical Center between December 2013 and August 2015. Results The cohort comprised 343 patients. Patients received SOF+ledipasvir (LDV) (n=155), SOF+simeprevir (SIM) (n=154), or SOF+peginterferon (PEG)+ribavirin (RBV) (n=34). Of the patients, 50.1% (n=172) had cirrhosis. The SVR rate was 92.2% for SOF/LDV, 87.0% for SOF/SIM, and 82.4% for SOF/PEG/RBV. Compared with the cirrhotic patients, the patients without cirrhosis had a higher SVR (96.8% vs 85.5%, p=0.01, SOF/LDV; 98.2% vs 80.6%, p=0.002, SOF/SIM; 86.4% vs 75.0%, p=0.41, SOF/PEG/RBV). In this study, prior treatment experience adversely affected the response rate in subjects treated with SOF/PEG/RBV. Conclusions In this single-center, real-world setting, the treatment of chronic HCV G1 resulted in a high rate of SVR, especially in patients without cirrhosis. PMID:28651301

Real-World Single-Center Experience with Sofosbuvir-Based Regimens for the Treatment of Chronic Hepatitis C Genotype 1 Patients.

PubMed

Shin, Hyun Phil; Burman, Blaire; Kozarek, Richard A; Zeigler, Amy; Wang, Chia; Lee, Houghton; Zehr, Troy; Edwards, Alicia M; Siddique, Asma

2017-09-15

The approval of sofosbuvir (SOF), a direct-acting antiviral, has revolutionized the treatment of chronic hepatitis C virus (HCV). We assessed the sustained virological response (SVR) of SOF-based regimens in a real-world single-center setting for the treatment of chronic HCV genotype 1 (G1) patients. This was a retrospective review of chronic HCV G1 adult patients treated with a SOF-based regimen at Virginia Mason Medical Center between December 2013 and August 2015. The cohort comprised 343 patients. Patients received SOF+ledipasvir (LDV) (n=155), SOF+simeprevir (SIM) (n=154), or SOF+peginterferon (PEG)+ribavirin (RBV) (n=34). Of the patients, 50.1% (n=172) had cirrhosis. The SVR rate was 92.2% for SOF/LDV, 87.0% for SOF/SIM, and 82.4% for SOF/PEG/RBV. Compared with the cirrhotic patients, the patients without cirrhosis had a higher SVR (96.8% vs 85.5%, p=0.01, SOF/LDV; 98.2% vs 80.6%, p=0.002, SOF/SIM; 86.4% vs 75.0%, p=0.41, SOF/PEG/RBV). In this study, prior treatment experience adversely affected the response rate in subjects treated with SOF/PEG/RBV. In this single-center, real-world setting, the treatment of chronic HCV G1 resulted in a high rate of SVR, especially in patients without cirrhosis.

A Comparison of Frailty Indexes for the Prediction of Falls, Disability, Fractures and Mortality in Older Men

PubMed Central

Ensrud, Kristine E.; Ewing, Susan K.; Cawthon, Peggy M.; Fink, Howard A.; Taylor, Brent C.; Cauley, Jane A.; Dam, Thuy-Tien; Marshall, Lynn M.; Orwoll, Eric S.; Cummings, Steven R.

2010-01-01

Objective To compare validity of a parsimonious frailty index (components: weight loss, inability to rise from a chair, and poor energy [SOF index]) with that of the more complex CHS index (components: unintentional weight loss, low grip strength, poor energy, slowness, and low physical activity) for prediction of adverse outcomes in older men. Design Prospective cohort study Setting Six U.S. centers Participants 3132 men ≥67 years Measurements Men classified as robust, intermediate stage or frail using SOF index and criteria similar to those used in CHS index. Falls reported tri-annually for 1 year. Disability (≥1 new impairment in performing IADL) ascertained at 1 year. Fractures and deaths ascertained during 3 years of follow-up. Area under the curve (AUC) statistics from receiver operating characteristic curve analysis compared for models containing SOF index versus CHS index. Results Greater evidence of frailty as defined by either index was associated with increased risks of adverse outcomes. Frail men had a higher age-adjusted risk of recurrent falls (odds ratio [OR] 3.0–3.6), disability (OR 5.3–7.5), nonspine fracture (hazards ratio [HR] 2.2–2.3), and death (HR 2.5–3.5) (P<0.001 for all models). AUC comparisons revealed no differences between models with SOF index versus models with CHS index in discriminating falls (AUC=0.63, P= 0.97), disability (AUC=0.68, P=0.86), nonspine fracture (AUC=0.63, P=0.90), or death (AUC=0.71 for model with SOF index and 0.72 for model with CHS index, P=0.19). Conclusion The simple SOF index predicts risk of falls, disability, fracture and mortality in men as well as the more complex CHS index. PMID:19245414

Reorganizing SOF for Irregular Warfare

DTIC Science & Technology

2008-12-01

assassins , war by ambush instead of by combat, by infiltration instead of aggression, seeking victory by eroding and exhausting the enemy instead of...saved: a whole new kind of strategy, a wholly different kind of force, and therefore a new and wholly different kind of military training. . . JFK

Development of real-time thermal neutron monitor using boron-loaded plastic scintillator with optical fiber for boron neutron capture therapy.

PubMed

Ishikawa, M; Ono, K; Sakurai, Y; Unesaki, H; Uritani, A; Bengua, G; Kobayashi, T; Tanaka, K; Kosako, T

2004-11-01

A new thermal neutron monitor for boron neutron capture therapy was developed in this study. We called this monitor equipped boron-loaded plastic scintillator that uses optical fiber for signal transmission as an [scintillator with optical fiber] SOF detector. A water phantom experiment was performed to verify how the SOF detector compared with conventional method of measuring thermal neutron fluence. Measurements with a single SOF detector yielded indistinguishable signals for thermal neutrons and gamma rays. To account for the gamma ray contribution in the signal recorded by the SOF detector, a paired SOF detector system was employed. This was composed of an SOF detector with boron-loaded scintillator and an SOF detector with a boron-free scintillator. The difference between the recorded counts of these paired SOF detectors was used as the measure of the gamma ray contribution in the measured neutron fluence. The paired SOF detectors were ascertained to be effective in measuring thermal neutron flux in the range above 10(6)(n/cm(2)/s). Clinical trials using paired SOF to measure thermal neutron flux during therapy confirmed that paired SOF detectors were effective as a real-time thermal neutron flux monitor.

Better Together: SOF and Conventional Forces Integration in Security Force Assistance

DTIC Science & Technology

2017-06-09

substantial investment in both American taxpayer dollars and military man- power ; but does it accomplish the assumptive hypothesis of conflict prevention...Arguably, the initial military incursions into Afghanistan and Iraq were textbook examples of American tactical and strategic prowess. The high ...conflict does not necessarily signify a failed or failing 48 state (i.e. Mexico or Ukraine) and likewise some states with “ high instability” did not

Three-year incidence of Nd:YAG capsulotomy and posterior capsule opacification and its relationship to monofocal acrylic IOL biomaterial: a UK Real World Evidence study.

PubMed

Ursell, Paul G; Dhariwal, Mukesh; Majirska, Katarina; Ender, Frank; Kalson-Ray, Shoshannah; Venerus, Alessandra; Miglio, Cristiana; Bouchet, Christine

2018-06-11

To evaluate 3-year incidence of Nd:YAG capsulotomy and PCO and compare the effect of different IOL materials. Data were retrospectively collected from seven UK ophthalmology clinics using Medisoft electronic medical records. Eyes from patients ≥65 years undergoing cataract surgery with implantation of acrylic monofocal IOLs during 2010-2013 and 3-year follow-up were analysed. Nd:YAG capsulotomy and PCO incidence proportions were reported for 3 IOL cohorts: AcrySof, other hydrophobic and hydrophilic acrylic IOLs. Unadjusted/adjusted odds ratios (OR) of Nd:YAG capsulotomy were calculated through logistic regression for non-AcrySof cohorts versus AcrySof. A sub-group analysis in single-piece IOLs (>90% of sample eyes) was also performed. The AcrySof cohort included 13,329 eyes, non-AcrySof hydrophobic 19,025 and non-AcrySof hydrophilic 19,808. The 3-year Nd:YAG capsulotomy incidence (95% CI) for AcrySof (2.4%, 2.2-2.7%) was approximately two times lower than non-AcrySof hydrophobic IOLs (4.4%, 4.1-4.7%) and approximately fourfold lower than non-AcrySof hydrophilic IOLs (10.9%, 10.5-11.3%). Trends were similar in PCO incidence (AcrySof: 4.7%; non-AcrySof hydrophobic: 6.3%; non-AcrySof hydrophilic: 14.8%). Also in the analysis restricted to single-piece IOLs, the pattern remained (2.4% vs 5.1% vs. 10.9%, respectively). Adjusted regression analysis showed a approximately two and fivefold increased odds of Nd:YAG for non-AcrySof hydrophobic and hydrophilic acrylic IOLs respectively vs. AcrySof IOLs. Nd:YAG capsulotomy ORs were similar and remained statistically significant in the single-piece IOL sub-group. Real-world evidence shows that within 3 years following implantation, AcrySof IOLs are significantly superior in reducing Nd:YAG capsulotomy and PCO incidence compared to other hydrophilic and hydrophobic acrylic IOLs.

Joint Force Quarterly. Number 2, Autumn 1993

DTIC Science & Technology

1993-09-01

donated American vaccines ▼ SOF in East Africa teach game wardens how to stop poaching to enhance the political, economic, and social stability of local... ivory -tower syndrome and regain opera- tional currency while service officers could move onto the general staff to offer opera- tional expertise and

SOF: A Joint Force Integrator

DTIC Science & Technology

2007-04-05

of viole shifted to the level of the individual actor.”12 Today the threat is ambiguous, unconventional, and irregular in nature. It no longer can...internet on 19 September 2006 at http://www.csbaonline.org/4Publications/Archive/T.20060315.ImplementingGWOT/T.20060315.Impleme ntingGWOT.pdf 45 agents

Early clinical experience utilizing scintillator with optical fiber (SOF) detector in clinical boron neutron capture therapy: its issues and solutions.

PubMed

Ishikawa, Masayori; Yamamoto, Tetsuya; Matsumura, Akira; Hiratsuka, Junichi; Miyatake, Shin-Ichi; Kato, Itsuro; Sakurai, Yoshinori; Kumada, Hiroaki; Shrestha, Shubhechha J; Ono, Koji

2016-08-09

Real-time measurement of thermal neutrons in the tumor region is essential for proper evaluation of the absorbed dose in boron neutron capture therapy (BNCT) treatment. The gold wire activation method has been routinely used to measure the neutron flux distribution in BNCT irradiation, but a real-time measurement using gold wire is not possible. To overcome this issue, the scintillator with optical fiber (SOF) detector has been developed. The purpose of this study is to demonstrate the feasibility of the SOF detector as a real-time thermal neutron monitor in clinical BNCT treatment and also to report issues in the use of SOF detectors in clinical practice and their solutions. Clinical measurements using the SOF detector were carried out in 16 BNCT clinical trial patients from December 2002 until end of 2006 at the Japanese Atomic Energy Agency (JAEA) and Kyoto University Research Reactor Institute (KURRI). The SOF detector worked effectively as a real-time thermal neutron monitor. The neutron fluence obtained by the gold wire activation method was found to differ from that obtained by the SOF detector. The neutron fluence obtained by the SOF detector was in better agreement with the expected fluence than with gold wire activation. The estimation error for the SOF detector was small in comparison to the gold wire measurement. In addition, real-time monitoring suggested that the neutron flux distribution and intensity at the region of interest (ROI) may vary due to the reactor condition, patient motion and dislocation of the SOF detector. Clinical measurements using the SOF detector to measure thermal neutron flux during BNCT confirmed that SOF detectors are effective as a real-time thermal neutron monitor. To minimize the estimation error due to the displacement of the SOF probe during treatment, a loop-type SOF probe was developed.

CSS/EMW/SOF (Combat Service Support/Engineering and Mine Warfare/Special Operations Forces) Mission Area Materiel Plan (MAMP) Software.

DTIC Science & Technology

1986-09-01

receive much benefit . [] 2. The MAMP program prioritization algorithm is the responsibility of TRADOC. This study analyzed the perceived deficiencies...C o I 0 w m a 0 0 - 0.. -W >. m a -a ZZ II w u3 c w Ir 0 ccD I j cnC 0 o w a w W a- Im 3 El0 1>1- - < OUU4 0 .0.. 3.0 I * T- ui l. IT w3 >0 . I- *, wWE ...34Related" else if deftpe - 3 then print "Non-Materiel" else if def tqjpe - 4 then print " Health Service’ alse print skip I line printcolum-81

A comparison of visual outcomes in three different types of monofocal intraocular lenses

PubMed Central

Shetty, Vijay; Haldipurkar, Suhas S; Gore, Rujuta; Dhamankar, Rita; Paik, Anirban; Setia, Maninder Singh

2015-01-01

AIM To compare the visual outcomes (distance and near) in patients opting for three different types of monofocal intraocular lens (IOL) (Matrix Aurium, AcrySof single piece, and AcrySof IQ lens). METHODS The present study is a cross-sectional analysis of secondary clinical data collected from 153 eyes (52 eyes in Matrix Aurium, 48 in AcrySof single piece, and 53 in AcrySof IQ group) undergoing cataract surgery (2011-2012). We compared near vision, distance vision, distance corrected near vision in these three types of lenses on day 15 (±3) post-surgery. RESULTS About 69% of the eyes in the Matrix Aurium group had good uncorrected distance vision post-surgery; the proportion was 48% and 57% in the AcrySof single piece and AcrySof IQ group (P=0.09). The proportion of eyes with good distance corrected near vision were 38%, 33%, and 15% in the Matrix Aurium, AcrySof single piece, and AcrySof IQ groups respectively (P=0.02). Similarly, The proportion with good “both near and distance vision” were 38%, 33%, and 15% in the Matrix Aurium, AcrySof single piece, and AcrySof IQ groups respectively (P=0.02). It was only the Matrix Aurium group which had significantly better both “distance and near vision” compared with the AcrySof IQ group (odds ratio: 5.87, 95% confidence intervals: 1.68 to 20.56). CONCLUSION Matrix Aurium monofocal lenses may be a good option for those patients who desire to have a good near as well as distance vision post-surgery. PMID:26682168

A comparison of visual outcomes in three different types of monofocal intraocular lenses.

PubMed

Shetty, Vijay; Haldipurkar, Suhas S; Gore, Rujuta; Dhamankar, Rita; Paik, Anirban; Setia, Maninder Singh

2015-01-01

To compare the visual outcomes (distance and near) in patients opting for three different types of monofocal intraocular lens (IOL) (Matrix Aurium, AcrySof single piece, and AcrySof IQ lens). The present study is a cross-sectional analysis of secondary clinical data collected from 153 eyes (52 eyes in Matrix Aurium, 48 in AcrySof single piece, and 53 in AcrySof IQ group) undergoing cataract surgery (2011-2012). We compared near vision, distance vision, distance corrected near vision in these three types of lenses on day 15 (±3) post-surgery. About 69% of the eyes in the Matrix Aurium group had good uncorrected distance vision post-surgery; the proportion was 48% and 57% in the AcrySof single piece and AcrySof IQ group (P=0.09). The proportion of eyes with good distance corrected near vision were 38%, 33%, and 15% in the Matrix Aurium, AcrySof single piece, and AcrySof IQ groups respectively (P=0.02). Similarly, The proportion with good "both near and distance vision" were 38%, 33%, and 15% in the Matrix Aurium, AcrySof single piece, and AcrySof IQ groups respectively (P=0.02). It was only the Matrix Aurium group which had significantly better both "distance and near vision" compared with the AcrySof IQ group (odds ratio: 5.87, 95% confidence intervals: 1.68 to 20.56). Matrix Aurium monofocal lenses may be a good option for those patients who desire to have a good near as well as distance vision post-surgery.

Eye Development in Sepia officinalis Embryo: What the Uncommon Gene Expression Profiles Tell Us about Eye Evolution.

PubMed

Imarazene, Boudjema; Andouche, Aude; Bassaglia, Yann; Lopez, Pascal-Jean; Bonnaud-Ponticelli, Laure

2017-01-01

In metazoans, there is a remarkable diversity of photosensitive structures; their shapes, physiology, optical properties, and development are different. To approach the evolution of photosensitive structures and visual function, cephalopods are particularly interesting organisms due to their most highly centralized nervous system and their camerular eyes which constitute a convergence with those of vertebrates. The eye morphogenesis in numerous metazoans is controlled mainly by a conserved Retinal Determination Gene Network (RDGN) including pax, six, eya , and dac playing also key developmental roles in non-retinal structures and tissues of vertebrates and Drosophila . Here we have identified and explored the role of Sof-dac, Sof-six1/2, Sof-eya in eye morphogenesis, and nervous structures controlling the visual function in Sepia officinalis . We compare that with the already shown expressions in eye development of Sof-otx and Sof-pax genes. Rhodopsin is the pigment responsible for light sensitivity in metazoan, which correlate to correlate visual function and eye development. We studied Sof-rhodopsin expression during retina differentiation. By in situ hybridization, we show that (1) all of the RDGN genes, including Sof-pax6 , are expressed in the eye area during the early developmental stages but they are not expressed in the retina, unlike Sof-otx , which could have a role in retina differentiation; (2) Sof-rhodopsin is expressed in the retina just before vision gets functional, from stage 23 to hatching. Our results evidence a role of Sof-six1/2, Sof-eya , and Sof-dac in eye development. However, the gene network involved in the retinal photoreceptor differentiation remains to be determined. Moreover, for the first time, Sof-rhodopsin expression is shown in the embryonic retina of cuttlefish suggesting the evolutionary conservation of the role of rhodopsin in visual phototransduction within metazoans. These findings are correlated with the physiological and behavioral observations suggesting that S. officinalis is able to react to light stimuli from stage 25 of organogenesis on, as soon as the first retinal pigments appear.

Eye Development in Sepia officinalis Embryo: What the Uncommon Gene Expression Profiles Tell Us about Eye Evolution

PubMed Central

Imarazene, Boudjema; Andouche, Aude; Bassaglia, Yann; Lopez, Pascal-Jean; Bonnaud-Ponticelli, Laure

2017-01-01

In metazoans, there is a remarkable diversity of photosensitive structures; their shapes, physiology, optical properties, and development are different. To approach the evolution of photosensitive structures and visual function, cephalopods are particularly interesting organisms due to their most highly centralized nervous system and their camerular eyes which constitute a convergence with those of vertebrates. The eye morphogenesis in numerous metazoans is controlled mainly by a conserved Retinal Determination Gene Network (RDGN) including pax, six, eya, and dac playing also key developmental roles in non-retinal structures and tissues of vertebrates and Drosophila. Here we have identified and explored the role of Sof-dac, Sof-six1/2, Sof-eya in eye morphogenesis, and nervous structures controlling the visual function in Sepia officinalis. We compare that with the already shown expressions in eye development of Sof-otx and Sof-pax genes. Rhodopsin is the pigment responsible for light sensitivity in metazoan, which correlate to correlate visual function and eye development. We studied Sof-rhodopsin expression during retina differentiation. By in situ hybridization, we show that (1) all of the RDGN genes, including Sof-pax6, are expressed in the eye area during the early developmental stages but they are not expressed in the retina, unlike Sof-otx, which could have a role in retina differentiation; (2) Sof-rhodopsin is expressed in the retina just before vision gets functional, from stage 23 to hatching. Our results evidence a role of Sof-six1/2, Sof-eya, and Sof-dac in eye development. However, the gene network involved in the retinal photoreceptor differentiation remains to be determined. Moreover, for the first time, Sof-rhodopsin expression is shown in the embryonic retina of cuttlefish suggesting the evolutionary conservation of the role of rhodopsin in visual phototransduction within metazoans. These findings are correlated with the physiological and behavioral observations suggesting that S. officinalis is able to react to light stimuli from stage 25 of organogenesis on, as soon as the first retinal pigments appear. PMID:28883798

Comparison of different fertilisation media for an in vitro maturation?fertilisation?culture system using flow-cytometrically sorted X chromosome-bearing spermatozoa for bovine embryo production.

PubMed

Ferré, Luis B; Bogliotti, Yanina; Chitwood, James L; Fresno, Cristóbal; Ortega, Hugo H; Kjelland, Michael E; Ross, Pablo J

2015-05-13

High demand exists among commercial cattle producers for in vitro-derived bovine embryos fertilised with female sex-sorted spermatozoa from high-value breeding stock. The aim of this study was to evaluate three fertilisation media, namely M199, synthetic oviductal fluid (SOF) and Tyrode's albumin-lactate-pyruvate (TALP), on IVF performance using female sex-sorted spermatozoa. In all, 1143, 1220 and 1041 cumulus-oocyte complexes were fertilised in M199, SOF and TALP, respectively. There were significant differences among fertilisation media (P < 0.05) in cleavage rate (M199 = 57%, SOF = 71% and TALP = 72%), blastocyst formation (M199 = 9%, SOF = 20% and TALP = 19%), proportion of Grade 1 blastocysts (M199 = 15%, SOF = 52% and TALP = 51%), proportion of Grade 3 blastocysts (M199 = 58%, SOF = 21% and TALP = 20%) and hatching rates (M199 = 29%, SOF = 60% and TALP = 65%). The inner cell mass (ICM) and trophectoderm (TE) cells of Day 7 blastocysts were also affected by the fertilisation medium. Embryos derived from SOF and TALP fertilisation media had higher numbers of ICM, TE and total cells than those fertilised in M199. In conclusion, fertilisation media affected cleavage rate, as well as subsequent embryo development, quality and hatching ability. SOF and TALP fertilisation media produced significantly more embryos of higher quality than M199.

Effects of TEL Confusers on Operator Target Acquisition Performance with SAR Imagery

DTIC Science & Technology

1998-12-01

processing known as the theory of signal detection (TSD) (Gescheider, 1985; Green & Swets, 1966; Macmillan & Creelman , 1991; Wilson, 1992). A TSD...localizations (Hacker & Ratcliff, 1979; Macmillan & Creelman , 1991). The index of bias in a target localization task provides a measure of the operator’s...of correct localizations substituted for hits (Macmillan & Creelman , 1991). Receiver Operating Characteristic Curves. In addition to the calculation

Cost-Effectiveness of Treatments for Genotype 1 Hepatitis C Virus Infection in non-VA and VA Populations

PubMed Central

Liu, Shan; Barnett, Paul G.; Holodniy, Mark; Lo, Jeanie; Joyce, Vilija R.; Gidwani, Risha; Asch, Steven M.; Owens, Douglas K.; Goldhaber-Fiebert, Jeremy D.

2018-01-01

Background Chronic hepatitis C viral (HCV) infection affects millions of Americans. Healthcare systems face complex choices between multiple highly efficacious, costly treatments. This study assessed the cost-effectiveness of HCV treatments for chronic, genotype 1 HCV monoinfected, treatment-naïve individuals in the Department of Veterans Affairs (VA) and general U.S. healthcare systems. Methods We conducted a decision-analytic Markov model-based cost-effectiveness analysis, employing appropriate payer perspectives and time horizons, and discounting benefits and costs at 3% annually. Interventions included: Sofosbuvir/ledipasvir (SOF-LDV); ombitasvir/paritaprevir/ritonavir/dasabuvir (3D); sofosbuvir/simeprevir (SOF-SMV); sofosbuvir/pegylated interferon/ribavirin (SOF-RBV-PEG); boceprevir/pegylated interferon/ribavirin (BOC-RBV-PEG); and pegylated interferon/ribavirin (PEG-RBV). Outcomes were sustained virologic response (SVR), advanced liver disease, costs, quality adjusted life years (QALYs), and incremental cost-effectiveness. Results SOF-LDV and 3D achieve higher SVR rates compared to older regimens and reduce advanced liver disease (>20% relative to no treatment), increasing QALYs by over 2 years per person. For the non-VA population, at current prices ($5,040 per week for SOF-LDV and $4,796 per week for 3D), SOF-LDV’s lifetime cost ($293,370) is $18,000 lower than 3D’s because of its shorter treatment duration in subgroups. SOF-LDV costs $17,100 per QALY gained relative to no treatment. 3D costs $208,000 per QALY gained relative to SOF-LDV. Both dominate other treatments and are even more cost-effective for the VA, though VA aggregate treatment costs still exceed $4 billion at SOF-LDV prices of $3,308 per week. Drug prices strongly determine relative cost-effectiveness for SOF-LDV and 3D; With sufficient price reductions (approximately 20–30% depending on the health system), 3D could be cost-effective relative to SOF-LDV. Limitations include the lack of long-term head-to-head regimen effectiveness trials. Conclusions New HCV treatments are cost-effective in multiple healthcare systems if trial-estimated efficacy is achieved in practice, though, at current prices, total expenditures could present substantial challenges.

Analyses of Sox-B and Sox-E Family Genes in the Cephalopod Sepia officinalis: Revealing the Conserved and the Unusual

PubMed Central

Focareta, Laura; Cole, Alison G.

2016-01-01

Cephalopods provide an unprecedented opportunity for comparative studies of the developmental genetics of organ systems that are convergent with analogous vertebrate structures. The Sox-family of transcription factors is an important class of DNA-binding proteins that are known to be involved in many aspects of differentiation, but have been largely unstudied in lophotrochozoan systems. Using a degenerate primer strategy we have isolated coding sequence for three members of the Sox family of transcription factors from a cephalopod mollusk, the European cuttlefish Sepia officinalis: Sof-SoxE, Sof-SoxB1, and Sof-SoxB2. Analyses of their expression patterns during organogenesis reveals distinct spatial and temporal expression domains. Sof-SoxB1 shows early ectodermal expression throughout the developing epithelium, which is gradually restricted to presumptive sensory epithelia. Expression within the nervous system appears by mid-embryogenesis. Sof-SoxB2 expression is similar to Sof-SoxB1 within the developing epithelia in early embryogenesis, however appears in largely non-overlapping expression domains within the central nervous system and is not expressed in the maturing sensory epithelium. In contrast, Sof-SoxE is expressed throughout the presumptive mesodermal territories at the onset of organogenesis. As development proceeds, Sof-SoxE expression is elevated throughout the developing peripheral circulatory system. This expression disappears as the circulatory system matures, but expression is maintained within undifferentiated connective tissues throughout the animal, and appears within the nervous system near the end of embryogenesis. SoxB proteins are widely known for their role in neural specification in numerous phylogenetic lineages. Our data suggests that Sof-SoxB genes play similar roles in cephalopods. In contrast, Sof-SoxE appears to be involved in the early stages of vasculogenesis of the cephalopod closed circulatory system, a novel role for a member of this gene family. PMID:27331398

Apolipoprotein AI Deficiency Inhibits Serum Opacity Factor Activity against Plasma High Density Lipoprotein via a Stabilization Mechanism

PubMed Central

Rosales, Corina; Patel, Niket; Gillard, Baiba K.; Yelamanchili, Dedipya; Yang, Yaliu; Courtney, Harry S.; Santos, Raul D.; Gotto, Antonio M.; Pownall, Henry J.

2016-01-01

The reaction of Streptococcal serum opacity factor (SOF) against plasma high-density lipoproteins (HDL) produces a large cholesteryl ester-rich microemulsion (CERM), a smaller neo HDL that is apolipoprotein (apo) AI-poor, and lipid-free apo AI. SOF is active vs. both human and mouse plasma HDL. In vivo injection of SOF into mice reduces plasma cholesterol ~40% in 3 hours while forming the same products observed in vitro, but at different ratios. Previous studies supported the hypothesis that labile apo AI is required for the SOF reaction vs. HDL. Here we further tested that hypothesis by studies of SOF against HDL from apo AI-null mice. When injected into apo AI-null mice, SOF reduced plasma cholesterol ~35% in three hours. The reaction of SOF vs. apo AI-null HDL in vitro produced a CERM and neo HDL, but no lipid-free apo. Moreover, according to the rate of CERM formation, the extent and rate of the SOF reaction vs. apo AI-null mouse HDL was less than that against wild-type (WT) mouse HDL. Chaotropic perturbation studies using guanidine hydrochloride showed that apo AI-null HDL was more stable than WT HDL. Human apo AI added to apo AI-null HDL was quantitatively incorporated, giving reconstituted HDL. Both SOF and guanidine hydrochloride displaced apo AI from the reconstituted HDL. These results support the conclusion that apo AI-null HDL is more stable than WT HDL because it lacks apo AI, a labile protein that is readily displaced by physico-chemical and biochemical perturbations. Thus, apo AI-null HDL is less SOF-reactive than WT HDL. The properties of apo AI-null HDL can be partially restored to those of WT HDL by the spontaneous incorporation of human apo AI. It remains to be determined what other HDL functions are affected by apo AI deletion. PMID:25790332

Crystal structure of a birefringent andradite-grossular from Crowsnest Pass, Alberta, Canada

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

Antao, Sytle M.; Klincker, Allison M.

2014-02-20

The structure of a birefringent andradite–grossular sample was refined using single-crystal X-ray diffraction (SCD) and synchrotron high-resolution powder X-ray diffraction (HRPXRD) data. Electron-microprobe results indicate a homogeneous composition of {Ca 2.88Mn 2+ 0.06Mg 0.04Fe 2+ 0.03} Σ3[Fe 3+ 1.29Al 0.49Ti 4+ 0.17Fe 2+ 0.06] Σ2(Si 2.89Al 0.11) Σ3O 12. The Rietveld refinement reduced χ 2 = 1.384 and overall R (F 2) = 0.0315. The HRPXRD data show that the sample contains three phases. For phase-1, the weight %, unit-cell parameter (Å), distances (Å), and site occupancy factor (sof) are 62.85(7)%, a = 12.000 06(2), average = 2.4196, Fe–O =more » 1.9882(5), Si–O = 1.6542(6) Å, Ca(sof) = 0.970(2), Fe(sof) = 0.763(1), and Si(sof) = 0.954(2). The corresponding data for phase-2 are 19.14(9)%, a = 12.049 51(2), average = 2.427, Fe–O = 1.999(1), Si–O = 1.665(1) Å, Ca(sof) = 0.928(4), Fe(sof) = 0.825(3), and Si(sof) = 0.964(4). The corresponding data for phase-3 are 18.01(9)%, a = 12.019 68(3), average = 2.424, Fe–O = 1.992(2), Si–O = 1.658(2) Å, Ca(sof) = 0.896(5), Fe(sof) = 0.754(4), and Si(sof) = 0.936(5). The fine-scale coexistence of the three phases causes strain that arises from the unit-cell and bond distances differences, and gives rise to strain-induced birefringence. The results from the SCD are similar to the dominant phase-1 obtained by the HRPXRD, but the SCD misses the minor phases.« less

Measuring Frailty Can Help Emergency Departments Identify Independent Seniors at Risk of Functional Decline After Minor Injuries.

PubMed

Sirois, Marie-Josée; Griffith, Lauren; Perry, Jeffrey; Daoust, Raoul; Veillette, Nathalie; Lee, Jacques; Pelletier, Mathieu; Wilding, Laura; Émond, Marcel

2017-01-01

This study aims to (i) describe frailty in the subgroup of independent community-dwelling seniors consulting emergency departments (EDs) for minor injuries, (ii) examine the association between frailty and functional decline 3 months postinjury, (iii) ascertain the predictive accuracy of frailty measures and emergency physicians' for functional decline. Prospective cohort in 2011-2013 among 1,072 seniors aged 65 years or older, independent in basic daily activities, evaluated in Canadian EDs for minor injuries.Frailty was assessed at EDs using the Canadian Study of Health and Aging-Clinical Frailty scale (CSHA-CFS) and the Study of Osteoporotic Fracture frailty index (SOF). Functional decline was defined as a loss ≥2/28 on the Older American Resources Services scale 3 months postinjury. Generalized mixed models were used to explore differences in functional decline across frailty levels. Areas under the receiver operating characteristic curve were used to ascertain the predictive accuracy of frailty measures and emergency physicians' clinical judgment. The SOF and CSHA-CFS were available in 342 and 1,058 participants, respectively. The SOF identified 55.6%, 32.7%, 11.7% patients as robust, prefrail, and frail. These CSHA-CFS (n = 1,058) proportions were 51.9%, 38.3%, and 9.9%. The 3-month incidence of functional decline was 12.1% (10.0%-14.6%). The Areas under the receiver operating characteristic curves of the CSHA-CFS and the emergency physicians' were similar (0.548-0.777), while the SOF was somewhat higher (0.704-0.859). Measuring frailty in community-dwelling seniors with minor injuries in EDs may enhance current risk screening for functional decline. However, before implementation in usual care, feasibility issues such as inter-rater reliability and acceptability of frailty tools in the EDs have to be addressed. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Measuring Frailty Can Help Emergency Departments Identify Independent Seniors at Risk of Functional Decline After Minor Injuries

PubMed Central

Griffith, Lauren; Perry, Jeffrey; Daoust, Raoul; Veillette, Nathalie; Lee, Jacques; Pelletier, Mathieu; Wilding, Laura; Émond, Marcel

2017-01-01

Background. This study aims to (i) describe frailty in the subgroup of independent community-dwelling seniors consulting emergency departments (EDs) for minor injuries, (ii) examine the association between frailty and functional decline 3 months postinjury, (iii) ascertain the predictive accuracy of frailty measures and emergency physicians’ for functional decline. Method. Prospective cohort in 2011–2013 among 1,072 seniors aged 65 years or older, independent in basic daily activities, evaluated in Canadian EDs for minor injuries. Frailty was assessed at EDs using the Canadian Study of Health and Aging-Clinical Frailty scale (CSHA-CFS) and the Study of Osteoporotic Fracture frailty index (SOF). Functional decline was defined as a loss ≥2/28 on the Older American Resources Services scale 3 months postinjury. Generalized mixed models were used to explore differences in functional decline across frailty levels. Areas under the receiver operating characteristic curve were used to ascertain the predictive accuracy of frailty measures and emergency physicians’ clinical judgment. Results. The SOF and CSHA-CFS were available in 342 and 1,058 participants, respectively. The SOF identified 55.6%, 32.7%, 11.7% patients as robust, prefrail, and frail. These CSHA-CFS (n = 1,058) proportions were 51.9%, 38.3%, and 9.9%. The 3-month incidence of functional decline was 12.1% (10.0%−14.6%). The Areas under the receiver operating characteristic curves of the CSHA-CFS and the emergency physicians’ were similar (0.548–0.777), while the SOF was somewhat higher (0.704–0.859). Conclusion. Measuring frailty in community-dwelling seniors with minor injuries in EDs may enhance current risk screening for functional decline. However, before implementation in usual care, feasibility issues such as inter-rater reliability and acceptability of frailty tools in the EDs have to be addressed. PMID:26400735

Differential expression of SofDIR16 and SofCAD genes in smut resistant and susceptible sugarcane cultivars in response to Sporisorium scitamineum.

PubMed

Sánchez-Elordi, Elena; Contreras, Roberto; de Armas, Roberto; Benito, Mario C; Alarcón, Borja; de Oliveira, Eliandre; Del Mazo, Carlos; Díaz-Peña, Eva M; Santiago, Rocío; Vicente, Carlos; Legaz, María E

2018-05-04

Proteomic profiling of the stalk of a smut resistant and a susceptible sugarcane cultivars revealed the presence of dirigent and dirigent-like proteins in abundance in the pool of high molecular mass (HMMG) and mid-molecular mass (MMMG) glycoproteins, produced as part of the defensive response to the fungal smut pathogen. Quantitative RT-PCR analysis showed that expression levels of SofDIR16 (sugarcane dirigent16) and SofCAD (sugarcane cinnamyl alcohol dehydrogenase) were higher in the smut resistant My 55-14 cultivar than in the sensitive B 42231 cultivar prior to infection. Inoculation with fungal sporidia or water decreased the level of SofCAD transcripts in My 55-14, indicating that regulation of SofCAD expression does not take part of the specific response to smut infection. In contrast, SofDIR16 expression was almost nullified in My 55-14 after inoculation with fungal sporidia, but not after water injection. It is proposed that the decreased expression of dirigent proteins induces the formation of lignans, which are involved in the defense response of the smut resistant My 55-14 cultivar. Published by Elsevier GmbH.

Fertilization capacity of cryopreserved Iberian ibex epididymal sperm in a heterologous in vitro fertilization assay.

PubMed

López-Saucedo, J; Santiago-Moreno, J; Fierro, R; Izquierdo, D; Coloma, M A; Catalá, M G; Jiménez, I; Paramio, M T

2015-02-01

In vitro fertilization (IVF) can be used to assess the fertilization capacity of sperm. Heterologous IVF may be useful when assessing that of wild animals as it is often difficult to obtain adequate numbers of naturally corresponding oocytes. The aim of the present study was to assess the fertilization capacity of frozen-thawed ibex epididymal spermatozoa via heterologous IVF involving the oocytes of prepubertal domestic goats. The effect on fertilization and embryo development of adding oestrous sheep serum (ESS) to the fertilization medium was also examined. Cumulus-oocyte complexes (COCs) were matured in TCM-199 for 24-27 h at 38.5°C in a 5% CO2 in air atmosphere. Frozen-thawed epididymal spermatozoa were selected by density gradient centrifugation. After maturation, the oocytes were co-incubated with spermatozoa in synthetic oviductal fluid (SOF) with different concentrations of ESS: SOF-C (0%), SOF-2 (2%) and SOF-20 (20%). At 17 h post-insemination (hpi), zygotes with one female and one male pronucleus (2PN) were categorised as normal; zygotes with 3PN were recorded as polyspermic, and oocytes with 1PN as asynchronous. Cleavage and blastocyst development were assessed at 48 and 168 hpi respectively. The percentage of zygotes with 2PN was higher in the SOF-2 than in the SOF-20 treatment group (27.7% versus 2.9% P < 0.05). The percentage of blastocysts formed with the SOF-C, SOF-2 and SOF-20 treatments were 1.1%, 7.5% and 0% respectively. These results show that the presence of 2% ESS achieves better results than the use of no serum or the standard 20% concentration. Heterologous IVF may be an effective method for predicting the fertilization capacity of ibex spermatozoa, and therefore perhaps that of other wild mountain ungulates.

Directly observed therapy of sofosbuvir/ribavirin +/- peginterferon with minimal monitoring for the treatment of chronic hepatitis C in people with a history of drug use in Chennai, India (C-DOT).

PubMed

Solomon, S S; Sulkowski, M S; Amrose, P; Srikrishnan, A K; McFall, A M; Ramasamy, B; Kumar, M S; Anand, S; Thomas, D L; Mehta, S H

2018-01-01

We assessed the feasibility of field-based directly observed therapy (DOT) with minimal monitoring to deliver HCV treatment to people with a history of drug use in Chennai, India. Fifty participants were randomized 1:1 to sofosbuvir+peginterferon alfa 2a+ribavirin (SOF+PR) for 12 weeks (Arm 1) vs sofosbuvir+ribavirin (SOF+R) for 24 weeks (Arm 2). SOF+R was delivered daily at participant chosen venues and weekly peginterferon injections at the study clinic. HCV RNA testing was performed to confirm active HCV infection and sustained virologic response 12 weeks after treatment completion (SVR12). No baseline genotyping or on-treatment viral loads were performed. Median age was 46 years. All were male and 20% had significant fibrosis/cirrhosis. All self-reported history of injection drug use, 18% recent noninjection drug use and 38% alcohol dependence. Six discontinued treatment (88% completed treatment in each arm). Of 22 who completed SOF+PR, all achieved SVR12 (22/25=88%); 15 of 22 who completed SOF+R achieved SVR12 (15/25=60%; P=.05). Among those completing SOF+R, SVR12 was significantly less common in participants reporting ongoing substance use (36% vs 100%) and missed doses. Active substance use and missed doses did not impact SVR with SOF+PR. Field-based DOT of HCV therapy without real-time HCV RNA monitoring was feasible; however, achieving 100% adherence was challenging. SOF+PR appeared superior to SOF+R in achieving SVR12, even when doses were missed with no discontinuations due to side effects. Further exploration of short duration treatment with peginterferon plus direct-acting antivirals is warranted. © 2017 John Wiley & Sons Ltd.

Help a Brother Out: A Case Study in Multinational Intelligence Sharing, NATO SOF

DTIC Science & Technology

2011-12-01

increases the likelihood of operational failure and further risks the personal safety of the operators. NATO (and many of the individual member states... personalities in a region. The more 33 Lucien S. Vandenbroucke, Perilous Options: Special Operations as an...ICBMs, tank armies -- they were actually relatively easy to find , but they were very hard to kill. Intelligence was important, don’t get me wrong, but

Effectiveness of All-Oral Antiviral Regimens in 996 Human Immunodeficiency Virus/Hepatitis C Virus Genotype 1-Coinfected Patients Treated in Routine Practice.

PubMed

Bhattacharya, Debika; Belperio, Pamela S; Shahoumian, Troy A; Loomis, Timothy P; Goetz, Matthew B; Mole, Larry A; Backus, Lisa I

2017-06-15

Large cohorts are needed to assess human immunodeficiency virus (HIV)/hepatitis C virus (HCV) real-world treatment outcomes. We examined the effectiveness of ledipasvir/sofosbuvir with or without ribavirin (LDV/SOF ± RBV) and ombitasvir/ paritaprevir/ritonavir plus dasabuvir (OPrD) ± RBV in HIV/HCV genotype 1 (GT1)-coinfected patients initiating HCV therapy in clinical practice. Observational intent-to-treat cohort analysis using the Veterans Affairs Clinical Case Registry to identify HIV/HCV GT1-coinfected veterans initiating 12 weeks of LDV/SOF ± RBV or OPrD ± RBV. Multivariate models of sustained virologic response (SVR) included age, race, cirrhosis, proton pump inhibitor (PPI) prescription, prior HCV treatment, body mass index, genotype subtype, and HCV treatment regimen. Nine hundred ninety-six HIV/HCV GT1-coinfected veterans initiated therapy: 757 LDV/SOF, 138 LDV/SOF + RBV, 28 OPrD, and 73 OPrD + RBV. Overall SVR was 90.9% (823/905); LDV/SOF 92.1% (631/685), LDV/SOF + RBV 86.3% (113/131), OPrD 88.9% (24/27), and OPrD + RBV 88.7% (55/62). SVR was 85.9% (176/205) and 92.4% (647/700) in those with and without cirrhosis (P = .006). SVR was similar between African Americans (90.5% [546/603]) and all others (91.7% [277/302]). PPI use with LDV/SOF ± RBV did not affect SVR (89.7% [131/146] with PPI and 91.5% [613/670] without PPI). Cirrhosis was predictive of reduced SVR (0.51 [95% confidence interval {CI}, .31-.87]; P = .01). Median creatinine change did not differ among patients receiving LDV/SOF and tenofovir disoproxil fumarate (TDF) without a protease inhibitor (PI) (0.18 [interquartile range {IQR}, 0.08-0.30]; n = 372), LDV/SOF and TDF/PI (0.17 [IQR, 0.04-0.30]; n = 100), and LDV/SOF without TDF (0.15 [IQR, 0.00-0.30]; n = 423). SVR rates in HIV/HCV GT1-coinfected patients were high. African American race or PPI use with LDV/SOF ± RBV was not associated with lower SVR rates, but cirrhosis was. Renal function did not worsen on LDV/SOF regimens with TDF. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

RAF and SOF Integration

DTIC Science & Technology

2015-02-01

must continue efforts to change the Service’s cultural perspective on the AC-RC dynamic. Far too much parochialism exists with the net effect of...based on their ability to operate independently. These leaders must think creatively and solve problems, all within the legal, moral and ethical

33 CFR 337.6 - Statement of Findings (SOF).

Code of Federal Regulations, 2012 CFR

2012-07-01

... ROD will be prepared in accordance with 33 CFR part 230 and should be used in lieu of the SOF... determinations section should reference the results of the EA and/or EIS and any conditions necessary to meet the... part 230 may be incorporated into the SOF, as appropriate. ...

33 CFR 337.6 - Statement of Findings (SOF).

Code of Federal Regulations, 2011 CFR

2011-07-01

... ROD will be prepared in accordance with 33 CFR part 230 and should be used in lieu of the SOF... determinations section should reference the results of the EA and/or EIS and any conditions necessary to meet the... part 230 may be incorporated into the SOF, as appropriate. ...

33 CFR 337.6 - Statement of Findings (SOF).

Code of Federal Regulations, 2014 CFR

2014-07-01

... ROD will be prepared in accordance with 33 CFR part 230 and should be used in lieu of the SOF... determinations section should reference the results of the EA and/or EIS and any conditions necessary to meet the... part 230 may be incorporated into the SOF, as appropriate. ...

33 CFR 337.6 - Statement of Findings (SOF).

Code of Federal Regulations, 2013 CFR

2013-07-01

... ROD will be prepared in accordance with 33 CFR part 230 and should be used in lieu of the SOF... determinations section should reference the results of the EA and/or EIS and any conditions necessary to meet the... part 230 may be incorporated into the SOF, as appropriate. ...

33 CFR 337.6 - Statement of Findings (SOF).

Code of Federal Regulations, 2010 CFR

2010-07-01

... ROD will be prepared in accordance with 33 CFR part 230 and should be used in lieu of the SOF... determinations section should reference the results of the EA and/or EIS and any conditions necessary to meet the... part 230 may be incorporated into the SOF, as appropriate. ...

USSOCOM Research Topics 2012

DTIC Science & Technology

2012-01-01

challenges in their respective littorals, both within and across areas of operation, with specific emphasis on how irregular threat impacts the...theater, the five countries most likely to be the source of destabilization, and the impact of littorals on each. Make recommendations regarding the...awareness impact SOF operations? What is the linkage between the U.S. and Host Nation End State and cultural understanding? 30 USSOCOM Research

Safety analysis of sofosbuvir and ledipasvir for treating hepatitis C.

PubMed

Fazel, Yousef; Lam, Brian; Golabi, Pegah; Younossi, Zobair

2015-08-01

The approval of sofosbuvir (SOF), a nucleotide analogue NS5B polymerase inhibitor, and ledipasvir (LDV), a NS5A inhibitor, marked a new chapter in IFN and ribavirin-free treatment of hepatitis C virus (HCV). This drug reduces adverse events associated with IFN therapy. The purpose of this paper is to evaluate the safety and efficacy of LDV/SOF. Clinical trials illustrating safety and efficacy of LDV/SOF are reviewed and compared to other IFN and ribavirin-free treatment options available. In trials enrolling more than 3000 patients, LDV/SOF is well tolerated with a good safety and side-effect profile in diverse cohorts, including previous direct-acting antiviral (DAA) treatment failures, liver transplant recipients, decompensated cirrhosis and HIV/HCV co-infection. As with all DAAs, the potential for drug-drug interactions must be carefully evaluated, as demonstrated by recent post-marketing reports of symptomatic bradycardia when LDV/SOF is co-administered with amiodarone. Currently, dose recommendations cannot be given for patients with advanced renal disease. Trials in this population are ongoing, more study is warranted. When surveying the DAA regimens available, efficacy, safety and tolerability of LDV/SOF is comparable or better, and LDV/SOF provides an option with convenient single-tablet, once daily, ribavirin-free dosing with relatively few significant drug-drug interactions.

Impact of hepatitis C virus recombinant form RF1_2k/1b on treatment outcomes within the Georgian national hepatitis C elimination program.

PubMed

Karchava, Marine; Chkhartishvili, Nikoloz; Sharvadze, Lali; Abutidze, Akaki; Dvali, Natia; Gatserelia, Lana; Dzigua, Lela; Bolokadze, Natalia; Dolmazashvili, Ekaterine; Kotorashvili, Adam; Imnadze, Paata; Gamkrelidze, Amiran; Tsertsvadze, Tengiz

2018-01-01

Hepatitis C virus (HCV) recombinant form RF1_2k/1b is common in ethnic Georgians. This chimera virus contains genomic fragments of genotype 2 and genotype 1 and is misclassified as genotype 2 by standard genotyping. We aimed to identify RF1_2k/1b strains among genotype 2 patients and assess its impact on treatment outcomes. The study included 148 patients with HCV genotype 2 as determined by 5-untranslated region/core genotyping assay. RF1_2k/1b was identified by sequencing the non-structural protein 5B region. Patients were treated within the national hepatitis C elimination program with sofosbuvir/ribavirin (SOF/RBV), interferon (IFN)/SOF/RBV, or ledipasvir (LDV)/SOF/RBV. Of 148 patients, 103 (69.5%) had RF1_ 2k/1b. Sustained virologic response (SVR) data was available for 136 patients (RF1_ 2k/1b, n = 103; genotype 2, n = 33). Sustained virologic response was achieved in more genotype 2 patient than in RF1_2k/1b patients (97.0% vs. 76.7%, P = 0.009). Twelve weeks of LDV/SOF/RBV treatment was highly effective (100% SVR) in both genotypes. Among RF1_2k/1b patients, LDV/SOF/RBV for 12 weeks was superior (100% SVR) to SOF/RBV for 12 weeks (56.4%, P < 0.0001) or 20 weeks (79.2%, P = 0.05). Twelve weeks of IFN/SOF/RBV also showed better response than SOF/RBV for 12 weeks (88.9% vs. 56.4%, P = 0.02) in these patients. High prevalence of the RF1_2k/1b strain can significantly affect treatment outcomes. Treatment with IFN/SOF/RBV and especially LDV/SOF/RBV ensured significantly higher SVR in patients infected with RF1_2k/1b strain compared to standard HCV genotype 2 treatment with SOF/RBV. There is a need to reassess existing methods for the management of HCV genotype 2 infections, especially in areas with high prevalence of the RF1_2k/1b strain. © 2017 The Japan Society of Hepatology.

Experimental investigation on regulated and unregulated emissions of a diesel/methanol compound combustion engine with and without diesel oxidation catalyst.

PubMed

Zhang, Z H; Cheung, C S; Chan, T L; Yao, C D

2010-01-15

The use of methanol in combination with diesel fuel is an effective measure to reduce particulate matter (PM) and nitrogen oxides (NOx) emissions from in-use diesel vehicles. In this study, a diesel/methanol compound combustion (DMCC) scheme was proposed and a 4-cylinder naturally-aspirated direct-injection diesel engine modified to operate on the proposed combustion scheme. The effect of DMCC and diesel oxidation catalyst (DOC) on the regulated emissions of total hydrocarbons (THC), carbon monoxide (CO), NOx and PM was investigated based on the Japanese 13 Mode test cycle. Certain unregulated emissions, including methane, ethyne, ethene, 1,3-butadiene, BTX (benzene, toluene, xylene), unburned methanol and formaldehyde were also evaluated based on the same test cycle. In addition, the soluble organic fraction (SOF) in the particulate and the particulate number concentration and size distribution were investigated at certain selected modes of operation. The results show that the DMCC scheme can effectively reduce NOx, particulate mass and number concentrations, ethyne, ethene and 1,3-butadiene emissions but significantly increase the emissions of THC, CO, NO(2), BTX, unburned methanol, formaldehyde, and the proportion of SOF in the particles. After the DOC, the emission of THC, CO, NO(2), as well as the unregulated gaseous emissions, can be significantly reduced when the exhaust gas temperature is sufficiently high while the particulate mass concentration is further reduced due to oxidation of the SOF. Copyright 2009 Elsevier B.V. All rights reserved.

The Military Assistance Command-Vietnam Studies and Observations Group-A Case Study in Special Operations Campaigning

DTIC Science & Technology

2016-06-10

viewed as the panacea for all military problems. Politicians view SOF as a low risk minimalist investment that produces results; even for problems...of published work that has been dedicated to discussing special operations theory as an element of military strategy. A good starting point to...utility. Doctrine As a starting point for framing understanding of special operations, Joint Publication (JP) 3-05 Special Operations, provides the basis

Effective SOF Employment: Mitigating Causes of Conflict

DTIC Science & Technology

2013-06-01

Improved road networks increase the accessibility of government forces in denied areas. Also, education centers, wells, and medical centers become the hub...community relations activities as CA and SF teams conduct CMOs. MISO also produces pamphlets and comic books with anti-terrorist themes in order to...www.economist.com/node/576197. 132 “Colombia: Show of strength to eradicate child labour,” Education International, accessed April 10, 2013, http

Fighting With One Arm Behind Our Back: Cultural Capability in the 21st Century

DTIC Science & Technology

2013-03-01

deploying into a foreign environment. However, if unprepared for the challenges that accompany cultural immersion under adverse and stressful...reflects established and effective pedagogical methods.44 This is no small task, as the Army must deal with this daunting challenge while balancing...affect mentors. After ten years of counterinsurgency and the accompanying mission of building foreign security force capacity, both SOF and GPF

Review on structured optical field generated from array beams

NASA Astrophysics Data System (ADS)

Hou, Tianyue; Zhou, Pu; Ma, Yanxing; Zhi, Dong

2018-03-01

Structured optical field (SOF), which includes vortex beams, non-diffraction beams, cylindrical vector beams and so on, has been under intensive investigation theoretically and experimentally in recent years. Generally, current research focus on the extraordinary properties (non-diffraction propagation, helical wavefront, rotation of electrical field, et al), which can be widely applied in micro-particle manipulation, super-resolution imaging, free-space communication and so on. There are mainly two technical routes, that is, inner-cavity and outer-cavity (spatial light modulators, diffractive phase holograms, q-plates). To date, most of the SOFs generated from both technical routes involves with single monolithic beam. As a novel technical route, SOF based on array beams has the advantage in more flexible freedom degree and power scaling potential. In this paper, research achievements in SOF generation based on array beams are arranged and discussed in detail. Moreover, experiment of generating exotic beam by array beams is introduced, which illustrates that SOF generated from array beams is theoretically valid and experimentally feasible. SOF generated from array beams is also beneficial for capacity increasing and data receiving for free-space optical communication systems at long distance.

Cost-utility analysis of ledipasvir/sofosbuvir for the treatment of genotype 1 chronic hepatitis C in Japan.

PubMed

Igarashi, Ataru; Tang, Wentao; Guerra, Ines; Marié, Lucile; Cure, Sandrine; Lopresti, Michael

2017-01-01

Hepatitis C is the result of a ribonucleic acid (RNA) virus (hepatitis C virus; HCV). The Japan Society of Hepatology (JSH) estimated that 1.5-2 million people in Japan carry HCV. Six major HCV genotypes (GT) and a large number of subtypes have been described in the literature. In Japan, around 70% to 80% of people are infected with HCV genotype 1b. The progress of the disease primarily affects the liver and may lead to liver cirrhosis, hepatocellular carcinoma (HCC) and death. Sofosbuvir (SOF) is a nucleotide analogue NS5B inhibitor and ledipasvir (LDV) is an inhibitor of the HCV NS5A protein. They are combined in a single tablet regimen for the treatment of GT1 patients and resulted in sustained virological response (SVR) above 94% in large phase III trials. This analysis assesses the cost-utility of LDV/SOF in GT1 patients in Japan. A cohort of 10,000 patients was followed through a Markov model until they reached 100 years of age. GT1 treatment-naïve and experienced, non-cirrhotic and cirrhotic patients were studied separately. LDV/SOF was compared to several treatment regimens containing pegylated interferon (PEGIFN), telaprevir (TVR), simeprevir (SMV), daclatasvir (DCV), asunaprevir (ASV) and ribavirin (RBV). Discount rates of 2% were applied to costs and outcomes according to the Japanese guidelines. LDV/SOF was cost-effective against most comparators with incremental cost-effectiveness ratios (ICERs) below JPY 5,000,000. By applying a societal perspective, LDV/SOF was the dominant treatment strategy in all cases. Moreover, LDV/SOF reduced the number of cases of advanced liver disease. These results were robust to sensitivity analyses. LDV/SOF was cost-effective compared to most of the currently recommended treatments. Furthermore, LDV/SOF extends treatments to HCV-infected patients who are ineligible for interferon and RBV-based regimens. LDV/SOF thus has the potential to help reduce the burden of HCV in Japan.

Training Community Modeling and Simulation Business Plan: 2009 Edition

DTIC Science & Technology

2010-04-01

strategic information assurance 33 33 Provide crisis action procedures training 34 34 Provide the IC SOF-specific training at the operational level... information and products • Collaborative analysis processes • Dissemination of information throughout a command and to subordinates by redundant means...centric M&S capabilities will improve training for information warfare, assist with training for homeland defense operations, crisis -management plan- ning

Performance comparison of the medtronic sof-sensor and enlite glucose sensors in inpatient studies of individuals with type 1 diabetes.

PubMed

Calhoun, Peter; Lum, John; Beck, Roy W; Kollman, Craig

2013-09-01

Knowledge of the accuracy of continuous glucose monitoring (CGM) devices is important for its use as a management tool for individuals with diabetes and for its use to assess outcomes in clinical studies. Using data from several inpatient studies, we compared the accuracy of two sensors, the Medtronic Enlite™ using MiniMed Paradigm(®) Veo™ calibration and the Sof-Sensor(®) glucose sensor using Guardian(®) REAL-Time CGM calibration (all from Medtronic Diabetes, Northridge, CA). Nocturnal data were analyzed from eight inpatient studies in which both CGM and reference glucose measurements were available. The analyses included 1,666 CGM-reference paired glucose values for the Enlite in 54 participants over 69 nights and 3,627 paired values for the Sof-Sensor in 66 participants over 91 nights. The Enlite sensor tended to report glucose levels lower than the reference over the entire range of glucose values, whereas the Sof-Sensor values tended to be higher than reference values in the hypoglycemic range and lower than reference values in the hyperglycemic range. The overall median sensor-reference difference was -15 mg/dL for the Enlite and -1 mg/dL for the Sof-Sensor (P<0.001). The median relative absolute difference was 15% for the Enlite versus 12% for the Sof-Sensor (P=0.06); 66% of Enlite values and 73% of Sof-Sensor values met International Organization for Standardization criteria. We found that the Enlite tended to be biased low over the entire glucose range, whereas the Sof-Sensor showed the more typical sensor pattern of being biased high in the hypoglycemic range and biased low in the hyperglycemic range.

Revisiting policy on chronic HCV treatment under the Thai Universal Health Coverage: An economic evaluation and budget impact analysis.

PubMed

Rattanavipapong, Waranya; Anothaisintawee, Thunyarat; Teerawattananon, Yot

2018-01-01

Thailand is encountering challenges to introduce the high-cost sofosbuvir for chronic hepatitis C treatment as part of the Universal Health Care's benefit package. This study was conducted in respond to policy demand from the Thai government to assess the value for money and budget impact of introducing sofosbuvir-based regimens in the tax-based health insurance scheme. The Markov model was constructed to assess costs and benefits of the four treatment options that include: (i) current practice-peginterferon alfa (PEG) and ribavirin (RBV) for 24 weeks in genotype 3 and 48 weeks for other genotypes; (ii) Sofosbuvir plus peginterferon alfa and ribavirin (SOF+PEG-RBV) for 12 weeks; (iii) Sofosbuvir and daclatasvir (SOF+DCV) for 12 weeks; (iv) Sofosbuvir and ledipasvir (SOF+LDV) for 12 weeks for non-3 genotypes and SOF+PEG-RBV for 12 weeks for genotype 3 infection. Given that policy options (ii) and (iii) are for pan-genotypic infection, the cost of genotype testing was applied only for policy options (i) and (iv). Results reveal that all sofosbuvir-based regimens had greater quality adjusted life years (QALY) gains compared with the current treatment, therefore associated with lower lifetime costs and more favourable health outcomes. Additionally, among the three regimens of sofosbuvir, SOF+PEG-RBV for genotype 3 and SOF+LDV for non-3 genotype are the most cost-effective treatment option with the threshold of 160,000 THB per QALY gained. The results of this study had been used in policy discussion which resulted in the recent inclusion of SOF+PEG-RBV for genotype 3 and SOF+LDV for non-3 genotype in the Thailand's benefit package.

Environmental Assessment (EA) for the Comprehensive Range Plan (CRP), Melrose Air Force Range (AFR), New Mexico

DTIC Science & Technology

2011-07-01

11,674 sq ft C-130 maintenance hangar with reinforced concrete footings, a foundation and footing slab, a structural steel frame, insulated metal...regional farming output significantly; however, it could potentially have a detrimental effect to the lessee. Environmental Justice – There are no...Facility – Construct a pre-engineered one story steel framed structure including the necessary concrete foundations to support the building.  SOF

SOF/Convention Force Light Footprint Interdependence in Asia and Beyond

DTIC Science & Technology

2013-04-01

risk for food and waterborne illness.47 In many of these isolated rural areas, farming of crops is barely at a subsistence level, and livestock...mostly sheep and goats, compete for food with people. After thirty years of warfare, most modern infrastructure and many traditional institutions...These water sources are often of questionable quality, with animal and human waste run-off contaminating many of them. Men work farm fields to

Journal of Special Operations Medicine. Volume 2, Edition 4, Fall 2002

DTIC Science & Technology

2002-01-01

Blessing Journal of Special Operations Medicine6 GENERAL RULES FOR SUBMISSIONS 1. Use the active voice when possible. 2. Secure permission before...Afghanistan to the Philippines . I am currently writ- ing this at the "Advanced Technology Applications for Combat Casualty Care" (ATACCC) meeting...ference some of the time. 91W Transition- All active component SOF units with medics that are not 18D are 91Ws as 91W_W1 Special Operations Combat

Tourniquet Effectiveness When Placed Over the Joint Service Lightweight Integrated Suit Technology.

PubMed

Peponis, Thomas; Ramly, Elie; Roth, Kym A; King, David R

2016-01-01

Chemical, biological, radiological, and nuclear threats (CBRNs) are uncommon; however, Special Operations Forces (SOF) are likely at the highest risk for tactical exposure. In the event of exposure, SOF will rely on the Joint Service Lightweight Integrated Suit Technology (JSLIST) for survival. Doctrine dictates that a tourniquet should be applied over the JSLIST after a severe limb injury with hemorrhage. There is no evidence in the literature that the Combat Application Tourniquet (C-A-T), which is currently the most widely available tourniquet on the battlefield, can effectively occlude arterial blood flow when applied over the JSLIST. We hypothesized that C-A-T application over the JSLIST would be ineffective at occluding arterial blood flow in the lower extremity. Following institutional review board approval, 20 healthy volunteers were recruited to participate. All volunteers wore the G3 Combat Pant and they donned the JSLIST. First, an operating room pneumatic tourniquet (gold standard) was applied in the proximal thigh and inflated to 300mmHg. Distal arterial interrogation was performed by examination of distal pulses and noninvasive arterial plethysmography wave-form analysis. After a 1-hour recovery period, the C-A-T was applied and tightened. A double routing technique was used, with three 180° turns of the windlass. The same distal interrogation followed. Half of the volunteers had the pneumatic tourniquet applied first, and the other half had the C-A-T applied first. All volunteers had palpable pulses at baseline despite a wide range in volunteer body mass index. Distal pulses were absent in all volunteers following inflation of the pneumatic tourniquet as well as tightening of the C-A-T. The observed difference between the mean amplitude of plethysmographic waveforms was not different. The C-A-T effectively occludes arterial flow in the lower extremity, even when applied over the JSLIST. This finding supports existing military doctrine for tourniquet application over the JSLIST in the nonpermissive CBRN environment to control extremity exsanguination. 2016.

Simultaneous quantitation of two direct acting hepatitis C antivirals (sofosbuvir and daclatasvir) by an HPLC-UV method designated for their pharmacokinetic study in rabbits.

PubMed

Atia, Noha N; El-Shaboury, Salwa R; El-Gizawy, Samia M; Abo-Zeid, Mohammad Nabil

2018-05-22

Sofosbuvir (SOF) and daclatasvir (DCS) are novel, recently developed direct acting antiviral agents characterized by potent anti-hepatitis C virus action. A fast and efficient HPLC-UV method was developed, validated and applied for simultaneous determination of SOF and DCS in pharmaceutical formulations and biological fluids based on coupling liquid-liquid extraction with ultrasound and dual wavelength detection at λ max ; 260 and 313 nm for SOF and DCS, respectively. This approach provided simple, sensitive, specific and cost-effective determination of the SOF-DCS mixture with good recoveries of the analytes from plasma. Analytes were separated within 7 min on C 18 analytical column with acetonitrile-10 mM acetate buffer of pH 5.0 at a flow rate of 1.0 mL min -1 . The linear ranges were 1-20 μg mL -1 for SOF and 0.6-6 μg mL -1 for DCS with correlation coefficients ≥0.9995. The detection limits in spiked rabbit plasma were 0.20 and 0.19 μg mL -1 for SOF and DCS, respectively. The method was validated according to ICH and US-FDA guidelines. Finally, the method was successfully applied for simultaneous pharmacokinetic studies of SOF and DCS in rabbits using rofecoxib as internal standard. Copyright © 2018 Elsevier B.V. All rights reserved.

Efficient HPTLC-dual wavelength spectrodensitometric method for simultaneous determination of sofosbuvir and daclatasvir: Biological and pharmaceutical analysis.

PubMed

Abo-Zeid, Mohammad Nabil; El-Gizawy, Samia M; Atia, Noha N; El-Shaboury, Salwa R

2018-05-01

Sofosbuvir (SOF) and daclatasvir (DCS) are newly discovered anti-hepatitis C drugs that have direct antiviral activity. A novel and simple high-performance thin-layer chromatography (HPTLC) method was designed for simultaneous determination of SOF and DCS in miscellaneous matrices. The method adopts coupling HPTLC with dual wavelength spectrodensitometry. Consequently, this enabled sensitive, specific and cost-effective determination of the SOF-DCS mixture. The developed HPTLC procedure is based on a simple liquid-liquid extraction, enrichment of the analytes and subsequent chromatographic separation with UV detection. Separations were performed on HPTLC silica gel 60 F 254 aluminum plates with a mobile phase consisting of ethyl acetate-isopropanol (85:15, v/v). Dual wavelength scanning was carried out in the absorbance mode at 265 and 311 nm for SOF and DCS, respectively. The linear ranges were 40-640 and 20-320 ng band -1 for SOF and DCS, respectively with correlation coefficients of ≥0.9997. The detection limits were 11.3 and 6.5 ng band -1 for SOF and DCS, respectively indicating high sensitivity of the proposed method. Consequently, this permits in vitro and in vivo application of the proposed method in human plasma with good percentage recovery (94.1-103.5%). Validation parameters were assessed according to ICH guidelines and US-FDA guidelines. Furthermore, the application was extended to analysis of SOF and DCS in their pharmaceutical formulations. Copyright © 2018 Elsevier B.V. All rights reserved.

Effectiveness and Safety of Sofosbuvir/Ledipasvir and Paritaprevir/ritonavir/Ombitasvir + Dasabuvir in Patients with Chronic Kidney Diseases: Results from ERCHIVES

PubMed Central

Butt, Adeel; Ren, Yanjie; Puenpatom, Amy; Arduino, Jean Marie; Kumar, Ritesh; Abou-Samra, Abdul-Badi

2017-01-01

Abstract Background Chronic kidney disease (CKD) was a relative contraindication to HCV treatment in the interferon/ribavirin era due to poor tolerability and lower efficacy. Our aim was to determine the effectiveness treatment completion, and safety of sofosbuvir/ledipasvir (SOF/LDV) and paritaprevir/ritonavir/ombitasvir/dasabuvir (PrOD) regimens in persons with CKD. Methods We identified all persons started on a SOF/LDV or PrOD regimen in ERCHIVES before 30 April 2016. We excluded those with missing HCV genotype, or eGFR values. We determined treatment completion, sustained virologic response (SVR) rates and proportion of persons with worseningrenal function or developing grade 3/4 anemia. Results We identified 9,837 persons on SOF/LDV, 3,826 on SOF/LDV+RBV, 1,017 on PrOD and 2,944 on PrOD+RBV. Genotype 1a was the predominant genotype for SOF/LDV+RBV (77.3% no RBV; 70.0% with RBV) and PrOD+RBV (79.5%) groups, while only 4.3% of PrOD with no RBV group were genotype 1a. Among treated patients, the prevalence of patients with stage 4–5 CKD was 0.8% (SOF/LDV + RBV), 1.1% (SOF/LDVno RBV), 2.2% (PrOD +RBV) and 5.4% (PrOD no RBV). Among 13,663 total persons on SOF/LDV, 67.8% completed treatment while the treatment completion rate of those on PrOD was 74.0% (N = 2,932/3,961) (Table 1). The overall SVR rates of persons on SOF/LDV or PrOD regimens were 96.3%. A drop in treatment completion rates was seen in CKD stage 4–5 and those on PrOD+RBV, but the impact of RBV on SVR was unclear. While about one-third of the persons with a CKD stage 1–2 experienced a >10 mL/minute/1,73m2, about 15% decline among those with CKD stage 3. The incidence of grade3/4 anemia by CKD stages increased significantly across the treatment groups. Grade 3/4 anemia ranged from 9.7% (SOF/LDV) to 21.8% (PrOD) among patients with CKD stage 4–5 (Table 2). Conclusion SVR rates among persons treated with SOF/LDV or PrOD were high in the CKD population despite 22% not completing the treatment regimen. Incidence of grade3/4 anemia increased significantly in CKD stage 4–5 across the treatment groups. Disclosures A. Butt, Merck: Investigator, Grant recipient.A. Puenpatom, Merck: Employee, Salary. J. M. Arduino, Merck: Employee, Salary. R. Kumar, Merck: Employee, Salary

Kalman filter for onboard state of charge estimation and peak power capability analysis of lithium-ion batteries

NASA Astrophysics Data System (ADS)

Dong, Guangzhong; Wei, Jingwen; Chen, Zonghai

2016-10-01

To evaluate the continuous and instantaneous load capability of a battery, this paper describes a joint estimator for state-of-charge (SOC) and state-of-function (SOF) of lithium-ion batteries (LIB) based on Kalman filter (KF). The SOC is a widely used index for remain useful capacity left in a battery. The SOF represents the peak power capability of the battery. It can be determined by real-time SOC estimation and terminal voltage prediction, which can be derived from impedance parameters. However, the open-circuit-voltage (OCV) of LiFePO4 is highly nonlinear with SOC, which leads to the difficulties in SOC estimation. To solve these problems, this paper proposed an onboard SOC estimation method. Firstly, a simplified linearized equivalent-circuit-model is developed to simulate the dynamic characteristics of a battery, where the OCV is regarded as a linearized function of SOC. Then, the system states are estimated based on the KF. Besides, the factors that influence peak power capability are analyzed according to statistical data. Finally, the performance of the proposed methodology is demonstrated by experiments conducted on a LiFePO4 LIBs under different operating currents and temperatures. Experimental results indicate that the proposed approach is suitable for battery onboard SOC and SOF estimation.

'Do not attempt resuscitation'--do standardised order forms make a clinical difference above hand-written note entries?

PubMed

Lewis, Keir Edward; Edwards, Victoria Middleton; Hall, Sian; Temblett, Paul; Hutchings, Hayley

2009-01-01

To quantify any effect of Standardised Order Forms (SOFs), versus hand-written note entries for 'Do Not Attempt Resuscitation'--on the selection and survival of remaining cardiopulmonary resuscitation (CPR) attempts. A prospective, observational study in two UK Hospitals, comparing numbers, demographics and survival rates from CPR attempts for 2 years prior to and 2 years after the introduction of SOFs (the only change in DNAR policy). There were 133 CPR attempts, representing 0.30% of the 44,792 admissions, pre SOFs and 147 CPR attempts representing 0.32% of the 45,340 admissions following the SOFs (p=0.46). The median duration of a CPR attempt was 11min prior to and 15min following the SOFs (p=0.02). Of the CPR attempts, there was no change in mean age (p=0.34), proportions occurring outside working hours (p=0.70) or proportions presenting with an initial shockable rhythm (p=0.30). Survival to discharge following CPR was unchanged (p=0.23). The introduction of SOFs for DNAR orders was associated with a significantly longer duration of CPR (on average by 3-4min) but no difference in overall number, demographics or type of arrest or survival in the remaining CPR attempts.

The Search for a Permanent Home: Explaining the Organizational Instability of Air Force Rescue

DTIC Science & Technology

2015-06-01

capability became a major concern after the failed attempt to rescue American hostages in Iran in 1979 . The merger of Rescue and SOF in 1983 succeeded in...Participants General Huyser’s opinion was counter to General Ralph Saunders, the Rescue commander from 1974 to 1979 , who was dedicated to...subsequent Rescue commander, Brigadier General Cornelius Nugteren, took command on 29 September 1979 and was more open to the idea of consolidation. In

Joint Force Quarterly. Number 33, Winter 2002-03

DTIC Science & Technology

2003-04-01

by Richard B. Myers 9 A Quiet Revolution: Nuclear Strategy for the 21st Century by James J. Wirtz and James A. Russell 16 Army SOF in Afghanistan...warfighting strategies of attrition or annihilation. The Coalition commander would restrict enemy decisionmaking processes in order to take away options...highlighted the role of precision and ad hoc innovations in the area of time-sensitive targeting Winter 2002–03 / JFQ 5 F/A–18C taking off, Iraqi Freedom

Is Interferon-Based Treatment of Viral Hepatitis C Genotype 3 Infection Still of Value in the Era of Direct-Acting Antivirals?

PubMed

Zarębska-Michaluk, Dorota; Flisiak, Robert; Jaroszewicz, Jerzy; Janczewska, Ewa; Czauż-Andrzejuk, Agnieszka; Berak, Hanna; Horban, Andrzej; Staniaszek, Agnieszka; Gietka, Andrzej; Tudrujek, Magdalena; Tomasiewicz, Krzysztof; Dybowska, Dorota; Halota, Waldemar; Piekarska, Anna; Sitko, Marek; Garlicki, Aleksander; Orłowska, Iwona; Simon, Krzysztof; Belica-Wdowik, Teresa; Baka-Ćwierz, Barbara; Mazur, Włodzimierz; Białkowska, Jolanta; Socha, Łukasz; Wawrzynowicz-Syczewska, Marta; Laurans, Łukasz; Deroń, Zbigniew; Lorenc, Beata; Dobracka, Beata; Tronina, Olga; Pawłowska, Małgorzata

2018-02-01

The aim of the study is to analyze treatments available for patients infected with genotype (G) 3 hepatitis C virus (HCV) in Poland at the beginning of the interferon (IFN)-free era and evaluate the efficacy and safety of different therapeutic options administered in a real-world setting. We analyzed data of 198 patients who started antiviral therapy after July 1, 2015, and completed it before December 31, 2016; 57.6% of them had liver cirrhosis and 46% were treatment experienced. Fifty percent of patients were assigned to sofosbuvir (SOF)+pegylated IFN alfa (PegIFNa)+ribavirin (RBV), 9% to PegIFNa+RBV, 36% received SOF+RBV, and 5% SOF+daclatasvir (DCV)±RBV. Cirrhotic patients were assigned more frequently to IFN-free regimens. Overall, a sustained virological response was achieved by 84.3% of patients in intent-to-treat (ITT) analysis and 87% in modified ITT analysis. For SOF+PegIFNa+RBV and SOF+DCV±RBV regimens, the sustained virologic response (SVR) rate reached at least 90%, whereas the two other therapeutic options demonstrated efficacy <80%. The SVR rate in noncirrhotics was higher than in cirrhotics, irrespective of regimen. Adverse events were documented in 52.5%, with the most common being weakness/fatigue and anemia. We confirmed effectiveness and safety of the SOF-based treatment in a real-world cohort of patients with chronic HCV G3 infection. Most notably, we demonstrated good tolerability and high efficacy of the SOF+PegIFNa+RBV regimen.

Journal of Special Operations Medicine, Volume 6, Edition 4

DTIC Science & Technology

2006-01-01

units and our active editorial consultants. 2) SOMA members receive the JSOM as part of membership. Please note, if you are a SOMA member and are...directed by the Commander. As of September, the SOF Warrior, Program Executive Office (PEO) has an active and forward moving TC3 program that will...AFSOC medics have been actively deployed around the world. The 352nd Special Operations Group (SOG) medics support- ed a humanitarian non-combatant

Authorities and Options for Funding USSOCOM Operations

DTIC Science & Technology

2014-01-01

Operations and Maintenance funds to anticipate emergent SOF sup- port funding requirements. The MILDEPs have some flexibility to make “fact of life ...but does not direct a specific funding pathway) USSOCOM directs a stop to use of MFP-11 funding for TSOC HQ suport . PBD realigns MFP-11 and MFP-2...planning advances relatively quickly, while the search for funding lags. The planning also has a dynamic quality, so the Statement of Requirements

Cost-effectiveness of combination daclatasvir-sofosbuvir for treatment of genotype 3 chronic hepatitis C infection in the United States.

PubMed

Saint-Laurent Thibault, Catherine; Moorjaney, Divya; Ganz, Michael L; Sill, Bruce; Hede, Shalini; Yuan, Yong; Gorsh, Boris

2017-07-01

A phase III trial evaluated the efficacy and safety of Daklinza (daclatasvir or DCV) in combination with sofosbuvir (SOF) for treatment of genotype (GT) 3 hepatitis C virus (HCV) patients. This study evaluated the cost-effectiveness of DCV + SOF vs SOF in combination with ribavirin (RBV) over a 20-year time horizon from the perspective of a United States (US) payer. A published Markov model was adapted to reflect US demographic characteristics, treatment patterns, costs of drug acquisition, monitoring, disease and adverse event management, and mortality risks. Clinical inputs came from the ALLY-3 and VALENCE trials. The primary outcome was the incremental cost-utility ratio. Life-years, incidence of complications, number of patients achieving sustained virological response (SVR), and the total cost per SVR were secondary outcomes. Costs (2014 USD) and quality-adjusted life years (QALYs) were discounted at 3% per year. Deterministic, probabilistic, and scenario sensitivity analyses were conducted. DCV + SOF was associated with lower costs and better effectiveness than SOF + RBV in the base case and in almost all scenarios (i.e. treatment-experienced, non-cirrhotic, time horizons of 5, 10, and 80 years). DCV + SOF was less costly, but also slightly less effective than SOF + RBV in the cirrhotic and treatment-naïve population scenarios. Results were sensitive to variations in the probability of achieving SVR for both treatment arms. DCV + SOF costs less than $50,000 per QALY gained in 79% of all probabilistic iterations compared with SOF + RBV. DCV + SOF is a dominant option compared with SOF + RBV in the US for the overall GT 3 HCV patient population.

The safety and efficacy of ledipasvir/sofosbuvir with or without ribavirin in the treatment of orthotopic liver transplant recipients with recurrent hepatitis C: real-world data.

PubMed

Pyrsopoulos, Nikolaos; Trilianos, Panagiotis; Lingiah, Vivek A; Fung, Phoenix; Punnoose, Merlin

2018-07-01

Recurrent hepatitis C (RHC) in orthotopic liver transplantation (OLT) population is associated with accelerated rates of fibrosis, low efficacy and decreased tolerability with traditional therapies. The aim of this study was to evaluate the safety and efficacy of ledipasvir/sofosbuvir (LED/SOF) with or without ribavirin (RBV) in OLT patients with RHC. Patients at least 3 months post-OLT and with documented RHC were treated with LED/SOF with or without RBV for either 12 or 24 weeks. End-of-treatment and sustained virological response 12 weeks after the completion of treatment were documented. Patients were closely monitored for treatment-related adverse effects and the potential need for adjustment in their immunosuppression. Seventy-one patients were included in the study. Median age was 62 years. Median time from OLT was 55 months. Twenty-six (36.6%) patients were treatment-naive and 45 (63.4%) had previously failed interferon-based therapies. The majority of patients (57.7%) had stage F0-F2 fibrosis. Sixty-seven (94.3%) patients completed 12 weeks of LED/SOF with RBV, three patients completed 12 or 24 weeks of LED/SOF without RBV, and one patient completed only 8 weeks of LED/SOF without RBV owing to severe allograft dysfunction. Sustained virological response was near universal in our cohort (98.5%) regardless of genotype, fibrosis stage, and regimen or treatment duration. Most commonly reported side effects were malaise and gastrointestinal upset. No patient required adjustment in immunosuppression and no episodes of rejection were documented during treatment. The combination of LED/SOF with RBV for 12 weeks or LED/SOF for 24 weeks is very effective and safe in treating OLT recipients with RHC.

Treating Medicaid patients with hepatitis C: clinical and economic impact.

PubMed

Younossi, Zobair; Gordon, Stuart C; Ahmed, Aijaz; Dieterich, Douglas; Saab, Sammy; Beckerman, Rachel

2017-02-01

To estimate change in chronic hepatitis C virus (HCV) disease and the economic burden associated with comprehensive treatment of the chronic HCV-infected Medicaid population. Decision-analytic Markov model. Treatment-naïve patients with genotype 1 chronic HCV were followed over a lifetime horizon from the third-party payer perspective. Patients entered the model insured under Medicaid and were treated under state-specific restrictions by Metavir fibrosis stage (base case) or all treated (all-patient strategy) with an approved all-oral regimen (ledipasvir/sofosbuvir [LDV/SOF] for 8 weeks or 12 weeks, depending on cirrhosis status, viral load, and state-specific LDV/SOF restrictions). Untreated patients were assumed to age into Medicare at 65 years, where they were treated with LDV/SOF without restriction by fibrotic stage. The sustained virologic response (SVR) rate of the current Medicaid LDV/SOF restriction strategy was 75.2% versus 95.9% if all LDV/SOF-eligible patients were treated under Medicaid. Treating all eligible Medicaid patients with LDV/SOF, regardless of fibrotic stage, was projected to result in 36,752 fewer cases of cirrhosis; 1739 fewer liver transplants; 8169 fewer cases of hepatocellular carcinoma; 16,173 fewer HCV-related deaths; 0.84 additional life-years per patient; and 1.03 additional quality-adjusted life-years per patient. Treating all Medicaid patients with chronic HCV using LDV/SOF resulted in a 39.4% ($3.8 billion) savings and decreased the proportion of total costs attributable to downstream costs of care to 18.3%. A "treat all" strategy in a Medicaid population resulted in superior SVRs, substantial reductions in downstream negative clinical outcomes, and considerable cost savings. Current restrictive state policies regarding HCV treatment in Medicaid populations must be reassessed in light of these data.

Safety of Sofosbuvir and Ribavirin Combination Therapy in a Patient Who Developed Anemia due to Ribavirin.

PubMed

Suii, Hirokazu; Ozeki, Itaru; Tatsumi, Ryoji; Yamaguchi, Masakatsu; Kimura, Mutsuumi; Arakawa, Tomohiro; Nakajima, Tomoaki; Kuwata, Yasuaki; Ohmura, Takumi; Hige, Shuhei; Karino, Yoshiyasu; Toyota, Joji

2017-01-01

Interferon (IFN) and ribavirin (RBV) combination therapy was previously the standard of care for treatment of hepatitis C virus (HCV) genotype 2 infection. But, it often induced hemolytic anemia. In 2014, sofosbuvir (SOF) was approved for the treatment of chronic HCV genotype 2 in Japan. SOF/RBV therapy is more effective against genotype 2 than IFN/RBV therapy. We report a case of a 74-year-old woman with chronic HCV genotype 2b infection. She received five treatments including RBV and IFN therapy before SOF was approved and all of them were ineffective. Therapies that included RBV induced severe anemia and led to discontinuation of treatment. With pegylated IFN/RBV therapy, the maximum change in hemoglobin (Hb) from baseline was -3.7 g/dL. However, SOF/RBV therapy was effective and she achieved sustained virologic response (SVR) with a maximum change in Hb from baseline of only -1.2 g/dL. We also found reticulocyte count was very low during treatment in this case and speculate it was one of the reasons that she developed hemolytic anemia with RBV. In conclusion, SOF/RBV therapy is effective and allowed the patient to achieve SVR. An SOF/RBV regimen is safe and effective for patients who have or are at risk of anemia induced by RBV.

Serum Opacity Factor Enhances HDL-Mediated Cholesterol Efflux, Esterification and Anti Inflammatory Effects

PubMed Central

Tchoua, Urbain; Rosales, Corina; Tang, Daming; Gillard, Baiba K.; Vaughan, Ashley; Lin, Hu Yu; Courtney, Harry S.

2011-01-01

Serum opacity factor (SOF) is a streptococcal protein that disrupts the structure of human high density lipoproteins (HDL) releasing lipid-free apo A-I while forming a large cholesteryl ester-rich particle and a small neo HDL. Given its low cholesterol and high phospholipid contents, we tested the hypotheses that neo HDL is a better substrate for cholesterol esterification via lecithin:cholesterol acyltransferase (LCAT), better than HDL as an acceptor of THP-1 macrophage cholesterol efflux, and improves reduction of oxidized LDL-induced production of inflammatory markers. We observed that both cholesterol efflux and esterification were improved by recombinant (r)SOF treatment of whole plasma and that the underlying cause of the improved cholesterol esterification in plasma and macrophage cholesterol efflux to rSOF-treated plasma was due to the rSOF-mediated conversion of HDL to neo HDL. Moreover, the reduction of secretion of TNF-α and IL-6 by THP-1 cells by neo HDL was twice that of HDL. Studies in BHK cells overexpressing cholesterol transporters showed that efflux to neo HDL occurred primarily via ABCA1 not ABCG1. Thus, rSOF improves two steps in reverse cholesterol transport with a concomitant reduction in the release of macrophage markers of inflammation. We conclude that rSOF catalyzes a novel reaction that might be developed as a new therapy that prevents or reverses atherosclerosis via improved reverse cholesterol transport. PMID:20972840

Safety of Sofosbuvir and Ribavirin Combination Therapy in a Patient Who Developed Anemia due to Ribavirin

PubMed Central

Ozeki, Itaru; Tatsumi, Ryoji; Yamaguchi, Masakatsu; Kimura, Mutsuumi; Arakawa, Tomohiro; Nakajima, Tomoaki; Kuwata, Yasuaki; Ohmura, Takumi; Hige, Shuhei; Karino, Yoshiyasu; Toyota, Joji

2017-01-01

Interferon (IFN) and ribavirin (RBV) combination therapy was previously the standard of care for treatment of hepatitis C virus (HCV) genotype 2 infection. But, it often induced hemolytic anemia. In 2014, sofosbuvir (SOF) was approved for the treatment of chronic HCV genotype 2 in Japan. SOF/RBV therapy is more effective against genotype 2 than IFN/RBV therapy. We report a case of a 74-year-old woman with chronic HCV genotype 2b infection. She received five treatments including RBV and IFN therapy before SOF was approved and all of them were ineffective. Therapies that included RBV induced severe anemia and led to discontinuation of treatment. With pegylated IFN/RBV therapy, the maximum change in hemoglobin (Hb) from baseline was −3.7 g/dL. However, SOF/RBV therapy was effective and she achieved sustained virologic response (SVR) with a maximum change in Hb from baseline of only −1.2 g/dL. We also found reticulocyte count was very low during treatment in this case and speculate it was one of the reasons that she developed hemolytic anemia with RBV. In conclusion, SOF/RBV therapy is effective and allowed the patient to achieve SVR. An SOF/RBV regimen is safe and effective for patients who have or are at risk of anemia induced by RBV. PMID:29375917

Journal of Special Operations Medicine. Volume 4, Edition 3, Summer 2004

DTIC Science & Technology

2004-01-01

several ways for you to obtain the Journal of Special Operations Medicine (JSOM). USSOCOM-SG distributes the JSOM to all our SOF units and our active ...training in the Philippines Volume 4, Edition 3 / Summer 04 1 From the Surgeon Kudos One of SOF’s most distinguished members has just received a...of this educa- tional activity . OBJECTIVES 1. Discuss the steps involved in rapid sequence induction. 2. Identify medications used in rapid

Resistance Analyses of Japanese Hepatitis C-Infected Patients Receiving Sofosbuvir or Ledipasvir/Sofosbuvir Containing Regimens in Phase 3 Studies.

PubMed

Mizokami, M; Dvory-Sobol, H; Izumi, N; Nishiguchi, S; Doehle, B; Svarovskaia, E S; De-Oertel, S; Knox, S; Brainard, D M; Miller, M D; Mo, H; Sakamoto, N; Takehara, T; Omata, M

2016-10-01

High rates of sustained virologic response (SVR) has been achieved in Japanese patients with chronic hepatitis C virus (HCV) genotype (GT)1 and GT2 infection treated with ledipasvir/sofosbuvir (LDV/SOF) ±ribavirin (RBV) and SOF+RBV, respectively. We evaluated the effect of baseline HCV NS5A and NS5B resistance-associated variants (RAVs) on treatment outcome and characterized variants at virologic failure. Baseline deep sequencing for NS5A and NS5B genes was performed for all GT1 patients. Deep sequencing of NS5A (GT1 only) and NS5B (GT1 and GT2) was performed for patients who failed treatment or discontinued early with detectable HCV RNA (i.e., >25 IU/mL). In patients with HCV GT1 infection, 22.3% (GT1a: 2/11; GT1b: 74/330) had ≥1 baseline NS5A RAV. The most frequent NS5A RAVs in GT1b were Y93H (17.9%, 59/330) and L31M (2.4%, 8/330). Despite the presence of NS5A RAVs at baseline, 100% and 97% of patients achieved SVR12, compared with 100% and 99% for those with no NS5A RAVs with LDV/SOF and LDV/SOF+RBV, respectively. All patients with NS5B RAVs at baseline achieved SVR12. Of the 153 patients with GT2 infection (GT2a 60.1%, GT2b 39.9%), 3.3% (5/153) experienced viral relapse. No S282T or other NS5B RAVs were detected at baseline or relapse; no change in susceptibility to SOF or RBV was observed at relapse. In conclusion, LDV/SOF and SOF+RBV demonstrate a high barrier to resistance in Japanese patients with HCV GT1 and GT2 infection. The presence of baseline NS5A RAVs did not impact treatment outcome in GT1 Japanese patients treated with LDV/SOF for 12 weeks. © 2016 John Wiley & Sons Ltd.

Ledipasvir/sofosbuvir for treatment of hepatitis C virus in sofosbuvir-experienced, NS5A treatment-naïve patients: Findings from two randomized trials.

PubMed

Tam, Edward; Luetkemeyer, Anne F; Mantry, Parvez S; Satapathy, Sanjaya K; Ghali, Peter; Kang, Minhee; Haubrich, Richard; Shen, Xianlin; Ni, Liyun; Camus, Gregory; Copans, Amanda; Rossaro, Lorenzo; Guyer, Bill; Brown, Robert S

2018-06-01

We report data from two similarly designed studies that evaluated the efficacy, safety, and optimal duration of ledipasvir/sofosbuvir (LDV/SOF) ± ribavirin (RBV) for retreatment of chronic hepatitis C virus (HCV) in individuals who failed to achieve sustained virological response (SVR) with prior SOF-based, non-NS5A inhibitor-containing regimens. The RESCUE study enrolled HCV mono-infected adults with genotype (GT) 1 or 4. Non-cirrhotic participants were randomized to 12 weeks of LDV/SOF or LDV/SOF + RBV. Compensated cirrhotic participants were randomized to LDV/SOF + RBV (12 weeks) or LDV/SOF (24 weeks). The AIDS Clinical Trials Group A5348 study randomized genotype 1 adults with HCV/HIV co-infection to LDV/SOF + RBV (12 weeks) or LDV/SOF (24 weeks). Both studies used SVR at 12 weeks post-treatment (SVR12) as the primary endpoint. In the RESCUE study, 82 participants were randomized and treated, and all completed treatment. Overall, SVR12 was 88% (72/82); 81-100% in non-cirrhotic participants treated with LDV/SOF or LDV/SOF + RBV for 12 weeks and 80-92% in cirrhotic participants treated with LDV/SOF + RBV for 12 weeks or LDV/SOF for 24 weeks. Adverse events (AEs), mostly mild-to-moderate in severity, were experienced by 78% of participants, with headache and fatigue most frequently reported. One serious AE, not related to treatment, was observed. No premature discontinuations of study drug, or deaths occurred. In the A5348 study, seven participants were randomized (cirrhotic n = 1; GT1a n = 5) and all attained SVR12, with no serious AEs or premature discontinuations. In this SOF-experienced, NS5A inhibitor-naïve population, which included participants with cirrhosis or HCV/HIV co-infection, high SVR12 rates were achieved. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Adsorption of SF6 decomposed gas on anatase (101) and (001) surfaces with oxygen defect: A density functional theory study

PubMed Central

Zhang, Xiaoxing; Chen, Qinchuan; Tang, Ju; Hu, Weihua; Zhang, Jinbin

2014-01-01

The detection of partial discharge by analyzing the components of SF6 gas in gas-insulated switchgears is important to the diagnosis and assessment of the operational state of power equipment. A gas sensor based on anatase TiO2 is used to detect decomposed gases in SF6. In this paper, first-principle density functional theory calculations are adopted to analyze the adsorption of SO2, SOF2, and SO2F2, the primary decomposition by-products of SF6 under partial discharge, on anatase (101) and (001) surfaces. Simulation results show that the perfect anatase (001) surface has a stronger interaction with the three gases than that of anatase (101), and both surfaces are more sensitive and selective to SO2 than to SOF2 and SO2F2. The selection of a defect surface to SO2, SOF2, and SO2F2 differs from that of a perfect surface. This theoretical result is corroborated by the sensing experiment using a TiO2 nanotube array (TNTA) gas sensor. The calculated values are analyzed to explain the results of the Pt-doped TNTA gas sensor sensing experiment. The results imply that the deposited Pt nanoparticles on the surface increase the active sites of the surface and the gas molecules may decompose upon adsorption on the active sites. PMID:24755845

Ledipasvir-Sofosbuvir for Treating Chronic Hepatitis C: A NICE Single Technology Appraisal-An Evidence Review Group Perspective.

PubMed

Thokala, P; Simpson, E L; Tappenden, P; Stevens, J W; Dickinson, K; Ryder, S; Harrison, P

2016-08-01

The National Institute for Health and Care Excellence (NICE) invited Gilead, the company manufacturing ledipasvir-sofosbuvir (LDV/SOF), to submit evidence for the clinical effectiveness and cost effectiveness of LDV/SOF for treating chronic hepatitis C. The School of Health and Related Research (ScHARR) Technology Assessment Group was commissioned as the Evidence Review Group (ERG). This paper describes the company's submission (CS), the ERG review and the subsequent decision of the NICE Appraisal Committee (AC). The ERG produced a critical review of the clinical effectiveness and cost-effectiveness evidence of LDV/SOF based upon the CS. The clinical effectiveness data for LDV/SOF were taken from ten trials: three phase III trials and seven phase II trials. Trials compared different durations of LDV/SOF, with and without ribavirin (RBV). There were no head-to-head trials comparing LDV/SOF with any comparator listed in the NICE scope. Data from the trials were mostly from populations with genotype 1 (GT1) disease, although some limited data were available for populations with genotypes 3 and 4. For GT1 treatment-naïve patients, sustained viral response for 12 weeks (SVR12) rates for LDV/SOF ranged from 93.1 to 99.4 % for subgroups of patients with non-cirrhotic disease, whilst SVR rates of 94.1 to 100 % were reported for subgroups of patients with compensated cirrhosis. For GT1 treatment-experienced patients, SVR12 rates ranging from 95.4 to 100 % were reported for subgroups of non-cirrhotic patients, and SVR rates ranging from 81.8 to 100 % were reported within subgroups of patients with compensated cirrhosis. Comparator data were not searched systematically as part of the submission, but were based on the company's previous NICE submission of sofosbuvir, with additional targeted searches. The ERG's critical appraisal of the company's economic evaluation highlighted a number of concerns. The ERG's base case analyses suggested that the incremental cost-effectiveness ratios (ICERs) for LDV/SOF (+RBV) are dependent on (a) treatment durations, (b) whether patients have been previously treated and (c) whether patients have liver cirrhosis or not. The AC concluded that it was appropriate to use the approach taken in the ERG's exploratory analyses, in line with the marketing authorisation, which considered people with and without cirrhosis separately, and estimated the cost effectiveness for each recommended treatment duration of LDV/SOF.

The Use of Fresh Whole Blood Transfusions by the SOF Medic for Hemostatic Resuscitation in the Austere Environment

DTIC Science & Technology

2010-11-24

training and safety measures, WFWB transfu- sions can be that tool. Shipment of whole blood collected from rear echelon troops in the ETO , December 1944...Operations. ( ETO ) WWII. (U.S. AMEDD Office of Medical History) Journal of Special Operations Medicine Volume 10, Edition 3 / Summer 1030 Whole blood...27. 5. Brohi, K ., Singh, J., et al. (2003). Acute traumatic coagulo- pathy. Journal of Trauma; 54:1127-1130. 6. Borgman, M. A., Spinella

Journal of Special Operations Medicine, Volume 8, Edition 2

DTIC Science & Technology

2008-01-01

NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Joint Special...Order Desk — orders@gpo.gov. 4) The JSOM is on- line through the Joint Special Operations University’s new SOF Medical Gateway; it is available to all...From the Command Surgeon WARNER D. “Rocky” FARR COLONEL, U.S. ARMY Command Surgeon HQ USSOCOM • Recommended, and all concurred, that we need a Joint

Micro-costing analysis of guideline-based treatment by direct-acting agents: the real-life case of hepatitis C management in Brazil.

PubMed

Perazzo, Hugo; Jorge, Marcelino Jose; Silva, Julio Castro; Avellar, Alexandre Monken; Silva, Patrícia Santos; Romero, Carmen; Veloso, Valdilea Gonçalves; Mujica-Mota, Ruben; Anderson, Rob; Hyde, Chris; Castro, Rodolfo

2017-11-23

Eradication of hepatitis C virus (HCV) using direct-acting agents (DAA) has been associated with a financial burden to health authorities worldwide. We aimed to evaluate the guideline-based treatment costs by DAAs from the perspective of the Brazilian Ministry of Health (BMoH). The activity based costing method was used to estimate the cost for monitoring/treatment of genotype-1 (GT1) HCV patients by the following strategies: peg-interferon (PEG-IFN)/ribavirin (RBV) for 48 weeks, PEG-IFN/RBV plus boceprevir (BOC) or telaprevir (TEL) for 48 weeks, and sofosbuvir (SOF) plus daclastavir (DCV) or simeprevir (SIM) for 12 weeks. Costs were reported in United States Dollars without (US$) and with adjustment for purchasing power parity (PPP$). Drug costs were collected at the National Database of Health Prices and an overview of the literature was performed to assess effectiveness of SOF/DCV and SOF/SIM regimens in real-world cohorts. Treatment costs of GT1-HCV patients were PPP$ 43,176.28 (US$ 24,020.16) for PEG-IFN/RBV, PPP$ 71,196.03 (US$ 39,578.23) for PEG-IFN/RBV/BOC and PPP$ 86,250.33 (US$ 47,946.92) for PEG-IFN/RBV/TEL. Treatment by all-oral interferon-free regimens were the less expensive approach: PPP$ 19,761.72 (US$ 10,985.90) for SOF/DCV and PPP$ 21,590.91 (US$ 12,002.75) for SOF/SIM. The overview reported HCV eradication in up to 98% for SOF/DCV and 96% for SOF/SIM. Strategies with all oral interferon-free might lead to lower costs for management of GT1-HCV patients compared to IFN-based regimens in Brazil. This occurred mainly because of high discounts over international DAA prices due to negotiation between BMoH and pharmaceutical industries.

Impact of interferon-free antivirus therapy on lipid profiles in patients with chronic hepatitis C genotype 1b

PubMed Central

Endo, Daisuke; Satoh, Kenichi; Shimada, Noritomo; Hokari, Atsushi; Aizawa, Yoshio

2017-01-01

AIM To investigate the influence of interferon-free antivirus therapy on lipid profiles in chronic hepatitis C virus genotype 1b (HCV1b) infection. METHODS Interferon-free antiviral agents were used to treat 276 patients with chronic HCV1b infection, and changes in serum lipids of those who achieved sustained virologic response (SVR) were examined. The treatment regimen included 24 wk of daclatasvir plus asunaprevir (DCV + ASV) or 12 wk of sofosbuvir plus ledipasvir (SOF + LDV). SVR was achieved in 121 (85.8%) of 141 patients treated with DCV + ASV and 132 (97.8%) of 135 patients treated with SOF + LDV. In the two patient groups (DCV + ASV-SVR and SOF + LDV-SVR), serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides were measured at baseline during treatment and at 4 and 12 wk after treatment. Then, longitudinal changes in lipid profiles were analyzed. RESULTS Serum levels of TC, LDL-C, and HDL-C were significantly increased throughout the observation period in both the DCV + ASV-SVR and SOF + LDV-SVR groups. During antivirus treatment, the increases in TC and LDL-C were significantly greater in the SOF + LDV-SVR group than in the DCV + ASV-SVR group (P < 0.001). At 4 and 12 wk after the therapy, serum levels of TC and LDL-C were similar between the two groups and were significantly greater than those at baseline. Approximately 75%-80% of the increase in TC was derived from an increased LDL-C. In multiple regression analysis, the difference in therapy protocol (DCA + ASV or SOF + LDV) was an independent predictor that was significantly associated with the increase in TC and LDL-C at 4 wk of therapy. CONCLUSION Serum cholesterol significantly increased during SOF + LDV treatment. After treatment, HCV elimination was associated with a similar increase in cholesterol regardless of the therapy protocol. PMID:28428715

Light scatter on the surface of AcrySof intraocular lenses: part II. Analysis of lenses following hydrolytic stability testing.

PubMed

Yaguchi, Shigeo; Nishihara, Hitoshi; Kambhiranond, Waraporn; Stanley, Daniel; Apple, David

2008-01-01

To investigate the surface light scatter and optical quality of AcrySof lenses (Alcon Laboratories, Inc., Fort Worth, TX) following simulated aging of 20 years. AcrySof lenses were exposed to exaggerated thermal conditions to simulate up to 20 years of aging and were tested for surface light scatter and optical quality (modulation transfer function). There were no significant differences from baseline for either the surface light scatter or optical quality of the lenses over time. The current study demonstrated that surface light scatter on AcrySof lenses did not increase under conditions simulating 20 years of aging. Because the simulated aging environment contained no protein, this work indirectly supports the finding that surface light scatter is due to the deposition of a biomaterial on the lens surface rather than changes in the material. Optical performance integrity of the test lenses was maintained under severe environmental conditions.

Unmanned Aerial Vehicles (UAVs): a new tool in counterterrorism operations?

NASA Astrophysics Data System (ADS)

Dörtbudak, Mehmet F.

2015-05-01

Terrorism is not a new phenomenon to the world, yet it remains difficult to define and counter. Countering terrorism requires several measures that must be taken simultaneously; however, counterterrorism strategies of many countries mostly depend on military measures. In the aftermath of the 2001 terrorist attack on the Twin Towers of the World Trade Center, the United States (U.S.) has started and led the campaign of Global War on Terrorism. They have invaded Afghanistan and Iraq and have encountered insurgencies run by terrorist organizations, such as al-Qaeda and its affiliates. The U.S. made the utilization of Air and Space Power very intensively during these operations. In order to implement operations; Intelligence, Surveillance, and Reconnaissance (ISR) assets were used to collect the necessary information. Before the successful insertion of a small number of U.S. Special Operation Force (SOF) teams into Afghanistan, the U.S. Air Force attacked al-Qaeda and Taliban's targets such as infrastructure, airfields, ground forces, command-control facilities etc. As soon as the U.S. troops got on the ground and started to marshal to Kabul, the Air Force supported them by attacking jointly determined targets. The Air Force continued to carry out the missions and played a significant role to achieve the objective of operation during all the time. This is not the only example of utilization of Air and Space Power in counterterrorism and counterinsurgency operations. All around the world, many countries have also made the utilization of Air Power in different missions ranging from ISR to attacking. Thinking that terrorism has a psychological dimension and losing a pilot during operations may result in decreasing the population support to operations, Unmanned Aerial Vehicles (UAVs) started to be used by practitioners and took priority over other assets. Although UAVs have been on the theatre for a long time used for ISR mission in conventional conflicts, with the advent of drones, UAVs have also started to be used for attack missions in counterterrorism operations. In this study, it is aimed to determine whether UAVs are appropriate assets that can be used in counterterrorism operations. The study starts by examining the term terrorism and counterterrorism and discusses the role of the Air and Space Power in counterterrorism operations. After proposing that UAVs are appropriate assets for counterterrorism operations, it continues by explaining types and common usage concepts of UAVs. The advantages and disadvantages of UAVs are put forward from the counterterrorism operations' perspectives. It finally examines the utilization of UAVs in counterterrorism operations. In this context, as much as obtained from open sources, countries' roadmaps, usage concepts, experience, and current structure are examined to determine whether UAVs are appropriate assets in counterterrorism operations. When the advantages of UAVs and the disadvantages of manned systems are analyzed, other findings of our survey will show us that UAVs will be increasingly used in counterterrorism operations

Sofosbuvir plus ledispasvir for recurrent hepatitis C in liver transplant recipients.

PubMed

Kwok, Ryan M; Ahn, Joseph; Schiano, Thomas D; Te, Helen S; Potosky, Darryn R; Tierney, Amber; Satoskar, Rohit; Robertazzi, Suzanne; Rodigas, Colleen; Lee Sang, Michelle; Wiegel, Joshua; Patel, Neal; Gripshover, Janet; Hassan, Mohamed A; Branch, Andrea; Smith, Coleman I

2016-11-01

Hepatitis C virus (HCV) recurrence after liver transplantation (LT) is associated with worse outcomes. The combination of ledipasvir (LDV) and sofosbuvir (SOF) has been approved for HCV treatment after LT, but there are limited data on the effectiveness and safety of LDV/SOF in the "real-world" setting. This multicenter study is the largest report to date on the effectiveness and safety of LDV/SOF in the post-LT setting. A total of 204 patients (72% male, 68% Caucasian, 66% genotype [GT] 1a, 21% METAVIR F3-F4, 49% treatment-experienced) were treated with LDV/SOF. The mean duration from LT to treatment initiation was 4.8 years. The overall sustained virological response rate 12 weeks after completion of therapy (SVR12) was 96%. Patients treated with 8 or 12 weeks of LDV/SOF without RBV experienced an SVR12 rate of 100% and 96%, respectively. Calcineurin inhibitors were used in 89% of patients, and 32% of patients underwent adjustment in immunosuppression during treatment. One episode of mild rejection, responsive to an increase in immunosuppression dosage, was observed. There was no graft loss attributed to HCV treatment. Four deaths occurred unrelated to HCV treatment, and no significant serious adverse events were documented. In conclusion, SOF and LDV with or without RBV for 8, 12, or 24 weeks in post-LT patients was effective and safe with a high SVR12 rate across a spectrum of GTs and stages of fibrosis. Liver Transplantation 22 1536-1543 2016 AASLD. © 2016 by the American Association for the Study of Liver Diseases.

Cure with ledipasvir/sofosbuvir for chronic hepatitis C virus in an individual with gastric bypass.

PubMed

Johnson, S W; Teachey, A L; Valanejad, S M; Griffin, S M; Weber, S F

2017-10-01

The impact of gastric bypass surgery on the pharmacokinetics of various medications has been reported. Presently, no data exist for the treatment of chronic hepatitis C virus with ledipasvir/sofosbuvir (LDV/SOF) in an individual with a history of gastric bypass. We report the successful cure of an individual who was treated with LDV/SOF who had a history of gastric bypass. The patient tolerated LDV/SOF well while only experiencing a minor headache. Ledipasvir/sofosbuvir treatment may still be effective in those with a history of gastric bypass surgery. © 2017 John Wiley & Sons Ltd.

A Systems Thinking Approach to Engineering Challenges of Military Systems-of-Systems

DTIC Science & Technology

2016-09-01

UNCLASSIFIED UNCLLASIFIED A Systems Thinking Approach to Engineering Challenges of Military Systems -of- Systems Pin Chen and Mark...Unewisse Joint & Operations Analysis Division Defence Science and Technology Group DST-Group-TR-3271 ABSTRACT System (s)-of- Systems (SoS...their products and outcomes. This report introduces a systems thinking-based approach, SoS thinking, which offers a language and a thoughtful process

Adsorption behaviour of SF6 decomposed species onto Pd4-decorated single-walled CNT: a DFT study

NASA Astrophysics Data System (ADS)

Cui, Hao; Zhang, Xiaoxing; Zhang, Jun; Tang, Ju

2018-07-01

Metal nanocluster decorated single-walled carbon nanotubes (SWCNT) with improved adsorption behaviour towards gaseous molecules compared with intrinsic ones, have been widely accepted as a workable media for gas interaction due to their strong catalysis. In this work, Pd4 cluster is determined as a catalytic centre to theoretically study the adsorption property of Pd4-decorated SWCNT upon SF6 decomposed species. Results indicate that Pd4-SWCNT possessing good responses and sensitivities towards three composed species of SF6 could realise selective detection for them according to the different conductivity changes resulting from the varying adsorption ability. The response of Pd4-SWCNT upon three molecules in order is SOF2 > H2S > SO2, and the conductivity of the proposed material is about to increase in SOF2 and H2S systems, while declining in SO2 system. Such conclusions would be helpful for experimentalists to explore novel SWCNT-based sensors in evaluating the operating state of SF6 insulation devices.

Toric Intraocular Lens for Astigmatism Correction in Cataract Patients.

PubMed

Razmjoo, Hassan; Ghoreishi, Mohammad; Milasi, Azadeh Mohammadi; Peyman, Alireza; Jafarzadeh, Zahra; Mohammadinia, Mohadeseh; Kobra, Nasrollahi

2017-01-01

To assess the clinical consequences of AcrySof toric intraocular lens (IOL) and Hoya toric IOL implantation to correct preexisting corneal astigmatism in patients undergoing cataract surgery. In this study, we examined 55 eyes of 45 patients with at least 1.00 D corneal astigmatism who were scheduled for cataract surgery. After phacoemulsification, toric IOL was inserted and axis was aligned. We observed the patients, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry, manifest refraction, and IOL axis alignment 6 months after surgery. After 6 months, the UDVA was 0.17 ± 0.17 logMAR in the AcrySof group and 0.17 ± 0.18 logMar in the Hoya group. More than 78% of eyes in the AcrySof group and 80% of eyes in the Hoya toric IOL achieved a UDVA of 20/40 or better. In the AcrySof group, the mean preoperative corneal astigmatism was 2.73 ± 0.92 D. The mean postoperative refractive astigmatism was 0.84 ± 0.63 D. In the Hoya group, the preoperative corneal astigmatism was 2.58 ± 0.76 D and the postoperative refractive astigmatism was 0.87 ± 0.66 D ( P < 0.05). The mean AcrySof IOL axis rotation was 1.88° ± 3.05°. In the Hoya group, the mean axis rotation was 1.53° ± 3.66°. All changes in visual and refractive data before and after surgery were statistically significant ( P < 0.05). There was no significant difference between the two groups regarding refractive and visual outcome after surgery ( P > 0.05 for all). Implantation of AcrySof toric IOL and Hoya toric IOL was an effective way to correct preexisting corneal astigmatism in cataract surgery.

Real-World Study on Sofosbuvir-based Therapies in Asian Americans With Chronic Hepatitis C.

PubMed

Pan, Calvin Q; Tiongson, Benjamin C; Hu, Ke-Qin; Han, Steven-Huy B; Tong, Myron; Chu, Danny; Park, James; Lee, Tai Ping; Bhamidimarri, Kalyan Ram; Ma, Xiaoli; Xiao, Pei Ying; Mohanty, Smruti R; Wang, Dan

2018-06-16

Limited data exist with regard to treatment outcomes in Asian Americans with chronic hepatitis C (CHC). We evaluated sofosbuvir (SOF)-based regimens in a national cohort of Asian Americans. Eligible Asian Americans patients with CHC who had posttreatment follow-up of 24 weeks for SOF -based therapies from December 2013 to June 2017 were enrolled from 11 sites across the United States. The primary endpoint was sustained virologic response (SVR) rates at posttreatment weeks 12 and 24. Secondary endpoints were to evaluate safety by tolerability and adverse events (AEs). Among 231 patients screened, 186 were enrolled. At baseline, 31% (57/186) patients were cirrhotic, 34% (63/186) were treatment experienced. Most of the subjects (42%, 79/186) received ledispavir/SOF therapy. The overall SVR12 was 95%, ranging from 86% in genotype (GT) 1b on SOF+ribavirin to 100% in GT 1b patients on ledipasvir/SOF at subgroup analyses. SVR12 was significantly lower in cirrhotic than in noncirrhotic patients [88% (50/57) vs. 98% (126/129), P<0.01]. Stratified by GT, SVR12 were: 96% (43/45) in GT 1a; 93% (67/72) in GT 1b; 100% (23/23) in GT 2; 90% (19/21) in GT 3; 100% (1/1) in GT 4; 83% (5/6) in GT 5; and 100% (16/16) in GT 6. Cirrhotic patients with treatment failure were primarily GT 1, (GT 1a, n=2; GT 1b, n=4) with 1 GT 5 (n=1). Patients tolerated the treatment without serious AEs. Late relapse occurred in 1 patient after achieving SVR12. In Asian Americans with CHC, SOF-based regimens were well tolerated without serious AEs and could achieve high SVR12 regardless of hepatitis C viral infection GT.

Development of a wavelength-separated type scintillator with optical fiber (SOF) dosimeter to compensate for the Cerenkov radiation effect

PubMed Central

Ishikawa, Masayori; Nagase, Naomi; Matsuura, Taeko; Hiratsuka, Junichi; Suzuki, Ryusuke; Miyamoto, Naoki; Sutherland, Kenneth Lee; Fujita, Katsuhisa; Shirato, Hiroki

2015-01-01

Abstract The scintillator with optical fiber (SOF) dosimeter consists of a miniature scintillator mounted on the tip of an optical fiber. The scintillator of the current SOF dosimeter is a 1-mm diameter hemisphere. For a scintillation dosimeter coupled with an optical fiber, measurement accuracy is influenced by signals due to Cerenkov radiation in the optical fiber. We have implemented a spectral filtering technique for compensating for the Cerenkov radiation effect specifically for our plastic scintillator-based dosimeter, using a wavelength-separated counting method. A dichroic mirror was used for separating input light signals. Individual signal counting was performed for high- and low-wavelength light signals. To confirm the accuracy, measurements with various amounts of Cerenkov radiation were performed by changing the incident direction while keeping the Ir-192 source-to-dosimeter distance constant, resulting in a fluctuation of <5%. Optical fiber bending was also addressed; no bending effect was observed for our wavelength-separated SOF dosimeter. PMID:25618136

Cost-effectiveness analysis of therapeutic options for chronic hepatitis C genotype 3 infected patients.

PubMed

Gimeno-Ballester, Vicente; Mar, Javier; O'Leary, Aisling; Adams, Róisín; San Miguel, Ramón

2017-01-01

This study provides a cost-effectiveness analysis of therapeutic strategies for chronic hepatitis C genotype 3 infected patients in Spain. A Markov model was designed to simulate the progression in a cohort of patients aged 50 years over a lifetime horizon. Sofosbuvir (SOF) plus peginterferon and ribavirin for 12 weeks was a cost-effective option when compared to standard of care (SoC) in the treatment of both 'moderate fibrosis' and 'cirrhotic' patients. Incremental cost-effectiveness ratios were €35,276/QALY and €18,374/QALY respectively. ICERs for SOF plus daclatasvir (DCV) regimens versus SoC were over the threshold limit considered, at €56,178/QALY and €77,378/QALY for 'moderate fibrosis' and 'cirrhotic' patients respectively. Addition of SOF to IFN-based regimens for genotype 3 was cost-effective for both 'moderate fibrosis' and 'cirrhotic' patients. IFN-free options including SOF and DCV association required price reductions lower than the list prices to be considered cost-effective.

A mindfulness-based intervention for self-management of verbal and physical aggression by adolescents with Prader-Willi syndrome.

PubMed

Singh, Nirbhay N; Lancioni, Giulio E; Myers, Rachel E; Karazsia, Bryan T; Courtney, Theresa M; Nugent, Kristen

2017-07-01

There is a dearth of clinical and research literature on the treatment of maladaptive behaviors in adolescents with Prader-Willi syndrome (PWS). The purpose of this study was to evaluate the effectiveness of a mindfulness-based intervention, Meditation on the Soles of the Feet (SoF), to facilitate self-management of verbal and physical aggression. We utilized a multiple-baseline design across participants to test the intervention with three adolescents diagnosed with PWS. Relative to baseline, verbal aggression decreased to minimal levels following mindfulness-based practice and physical aggression was nearly eliminated. Intervention effects were maintained at 12-month follow-up. Quantitative analytics confirmed statistically significant outcomes. The SoF mindfulness intervention was effective in reducing verbal and physical aggression in three adolescents with PWS. Future research should test the SoF intervention with this clinical population in a larger clinical trial, and the SoF intervention may be applicable to other pediatric populations.

Application of an ultraminiature thermal neutron monitor for irradiation field study of accelerator-based neutron capture therapy

PubMed Central

Ishikawa, Masayori; Tanaka, Kenichi; Endo, Satrou; Hoshi, Masaharu

2015-01-01

Abstract Phantom experiments to evaluate thermal neutron flux distribution were performed using the Scintillator with Optical Fiber (SOF) detector, which was developed as a thermal neutron monitor during boron neutron capture therapy (BNCT) irradiation. Compared with the gold wire activation method and Monte Carlo N-particle (MCNP) calculations, it was confirmed that the SOF detector is capable of measuring thermal neutron flux as low as 105 n/cm2/s with sufficient accuracy. The SOF detector will be useful for phantom experiments with BNCT neutron fields from low-current accelerator-based neutron sources. PMID:25589504

Development of ovine embryos in synthetic oviductal fluid containing amino acids at oviductal fluid concentrations.

PubMed

Walker, S K; Hill, J L; Kleemann, D O; Nancarrow, C D

1996-09-01

The effects of supplementing synthetic oviductal fluid (SOF) with amino acids, at oviductal fluid concentrations, on the development of ovine in vitro-matured/in vitro-fertilized embryos was examined in three experiments. In the first, embryo development in SOF, SOF + 2% human serum (HS), SOF + 20% HS, and SOF + BSA, with and without amino acid supplementation, was examined. Development of zygotes to the blastocyst and hatching blastocyst stages was highest in medium containing 20% HS (64.8% and 54.4%, respectively) irrespective of amino acid supplementation. However, supplementation was significantly beneficial in all other media, with up to 42.1% of zygotes developing into hatching blastocysts. In these media, supplementation also significantly increased the mean number of nuclei per newly formed blastocyst (up to a mean of 70.8) and reduced the time during which blastocysts formed. Experiment 2 was an examination of the effect on embryo development of three amino acid preparations (oviduct amino acid concentrations vs. Eagle's Basal Medium (BME) essential + Minimum Essential Medium (MEM) nonessential vs. MEM essential + MEM nonessential concentrations) and the presence or absence of BSA. Both the amino acid and BSA treatments significantly influenced the percentage of zygotes that developed to the hatching blastocyst stage but not to the blastocyst stage. The preferred medium contained amino acids at oviductal fluid concentrations and BSA (54.5% hatching rate). The amino acid treatments did not significantly influence the mean number of nuclei per newly formed blastocyst, but the addition of BSA had a significant effect (70.7 +/- 1.14 vs. 75.7 +/- 1.13). In experiment 3, embryo development to Day 13 was examined after culture in SOF containing amino acids at oviductal fluid concentrations. Embryos were cultured in the presence of either BSA, polyvinyl alcohol (PVA), or no additional supplement and were transferred to recipient ewes on either Day 0 (after in vitro fertilization), 3, or 5. The addition of BSA or PVA had no significant effect, but significantly more embryos developed to Day 13 following transfer on Day 0 (60.0%) than on either Day 3 or 5 (overall 45.4%). It is concluded that SOF containing oviductal fluid concentrations of amino acids 1) facilitates the development of a high percentage (57.5%) of blastocysts, 2) improves embryo morphology compared with that observed in medium containing HS, 3) significantly improves hatching rates compared with those obtained in SOF containing commercially available preparations of amino acids, and 4) produces embryos with relatively high levels of viability to Day 13 of pregnancy.

Spur-of-the-Moment Modification in National Treatment Policies Leads to a Surprising HCV Viral Suppression in All Treated Patients: Real-Life Egyptian Experience.

PubMed

El Kassas, Mohamed; Omran, Dalia; Elsaeed, Kadry; Alboraie, Mohamed; Elakel, Wafaa; El Tahan, Adel; Abd El Latif, Yasmeen; Nabeel, Mohamed Mahmoud; Korany, Mohamed; Ezzat, Sameera; El-Serafy, Magdy; ElShazly, Yehia; Doss, Wahid; Esmat, Gamal

2018-02-01

The aim of this study was to retrospectively analyze the outcome of an unscheduled change in national Egyptian policies for the treatment of hepatitis C virus (HCV), which was transpired as a result of a reduction in interferon supplies, and to manage patients who already started interferon-based therapy. After completing a priming 4-weeks course of sofosbuvir/pegylated interferon/ribavirin (SOF/PEG IFN/RBV), a 12-weeks course of sofosbuvir/daclatasvir (SOF/DCV) combination was initiated. We evaluated the sustained virologic response at 12 weeks posttreatment (SVR12) for 2 groups of patients; Group 1, which included patients who had the previous regimen with IFN priming, and group 2, which included the first consecutive group of patients who received SOF/DCV for 12 weeks from the start without IFN priming. All group 1 patients (1,214 patients) achieved SVR12 (100%) and this was statistically significant when compared with the overall SVR12 in group 2 [8,869 patients with sustained virologic response [SVR] of 98.9%] (P value <0.001). No serious adverse events were reported in both groups. In this real-life treatment experience, interferon-based directly acting antiviral treatment with SOF/PEG IFN/RBV as a priming for 4 weeks, followed by SOF/DCV combination for 12 weeks, led to HCV viral suppression in all treated patients.

Hepatocellular carcinoma or interferon-based therapy history attenuates sofosbuvir/ribavirin for Japanese genotype 2 hepatitis C virus.

PubMed

Yada, Masayoshi; Miyazaki, Masayuki; Tanaka, Kosuke; Masumoto, Akihide; Motomura, Kenta

2018-04-07

To investigate the real-world efficacy and safety of sofosbuvir/ribavirin (SOF/RBV) therapy for Japanese patients with genotype 2 hepatitis C virus (GT2-HCV). A total of 182 patients with GT2-HCV infection who received SOF/RBV therapy for 12 wk at our hospital were enrolled. The patients comprised 122 men and 60 women (age range: 17-84 years; mean age ± SD: 60.1 ± 12.1 years). Relationships between virological response and clinical data were examined by logistic regression analyses. The proportions of patients with liver cirrhosis and history of hepatocellular carcinoma (HCC) were 29.0% and 17.3%, respectively. The proportion of patients with prior interferon (IFN)-based therapy was 25.6%. SOF/RBV therapy rapidly decreased HCV RNA levels. Several patients required RBV dose reduction because of anemia or fatigue. Four patients discontinued the therapy. The rates of sustained virological response at 12 wk after the end of treatment were 87.9% (intention to treat: 160/182) and 94.1% (per protocol: 159/169). Multivariate analyses showed that history of HCC or IFN-based therapy independently reduced the efficacy of SOF/RBV therapy. SOF/RBV therapy for GT2-HCV is safe, highly tolerated, and effective. History of HCC or IFN-based therapy independently reduces the efficacy of this treatment.

Effectiveness of ledipasvir/sofosbuvir in real-world patients with chronic hepatitis C: a collaborative treatment approach.

PubMed

Johnson, Steven W; Ammirati, Shelby R; Hartis, Charles E; Weber, Stephen F; Morgan, Michael R; Darnell, Timothy A; Silwal, Adwait; Schmidlin, Holly N; Priest, David H

2017-06-01

The effectiveness of ledipasvir/sofosbuvir (LDV/SOF) in routine use in clinical practice for the management of chronic hepatitis C virus (HCV) has not been well described. Data with prior agents suggest that management of HCV using an interprofessional approach in clinical practice is associated with better outcomes. This single-centre, prospective, observational cohort study evaluated patients treated with LDV/SOF for 8, 12 or 24 weeks as part of the standardized interprofessional treatment protocol at Novant Health Infectious Diseases Specialists. Eighty-four patients treated with LDV/SOF were evaluated; of these, 97.5% and 91.7% of patients achieved a sustained virological response (SVR) in the per-protocol analysis and the intention-to-treat analysis, respectively. Two patients were not cured after relapse of HCV. No patients required LDV/SOF discontinuation and all patients completed the appropriate treatment duration. The majority (56%) of patients reported no adverse effects and all adverse effects that were reported were mild. The most commonly reported adverse effects were headache and fatigue. SVR and tolerability rates were similar to those seen in the clinical trials. LDV/SOF was associated with a successful translation from the clinical trial setting to clinical practice. A collaborative treatment approach should be considered in the management of HCV. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Impact of different sofosbuvir based treatment regimens on the biochemical profile of chronic hepatitis C genotype 4 patients.

PubMed

Elsharkawy, Aisha; Eletreby, Rasha; Fouad, Rabab; Soliman, Zeinab; Abdallah, Mohamed; Negm, Mohamed; Mohey, Mohammad; Esmat, Gamal

2017-08-01

Huge efforts have been made to control chronic HCV in Egypt with introduction of Direct-Acting Antivirals (DAAs). Current study aims at evaluating effect of various DAA regimens on liver biochemical profile and haematological indices during treatment. 272 patients with chronic HCV genotype 4 treated by different DAA regimens (SOF/RBV, SOF/DAC ± RBV, SOF/SIM) for a duration of 12 or 24 weeks in Kasr Alainy Viral Hepatitis Center, Cairo University were followed up for serum bilirubin (BIL), albumin (ALB), alanine transaminase (ALT), aspartate aminotransferase (AST), prothrombin concentration, international normalized ratio (INR), and CBC at baseline, week-4 and end of treatment. Mean age was 54 years. Males comprised 64.7%, 72.4% were treatment-naïve, 39% were cirrhotic. Overall SVR12 rate was (93.4%). With all regimens, ALT and AST declined after treatment. In cirrhotics, there was a rise in BIL and INR; with no change in ALB and a decrease in White blood cells. Drop in Hemoglobin and platelets in cirrhotic patients were noted with SOF/RBV, while SOF/SIM showed rise in BIL. DAAs are safe and effective in genotype 4 chronic HCV patients. It improves liver necro-inflammatory markers in cirrhotics and non-cirrhotics. Cirrhotic patients require careful observation being more vulnerable for treatment related complications.

My Brother’s Keeper: Forging SOF Operators Through Developmental Relationships

DTIC Science & Technology

2016-06-01

85 2. Formal development effectiveness (Q30) ...................................85 3. Formal development drawbacks (Q31...experience, does formal (mandated) development work in the military? 31. What would be the top one or two drawbacks you would foresee with a formal...figuring out the direction of the team. The pendulum has swung too far to one side. Where’s our focus? Regionally? Skill set? All that changes who you get

U.S. Army War College Key Strategic Issues List 2014-2015

DTIC Science & Technology

2014-06-17

leaner while retaining capability, become more expeditionary, prevent overmatch through 2025, and set conditions for fundamental change by 2030-40? (POC...CF) become more interdependent across each operation plan phase, and what are the ways and means through which SOF and CF can efficiently increase...CAPE, john.vermeesch@usma.edu, 845-938-0475) 14) What is the character and motivation of Millennial volunteers, both uniformed and civilian? Is

Journal of Special Operation Medicine: A Peer Reviewed Journal for SOF Medical Professionals. Training Supplement, Winter 10

DTIC Science & Technology

2010-01-01

anaphylactic reaction, spontaneous pneumothorax, HAPE, and pulmonary embolism . DISPOSITION: 1. Urgent evacuation if no response to treatment. 2. If...syndrome may present with chest pain, dyspnea, mediastinal emphysema, subcutaneous emphysema, pneumothorax, and arterial gas embolism (AGE...breathed at depth followed by ascending with a closed airway (i.e. breath-holding), and can cause pneumothorax or arterial gas embolism . Winter 2010

Causes of death in U.S. Special Operations Forces in the global war on terrorism: 2001-2004.

PubMed

Holcomb, John B; McMullin, Neil R; Pearse, Lisa; Caruso, Jim; Wade, Charles E; Oetjen-Gerdes, Lynne; Champion, Howard R; Lawnick, Mimi; Farr, Warner; Rodriguez, Sam; Butler, Frank K

2007-06-01

Effective combat trauma management strategies depend upon an understanding of the epidemiology of death on the battlefield. A panel of military medical experts reviewed photographs and autopsy and treatment records for all Special Operations Forces (SOF) who died between October 2001 and November 2004 (n = 82). Fatal wounds were classified as nonsurvivable or potentially survivable. Training and equipment available at the time of injury were taken into consideration. A structured analysis was conducted to identify equipment, training, or research requirements for improved future outcomes. Five (6%) of 82 casualties had died in an aircraft crash, and their bodies were lost at sea; autopsies had been performed on all other 77 soldiers. Nineteen deaths, including the deaths at sea were noncombat; all others were combat related. Deaths were caused by explosions (43%), gunshot wounds (28%), aircraft accidents (23%), and blunt trauma (6%). Seventy of 82 deaths (85%) were classified as nonsurvivable; 12 deaths (15%) were classified as potentially survivable. Of those with potentially survivable injuries, 16 causes of death were identified: 8 (50%) truncal hemorrhage, 3 (19%) compressible hemorrhage, 2 (13%) hemorrhage amenable to tourniquet, and 1 (6%) each from tension pneumothorax, airway obstruction, and sepsis. The population with nonsurvivable injuries was more severely injured than the population with potentially survivable injuries. Structured analysis identified improved methods of truncal hemorrhage control as a principal research requirement. The majority of deaths on the modern battlefield are nonsurvivable. Improved methods of intravenous or intracavitary, noncompressible hemostasis combined with rapid evacuation to surgery may increase survival.

Causes of Death in U.S. Special Operations Forces in the Global War on Terrorism

PubMed Central

Holcomb, John B.; McMullin, Neil R.; Pearse, Lisa; Caruso, Jim; Wade, Charles E.; Oetjen-Gerdes, Lynne; Champion, Howard R.; Lawnick, Mimi; Farr, Warner; Rodriguez, Sam; Butler, Frank K.

2007-01-01

Background: Effective combat trauma management strategies depend upon an understanding of the epidemiology of death on the battlefield. Methods: A panel of military medical experts reviewed photographs and autopsy and treatment records for all Special Operations Forces (SOF) who died between October 2001 and November 2004 (n = 82). Fatal wounds were classified as nonsurvivable or potentially survivable. Training and equipment available at the time of injury were taken into consideration. A structured analysis was conducted to identify equipment, training, or research requirements for improved future outcomes. Results: Five (6%) of 82 casualties had died in an aircraft crash, and their bodies were lost at sea; autopsies had been performed on all other 77 soldiers. Nineteen deaths, including the deaths at sea were noncombat; all others were combat related. Deaths were caused by explosions (43%), gunshot wounds (28%), aircraft accidents (23%), and blunt trauma (6%). Seventy of 82 deaths (85%) were classified as nonsurvivable; 12 deaths (15%) were classified as potentially survivable. Of those with potentially survivable injuries, 16 causes of death were identified: 8 (50%) truncal hemorrhage, 3 (19%) compressible hemorrhage, 2 (13%) hemorrhage amenable to tourniquet, and 1 (6%) each from tension pneumothorax, airway obstruction, and sepsis. The population with nonsurvivable injuries was more severely injured than the population with potentially survivable injuries. Structured analysis identified improved methods of truncal hemorrhage control as a principal research requirement. Conclusions: The majority of deaths on the modern battlefield are nonsurvivable. Improved methods of intravenous or intracavitary, noncompressible hemostasis combined with rapid evacuation to surgery may increase survival. PMID:17522526

Quantifying emissions of NH3 and NOx from Agricultural Sources and Biomass Burning using SOF

NASA Astrophysics Data System (ADS)

Kille, N.; Volkamer, R. M.; Dix, B. K.

2017-12-01

Column measurements of trace gas absorption along the direct solar beam present a powerful yet underused approach to quantify emission fluxes from area sources. The University of Colorado Solar Occultation Flux (CU SOF) instrument (Kille et al., 2017, AMT, doi:10.5194/amt-10-373-2017) features a solar tracker that is self-positioning for use from mobile platforms that are in motion (Baidar et al., 2016, AMT, doi: 10.5194/amt-9-963-2016). This enables the use from research aircraft, as well as the deployment under broken cloud conditions, while making efficient use of aircraft time. First airborne SOF measurements have been demonstrated recently, and we discuss applications to study emissions from biomass burning using aircraft, and to study primary emissions of ammonia and nitrogen oxides (= NO + NO2) from area sources such as concentrated animal feeding operations (CAFO). SOF detects gases in the open atmosphere (no inlets), does not require access to the source, and provides results in units that can be directly compared with emission inventories. The method of emission quantification is relatively straightforward. During FRAPPE (Front Range Air Pollution and Photochemistry Experiment) in Colorado in 2014, we measured emission fluxes of NH3, and NOx from CAFO, quantifying the emissions from 61400 of the 535766 cattle in Weld County, CO (11.4% of the cattle population). We find that NH3 emissions from dairy and cattle farms are similar after normalization by the number of cattle, i.e., we find emission factors, EF, of 11.8 ± 2.0 gNH3/h/head for the studied CAFOs; these EFs are at the upper end of reported values. Results are compared to daytime NEI emissions for case study days. Furthermore, biologically active soils are found to be a strong source of NOx. The NOx sources account for 1.2% of the N-flux (i.e., NH3), and can be competitive with other NOx sources in Weld, CO. The added NOx is particularly relevant in remote regions, where O3 formation and oxidative capacity is NOx limited.

Combusting vegetable oils in diesel engines: the impact of unsaturated fatty acids on particle emissions and mutagenic effects of the exhaust.

PubMed

Bünger, Jürgen; Bünger, Jörn F; Krahl, Jürgen; Munack, Axel; Schröder, Olaf; Brüning, Thomas; Hallier, Ernst; Westphal, Götz A

2016-06-01

High particle emissions and strong mutagenic effects were observed after combustion of vegetable oil in diesel engines. This study tested the hypothesis that these results are affected by the amount of unsaturated or polyunsaturated fatty acids of vegetable oils. Four different vegetable oils (coconut oil, CO; linseed oil, LO; palm tree oil, PO; and rapeseed oil, RO) and common diesel fuel (DF) were combusted in a heavy-duty diesel engine. The exhausts were investigated for particle emissions and mutagenic effects in direct comparison with emissions of DF. The engine was operated using the European Stationary Cycle. Particle masses were measured gravimetrically while mutagenicity was determined using the bacterial reverse mutation assay with tester strains TA98 and TA100. Combustion of LO caused the largest amount of total particulate matter (TPM). In comparison with DF, it particularly raised the soluble organic fraction (SOF). RO presented second highest TPM and SOF, followed by CO and PO, which were scarcely above DF. RO revealed the highest number of mutations of the vegetable oils closely followed by LO. PO was less mutagenic, but still induced stronger effects than DF. While TPM and SOF were strongly correlated with the content of polyunsaturated fatty acids in the vegetable oils, mutagenicity had a significant correlation with the amount of total unsaturated fatty acids. This study supports the hypothesis that numbers of double bounds in unsaturated fatty acids of vegetable oils combusted in diesel engines influence the amount of emitted particles and the mutagenicity of the exhaust. Further investigations have to elucidate the causal relationship.

Pillar[n]arene-based supramolecular organic frameworks with high hydrocarbon storage and selectivity

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

Tan, Li-Li; Zhu, Youlong; Long, Hai

2017-01-01

We report the high hydrocarbon storage capacity and adsorption selectivity of two low-density pillar[n]arene-based SOFs. Our study would open new perspectives in the development of pillar[n]arene-based SOFs and study of their great potential in gas-storage and gas-separation applications.

Development of a wavelength-separated type scintillator with optical fiber (SOF) dosimeter to compensate for the Cerenkov radiation effect.

PubMed

Ishikawa, Masayori; Nagase, Naomi; Matsuura, Taeko; Hiratsuka, Junichi; Suzuki, Ryusuke; Miyamoto, Naoki; Sutherland, Kenneth Lee; Fujita, Katsuhisa; Shirato, Hiroki

2015-03-01

The scintillator with optical fiber (SOF) dosimeter consists of a miniature scintillator mounted on the tip of an optical fiber. The scintillator of the current SOF dosimeter is a 1-mm diameter hemisphere. For a scintillation dosimeter coupled with an optical fiber, measurement accuracy is influenced by signals due to Cerenkov radiation in the optical fiber. We have implemented a spectral filtering technique for compensating for the Cerenkov radiation effect specifically for our plastic scintillator-based dosimeter, using a wavelength-separated counting method. A dichroic mirror was used for separating input light signals. Individual signal counting was performed for high- and low-wavelength light signals. To confirm the accuracy, measurements with various amounts of Cerenkov radiation were performed by changing the incident direction while keeping the Ir-192 source-to-dosimeter distance constant, resulting in a fluctuation of <5%. Optical fiber bending was also addressed; no bending effect was observed for our wavelength-separated SOF dosimeter. © The Author 2015. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

Intrapatient viral diversity and treatment outcome in patients with genotype 3a hepatitis C virus infection on sofosbuvir-containing regimens.

PubMed

Bhardwaj, N; Ragonnet-Cronin, M; Murrell, B; Chodavarapu, K; Martin, R; Chang, S; Miller, M D; Feld, J J; Sulkowski, M; Mangia, A; Wertheim, J O; Osinusi, A; McNally, J; Brainard, D; Mo, H; Svarovskaia, E S

2018-04-01

Treatment with the direct-acting antiviral agent (DAA) sofosbuvir (SOF), an NS5B inhibitor, and velpatasvir (VEL), an NS5A inhibitor, demonstrates viral cure rates of ≥95% in hepatitis C virus (HCV) genotypes (GT) 1-6. Here, we investigated intrapatient HCV diversity in NS5A and NS5B using Shannon entropy to examine the relationship between viral diversity and treatment outcome. At baseline, HCV diversity was lowest in patients infected with HCV GT3 as compared to the other GTs, and viral diversity was greater in NS5A than NS5B (P < .0001). Treatment outcome with SOF/VEL or the comparator regimen of SOF with ribavirin (RBV) was not correlated with baseline diversity. However, among persons treated with SOF/VEL, a decrease in diversity from baseline was observed at relapse in the majority virologic failures, consistent with a viral bottleneck event at relapse. In contrast, an increase in diversity was observed in 27% of SOF+RBV virologic failures. We investigated whether the increase in diversity was due to an increase in the transition rate, one mode of potential RBV-mediated mutagenesis; however, we found no evidence of this mechanism. Overall, we did not observe that viral diversity at baseline influenced treatment outcome, but the diversity changes observed at relapse can improve our understanding of RBV viral suppression in vivo. © 2017 John Wiley & Sons Ltd.

[Cost-effectiveness analysis of sofosbuvir, peginterferon and ribavirin in patients with chronic hepatitis C: Early treatment in the initial stage of fibrosis vs. delayed treatment in advanced fibrosis].

PubMed

Buti, María; Domínguez-Hernández, Raquel; Oyagüez, Itziar; Casado, Miguel Ángel

2016-01-01

Cost-effectiveness analysis of sofosbuvir combined with peginterferon alpha-2a and ribavirin (SOF/Peg-IFN/RBV) in early versus advanced fibrosis in previously untreated patients with chronic hepatitis C genotype 1 (CHC-GT1), from the perspective of the Spanish National Health System (NHS). A Markov model was developed to compare lifetime costs and outcomes (life years gained [LYGs] and quality-adjusted life years [QALYs]) of 2 treatment strategies: SOF/Peg-IFN/RBV administered during early fibrosis (mild-moderate fibrosis; F2-F3) or advanced fibrosis (cirrhosis; F4). Efficacy (sustained virologic response), annual transition probabilities, disease management costs and utilities were obtained from the literature. Costs and outcomes were discounted annually at 3%. Direct costs were considered, expressed in Euros (€, 2014). Probabilistic sensitivity analysis (PSA) was also performed. SOF/Peg-IFN/RBV therapy at F2-F3 was more effective (19.12 LYGs and 14.14 QALYs) compared to F4. In a cohort of 1,000 patients, SOF/Peg-IFN/RBV prevented 66 cases of decompensated cirrhosis, 60 hepatocellular carcinomas and 4 liver transplantations compared with therapy in advanced fibrosis. The total lifetime cost of early therapy (€43,263) was less than the cost of treatment in the advanced stage (€49,018). Early therapy was a dominant strategy, more effective and less costly in all simulations. In the PSA analysis, administration of SOF/PEG-IFN/RBV at F2-F3 was dominant in all simulations. Starting SOF/Peg-IFN/RBV therapy at F2-F3, compared with therapy at F4, reduced the incidence of liver disease complications and was associated with cost savings for the Spanish NHS in CHC-GT1 patients. Copyright © 2016 Elsevier España, S.L.U. y AEEH y AEG. All rights reserved.

Cost-effectiveness analysis of ledipasvir/sofosbuvir in patients with chronic hepatitis C: Treatment of patients with absence or mild fibrosis compared to patients with advanced fibrosis.

PubMed

Buti, M; Domínguez-Hernández, R; Oyagüez, I; Casado, M A; Esteban, R

2017-09-01

To evaluate the cost-effectiveness of ledipasvir/sofosbuvir (LDV/SOF) in treatment-naïve patients with chronic hepatitis C (CHC) genotype 1 (GT1) in the absence or mild fibrosis (F0-F1) versus advanced fibrosis (F2-F4), from the perspective of the Spanish Health System. A Markov model was developed to simulate disease progression, estimating costs and outcomes [life years gained (LYG) and quality-adjusted life years (QALY)] derived from starting with LDV/SOF in patients with F0-F1 compared with F2-F4. Therapy duration was 8 weeks in noncirrhotic patients with viral load <6 million IU/mL and 12 weeks in the remaining patients. Sustained virologic response rates were obtained from real-world cohort studies. Transition probabilities, utilities and direct costs were obtained from the literature. A 3% annual discount rate was applied to costs and outcomes. Sensitivity analyses were performed. LDV/SOF in F0-F1 patients was a dominant strategy, being more effective (19.85 LYG and 19.80 QALY) than beginning treatment in F2-F4 patients (18.63 LYG and 16.25 QALY), generating savings of €9228 per patient (€3661 due to disease management and monitoring). In a cohort of 1000 patients, LDV/SOF in F0-F1 patients decreased the number of cases of decompensated cirrhosis (93%), hepatocellular carcinoma (97%) and liver-related deaths (95%) and prevented 6 liver transplants compared to initiating LDV/SOF in F2-F4 patients. In CHC treatment-naïve GT1 patients, starting treatment with LDV/SOF in patients with F0-F1 compared to those with F2-F4 increases effectiveness by 1.22 LYG and 3.55 QALY gained and reduces disease burden and it is associated with cost savings. © 2017 John Wiley & Sons Ltd.

Journal of Special Operations Medicine. Volume 5, Edition 3, Summer 2005

DTIC Science & Technology

2005-01-01

bacteri- al inoculation of wounded animals prevented infec- tion for three days, but therapy delayed for six hours was ineffective.7 Antibacterial activity ...the case of shock, unconsciousness, or penetrating abdominal injury. 3. In an animal model, antibacterial activity can be overcome if...SOF units and our active editorial consultants. 2) SOMA members receive the JSOM as part of membership. Please note, if you are a SOMA member and

Journal of Special Operations Medicine. Volume 5, Edition 2, Spring 2005

DTIC Science & Technology

2005-01-01

some Gram-positive bacteria.3 Sulconazole has some antibacterial activity against Gram- positive Staphylococcus aureus, Staphylococcus epidermidis...Medicine (JSOM). USSOCOM-SG distributes the JSOM to all our SOF units and our active editorial consultants. We can also email you the JSOM PDF; if you...continually had a very strong pro- gram and have definitely set the standard for NTMs among all the groups, both active and reserve component. This

Journal of Special Operations Medicine, Volume 7, Edition 1

DTIC Science & Technology

2007-01-01

SOMA through www.somaonline.org or contact MSG Russell Justice at justicer@earthlink.net. SOMA pro - vides a very valuable means of obtaining SOF...battlefield. The committee now has representation from all the Serv- ices and is busy deciding which way it needs to pro - ceed. There should be a...medical lessons learned and unit after actions reports (AARs) that con - tain combat mission needs has been a discussed item; this has been

Regional Understanding and Unity of Effort: Applying the Global SOF Network in Future Operating Environments Communications

DTIC Science & Technology

2016-12-07

Communications BY CHRISTOPHER VARHOLA The convergence of popular wars, ethnic and religious conflict, ideological extremism, and competition over diminishing...regardless of the skills and prepa- ration of military members. Even with clear authorities, uncertainty about how to accom- plish mission sets...This tension is good when based on clear understandings and hon- est communication ; however, the tension is destructive and cyclical when based on

Special Operations Liaison Officer: Looking Back to See the Future

DTIC Science & Technology

2014-06-01

Officer GSN global SOF network HQ Headquarters HRC Human Resources Command HRM human resource management xiii IEP International...life away from a U.S. base in a foreign country In May 2013, the USSOCOM International Engagement Program ( IEP ) provided funding to the Naval...manages the USSOCOM IEP . The intent of this study was to produce a formal career path for SOLOs that would eliminate most, if not all, the current

Training Supplement Winter 2010 Journal of Special Operations Medicine. A Peer Reviewed Journal for SOF Medical Professionals

DTIC Science & Technology

2010-01-01

spontaneous pneumothorax, HAPE, and pulmonary embolism . DISPOSITION: 1. Urgent evacuation if no response to treatment. 2. If the patient responds to...chest pain, dyspnea, mediastinal emphysema, subcutaneous emphysema, pneumothorax, and arterial gas embolism (AGE). . MANAGEMENT: 1. Middle ear A...ascending with a closed airway (i.e. breath-holding), and can cause pneumothorax or arterial gas embolism . Winter 2010 Training Supplement TMEPS A15

Re-re-treatment of hepatitis C virus: Eight patients who relapsed twice after direct-acting-antiviral drugs

PubMed Central

Hartman, Joshua; Bichoupan, Kian; Patel, Neal; Chekuri, Sweta; Harty, Alyson; Dieterich, Douglas; Perumalswami, Ponni; Branch, Andrea D

2015-01-01

AIM: To determine risk factors associated with hepatitis C virus (HCV) treatment failure after direct acting antivirals in patients with complex treatment histories. METHODS: All HCV mono-infected patients who received treatment at our institution were queried. Analysis was restricted to patients who previously failed treatment with boceprevir (BOC) or telaprevir (TVR) and started simeprevir (SMV) and sofosbuvir (SOF) ± ribavirin (RBV) between December 2013 and June 2014. Patients with human immunodeficiency virus (HIV)/HCV co-infection or patients who received a liver transplant in the past were excluded. Viral loads were recorded while on treatment and after treatment. Data collection continued until December, 31st 2014 when data analysis was initiated. Patients missing virologic outcomes data were not included in the analysis. Analysis of 35 patients who had virologic outcome data available resulted in eight patients who were viral load negative at the end of treatment with SMF/SOF but later relapsed. Data related to patient demographics, HCV infection, and treatment history was collected in order to identify risk factors shared among patients who failed treatment with SMF/SOF. RESULTS: Eight patients who were treated with the first generation HCV protease inhibitors BOC or TVR in combination with pegylated-interferon (PEG) and RBV who failed this triple therapy were subsequently re-treated with an off-label all-oral regimen of SMV and SOF for 12 wk, with RBV in seven cases. Treatment was initiated before the Food and Drug Administration approved a 24-wk SMV/SOF regimen for patients with liver cirrhosis. All eight patients had an end of treatment response, but later relapsed. Eight (100%) patients were male. Mean age was 56 (range, 49-64). Eight (100%) patients had previously failed PEG/RBV dual therapy at least once in addition to prior failure with triple therapy. Total number of times treated ranged from 3-6 (mean 3.8). Eight (100%) patients were male had liver cirrhosis as determined by Fibroscan or MRI. Seven (87.5%) patients had genotype 1a HCV. Seven (87.5%) patients had over 1 million IU/mL HCV RNA at the time of re-treatment. CONCLUSION: This study identifies factors associated with SMV/SOF treatment failure and provides evidence that twleve weeks of SMV/SOF/RBV is insufficient in cirrhotics with high-titer genotype 1a HCV. PMID:26604650

Effectiveness of ophthalmic solution preservatives: a comparison of latanoprost with 0.02% benzalkonium chloride and travoprost with the sofZia preservative system.

PubMed

Ryan, Gerard; Fain, Joel M; Lovelace, Cherie; Gelotte, Karl M

2011-04-21

Although in vitro and in vivo laboratory studies have suggested that benzalkonium chloride (BAK) in topical ophthalmic solutions may be detrimental to corneal epithelial cells, multiple short- and long-term clinical studies have provided evidence supporting the safety of BAK. Despite the conflicting evidence, BAK is the most commonly used preservative in ophthalmic products largely due to its proven antimicrobial efficacy. This study was designed to characterize the antimicrobial performance of two commonly used topical ocular hypotensive agents that employ different preservative systems: latanoprost 0.005% with 0.02% BAK and travoprost 0.004% with sofZia, a proprietary ionic buffer system. Each product was tested for antimicrobial effectiveness by European Pharmacopoeia A (EP-A) standards, the most stringent standards of the three major compendia, which specify two early sampling time points (6 and 24 hours) not required by the United States Pharmacopeia or Japanese Pharmacopoeia. Aliquots were inoculated with between 10(5) and 10(6) colony-forming units of the test organisms: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Candida albicans and Aspergillus brasiliensis. Sampling and enumeration were conducted at protocol-defined time points through 28 days. BAK-containing latanoprost met EP-A criteria by immediately reducing all bacterial challenge organisms to the test sensitivity and fungal challenges within the first six hours while the preservative activity of travoprost with sofZia did not. Complete bacterial reduction by travoprost with sofZia was not shown until seven days into the test, and fungal reduction never exceeded the requisite 2 logs during the 28-day test. Travoprost with sofZia also did not meet EP-B criteria due to its limited effectiveness against Staphylococcus aureus. Both products satisfied United States and Japanese pharmacopoeial criteria. Latanoprost with 0.02% BAK exhibited more effective microbial protection than travoprost with sofZia using rates of microbial reduction, time to no recovery for all challenges and evaluation against EP-A criteria as measures. The rapid and complete reduction of all microbial challenges demonstrates that antimicrobial activity of latanoprost with 0.02% BAK exceeds that of travoprost with sofZia preservative system in these products and provides a more protective environment in the event of contamination and subsequent exposure to microorganisms during use.

Effectiveness of ophthalmic solution preservatives: a comparison of latanoprost with 0.02% benzalkonium chloride and travoprost with the sofZia preservative system

PubMed Central

2011-01-01

Background Although in vitro and in vivo laboratory studies have suggested that benzalkonium chloride (BAK) in topical ophthalmic solutions may be detrimental to corneal epithelial cells, multiple short- and long-term clinical studies have provided evidence supporting the safety of BAK. Despite the conflicting evidence, BAK is the most commonly used preservative in ophthalmic products largely due to its proven antimicrobial efficacy. This study was designed to characterize the antimicrobial performance of two commonly used topical ocular hypotensive agents that employ different preservative systems: latanoprost 0.005% with 0.02% BAK and travoprost 0.004% with sofZia, a proprietary ionic buffer system. Methods Each product was tested for antimicrobial effectiveness by European Pharmacopoeia A (EP-A) standards, the most stringent standards of the three major compendia, which specify two early sampling time points (6 and 24 hours) not required by the United States Pharmacopeia or Japanese Pharmacopoeia. Aliquots were inoculated with between 105 and 106 colony-forming units of the test organisms: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Candida albicans and Aspergillus brasiliensis. Sampling and enumeration were conducted at protocol-defined time points through 28 days. Results BAK-containing latanoprost met EP-A criteria by immediately reducing all bacterial challenge organisms to the test sensitivity and fungal challenges within the first six hours while the preservative activity of travoprost with sofZia did not. Complete bacterial reduction by travoprost with sofZia was not shown until seven days into the test, and fungal reduction never exceeded the requisite 2 logs during the 28-day test. Travoprost with sofZia also did not meet EP-B criteria due to its limited effectiveness against Staphylococcus aureus. Both products satisfied United States and Japanese pharmacopoeial criteria. Conclusions Latanoprost with 0.02% BAK exhibited more effective microbial protection than travoprost with sofZia using rates of microbial reduction, time to no recovery for all challenges and evaluation against EP-A criteria as measures. The rapid and complete reduction of all microbial challenges demonstrates that antimicrobial activity of latanoprost with 0.02% BAK exceeds that of travoprost with sofZia preservative system in these products and provides a more protective environment in the event of contamination and subsequent exposure to microorganisms during use. PMID:21510881

Re-re-treatment of hepatitis C virus: Eight patients who relapsed twice after direct-acting-antiviral drugs.

PubMed

Hartman, Joshua; Bichoupan, Kian; Patel, Neal; Chekuri, Sweta; Harty, Alyson; Dieterich, Douglas; Perumalswami, Ponni; Branch, Andrea D

2015-11-21

To determine risk factors associated with hepatitis C virus (HCV) treatment failure after direct acting antivirals in patients with complex treatment histories. All HCV mono-infected patients who received treatment at our institution were queried. Analysis was restricted to patients who previously failed treatment with boceprevir (BOC) or telaprevir (TVR) and started simeprevir (SMV) and sofosbuvir (SOF) ± ribavirin (RBV) between December 2013 and June 2014. Patients with human immunodeficiency virus (HIV)/HCV co-infection or patients who received a liver transplant in the past were excluded. Viral loads were recorded while on treatment and after treatment. Data collection continued until December, 31(st) 2014 when data analysis was initiated. Patients missing virologic outcomes data were not included in the analysis. Analysis of 35 patients who had virologic outcome data available resulted in eight patients who were viral load negative at the end of treatment with SMF/SOF but later relapsed. Data related to patient demographics, HCV infection, and treatment history was collected in order to identify risk factors shared among patients who failed treatment with SMF/SOF. Eight patients who were treated with the first generation HCV protease inhibitors BOC or TVR in combination with pegylated-interferon (PEG) and RBV who failed this triple therapy were subsequently re-treated with an off-label all-oral regimen of SMV and SOF for 12 wk, with RBV in seven cases. Treatment was initiated before the Food and Drug Administration approved a 24-wk SMV/SOF regimen for patients with liver cirrhosis. All eight patients had an end of treatment response, but later relapsed. Eight (100%) patients were male. Mean age was 56 (range, 49-64). Eight (100%) patients had previously failed PEG/RBV dual therapy at least once in addition to prior failure with triple therapy. Total number of times treated ranged from 3-6 (mean 3.8). Eight (100%) patients were male had liver cirrhosis as determined by Fibroscan or MRI. Seven (87.5%) patients had genotype 1a HCV. Seven (87.5%) patients had over 1 million IU/mL HCV RNA at the time of re-treatment. This study identifies factors associated with SMV/SOF treatment failure and provides evidence that twleve weeks of SMV/SOF/RBV is insufficient in cirrhotics with high-titer genotype 1a HCV.

NPS Field Experimentation Program for Special Operations (FEPSO) TNT 13-1 Report

DTIC Science & Technology

2013-03-01

testing  is  already  providing  results  in  ឬ  minutes),  gait,   sweat,  periocular,  iris,  heartbeat,  sweat...Successful urban operations conducted by SOF require a thorough understanding of the urban environment, which may include: • The psychological impact of...deprived  environments.  NSW CRANE ‐ Results of 2012 Urban Combat  testing  of how a Marine Corps Ring Mount Gunner (RMG)  does their job and what senses

Light scatter on the surface of AcrySof intraocular lenses: part I. Analysis of lenses retrieved from pseudophakic postmortem human eyes.

PubMed

Yaguchi, Shigeo; Nishihara, Hitoshi; Kambhiranond, Waraporn; Stanley, Daniel; Apple, David J

2008-01-01

To investigate the cause of light scatter measured on the surface of AcrySof intraocular lenses (Alcon Laboratories, Inc., Fort Worth, TX) retrieved from pseudophakic postmortem human eyes. Ten intraocular lenses (Alcon AcrySofModel MA60BM) were retrieved postmortem and analyzed for light scatter before and after removal of surface-bound biofilms. Six of the 10 lenses exhibited light scatter that was clearly above baseline levels. In these 6 lenses, both peak and average pixel density were reduced by approximately 80% after surface cleaning. The current study demonstrates that a coating deposited in vivo on the lens surface is responsible for the light scatter observed when incident light is applied.

SPECIAL ANALYSIS OF OPERATIONAL STORMWATER RUNOFF COVERS OVER SLIT TRENCHES

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

Collard, L; Luther Hamm, L

2008-12-18

Solid Waste Management (SWM) commissioned this Special Analysis (SA) to determine the effects of placing operational stormwater runoff covers (referred to as covers in the remainder of this document) over slit trench (ST) disposal units ST1 through ST7 (the center set of slit trenches). Previously the United States Department of Energy (DOE) entered into an agreement with the United States Environmental Protection Agency (EPA) and the South Carolina Department of Health and Environmental Control (SCDHEC) to place covers over Slit Trenches 1 and 2 to be able to continue disposing Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) solid wastemore » (see USDOE 2008). Because the covers changed the operating conditions, DOE Order 435.1 (DOE 1999) required that an SA be performed to assess the impact. This Special Analysis has been prepared to determine the effects of placing covers over slit trenches at about years 5, 10 and 15 of the 30-year operational period. Because some slit trenches have already been operational for about 15 years, results from analyzing covers at 5 years and 10 years provide trend analysis information only. This SA also examined alternatives of covering Slit Trenches 1 and 2 with one cover and Slit Trenches 3 and 4 with a second cover versus covering them all with a single cover. Based on modeling results, minimal differences exist between covering Slit Trench groups 1-2 and 3-4 with two covers or one large cover. This SA demonstrates that placement of covers over slit trenches will slow the subsequent release and transport of radionuclides in the vadose zone in the early time periods (from time of placement until about 100 years). Release and transport of some radionuclides in the vadose zone beyond 100 years were somewhat higher than for the case without covers. The sums-of-fractions (SOFs) were examined for the current waste inventory in ST1 and ST2 and for estimated inventories at closure for ST3 through ST7. In all cases SOFs were less than one (except for one SOF for ST5 that remained at one), indicating that there should be no unacceptable impacts on operations from placing covers for the cover alternatives that were analyzed. Minimal operational limits provided in Table 4 should be used as the new set of limits for Slit Trenches 1 through 7. ST1 and ST2 are expected to be covered about 15 years after the first disposal in ST1. Because the time of actual placement of covers over the other slit trenches is unknown, this SA did not consider limit increases, only limit decreases. Thus, each minimal operational limit is the minimum of the Performance Assessment (PA) final limit and the limit calculated in this SA if covers were placed at about 5, 10 or 15 years. If other cover times are desired, further analysis will be required.« less

Supramolecular organic frameworks: engineering periodicity in water through host-guest chemistry.

PubMed

Tian, Jia; Chen, Lan; Zhang, Dan-Wei; Liu, Yi; Li, Zhan-Ting

2016-05-11

The development of homogeneous, water-soluble periodic self-assembled structures comprise repeating units that produce porosity in two-dimensional (2D) or three-dimensional (3D) spaces has become a topic of growing interest in the field of supramolecular chemistry. Such novel self-assembled entities, known as supramolecular organic frameworks (SOFs), are the result of programmed host-guest interactions, which allows for the thermodynamically controlled generation of monolayer sheets or a diamondoid architecture with regular internal cavities or pores under mild conditions. This feature article aims at propagating the conceptually novel SOFs as a new entry into conventional supramolecular polymers. In the first section, we will describe the background of porous solid frameworks and supramolecular polymers. We then introduce the self-assembling behaviour of several multitopic flexible molecules, which is closely related to the design of periodic SOFs from rigid multitopic building blocks. This is followed by a brief discussion of cucurbit[8]uril (CB[8])-encapsulation-enhanced aromatic stacking in water. The three-component host-guest pattern based on this stacking motif has been utilized to drive the formation of most of the new SOFs. In the following two sections, we will highlight the main advances in the construction of 2D and 3D SOFs and the related functional aspects. Finally, we will offer our opinions on future directions for both structures and functions. We hope that this article will trigger the interest of researchers in the field of chemistry, physics, biology and materials science, which should help accelerate the applications of this new family of soft self-assembled organic frameworks.

Clinical Effectiveness of Different Polishing Systems and Self-Etch Adhesives in Class V Composite Resin Restorations: Two-Year Randomized Controlled Clinical Trial.

PubMed

Jang, J-H; Kim, H-Y; Shin, S-M; Lee, C-O; Kim, D S; Choi, K-K; Kim, S-Y

The aim of this randomized controlled clinical trial was to compare the clinical effectiveness of different polishing systems and self-etch adhesives in class V composite resin restorations. A total of 164 noncarious cervical lesions (NCCLs) from 35 patients were randomly allocated to one of four experimental groups, each of which used a combination of polishing systems and adhesives. The two polishing systems used were Sof-Lex XT (Sof), a multistep abrasive disc, and Enhance/Pogo (EP), a simplified abrasive-impregnated rubber instrument. The adhesive systems were Clearfil SE bond (CS), a two-step self-etch adhesive, and Xeno V (XE), a one-step self-etch adhesive. All NCCLs were restored with light-cured microhybrid resin composites (Z250). Restorations were evaluated at baseline and at 6, 12, 18, and 24 months by two blinded independent examiners using modified FDI criteria. The Fisher exact test and generalized estimating equation analysis considering repeated measurements were performed to compare the outcomes between the polishing systems and adhesives. Three restorations were dislodged: two in CS/Sof and one in CS/EP. None of the restorations required any repair or retreatment except those showing retention loss. Sof was superior to EP with regard to surface luster, staining, and marginal adaptation (p<0.05). CS and XE did not show differences in any criteria (p>0.05). Sof is clinically superior to EP for polishing performance in class V composite resin restoration. XE demonstrates clinically equivalent bonding performance to CS.

Distance vision after bilateral implantation of AcrySof toric intraocular lenses: a randomized, controlled, prospective trial

PubMed Central

Zhang, Jin-Song; Zhao, Jiang-Yue; Sun, Qi; Ma, Li-Wei

2011-01-01

AIM To evaluate the distance vision of Chinese patients with cataracts and corneal astigmatism after implantation of bilateral AcrySof toric intraocular lens (IOL) versus bilateral AcrySof spherical IOL. METHODS This study randomized 60 patients into equal groups to receive toric IOL or spherical IOL. IOL powers targeting emmetropia were selected for 93% of toric IOL patients and for 90% of spherical IOL patients. Assessments included monocular and binocular distance vision, with and without best correction. Patients also completed surveys about their distance vision. RESULTS Preoperatively, the two study groups were similar in age, in distance visual acuity, and in the magnitude of corneal astigmatism. At 6 months postoperative, binocular uncorrected distance vision was 0.06±0.14 logMAR in the AcrySof toric IOL group, significantly better than the 0.14±0.11 logMAR in the spherical IOL group (P<0.05). For eyes with emmetropia as a target, the equivalent of 20/20 uncorrected vision was more likely (P<0.001) in the toric IOL group (36% of eyes) than in the spherical IOL group (4% of eyes). No patients in the emmetropia/toric IOL group used distance glasses, as compared to 52% of patients in the emmetropia/spherical IOL group. All patients were satisfied or highly satisfied. Quality of distance vision was rated higher by toric IOL patients than by spherical IOL patients (P<0.05). CONCLUSION Bilateral AcrySof toric IOL is superior to bilateral spherical IOL in providing uncorrected distance vision to cataract patients with corneal astigmatism. PMID:22553636

Command, Control and Integration of Weaponized Unmanned Aircraft into the Air-to-Ground System

DTIC Science & Technology

2007-02-23

munitions. A synthetic aperture radar (SAR) payload is also available for the MQ-1 which allows the system to see through weather and clouds but the...SOF) can pull mensurated or “ sweetened ” coordinates for PGM engagement.70 The ISR deck should be serviced by traditional assets such as F-16s with...Operating Zone RSTA Reconnaissance, Surveillance and Target Acquisition SAR Synthetic Aperture Radar SIAP Standard Integrated Air Picture SDB

Journal of Special Operations Medicine. Volume 4, Edition 1, Winter 2004

DTIC Science & Technology

2004-01-01

an ophthalmologist. He has been instrumental in PRK initiatives, has been a very productive mem- ber of the BISC, knows the risks of our missions...results to SOF mission commanders in a format suit- able for training at the unit level. 1999-3 PROSPECTIVE EVALUATION OF WAVE- FRONT-GUIDED PRK (Year...1 of 3) Conduct a prospective, randomized clinical trial to compare PRK for the treatment of naturally occurring myopia and astigmatism using

Effects of diesel/biodiesel blends on regulated and unregulated pollutants from a passenger vehicle operated over the European and the Athens driving cycles

NASA Astrophysics Data System (ADS)

Karavalakis, George; Stournas, Stamoulis; Bakeas, Evangelos

This paper presents the regulated and unregulated exhaust emissions of a diesel passenger vehicle, operated with low sulphur automotive diesel and soy methyl ester blends. Emission and fuel consumption measurements were conducted under real driving conditions (Athens Driving Cycle, ADC) and compared with those of a modified New European Driving Cycle (NEDC) using a chassis dynamometer. A Euro II compliant diesel vehicle was used in this study, equipped with an indirect injection diesel engine, fuelled with diesel fuel and biodiesel blends at proportions of 5, 10, and 20% respectively. Unregulated emissions of 11 polycyclic aromatic hydrocarbons (PAHs), 5 nitro-PAHs, 13 carbonyl compounds (CBCs) and the soluble organic fraction (SOF) of the particulate matter were measured. Qualitative hydrocarbon analysis was also performed on the SOF. Regulated emissions of NO x, CO, HC, CO 2, and PM were also measured over the two test cycles. It was established that some of the emissions measured over the (hot-start) NEDC differed from the real-world cycle. Significant differences were also observed in the vehicle's fuel consumption between the two test cycles. The addition of biodiesel reduced the regulated emissions of CO, HC and PM, while an increase in NO x was observed over the ADC. Carbonyl emissions, PAHs and nitro-PAHs were reduced with the addition of biodiesel over both driving cycles.

Cost-effectiveness of daclatasvir plus sofosbuvir-based regimen for treatment of hepatitis C virus genotype 3 infection in Canada.

PubMed

Moshyk, A; Martel, M-J; Tahami Monfared, A A; Goeree, R

2016-01-01

New regimens for the treatment of chronic hepatitis C virus (HCV) genotype 3 have demonstrated substantial improvement in sustained virologic response (SVR) compared with existing therapies, but are considerably more expensive. The objective of this study was to evaluate the cost-effectiveness of two novel all-oral, interferon-free regimens for the treatment of patients with HCV genotype 3: daclatasvir plus sofosbuvir (DCV + SOF) and sofosbuvir plus ribavirin (SOF + RBV), from a Canadian health-system perspective. A decision analytic Markov model was developed to compare the effect of various treatment strategies on the natural history of the disease and their associated costs in treatment-naïve and treatment-experienced patients. Patients were initially distributed across fibrosis stages F0-F4, and may incur disease progression through fibrosis stages and on to end-stage liver disease complications and death; or may achieve SVR. Clinical efficacy, health-related quality-of-life, costs, and transition probabilities were based on published literature. Probabilistic sensitivity analysis was performed to assess parameter uncertainty associated with the analysis. In treatment-naive patients, the expected quality-adjusted life years (QALYs) for interferon-free regimens were higher for DCV + SOF (12.37) and SOF + RBV (12.48) compared to that of pINF + RBV (11.71) over a lifetime horizon, applying their clinical trial treatment durations. The expected costs were higher for DCV + SOF ($170,371) and SOF + RBV ($194,776) vs pINF + RBV regimen ($90,905). Compared to pINF + RBV, the incremental cost-effectiveness ratios (ICER) were $120,671 and $135,398 per QALYs for DCV + SOF and SOF + RBV, respectively. In treatment-experienced patients, DCV + SOF regimen dominated the SOF + RBV regimen. Probabilistic sensitivity analysis indicated a 100% probability that a DCV + SOF regimen was cost saving in treatment-experienced patients. Daclatasvir plus sofosbuvir is a safe and effective option for the treatment of chronic HCV genotype 3 patients. This regimen could be considered a cost-effective option following a first-line treatment of peg-interferon/ribavirin treatment experienced patients with HCV genotype-3 infection.

Superiority of Interferon-Free Regimens for Chronic Hepatitis C

PubMed Central

Younossi, Zobair M.; Stepanova, Maria; Esteban, Rafael; Jacobson, Ira; Zeuzem, Stefan; Sulkowski, Mark; Henry, Linda; Nader, Fatema; Cable, Rebecca; Afendy, Mariam; Hunt, Sharon

2017-01-01

Abstract Patient-reported outcomes (PROs) such as quality of life and work productivity are important for measuring patient's experience. We assessed PROs during and after treatment of hepatitis C virus (HCV) patients. Data were obtained from a phase 3 open label study of sofosbuvir and ribavirin (SOF + RBV) with and without interferon (IFN). Patients completed 4 PRO assessment instruments (SF-36, Functional Assessment of Chronic Illness Therapy—Fatigue, Chronic Liver Disease Questionnaire— HCV, Work Productivity and Activity—Specific Health Problem) before, during, and after treatment. A total of 533 patients with chronic HCV were enrolled; 28.9% treatment-naïve, 23.1% cirrhotic, 219 received IFN + SOF + RBV and 314 received IFN-free SOF + RBV. At baseline, there were no differences in PROs between the IFN-free and IFN-containing treatment arms (all P > 0.05). During treatment, patients receiving IFN + SOF + RBV had a substantial impairment in their PROs (up to −24.4% by treatment week 12, up to −8.3% at week 4 post-treatment). The PRO decrements seen in the SOF + RBV arm were smaller in magnitude (up to −7.1% by treatment week 12), and all returned to baseline or improved by post-treatment week 4. By 12 weeks after treatment cessation, patients who achieved sustained viral response-12 showed some improvement of PRO scores regardless of the regimen (up to +7.1%, P < 0.0001) or previous treatment experience. In multivariate analysis, the use of IFN was independently associated with lower PROs. IFN-based regimens have a profoundly negative impact to PROs. By contrast, the impact of RBV on these PROs is relatively modest. Achieving HCV cure is associated with improvement of most of the PRO scores. PMID:28207507

Curing Chronic Hepatitis C: A Cost Comparison of the Combination Simeprevir Plus Sofosbuvir vs. Protease-Inhibitor-Based Triple Therapy.

PubMed

Langness, Jacob A; Tabano, David; Wieland, Amanda; Tise, Sarah; Pratt, Lindsay; Harrington, Lauren Ayres; Lin, Sonia; Ghuschcyan, Vahram; Nair, Kavita V; Everson, Gregory T

Interferon-free, multi-direct acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection is highly effective and well tolerated, but costly. To gain perspective on the evolving economics of HCV therapy, we compared the cost per cure of a multi-DAA regimen with the prior standard of triple therapy. Patients infected with HCV genotype 1 who were treated through the University of Colorado Hepatology Clinic between May 2011 and December 2014 comprised the study population. The multi-DAA regimen of simeprevir plus sofosbuvir (SMV/SOF) was compared to the triple therapy regimen consisting of peginterferon and ribavirin, with either boceprevir or telaprevir (TT). Sustained-virologic response (SVR) rates, total costs per treatment and adverse events were recorded. Total cost per SVR were compared for the two treatments, controlling for patient demographics and clinical characteristics. One hundred eighty-three patients received SMV/SOF (n = 70) or TT (n = 113). Patients receiving SMV/SOF were older, more treatment experienced, and had a higher stage of fibrosis. SVRs were 86% and 59%, average total costs per patient were $152,775 and $95,943, and average total costs per SVR were $178,237 vs. $161,813.49 for SMV/SOF and TT groups, respectively. Medication costs accounted for 98% of SMV/SOF and 85% of TT treatment costs. The high cure rate of multi-DAA treatment of HCV is offset by the high costs of the DAAs, such that the cost per cure from TT to multi-DAA therapy has been relatively constant. In order to cure more patients, either additional financial resources will need to be allocated to the treatment of HCV or drug costs will need to be reduced.

Treatment of Chronic HCV Infection with the New Direct Acting Antivirals (DAA): First Report of a Real World Experience in Southern Brazil.

PubMed

Cheinquer, Hugo; Sette, Hoel; Wolff, Fernando H; de Araujo, Alexandre; Coelho-Borges, Silvia; Soares, Silvia R P; Barros, Mauricio F A

2017-01-01

There is almost no data regarding the efficacy of direct acting antivirals (DAAs) therapy in Brazil. The aim of this historical cohort study is to describe the sustained virologic response (SVR) rate among real-world compensated chronic hepatitis C patients in three hepatology centers from Southern Brazil. Patients were included if they had at least 12 weeks follow-up after the end of therapy. Patients that were lost to follow-up or had treatment prematurely interrupted for any reason were considered treatment failure in this intention to treat analysis. 219 patients were analyzed. Mean age was 57.4 ± 10.9 years and 142/219 (64.8%) were male. Genotype 1 was present in 166 patients (75.8%; 1a 29.2%, 1b 46.6%); Genotypes 2, 3 and 4 in 8 (3.7%), 43 (19.6%) and 2 (0.9%), respectively. 96 (43.8%) were cirrhotic. 134 (59.5%) were treatment experienced. DAA therapies were: sofosbuvir (SOF) + ribavirin (RBV) in 10 patients; SOF + simeprevir (SMV) ± RBV in 73; SOF + pegylated interferon (PEG-IFN) + RBV in 6; SOF + daclatasvir (DCV) ± RBV in 51, SOF + ledipasvir (LDV) ± RBV in 61, and paritaprevir/ ritonavir + ombitasvir + dasabuvir (PTVr/OBV/DSV) ± RBV in 18 patients. SVR-12 was achieved in 208/219 (95%). Ten patients had virologic failure: 6 cirrhotic, 7 treatment experienced, and 6 either genotype 3 or 1a. No adverse event was attributed to the DAA therapy. Real world experience with DAA therapy in Southern Brazil showed a high rate of SVR and excellent tolerability. Failure to achieve SVR was mainly observed among patients with at least one negative predictor of response: cirrhosis and/or genotypes 1a or 3.

AcrySof Natural SN60AT versus AcrySof SA60AT intraocular lens in patients with color vision defects.

PubMed

Raj, Shetal M; Vasavada, Abhay R; Nanavaty, Mayank A

2005-12-01

To determine whether implantation of the AcrySof Natural intraocular lens (IOL) worsened the severity of existing color deficit in congenital partial red-green color deficient individuals (CPRG). A prospective controlled randomized double-masked analysis of 30 consecutive patients with CPRG defect and bilateral cataracts received a Natural IOL (test group) in 1 eye and a single-piece AcrySof IOL (control group) in the other eye. Patients were tested unilaterally to detect CPRG defect using Ishihara pseudoisochromatic plates and the Farnsworth D-15 test. Plates 1 to 21 measured the Ishihara error score; plates 22 to 25 indicated severity of defect based on clarity of both numerals as partial mild/moderate (both visible), partial severe defect (only 1 visible). The D-15 test is based on number of diametrical crossings on the circular diagram; severity is graded as mild (1 crossing), moderate (2 crossings), or severe (>2 crossings). Tests were performed before and after IOL implantation at 1, 3, and 6 months. At mean follow-up of 6.13 months +/- 1.2 (SD), analysis of variance test judged the difference in error scores and cross tabulation represented change in number of diametrical crossings. The mean age was 62.3 +/- 8.5 years. All patients were men. Before IOL implantation, all patients had moderate CPRG defect on both tests. The Ishihara error score in the test and control groups did not reveal statistically significant differences (P = .505 and P = .119, respectively). With D-15, none of the patients in the test or control group showed >2 crossings. The implantation of AcrySof Natural IOL did not worsen the preexisting severity of color defect in CPRG individuals.

Sofosbuvir/Ledipasvir Without Ribavirin Achieved High Sustained Virologic Response for Hepatitis C Recurrence After Liver Transplantation: Two-Center Experience.

PubMed

Elfeki, Mohamed A; Abou Mrad, Rachel; Modaresi Esfeh, Jamak; Zein, Nizar N; Eghtesad, Bijan; Zervos, Xaralambos; Hanouneh, Ibrahim A; O'Shea, Robert; Carey, William D; Alkhouri, Naim

2017-05-01

Current recommended regimens to treat patients with hepatitis C virus (HCV) infection after liver transplantation include the use of ribavirin (RBV). Limited data are available on the efficacy of RBV-free regimens posttransplant, particularly the use of sofosbuvir (SOF)/ledipasvir (LDV) without RBV in this patient population. We aimed to assess the efficacy and safety of SOF/LDV fixed-dose combination without RBV in patients with HCV recurrence posttransplant. This is a retrospective study of 46 patients with HCV recurrence posttransplant. SOF/LDV without RBV was used for 12 weeks in patients with early-stage fibrosis (F0-F2) or for 24 weeks in those with advanced fibrosis (F3-F4) and/or cholestatic hepatitis. The primary endpoint was sustained virologic response at 12 weeks after the end of treatment. Secondary outcomes included relapse after treatment and adverse events. Forty-six patients, with a mean age of 62 ± 8 years, a median duration since time of transplant of 904 days (range, 78-3525 days), an HCV genotype 1, and a mean baseline viral load of 7.79 million IU/mL, were treated. Of these, 32 patients were treated for 12 weeks, and 14 patients were treated for 24 weeks. Twenty-five patients (54%) were treatment experienced (21 with interferon and 4 with SOF). All 46 patients (100%) achieved sustained virological response (SVR) 12. Neither virologic relapses nor serious adverse events were noted. The combination of SOF/LDV without RBV for 12 or 24 weeks produced 100% SVR 12 in patients with HCV recurrence after liver transplantation. The use of RBV may not be necessary to achieve SVR in this patient population.

Superiority of Interferon-Free Regimens for Chronic Hepatitis C: The Effect on Health-Related Quality of Life and Work Productivity.

PubMed

Younossi, Zobair M; Stepanova, Maria; Esteban, Rafael; Jacobson, Ira; Zeuzem, Stefan; Sulkowski, Mark; Henry, Linda; Nader, Fatema; Cable, Rebecca; Afendy, Mariam; Hunt, Sharon

2017-02-01

Patient-reported outcomes (PROs) such as quality of life and work productivity are important for measuring patient's experience. We assessed PROs during and after treatment of hepatitis C virus (HCV) patients.Data were obtained from a phase 3 open label study of sofosbuvir and ribavirin (SOF + RBV) with and without interferon (IFN). Patients completed 4 PRO assessment instruments (SF-36, Functional Assessment of Chronic Illness Therapy-Fatigue, Chronic Liver Disease Questionnaire- HCV, Work Productivity and Activity-Specific Health Problem) before, during, and after treatment.A total of 533 patients with chronic HCV were enrolled; 28.9% treatment-naïve, 23.1% cirrhotic, 219 received IFN + SOF + RBV and 314 received IFN-free SOF + RBV. At baseline, there were no differences in PROs between the IFN-free and IFN-containing treatment arms (all P > 0.05). During treatment, patients receiving IFN + SOF + RBV had a substantial impairment in their PROs (up to -24.4% by treatment week 12, up to -8.3% at week 4 post-treatment). The PRO decrements seen in the SOF + RBV arm were smaller in magnitude (up to -7.1% by treatment week 12), and all returned to baseline or improved by post-treatment week 4. By 12 weeks after treatment cessation, patients who achieved sustained viral response-12 showed some improvement of PRO scores regardless of the regimen (up to +7.1%, P < 0.0001) or previous treatment experience. In multivariate analysis, the use of IFN was independently associated with lower PROs.IFN-based regimens have a profoundly negative impact to PROs. By contrast, the impact of RBV on these PROs is relatively modest. Achieving HCV cure is associated with improvement of most of the PRO scores.

Streptococcal Serum Opacity Factor Increases Hepatocyte Uptake of Human Plasma High Density Lipoprotein-Cholesterol1

PubMed Central

Gillard, Baiba K.; Rosales, Corina; Pillai, Biju K.; Lin, Hu Yu; Courtney, Harry S.; Pownall, Henry J.

2010-01-01

Serum opacity factor (SOF), a virulence determinant of Streptococcus pyogenes, converts plasma high density lipoproteins (HDL) to three distinct species: lipid-free apolipoprotein (apo) A-I, neo HDL, a small discoidal HDL-like particle, and a large cholesteryl ester-rich microemulsion (CERM), that contains the cholesterol esters (CE) of up to ~400,000 HDL particles and apo E as its major protein. Similar SOF reaction products are obtained with HDL, total plasma lipoproteins and whole plasma. We hypothesized that hepatic uptake of CERM-CE via multiple apo E dependent receptors would be faster than that of HDL-CE. We tested our hypothesis using human hepatoma cells and lipoprotein receptor-specific Chinese hamster ovary (CHO) cells. [3H]CE uptake by HepG2 and Huh7 cells from HDL after SOF treatment, which transfers >90% of HDL-CE to CERM, was respectively 2.4 and 4.5 times faster than from control HDL. CERM-[3H]CE uptake was inhibited by LDL and HDL, suggestive of uptake by both the LDL receptor (LDL-R) and scavenger receptor class B type I (SR-BI). Studies in CHO cells specifically expressing LDL-R and SR-BI confirmed CERM-[3H]CE uptake by both receptors. RAP and heparin inhibit CERM-[3H]CE but not HDL-[3H]CE uptake thereby implicating LRP-1 and cell surface proteoglycans in this process. These data demonstrate that SOF treatment of HDL increases CE uptake via multiple hepatic apo E receptors. In so doing, SOF might increase hepatic disposal of plasma cholesterol in a way that is therapeutically useful. PMID:20879789

2011 Joint Missions Conference Held in Bloomington, Indiana on August 29-31, 2011

DTIC Science & Technology

2011-08-31

Breakfast Sponsored by CTC Foyer 8:00 AM – 8:15 AM NSWC Crane Welcome Remarks Great Hall  Mr. Duane Embree (SES), Technical...Director, NSWC Crane 8:15 AM – 8:30 AM NDIA Welcome Remarks Great Hall  MG Barry D. Bates, USA (Ret), VP Operations, NDIA 8:30 AM...Agile Response • Test and Evaluation Design • Concurrent systems evolution NPS Perspective on FX Research Dimensions HADR FX COCOM FX (Proposed)SOF FX

Disoxaril mutants of Coxsackievirus B1: phenotypic characteristics and analysis of the target VP1 gene.

PubMed

Nikolova, Ivanka; Galabov, Angel S; Petkova, Rumena; Chakarov, Stoyan; Atanasov, Boris

2011-01-01

Disoxaril inhibits enterovirus replication by binding to the hydrophobic pocket within the VP1 coat protein, thus stabilizing the virion and blocking its uncoating. Disoxaril-resistant (RES) mutants of the Coxsackievirus B1 (CVB1/RES) were derived from the wild disoxaril-sensitive (SOF) strain (CVB1/SOF) using a selection approach. A disoxaril-dependent (DEP) mutant (CVB1/DEP) was obtained following nine consecutive passages of the disoxaril-resistant mutant in the presence of disoxaril. Phenotypic characteristics of the disoxaril mutants were investigated. A timing-of-addition study of the CVB1/DEP replication demonstrated that in the absence of disoxaril the virus particle assembly stopped. VP1 RNA sequences of disoxaril mutants were compared with the existing Gen Bank CVB1 reference structure. The amino acid sequence of a large VP1 196-258 peptide (disoxaril-binding region) of CVB1/RES was significantly different from that of the CVB1/SOF. Crucially important changes in CVB1/RES were two point mutations, M213H and F237L, both in the ligand-binding pocket. The sequence analysis of the CVB1/DEP showed some reversion to CVB1/SOF. The amino acid sequences of the three VP1 proteins are presented.

Noble metal (Pt or Au)-doped monolayer MoS2 as a promising adsorbent and gas-sensing material to SO2, SOF2 and SO2F2: a DFT study

NASA Astrophysics Data System (ADS)

Chen, Dachang; Zhang, Xiaoxing; Tang, Ju; Cui, Hao; Li, Yi

2018-02-01

We explored the adsorption of SO2, SOF2, and SO2F2 on Pt- or Au-doped MoS2 monolayer based on density functional theory. The adsorption energy, adsorption distance, charge transfer as well as density of states were discussed. SO2 and SOF2 exhibit strong chemical interactions with Pt-doped MoS2 based on large adsorption energy, charge transfer, and changes of electron orbitals in gas molecule. SO2 also shows obvious chemisorption on Au-doped MoS2 with apparent magnetism transfer from Au to gas molecules. The adsorption of SO2F2 on Pt-MoS2 and SOF2 on Au-MoS2 exhibits weaker chemical interactions and SO2F2 losses electrons when adsorbed on Pt-MoS2 which is different from other gas adsorption. The adsorption of SO2F2 on Au-MoS2 represents no obvious chemical interaction but physisorption. The gas-sensing properties are also evaluated based on DFT results. This work could provide prospects and application value for typical noble metal-doped MoS2 as gas-sensing materials.

THOR3: Humans Are More Important Than Hardware

DTIC Science & Technology

2010-12-01

concepts to one’s diet is perhaps the hardest human performance aspect for the SOF Soldier to understand and implement. Proper nutrition forms the...choose the best diet to enhance human performance (Clark, 2008). Learning nutritional basics is similar to learning any other military skill... nutrition discussion, the SOF Soldier must know that many eating styles can equate to an adequate diet ; there is no one “right” diet for all athletes

The Feasibility of Converting the Tanker, Transport, and Bomber (TTB) Track of Specialized Undergraduate Navigator Training (SUNT) to an All-Simulator Course.

DTIC Science & Technology

1988-04-01

or will be feasibly capable of adapting students to the physical and psychological stresses of flight, or adequately preparing them to enter combat...8217.ement . in the desion and use ot .imJ1 atar -a are m:r e 1 ikelv to depend or, de,elop- mrer and u ,_e at Leh..’,or o I. [nowl edoe h an or ad,’ar cea ir...vi, ...y -vlue is larQely ga, r ned by Sits h.rdwar e..sof tware design and the qual i tv of in truc t lon. Hence . !i r Force s. imu 1 atar polo ic

Sofosbuvir/Velpatasvir for 12 Weeks in Genotype 1-4 HCV-Infected Liver Transplant Recipients.

PubMed

Agarwal, Kosh; Castells, Lluís; Müllhaupt, Beat; Rosenberg, William M C; McNabb, Brian; Arterburn, Sarah; Camus, Gregory; McNally, John; Stamm, Luisa M; Brainard, Diana M; Subramanian, G Mani; Mariño, Zoe; Dufour, Jean-François; Forns, Xavier

2018-06-07

Sofosbuvir, an NS5B inhibitor, combined with velpatasvir, an NS5A inhibitor (SOF/VEL), produces high sustained virologic response rates 12 weeks after treatment (SVR12) in patients with genotype 1-6 HCV infection, and has no anticipated clinically relevant drug-drug interactions with immunosuppressants. This study evaluated the safety and efficacy of SOF/VEL in adults with recurrent chronic genotype 1-4 HCV infection after liver transplant. Patients received SOF/VEL 400/100 mg daily for 12 weeks. Patients could be treatment experienced or treatment naïve with no cirrhosis or with compensated cirrhosis. The primary endpoints were SVR12 and discontinuations due to adverse events. The study enrolled and treated 79 patients (37 [47%] had genotype 1, 3 [4%] genotype 2, 35 [44%] genotype 3, and 4 [5%] genotype 4 HCV). Of these, 81% were male, 82% were white, 18% had compensated cirrhosis, and 59% were treatment experienced. The most commonly used immunosuppressants were tacrolimus (71%), mycophenolic acid (24%), cyclosporine (14%), and azathioprine (11%). Median (range) time from liver transplantation was 7.5 (0.3, 24) years. The SVR12 rate was 96%. By genotype, SVR12 rates were 95% (genotype 1), 100% (genotype 2), 97% (genotype 3), and 100% (genotype 4). Two patients experienced virologic relapse: one with genotype 1a infection was non-cirrhotic and treatment naïve, and one with genotype 3 infection was non-cirrhotic and treatment experienced. One patient discontinued SOF/VEL due to hyperglycemia. No serious or severe adverse events were deemed SOF/VEL-related by the investigator, and no liver transplant rejection episodes or deaths occurred during the study period. Treatment with SOF/VEL for 12 weeks was highly effective and well tolerated in genotype 1-4 HCV-infected liver transplant recipients with and without cirrhosis. Sofosbuvir/velpatasvir is a combination of two drugs in one tablet that is approved for the treatment of patients with chronic hepatitis C virus (HCV) infection. When patients with chronic HCV infection receive a liver transplant, the HCV infection usually recurs, and damages the liver transplant. This study tested the effects of 12 weeks of sofosbuvir/velpatasvir treatment in patients who had HCV recurrence after a liver transplant. Three months following the end of treatment, 96% of patients were cured of HCV infection. Copyright © 2018. Published by Elsevier B.V.

Ada Software Design Methods Formulation.

DTIC Science & Technology

1982-10-01

aside for one-to-one, non -judgemental discussions between SofTech and the design teams. SofTech’s role in the meetings was to address any Ada-specific...assurance 1.0 prepare version audits 1.0 monitoring contracts 1.0 library control 1.0 other development 1.0 correspondence 1.0 conduct support design ...quality assurance 2.0 Control Board update training manuals 2.0 participation 2.5 being trained 2.0 formulation of policy 2.5 functional system design

Fluorescence enhancement through the formation of a single-layer two-dimensional supramolecular organic framework and its application in highly selective recognition of picric acid.

PubMed

Zhang, Ying; Zhan, Tian-Guang; Zhou, Tian-You; Qi, Qiao-Yan; Xu, Xiao-Na; Zhao, Xin

2016-06-18

A two-dimensional (2D) supramolecular organic framework (SOF) has been constructed through the co-assembly of a triphenylamine-based building block and cucurbit[8]uril (CB[8]). Fluorescence turn-on of the non-emissive building block was observed upon the formation of the 2D SOF, which displayed highly selective and sensitive recognition of picric acid over a variety of nitroaromatics.

Endoscopic transmaxillary transMüller's muscle approach for decompression of superior orbital fissure: a cadaveric study with illustrative case.

PubMed

Wang, Xiang; Li, Yi-Ming; Huang, Cheng-Guang; Liu, Hong-Chao; Li, Qing-Chu; Yu, Ming-Kun; Hou, Li-Jun

2014-03-01

In an effort to avoid the damage and inconvenience associated with transcranial approaches, we developed an endoscopic transmaxillary transMüller's muscle approach for decompression of the superior orbital fissure (SOF). The endoscopic transmaxillary transMüller's muscle route was performed in ten cadaveric heads. We measured important anatomic landmarks, and angles radiographically. This approach was initially attempted in one patient with traumatic superior orbital fissure syndrome (tSOFS). A maxillary antrostomy was carried out with a buccal sulcus incision. The sinus ostium and the course of infraorbital nerve were used as endoscopic anatomic landmarks. Then the inferior orbital fissure was drilled out, followed by separating the Müller's muscle. The periorbita were peeled off from the lateral wall, followed by the endoscope going along the periorbital space, until the lateral aspect of the SOF could be visualized. Decompression was successfully performed in all specimens. The initial clinical application justified this approach. The patient had an uneventful postoperative course and satisfactory recovery. This approach offers sufficient endoscopic visualization and reliable decompression of SOF. It avoids the need for brain retraction, temporalis muscle manipulation, or any external incision, and appears to be able to deliver satisfying aesthetic results as well as favourable functional recovery. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Improving GRADE evidence tables part 1: a randomized trial shows improved understanding of content in summary of findings tables with a new format.

PubMed

Carrasco-Labra, Alonso; Brignardello-Petersen, Romina; Santesso, Nancy; Neumann, Ignacio; Mustafa, Reem A; Mbuagbaw, Lawrence; Etxeandia Ikobaltzeta, Itziar; De Stio, Catherine; McCullagh, Lauren J; Alonso-Coello, Pablo; Meerpohl, Joerg J; Vandvik, Per Olav; Brozek, Jan L; Akl, Elie A; Bossuyt, Patrick; Churchill, Rachel; Glenton, Claire; Rosenbaum, Sarah; Tugwell, Peter; Welch, Vivian; Garner, Paul; Guyatt, Gordon; Schünemann, Holger J

2016-06-01

The current format of summary of findings (SoFs) tables for presenting effect estimates and associated quality of evidence improve understanding and assist users finding key information in systematic reviews. Users of SoF tables have demanded alternative formats to express findings from systematic reviews. We conducted a randomized controlled trial among systematic review users to compare the relative merits of a new format with the current formats of SoF tables regarding understanding, accessibility of information, satisfaction, and preference. Our primary goal was to show that the new format is not inferior to the current format. Of 390 potentially eligible subjects, 290 were randomized. Of seven items testing understanding, three showed similar results, two showed small differences favoring the new format, and two (understanding risk difference and quality of the evidence associated with a treatment effect) showed large differences favoring the new format [63% (95% confidence interval {CI}: 55, 71) and 62% (95% CI: 52, 71) more correct answers, respectively]. Respondents rated information in the alternative format as more accessible overall and preferred the new format over the current format. While providing at least similar levels of understanding for some items and increased understanding for others, users prefer the new format of SoF tables. Copyright © 2016 Elsevier Inc. All rights reserved.

Prevalence and impact of baseline resistance-associated substitutions on the efficacy of ledipasvir/sofosbuvir or simeprevir/sofosbuvir against GT1 HCV infection.

PubMed

Wang, Gary P; Terrault, Norah; Reeves, Jacqueline D; Liu, Lin; Li, Eric; Zhao, Lisa; Lim, Joseph K; Morelli, Giuseppe; Kuo, Alexander; Levitsky, Josh; Sherman, Kenneth E; Frazier, Lynn M; Ramani, Ananthakrishnan; Peter, Joy; Akuskevich, Lucy; Fried, Michael W; Nelson, David R

2018-02-16

Baseline resistance-associated substitutions (RASs) have variable impacts in clinical trials but their prevalence and impact in real-world patients remains unclear. We performed baseline resistance testing using a commercial assay (10% cutoff) for 486 patients treated with LDV/SOF or SMV/SOF, with or without ribavirin, in the multi-center, observational HCV-TARGET cohort. Linkage of RASs was evaluated in selected samples using a novel quantitative single variant sequencing assay. Our results showed that the prevalence of NS3, NS5A, NS5B RASs was 45%, 13%, and 8%, respectively, and 10% of patients harbored RASs in 2 or more drug classes. Baseline LDV RASs in GT1a, TE, and cirrhosis LDV/SOF subgroup was associated with 2-4% lower SVR12 rates. SMV RASs was associated with lower SVR12 rates in GT1a, treatment-experienced, cirrhotics SMV/SOF subgroup. Pooled analysis of all patients with baseline RASs revealed that SVR12 was 100% (19/19) in patients treated for longer than 98 days but was 87% (81/93) in patients treated for shorter than 98 days. These results demonstrate that RASs prevalence and their impact in real world practice are in general agreement with registration trials, and suggest that longer treatment duration may overcome the negative impact of baseline RASs on SVR12 rates in clinical practice.

Interaction between amiodarone and hepatitis-C virus nucleotide inhibitors in human induced pluripotent stem cell-derived cardiomyocytes and HEK-293 Cav1.2 over-expressing cells.

PubMed

Lagrutta, Armando; Zeng, Haoyu; Imredy, John; Balasubramanian, Bharathi; Dech, Spencer; Lis, Edward; Wang, Jixin; Zhai, Jin; DeGeorge, Joseph; Sannajust, Frederick

2016-10-01

Several clinical cases of severe bradyarrhythmias have been reported upon co-administration of the Hepatitis-C NS5B Nucleotide Polymerase Inhibitor (HCV-NI) direct-acting antiviral agent, sofosbuvir (SOF), and the Class-III anti-arrhythmic amiodarone (AMIO). We model the cardiac drug-drug interaction (DDI) between AMIO and SOF, and between AMIO and a closely-related SOF analog, MNI-1 (Merck Nucleotide Inhibitor #1), in functional assays of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs), to provide mechanistic insights into recently reported clinical cases. AMIO co-applied with SOF or MNI-1 increased beating rate or field potential (FP) rate and decreased impedance (IMP) and Ca(2+) transient amplitudes in hiPSC-CM syncytia. This action resembled that of Ca(2+) channel blockers (CCBs) in the model, but CCBs did not substitute for AMIO in the DDI. AMIO analog dronedarone (DRON) did not substitute for, but competed with AMIO in the DDI. Ryanodine and thapsigargin, decreasing intracellular Ca(2+) stores, and SEA-0400, a Na(+)/Ca(2+) exchanger-1 (NCX1) inhibitor, partially antagonized or suppressed DDI effects. Other agents affecting FP rate only exerted additive or subtractive effects, commensurate with their individual effects. We also describe an interaction between AMIO and MNI-1 on Cav1.2 ion channels in an over-expressing HEK-293 cell line. MNI-1 enhanced Cav1.2 channel inhibition by AMIO, but did not affect inhibition of Cav1.2 by DRON, verapamil, nifedipine, or diltiazem. Our data in hiPSC-CMs indicate that HCV-NI agents such as SOF and MNI-1 interact with key intracellular Ca(2+)-handling mechanisms. Additional study in a Cav1.2 HEK-293 cell-line suggests that HCV-NIs potentiate the inhibitory action of AMIO on L-type Ca(2+) channels. Copyright © 2016 Elsevier Inc. All rights reserved.

In vivo chromatic aberration in eyes implanted with intraocular lenses.

PubMed

Pérez-Merino, Pablo; Dorronsoro, Carlos; Llorente, Lourdes; Durán, Sonia; Jiménez-Alfaro, Ignacio; Marcos, Susana

2013-04-12

To measure in vivo and objectively the monochromatic aberrations at different wavelengths, and the chromatic difference of focus between green and infrared wavelengths in eyes implanted with two models of intraocular lenses (IOL). EIGHTEEN EYES PARTICIPATED IN THIS STUDY: nine implanted with Tecnis ZB99 1-Piece acrylic IOL and nine implanted with AcrySof SN60WF IOL. A custom-developed laser ray tracing (LRT) aberrometer was used to measure the optical aberrations, at 532 nm and 785 nm wavelengths. The monochromatic wave aberrations were described using a fifth-order Zernike polynomial expansion. The chromatic difference of focus was estimated as the difference between the equivalent spherical errors corresponding to each wavelength. Wave aberration measurements were highly reproducible. Except for the defocus term, no significant differences in high order aberrations (HOA) were found between wavelengths. The average chromatic difference of focus was 0.46 ± 0.15 diopters (D) in the Tecnis group, and 0.75 ± 0.12 D in the AcrySof group, and the difference was statistically significant (P < 0.05). Chromatic difference of focus in the AcrySof group was not statistically significantly different from the Longitudinal chromatic aberration (LCA) previously reported in a phakic population (0.78 ± 0.16 D). The impact of LCA on retinal image quality (measured in terms of Strehl ratio) was drastically reduced when considering HOA and astigmatism in comparison with a diffraction-limited eye, yielding the differences in retinal image quality between Tecnis and AcrySof IOLs not significant. LRT aberrometry at different wavelengths is a reproducible technique to evaluate the chromatic difference of focus objectively in eyes implanted with IOLs. Replacement of the crystalline lens by the IOL did not increase chromatic difference of focus above that of phakic eyes in any of the groups. The AcrySof group showed chromatic difference of focus values very similar to physiological values in young eyes.

Comparative study of six sequential spectrophotometric methods for quantification and separation of ribavirin, sofosbuvir and daclatasvir: An application on Laboratory prepared mixture, pharmaceutical preparations, spiked human urine, spiked human plasma, and dissolution test.

PubMed

Hassan, Wafaa S; Elmasry, Manal S; Elsayed, Heba M; Zidan, Dalia W

2018-09-05

In accordance with International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) guidelines, six novel, simple and precise sequential spectrophotometric methods were developed and validated for the simultaneous analysis of Ribavirin (RIB), Sofosbuvir (SOF), and Daclatasvir (DAC) in their mixture without prior separation steps. These drugs are described as co-administered for treatment of Hepatitis C virus (HCV). HCV is the cause of hepatitis C and some cancers such as liver cancer (hepatocellular carcinoma) and lymphomas in humans. These techniques consisted of several sequential steps using zero, ratio and/or derivative spectra. DAC was first determined through direct spectrophotometry at 313.7 nm without any interference of the other two drugs while RIB and SOF can be determined after ratio subtraction through five methods; Ratio difference spectrophotometric method, successive derivative ratio method, constant center, isoabsorptive method at 238.8 nm, and mean centering of the ratio spectra (MCR) at 224 nm and 258 nm for RIB and SOF, respectively. The calibration curve is linear over the concentration ranges of (6-42), (10-70) and (4-16) μg/mL for RIB, SOF, and DAC, respectively. This method was successfully applied to commercial pharmaceutical preparation of the drugs, spiked human urine, and spiked human plasma. The above methods are very simple methods that were developed for the simultaneous determination of binary and ternary mixtures and so enhance signal-to-noise ratio. The method has been successfully applied to the simultaneous analysis of RIB, SOF, and DAC in laboratory prepared mixtures. The obtained results are statistically compared with those obtained by the official or reported methods, showing no significant difference with respect to accuracy and precision at p = 0.05. Copyright © 2018 Elsevier B.V. All rights reserved.

Properties of fluorosulfate-based ionic liquids and geometries of (FO2SOH)OSO2F- and (FO2SOH)2O2SOF-.

PubMed

Enomoto, Takeshi; Matsumoto, Kazuhiko; Hagiwara, Rika

2011-12-14

A room temperature ionic liquid (IL) based on the fluorosulfate anion (SO(3)F(-)) has been synthesized by the reaction of 1-ethyl-3-methylimidazolium (EMIm(+)) chloride and fluorosulfuric acid (HOSO(2)F). The viscosity, ionic conductivity, and electrochemical window of EMImSO(3)F at 25 °C are 46.6 mPa s, 10.8 mS cm(-1), and 4.3 V, respectively. According to a solvatochromic measurement using ILs, there is a trend in the donor ability of fluoro- and oxofluoroanions, PF(6)(-) < BF(4)(-) < N(SO(2)CF(3))(2)(-) < SO(3)CF(3)(-) < SO(3)F(-) < PO(2)F(2)(-), which is explained by the atomic charges obtained from quantum mechanical calculations. The 1 : 2 and 1 : 3 stoichiometric reactions of EMImCl and HOSO(2)F give EMIm(FO(2)SOH)OSO(2)F and EMIm(FO(2)SOH)(2)O(2)SOF, respectively. Both the salts are liquid at room temperature without a HOSO(2)F dissociation pressure (< 1 Pa) and have low viscosity and high ionic conductivity (9.2 mPa s and 30.8 mS cm(-1) for EMIm(FO(2)SOH)OSO(2)F and 5.1 mPa s and 43.2 mS cm(-1) for EMIm(FO(2)SOH)(2)O(2)SOF). The vibrational modes and bonding properties of these anionic species are discussed with the aid of quantum mechanical calculations. The (FO(2)SOH)OSO(2)F(-) anion in EMIm(FO(2)SOH)OSO(2)F does not have an inversion centre, which stands in contrast to the one with an inversion centre (e.g. observed in solid Cs(FO(2)SOH)OSO(2)F). The (FO(2)SOH)(2)O(2)SOF(-) anion in EMIm(FO(2)SOH)(2)O(2)SOF is characterized by vibrational spectroscopy under C(s) symmetry.

Efficacy of ledipasvir/sofosbuvir with or without ribavirin for 12 weeks in genotype 1b HCV patients previously treated with a nonstructural protein 5A inhibitor-containing regimen.

PubMed

Ikeda, Hiroki; Watanabe, Tsunamasa; Shimizu, Hirohito; Hiraishi, Tetsuya; Kaneko, Rena; Baba, Toshiyuki; Takahashi, Hideaki; Matsunaga, Kotaro; Matsumoto, Nobuyuki; Yasuda, Hiroshi; Okuse, Chiaki; Iwabuchi, Shogo; Suzuki, Michihiro; Itoh, Fumio

2018-03-05

The therapeutic benefit of adding ribavirin (RBV) to 12 weeks of ledipasvir/sofosbuvir (LDV/SOF) for patients who experienced failure of a previous nonstructural protein (NS) 5A inhibitor-containing regimen is unclear. A total of 29 genotype 1b HCV patients who had failed prior daclatasvir (DCV) plus asunaprevir (ASV) treatment were retreated for 12 weeks of LDV/SOF, with or without RBV. Antiviral efficacy and predictive factors associating with a sustained virological response at 24 weeks (SVR24) were evaluated retrospectively. SVR24 was achieved in 67% (10/15) of patients who received LDV/SOF with, and 64% (9/14) without, RBV. The SVR24 rates were 80% in patients with, and 58% without, mild fibrosis (FIB-4 < 3.25). The SVR24 rate was lower with unfavorable IL28B rs8099917 SNP genotypes; specifically, the TT, TG and GG had SVR24 rates of 78%, 50% and 40%. The SVR24 rate was lower with a poor response to prior DCV plus ASV, where relapse, viral breakthrough and no response had SVR24 rates 71%, 58% and 0%. The SVR24 rate was lower with the number of NS5A resistance-associated substitutions (RAS), where 2, 3, 4 and 5 RAS had SVR24 rates of 78%, 67%, 50% and 0%. A patient with an NS5A-P32 deletion, which shows resistance to next-generation NS5A inhibitors, was retreated with LDV/SOF with RBV and achieved SVR24. The addition of RBV to 12 weeks of LDV/SOF has little therapeutic benefit when retreating patients in whom a prior NS5A inhibitor-containing regimen had failed. © 2018 The Japan Society of Hepatology.

Assessment of the clinical cardiac drug-drug interaction associated with the combination of hepatitis C virus nucleotide inhibitors and amiodarone in guinea pigs and rhesus monkeys.

PubMed

Regan, Christopher P; Morissette, Pierre; Regan, Hillary K; Travis, Jeffery J; Gerenser, Pamela; Wen, Jianzhong; Fitzgerald, Kevin; Gruver, Shaun; DeGeorge, Joseph J; Sannajust, Frederick J

2016-11-01

In 2015, European and U.S. health agencies issued warning letters in response to 9 reported clinical cases of severe bradycardia/bradyarrhythmia in hepatitis C virus (HCV)-infected patients treated with sofosbuvir (SOF) in combination with other direct acting antivirals (DAAs) and the antiarrhythmic drug, amiodarone (AMIO). We utilized preclinical in vivo models to better understand this cardiac effect, the potential pharmacological mechanism(s), and to identify a clinically translatable model to assess the drug-drug interaction (DDI) cardiac risk of current and future HCV inhibitors. An anesthetized guinea pig model was used to elicit a SOF+AMIO-dependent bradycardia. Detailed cardiac electrophysiological studies in this species revealed SOF+AMIO-dependent selective nodal dysfunction, with initial, larger effects on the sinoatrial node. Further studies in conscious, rhesus monkeys revealed an emergent bradycardia and bradyarrhythmia in 3 of 4 monkeys administered SOF+AMIO, effects not observed with either agent alone. Morever, bradycardia and bradyarrhythmia were not observed in rhesus monkeys when intravenous infusion of MK-3682 was completed after AMIO pretreatment. These are the first preclinical in vivo experiments reported to replicate the severe clinical SOF+AMIO cardiac DDI and provide potential in vivo mechanism of action. As such, these data provide a preclinical risk assessment paradigm, including a clinically relevant nonhuman primate model, with which to better understand cardiovascular DDI risk for this therapeutic class. Furthermore, these studies suggest that not all HCV DAAs and, in particular, not all HCV nonstructural protein 5B inhibitors may exhibit this cardiac DDI with amiodarone. Given the selective in vivo cardiac electrophysiological effect, these data enable targeted cellular/molecular mechanistic studies to more precisely identify cell types, receptors, and/or ion channels responsible for the clinical DDI. (Hepatology 2016;64:1430-1441). © 2016 by the American Association for the Study of Liver Diseases.

Supplemental Conceptual Design Study of an Integrated Voice/Data Switching and Multiplexing Technique for an Access Area Exchange

DTIC Science & Technology

1976-11-11

exchange. The basis for this choice was derived from several factors . One was a timing analysis that was made for certain basic time-critical software...randidate 6jrstem designs were developed and _*xamined with respect to L their capability to demonstrate the workability of the basic concept and for factors ...algorithm recuires a bit time completion, while SOF production allows byte timing and the involved = SOF correlation procedure may be perfor-med during

Is Sordac’s Rapid Acquisition Process Best Prepared To Field Solutions For Future Technological Challenges

DTIC Science & Technology

2016-03-31

approximately 700-800 capability submissions each year with about 25-30% resulting in further review.16 SORDAC has also partnered with the Doolittle ...Institute to run ‘SofWerX,’ a technology incubator in downtown Tampa. The Doolittle Institute is a Florida non-profit with a charter, “to create an... Doolittle Institute,” accessed 3 March 2016, http://doolittleinstitute.org/. 18 “SofWerX,” accessed 28 February 2016, www.sofwerx.org. (website

Evaluation of the surface hardness, roughness, gloss and color of composites after different finishing/polishing treatments and thermocycling using a multitechnique approach.

PubMed

Pala, Kanşad; Tekçe, Neslihan; Tuncer, Safa; Serim, Merve Efe; Demirci, Mustafa

2016-01-01

The objectives of this study were to evaluate the mechanical and physical properties of resin composites. The materials evaluated were the Clearfil Majesty Posterior, Filtek Z550 and G-aenial Posterior composites. A total of 189 specimens were fabricated for microhardness, roughness, gloss and color tests. The specimens were divided into three finishing and polishing systems: Enhance, OneGloss and Sof-Lex Spiral. Microhardness, roughness, gloss and color were measured after 24 h and after 10,000 thermocycles. Two samples from each group were evaluated using SEM and AFM. G-aenial Posterior exhibited the lowest microhardness values. The mean roughness ranged from 0.37 to 0.61 µm. The smoothest surfaces were obtained with Sof-Lex Spiral for each material. G-aenial Posterior with Enhance was determined to be the glossiest surfaces. All of the materials exhibited similar ΔE values ranging between 1.69 and 2.75. Sof-Lex Spiral discs could be used successfully to polish composites.

Pharmacokinetics and pharmacodynamics of sofosbuvir and ledipasvir for the treatment of hepatitis C.

PubMed

Cuenca-Lopez, Francisca; Rivero, Antonio; Rivero-Juárez, Antonio

2017-01-01

The sofosbuvir (SOF) plus ledipasvir (LDV) fixed dose combination is the first direct action antiviral (DAA) single-treatment regimen (STR) to be commercialized. It is approved for the treatment of Hepatitis C virus (HCV) genotypes 1,3,4,5 and 6. Following approval in 2014, new pharmacokinetics and pharmacodynamics data were reported, which led to important clinical applications. Areas covered: This article reviews the pharmacokinetic and pharmacodynamic properties of the SOF/LDV fixed dose combination for the treatment of HCV. The topics covered include data regarding the drug´s absorption, distribution, metabolism and excretion and antiviral activity strategies such as the clinical dose selection and treatment duration. Expert opinion: The SOF/LDV fixed dose combination has good pharmacological properties that lead to a high sustained virological response after 12 or 24 weeks of treatment; there is minimal interference with other drugs or associated renal or hepatic impairment, such that dose adjustment is not necessary.

Scanning electron microscopic and histologic evaluation of the AcrySof SA30AL acrylic intraocular lens. Manufacturing quality and morphology in the capsular bag.

PubMed

Escobar-Gomez, Marcela; Apple, David J; Vargas, Luis G; Werner, Liliana; Arthur, Stella N; Pandey, Suresh K; Izak, Andrea M; Schmidbauer, Josef M

2003-01-01

To evaluate the properties of the AcrySof(R) SA30AL (Alcon Laboratories, Inc.) single-piece foldable posterior chamber intraocular lens (IOL). Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. Two nonimplanted clinical-quality AcrySof IOLs were examined by gross, light, and scanning electron microscopy (SEM). In addition, 2 eyes implanted with this IOL obtained post-mortem, the first such eyes accessioned in our laboratory and the first described to date, were examined using the Miyake-Apple posterior photographic technique and by histologic sections. Scanning electron microscopy of the SA30AL IOL showed excellent surface finish. The edge of the optic was square (truncated) and had a matte (velvet or ground-glass) appearance, a feature that may minimize edge glare and other visual phenomena. A well-fabricated square or truncated optic edge was demonstrated. Miyake-Apple analysis revealed that the SA30AL IOL showed appropriate fit and configuration within the capsular bag. Histologic correlation of the IOL's square edge and its relation to the capsular bag and adjacent Soemmering's ring were noted. The AcrySof SA30AL IOL is a well-fabricated lens that situates well in the capsular bag. The truncated optic and its relationship to adjacent structures show a morphological profile that has been shown to be highly efficacious in reducing the rate of posterior capsule opacification.

High intensity scenario training of military medical students to increase learning capacity and management of stress response.

PubMed

Mueller, Genevieve R; Moloff, Alan L; Wedmore, Ian S; Schoeff, Jonathan E; Laporta, Anthony J

2012-01-01

A delicate balance exists between a beneficial stress response that enhances memory and recall performance and a detrimental high stress response that impairs memory and learning. Repetitive training in stressful situations enables people to lower their stress levels from the detrimental range to a more beneficial one.1 This is particularly true for physicians in training as they seek to achieve advanced skills and knowledge in the fields of triage, emergency medicine, and surgery prior to graduation. This need is significant for medical students entering military service after graduation. We theorize that military medical students can advance their proficiencies through an Intensive Skills Week (ISW) prior to entering their third and forth year rotations. To test this theory, Rocky Vista University will hold a week long high-intensity first-responder, emergency medicine and surgical training course, facilitated by military medical physicians, to further students? skills and maximize training using the Human Worn Partial Surgical Task Simulator (Cut Suit). We also see the possible benefit to physician and non-physician military personnel, especially Special Operations Forces (SOF) medical personnel, from developing and implementing similar training programs when live tissue or cadaver models are unavailable or not feasible. Stress, cortisol, medical student, enhanced learning, scenario, high intensity. 2012.

Ledipasvir + Sofosbuvir for Liver Transplant Recipients With Recurrent Hepatitis C: A Systematic Review and Meta-analysis.

PubMed

Liao, H-T; Tan, P; Huang, J-W; Yuan, K-F

2017-10-01

Studies focusing on the efficacy and safety of ledipasvir (LDV) + sofosbuvir (SOF) therapy in liver transplant (LT) recipients with hepatitis C virus (HCV) recurrence are still limited. Therefore, the aim of our work was to perform a systematic review and meta-analysis to evaluate outcome data of LDV + SOF therapy in LT recipients. Multiple databases were systematically searched for eligible studies. We included studies reporting sustained virological response 12 weeks after treatment (SVR12) and treatment-related adverse events (AEs) in LT recipients treated with LDV + SOF ± ribavirin (RBV) for HCV recurrence. All statistical analyses were conducted by using R version 3.3.1 (The R Foundation for Statistical Computing, Vienna, Austria). Twelve studies with a total of 994 LT recipients were included, most of which were diagnosed with HCV genotype 1 infection. The overall SVR12 reached 96.3% (95% confidence interval [CI]: 94.9%-97.5%) and no significant heterogeneity was observed (Q statistic = 10.63, P = .47; I 2  = 0%). No difference was found in SVR12 between treatments for 12 weeks and 24 weeks (P = .18). Patients treated with LDV + SOF + RBV (n = 525) exhibited an SVR12 rate of 95.1% (95% CI 92.8%-96.6%), which showed no difference from the findings in the LDV + SOF treatment group (n = 314) with an SVR12 reaching 94.9% (95% CI 91.5%-97.0%; P = .92). There was a tendency for a higher SVR12 in patients without cirrhosis than those with cirrhosis (P < .05). The most common AEs were listed as following: anemia 41.9% (n = 203 of 484), fatigue 39.1% (n = 207 of 530), headache 24.2% (n = 128 of 530), nausea 21.9% (n = 106 of 484), and diarrhea 19.0% (n = 92 of 484). LDV + SOF-based treatment is highly effective and well tolerated in LT recipients with HCV reinfection. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of the association of IGF-I, IGF-II, bFGF, TGF-beta1, GM-CSF, and LIF on the development of bovine embryos produced in vitro.

PubMed

Neira, J A; Tainturier, D; Peña, M A; Martal, J

2010-03-15

This study examined the influence of the following growth factors and cytokines on early embryonic development: insulin-like growth factors I and II (IGF-I, IGF-II), basic fibroblast growth factor (bFGF), transforming growth factor (TGF-beta), granulocyte-macrophage colony-stimulating factor (GM-CSF), and leukemia inhibitory factor (LIF). Synthetic oviduct fluid (SOF) was used as the culture medium. We studied the development of bovine embryos produced in vitro and cultured until Day 9 after fertilization. TGF-beta1, bFGF, GM-CSF, and LIF used on their own significantly improved the yield of hatched blastocysts. IGF-I, bFGF, TGF-beta1, GM-CSF, and LIF significantly accelerated embryonic development, especially the change from the expanded blastocyst to hatched blastocyst stages. Use of a combination of these growth factors and cytokines (GF-CYK) in SOF medium produced higher percentages of blastocysts and hatched blastocysts than did use of SOF alone (45% and 22% vs. 24% and 12%; P<0.05) on Day 8 after in vitro fertilization and similar results to use of SOF+10% fetal calf serum (38% and 16%, at the same stages, respectively). The averages of total cells, inner cell mass cells, and trophectoderm cells of exclusively in vitro Day-8 blastocysts for pooled GF-CYK treatments were higher than those for SOF and similar to those for fetal calf serum. The presence of these growth factors and cytokines in the embryo culture medium therefore has a combined stimulatory action on embryonic development; in particular through an increase in hatching rate and in the number of cells of both the inner cell mass and trophoblast. These results are the first to demonstrate that use of a combination of recombinant growth factors and cytokine, as IGF-I, IGF-II, bFGF, TGF-beta1, LIF, and GM-CSF, produces similar results to 10% fetal calf serum for the development of in vitro-produced bovine embryos. This entirely synthetic method of embryo culture has undeniable advantages for the biosecurity of embryo transfer. Copyright 2010 Elsevier Inc. All rights reserved.

Special Operations Soldier With Cardiac Family History: Use of CCTA and Protein Biomarker Testing to Detect Risk of Heart Attack From Noncalcified Plaque.

PubMed

Singh, Millee; Kroman, Anne; Singh, Juile; Tariq, Hassan; Amin, Shetal; Morales-Pablon, Cesar Alberto; Cahill, Kristina Vanessa; Harrison, Eric Edward

2015-01-01

We sought to characterize the risk of a heart attack in a 48-year-old asymptomatic US Special Operations Command (SOCOM) Soldier without known coronary artery disease (CAD). CAD continues to be a leading cause of morbidity and mortality among most age groups in the United States. Much research is dedicated to establishing new techniques to predict myocardial infarction (MI). Coronary computed tomography (CT) angiography, also known as CCTA, along with 7-protein serum biomarker risk assessment was performed for risk evaluation. A 48-year-old SOCOM Soldier with a family history of heart disease had skeletal chest pain from war injuries and a 5-fold higher risk of heart attack over the next 5 years on the basis of protein markers. A nonobstructive left anterior descending coronary artery (LAD) plaque with a lipid-rich core and a thin fibrous cap (i.e., vulnerable plaque) was detected by CCTA. The patient was warned about his risk and prescribed four cardiac medications and scheduled for angioplasty even though he fell outside the guidelines by not having a severe obstructive blockage. Four days later, unfortunately, he had a heart attack before starting his medications and before angioplasty. CCTA with biomarker testing may have an important role in predicating acute coronary syndrome (ACS) in Special Operations Forces (SOF) Soldiers with at least one risk factor. Conventional stress testing and nuclear scanning would not detect non-flow-limiting vulnerable plaques in vulnerable patients. In order to collect more data, the PROTECT Registry has been started to evaluate asymptomatic Soldiers with at least one risk factor referred to the clinic by military physicians. 2015.

Real-world effectiveness for 12 weeks of ledipasvir-sofosbuvir for genotype 1 hepatitis C: the Trio Health study.

PubMed

Tapper, E B; Bacon, B R; Curry, M P; Dieterich, D T; Flamm, S L; Guest, L E; Kowdley, K V; Lee, Y; Tsai, N C; Younossi, Z M; Afdhal, N H

2017-01-01

Early data regarding the "real-world" experience with novel therapies for hepatitis C (HCV) are encouraging. Data are still limited, however, regarding real-world rates of sustained virologic response (SVR) for ledipasvir-sofosbuvir (LDV-SOF), particularly for patients with prior treatment failure. We performed a retrospective cohort study of 1597 patients with chronic genotype 1 HCV who were treated using 12 weeks of the following regimens LDV-SOF±ribavirin (RBV) (n=1521 without RBV, n=76 with RBV). The primary outcome was SVR-determined at 12 weeks in an intention-to-treat design. Prescription according to Food and Drug Administration (FDA) approved labelling (adding RBV for patients with cirrhosis and treatment failure) was assessed in multivariate models. The study population was aged 60 years on average (range 19-89), 60% male, 50% Caucasian, 43% cared for at an academic centre and 30% cirrhotic. Overall, LDV-SOF resulted in a 94% SVR rate. Only 44 (2.9%) patients relapsed. LDV-SOF+RBV yielded SVR in 97% with 0 viral relapses. While cirrhosis and thrombocytopenia were associated with lower odds of SVR, in a multivariable regression model, only treatment at an academic centre and prescriptions contrary to FDA labelling were significantly associated with lower SVR-odds ratios, 0.56 95% CI (0.35-0.87) and 0.29 95% CI(0.12-0.68), respectively. The real-world experience with LDV-SOF mirrors the SVR rates observed in clinical trials. Efforts to promote prescription within FDA recommendations are warranted. © 2016 John Wiley & Sons Ltd.

Polishing mechanism of light-initiated dental composite: Geometric optics approach.

PubMed

Chiang, Yu-Chih; Lai, Eddie Hsiang-Hua; Kunzelmann, Karl-Heinz

2016-12-01

For light-initiated dental hybrid composites, reinforcing particles are much stiffer than the matrix, which makes the surface rugged after inadequate polish and favors bacterial adhesion and biofilm redevelopment. The aim of the study was to investigate the polishing mechanism via the geometric optics approach. We defined the polishing abilities of six instruments using the obtained gloss values through the geometric optics approach (micro-Tri-gloss with 20°, 60°, and 85° measurement angles). The surface texture was validated using a field emission scanning electron microscope (FE-SEM). Based on the gloss values, we sorted polishing tools into three abrasive levels, and proposed polishing sequences to test the hypothesis that similar abrasive levels would leave equivalent gloss levels on dental composites. The three proposed, tested polishing sequences included: S1, Sof-Lex XT coarse disc, Sof-Lex XT fine disc, and OccluBrush; S2, Sof-Lex XT coarse disc, Prisma Gloss polishing paste, and OccluBrush; and S3, Sof-Lex XT coarse disc, Enhance finishing cups, and OccluBrush. S1 demonstrated significantly higher surface gloss than the other procedures (p < 0.05). The surface textures (FE-SEM micrographs) correlated well with the obtained gloss values. Nominally similar abrasive abilities did not result in equivalent polish levels, indicating that the polishing tools must be evaluated and cannot be judged based on their compositions or abrasive sizes. The geometric optic approach is an efficient and nondestructive method to characterize the polished surface of dental composites. Copyright © 2015. Published by Elsevier B.V.

Effects of deployment on diet quality and nutritional status markers of elite U.S. Army special operations forces soldiers.

PubMed

Farina, Emily K; Taylor, Jonathan C; Means, Gary E; Murphy, Nancy E; Pasiakos, Stefan M; Lieberman, Harris R; McClung, James P

2017-07-03

Special Operations Forces (SOF) Soldiers deploy frequently and require high levels of physical and cognitive performance. Nutritional status is linked to cognitive and physical performance. Studies evaluating dietary intake and nutritional status in deployed environments are lacking. Therefore, this study assessed the effects of combat deployment on diet quality and serum concentrations of nutritional status markers, including iron, vitamin D, parathyroid hormone (PTH), glucose, and lipids, among elite United States (U.S.) Army SOF Soldiers. Changes from baseline to post-deployment were determined with a repeated measure within-subjects design for Healthy Eating Index-2010 (HEI-2010) scores, intake of foods, food groups, key nutrients, and serum nutritional status markers. Dietary intake was assessed with a Block Food Frequency Questionnaire. The association between post-deployment serum 25-hydroxy vitamin D (25-OH vitamin D) and PTH was determined. Analyses of serum markers were completed on 50 participants and analyses of dietary intake were completed on 33 participants. In response to deployment, HEI-2010 scores decreased for total HEI-2010 (70.3 ± 9.1 vs. 62.9 ± 11.1), total fruit (4.4 ± 1.1 vs. 3.7 ± 1.5), whole fruit (4.6 ± 1.0 vs. 4.2 ± 1.4), dairy (6.2 ± 2.7 vs. 4.8 ± 2.4), and empty calories (14.3 ± 3.2 vs. 11.1 ± 4.5) (P ≤ 0.05). Average daily intakes of foods and food groups that decreased included total dairy (P < 0.01), milk (P < 0.01), and non-juice fruit (P = 0.03). Dietary intake of calcium (P = 0.05) and vitamin D (P = 0.03) decreased. PTH increased from baseline (3.4 ± 1.6 vs. 3.8 ± 1.4 pmol/L, P = 0.04), while there was no change in 25-OH vitamin D. Ferritin decreased (385 ± 173 vs. 354 ± 161 pmol/L, P = 0.03) and soluble transferrin receptor increased (16.3 ± 3.7 vs. 17.1 ± 3.5 nmol/L, P = 0.01). There were no changes in glucose or lipids. Post-deployment, serum 25-OH vitamin D was inversely associated with PTH (r = -0.43, P < 0.01). HEI-2010 scores and dietary intake of milk, calcium, and vitamin D decreased following deployment. Serum PTH increased and iron stores were degraded. No Soldiers were iron deficient. Personnel that deploy frequently should maintain a high diet quality in the U.S. and while deployed by avoiding empty calories and consuming fruits, vegetables, and adequate sources of calcium, vitamin D, and iron. Improving availability and quality of perishable food during deployment may improve diet quality.

Effect of the Polishing Procedures on Color Stability and Surface Roughness of Composite Resins

PubMed Central

Schmitt, Vera Lucia; Puppin-Rontani, Regina Maria; Naufel, Fabiana Scarparo; Nahsan, Flávia Pardo Salata; Alexandre Coelho Sinhoreti, Mário; Baseggio, Wagner

2011-01-01

Objectives. To evaluate the polishing procedures effect on color stability and surface roughness of composite resins. Methods. Specimens were distributed into 6 groups: G1: Filtek Supreme XT + PoGo; G2: Filtek Supreme XT + Sof-Lex; G3: Filtek Supreme XT + no polishing; G4: Amelogen + PoGo; G5: Amelogen + Sof-Lex.; G6: Amelogen + no polishing. Initial color values were evaluated using the CIELab scale. After polishing, surface roughness was evaluated and the specimens were stored in coffee solution at 37°C for 7 days. The final color measurement and roughness were determined. Results. Sof-Lex resulted in lower staining. Amelogen showed the highest roughness values than Filtek Supreme on baseline and final evaluations regardless of the polishing technique. Filtek Supreme polished with PoGo showed the lowest roughness values. All groups presented discoloration after storage in coffee solution, regardless of the polishing technique. Conclusion. Multiple-step polishing technique provided lower degree of discoloration for both composite resins. The final surface texture is material and technique dependent. PMID:21991483

The influence of novel compliant floors on balance control in elderly women--A biomechanical study.

PubMed

Wright, Alexander D; Laing, Andrew C

2011-07-01

Novel compliant floors aim to decrease the risk for fall-related injury by providing substantial force attenuation during the impact phase of falls. Certain models of compliant flooring have been shown to have limited influence on postural sway and successful completion of dynamic balance tasks. However, the effects of these products on balance recovery mechanisms following an externally induced perturbation have yet to be quantified. We used a floor translation paradigm to induce a balance perturbation to thirteen elderly community-dwelling women. Outcome measures included the displacement rates and margins of safety for both the underfoot centre-of-pressure and whole-body centre-of-mass across two novel compliant floors (SmartCell, SofTile), two basic foam surfaces (Firm-Foam, Soft-Foam) and a standard 'Rigid' floor as a control condition. The centre-of-mass and centre-of-pressure margins of safety, and all centre-of-mass displacement rates, were not significantly lower for the two novel compliant flooring systems compared to the control floor. The centre-of-pressure displacement rates were similar to the control floor for the SmartCell floor condition. The majority of the margin of safety and displacement rate variables for the foam floors were significantly lower than the control condition. This study illustrates that the SmartCell and SofTile novel compliant floors have minimal influences on balance and balance control responses following externally induced perturbations in older community-dwelling women, and supports pilot installations of these floors to inform decisions regarding the development of clinical trials. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

The influence of novel compliant floors on balance control in elderly women—A biomechanical study

PubMed Central

Wright, Alexander D.; Laing, Andrew C.

2012-01-01

Novel compliant floors aim to decrease the risk for fall-related injury by providing substantial force attenuation during the impact phase of falls. Certain models of compliant flooring have been shown to have limited influence on postural sway and successful completion of dynamic balance tasks. However, the effects of these products on balance recovery mechanisms following an externally induced perturbation have yet to be quantified. We used a floor translation paradigm to induce a balance perturbation to thirteen elderly community-dwelling women. Outcome measures included the displacement rates and margins of safety for both the underfoot centre-of-pressure and whole-body centre-of-mass across two novel compliant floors (Smart-Cell, SofTile), two basic foam surfaces (Firm-Foam, Soft-Foam) and a standard ‘Rigid’ floor as a control condition. The centre-of-mass and centre-of-pressure margins of safety, and all centre-of-mass displacement rates, were not significantly lower for the two novel compliant flooring systems compared to the control floor. The centre-of-pressure displacement rates were similar to the control floor for the SmartCell floor condition. The majority of the margin of safety and displacement rate variables for the foam floors were significantly lower than the control condition. This study illustrates that the SmartCell and SofTile novel compliant floors have minimal influences on balance and balance control responses following externally induced perturbations in older community-dwelling women, and supports pilot installations of these floors to inform decisions regarding the development of clinical trials. PMID:21545881

Comparison of different finishing/polishing systems on surface roughness and gloss of resin composites.

PubMed

Antonson, Sibel A; Yazici, A Rüya; Kilinc, Evren; Antonson, Donald E; Hardigan, Patrick C

2011-07-01

The aim of this study was to compare four finishing/polishing systems (F/P) on surface roughness and gloss of different resin composites. A total of 40 disc samples (15 mm × 3 mm) were prepared from a nanofill - Filtek Supreme Plus (FS) and a micro-hybrid resin composite - Esthet-X (EX). Following 24h storage in 37°C water, the top surfaces of each sample were roughened using 120-grit sandpaper. Baseline measurements of surface roughness (Ra, μm) and gloss were recorded. Each composite group was divided into four F/P disk groups: Astropol[AP], Enhance/PoGo[EP], Sof-Lex[SL], and an experimental disk system, EXL-695[EXL] (n=5). The same operator finished/polished all samples. One sample from each group was evaluated under SEM. Another blinded-operator conducted postoperative measurements. Results were analysed by two-way ANOVA, two interactive MANOVA and Tukey's t-test (p<0.05). In surface roughness, the baseline of two composites differed significantly from each other whereas postoperatively there was no significance. The Sof-Lex F/P system provided the smoothest surface although there were no statistical significance differences between F/P systems (p>0.01). In gloss, FS composite with the EXL-695 system provided a significantly higher gloss (p<0.01). EX treated by Soflex revealed the least gloss (p<0.05). SEM images revealed comparable results for F/P systems but EX surfaces included more air pockets. Four different finishing/polishing systems provided comparable surface smoothness for both composites, whereas EXL with FS provided significantly higher gloss. SEM evaluations revealed that the EX surface contained more air pockets but F/P systems were compatible. Copyright © 2011 Elsevier Ltd. All rights reserved.

Efficacy of Second Generation Direct-Acting Antiviral Agents for Treatment Naïve Hepatitis C Genotype 1: A Systematic Review and Network Meta-Analysis

PubMed Central

Sobhonslidsuk, Abhasnee; Thakkinstian, Ammarin; Teerawattananon, Yot

2015-01-01

Background The treatment of hepatitis C (HCV) infections has significantly changed in the past few years due to the introduction of direct-acting antiviral agents (DAAs). DAAs could improve the sustained virological response compared to pegylated interferon with ribavirin (PR). However, there has been no evidence from randomized controlled trials (RCTs) that directly compare the efficacy among the different regimens of DAAs. Aim Therefore, we performed a systematic review and network meta-analysis aiming to compare the treatment efficacy between different DAA regimens for treatment naïve HCV genotype 1. Methods Medline and Scopus were searched up to 25th May 2015. RCTs investigating the efficacy of second generation DAA regimens for treatment naïve HCV genotype 1 were eligible for the review. Due to the lower efficacy and more side effects of first generation DAAs, this review included only second generation DAAs approved by the US or EU Food and Drug Administration, that comprised of simeprevir (SMV), sofosbuvir (SOF), daclatasvir (DCV), ledipasvir (LDV), and paritaprevir/ritonavir/ombitasvir plus dasabuvir (PrOD). Primary outcomes were sustained virological response at weeks 12 (SVR12) and 24 (SVR24) after the end of treatment and adverse drug events (i.e. serious adverse events, anemia, and fatigue). Efficacy of all treatment regimens were compared by applying a multivariate random effect meta-analysis. Incidence rates of SVR12 and SVR24, and adverse drug events of each treatment regimen were pooled using ‘pmeta’ command in STATA program. Results Overall, 869 studies were reviewed and 16 studies were eligible for this study. Compared with the PR regimen, SOF plus PR, SMV plus PR, and DVC plus PR regimens yielded significantly higher probability of having SVR24 with pooled risk ratios (RR) of 1.98 (95% CI 1.24, 3.14), 1.46 (95% CI: 1.22, 1.75), and 1.68 (95% CI: 1.14, 2.46), respectively. Pooled incidence rates of SVR12 and SVR24 in all treatment regimens without PR, i.e. SOF plus LDV with/without ribavirin, SOF plus SMV with/without ribavirin, SOF plus DCV with/without ribavirin, and PrOD with/without ribavirin, (pooled incidence of SVR12 ranging from 93% to 100%, and pooled incidence of SVR24 ranging from 89% to 96%) were much higher than the pooled incidence rates of SVR12 (51%) and SVR24 (48%) in PR alone. In comparing SOF plus LDV with ribavirin and SOF plus LDV without ribavirin, the chance of having SVR12 was not significantly different between these two regimens, with the pooled RR of 0.99 (95% CI: 0.97, 1.01). Regarding adverse drug events, risk of serious adverse drug events, anemia and fatigue were relatively higher in treatment regimens with PR than the treatment regimens without PR. The main limitation of our study is that a subgroup analysis according to dosages and duration of treatment could not be performed. Therefore, the dose and duration of recommended treatment have been suggested in range and not in definite value. Conclusions Both DAA plus PR and dual DAA regimens should be included in the first line drug for treatment naïve HCV genotype 1 because of the significant clinical benefits over PR alone. However, due to high drug costs, an economic evaluation should be conducted in order to assess the value of the investment when making coverage decisions. PMID:26720298

Economic considerations related to choice of intraocular lens (IOL) and posterior capsule opacification frequency - a comparison of three different IOLs.

PubMed

Cullin, Felix; Busch, Tobias; Lundström, Mats

2014-03-01

To evaluate the posterior capsule opacification (PCO) rates in three different modern standard intraocular lenses (IOL) and analyse the related cost. Retrospective study of medical records from 1527 patients who underwent uneventful cataract surgery by phacoemulsification with posterior chamber implantation of either AcrySof SN60 (n = 375), Akreos Adapt (n = 350) or Tecnis Acryl IOL (n = 801). All surgeries were performed by the same surgeon using the same surgical technique and equipment. Primary end-point was neodymium:yttrium-aluminium-garnet (Nd:YAG) capsulotomy for visual impairment secondary to PCO. Cost of IOL material and Nd:YAG capsulotomy for PCO was then evaluated and compared between the IOLs. Mean follow-up was 41.5 months, and the only statistically significant variable of developing PCO was IOL type and individual follow-up time. Nd:YAG capsulotomy was performed in 7.47% in the AcrySof group, 17.71% in the Akreos group and 3.75% in the Tecnis group. Average cost for Nd:YAG capsulotomy per surgery was €18.75 in the AcrySof SN60 group, €44.25 in the Akreos Adapt group and €9.25 in the Tecnis Acryl group. The combined cost of cataract surgery and PCO treatment was €9.81 higher in for the Akreos Adapt group than the other two combined. This retrospective study shows that the risk of PCO and Nd:YAG capsulotomy is significantly higher in hydrophilic Akreos IOL compared with both AcrySof and Tecnis hydrophobic IOLs. The increased risk of PCO in the hydrophilic IOL is related to higher total average costs for cataract surgery. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

Building a Sustainable Global Surgery Nonprofit Organization at an Academic Institution.

PubMed

Frisella, Margaret M

Surgical Outreach for the Americas is a 501(c)3 nonprofit organization providing surgical care to those in need in developing countries of the Western Hemisphere. Every year since its inception in 2008, teams of surgeons, nurses, and allied health professionals have traveled to areas of need and performed primarily hernia repair surgeries for those without access to affordable health care. Surgical Outreach for the Americas (SOfA) began as a general concept based on World Health Organization statistics claiming that 11% of the global burden of disease can be resolved via surgery. Armed with this information, a group of compassionate and selfless health care professionals planned the first trip, to the Dominican Republic, in January 2009. Building on what was first just an ambition to help others, we now also train surgeons, surgery residents, and nurses in the countries we serve. To date, SOfA has successfully treated 734 patients, with 899 total surgical procedures performed (693 of these under general anesthesia). These procedures include inguinal hernia, umbilical hernia, testicular masses, orchiectomies, and various general surgical procedures. Through the efforts of a great many talented individuals and robust fundraising efforts, the SOfA message continues to gain momentum. SOfA not only considers the health and well-being of the disadvantaged through capacity-building efforts but strives to educate and improve the skills of health care professionals in the countries we visit. Our goal is to increase the number of missions each year and begin a 2-fold educational program that (a) provides surgical resident education through participation in mission work and (b) provides local surgeon education in the areas served. Copyright © 2016. Published by Elsevier Inc.

Impact of ledipasvir/sofosbuvir on the work productivity of genotype 1 chronic hepatitis C patients in Asia.

PubMed

Younossi, Z M; Chan, H L Y; Dan, Y Y; Lee, M H; Lim, Y-S; Kruger, E; Tan, S C

2018-03-01

Chronic, untreated hepatitis C virus (HCV) infection is associated with a poor clinical prognosis and a detrimental impact on patients' lives, including on work productivity. To estimate the value of productivity losses due to genotype 1 (GT1) HCV infection in Hong Kong, Singapore, South Korea and Taiwan and to estimate the potential productivity gains associated with treating patients with ledipasvir/sofosbuvir (LDV/SOF) therapy, an economic model was developed with a time horizon of 1 year. Hepatitis C virus patients entered the model at 12 weeks post-treatment, having achieved or not achieved sustained virological response (SVR). Absenteeism and presenteeism rates were taken from a pooled analysis of data from the ION 1-3 studies. These rates were converted into hours of lost productivity, multiplied by the average wage and applied to the total employed, adult GT1 population in each country. Results were compared assuming no treatment, and assuming all patients were treated with LDV/SOF. Total productivity losses due to untreated HCV were: $11.3 million, $17.1 m, $146.0 m and $349.1 m in Hong Kong, Singapore, South Korea and Taiwan. LDV/SOF treatment resulted in economic gains of $4.5 m, $6.8 m, $58.7 m and $138 m, respectively. These gains were due to reduced presenteeism. The results were sensitive to changes in the prevalence of HCV and the average wage. In conclusion, productivity losses due to untreated HCV infection represent a substantial economic burden. By instituting universal HCV treatment with LDV/SOF (or other therapies with high SVR rates), productivity gains can be achieved. © 2017 John Wiley & Sons Ltd.

Impact of Direct Acting Antiviral Therapy for Treatment of Hepatitis C Genotypes 1, 3 and 4: A Real Life Experience from India.

PubMed

Mehta, Varun; Mahajan, Ramit; Midha, Vandana; Narang, Vikram; Kaur, Kirandeep; Singh, Arshdeep; Malhotra, Anand; Parvez, Aslam; Sood, Ajit

2018-03-01

To assess impact of Direct Acting Antiviral (DAA) therapies for treatment of Hepatitis C Virus (HCV) genotypes 1, 3 and 4 in a real-world cohort from India. Adults with chronic HCV infection treated with Sofosbuvir (SOF) and Ledipasvir (LDV) (genotypes 1 and 4) or SOF and Daclatasvir (DCV) (genotype 3), with or without Ribavirin (RBV) between December 2015 and December 2016 were included. The primary endpoint was Sustained Virological Response at Post-treatment Week 12 (SVR12). Of the 648 patients, 181 received SOF/LDV (65 with RBV) and 467 received SOF/DCV (135 with RBV). Most patients were males (65.4%), aged 41-60 years (49.4%) and treatment-naïve (92.6%). Genotype 3 (72.1%) was most common, followed by genotypes 1 (22.4%) and 4 (5.6%). Forty two percent patients ( n  = 271) had cirrhosis (112 patients were decompensated). SVR12 (modified intention-to-treat) was achieved by 98.1% of patients (512/522) (100% in genotypes 1 and 4, and 97.3% (362/372) in genotype 3). On intention to treat analysis, SVR12 was 88.1% (512/581) [genotype 1-96.8% (121/125), genotype 3-85.2%, genotype 4-93.5% (29/31)]. Seventy patients had treatment failure (non response in 6, virological breakthrough in 2, 10 patients relapsed, 2 died and 50 were lost to follow up). High SVR was observed regardless of HCV genotype, presence of cirrhosis or past history of treatment. No major adverse events warranting discontinuation of treatment were noted. DAA therapy for HCV genotypes 1, 3 and 4 achieves high SVR rates in all patients, including those with cirrhosis and previous non-responders.

Cost-Effectiveness of Treating Hepatitis C with Sofosbuvir/Ledipasvir in Germany.

PubMed

Stahmeyer, Jona T; Rossol, Siegbert; Liersch, Sebastian; Guerra, Ines; Krauth, Christian

2017-01-01

Infections with the hepatitis C virus (HCV) are a global public health problem. Long-term consequences are the development of liver cirrhosis and hepatocellular carcinoma. Newly introduced direct acting antivirals, especially interferon-free regimens, have improved rates of sustained viral response above 90% in most patient groups and allow treating patients who were ineligible for treatment in the past. These new regimens have replaced former treatment and are recommended by current guidelines. However, there is an ongoing discussion on high pharmaceutical prices. Our aim was to assess the long-term cost-effectiveness of treating hepatitis C genotype 1 patients with sofosbuvir/ledipasvir (SOF/LDV) treatment in Germany. We used a Markov cohort model to simulate disease progression and assess cost-effectiveness. The model calculates lifetime costs and outcomes (quality-adjusted life years, QALYs) of SOF/LDV and other strategies. Patients were stratified by treatment status (treatment-naive and treatment-experienced) and absence/presence of cirrhosis. Different treatment strategies were compared to prior standard of care. Sensitivity analyses were performed to evaluate model robustness. Base-case analyses results show that in treatment-naive non-cirrhotic patients treatment with SOF/LDV dominates the prior standard of care (is more effective and less costly). In cirrhotic patients an incremental cost-effectiveness ratio (ICER) of 3,383 €/QALY was estimated. In treatment-experienced patients ICERs were 26,426 €/QALY and 1,397 €/QALY for treatment-naive and treatment-experienced patients, respectively. Robustness of results was confirmed in sensitivity analyses. Our analysis shows that treatment with SOF/LDV is cost-effective compared to prior standard of care in all patient groups considering international costs per QALY thresholds.

Secondary membrane formation after cataract surgery with primary intraocular lens implantation in children.

PubMed

Bar-Sela, Shai M; Har-Noy, Nurit Birman; Spierer, Abraham

2014-08-01

To evaluate the risk factors for secondary membrane (SM) formation after congenital cataract surgery with intraocular lens (IOL) implantation. A retrospective non-interventional comparative study. Thirty-nine patients (63 eyes) aged 1-135 months. The study included patients who underwent cataract extraction and primary IOL implantation between 1994 and 2001 at the University Hospital. The postoperative follow-up was 6-24 months. Thirty-three eyes received a poly(methyl methacrylate) (PMMA) IOL without square edges, 29 eyes received a hydrophobic acrylic IOL with truncated square edges (AcrySof), and there was no data for IOL type in one eye. Thirty-nine eyes had primary posterior capsulotomy (PPC) and anterior vitrectomy (AV) and in 24 eyes the posterior capsule was left intact. Cox proportional hazard regression analysis was performed to identify significant risk factors for SM formation, and Wilcoxon test to evaluate the difference in time from surgery to SM formation. SM developed in 24 eyes (38 %)--58 % of eyes with an intact posterior capsule and 26 % of eyes having PPC and AV, 42 % of eyes with a PMMA IOL, and 34 % of eyes with an AcrySof lens. In multivariate Cox regression analysis intraoperative PPC and AV (P = 0.02) and AcrySof lens implantation (P = 0.097) were associated with decreased postoperative incidence of SM formation. Median time until SM development was 2.9 months with PMMA IOLs (range 1-17 months) and 6 months with AcrySof lenses (range 1-21.8 months) (P = 0.037). Posterior capsule management as well as IOL design and material influence the incidence and the timing of SM formation after primary IOL implantation in children.

Gas Sensing Analysis of Ag-Decorated Graphene for Sulfur Hexafluoride Decomposition Products Based on the Density Functional Theory

PubMed Central

Zhang, Xiaoxing; Huang, Rong; Gui, Yingang; Zeng, Hong

2016-01-01

Detection of decomposition products of sulfur hexafluoride (SF6) is one of the best ways to diagnose early latent insulation faults in gas-insulated equipment, and the occurrence of sudden accidents can be avoided effectively by finding early latent faults. Recently, functionalized graphene, a kind of gas sensing material, has been reported to show good application prospects in the gas sensor field. Therefore, calculations were performed to analyze the gas sensing properties of intrinsic graphene (Int-graphene) and functionalized graphene-based material, Ag-decorated graphene (Ag-graphene), for decomposition products of SF6, including SO2F2, SOF2, and SO2, based on density functional theory (DFT). We thoroughly investigated a series of parameters presenting gas-sensing properties of adsorbing process about gas molecule (SO2F2, SOF2, SO2) and double gas molecules (2SO2F2, 2SOF2, 2SO2) on Ag-graphene, including adsorption energy, net charge transfer, electronic state density, and the highest and lowest unoccupied molecular orbital. The results showed that the Ag atom significantly enhances the electrochemical reactivity of graphene, reflected in the change of conductivity during the adsorption process. SO2F2 and SO2 gas molecules on Ag-graphene presented chemisorption, and the adsorption strength was SO2F2 > SO2, while SOF2 absorption on Ag-graphene was physical adsorption. Thus, we concluded that Ag-graphene showed good selectivity and high sensitivity to SO2F2. The results can provide a helpful guide in exploring Ag-graphene material in experiments for monitoring the insulation status of SF6-insulated equipment based on detecting decomposition products of SF6. PMID:27809269

Brief Report: The Impact of Ledipasvir/Sofosbuvir on HIV-Positive and HIV-Negative Japanese Hemophilia Patients With 1, 4, and Mixed-Genotype HCV.

PubMed

Nagao, Azusa; Hanabusa, Hideji

2017-04-01

Approximately 80% of patients with hemophilia who received nonheated coagulation factor concentrates in the early 1980s were infected with hepatitis C virus (HCV), and approximately 40% of them were infected with HIV. We evaluated the efficacy and safety of administering ledipasvir (LDV)/sofosbuvir (SOF) to Japanese patients with hemophilia. Forty-three patients with hemophilia with genotype 1 or 4 HCV were treated with LDV/SOF for 12 weeks. The efficacy, safety, and results of the laboratory tests were evaluated. Twenty patients were coinfected with HIV and HCV. The sustained virological response (SVR) at 12 weeks after therapy was 90% in HIV-positive patients and 100% in HIV-negative patients. The efficacy of LDV/SOF was not significantly different between HIV-positive and HIV-negative patients (P = 0.12). However, the rate of SVR at 12 weeks after therapy in the patients with cirrhosis was significantly lower than that in patients without cirrhosis (P = 0.005). Overall, 20 patients (46%) had adverse events, and while the severity of most was mild to moderate, 3 were serious, including 1 death in the HIV-positive group. All patients completed treatment with no alterations in the antiretroviral regimen. No significant abnormalities in the renal function were detected in patients taking an antiretroviral regimen of tenofovir disoproxil fumarate. In this cohort study, LDV/SOF was effective and safe, but the SVR in patients with cirrhosis was lower than that in the noncirrhosis group. Thus, patients with hemophilia with genotype 1/4 HCV should be treated as early as possible before the onset of cirrhosis.

Safety and efficacy of sofosbuvir and ribavirin for genotype 2 hepatitis C Japanese patients with renal dysfunction.

PubMed

Sho, Takuya; Suda, Goki; Nagasaka, Atsushi; Yamamoto, Yoshiya; Furuya, Ken; Kumagai, Kenichi; Uebayashi, Minoru; Terashita, Katsumi; Kobayashi, Tomoe; Tsunematsu, Izumi; Onodera, Manabu; Meguro, Takashi; Kimura, Megumi; Ito, Jun; Umemura, Machiko; Izumi, Takaaki; Kawagishi, Naoki; Ohara, Masatsugu; Ono, Yuji; Nakai, Masato; Natsuizaka, Mitsuteru; Morikawa, Kenichi; Ogawa, Koji; Sakamoto, Naoya

2018-06-01

The safety and efficacy of sofosbuvir (SOF) and ribavirin (RBV) have not been well clarified in patients with renal dysfunction because clinical trials have not included such patients. We evaluated the safety and efficacy of SOF and RBV for genotype 2 hepatitis C virus (HCV)-infected patients with renal dysfunction. The study included genotype 2 HCV-infected patients who received SOF and RBV between July 2014 and May 2017. The sustained virologic response (SVR) after the treatment and safety during the therapy were evaluated according to renal function. A total of 231 patients were included in this study. The median age was 62 years old, and 45.9% (106/231) were men. Of the 231 patients, 191 (82.8%) and 40 (17.2%) were classified as having chronic kidney disease (CKD) stages G1/2 and G3, respectively. The overall SVR rate was 97% (224/231). The SVR rates in patients with CKD stages G1, 2, G3a, and G3b were 98.1%, 98.6%, 87.9%, and 100%, respectively, and this therapy was tolerated. Multivariate analysis indicated that renal dysfunction was significantly associated with a non-SVR (odds ratio, 6.963; 95% confidence interval, 1.494-32.41; P = 0.013). The patients with renal dysfunction were older, had advanced liver fibrosis, lower baseline platelet and hemoglobin levels, and a higher rate of RBV dose reduction. Sofosbuvir and RBV therapy is highly effective and safe for genotype 2 HCV-infected Japanese patients. However, attention should be paid to baseline renal function when SOF- and RBV-containing regimens are used for patients with renal dysfunction. © 2018 The Japan Society of Hepatology.

Effects of SofZia-preserved travoprost and benzalkonium chloride-preserved latanoprost on the ocular surface -- a multicentre randomized single-masked study.

PubMed

Aihara, Makoto; Oshima, Hiromi; Araie, Makoto

2013-02-01

To assess the effect of SofZia-preserved travoprost on ocular surface conditions in comparison with benzalkonium chloride (BAK)-preserved latanoprost. A prospective randomized multicentre single-masked comparative study. Patients with open-angle glaucoma or ocular hypertension who had been treated with BAK-preserved latanoprost 0.005% (Xalatan(®) ) monotherapy for at least 3 months. Patients were enrolled at 23 facilities. Patients were randomly divided into the X-X group, continuous use of Xalatan(®) , or the X-T group, switching from Xalatan(®) to SofZia-preserved travoprost 0.004% (TravatanZ(®) ), and followed for 3 months. The superficial punctate keratopathy (SPK), conjunctival epitheliopathy, hyperaemia, tear break-up time (TBUT) and intraocular pressure (IOP) were examined for each patient in a masked manner. Changes in the frequency of keratoconjunctival epitheliopathy were evaluated 3 months after study initiation. Intra- and intergroup comparisons of changes in SPK, conjunctival epitheliopathy, hyperaemia, TBUT and IOP were also carried out. Two hundred twenty patients participated and 215 completed the 3-month study. The frequency of keratoconjunctival epitheliopathy significantly decreased in the X-T group (p = 0.036) and the intergroup difference was also significant (p = 0.001). SPK scores and TBUT were significantly improved in the X-T group (p = 0.034, 0.049), also with significant intergroup differences in the cornea excluding the inferior area and TBUT. There were no significant intergroup differences in changes of the hyperaemia scores and the IOP reduction. Switching to SofZia-preserved travoprost after BAK-preserved latanoprost resulted in a lower incidence of keratoconjunctival epitheliopathy, especially in the cornea, with no clinically relevant changes in hyperaemia and IOP. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

User testing and stakeholder feedback contributed to the development of understandable and useful Summary of Findings tables for Cochrane reviews.

PubMed

Rosenbaum, Sarah E; Glenton, Claire; Nylund, Hilde Kari; Oxman, Andrew D

2010-06-01

To develop a Summary of Findings (SoF) table for use in Cochrane reviews that is understandable and useful for health professionals, acceptable to Cochrane Collaboration stakeholders, and feasible to implement. We gathered stakeholder feedback on the format and content of an SoF table from an advisory group of more than 50 participants and their constituencies through e-mail consultations. We conducted user tests using a think-aloud protocol method, collecting feedback from 21 health professionals and researchers in Norway and the UK. We analyzed the feedback, defined problem areas, and generated new solutions in brainstorming workshops. Stakeholders were concerned about precision in the data representation and about production feasibility. User testing revealed unexpected comprehension problems, mainly confusion about what the different numbers referred to (class reference). Resolving the tension between achieving table precision and table simplicity became the main focus of the working group. User testing led to a table more useful and understandable for clinical audiences. We arrived at an SoF table that was acceptable to the stakeholders and in principle feasible to implement technically. Some challenges remain, including presenting continuous outcomes and technical/editorial implementation.

Cost-Utility of Elbasvir/Grazoprevir in Patients with Chronic Hepatitis C Genotype 1 Infection.

PubMed

Corman, Shelby; Elbasha, Elamin H; Michalopoulos, Steven N; Nwankwo, Chizoba

2017-09-01

To evaluate the cost-utility of treatment with elbasvir/grazoprevir (EBR/GZR) regimens compared with ledipasvir/sofosbuvir (LDV/SOF), ombitasvir/paritaprevir/ritonavir + dasabuvir ± ribavirin (3D ± RBV), and sofosbuvir/velpatasvir (SOF/VEL) in patients with chronic hepatitis C genotype (GT) 1 infection. A Markov cohort state-transition model was constructed to evaluate the cost-utility of EBR/GZR ± RBV over a lifetime time horizon from the payer perspective. The target population was patients infected with chronic hepatitis C GT1 subtypes a or b (GT1a or GT1b), stratified by treatment history (treatment-naive [TN] or treatment-experienced), presence of cirrhosis, baseline hepatitis C virus RNA (< or ≥6 million IU/mL), and presence of NS5A resistance-associated variants. The primary outcome was incremental cost-utility ratio for EBR/GZR ± RBV versus available oral direct-acting antiviral agents. One-way and probabilistic sensitivity analyses were performed to test the robustness of the model. EBR/GZR ± RBV was economically dominant versus LDV/SOF in all patient populations. EBR/GZR ± RBV was also less costly than SOF/VEL and 3D ± RBV, but produced fewer quality-adjusted life-years in select populations. In the remaining populations, EBR/GZR ± RBV was economically dominant. One-way sensitivity analyses showed varying sustained virologic response rates across EBR/GZR ± RBV regimens, commonly impacted model conclusions when lower bound values were inserted, and at the upper bound resulted in dominance over SOF/VEL in GT1a cirrhotic and GT1b TN noncirrhotic patients. Results of the probabilistic sensitivity analysis showed that EBR/GZR ± RBV was cost-effective in more than 99% of iterations in GT1a and GT1b noncirrhotic patients and more than 69% of iterations in GT1b cirrhotic patients. Compared with other oral direct-acting antiviral agents, EBR/GZR ± RBV was the economically dominant regimen for treating GT1a noncirrhotic and GT1b TN cirrhotic patients, and was cost saving in all other populations. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

[New direct-acting antiviral agents for the treatment of chronic hepatitis C in 2014].

PubMed

Cornberg, M; Höner zu Siederdissen, C; Maasoumy, B; Manns, M P

2014-04-01

The development of direct-acting antiviral agents (DAA) against the hepatitis C virus (HCV) has seen enormous progress in recent years. In 2011, the first protease inhibitors boceprevir (BOC) and telaprevir (TLV) were approved, which still need to be combined with pegylated interferon α (PEG-IFN α) and ribavirin (RBV) and are used only in patients with genotype 1. With sofosbuvir (SOF) and simeprevir (SMV), two new DAA are available. More DAA are in clinical development. Which changes in the treatment of chronic hepatitis C infection can be expected with the approval of the new DAA in 2014? Relevant phase IIb and phase III studies for the approval in 2014 were considered for drugs approved by the FDA or EMA at the editorial deadline. For patients with genotype 1, the combination of SOF, SMV or faldaprevir with PEG-IFN α and RBV was successfully evaluated in phase III studies. In contrast to previous treatment with PEG-IFN α, RBV and telaprevir (TLV) or boceprevir (BOC), therapy can be shortened in most cases with a significantly improved side-effect profile. Cure rates above 80 % are possible. Data are also available for an interferon-free therapy with either SOF and RBV or SOF and SMV in GT-1 patients. SVR rates exceeding 60 % and up to 90 % are possible. However, treatment experience with these combinations is low and an unrestricted interferon-free therapy for genotype 1 should not be expected before 2015. For patients with genotypes 2 and 3, valid data for interferon-free therapies are available. The combination of SOF and RBV for 12 weeks in genotype 2 and 24 weeks for genotype 3 is effective and shows equal or superior cure rates with fewer side effects than the PEG-IFN α/RBV therapy. For patients with genotype 1, the duration of therapy can be further reduced with better side effect profile. In certain situations, therapy without PEG-IFN α is possible and should be considered. For patients with genotypes 2 and 3, an interferon-free therapy will be standard of care in 2014.

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

Lagrutta, Armando, E-mail: armando_lagrutta@merck.

Several clinical cases of severe bradyarrhythmias have been reported upon co-administration of the Hepatitis-C NS5B Nucleotide Polymerase Inhibitor (HCV-NI) direct-acting antiviral agent, sofosbuvir (SOF), and the Class-III anti-arrhythmic amiodarone (AMIO). We model the cardiac drug-drug interaction (DDI) between AMIO and SOF, and between AMIO and a closely-related SOF analog, MNI-1 (Merck Nucleotide Inhibitor #1), in functional assays of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs), to provide mechanistic insights into recently reported clinical cases. AMIO co-applied with SOF or MNI-1 increased beating rate or field potential (FP) rate and decreased impedance (IMP) and Ca{sup 2+} transient amplitudes in hiPSC-CM syncytia.more » This action resembled that of Ca{sup 2+} channel blockers (CCBs) in the model, but CCBs did not substitute for AMIO in the DDI. AMIO analog dronedarone (DRON) did not substitute for, but competed with AMIO in the DDI. Ryanodine and thapsigargin, decreasing intracellular Ca{sup 2+} stores, and SEA-0400, a Na{sup +}/Ca{sup 2+} exchanger-1 (NCX1) inhibitor, partially antagonized or suppressed DDI effects. Other agents affecting FP rate only exerted additive or subtractive effects, commensurate with their individual effects. We also describe an interaction between AMIO and MNI-1 on Cav{sub 1.2} ion channels in an over-expressing HEK-293 cell line. MNI-1 enhanced Cav{sub 1.2} channel inhibition by AMIO, but did not affect inhibition of Cav{sub 1.2} by DRON, verapamil, nifedipine, or diltiazem. Our data in hiPSC-CMs indicate that HCV-NI agents such as SOF and MNI-1 interact with key intracellular Ca{sup 2+}-handling mechanisms. Additional study in a Cav{sub 1.2} HEK-293 cell-line suggests that HCV-NIs potentiate the inhibitory action of AMIO on L-type Ca{sup 2+} channels. - Highlights: • Adverse clinical interaction between amiodarone and HCV-NI drugs is captured by in vitro models. • Human iPSC-derived cardiomyocyte beating syncytial model points to Ca{sup 2+} handling effects. • Overexpressing human Ca{sup 2+} channel line model points to shifts in Ca{sup 2+} influx. • Shifts in Ca{sup 2+} current voltage-dependent inactivation play a role in the AER interaction.« less

Amino Acid Conjugated Anthraquinones from the Marine-Derived Fungus Penicillium sp. SCSIO sof101.

PubMed

Luo, Minghe; Cui, Zhaomeng; Huang, Hongbo; Song, Xianqin; Sun, Aijun; Dang, Yongjun; Lu, Laichun; Ju, Jianhua

2017-05-26

Emodacidamides A-H (1-8), natural products featuring anthraquinone-amino acid conjugates, have been isolated from a marine-derived fungus, Penicillium sp. SCSIO sof101, together with known anthraquinones 9 and 10. The planar structures of 1-8 were elucidated using a combination of NMR spectroscopy and mass spectrometry. The absolute configurations of the amino acid residues were confirmed using Marfey's method and chiral-phase HPLC analyses. Additionally, isolates were evaluated for possible immunomodulatory and cytotoxic activities. Emodacidamides A (1), C (3), D (4), and E (5) inhibited interleukin-2 secretion from Jurkat cells with IC 50 values of 4.1, 5.1, 12, and 5.4 μM, respectively.

Efficacy of sofosbuvir and ledipasvir in an HCV+ gastro-resected patient.

PubMed

Taibi, C; Tempestilli, M; D'Avolio, A; Garbuglia, A R; De Nicolò, A; Montalbano, M; D'Offizi, G

2017-10-01

The second-generation direct-acting antivirals represented the first major turning point for the eradication of HCV infection in almost all settings of patients. However, no data were available on use in gastro-resected patients. We report on a gastrectomized patient with chronic hepatitis C infection. She was treated with sofosbuvir and ledipasvir (SOF/LDV) for 12 weeks, with measurement of blood levels of the drugs. She obtained sustained virological response at week 12 and 24 without dose adjustment. This case report can provide information useful for clinical practice in this set of patients and can open new perspectives in evaluating actual SOF/LDV bioavailability. © 2017 John Wiley & Sons Ltd.

FORCAST Observations of Galactic Evolved Stars: Measurements of Carbonaceous Dust, Crystalline Silicates, and Fullerenes from SOFIA

NASA Astrophysics Data System (ADS)

Kraemer, Kathleen; Sloan, G. C.; Keller, L. D.; Groenewegen, M. A. T.

2018-01-01

We present preliminary results from two projects to observe the mid-infrared spectra of evolved stars in the Milky Way using the FORCAST instrument on SOFIA. In the first project, we observed a set of 31 carbon stars over the course of three cycles (government shutdowns contributed to the delays in the program execution), covering a wavelength range of 5-13.7 μm, which includes prominent dust and gas diagnostics. The sources were selected to sample portions of period and flux phase space which were not covered in existing samples from older telescopes such as the Infrared Space Observatory (ISO) or Infrared Astronomical Satellite (IRAS). In the second project, we searched for fullerene emission (C60) at 18.9 μm in Galactic sources with crystalline silicate emission. Although most evolved stars are either carbon-rich or oxygen- (silicate-) rich, fullerenes, a carbon-rich molecule, have been observed in several oxygen-rich evolved stars whose silicate emission features are crystalline rather than the more usual amorphous types. None of our targets show clear signatures of fullerene emission.Support for this work was provided by NASA through awards SOF 03-0079, SOF 03-0104, and SOF 04-0129 issued by USRA.

FIRE_AX_SOF_ARAT_FLT

Atmospheric Science Data Center

2015-11-25

... Microwave Radiometer Optical Counter Platinum Resistance Pyranometer Pyrgeometer Variable Capacitance ... Parameters:  Aerosol Particle Properties Air Temperature Cloud Liquid Water Deiced Temperature Dew Point Doppler ...

[Early warning for various internal faults of GIS based on ultraviolet spectroscopy].

PubMed

Zhao, Yu; Wang, Xian-pei; Hu, Hong-hong; Dai, Dang-dang; Long, Jia-chuan; Tian, Meng; Zhu, Guo-wei; Huang, Yun-guang

2015-02-01

As the basis of accurate diagnosis, fault early-warning of gas insulation switchgear (GIS) focuses on the time-effectiveness and the applicability. It would be significant to research the method of unified early-warning for partial discharge (PD) and overheated faults in GIS. In the present paper, SO2 is proposed as the common and typical by-product. The unified monitoring could be achieved through ultraviolet spectroscopy (UV) detection of SO2. The derivative method and Savitzky-Golay filtering are employed for baseline correction and smoothing. The wavelength range of 290-310 nm is selected for quantitative detection of SO2. Through UV method, the spectral interference of SF6 and other complex by-products, e.g., SOF2 and SOF2, can be avoided and the features of trace SO2 in GIS can be extracted. The detection system is featured by compacted structure, low maintenance and satisfactory suitability in filed surveillance. By conducting SF6 decomposition experiments, including two types of PD faults and the overheated faults between 200-400 degrees C, the feasibility of proposed UV method has been verified. Fourier transform infrared spectroscopy and gas chromatography methods can be used for subsequent fault diagnosis. The different decomposition features in two kinds of faults are confirmed and the diagnosis strategy has been briefly analyzed. The main by-products under PD are SOF2 and SO2F2. The generated SO2 is significantly less than SOF2. More carbonous by-products will be generated when PD involves epoxy. By contrast, when the material of heater is stainless steel, SF6 decomposes at about 300 "C and the main by-products in overheated faults are SO2 and SO2F2. When heated over 350 degrees C, SO2 is generated much faster. SOz content stably increases when the GIS fault lasts. The faults types could be preliminarily identified based on the generation features of SO2.

High efficacy of Sofosbuvir plus Simeprevir in a large cohort of Spanish cirrhotic patients infected with genotypes 1 and 4.

PubMed

Mariño, Zoe; Pascasio-Acevedo, Juan M; Gallego, Adolfo; Diago, Moisés; Baliellas, Carme; Morillas, Rosa; Prieto, Martín; Moreno, José M; Sánchez-Antolín, Gloria; Vergara, Mercedes; Forné, Montserrat; Fernández, Inmaculada; Castro, María A; Pascual, Sonia; Gómez, Alexandra; Castells, Lluis; Montero, José L; Crespo, Javier; Calleja, José L; García-Samaniego, Javier; Carrión, Jose A; Arencibia, Ana C; Blasco, Alejandro; López-Núñez, Carmen; Sánchez-Ruano, Juan J; Gea-Rodríguez, Francisco; Giráldez, Álvaro; Cabezas, Joaquín; Hontangas, Vanessa; Torras, Xavier; Castellote, Jose; Romero-Gómez, Manuel; Turnes, Juan; de Artaza, Tomás; Narváez, Isidoro; Cuervas-Mons, Valentín; Forns, Xavier

2017-12-01

Hepatitis C (HCV) therapy with Sofosbuvir (SOF)/Simeprevir (SMV) in clinical trials and real-world clinical practice, showed high rates of sustained virological response (SVR) in non-cirrhotic genotype (GT)-1 and GT-4 patients. These results were slightly lower in cirrhotic patients. We investigated real-life effectiveness and safety of SOF/SMV with or without ribavirin (RBV) in a large cohort of cirrhotic patients. This collaborative multicentre study included data from 968 patients with cirrhosis infected with HCV-GT1 or 4, treated with SOF/SMV±RBV in 30 centres across Spain between January-2014 and December-2015. Demographic, clinical, virological and safety data were analysed. Overall SVR was 92.3%; the majority of patients were treated with RBV (62%) for 12 weeks (92.4%). No significant differences in SVR were observed between genotypes (GT1a:94.3%; GT1b:91.7%; GT4:91.1%). Those patients with more advanced liver disease (Child B/C, MELD≥10) or portal hypertension (platelet count≤100×10 9 /L, transient elastography≥21 Kpa) showed significantly lower SVR rates (84.4%-91.9%) than patients with less advanced liver disease (93.8%-95.9%, P<.01 in all cases). In the multivariate analysis, the use of RBV, female gender, baseline albumin≥35 g/L, MELD<10 and lack of exposure to a triple therapy regimen were independent predictors of SVR (P<.05). Serious adverse events (SAEs) and SAE-associated discontinuation events occurred in 5.9% and 2.6%. In this large cohort of cirrhotic patients managed in the real-world setting in Spain, SOF/SMV±RBV yielded to excellent SVR rates, especially in patients with compensated liver cirrhosis. In addition, this combination showed to be safe, with low rates of SAEs and early discontinuations. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Patient-reported Outcomes in Asian Patients With Chronic Hepatitis C Treated With Ledipasvir and Sofosbuvir

PubMed Central

Younossi, Zobair M.; Stepanova, Maria; Chan, Henry L.Y.; Lee, Mei H.; Yu, Ming-Lung; Dan, Yock Y.; Choi, Moon S.; Henry, Linda

2016-01-01

Abstract Prevalence of chronic hepatitis C (CH-C) infection in patients of Asian ancestry ranges between 1% and 20%. Interferon (IFN)- and ribavirin (RBV)-containing regimens for CH-C have a negative impact on patient-reported outcomes (PROs) during treatment. The aim of this study was to assess the impact of IFN-free RBV-free sofosbuvir (SOF)-based regimens on PROs in CH-C patients of Asian ancestry. In this observational retrospective study, the PRO data from 12 multicenter multinational phase 3 clinical trials (2012–2015, conducted in Europe, North America, Australia, and New Zealand) of SOF-based regimens with and without IFN, ledipasvir (LDV), and/or RBV were used. At baseline, during treatment, and post-treatment, patients completed 4 validated PRO questionnaires (SF-36, CLDQ-HCV, FACIT-F, and WPAI:SHP). The resulting PROs in Asian patients were compared across the treatment regimens. Of 4485 of the trials’ participants, 106 patients were of Asian ancestry (55.7% male, 69.8% treatment-naïve, 17.0% cirrhotic). In comparison with other patients, the Asian CH-C cohort was younger, had lower BMI, and lower rates of pre-treatment psychiatric comorbidities (anxiety, depression, sleep disorders) (all P < .05). At baseline, Asian patients also had lower SF-36 physical functioning scores (on average, by −5.6% on a normalized 0–100% PRO scale, P = .001). During treatment, Asian CH-C patients experienced a decline in their PRO scores while receiving IFN and/or RBV-containing regimens (up to −19.6%, P < .001). In contrast, patients receiving LDV/SOF experienced no PRO decrement and improvement of some PRO scores during treatment (+9.0% in general health of SF-36, P = .03). After achieving SVR-12, some of the PRO scores in Asian patients improved regardless of the regimen (up to +9.3%, P < .001). In multivariate analysis of Asian patients, the use of LDV/SOF was independently associated with higher PRO scores during and soon after the end of treatment (betas +15.0% to +29.3%, all P < .05). Other predictors of PRO impairment included depression, type 2 diabetes mellitus, and cirrhosis. The use of IFN- and RBV-free LDV/SOF regimens leads to PRO improvement in Asian patients with CH-C during treatment. Achieving SVR-12 results in improvement of PRO scores. PMID:26945356

FIRE_AX_SOF_SUR_MET

Atmospheric Science Data Center

2015-11-25

... Buoy Instrument:  Barometer Sonic Anemometer Thermistor Spatial Coverage:  (34.60, ... Earthdata Search Parameters:  Dry Bulb Temperature Pressure Sea Surface Temperature Wet Bulb Temperature ...

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

Butcher, T.; Hamm, L.; Flach, G.

Revision 0 of this UDQE addressed the proposal to place Engineered Trench #3 (ET#3) in the footprint designated for Slit Trench #12 (ST#12) and operate using ST#12 disposal limits. Similarly, Revision 1 evaluates whether ET#4 can be located in and operated to Slit Trench #13 (ST#13) disposal limits. Both evaluations conclude that the proposed operations result in an acceptably small risk of exceeding a SOF of 1.0 and approve these actions from a performance assessment (PA) perspective. Because ET#3 will be placed in the location previously designated for ST#12, Solid Waste Management (SWM) requested that the Savannah River National Laboratorymore » (SRNL) determine if the ST#12 limits could be employed as surrogate disposal limits for ET#3 operations. SRNL documented in this Unreviewed Disposal Question Evaluation (UDQE) that the use of ST#12 limits as surrogates for the new ET#3 disposal unit will provide reasonable assurance that Department of Energy (DOE) 435.1 performance objectives and measures (USDOE, 1999) will be protected. Therefore, new ET#3 inventory limits as determined by a Special Analysis (SA) are not required.« less

Lithium-ion battery state of function estimation based on fuzzy logic algorithm with associated variables

NASA Astrophysics Data System (ADS)

Gan, L.; Yang, F.; Shi, Y. F.; He, H. L.

2017-11-01

Many occasions related to batteries demand to know how much continuous and instantaneous power can batteries provide such as the rapidly developing electric vehicles. As the large-scale applications of lithium-ion batteries, lithium-ion batteries are used to be our research object. Many experiments are designed to get the lithium-ion battery parameters to ensure the relevance and reliability of the estimation. To evaluate the continuous and instantaneous load capability of a battery called state-of-function (SOF), this paper proposes a fuzzy logic algorithm based on battery state-of-charge(SOC), state-of-health(SOH) and C-rate parameters. Simulation and experimental results indicate that the proposed approach is suitable for battery SOF estimation.

In vitro development of canine somatic cell nuclear transfer embryos in different culture media.

PubMed

Kim, Dong-Hoon; No, Jin-Gu; Choi, Mi-Kyung; Yeom, Dong-Hyeon; Kim, Dong-Kyo; Yang, Byoung-Chul; Yoo, Jae Gyu; Kim, Min Kyu; Kim, Hong-Tea

2015-01-01

The objective of the present study was to investigate the effects of three different culture media on the development of canine somatic cell nuclear transfer (SCNT) embryos. Canine cloned embryos were cultured in modified synthetic oviductal fluid (mSOF), porcine zygote medium-3 (PZM-3), or G1/G2 sequential media. Our results showed that the G1/G2 media yielded significantly higher morula and blastocyst development in canine SCNT embryos (26.1% and 7.8%, respectively) compared to PZM-3 (8.5% and 0%or mSOF (2.3% and 0%) media. In conclusion, this study suggests that blastocysts can be produced more efficiently using G1/G2 media to culture canine SCNT embryos.

Using Separation-of-Function Mutagenesis To Define the Full Spectrum of Activities Performed by the Est1 Telomerase Subunit in Vivo.

PubMed

Lubin, Johnathan W; Tucey, Timothy M; Lundblad, Victoria

2018-01-01

A leading objective in biology is to identify the complete set of activities that each gene performs in vivo In this study, we have asked whether a genetic approach can provide an efficient means of achieving this goal, through the identification and analysis of a comprehensive set of separation-of-function ( sof - ) mutations in a gene. Toward this goal, we have subjected the Saccharomyces cerevisiae EST1 gene, which encodes a regulatory subunit of telomerase, to intensive mutagenesis (with an average coverage of one mutation for every 4.5 residues), using strategies that eliminated those mutations that disrupted protein folding/stability. The resulting set of sof - mutations defined four biochemically distinct activities for the Est1 telomerase protein: two temporally separable steps in telomerase holoenzyme assembly, a telomerase recruitment activity, and a fourth newly discovered regulatory function. Although biochemically distinct, impairment of each of these four different activities nevertheless conferred a common phenotype (critically short telomeres) comparable to that of an est1 -∆ null strain. This highlights the limitations of gene deletions, even for nonessential genes; we suggest that employing a representative set of sof - mutations for each gene in future high- and low-throughput investigations will provide deeper insights into how proteins interact inside the cell. Copyright © 2018 by the Genetics Society of America.

Effect of different polishing systems on the surface roughness of nano-hybrid composites.

PubMed

Patel, Brijesh; Chhabra, Naveen; Jain, Disha

2016-01-01

The study aimed to investigate the influence of different polishing systems on the surface roughness of nano-hybrid composite resins. Different shapes of polishing systems are available according to the site of work. To minimize variability, a new system with single shape is developed that can be utilized in both anterior as well as posterior teeth. Seventy composite discs were fabricated using Teflon well (10 mm × 3 mm). Two main group of nano-hybrid composite Group I - Filtek Z350 and Group II - Tetric N-Ceram were used (n = 35 for each group). Both groups were further divided into four subgroups. Subgroup a - OneGloss (n = 10), Subgroup b - PoGo (n = 10), Subgroup c - Sof-Lex spiral (n = 10), Subgroup d - Mylar strip (control, n = 5). Samples were polished according to the manufacturer's recommendations. Surface roughness test was performed using contact profilometer. The obtained data were analyzed using the one-way analysis of variance test. Tetric N-Ceram produced smoother surfaces than Filtek Z350 (P < 0.05). Mylar strip and "PoGo" created equally smooth surfaces, while significantly rougher surfaces were obtained after applications of "Sof-Lex spiral" and "OneGloss" (P < 0.05). Polishing ability of Tetric N-Ceram is better than Filtek Z350 XT. "PoGo" seems to be a better polishing system than "OneGloss" and "Sof-Lex Spiral."

The Italian compassionate use of sofosbuvir in HCV patients waitlisted for liver transplantation: A national real-life experience.

PubMed

Martini, Silvia; Donato, Maria Francesca; Mazzarelli, Chiara; Rendina, Maria; Visco-Comandini, Ubaldo; Filì, Daniela; Gianstefani, Alice; Fagiuoli, Stefano; Melazzini, Mario; Montilla, Simona; Pani, Luca; Petraglia, Sandra; Russo, Pierluigi; Trotta, Maria Paola; Carrai, Paola; Caraceni, Paolo

2018-04-01

This study aimed to assess the real-life clinical and virological outcomes of HCV waitlisted patients for liver transplantation (LT) who received sofosbuvir/ribavirin (SOF/R) within the Italian compassionate use program. Clinical and virological data were collected in 224 patients with decompensated cirrhosis and/or hepatocellular carcinoma (HCC) receiving daily SOF/R until LT or up a maximum of 48 weeks. Of 100 transplanted patients, 51 were HCV-RNA negative for >4 weeks before LT (SVR12: 88%) and 49 negative for <4 weeks or still viraemic at transplant: 34 patients continued treatment after LT (bridging therapy) (SVR12: 88%), while 15 stopped treatment (SVR12: 53%). 98 patients completed SOF/R without LT (SVR12: 73%). In patients with advanced decompensated cirrhosis (basal MELD ≥15 and/or C-P ≥B8), a marked improvement of the scores occurred in about 50% of cases and almost 20% of decompensated patients without HCC reached a condition suitable for inactivation and delisting. These real-life data indicate that in waitlisted patients: (i) bridging antiviral therapy can be an option for patients still viraemic or negative <4 weeks at LT; and (ii) clinical improvement to a condition suitable for delisting can occur even in patients with advanced decompensated cirrhosis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A first principle simulation of competitive adsorption of SF6 decomposition components on nitrogen-doped anatase TiO2 (101) surface

NASA Astrophysics Data System (ADS)

Dong, Xingchen; Zhang, Xiaoxing; Cui, Hao; Zhang, Jun

2017-11-01

Gas insulated switchgear has been widely used in modern electric systems due to its significantly excellent performances such as compact structure and low land occupation as well as the security stability. However, inside defects caused during manufacture process can lead to partial discharge which might develop into serious insulation failure. Online monitoring method on basis of gas sensors is considered a promising way of detecting partial discharge for alarm ahead of time. Research has found that TiO2 nanotubes sensors show good response to SO2, SOF2, SO2F2, the decomposition components as a result of partial discharge. In order to investigate the gas-sensing mechanism of nitrogen-doped TiO2 prepared via plasma treatment methods to SO2, SOF2, and SO2F2, the adsorption structures of both three gas molecules and anatase TiO2 (101) surface were built, and DFT calculations were then carried out for calculation and analysis of adsorption parameters. Adsorption property comparison of anatase TiO2 (101) surface after nitrogen doping with Au doping and without doping shows that nitrogen doping can obviously enhance the adsorption energy for SO2 and SOF2 adsorption and no charge transfer for SO2F2 adsorption, further explaining the adsorption mechanism and doping influence of different doping elements.

Effectiveness, safety and clinical outcomes of direct-acting antiviral therapy in HCV genotype 1 infection: Results from a Spanish real-world cohort.

PubMed

Calleja, Jose Luis; Crespo, Javier; Rincón, Diego; Ruiz-Antorán, Belén; Fernandez, Inmaculada; Perelló, Christie; Gea, Francisco; Lens, Sabela; García-Samaniego, Javier; Sacristán, Begoña; García-Eliz, María; Llerena, Susana; Pascasio, Juan Manuel; Turnes, Juan; Torras, Xavier; Morillas, Rosa Maria; Llaneras, Jordi; Serra, Miguel A; Diago, Moises; Rodriguez, Conrado Fernández; Ampuero, Javier; Jorquera, Francisco; Simon, Miguel A; Arenas, Juan; Navascues, Carmen Alvarez; Bañares, Rafael; Muñoz, Raquel; Albillos, Agustin; Mariño, Zoe

2017-06-01

Clinical trials evaluating second-generation direct-acting antiviral agents (DAAs) have shown excellent rates of sustained virologic response (SVR) and good safety profiles in patients with chronic hepatitis C virus (HCV) genotype 1 infection. We aimed to investigate the effectiveness and safety of two oral DAA combination regimens, ombitasvir/paritaprevir/ritonavir plus dasabuvir (OMV/PTV/r+DSV) and ledipasvir/sofosbuvir (LDV/SOF), in a real-world clinical practice. Data from HCV genotype 1 patients treated with either OMV/PTV/r+DSV±ribavirin (RBV) (n=1567) or LDV/SOF±RBV (n=1758) in 35 centers across Spain between April 1, 2015 and February 28, 2016 were recorded in a large national database. Demographic, clinical and virological data were analyzed. Details of serious adverse events (SAEs) were recorded. The two cohorts were not matched with respect to baseline characteristics and could not be compared directly. The SVR12 rate was 96.8% with OMV/PTVr/DSV±RBV and 95.8% with LDV/SOF±RBV. No significant differences were observed in SVR according to HCV subgenotype (p=0.321 [OMV/PTV/r+DSV±RBV] and p=0.174 [LDV/SOF]) or degree of fibrosis (c0.548 [OMV/PTV/r/DSV±RBV] and p=0.085 [LDV/SOF]). Only baseline albumin level was significantly associated with failure to achieve SVR (p<0.05) on multivariate analysis. Rates of SAEs and SAE-associated treatment discontinuation were 5.4% and 1.7%, in the OMV/PTV/r+DSV subcohort and 5.5% and 1.5% in the LDV/SOF subcohort, respectively. Hepatocellular carcinoma (HCC) recurred in 30% of patients with a complete response to therapy for previous HCC. Incident HCC was reported in 0.93%. In this large cohort of patients managed in the real-world setting in Spain, OMV/PTV/r+DSV and LDV/SOF achieved high rates of SVR12, comparable to those observed in randomized controlled trials, with similarly good safety profiles. In clinical trials, second-generation direct-acting antiviral agents (DAAs) have been shown to cure over 90% of patients chronically infected with the genotype 1 hepatitis C virus and have been better tolerated than previous treatment regimens. However, patients enrolled in clinical trials do not reflect the real patient population encountered in routine practice. The current study, which includes almost 4,000 patients, demonstrates comparable rates of cure with two increasingly used DAA combinations as those observed in the clinical trial environment, confirming that clinical trial findings with DAAs translate into the real-world setting, where patient populations are more diverse and complex. Copyright © 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Towards core outcome set (COS) development: a follow-up descriptive survey of outcomes in Cochrane reviews.

PubMed

Wuytack, Francesca; Smith, Valerie; Clarke, Mike; Williamson, Paula; Gargon, Elizabeth

2015-05-19

A core outcome set (COS) can address problems of outcome heterogeneity and outcome reporting bias in trials and systematic reviews, including Cochrane reviews, helping to reduce waste. One of the aims of the international Core Outcome Measures in Effectiveness Trials (COMET) Initiative is to link the development and use of COS with the outcomes specified and reported in Cochrane reviews, including the outcomes listed in the summary of findings (SoF) tables. As part of this work, an earlier exploratory survey of the outcomes of newly published 2007 and 2011 Cochrane reviews was performed. This survey examined the use of COS, the variety of specified outcomes, and outcome reporting in Cochrane reviews by Cochrane Review Group (CRG). To examine changes over time and to explore outcomes that were repeatedly specified over time in Cochrane reviews by CRG, we conducted a follow-up survey of outcomes in 2013 Cochrane reviews. A descriptive survey of outcomes in Cochrane reviews that were first published in 2013. Outcomes specified in the methods sections and reported in the results section of the Cochrane reviews were examined by CRG. We also explored the uptake of SoF tables, the number of outcomes included in these, and the quality of the evidence for the outcomes. Across the 50 CRGs, 375 Cochrane reviews that included at least one study specified a total of 3142 outcomes. Of these outcomes, 32 % (1008) were not reported in the results section of these reviews. For 23 % (233) of these non-reported outcomes, we did not find any reason in the text of the review for this non-report. Fifty-seven percent (216/375) of reviews included a SoF table. The proportion of specified outcomes that were reported in Cochrane reviews had increased in 2013 (68 %) compared to 2007 (61 %) and 2011 (65 %). Importantly, 2013 Cochrane reviews that did not report specified outcomes were twice as likely to provide an explanation for why the outcome was not reported. There has been an increased uptake of SoF tables in Cochrane reviews. Outcomes that were repeatedly specified in Cochrane reviews by CRG in 2007, 2011, and 2013 may assist COS development.

Elbasvir/grazoprevir and sofosbuvir for hepatitis C virus genotype 3 infection with compensated cirrhosis: A randomized trial.

PubMed

Foster, Graham R; Agarwal, Kosh; Cramp, Matthew E; Moreea, Sulleman; Barclay, Stephen; Collier, Jane; Brown, Ashley S; Ryder, Stephen D; Ustianowski, Andrew; Forton, Daniel M; Fox, Ray; Gordon, Fiona; Rosenberg, William M; Mutimer, David J; Du, Jiejun; Gilbert, Christopher L; Asante-Appiah, Ernest; Wahl, Janice; Robertson, Michael N; Barr, Eliav; Haber, Barbara

2018-06-01

Many direct-acting antiviral regimens have reduced activity in people with hepatitis C virus (HCV) genotype (GT) 3 infection and cirrhosis. The C-ISLE study assessed the efficacy and safety of elbasvir/grazoprevir (EBR/GZR) plus sofosbuvir (SOF) with and without ribavirin (RBV) in compensated cirrhotic participants with GT3 infection. This was a phase 2, randomized, open-label study. Treatment-naive participants received EBR/GZR + SOF + RBV for 8 weeks or EBR/GZR + SOF for 12 weeks, and peginterferon/RBV treatment-experienced participants received EBR/GZR + SOF ± RBV for 12 weeks or EBR/GZR + SOF for 16 weeks. The primary endpoint was HCV RNA <15 IU/mL 12 weeks after the end of treatment (sustained virologic response at 12 weeks [SVR12]). Among treatment-naive participants, SVR12 was 91% (21/23) in those treated with RBV for 8 weeks and 96% (23/24) in those treated for 12 weeks. Among treatment-experienced participants, SVR12 was 94% (17/18) and 100% (17/17) in the 12-week arm, with and without RBV, respectively, and 94% (17/18) in the 16-week arm. Five participants failed to achieve SVR: 2 relapsed (both in the 8-week arm), 1 discontinued due to vomiting/cellulitis (16-week arm), and 2 discontinued (consent withdrawn/lost to follow-up). SVR12 was not affected by the presence of resistance-associated substitutions (RASs). There was no consistent change in insulin resistance, and 5 participants reported serious adverse events (pneumonia, chest pain, opiate overdose, cellulitis, decreased creatinine). High efficacy was demonstrated in participants with HCV GT3 infection and cirrhosis. Treatment beyond 12 weeks was not required, and efficacy was maintained regardless of baseline RASs. Data from this study support the use of EBR/GZR plus SOF for 12 weeks without RBV for treatment-naive and peginterferon/RBV-experienced people with GT3 infection and cirrhosis (ClinicalTrials.gov NCT02601573). (Hepatology 2018;67:2113-2126). © 2018 by the American Association for the Study of Liver Diseases.

Disruption of Human Plasma High Density Lipoproteins by Streptococcal Serum Opacity Factor Requires Labile Apolipoprotein A-I

PubMed Central

Han, Mikyung; Gillard, Baiba K.; Courtney, Harry S.; Ward, Kathryn; Rosales, Corina; Khant, Htet; Ludtke, Steven J.; Pownall, Henry J.

2010-01-01

Human plasma high density lipoproteins (HDL), the primary vehicle for reverse cholesterol transport, are the target of serum opacity factor (SOF), a virulence determinant of Streptococcus pyogenes that turns serum opaque. HDL comprise a core of neutral lipids–cholesteryl esters and some triglyceride–surrounded by a surface monolayer of cholesterol, phospholipids, and specialized proteins–apolipoproteins (apos) A-I and A-II. HDL is an unstable particle residing in a kinetic trap from which it can escape via chaotropic, detergent or thermal perturbation. Recombinant (r) SOF catalyzes the transfer of nearly all neutral lipids of ~100,000 HDL particles (D ~ 8.5 nm) into a single, large cholesteryl ester-rich microemulsion (CERM; D >100 nm) leaving a new HDL-like particle–neo HDL (D ~5.8 nm) while releasing lipid-free (LF) apo A-I. CERM formation and apo A-I release have similar kinetics suggesting parallel or rapid consecutive steps. By using complementary physico-chemical methods, we have refined the mechanistic model for HDL opacification. According to size exclusion chromatography, HDL containing non-labile apo A-I resists rSOF-mediated opacification. Based on kinetic cryo electron microscopy, rSOF (10 nM) catalyzes the conversion of HDL (4 μM) to neo HDL via a step-wise mechanism in which intermediate-size particles are seen. Kinetic turbidimetry revealed opacification as a rising exponential reaction with a rate constant k = (4.400 ± 0.004) × 10−2 min−1. Analysis of the kinetic data using transition state theory gave an enthalpy, entropy and free energy of activation of ΔH‡ = 73.9 kJ/mol, ΔS‡ = −66.87 J/°K, and ΔG‡ = 94.6 kJ/mol respectively. The free energy of activation for opacification is nearly identical to that for the displacement of apo A-I from HDL by guanidine hydrochloride. We conclude that apo A-I lability is required for HDL opacification, LF apo A-I desorption is the rate-limiting step, and nearly all HDL particles contain at least one labile copy of apo A-I. PMID:19191587

SOF as a Learning Organization

DTIC Science & Technology

2012-06-01

and are tolerant to reaction against innovation and organizational adjustments. Typically, inputs from experience are incorporated in a tardy manner...165 Countries included Colombia, the Czech Republic, Germany, Hungary, Netherlands, Norway, Philippines , Sri Lanka

[52th Commemoration of French Journal of Plastic Aesthetic Surgery (1956-2007). Fifty-four years of editorial; five Editors-in-chief].

PubMed

Cariou, J-L

2007-08-01

The french Society of Plastic Reconstructive and Aesthetic Surgery (SOF.CPRE) is born December 3th 1952. Initially without "aesthetic", this "key-word" is agreed in 1983 and the symbols are advanced since: SFCPR, SFCPRE, SOF.CPRE. Its official organ, formerly included in Annales de chirurgie (1954-1955), become Annales de chirurgie plastique in 1956, Annales de chirurgie plastique et esthétique in 1983 and finally Annales de chirurgie plastique esthétique (ACPE) in 1992. Since the origin, five Editors-in-chief succeded: Claude Dufourmentel, Raymond Vilain, Jean-Pierre Lalardrie, Claude Lê-Quang, Jean-Luc Cariou. Four of them are alive, Raymond Vilain is dead. The author relate here the natural story of these five editors who had all a triple route: personnal, surgical and editorial.

Effect of different polishing systems on the surface roughness of nano-hybrid composites

PubMed Central

Patel, Brijesh; Chhabra, Naveen; Jain, Disha

2016-01-01

Objective: The study aimed to investigate the influence of different polishing systems on the surface roughness of nano-hybrid composite resins. Background: Different shapes of polishing systems are available according to the site of work. To minimize variability, a new system with single shape is developed that can be utilized in both anterior as well as posterior teeth. Materials and Methods: Seventy composite discs were fabricated using Teflon well (10 mm × 3 mm). Two main group of nano-hybrid composite Group I — Filtek Z350 and Group II — Tetric N-Ceram were used (n = 35 for each group). Both groups were further divided into four subgroups. Subgroup a — OneGloss (n = 10), Subgroup b - PoGo (n = 10), Subgroup c — Sof-Lex spiral (n = 10), Subgroup d - Mylar strip (control, n = 5). Samples were polished according to the manufacturer's recommendations. Surface roughness test was performed using contact profilometer. The obtained data were analyzed using the one-way analysis of variance test. Result: Tetric N-Ceram produced smoother surfaces than Filtek Z350 (P < 0.05). Mylar strip and “PoGo” created equally smooth surfaces, while significantly rougher surfaces were obtained after applications of “Sof-Lex spiral” and “OneGloss” (P < 0.05). Conclusion: Polishing ability of Tetric N-Ceram is better than Filtek Z350 XT. “PoGo” seems to be a better polishing system than “OneGloss” and “Sof-Lex Spiral.” PMID:26957791

Enhancing the Cassini Mission Through FP Applications After Launch

NASA Technical Reports Server (NTRS)

Morgan, Paula S.

2016-01-01

Although rigorous pre-emptive measures are taken to preclude failures and anomalous conditions from occurring in JPL spacecraft missions prior to launch, unforeseeable problems can still surface after liftoff. In the case of the Cassini/Huygens Mission-to-Saturn spacecraft, several problems were observed post-launch: 1) immediately after takeoff, the collected engineering/science data stored on the Solid State Recorders (SSR) contained a significantly higher number of corrupted bits than was expected (considerably over spec) due to human error in the memory mapping of these devices, 2) numerous Solid State Power Switches (SSPS) sporadically tripped off throughout the mission due to cosmic ray bombardment from the unique space environment, and 3) false assumptions in the pressure regulator design in combination with missing heritage test data led to inaccurate design conclusions, causing the issuance of two waivers for the regulator to close properly (a potentially mission catastrophic single-point failure which occurred 24 days after launch) - amongst other problems. For Cassini, some of these anomalies led to arduous work-arounds or required continuous monitoring of telemetry variables by the ground-based Spacecraft Operations Flight Support (SOFS) team in order to detect and fix fault occurrences as they happened. Fortunately, sufficient funding and schedule margin allowed several Fault Protection (FP) solutions to be implemented into post-launch Flight Software (FSW) uploads to help resolve these issues autonomously, reducing SOFS ground support efforts while improving anomaly recovery time in order to preserve maximum science capture. This paper details the FP applications used to resolve the above issues as well as to optimize solutions for several other problems experienced by the Cassini spacecraft during its fight, in order to enhance the spacecraft's overall mission success throughout the 18 years of its 20 year expedition to and within the Saturnian system.

Surface Roughness and Gloss of Actual Composites as Polished With Different Polishing Systems.

PubMed

Rodrigues-Junior, S A; Chemin, P; Piaia, P P; Ferracane, J L

2015-01-01

This in vitro study evaluated the effect of polishing with different polishing systems on the surface roughness and gloss of commercial composites. One hundred disk-shaped specimens (10 mm in diameter × 2 mm thick) were made with Filtek P-90, Filtek Z350 XT, Opallis, and Grandio. The specimens were manually finished with #400 sandpaper and polished by a single operator using three multistep systems (Superfix, Diamond Pro, and Sof-lex), one two-step system (Polidores DFL), and one one-step system (Enhance), following the manufacturer's instructions. The average surface roughness (μm) was measured with a surface profilometer (TR 200 Surface Roughness Tester), and gloss was measured using a small-area glossmeter (Novo-Curve, Rhopoint Instrumentation, East Sussex, UK). Data were analyzed by two-way analysis of variance and Tukey's test (α=0.05). Statistically significant differences in surface roughness were identified by varying the polishing systems (p<0.0001) and by the interaction between polishing system and composite (p<0.0001). Pairwise comparisons revealed higher surface roughness for Grandio when polished with Sof-Lex and Filtek Z250 and Opallis when polished with Enhance. Gloss was influenced by the composites (p<0.0001), the polishing systems (p<0.0001), and the interaction between them (p<0.0001). The one-step system, Enhance, produced the lowest gloss for all composites. Surface roughness and gloss were affected by composites and polishing systems. The interaction between both also influenced these surface characteristics, meaning that a single polishing system will not behave similarly for all composites. The multistep systems produced higher gloss, while the one-step system produced the highest surface roughness and the lowest gloss of all.

Calculated rate constants of the chemical reactions involving the main byproducts SO2F, SOF2, SO2F2 of SF6 decomposition in power equipment

NASA Astrophysics Data System (ADS)

Fu, Yuwei; Rong, Mingzhe; Yang, Kang; Yang, Aijun; Wang, Xiaohua; Gao, Qingqing; Liu, Dingxin; Murphy, Anthony B.

2016-04-01

SF6 is widely used in electrical equipment as an insulating gas. In the presence of an electric arc, partial discharge (PD) or spark, SF6 dissociation products (such as SF2, SF3 and SF4) react with the unavoidable gas impurities (such as water vapor and oxygen), electrodes and surrounding solid insulation materials, forming several toxic and corrosive byproducts. The main stable decomposition products are SO2F, SO2F2 and SOF2, which have been confirmed experimentally to have a direct relationship with discharge faults, and are thus expected to be useful in the fault diagnosis of power equipment. Various studies have been performed of the main SF6 decomposition species and their concentrations under different types of faults. However, most of the experiments focused on the qualitative analysis of the relationship between the stable products and discharge faults. Although some theoretical research on the formation of main SF6 derivatives have been carried out using chemical kinetics models, the basic data (chemical reactions and their rate constants) adopted in the model are inaccurate and incomplete. The complex chemical reactions of SF6 with the impurities are ignored in most cases. The rate constants of some reactions obtained at ambient temperature or in a narrow temperature range are adopted in the models over a far greater range, for example up to 12 000 K, due to the difficulty in the experimental measurement and theoretical estimation of rate coefficients, particularly at high temperatures. Therefore, improved theoretical models require not only the consideration of additional SF6 decomposition reactions in the presence of impurities but also on improved values of rate constants. This paper is devoted to determining the rate constants of the chemical reactions relating to the main byproducts of SF6 decomposition in SF6 gas-insulated power equipment: SO2F, SOF2 and SO2F2. Quantum chemistry calculations with density functional theory, conventional transition state theory and Wigner’s tunneling effect correction are employed to estimate the rate constants of four important chemical reactions: F  +  SO2F  →  SO2F2, F2  +  SO2  →  SO2F2, SO2F  +  SF5  →  SF6  +  SO2 and SOF3  +  SF3  →  SF4  +  SOF2. The results are derived for a large temperature range, from 300 to 12 000 K, and finally fitted by a three-parameter Arrhenius equation. This work lays a basis for the further study of the SF6 decomposition mechanism by means of chemical kinetics modelling.

Materials Data on S(OF)2 (SG:92) by Materials Project

DOE Data Explorer

Kristin Persson

2014-07-09

Computed materials data using density functional theory calculations. These calculations determine the electronic structure of bulk materials by solving approximations to the Schrodinger equation. For more information, see https://materialsproject.org/docs/calculations

Sapphire: Canada's Answer to Space-Based Surveillance of Orbital Objects

NASA Astrophysics Data System (ADS)

Maskell, P.; Oram, L.

The Canadian Department of National Defence is in the process of developing the Canadian Space Surveillance System (CSSS) as the main focus of the Surveillance of Space (SofS) Project. The CSSS consists of two major elements: the Sapphire System and the Sensor System Operations Centre (SSOC). The space segment of the Sapphire System is comprised of the Sapphire Satellite - an autonomous spacecraft with an electro-optical payload which will act as a contributing sensor to the United States (US) Space Surveillance Network (SSN). It will operate in a circular, sunsynchronous orbit at an altitude of approximately 750 kilometers and image a minimum of 360 space objects daily in orbits ranging from 6,000 to 40,000 kilometers in altitude. The ground segment of the Sapphire System is composed of a Spacecraft Control Center (SCC), a Satellite Processing and Scheduling Facility (SPSF), and the Sapphire Simulator. The SPSF will be responsible for data transmission, reception, and processing while the SCC will serve to control and monitor the Sapphire Satellite. Surveillance data will be received from Sapphire through two ground stations. Following processing by the SPSF, the surveillance data will then be forwarded to the SSOC. The SSOC will function as the interface between the Sapphire System and the US Joint Space Operations Center (JSpOC). The JSpOC coordinates input from various sensors around the world, all of which are a part of the SSN. The SSOC will task the Sapphire System daily and provide surveillance data to the JSpOC for correlation with data from other SSN sensors. This will include orbital parameters required to predict future positions of objects to be tracked. The SSOC receives daily tasking instructions from the JSpOC to determine which objects the Sapphire spacecraft is required to observe. The advantage of this space-based sensor over ground-based telescopes is that weather and time of day are not factors affecting observation. Thus, space-based optical surveillance does not suffer outage periods of surveillance as is the case with ground-based optical sensors. This allows a space-based sensor to obtain more data and to collect it from a more flexible vantage point. The Sapphire launch is planned for July 2011. The Sapphire spacecraft is designed to operate for a minimum of five years. It will contribute considerably to establishing a significant space capability for Canada. This and other current Canadian space initiatives, will have wide-ranging benefits in the area of National Defence.

Management of moderate and severe corneal astigmatism with AcrySof® toric intraocular lens implantation - Our experience.

PubMed

Farooqui, Javed Hussain; Koul, Archana; Dutta, Ranjan; Shroff, Noshir Minoo

2015-01-01

Visual performance following toric intraocular lens implantation for cataract with moderate and severe astigmatism. Cataract services, Shroff Eye Centre, New Delhi, India. Case series. This prospective study included 64 eyes of 40 patients with more than 1.50 dioptre (D) of pre-existing corneal astigmatism undergoing phacoemulsification with implantation of the AcrySof® toric IntraOcular Lens (IOL). The unaided visual acuity (UCVA), best corrected visual acuity (BCVA), residual refractive sphere and refractive cylinders were evaluated. Toric IOL axis and alignment error was measured by slit lamp method and Adobe Photoshop (version 7) method. Patient satisfaction was evaluated using a satisfaction questionnaire at 3 months. The mean residual refractive astigmatism was 0.57 D at the final follow-up of 3 months. Mean alignment error was 3.44 degrees (SD = 2.60) by slit lamp method and 3.88 degrees (SD = 2.86) by Photoshop method. Forty-six (71.9%) eyes showed misalignment of 5 degrees or less, and 60 (93.8%) eyes showed misalignment of 10 degrees or less. The mean log MAR UCVA at 1st post-op day was 0.172 (SD = 0.02), on 7th post-op day was 0.138 (SD = 0.11), and on 30th post-op day was 0.081 (SD = 0.11). The mean log MAR BCVA at three months was -0.04 (SD = 0.76). We believe that implantation of AcrySof® toric IOL is an effective, safe and predictable method to correct high amounts of corneal astigmatism during cataract surgery.

In vitro optical quality of monofocal aspheric toric intraocular lenses: effect of cylindrical power.

PubMed

Ferrer-Blasco, Teresa; Domínguez-Vicent, Alberto; García-Lázaro, Santiago; Diez, María Amparo; Alfonso, José F; Esteve-Taboada, José J

2018-06-01

To assess the in vitro optical quality of monofocal aspheric toric intraocular lenses (IOLs) as a function of the cylindrical power. The in vitro optical quality of the AcrySof IQ Toric IOLs SN6AT2, SN6AT3, SN6AT4, SN6AT5 and SN6AT6 (Alcon Laboratories Inc., Forth Worth, TX, USA) was assessed with an instrument conceived for measuring Zernike's coefficients at 3.0- and 5.0-mm apertures. As a reference, the aspheric monofocal lens AcrySof IQ Aspheric SN60WF (Alcon Laboratories Inc., Forth Worth, TX, USA) was also measured. The area of visibility and cut-off frequency were used to describe the modulation transfer function (MTF) of each lens; meanwhile, the light in the bucket and the diameter of a circular area centred on the point-spread function (PSF) peak that captures 50% of the light energy were used to describe the PSF of each lens. Finally, an image simulation was computed from the Zernike values with reference purposes. Small differences were found on the metrics used for describing the MTF and PSF of the lenses at both tested apertures, but these were not statistically significant (p > 0.05). Furthermore, the image simulation showed that these differences would not have clinical relevance at all. The optical performance of the AcrySof IQ toric IOLs in terms of MTF and PSF is good and seems to be independent of the cylindrical power and similar to a non-toric aspheric lens.

Effects of glaucoma medications and preservatives on cultured human trabecular meshwork and non-pigmented ciliary epithelial cell lines.

PubMed

Ammar, David A; Kahook, Malik Y

2011-10-01

We investigated the potential cytotoxicity of various topical ophthalmic glaucoma formulations containing different preservatives in cultured human trabecular meshwork (TM) and non-pigmented ciliary epithelial (NPCE) cell lines. We tested 0.004% travoprost preserved with either 0.015% benzalkonium chloride (BAK), sofZia or 0.001% Polyquad (PQ); and 0.005% latanoprost preserved with 0.020% BAK. We also tested a range of BAK concentrations in balanced salt solution (BSS). TM cells were treated for 10 min at 37°C with solutions diluted 1:10 to mimic the reduced penetration of topical preparations to the anterior chamber. Viability was determined by the uptake of the fluorescent vital dye calcein-AM (n = 6). BAK solutions (diluted 1:10) demonstrated a dose-dependent reduction in cell viability in both cell types (TM and NPCE). With a 1:10 dilution of 0.020% BAK, there were significantly more living NPCE cells (89 ± 6%) than TM cells (57 ± 6%; p < 0.001). In TM cells, travoprost + BAK had statistically fewer live cells (83 ± 5%) than both travoprost + sofZia (97 ± 5%) and travoprost + PQ (97 ± 6%; p < 0.05). Compared with BSS-treated NPCE cells, travoprost had statistically fewer live cells (p < 0.05) when preserved with BAK (85 ± 16%), sofZia (91 ± 6%) or PQ (94 ± 2%). These results demonstrate that substitution of BAK from topical ophthalmic drugs results in greater viability of cultured TM cells, the cells involved in the conventional outflow pathway. Cultured NPCE, responsible for aqueous inflow, appear more resilient to BAK.

GIS-Based Sub-Basin Scale Identification of Dominant Runoff Processes for Soil and Water Management in Anambra Area of Nigeria

NASA Astrophysics Data System (ADS)

Fagbohun, Babatunde Joseph; Olabode, Oluwaseun Franklin; Adebola, Abiodun Olufemi; Akinluyi, Francis Omowonuola

2017-12-01

Identifying landscapes having comparable hydrological characteristics is valuable for the determination of dominant runoff process (DRP) and prediction of flood. Several approaches used for DRP-mapping vary in relation to data and time requirement. Manual approaches which are based on field investigation and expert knowledge are time demanding and difficult to implement at regional scale. Automatic GIS-based approach on the other hand require simplification of data but is easier to implement and it is applicable on a regional scale. In this study, GIS-based automated approach was used to identify the DRPs in Anambra area. The result showed that Hortonian overland flow (HOF) has the highest coverage of 1508.3 km2 (33.5%) followed by deep percolation (DP) with coverage of 1455.3 km2 (32.3%). Subsurface flow (SSF) is the third dominant runoff process covering 920.6 km2 (20.4%) while saturated overland flow (SOF) covers the least area of 618.4 km2 (13.7%) of the study area. The result reveal that considerable amount of precipitated water would be infiltrated into the subsurface through deep percolation process contributing to groundwater recharge in the study area. However, it is envisaged that HOF and SOF will continue to increase due to the continuous expansion of built-up area. With the expected increase in HOF and SOF, and the change in rainfall pattern associated with perpetual problem of climate change, it is paramount that groundwater conservation practices should be considered to ensure continued sustainable utilization of groundwater in the study area.

Synthesis of Graphene-Based Sensors and Application on Detecting SF6 Decomposing Products: A Review

PubMed Central

Zhang, Xiaoxing; Cui, Hao; Gui, Yingang

2017-01-01

Graphene-based materials have aroused enormous focus on a wide range of engineering fields because of their unique structure. One of the most promising applications is gas adsorption and sensing. In electrical engineering, graphene-based sensors are also employed as detecting devices to estimate the operation status of gas insulated switchgear (GIS). This paper reviews the main synthesis methods of graphene, gas adsorption, and sensing mechanism of its based sensors, as well as their applications in detecting SF6 decomposing products, such as SO2, H2S, SO2F2, and SOF2, in GIS. Both theoretical and experimental researches on gas response of graphene-based sensors to these typical gases are summarized. Finally, the future research trend about graphene synthesis technique and relevant perspective are also given. PMID:28208836

Examining the clinical course of genotype 1 chronic hepatitis C patients treated with the cosmos regimen: including patients with advanced liver disease and East Asian ancestry

PubMed Central

Roytman, Marina; Ramkissoon, Resham; Wu, Christina; Hong, Leena; Trujillo, Ruby; Huddleston, Leslie; Poerzgen, Peter; Seto, Todd; Wong, Linda; Tsai, Naoky

2017-01-01

Background/objectives The COSMOS study was a phase 2a clinical trial that showed high cure rates of genotype 1 chronic hepatitis C (CHC) and a favorable side effect profile using a 12-week regimen of simeprevir + sofosbuvir (SIM + SOF). Given the small number of patients treated with the SIM + SOF regimen in the COSMOS trial, there is uncertainty regarding the efficacy and safety of this combination therapy. We now report our experience with the COSMOS regimen in the multiethnic population of Hawaii, including patients of East Asian ancestry and with decompensated cirrhosis. Methods This study is a retrospective review of 138 patients treated with a fixed dose regimen of SIM 150 mg and SOF 400 mg daily at a single referral center. We collected data on demographics, side effects, laboratory studies and sustained virological response (SVR). Statistical analysis was performed with Stata v8.2 software. Results Baseline characteristics of the 138 patients initiated with SIM + SOF therapy were: 68.8 % cirrhotic (22.1 % of those Child-Pugh Class B), 37 % Asian, 11.6 % Pacific Islander, 63 % male, mean age 61.3 ± 7.8 years, mean BMI 27.8 ± 6.1 kg/m2, 26.8 % diabetic, 63.8 % genotype 1a, 44.9 % previously treatment experienced. A total of 100 % of patients that completed therapy (n = 137) had undetectable viral loads at end of treatment (EOT). Twelve patients relapsed post-treatment resulting in an overall 12 week SVR (SVR12) rate of 89.1 %. 95 % of decompensated cirrhotic patients achieved SVR12, compared to 85.3 % of compensated cirrhotic patients and 93 % of non-cirrhotic patients. 92 % of Asian patients achieved SVR12 compared to 87.5 % in non-Asian patients. There were no statistically significant differences in SVR12 between treatment naive and treatment experienced patients (86.8 vs 91.9 %). 87.5 % of post-transplant patients achieved SVR12. The main side effects were headache 16.2 %, fatigue 24.2 %, pruritis 14.1 %; none were >grade 2 in severity. There were no differences in side effect profiles of patients with decompensated cirrhosis. Pruritis only was statistically significant between Asians and non-Asians (22 vs 5.7 %). Trends toward improvement in platelet counts and total bilirubin were noted at 12-weeks post treatment, while improvement in albumin in cirrhotic patients reached statistical significance (3.77–4.01 mg/dL, p = 0.0108). Conclusions The 12-week fixed dose course of SIM + SOF was well tolerated in a multiethnic population of primarily cirrhotic patients, including those with decompensated disease. This real world trial achieved SVR12 rates comparable to the COSMOS data. Higher incidence of adverse side effects was not observed with an exception of higher rate of pruritis in Asians. The increase in albumin in cirrhotic patients was statistically significant and suggested early improvement in synthetic function following viral eradication. Higher BMI (≥30 kg/m2) was the only factor that correlated with post-treatment relapse by multivariate analysis. PMID:27026431

Strontium Removal: Full-Scale Ohio Demonstrations

EPA Science Inventory

The objectives of this presentation are to present a brief overview of past bench-scale research to evaluate the impact lime softening on strontium removal from drinking water and present full-scale drinking water treatment studies to impact of lime softening and ion exchange sof...

Biochar Improves Performance of Plants for Mine Soil Revegetation

EPA Science Inventory

Biochar (the solid by-product of pyrolysis of biomass), has the potential to improve plant performance for revegetation of mine soils by improving soil chemistry, fertility, moisture holding capacity and by binding heavy metals. We investigated the effect of gasified conifer sof...

Sofosbuvir-based treatment regimens: real life results of 14 409 chronic HCV genotype 4 patients in Egypt.

PubMed

Elsharkawy, A; Fouad, R; El Akel, W; El Raziky, M; Hassany, M; Shiha, G; Said, M; Motawea, I; El Demerdash, T; Seif, S; Gaballah, A; El Shazly, Y; Makhlouf, M A M; Waked, I; Abdelaziz, A O; Yosry, A; El Serafy, M; Thursz, M; Doss, W; Esmat, G

2017-03-01

Chronic hepatitis C virus infection is one of the most important health problems in Egypt. The Ministry of Health's National Treatment Programme introduced sofosbuvir-based therapy in October 2014. To assess the clinical effectiveness and predictors of response to SOF-based treatment regimens, either dual therapy, with SOF/ribavirin (RBV) for 6 months or triple therapy with SOF/peg-IFN-alfa-2a/RBV for 3 months, in a cohort of patients treated in National Treatment Programme affiliated centres in Egypt. Between October 2014 and end of 2014, patients who were eligible for treatment were classified according to their eligibility for interferon therapy: Group 1 (interferon eligible) were treated with triple therapy for 12 weeks and Group 2 (interferon ineligible) were treated with dual therapy for 24 weeks. Difficult to treat patients included those with F3-F4 on Metavir score, Fib-4 >3.25, albumin ≤3.5, total Bilirubin >1.2 mg/dL, INR >1.2 and platelet count <150 000 mm 3 . Twelve weeks post-treatment data were available on 14 409 patients; 8742 in group 1 and 5667 in group 2. In group 1, the sustained virological response at week 12 (SVR12) was 94% and in group 2 the SVR12 was 78.7%. Multivariate logistic regression analysis in which treatment failure is the dependent variable was done. Male gender, being a difficult to treat patient and previous interferon therapy were significant predictors of nonresponse in both treatment groups. Results of sofosbuvir-based therapies in Egypt achieved similar rates of SVR12 as seen in phase III efficacy studies. © 2017 John Wiley & Sons Ltd.

Retreatment with sofosbuvir/velpatasvir in cirrhotic patients with genotype 4 who failed a previous interferon-free regimen: a case series.

PubMed

Boglione, Lucio; Pinna, Simone Mornese; Lupia, Tommaso; Cariti, Giuseppe; Di Perri, Giovanni

2018-02-14

The novel available interferon (IFN)-free regimens significantly improved the sustained virological response (SVR) in patients with chronic hepatitis C (CHC), without important side-effects and with shorter duration of treatment. In a subset of patients, however, the treatment failure (TF) was due to the presence of resistance-associated substitutions (RAS) that lead to virological breakthrough (BT) or relapse. We analyzed in this case-series the role of RAS on the TF in cirrhotic patients with GT4, treated with a previous IFN-free regimen, and retreated with the combination of sofosbuvir (SOF)/velpatasvir (VEL) for 12 or 24 weeks, without ribavirin (RBV). We included in this analysis all patients with GT4 who failed a previous IFN-free treatment, with the presence of RAS at BT or relapse. All patients were retreated with a fixed combination of SOF/VEL for 12/24 weeks, without RBV. We evaluated the SVR and the MELD score change after the treatment. Seven patients were described. All were cirrhotic, Child-Pug A (n=5), B (n=2); baseline RAS were detected in 4/7 subjects; at post-treatment detection, NS5 RAS were: F28S (n=1), Q30K (n=2), S30G (n=1), NS3 were: S122R (n=1), S122G (n=2), D168V (n=3). All retreated patients gained the SVR. MELD score improved in all subjects with a median change of 3 points. No significant side-effects or adverse events were reported. The combination SOF/VEL could be considered for the retreatment of cirrhotic GT4 patients who failed a previous IFN-free treatment with the presence of RAS in NS3 or NS5 regions.

Management of moderate and severe corneal astigmatism with AcrySof® toric intraocular lens implantation – Our experience

PubMed Central

Farooqui, Javed Hussain; Koul, Archana; Dutta, Ranjan; Shroff, Noshir Minoo

2015-01-01

Purpose Visual performance following toric intraocular lens implantation for cataract with moderate and severe astigmatism. Setting Cataract services, Shroff Eye Centre, New Delhi, India. Design Case series. Method This prospective study included 64 eyes of 40 patients with more than 1.50 dioptre (D) of pre-existing corneal astigmatism undergoing phacoemulsification with implantation of the AcrySof® toric IntraOcular Lens (IOL). The unaided visual acuity (UCVA), best corrected visual acuity (BCVA), residual refractive sphere and refractive cylinders were evaluated. Toric IOL axis and alignment error was measured by slit lamp method and Adobe Photoshop (version 7) method. Patient satisfaction was evaluated using a satisfaction questionnaire at 3 months. Results The mean residual refractive astigmatism was 0.57 D at the final follow-up of 3 months. Mean alignment error was 3.44 degrees (SD = 2.60) by slit lamp method and 3.88 degrees (SD = 2.86) by Photoshop method. Forty-six (71.9%) eyes showed misalignment of 5 degrees or less, and 60 (93.8%) eyes showed misalignment of 10 degrees or less. The mean log MAR UCVA at 1st post-op day was 0.172 (SD = 0.02), on 7th post-op day was 0.138 (SD = 0.11), and on 30th post-op day was 0.081 (SD = 0.11). The mean log MAR BCVA at three months was −0.04 (SD = 0.76). Conclusion We believe that implantation of AcrySof® toric IOL is an effective, safe and predictable method to correct high amounts of corneal astigmatism during cataract surgery. PMID:26586976

Retreatment with sofosbuvir/velpatasvir in cirrhotic patients with genotype-4 who failed a previous interferon-free regimen: a case series.

PubMed

Boglione, Lucio; Pinna, Simone Mornese; Lupia, Tommaso; Cariti, Giuseppe; Di Perri, Giovanni

2018-02-14

The novel available interferon (IFN)-free regimens significantly improved the sustained virological response (SVR) in patients with chronic hepatitis C (CHC), without important side effects and with shorter duration of treatment. In a subset of patients, however, the treatment failure (TF) was due to the presence of resistance-associated substitutions (RAS) that lead to virological breakthrough (BT) or relapse. We analysed in this case series the role of RAS on the TF in cirrhotic patients with genotype (GT)4, treated with a previous IFN-free regimen, and retreated with the combination of sofosbuvir (SOF)/velpatasvir (VEL) for 12 or 24 weeks, without ribavirin (RBV). We included in this analysis all patients with GT4 who failed a previous IFN-free treatment, with the presence of RAS at BT or relapse. All patients were retreated with a fixed combination of SOF/VEL for 12/24 weeks, without RBV. We evaluated the SVR and the MELD score change after the treatment. Seven patients were described. All were cirrhotic, Child-Pugh A (n=5), B (n=2); baseline RAS were detected in 4/7 subjects; at post-treatment detection, NS5 RAS were: F28S (n=1), Q30K (n=2), S30G (n=1), NS3 were: S122R (n=1), S122G (n=2), D168V (n=3). All retreated patients gained SVR. MELD score improved in all subjects with a median change of 3 points. No significant side effects or adverse events were reported. The combination SOF/VEL could be considered for the retreatment of cirrhotic GT4 patients who failed a previous IFN-free treatment with the presence of RAS in NS3 or NS5 regions.

Randomised clinical trial: sofosbuvir and ledipasvir in patients with transfusion-dependent thalassaemia and HCV genotype 1 or 4 infection.

PubMed

Mangia, A; Sarli, R; Gamberini, R; Piga, A; Cenderello, G; Piazzolla, V; Santoro, R; Caruso, V; Quarta, A; Ganga, R; Copetti, M; Forni, G

2017-08-01

Patients with thalassaemia major depend on blood transfusions. In Italy, up to 80% of thalassaemia patients bear HCV antibodies due to HCV contaminated transfusions before 1990. Thalassaemia patients with HCV infection have high risk of developing HCC. Treatment based on Pegylated-IFN (Peg-IFN) and Ribavirin (RBV) was limited by relevant side effects. To evaluate the impact of Sofosbuvir/Ledipasvir (SOF/LDV) fixed dose combination for 12 weeks without RBV, in patients with thalassaemia major and HCV Genotype 1 or 4 (GT1/4). Open label, historically-controlled, nationwide multicentre study in thalassaemia patients including naïve with cirrhosis and prior treatment failure without cirrhosis. SOF/LDV single pill was administered for 12 weeks to 100 patients of whom 16% had cirrhosis. The control group included 96 patients with comparable baseline characteristics treated with Peg-IFN/RBV. The primary end point was sustained virologic response at follow-up week 12 or 24 after IFN-free or Peg-IFN/RBV, respectively. In the study group, sustained virological response (SVR) was reported in 98% of patients (95% CI 95.3%-100%). Cirrhotic as well as prior treatment failure achieved 100% SVR. In the control group, SVR was 47.9% (95% CI 37.9%-57.9%). Adverse events including fatigue, headache, nausea, decrease in haemoglobin or increase in ferritin levels were rare and significantly less common in the study than in the historical control group. In conclusion, SOF/LDV for 12 weeks provides simple, highly effective and safe Peg-IFN/RBV-free treatment for HCV GT1/4 thalassaemia patients. EUDRACT number 2015-002401-1. © 2017 John Wiley & Sons Ltd.

Comparison of the Abbott RealTime HCV and Roche COBAS Ampliprep/COBAS TaqMan HCV assays for the monitoring of sofosbuvir-based therapy.

PubMed

Ogawa, Eiichi; Furusyo, Norihiro; Murata, Masayuki; Shimizu, Motohiro; Toyoda, Kazuhiro; Hotta, Taeko; Uchiumi, Takeshi; Hayashi, Jun

2017-01-01

On-treatment HCV kinetics play an invaluable role in evaluating the efficacy of interferon-based therapies. However, the importance of HCV RNA monitoring has not been well discussed concerning treatment with sofosbuvir (SOF)-based regimens, especially for the utility of the Abbott RealTime HCV (ART) assay. This study consisted of 151 patients infected with HCV genotype-1 or -2, including patients with prior treatment-experience or cirrhosis. HCV genotype-1 patients were treated with SOF/ledipasvir and genotype-2 patients with SOF/ribavirin, both for 12 weeks. Serial measurements of HCV RNA were performed with both the ART and COBAS AmpliPrep/COBAS TaqMan v2.0 (CAP/CTM) assays simultaneously at weeks 0, 1, 2, 4, 6, 8, 10 and 12 of treatment. The rates of HCV RNA target not detected (TND) by ART were significantly lower than those by CAP/CTM between weeks 2 and 12 (end of treatment [EOT]), irrespective of prior treatment-experience or cirrhosis. 11 (11.6%) genotype-1 and 8 (14.3%) genotype-2 patients did not achieve HCV RNA TND by ART at EOT, in contrast to all having HCV RNA TND by CAP/CTM; however, all achieved sustained virological response. The time at which HCV RNA became TND or unquantifiable was not associated with treatment outcome by either the ART or CAP/CTM assay. Over 10% of the patients continued to have detectable HCV RNA by ART at EOT, irrespective of HCV genotype, prior treatment-experience and/or cirrhosis. However, prolonged residual HCV RNA was not associated with treatment failure.

The Optimal Timing of Hepatitis C Therapy in Transplant Eligible Patients With Child B and C Cirrhosis: A Cost-Effectiveness Analysis.

PubMed

Tapper, Elliot B; Hughes, Michael S; Buti, Maria; Dufour, Jean-Francois; Flamm, Steve; Firdoos, Saima; Curry, Michael P; Afdhal, Nezam H

2017-05-01

Ledipasvir (LDV)/sofosbuvir (SOF) has demonstrated high efficacy, safety, and tolerability in hepatitis C virus (HCV)-infected patients. There is limited data, however, regarding the optimal timing of therapy in the context of possible liver transplantation (LT). We compared the cost-effectiveness of 12 weeks of HCV therapy before or after LT or nontreatment using a decision analytical microsimulation state-transition model for a simulated cohort of 10 000 patients with HCV Genotype 1 or 4 with Child B or C cirrhosis. All model parameters regarding the efficacy of therapy, adverse events and the effect of therapy on changes in model for end-stage liver disease (MELD) scores were derived from the SOLAR-1 and 2 trials. The simulations were repeated with 10 000 samples from the parameter distributions. The primary outcome was cost (2014 US dollars) per quality adjusted life year. Treatment before LT yielded more quality-adjusted life year for less money than treatment after LT or nontreatment. Treatment before LT was cost-effective in 100% of samples at a willingness-to-pay threshold of US $100 000 in the base-case and when the analysis was restricted to Child B alone, Child C, or MELD > 15. Treatment before transplant was not cost-effective when MELD was 6-10. In sensitivity analyses, the MELD after which treatment before transplant was cost-effective was 13 and the maximum cost of LDV/SOF therapy at which treatment before LT is cost-effective is US $177 381. From a societal perspective, HCV therapy using LDV/SOF with ribavirin before LT is the most cost-effective strategy for patients with decompensated cirrhosis and MELD score greater than 13.

Treatment of Patients With Hepatitis C Virus Infection With Ledipasvir-Sofosbuvir in the Liver Transplant Setting.

PubMed

Abaalkhail, Faisal; Elsiesy, Hussein; Elbeshbeshy, Hany; Shawkat, Mohamed; Yousif, Sarra; Ullah, Waheed; Alabbad, Saleh; Al-Jedai, Ahmed; Ajlan, Aziza; Broering, Dieter; Saab, Sammy; Al Sebayel, Mohammed; Al-Hamoudi, Waleed

2017-11-01

Hepatitis C virus (HCV) infection is a major cause of liver cirrhosis and hepatocellular carcinoma and the leading indication for liver transplantation. In the Middle East, genotype 4 HCV infection is the most common genotype. However, limited data exists on the treatment of genotype-4 in the liver transplant setting. We evaluated the safety and efficacy of ledipasvir (LDV)-sofosbuvir (SOF) in treating HCV genotype-4 infected patients with cirrhosis or postliver transplantation. This prospective, single-arm, observational study includes cohort of patients with cirrhosis before liver transplantation (cohort A) and a cohort of postliver transplantation patients (cohort B). Patients received LDV/SOF (90-400 mg) once daily for 12 to 24 weeks with or without ribavirin (RBV). Patients with creatinine clearance below 30 were excluded. A total of 111 patients (61 cirrhotic; 50 postliver transplants) with HCV genotype 4 were treated in King Faisal Specialist Hospital and Research Center; 55% cohort A and 44% cohort B received RBV. Sustained virological response sustain virological response (SVR)12 was 91.8% and 86% of cohorts A and B, respectively. There were no treatment-related mortality or serious adverse effects. RBV dose reduction occurred in 25% without any treatment discontinuation. SVR12 rates in cohort A were significantly higher in patients with a viral load below 800 000 (100% vs 83.9%, P value = 0.022). Viral load did not impact SVR rates in cohort B. The use of RBV did not increase SVR12 and was associated with anemia. LDV/SOF without RBV is an effective and safe treatment option for patients with HCV genotype 4 infection in preliver and postliver transplant settings.

Steady-State Diffusion of Water through Soft-Contact LensMaterials

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

Fornasiero, Francesco; Krull, Florian; Radke, Clayton J.

2005-01-31

Water transport through soft contact lenses (SCL) is important for acceptable performance on the human eye. Chemical-potential gradient-driven diffusion rates of water through soft-contact-lens materials are measured with an evaporation-cell technique. Water is evaporated from the bottom surface of a lens membrane by impinging air at controlled flow rate and humidity. The resulting weight loss of a water reservoir covering the top surface of the contact-lens material is recorded as a function of time. New results are reported for a conventional hydrogel material (SofLens{trademark} One Day, hilafilcon A, water content at saturation W{sub 10} = 70 weight %) and amore » silicone hydrogel material (PureVision{trademark}, balafilcon A, W{sub 10} = 36 %), with and without surface oxygen plasma treatment. Also, previously reported data for a conventional HEMA-SCL (W{sub 10} = 38 %) hydrogel are reexamined and compared with those for SofLens{trademark} One Day and PureVision{trademark} hydrogels. Measured steady-state water fluxes are largest for SofLens{trademark} One Day, followed by PureVision{trademark} and HEMA. In some cases, the measured steady-state water fluxes increase with rising relative air humidity. This increase, due to an apparent mass-transfer resistance at the surface (trapping skinning), is associated with formation of a glassy skin at the air/membrane interface when the relative humidity is below 55-75%. Steady-state water-fluxes are interpreted through an extended Maxwell-Stefan diffusion model for a mixture of species starkly different in size. Thermodynamic nonideality is considered through Flory-Rehner polymer-solution theory. Shrinking/swelling is self-consistently modeled by conservation of the total polymer mass. Fitted Maxwell-Stefan diffusivities increase significantly with water concentration in the contact lens.« less

Evaluation of surface roughness of enamel after various bonding and clean-up procedures on enamel bonded with three different bonding agents: An in-vitro study

PubMed Central

Goel, Amit; Singh, Atul; Gupta, Tarun

2017-01-01

Background The purpose of this study was to analyze and compare the enamel surface roughness before bonding and after debonding, to find correlation between the adhesive remnant index and its effect on enamel surface roughness and to evaluate which clean-up method is most efficient to provide a smoother enamel surface. Material and Methods 135 premolars were divided into 3 groups containing 45 premolars in each group. Group I was bonded by using moisture insensitive primer, Group II by using conventional orthodontic adhesive and Group III by using self-etching primer. Each group was divided into 3 sub-groups on the basis of type of clean-up method applied i,e scaling followed by polishing, tungsten carbide bur and Sof-Lex disc. Enamel surface roughness was measured and compared before bonding and after clean-up. Results Evaluation of pre bonding and post clean-up enamel surface roughness (Ra value) with the t test showed that Post clean-up Ra values were greater than Pre bonding Ra values in all the groups except in teeth bonded with self-etching primer cleaned with Sof-Lex disc. Reliability of ARI score taken at different time interval tested with Kruskal Wallis test suggested that all the readings were reliable. Conclusions No clean-up procedure was able to restore the enamel to its original smoothness. Self-etching primer and Sof-Lex disc clean-up method combination restored the enamel surface roughness (Ra value) closest to its pre-treatment value. Key words:Enamel surface roughness, clean-up method, adhesive remnant index. PMID:28512535

Incidence of Acute Kidney Injury in Patients Coinfected with HIV and Hepatitis C Virus Receiving Tenofovir Disoproxil Fumarate and Ledipasvir/Sofosbuvir in a Real-World, Urban, Ryan White Clinic.

PubMed

Michal, Jessica L; Rab, Saira; Patel, Manish; Kyle, Alison W; Miller, Lesley S; Easley, Kirk A; Kalapila, Aley G

2018-06-19

Ledipasvir/sofosbuvir (LDV/SOF), an antiviral treatment for hepatitis C virus (HCV), and tenofovir disoproxil fumarate (TDF), an antiretroviral for treating human immunodeficiency virus (HIV), may be coadministered in patients coinfected with these viruses. A drug interaction between LDV and TDF could increase TDF-associated nephrotoxicity rates; however, there is minimal clinical evidence describing acute kidney injury (AKI) rates in this population. This study was conducted at a Ryan White-funded facility in Atlanta, Georgia, that cares for over 5,000 patients with AIDS. This retrospective cohort used chart review to assess occurrence of and risk factors for AKI in HIV/HCV-coinfected patients receiving LDV/SOF and antiretroviral therapy (ART). AKI rates were compared between TDF-containing and non-TDF-containing ART groups according to Kidney Disease Improving Global Outcomes (KDIGO) criteria. Additional evaluated risk factors for AKI included chronic kidney disease and use of boosted protease inhibitor-based ART. In the 117 included patients, the overall incidence of AKI was 27.3%. AKI occurred more frequently in the non-TDF group (13/86, 15.1% vs. 19/31, 61.3%, p < .001). All AKI was KDIGO stage 1. From multivariable logistic regression, the only independent predictor of AKI was treatment with non-TDF relative to TDF (adjusted odds ratio 6.51, 95% confidence interval 2.34-18.10, p < .001). In this real-world cohort of HIV/HCV-coinfected patients, KDIGO-defined AKI was common, but occurred less frequently in patients receiving TDF-based ART. Our study suggests that patients with normal baseline renal function can be safely treated with TDF and LDV/SOF without significant nephrotoxicity if renal function is closely monitored.

Two-thirds of foods consumed on myplate contain SoFAS

USDA-ARS?s Scientific Manuscript database

Background: Public health efforts focus upon improving diet quality to prevent chronic disease. MyPlate, which represents the 2010 Dietary Guidelines for Americans, encourages limiting the consumption of solid fats (SoF) and added sugars (AS). We examined nationally representative consumption data t...

Out of the Blue: NATO SOF Air Wing

DTIC Science & Technology

2012-03-01

surveillance, targeting, and reconnaissance aircraft . This research also examines NSHQ’s training and readiness organizational structure, and proposes...mix contains rotary-wing and fixed-wing aviation platforms, as well as intelligence, surveillance, targeting, and reconnaissance aircraft . This...METHODOLOGY ..........................................................................................9  II.  AIRCRAFT CATEGORIZATION

Detecting decompositions of sulfur hexafluoride using reduced graphene oxide decorated with Pt nanoparticles

NASA Astrophysics Data System (ADS)

Chen, Dachang; Tang, Ju; Zhang, Xiaoxing; Fang, Jiani; Li, Yi; Zhuo, Ran

2018-05-01

The resistance-typed gas sensing material of Pt nanoparticles (PtNPs) decorated reduced graphene oxide (RGO) synthesized by one-step chemical reduction for the detection of four types of SF6 decompositions was explored. The PtNPs disperse uniformly on RGO with particle size near 2–4 nm and a small number of particles are larger than 10 nm. Gas sensing tests suggest that the introduction of PtNPs increases the response to SO2, SOF2 and H2S compared to pure RGO and PtNPs-RGO experiences resistance reducing in SO2 and SOF2 while presenting the opposite case in H2S. Elevating the temperature enhances the recovery properties to SO2 and H2S but lowers the sensitivity. The sensing mechanism for Pt-RGO in low oxygen and water environment depends mainly on the charge transfer between gas and adsorbent and the solvent on material surface. The work provides experimental investigation of Pt-RGO to detect SF6 decompositions.

Polishing and toothbrushing alters the surface roughness and gloss of composite resins.

PubMed

Kamonkhantikul, Krid; Arksornnukit, Mansuang; Takahashi, Hidekazu; Kanehira, Masafumi; Finger, Werner J

2014-01-01

This study aimed to investigate the surface roughness and gloss of composite resins after using two polishing systems and toothbrushing. Six composite resins (Durafill VS, Filtek Z250, Filtek Z350 XT, Kalore, Venus Diamond, and Venus Pearl) were evaluated after polishing with two polishing systems (Sof-Lex, Venus Supra) and after toothbrushing up to 40,000 cycles. Surface roughness (Ra) and gloss were determined for each composite resin group (n=6) after silicon carbide paper grinding, polishing, and toothbrushing. Two-way ANOVA indicated significant differences in both Ra and gloss between measuring stages for the composite resins tested, except Venus Pearl, which showed significant differences only in gloss. After polishing, the Filtek Z350 XT, Kalore, and Venus Diamond showed significant increases in Ra, while all composite resin groups except the Filtek Z350 XT and Durafill VS with Sof-Lex showed increases in gloss. After toothbrushing, all composite resin demonstrated increases in Ra and decreases in gloss.

Intensive skills week for military medical students increases technical proficiency, confidence, and skills to minimize negative stress.

PubMed

Mueller, Genevieve; Hunt, Bonnie; Wall, Van; Rush, Robert; Molof, Alan; Schoeff, Jonathan; Wedmore, Ian; Schmid, James; Laporta, Anthony

2012-01-01

The effects of stress induced cortisol on learning and memory is well documented in the literature.1-3 Memory and learning are enhanced at low levels while high levels are detrimental. Repetitive training in stressful situations enables management of the stress response4 as demonstrated by the high intensity training military members undergo to prepare for tactical situations. Appropriate management of one?s stress response is critical in the medical field, as the negative effects of stress can potentially hinder life-saving procedures and treatments. This also applies to physicians-in-training as they learn and practice triage, emergency medicine, and surgical skills prior to graduation. Rocky Vista University?s Military Medicine Honor?s Track (MMHT) held a week long high-intensity emergency medicine and surgical Intensive Skills Week (ISW), facilitated by military and university physicians, to advance students? skills and maximize training using the Human Worn Partial Surgical Task Simulator (Cut Suit). The short-term goal of the ISW was to overcome negative stress responses to increase confidence, technical and non-technical knowledge, and skill in surgery and emergency medicine in an effort to improve performance as third-year medical students. The long-term goal was to enhance performance and proficiency in residency and future medical practice. The metrics for the short-term goals were the focus of this pilot study. Results show an increase in confidence and decrease in perceived stress as well as statistically significant improvements in technical and non-technical skills and surgical instrumentation knowledge throughout the week. There is a correlative benefit to physician and non-physician military personnel, especially Special Operations Forces (SOF) medical personnel, from developing and implementing similar training programs when live tissue or cadaver models are unavailable or unfeasible. 2012.

Registration of "MSU E5024" wheat

USDA-ARS?s Scientific Manuscript database

'MSU E5024' (Reg. No. CV-1077, PI 664078) soft white winter wheat (Triticum aestivum L.) was developed by Michigan State University (MSU) AgBioResearch and released in 2011 via exclusive licensing agreements through MSU Technologies. In addition to researchers at MSU, USDA-ARS researchers at the Sof...

Collective Defense of the Baltic States: A SOF Beginning

DTIC Science & Technology

2012-03-20

in Baltic’s Region Russian Military Reform . Since the Soviet Union collapsed in 1989, Russia has attempted to re-organize its ineffective post...RIANOVOSTI Online, February 09 2009, http://en.rian.ru/russia/20090209/120055890.html (accessed November 09, 2011). 10 Jim Nichol, Russian Military Reform and

The Impact of Large, Multi-Function/Multi-Site Competitions

DTIC Science & Technology

2003-08-01

this approach generates larger savings and improved service quality , and is less expensive to implement. Moreover, it is a way to meet the President s...of the study is to assess the degree to which large-scale competitions completed have resulted in increased savings and service quality and decreased

Evaluation of the Effect of Surface Polishing, Oral Beverages and Food Colorants on Color Stability and Surface Roughness of Nanocomposite Resins

PubMed Central

Kumari, R Veena; Nagaraj, Hema; Siddaraju, Kishore; Poluri, Ramya Krishna

2015-01-01

Background: It is beyond doubt that finishing and polishing of a composite restoration enhance its esthetics and, is also essential for the health of the periodontium. A variety of instruments are commonly used for finishing and polishing tooth-colored restorative materials Thus, it is important to understand which type of surface finishing treatments would significantly affect the staining and surface irregularities of the composite resin restoration. Still one of the properties of the composite resins that have to pass the test of time is its color stability. In modern day dentistry, a large emphasis is laid over esthetics. Hence, it is important to understand the various agents capable of adversely affecting the esthetics of a restoration due to its staining capacity. Thus, the aim of this in vitro study was to evaluate the effect of surface polishing, oral beverages and food colorants on the color stability and surface roughness of nanocomposite resins. Materials and Methods: 90 Disks of nanocomposites resin (Filtek Z350 XT) measuring 8 mm in diameter and 2 mm in thickness were fabricated using a custom made silicon mold. Pre-polishing surface roughness (Ra1) of all the 90 samples were measured using a Surface Profilometer. The nano-composite disks were then randomly divided into 3 groups with 30 samples in each group. Group I: Control group: The samples were not subjected to any polishing procedures. Group II: Sof-Lex group: Samples subjected to polishing using different grits of Sof-Lex disks. Group III: Diamond polishing paste group: Samples were subjected with a polishing paste consisting of diamond particles. Following polishing procedures, the surface roughness of all samples were measured again to obtain change in surface roughness due to polishing procedures (Ra2), pre immersion spectrophotometric value (ΔE1) was also recorded for baseline color of the samples. The samples were then divided into subgroups (A, B, C, D, E), by including every first sample in Subgroup A, second in Subgroup B, third in Subgroup C, fourth in Subgroup D, and fifth in Subgroup E. Each was immersed in the respective test solution for 10 min, twice a day for 30 days. Group A - Tea, Group B - Coffee, Group C - Cola, Group D - Turmeric, Group E - Control (artificial saliva). Post immersion profilometric value was recorded to evaluate roughness bought about by the solutions (Ra3) and spectrophotometric value was recorded to evaluate the color change in samples (ΔE2). Results were statistically analyzed using ANOVA. Results: Higher mean roughness (Ra2-Ra1) value was recorded in Sof-Lex, followed by Diamond polishing paste and Control group. Comparison of surface roughness caused due to beverages and food colorant solution showed subgroup C (Coca Cola) increased surface roughness in all groups (Group I, II, III). Subgroup D (Turmeric) had the highest discoloration potential (P < 0001) in all groups, followed by coffee, tea, coca-cola and artificial saliva. Sof-Lex polishing System showed most color stability. Conclusion: Polishing procedures significantly roughen the surface of the restoration compared to the unpolished Mylar controls. One-step polishing system (diamond polishing paste) produces a smoother surface compared to a multi-step system (Sof-Lex polishing disks). Turmeric solution caused maximum staining of the samples, to a visually perceptible level. PMID:26229373

Evaluation of the Effect of Surface Polishing, Oral Beverages and Food Colorants on Color Stability and Surface Roughness of Nanocomposite Resins.

PubMed

Kumari, R Veena; Nagaraj, Hema; Siddaraju, Kishore; Poluri, Ramya Krishna

2015-07-01

It is beyond doubt that finishing and polishing of a composite restoration enhance its esthetics and, is also essential for the health of the periodontium. A variety of instruments are commonly used for finishing and polishing tooth-colored restorative materials Thus, it is important to understand which type of surface finishing treatments would significantly affect the staining and surface irregularities of the composite resin restoration. Still one of the properties of the composite resins that have to pass the test of time is its color stability. In modern day dentistry, a large emphasis is laid over esthetics. Hence, it is important to understand the various agents capable of adversely affecting the esthetics of a restoration due to its staining capacity. Thus, the aim of this in vitro study was to evaluate the effect of surface polishing, oral beverages and food colorants on the color stability and surface roughness of nanocomposite resins. 90 Disks of nanocomposites resin (Filtek Z350 XT) measuring 8 mm in diameter and 2 mm in thickness were fabricated using a custom made silicon mold. Pre-polishing surface roughness (Ra1) of all the 90 samples were measured using a Surface Profilometer. The nano-composite disks were then randomly divided into 3 groups with 30 samples in each group. Group I: The samples were not subjected to any polishing procedures. Group II: Sof-Lex group: Samples subjected to polishing using different grits of Sof-Lex disks. Group III: Diamond polishing paste group: Samples were subjected with a polishing paste consisting of diamond particles. Following polishing procedures, the surface roughness of all samples were measured again to obtain change in surface roughness due to polishing procedures (Ra2), pre immersion spectrophotometric value (ΔE1) was also recorded for baseline color of the samples. The samples were then divided into subgroups (A, B, C, D, E), by including every first sample in Subgroup A, second in Subgroup B, third in Subgroup C, fourth in Subgroup D, and fifth in Subgroup E. Each was immersed in the respective test solution for 10 min, twice a day for 30 days. Group A - Tea, Group B - Coffee, Group C - Cola, Group D - Turmeric, Group E - Control (artificial saliva). Post immersion profilometric value was recorded to evaluate roughness bought about by the solutions (Ra3) and spectrophotometric value was recorded to evaluate the color change in samples (ΔE2). Results were statistically analyzed using ANOVA. Higher mean roughness (Ra2-Ra1) value was recorded in Sof-Lex, followed by Diamond polishing paste and Control group. Comparison of surface roughness caused due to beverages and food colorant solution showed subgroup C (Coca Cola) increased surface roughness in all groups (Group I, II, III). Subgroup D (Turmeric) had the highest discoloration potential (P < 0001) in all groups, followed by coffee, tea, coca-cola and artificial saliva. Sof-Lex polishing System showed most color stability. Polishing procedures significantly roughen the surface of the restoration compared to the unpolished Mylar controls. One-step polishing system (diamond polishing paste) produces a smoother surface compared to a multi-step system (Sof-Lex polishing disks). Turmeric solution caused maximum staining of the samples, to a visually perceptible level.

Examining the clinical course of genotype 1 chronic hepatitis C patients treated with the cosmos regimen: including patients with advanced liver disease and East Asian ancestry.

PubMed

Roytman, Marina; Ramkissoon, Resham; Wu, Christina; Hong, Leena; Trujillo, Ruby; Huddleston, Leslie; Poerzgen, Peter; Seto, Todd; Wong, Linda; Tsai, Naoky

2016-07-01

The COSMOS study was a phase 2a clinical trial that showed high cure rates of genotype 1 chronic hepatitis C (CHC) and a favorable side effect profile using a 12-week regimen of simeprevir + sofosbuvir (SIM + SOF). Given the small number of patients treated with the SIM + SOF regimen in the COSMOS trial, there is uncertainty regarding the efficacy and safety of this combination therapy. We now report our experience with the COSMOS regimen in the multiethnic population of Hawaii, including patients of East Asian ancestry and with decompensated cirrhosis. This study is a retrospective review of 138 patients treated with a fixed dose regimen of SIM 150 mg and SOF 400 mg daily at a single referral center. We collected data on demographics, side effects, laboratory studies and sustained virological response (SVR). Statistical analysis was performed with Stata v8.2 software. Baseline characteristics of the 138 patients initiated with SIM + SOF therapy were: 68.8 % cirrhotic (22.1 % of those Child-Pugh Class B), 37 % Asian, 11.6 % Pacific Islander, 63 % male, mean age 61.3 ± 7.8 years, mean BMI 27.8 ± 6.1 kg/m(2), 26.8 % diabetic, 63.8 % genotype 1a, 44.9 % previously treatment experienced. A total of 100 % of patients that completed therapy (n = 137) had undetectable viral loads at end of treatment (EOT). Twelve patients relapsed post-treatment resulting in an overall 12 week SVR (SVR12) rate of 89.1 %. 95 % of decompensated cirrhotic patients achieved SVR12, compared to 85.3 % of compensated cirrhotic patients and 93 % of non-cirrhotic patients. 92 % of Asian patients achieved SVR12 compared to 87.5 % in non-Asian patients. There were no statistically significant differences in SVR12 between treatment naive and treatment experienced patients (86.8 vs 91.9 %). 87.5 % of post-transplant patients achieved SVR12. The main side effects were headache 16.2 %, fatigue 24.2 %, pruritis 14.1 %; none were >grade 2 in severity. There were no differences in side effect profiles of patients with decompensated cirrhosis. Pruritis only was statistically significant between Asians and non-Asians (22 vs 5.7 %). Trends toward improvement in platelet counts and total bilirubin were noted at 12-weeks post treatment, while improvement in albumin in cirrhotic patients reached statistical significance (3.77-4.01 mg/dL, p = 0.0108). The 12-week fixed dose course of SIM + SOF was well tolerated in a multiethnic population of primarily cirrhotic patients, including those with decompensated disease. This real world trial achieved SVR12 rates comparable to the COSMOS data. Higher incidence of adverse side effects was not observed with an exception of higher rate of pruritis in Asians. The increase in albumin in cirrhotic patients was statistically significant and suggested early improvement in synthetic function following viral eradication. Higher BMI (≥30 kg/m(2)) was the only factor that correlated with post-treatment relapse by multivariate analysis.

Oxidation characteristics of gasoline direct-injection (GDI) engine soot: Catalytic effects of ash and modified kinetic correlation

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

Choi, Seungmok; Seong, Heeje

In this paper, experimental analyses are conducted into the GDI soot oxidation characteristics as dependent on engine operating conditions. Soot is sampled at various engine operating conditions of a commercial 2.4 L GDI engine with a naturally aspirated, homogeneous, and stoichiometric operation strategy. The oxidation reactivity, ash composition, and carbon nanostructure of the GDI soot samples are analyzed using thermogravimetric analysis (TGA), scanning electron microscope–energy-dispersive spectroscopy (SEM-EDS), high-resolution transmission electron microscopy (HR-TEM), and Raman spectroscopy. Based on the analyses, a global GDI soot oxidation mechanism is proposed which includes the effects of soluble organic fractions (SOF)/weakly bonded carbon (WBC), andmore » three types of ash on GDI soot oxidation. The results show that GDI soot contains an order of magnitude higher ash fraction than does conventional diesel soot, and oxidation reactivity is significantly enhanced by the catalytic effects of ash, as a function of ash content in soot. A modified empirical kinetic correlation for GDI soot oxidation is suggested on the basis of the results, and the modified kinetic correlation predicts the GDI soot oxidation rate accurately for various engine operation points at wide ranges of soot conversion and temperature without modifying kinetic parameters. The kinetic parameters are determined from isothermal and non-isothermal thremogravimetric analysis (TGA) soot oxidation tests; the methods are elucidated in detail.« less

Oxidation characteristics of gasoline direct-injection (GDI) engine soot: Catalytic effects of ash and modified kinetic correlation

DOE PAGES

Choi, Seungmok; Seong, Heeje

2015-03-02

In this paper, experimental analyses are conducted into the GDI soot oxidation characteristics as dependent on engine operating conditions. Soot is sampled at various engine operating conditions of a commercial 2.4 L GDI engine with a naturally aspirated, homogeneous, and stoichiometric operation strategy. The oxidation reactivity, ash composition, and carbon nanostructure of the GDI soot samples are analyzed using thermogravimetric analysis (TGA), scanning electron microscope–energy-dispersive spectroscopy (SEM-EDS), high-resolution transmission electron microscopy (HR-TEM), and Raman spectroscopy. Based on the analyses, a global GDI soot oxidation mechanism is proposed which includes the effects of soluble organic fractions (SOF)/weakly bonded carbon (WBC), andmore » three types of ash on GDI soot oxidation. The results show that GDI soot contains an order of magnitude higher ash fraction than does conventional diesel soot, and oxidation reactivity is significantly enhanced by the catalytic effects of ash, as a function of ash content in soot. A modified empirical kinetic correlation for GDI soot oxidation is suggested on the basis of the results, and the modified kinetic correlation predicts the GDI soot oxidation rate accurately for various engine operation points at wide ranges of soot conversion and temperature without modifying kinetic parameters. The kinetic parameters are determined from isothermal and non-isothermal thremogravimetric analysis (TGA) soot oxidation tests; the methods are elucidated in detail.« less

EVALUATION OF VADOSE ZONE AND SORUCE MODULES FOR MULTI-MEDIA, MULTI-PATHWAY, AND MULTI-RECEPTOR RISK ASSESSMENT USING LARGE-SOIL-COLUMN EXPERIMENTAL DATA

EPA Science Inventory

The United States Environmental Protection Agency (EPA) is developing a comprehensive environmental exposure and risk analysis software system for agency-wide application using the methodology of a Multi-media, Multi-pathway, Multi-receptor Risk Assessment (3MRA) model. This sof...

Navy Trident Submarine Conversion (SSGN) Program: Background and Issues for Congress

DTIC Science & Technology

2005-03-25

the SSGNs would be functional replacements for the James K. Polk (SSN-645) and the Kamehameha (SSBN-642) — two older-generation SSBNs that were...converted into SSNs specifically for supporting larger numbers of SOF personnel. The Polk was retired in 1999 at age 33; the Kamehameha was retired in

Navy Trident Submarine Conversion SSGN Program: Background and Issues for Congress

DTIC Science & Technology

2002-02-06

role, the SSGNs would be functional replacements for the James K. Polk (SSN-645) and the Kamehameha (SSBN-642) – 2 older-generation SSBNs that were...converted into SSNs specifically for supporting larger numbers of SOF personnel. The Polk was retired in 1999 at age 33; the Kamehameha , commissioned in

Navy Trident Submarine Conversion (SSGN) Program: Background and Issues for Congress

DTIC Science & Technology

2006-06-20

the Kamehameha (SSBN-642) — two older-generation SSBNs that were converted into SSNs specifically for supporting larger numbers of SOF personnel...The Polk was retired in 1999 at age 33; the Kamehameha was retired in 2002 at age 36. The report of the 2001 Quadrennial Defense Review, submitted to

Navy Trident Submarine Conversion (SSGN) Program: Background and Issues for Congress

DTIC Science & Technology

2008-05-22

the Kamehameha (SSBN-642) — two older-generation SSBNs that were converted into SSNs specifically for supporting larger numbers of SOF personnel. The...Polk was retired in 1999 at age 33; the Kamehameha was retired in 2002 at age 36. Trident SSGNs and Navy Transformation. The Bush Administration and

Navy Trident Submarine Conversion (SSGN) Program: Background and Issues for Congress

DTIC Science & Technology

2008-10-02

the Kamehameha (SSBN-642) — two older-generation SSBNs that were converted into SSNs specifically for supporting larger numbers of SOF personnel. The...Polk was retired in 1999 at age 33; the Kamehameha was retired in 2002 at age 36. Trident SSGNs and Navy Transformation. The Bush Administration and

Enduring Engagement Yes, Episodic Engagement No: Lessons for SOF from Mali

DTIC Science & Technology

2013-12-01

ammunition cans. Even the non- rusted ammunition failed to reliably ignite due to prolonged exposure to the elements. 59 Weapons in Mali fall under the...In the personnel protection category, body armor for the unit was cut to fifty pieces— barley enough for a third of the ground element. Examples such

East Europe Report, Political, Sociological and Military Affairs, No. 2175.

DTIC Science & Technology

1983-08-02

remained a working chemist. He has a small laboratory in the basement of his family home and produces toilet water and shampoo for the family’s...of 8 November 1982 the communique stated: "The premier and the primate made a survey of the present situation in the country and expressed common

The sensing mechanism of N-doped SWCNTs toward SF6 decomposition products: A first-principle study

NASA Astrophysics Data System (ADS)

Gui, Yingang; Tang, Chao; Zhou, Qu; Xu, Lingna; Zhao, Zhongyong; Zhang, Xiaoxing

2018-05-01

In order to monitor the insulation status of SF6-insulated equipment on-line, SOF2 and SO2F2, two typical decomposition products of SF6 under electric discharge condition, are chosen as the target gases to evaluate the type and severity of discharge. In this work, single N atom doping method is adopted to improve the gas sensitivity of single wall carbon nanotubes to SOF2 and SO2F2. Single and double gas molecules adsorptions are considered to completely analyze the adsorption properties of N-doped single wall carbon nanotubes. Calculation results show that N atom doping enhances the surface activity of carbon nanotubes. When gas molecules physically adsorbed on N-doped single wall carbon nanotubes, the weak interaction between gas molecules and N-doped single wall carbon nanotubes nearly not changes the electrical property according to analysis of the density of states and molecular orbitals. While the chemisorption between gas molecules and N-doped single wall carbon nanotubes distinctly decreases the conductivity of adsorption system.

[Experimental study on characteristics of biodiesel exhausted particle].

PubMed

Ge, Yun-shan; He, Chao; Han, Xiu-kun; Wu, Si-jin; Lu, Xiao-ming

2007-07-01

A particle emission experiment of a direct-injection turbocharged diesel engine with biodiesel and diesel was carried out. A pump of 80 L/min and fiber glass filters with diameter of 90 mm was used to sample engine particles in exhaust pipe. The size distribution, soluble organic fraction (SOF) and 16 polycyclic aromatic hydrocarbons (PAHs) of particles were analyzed by a laser diffraction particle size analyzer and GC-MS. The results indicate that the volume weighted size distribution of biodiesel particle is single-peak and its median diameter d(0.5) and mean diameter d32 are decreased with the increasing speed. At the high speed the d32 and d(0.5) of biodiesel are larger than those of diesel, and quite the contrary at the low speed. SOF mass concentration and mass percentage of biodiesel are 12.3 - 31.5 mg/m3 and 38.2% - 58.0% respectively, which are much higher than those of diesel. The total PAHs emission concentration of biodiesel is 2.9 - 4.7 microg/m3 lower than that of diesel as much as 29.1% - 92.4%.

Effectiveness of interferon-free therapy for the treatment of HCV-patients with compensated cirrhosis treated through the Irish early access program.

PubMed

Gray, E; O'Leary, A; Bergin, C; Cannon, M; Courtney, G; Crosbie, O; De Gascun, C F; Fanning, L J; Feeney, E; Houlihan, D D; Kelleher, B; Lambert, J S; Lee, J; Mallon, Pwg; McConkey, S; McCormick, A; McKiernan, S; McNally, C; Murray, F; Sheehan, G; Stewart, S; Walsh, C; Norris, S

2017-06-01

We investigated the real-world effectiveness of interferon-free regimens for the treatment of patients with compensated cirrhosis infected with hepatitis C virus (HCV). Using the Irish national HCV treatment registry, the effectiveness and safety of interferon-free regimens for HCV-infected patients treated between April 2015 and August 2016, was determined. A SVR12 was achieved in 86% of subjects treated with sofosbuvir/ledipasvir ± ribavirin (SOF/LDV±RBV), 93% treated with paritaprevir, ombitasvir and ritonavir combined with dasabuvir ± ribavirin (3D±RBV) and 89% treated with sofosbuvir/daclatasvir ± ribavirin (SOF/DCV±RBV). The discontinuation rate was 5% and the on-treatment mortality rate was 1%. The availability of interferon-free regimens represents a significant breakthrough for the treatment of HCV infection. Treatments options, with high SVR12 rates, are now available for patients with compensated cirrhosis who were unsuitable for treatment with interferon-based regimens. Data obtained from studies conducted in real world practice provide robust information fundamental for input into future economic evaluations for agents used for the treatment of HCV infection.

Effect of astigmatism on visual acuity in eyes with a diffractive multifocal intraocular lens.

PubMed

Hayashi, Ken; Manabe, Shin-Ichi; Yoshida, Motoaki; Hayashi, Hideyuki

2010-08-01

To examine the effect of astigmatism on visual acuity at various distances in eyes with a diffractive multifocal intraocular lens (IOL). Hayashi Eye Hospital, Fukuoka, Japan. In this study, eyes had implantation of a diffractive multifocal IOL with a +3.00 diopter (D) addition (add) (AcrySof ReSTOR SN6AD1), a diffractive multifocal IOL with a +4.00 D add (AcrySof ReSTOR SN6AD3), or a monofocal IOL (AcrySof SN60WF). Astigmatism was simulated by adding cylindrical lenses of various diopters (0.00, 0.50, 1.00, 1.50, 2.00), after which distance-corrected acuity was measured at various distances. At most distances, the mean visual acuity in the multifocal IOL groups decreased in proportion to the added astigmatism. With astigmatism of 0.00 D and 0.50 D, distance-corrected near visual acuity (DCNVA) in the +4.00 D group and distance-corrected intermediate visual acuity (DCIVA) and DCNVA in the +3.00 D group were significantly better than in the monofocal group; the corrected distance visual acuity (CDVA) was similar. The DCNVA with astigmatism of 1.00 D was better in 2 multifocal groups; however, with astigmatism of 1.50 D and 2.00 D, the CDVA and DCIVA at 0.5m in the multifocal groups were significantly worse than in the monofocal group, although the DCNVA was similar. With astigmatism of 1.00 D or greater, the mean CDVA and DCNVA in the multifocal groups reached useful levels (20/40). The presence of astigmatism in eyes with a diffractive multifocal IOL compromised all distance visual acuities, suggesting the need to correct astigmatism of greater than 1.00 D. No author has a financial or proprietary interest in any material or method mentioned. Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Moderate Sustained Virologic Response Rates With 6-Week Combination Directly Acting Anti-Hepatitis C Virus Therapy in Patients With Advanced Liver Disease.

PubMed

Kattakuzhy, Sarah; Wilson, Eleanor; Sidharthan, Sreetha; Sims, Zayani; McLaughlin, Mary; Price, Angie; Silk, Rachel; Gross, Chloe; Akoth, Elizabeth; McManus, Maryellen; Emmanuel, Benjamin; Shrivastava, Shikha; Tang, Lydia; Nelson, Amy; Teferi, Gebeyehu; Chavez, Jose; Lam, Brian; Mo, Hongmei; Osinusi, Anuoluwapo; Polis, Michael A; Masur, Henry; Kohli, Anita; Kottilil, Shyamasundaran

2016-02-15

Treatment of genotype 1 hepatitis C virus (HCV) infection with combination directly acting antivirals (DAA) for 8-24 weeks is associated with high rates of sustained virologic response (SVR). We previously demonstrated that adding a third DAA to ledipasvir and sofosbuvir (LDV/SOF) can result in high SVR rates in patients without cirrhosis. In this study, we investigated whether a similar regimen would yield equivalent rates of cure in patients with advanced liver fibrosis. Fifty patients were enrolled at the Clinical Research Center of the National Institutes of Health and associated healthcare centers. Enrollment and follow-up data from April 2014 to June 2015 are reported here. Eligible participants were aged ≥18 years, had chronic HCV genotype 1 infection (serum HCV RNA ≥2000 IU/mL), and stage 3-4 liver fibrosis. HCV RNA was measured using a reverse-transcription polymerase chain reaction assay. Of patients treated with LDV, SOF, and the NS3/4A protease inhibitor GS-9451 for 6 weeks, 76% (38 of 50; 95% confidence interval, 60%-85%) had SVR achieved 12 weeks after the end of treatment. There was no statistically significant difference in treatment efficacy between treatment-naive patients (72%, 18 of 25) and those with treatment experience (80%; 20 of 25) (P = .51). Overall, 11 patients (22%) experienced virologic relapse, and 1 (2%) was lost to follow-up at 4 weeks after treatment. No serious adverse events, discontinuations, or deaths were associated with this regimen. Adding a third DAA to LDV/SOF may result in a moderate SVR rate, lower than that observed in patients without cirrhosis. Significant liver fibrosis remains an impediment to achieving SVR with short-duration DAA therapy. CT01805882. Published by Oxford University Press for the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Ledipasvir/sofosbuvir regimens for chronic hepatitis C infection: Insights from a work productivity economic model from the United States.

PubMed

Younossi, Zobair M; Jiang, Yushan; Smith, Nathaniel J; Stepanova, Maria; Beckerman, Rachel

2015-05-01

Patients with chronic hepatitis C (CHC) exhibit reduced work productivity owing to their disease. Historically, most regimens indicated for CHC genotype 1 (GT1) patients were administered with pegylated interferon (Peg-IFN) and/or ribavirin (RBV), which further compromised work productivity during treatment. The aim of this study was to model the impact of LDV/SOF (ledipasvir/sofosbuvir), the first Peg-IFN- and RBV-free regimen for CHC GT1 patients, on work productivity from an economic perspective, compared to receiving no treatment. The WPAI-SHP (Work Productivity and Activity Index-Specific Health Problem) questionnaire was administered to patients across the ION clinical trials (N = 1,923 U.S. patients). Before initiation of treatment, patients with CHC GT1 in the ION trials exhibited absenteeism and presenteeism impairments of 2.57% and 7.58%, respectively. Patients with cirrhosis exhibited greater work productivity impairment than patients without cirrhosis. In total, 93.21% of U.S. patients in the ION trials achieved SVR; these patients exhibited absenteeism and presenteeism impairments of 2.62% (P = 0.76, when compared to baseline) and 3.53% (P < 0.0001), respectively. Monetizing these data to the entire U.S. population, our model projects an annual societal cost of $7.1 billion owing to productivity loss in untreated GT1 CHC patients. Our model projects that, when compared to no treatment, treating all CHC GT1 patients with a regimen with very high viral eradication rates (LDV/SOF) would translate to annual productivity loss savings of $2.7 billion over a 1-year time horizon. Patients with untreated HCV impose a substantial societal burden owing to reduced work productivity. As a result of improvements in work productivity, treatment of CHC GT1 patients with LDV/SOF-based regimens is likely to result in significant cost savings from a societal perspective, relative to no treatment. © 2015 by the American Association for the Study of Liver Diseases.

Prevalence of NS5B resistance-associated variants in treatment-naïve Asian patients with chronic hepatitis C.

PubMed

Yang, Song; Xing, Huichun; Feng, Shenghu; Ju, Wei; Liu, Shunai; Wang, Xiaomei; Ou, Weini; Cheng, Jun; Pan, Calvin Q

2018-02-01

There is little information on the association between baseline non-structural protein (NS) 5b resistance-associated variants (RAVs) and treatment failure in hepatitis C patients. This study examined the frequencies of natural hepatitis C virus (HCV) NS5B resistance-associated variants (RAVs) in an Asian cohort. Samples from Asian HCV patients enrolled between October 2009 and September 2014 were analyzed for NS5B RAVs within the region from amino acid 230 to 371. Serum samples were tested by PCR genotyping, with sequence alignment performed using the neighbor-joining method. NS5B was detected by Sanger sequencing followed by Geno2pheno analysis. NS5B RAVs were detected in 80.52% (1199/1489) of patients; 68.4% (1019/1489) and 79.7% (1186/1489) were associated with resistance to sofosbuvir (SOF) and dasabuvir (DSV), respectively. These RAVs were present in 95% (1004/1058) of genotype 1b patients. When genotypes 1b and 2a were compared, SOF-associated RAVs were detected at a higher frequency in genotype 1b (94.8% [1004/1058] vs. 2.9% [9/309]; χ 2 = 1054.433, P < 0.001), C316H/N was more common in genotype 1b (94.7% [1002/1058] vs. 0% [0/309]; χ 2 = 1096.014, P < 0.001), M289F/L/I/W/V had a higher frequency in genotype 2a (0.7% [7/309] vs. 2.3% [7/1058]; χ 2 = 4.589, P = 0.032), DSV-associated RAVs were most often found in genotype 1b (95.0% [1005/1058] vs. 40.1% 124/309]; χ 2 = 500.577, P < 0.001), and frequency of C316Y/H/N/W was higher in genotype 1b (94.7% [1002/1058] vs. 0% [0/309]; χ 2 = 1096.014, P < 0.001). In conclusion, baseline SOF and DSV RAVs are common in Asian HCV patients and predominantly occur in genotype 1b.

Nonlinear aeroelastic analysis, flight dynamics, and control of a complete aircraft

NASA Astrophysics Data System (ADS)

Patil, Mayuresh Jayawant

The focus of this research was to analyze a high-aspect-ratio wing aircraft flying at low subsonic speeds. Such aircraft are designed for high-altitude, long-endurance missions. Due to the high flexibility and associated wing deformation, accurate prediction of aircraft response requires use of nonlinear theories. Also strong interactions between flight dynamics and aeroelasticity are expected. To analyze such aircraft one needs to have an analysis tool which includes the various couplings and interactions. A theoretical basis has been established for a consistent analysis which takes into account, (i) material anisotropy, (ii) geometrical nonlinearities of the structure, (iii) rigid-body motions, (iv) unsteady flow behavior, and (v) dynamic stall. The airplane structure is modeled as a set of rigidly attached beams. Each of the beams is modeled using the geometrically exact mixed variational formulation, thus taking into account geometrical nonlinearities arising due to large displacements and rotations. The cross-sectional stiffnesses are obtained using an asymptotically exact analysis, which can model arbitrary cross sections and material properties. An aerodynamic model, consisting of a unified lift model, a consistent combination of finite-state inflow model and a modified ONERA dynamic stall model, is coupled to the structural system to determine the equations of motion. The results obtained indicate the necessity of including nonlinear effects in aeroelastic analysis. Structural geometric nonlinearities result in drastic changes in aeroelastic characteristics, especially in case of high-aspect-ratio wings. The nonlinear stall effect is the dominant factor in limiting the amplitude of oscillation for most wings. The limit cycle oscillation (LCO) phenomenon is also investigated. Post-flutter and pre-flutter LCOs are possible depending on the disturbance mode and amplitude. Finally, static output feedback (SOF) controllers are designed for flutter suppression and gust alleviation. SOF controllers are very simple and thus easy to implement. For the case considered, SOF controllers with proper choice of sensors give results comparable to full state feedback (linear quadratic regulator) designs.

A Framework for Automating Cost Estimates in Assembly Processes

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

Calton, T.L.; Peters, R.R.

1998-12-09

When a product concept emerges, the manufacturing engineer is asked to sketch out a production strategy and estimate its cost. The engineer is given an initial product design, along with a schedule of expected production volumes. The engineer then determines the best approach to manufacturing the product, comparing a variey of alternative production strategies. The engineer must consider capital cost, operating cost, lead-time, and other issues in an attempt to maximize pro$ts. After making these basic choices and sketching the design of overall production, the engineer produces estimates of the required capital, operating costs, and production capacity. 177is process maymore » iterate as the product design is refined in order to improve its pe~ormance or manufacturability. The focus of this paper is on the development of computer tools to aid manufacturing engineers in their decision-making processes. This computer sof~are tool provides aj?amework in which accurate cost estimates can be seamlessly derivedfiom design requirements at the start of any engineering project. Z+e result is faster cycle times through first-pass success; lower ll~e cycie cost due to requirements-driven design and accurate cost estimates derived early in the process.« less

Radio frequency sensing measurements and methods for location classification in wireless networks

NASA Astrophysics Data System (ADS)

Maas, Dustin C.

The wireless radio channel is typically thought of as a means to move information from transmitter to receiver, but the radio channel can also be used to detect changes in the environment of the radio link. This dissertation is focused on the measurements we can make at the physical layer of wireless networks, and how we can use those measurements to obtain information about the locations of transceivers and people. The first contribution of this work is the development and testing of an open source, 802.11b sounder and receiver, which is capable of decoding packets and using them to estimate the channel impulse response (CIR) of a radio link at a fraction of the cost of traditional channel sounders. This receiver improves on previous implementations by performing optimized matched filtering on the field-programmable gate array (FPGA) of the Universal Software Radio Peripheral (USRP), allowing it to operate at full bandwidth. The second contribution of this work is an extensive experimental evaluation of a technology called location distinction, i.e., the ability to identify changes in radio transceiver position, via CIR measurements. Previous location distinction work has focused on single-input single-output (SISO) radio links. We extend this work to the context of multiple-input multiple-output (MIMO) radio links, and study system design trade-offs which affect the performance of MIMO location distinction. The third contribution of this work introduces the "exploiting radio windows" (ERW) attack, in which an attacker outside of a building surreptitiously uses the transmissions of an otherwise secure wireless network inside of the building to infer location information about people inside the building. This is possible because of the relative transparency of external walls to radio transmissions. The final contribution of this dissertation is a feasibility study for building a rapidly deployable radio tomographic (RTI) imaging system for special operations forces (SOF). We show that it is possible to obtain valuable tracking information using as few as 10 radios over a single floor of a typical suburban home, even without precise radio location measurements.

Tribal lands provide forest management laboratory for mainstream university students

Treesearch

Serra J. Hoagland; Ronald Miller; Kristen M. Waring; Orlando Carroll

2017-01-01

Northern Arizona University (NAU) faculty and Bureau of Indian Affairs (BIA) foresters initiated a partnership to expose NAU School of Forestry (SoF) graduate students to tribal forest management practices by incorporating field trips to the 1.68-million acre Fort Apache Indian Reservation as part of their silviculture curriculum. Tribal field trips were contrasted and...

The Project Coordinators: A Key to the School of the Future.

ERIC Educational Resources Information Center

Iscoe, Louise K.

The Hogg Foundation for Mental Health created the School of the Future (SoF) project to enable selected Texas schools to coordinate and implement school-based social and health services on their campuses and to demonstrate the effectiveness of this method of service delivery by evaluating the project. This booklet reports on one aspect of the…

Challenges and Realities: Evaluating a School-Based Service Project.

ERIC Educational Resources Information Center

Keir, Scott S.; Millea, Susan

The Hogg Foundation for Mental Health created the School of the Future (SoF) project to enable selected Texas schools to coordinate and implement school-based social and health services on their campuses and to demonstrate the effectiveness of this method of service delivery by evaluating the project to show the process used and the outcomes that…

Parent Volunteer Program. School of the Future: San Antonio.

ERIC Educational Resources Information Center

Iscoe, Louise

The Hogg Foundation for Mental Health created the School of the Future (SoF) project to enable selected Texas schools to coordinate and implement school-based social and health services on their campuses and to demonstrate the effectiveness of this method of service delivery by evaluating the project. This booklet focuses on the Parent Volunteer…

A Community Catalyst. School of the Future: Austin.

ERIC Educational Resources Information Center

Iscoe, Louise

The Hogg Foundation for Mental Health created the School of the Future (SoF) project to enable selected Texas schools to coordinate and implement school-based social and health services on their campuses and to demonstrate the effectiveness of this method of service delivery by evaluating the project. The projects, each of which involved a middle…

Field capture of Thyanta perditor with pheromone-baited traps and cross-attraction to other pentatomids

USDA-ARS?s Scientific Manuscript database

In Brazil, Thyanta perditor is one of the stink bugs attacking soybean and also could be found on others crops such as wheat, sunflower and sorghum. The objective of this work was to test the field attractiveness of traps baited with synthetic T. perditor pheromone. Two-liter transparent plastic sof...

On-line adaptive battery impedance parameter and state estimation considering physical principles in reduced order equivalent circuit battery models part 2. Parameter and state estimation

NASA Astrophysics Data System (ADS)

Fleischer, Christian; Waag, Wladislaw; Heyn, Hans-Martin; Sauer, Dirk Uwe

2014-09-01

Lithium-ion battery systems employed in high power demanding systems such as electric vehicles require a sophisticated monitoring system to ensure safe and reliable operation. Three major states of the battery are of special interest and need to be constantly monitored. These include: battery state of charge (SoC), battery state of health (capacity fade determination, SoH), and state of function (power fade determination, SoF). The second paper concludes the series by presenting a multi-stage online parameter identification technique based on a weighted recursive least quadratic squares parameter estimator to determine the parameters of the proposed battery model from the first paper during operation. A novel mutation based algorithm is developed to determine the nonlinear current dependency of the charge-transfer resistance. The influence of diffusion is determined by an on-line identification technique and verified on several batteries at different operation conditions. This method guarantees a short response time and, together with its fully recursive structure, assures a long-term stable monitoring of the battery parameters. The relative dynamic voltage prediction error of the algorithm is reduced to 2%. The changes of parameters are used to determine the states of the battery. The algorithm is real-time capable and can be implemented on embedded systems.

A Blueprint for School-Based Services. School of the Future: Dallas.

ERIC Educational Resources Information Center

Iscoe, Louise

The Hogg Foundation for Mental Health created the School of the Future (SoF) project to enable selected Texas schools to coordinate and implement school-based social and health services on their campuses and to demonstrate the effectiveness of this method of service delivery by evaluating the project. At each of four urban sites consisting of a…

Revisiting the School of the Future: The Evolution of a School-Based Services Project.

ERIC Educational Resources Information Center

Iscoe, Louise K.; Keir, Scott S.

The Hogg Foundation for Mental Health created the School of the Future (SoF) project to enable selected Texas schools to coordinate and implement school-based social and health services on their campuses and to demonstrate the effectiveness of this method of service delivery by evaluating the project. This report documents the evolution of the SoF…

Viking Software Data

DTIC Science & Technology

1977-05-01

RADC-TR-77-168 Final Technical Report M~ay 1977 ll VIKING SOF11WARE DATA Martin Marietta Corporation Approved for public release; distribution...practices employed on a large and complex system development by the Martin Marietta Corporation. The intent of the RADC program to which this document...the technique are described. The preparation of this report could not have been accomplished without considerable assistance from fellow Martin

China Report, Red Flag, Number 1, 1 January 1985

DTIC Science & Technology

1985-03-05

li0dSOf,the thlrd’ f°Urth’ and the fifth e^ elon . It is impossible for them to change. In recent times I have always told foreign guests that the...people sell hides, musk , and other articles to Han people in exchange for cloth and salt. The Yi costumes are completely different from the Han

Thickening the Global SOF Network

DTIC Science & Technology

2013-12-01

in thought, and regulate both positive and negative emotions in oneself and others. EI is a necessary, but not fully sufficient, quality Green...assimilate emotions in thought, and regulate both positive and negative emotions in oneself and others. EI is a necessary, but not fully sufficient...both positive and negative emotions in oneself and others. B. THE HISTORY AND CONTROVERSY SURROUNDING EMOTIONAL INTELLIGENCE Since its first

The Examination of the Aluminum Alloy 7017 as a Replacement for the Aluminum Alloy 7039 in Lightweight Armor Systems

DTIC Science & Technology

2016-07-01

ORGANIZATION REPORT NUMBER ARL-TR-7727 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10 . SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S...of 0.50-cal. FSP vs. AA7017 plate at 0° .......................................................................................................... 10 ... 10 List of Tables Table 1 Chemical composition, weight percent

STRUCTURES, ROTATION BARRIER AND THERMODYNAMIC PROPERTIES DHOF 298, SOF 298, AND CP(T) OF CHLORO-METHYL HYPOCHLORITES: CHO3CL, CH2CLOCL, CHCL2OCL AND CCL3OCL. (R824970)

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...

GRADE guidelines: 10. Considering resource use and rating the quality of economic evidence.

PubMed

Brunetti, Massimo; Shemilt, Ian; Pregno, Silvia; Vale, Luke; Oxman, Andrew D; Lord, Joanne; Sisk, Jane; Ruiz, Francis; Hill, Suzanne; Guyatt, Gordon H; Jaeschke, Roman; Helfand, Mark; Harbour, Robin; Davoli, Marina; Amato, Laura; Liberati, Alessandro; Schünemann, Holger J

2013-02-01

In this article, we describe how to include considerations about resource utilization when making recommendations according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. We focus on challenges with rating the confidence in effect estimates (quality of evidence) and incorporating resource use into evidence profiles and Summary of Findings (SoF) tables. GRADE recommends that important differences in resource use between alternative management strategies should be included along with other important outcomes in the evidence profile and SoF table. Key steps in considering resources in making recommendations with GRADE are the identification of items of resource use that may differ between alternative management strategies and that are potentially important to decision makers, finding evidence for the differences in resource use, making judgments regarding confidence in effect estimates using the same criteria used for health outcomes, and valuing the resource use in terms of costs for the specific setting for which recommendations are being made. With our framework, decision makers will have access to concise summaries of recommendations, including ratings of the quality of economic evidence, and better understand the implications for clinical decision making. Copyright © 2013 Elsevier Inc. All rights reserved.

LMI-based adaptive reliable H∞ static output feedback control against switched actuator failures

NASA Astrophysics Data System (ADS)

An, Liwei; Zhai, Ding; Dong, Jiuxiang; Zhang, Qingling

2017-08-01

This paper investigates the H∞ static output feedback (SOF) control problem for switched linear system under arbitrary switching, where the actuator failure models are considered to depend on switching signal. An active reliable control scheme is developed by combination of linear matrix inequality (LMI) method and adaptive mechanism. First, by exploiting variable substitution and Finsler's lemma, new LMI conditions are given for designing the SOF controller. Compared to the existing results, the proposed design conditions are more relaxed and can be applied to a wider class of no-fault linear systems. Then a novel adaptive mechanism is established, where the inverses of switched failure scaling factors are estimated online to accommodate the effects of actuator failure on systems. Two main difficulties arise: first is how to design the switched adaptive laws to prevent the missing of estimating information due to switching; second is how to construct a common Lyapunov function based on a switched estimate error term. It is shown that the new method can give less conservative results than that for the traditional control design with fixed gain matrices. Finally, simulation results on the HiMAT aircraft are given to show the effectiveness of the proposed approaches.

Analysis of the Sensitivity of K-Type Molecular Sieve-Deposited MWNTs for the Detection of SF6 Decomposition Gases under Partial Discharge

PubMed Central

Zhang, Xiaoxing; Li, Xin; Luo, Chenchen; Dong, Xingchen; Zhou, Lei

2015-01-01

Sulfur hexafluoride (SF6) is widely utilized in gas-insulated switchgear (GIS). However, part of SF6 decomposes into different components under partial discharge (PD) conditions. Previous research has shown that the gas responses of intrinsic and 4 Å-type molecular sieve-deposited multi-wall carbon nanotubes (MWNTs) to SOF2 and SO2F2, two important decomposition components of SF6, are not obvious. In this study, a K-type molecular sieve-deposited MWNTs sensor was developed. Its gas response characteristics and the influence of the mixture ratios of gases on the gas-sensing properties were studied. The results showed that, for sensors with gas mixture ratios of 5:1, 10:1, and 20:1, the resistance change rate increased by nearly 13.0% after SOF2 adsorption, almost 10 times that of MWNTs sensors, while the sensors’ resistance change rate with a mixture ratio of 10:1 reached 17.3% after SO2F2 adsorption, nearly nine times that of intrinsic MWNT sensors. Besides, a good linear relationship was observed between concentration of decomposition components and the resistance change rate of sensors. PMID:26569245

Analysis of the Sensitivity of K-Type Molecular Sieve-Deposited MWNTs for the Detection of SF₆ Decomposition Gases under Partial Discharge.

PubMed

Zhang, Xiaoxing; Li, Xin; Luo, Chenchen; Dong, Xingchen; Zhou, Lei

2015-11-11

Sulfur hexafluoride (SF6) is widely utilized in gas-insulated switchgear (GIS). However, part of SF6 decomposes into different components under partial discharge (PD) conditions. Previous research has shown that the gas responses of intrinsic and 4 Å-type molecular sieve-deposited multi-wall carbon nanotubes (MWNTs) to SOF2 and SO2F2, two important decomposition components of SF6, are not obvious. In this study, a K-type molecular sieve-deposited MWNTs sensor was developed. Its gas response characteristics and the influence of the mixture ratios of gases on the gas-sensing properties were studied. The results showed that, for sensors with gas mixture ratios of 5:1, 10:1, and 20:1, the resistance change rate increased by nearly 13.0% after SOF2 adsorption, almost 10 times that of MWNTs sensors, while the sensors' resistance change rate with a mixture ratio of 10:1 reached 17.3% after SO2F2 adsorption, nearly nine times that of intrinsic MWNT sensors. Besides, a good linear relationship was observed between concentration of decomposition components and the resistance change rate of sensors.

Special Forces Capabilities of the European Union Military Forces

DTIC Science & Technology

2004-05-26

16 A Review of the History of Special Operations and Special Operations Forces ..... 16 Special Operations Defined...Herzegovina.15 Chapter Two - The Theory Connection - Special Operations and Special Operation Forces This chapter reviews the history and defines...18 Ibid, 87. 19 Ibid, 88. 20 Ibid, 114. 16 Special Operations and Special Operation Forces Theory A Review of the History of Special

Water's Way at Sleepers River watershed - revisiting flow generation in a post-glacial landscape, Vermont USA

Treesearch

James B. Shanley; Stephen D. Sebestyen; Jeffrey J. McDonnell; Brian L. McGlynn; Thomas Dunne

2015-01-01

The Sleepers River Research Watershed (SRRW) in Vermont, USA, has been the site of active hydrologic research since 1959 and was the setting where Dunne and Black demonstrated the importance and controls of saturation-excess overland flow (SOF) on streamflow generation. Here, we review the early studies from the SRRW and show how they guided our conceptual approach to...

Teamharmony: Employing Matchmaking Algorithms to Team-Building

DTIC Science & Technology

2017-12-01

Army1 A. HUMAN CHEMISTRY Within groups of people , there exists the powerful social phenomenon known as human chemistry. Although many definitions...which occur when two or more people interact, and cause the resulting relationship to be positively cohesive or toxic. Much like the weather, human...use experiential intuition when staffing teams. Apart from SOF units, there are no systems in place to gauge psychological makeup. Figure 2

A SOF Damage Control Resuscitation Cocktail

DTIC Science & Technology

2015-05-01

include Hextend for volume resuscitation and tissue perfusion, fibrinogen concentrate for hemostasis, and tranexamic acid for hemostasis. These...for hemostasis, and tranexamic acid for hemostasis. These components are tested in a combat-relevant swine polytrauma model of hemorrhagic shock with...HexVasoCntl HexVasoAlb Ctrl 4 4 would not allow adequate blood loss from the aortic tear, preventing testing of fibrinogen and tranexamic acid as

Prevention of Human Mammary Carcinogenesis.

DTIC Science & Technology

1996-07-01

eicosapentaenoic acid (EPA), indole-3-carbinol (13C), 0-carotene (P3-C), (-) epigallocatechin gallate ( EGCG ) and genistein (GEN) effectively down...Alteration in Cell Cycle Progression of 184-B5/HER Cells by (-) Epigallocatechin Gallate ( EGCG ) status % distribution of cellsb, c- ac Sof treatm enta... epigallocatechin gallate ( EGCG ,a green tea polyphenol), indole-3-carbinol (13C,a plant indole) and genistein (GEN,a soy isoflavone) showed differential

Military Review: SOF/LIC

DTIC Science & Technology

1991-06-01

ment strategic environment and concludes that the United States must "integratedly and direct- ly act.., when vital global balances are truly...recognizes no borders and underdeveloped countries. The euphoria in- respects no government. Increasingly, drug car- duced by improved relations with...respond if peaceful solu- balance far more dynamic than it has been for tions fail. more than 40 years. In addition, little has been The United States

Investigation of anti-Hepatitis C virus, sofosbuvir and daclatasvir, in pure form, human plasma and human urine using micellar monolithic HPLC-UV method and application to pharmacokinetic study.

PubMed

Zidan, Dalia W; Hassan, Wafaa S; Elmasry, Manal S; Shalaby, Abdalla A

2018-06-01

Simultaneous determination of sofosbuvir (SOF), and daclatasvir (DAC) in their dosage forms, human urine and human plasma using simple and rapid micellar high performance liquid chromatographic method coupled with UV detection (HPLC-UV) had been developed and validated. These drugs are described as co-administered for treatment of Hepatitis C virus (HCV). HCV is the cause of Hepatitis C and some cancers such as liver cancer (hepatocellular carcinoma) and lymphomas in humans. Separation and quantitation were carried out on anonyx™ C 8 monolithic (100 × 4.6 mm (i.d.) analytical column maintained at 25 °C. The mobile phase consisted of 0.1 M sodium dodecyl sulfate (SDS) solution containing 20% (V/V) n-propanolol and 0.3% (V/V) triethylamine and pH was adjusted to 6.5 using 0.02 M phosphoric acid, respectively. The retention times of SOF and DAC were 4.8 min, and 6.5 min, respectively. Measurements were made at flow rate of 0.5 mL/min with injection volume of 20 μL and ultraviolet (UV) detection at 226 nm. Linearity of SOF and DAC was obtained over concentration ranges of 50-400, and 40-400 ng/mL, respectively in pure form, 60-300 and 50-300 ng/mL, respectively for human plasma and over 50-400, and 40-400 ng/mL, respectively for human urine with correlation coefficient >0.999. The proposed method demonstrated excellent intra- and inter-day precision and accuracy. The suggested method was applied for determination of the drugs in pure, dosage form, and in real human plasma, real human urine and drug-dissolution test of their tablets. The obtained results have been statistically compared to reported method to give a conclusion that there is no significant differences. Copyright © 2018 Elsevier B.V. All rights reserved.

Real-world effectiveness of ledipasvir/sofosbuvir in 4,365 treatment-naive, genotype 1 hepatitis C-infected patients.

PubMed

Backus, Lisa I; Belperio, Pamela S; Shahoumian, Troy A; Loomis, Timothy P; Mole, Larry A

2016-08-01

Real-world effectiveness data are needed to inform hepatitis C virus (HCV) treatment decisions. The uptake of ledipasvir/sofosbuvir (LDV/SOF) regimens across health care settings has been rapid, but variations often occur in clinical practice. The aim of this study was to assess sustained virologic response (SVR) of LDV/SOF±ribavirin (RBV) in routine medical practice. This observational, intent-to-treat cohort was comprised of 4,365 genotype 1, treatment-naive, HCV-infected veterans treated with LDV/SOF±RBV. SVR rates were 91.3% (3,191/3,495) for LDV/SOF and 92.0% (527/573) for LDV/SOF+RBV (P = 0.65). African American race (odds ratio 0.70, 95% confidence interval 0.54-0.90, P  = 0.004) and FIB-4 >3.25 (odds ratio 0.56, 95% confidence interval 0.43-0.71, P < 0.001) were independently associated with decreased likelihood of SVR; age, sex, body mass index, decompensated liver disease, diabetes, genotype 1 subtype, and regimen did not predict SVR. In models limited to those who completed 12 weeks of treatment, African American race was no longer a significant predictor of SVR but FIB-4 >3.25 (odds ratio 0.35, 95% confidence interval 0.24-0.50, P < 0.001) remained. Among those without cirrhosis (defined by FIB-4 ≤3.25) and with baseline HCV RNA<6,000,000 IU/mL, SVR rates were 93.2% (1,020/1,094) for those who completed 8 weeks of therapy and 96.6% (875/906) for those who completed 12 weeks of therapy (P = 0.001). In this real-world cohort, SVR rates with LDV/SOF±RBV nearly matched the rates reported in clinical trials and were consistently high across all subgroups; those without cirrhosis but with HCV RNA<6,000,000 IU/mL were less likely to achieve SVR with 8 weeks compared to 12 weeks of therapy, although the numeric difference in SVR rates was small. (Hepatology 2016;64:405-414). Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Drug Authorization for Sofosbuvir/Ledipasvir (Harvoni) for Chronic HCV Infection in a Real-World Cohort: A New Barrier in the HCV Care Cascade

PubMed Central

Liapakis, AnnMarie; Cohen, Elizabeth; Chau, Hong; Bertuccio, Claudia; Sapir, Dana; Wright, Jessica; Eggers, Carol; Drozd, Kristine; Ciarleglio, Maria; Deng, Yanhong; Lim, Joseph K.

2015-01-01

Background New treatments for hepatitis C (HCV) infection hold great promise for cure, but numerous challenges to diagnosing, establishing care, and receiving therapy exist. There are limited data on insurance authorization for these medications. Materials and Methods We performed a retrospective chart review of patients receiving sofosbuvir/ledipasvir (SOF/LED) from October 11-December 31, 2014 to determine rates and timing of drug authorization. We also determined predictors of approval, and those factors associated with faster decision and approval times. Results Of 174 patients prescribed HCV therapy during this period, 129 requests were made for SOF/LED, of whom 100 (77.5%) received initial approval, and an additional 17 patients (13.9%) ultimately received approval through the appeals process. Faster approval times were seen in patients with Child-Pugh Class B disease (14.4 vs. 24.7 days, p = 0.048). A higher proportion of patients were initially approved in those with Medicare/Medicaid coverage (92.2% vs. 71.4%, p = 0.002) and those with baseline viral load ≥6 million IU/mL (84.1% vs. 62.5%, p = 0.040). Linear regression modeling identified advanced fibrosis, high Model of End Stage Liver Disease (MELD) score, and female gender as significant predictors of shorter decision and approval times. On logistic regression, Medicare/Medicaid coverage (OR 5.96, 95% CI 1.66–21.48) and high viral load (OR 4.52, 95% CI 1.08–19.08) were significant predictors for initial approval. Conclusions Early analysis of real-world drug authorization outcomes between October-December 2014 reveals that nearly one in four patients are initially denied access to SOF/LED upon initial prescription, although most patients are eventually approved through appeal, which delays treatment initiation. Having Medicare/Medicaid and advanced liver disease resulted in a higher likelihood of approval as well as earlier decision and approval times. More studies are needed to determine factors resulting in higher likelihood of denial and to evaluate approval rates and times after implementation of restrictive prior authorization guidelines. PMID:26312999

Drug Authorization for Sofosbuvir/Ledipasvir (Harvoni) for Chronic HCV Infection in a Real-World Cohort: A New Barrier in the HCV Care Cascade.

PubMed

Do, Albert; Mittal, Yash; Liapakis, AnnMarie; Cohen, Elizabeth; Chau, Hong; Bertuccio, Claudia; Sapir, Dana; Wright, Jessica; Eggers, Carol; Drozd, Kristine; Ciarleglio, Maria; Deng, Yanhong; Lim, Joseph K

2015-01-01

New treatments for hepatitis C (HCV) infection hold great promise for cure, but numerous challenges to diagnosing, establishing care, and receiving therapy exist. There are limited data on insurance authorization for these medications. We performed a retrospective chart review of patients receiving sofosbuvir/ledipasvir (SOF/LED) from October 11-December 31, 2014 to determine rates and timing of drug authorization. We also determined predictors of approval, and those factors associated with faster decision and approval times. Of 174 patients prescribed HCV therapy during this period, 129 requests were made for SOF/LED, of whom 100 (77.5%) received initial approval, and an additional 17 patients (13.9%) ultimately received approval through the appeals process. Faster approval times were seen in patients with Child-Pugh Class B disease (14.4 vs. 24.7 days, p = 0.048). A higher proportion of patients were initially approved in those with Medicare/Medicaid coverage (92.2% vs. 71.4%, p = 0.002) and those with baseline viral load ≥ 6 million IU/mL (84.1% vs. 62.5%, p = 0.040). Linear regression modeling identified advanced fibrosis, high Model of End Stage Liver Disease (MELD) score, and female gender as significant predictors of shorter decision and approval times. On logistic regression, Medicare/Medicaid coverage (OR 5.96, 95% CI 1.66-21.48) and high viral load (OR 4.52, 95% CI 1.08-19.08) were significant predictors for initial approval. Early analysis of real-world drug authorization outcomes between October-December 2014 reveals that nearly one in four patients are initially denied access to SOF/LED upon initial prescription, although most patients are eventually approved through appeal, which delays treatment initiation. Having Medicare/Medicaid and advanced liver disease resulted in a higher likelihood of approval as well as earlier decision and approval times. More studies are needed to determine factors resulting in higher likelihood of denial and to evaluate approval rates and times after implementation of restrictive prior authorization guidelines.

Air Force Special Operations Command > Home > POTFF

Science.gov Websites

Air Force Special Operations Command Air Force Special Operations Command Join the Air Force Home Sheets AFSOC Senior Leaders AFSOC Heritage Units 1st Special Operations Wing 24th Special Operations Wing 27th Special Operations Wing 352nd Special Operations Wing 353rd Special Operations Group 492nd Special

High proportions of foods recommended for consumption by United States Dietary Guidance contain solid fats and added sugar: Results from the National Health and Nutrition Examination Survey (2007-2008)

USDA-ARS?s Scientific Manuscript database

The 2010 Dietary Guidelines for Americans (DGA) recommend that individuals older than one year reduce intakes of solid fats (SoF) and added sugars (AS; together SoFAS). MyPlate, illustrates the proportions of five major food groups to promote healthy eating (Vegetables, Grains, Protein Foods, Fruit...

The Changing Nature of Warfare, the Factors Mediating Future Conflict, and Implications for SOF

DTIC Science & Technology

2006-04-01

most commonly used vernacular today, one is describing the person’s sexual orientation.13 The English language is replete with other words that have...countries and those that are technologically more advanced, primarily due to labor cost differentials. Globaliza- tion has transmuted economics from a...fascination with forensic sci- ences, ala the acclaimed television pro- gram CSI, has transmuted from civilian criminal proceedings to microscopic

Monetary Policy Delelgation and Transparency of Policy Targets: A Positive Analysis

DTIC Science & Technology

2011-06-01

International Outsourcing : Solving ihc Puzzle. February 2009 87 Riindshagcn Bianc.i. Zimmermann. Klaus sv Buchanan-Kooperarion und...through surprise inflation. In a framework with endogenous wage setting by unions. Sorensen (1991) shows that uncertainty of the policy maker’s...of ronsi i vatism in open economies . Hughes Hallett and Weymark (2004, 2005) or Lockwood et al. (1998) apply two-stage models of monetary policy

Quantifying antiviral activity optimizes drug combinations against hepatitis C virus infection.

PubMed

Koizumi, Yoshiki; Ohashi, Hirofumi; Nakajima, Syo; Tanaka, Yasuhito; Wakita, Takaji; Perelson, Alan S; Iwami, Shingo; Watashi, Koichi

2017-02-21

With the introduction of direct-acting antivirals (DAAs), treatment against hepatitis C virus (HCV) has significantly improved. To manage and control this worldwide infectious disease better, the "best" multidrug treatment is demanded based on scientific evidence. However, there is no method available that systematically quantifies and compares the antiviral efficacy and drug-resistance profiles of drug combinations. Based on experimental anti-HCV profiles in a cell culture system, we quantified the instantaneous inhibitory potential (IIP), which is the logarithm of the reduction in viral replication events, for both single drugs and multiple-drug combinations. From the calculated IIP of 15 anti-HCV drugs from different classes [telaprevir, danoprevir, asunaprevir, simeprevir, sofosbuvir (SOF), VX-222, dasabuvir, nesbuvir, tegobuvir, daclatasvir, ledipasvir, IFN-α, IFN-λ1, cyclosporin A, and SCY-635], we found that the nucleoside polymerase inhibitor SOF had one of the largest potentials to inhibit viral replication events. We also compared intrinsic antiviral activities of a panel of drug combinations. Our quantification analysis clearly indicated an advantage of triple-DAA treatments over double-DAA treatments, with triple-DAA treatments showing enhanced antiviral activity and a significantly lower probability for drug resistance to emerge at clinically relevant drug concentrations. Our framework provides quantitative information to consider in designing multidrug strategies before costly clinical trials.

Influence of surface light scattering in hydrophobic acrylic intraocular lenses on laser beam transmittance.

PubMed

Shiraya, Tomoyasu; Kato, Satoshi; Minami, Keiichiro; Miyata, Kazunori

2017-02-01

The aim of this study was to experimentally examine the changes in the transmittances of photocoagulation lasers when surface light scattering increases in AcrySof intraocular lenses (IOLs). SA60AT IOLs (Alcon) were acceleratingly aging for 0, 3, 5, and 10 years to simulate surface light scattering, and the surface light-scattering intensities of both IOL surfaces were measured using a Scheimpflug photographer. The powers of laser beams that passed from a laser photocoagulator through the aged IOLs were measured at 532, 577, and 647 nm. Changes in the laser power and transmittance with the years of aging and the intensities of surface light scattering were examined. Although the intensity of surface light scattering increased with the years of aging, the laser power did not change with the years of aging (P > 0.30, Kruskal-Wallis test). There were no significant changes in the laser transmittance with the years of aging or the laser wavelength (P > 0.30 and 0.57, respectively). The intensity of surface light scattering revealed no significant association with the laser transmittance at any wavelength (P > 0.37, liner regression). The increases in the surface light scattering of the AcrySof IOLs would not influence retinal photocoagulation treatments for up to 10 years after implantation.

A pangenotypic, single tablet regimen of sofosbuvir/velpatasvir for the treatment of chronic hepatitis C infection.

PubMed

Weisberg, Ilan S; Jacobson, Ira M

2017-04-01

Hepatitis C virus (HCV) infects nearly 170 million people worldwide and is a leading cause of progressive liver damage, cirrhosis, and hepatocellular carcinoma. Curative therapies have historically relied on interferon-based treatments and were limited by significant toxicity and poor response rates, particularly among patients with prior treatment failure and advanced hepatic fibrosis. The recent advent of direct acting antiviral (DAA) agents which target key steps in the HCV viral life cycle has transformed the landscape of HCV treatment by offering highly effective and well tolerated interferon-free treatments. However, current therapies are genotype-specific and have variable efficacy amongst less prevalent HCV variants. Areas covered: This review covers the preclinical and clinical development of sofosbuvir/velpatasvir (SOF/VEL), an interferon-free, once daily, pangenotypic treatment for the treatment of chronic hepatitis C virus (HCV) infection. All relevant literature from 2014 through September of 2016 is included. Expert opinion: SOF/VEL offers the promise of a single tablet, interferon- and ribavirin-free treatment that has extremely high efficacy in persons with chronic HCV infection regardless of genotype, subtype, treatment history or fibrosis status. It is expected to play a major role on a global scale in the therapeutic armamentarium against this ubiquitous threat to human health.

An Analytical Approach to Prioritizing the Development of Seabasing Components

DTIC Science & Technology

2007-04-05

high - speed ferries. The ships have served in intra-theater lift roles worldwide, as a staging platform for SOF during OIF, and as a ...testing. If Seabasing is to reach its full potential, a concerted effort needs to be made to develop a long-range, high - speed , heavy-lift cargo ...deck, high speed , containerized amphibious aircraft carriers) and aircraft (large, long range, naval airlift). A lot of money and energy will

What Is the Future for SOF in the Arctic?

DTIC Science & Technology

2014-12-01

Beaufort Sea) and the August values of the listed variables (two-month lead time). The variables are ranked by their R2 values (highest R2 listed first...refueling AA additional activities AJP Allied Joint Publication (NATO) ALCOM Alaska Command (U.S.) AKO Arktisk Kommando, Arctic command (DNK) AMC...capabilities. Although the scope is limited to the three nations, the overall analysis and recommendations will be of value to all states with a

Compilation of Abstracts of Theses Submitted by Candidates for Degrees

DTIC Science & Technology

1987-09-30

Paral- lel, Multiple Backend Database Systems Feudo, C.V. Modern Hardware Tochnololies 88 MAJ , USA 8nd. Sof ware Techniques for Online uatabase Storage...and itsApplication in the War- gaming , Reseamth and Analysis (W.A.R.) Lab Waltens erger, G.M. On Limited War, Escalation 524 CPT,, USRF Control, and...TECHNIQIUES FOR ONLINE DATABASE ,TORAGE AND ACCESS Christopher V. Feudo Ma or, United States Army B.S., United States Military Academy# 1972

The Deployment Life Study. Appendixes

DTIC Science & Technology

2014-01-01

dMdC SOFS x x immigration status Created for deployment Life Study x x Religious engagement or denomination FpnMAd (Trail and Karney, 2012) x x x x...Homefront Study (Chandra, Burns, et al., 2008; Chandra, Lara-Cinisomo, Jaycox, Tanielian, Han, et al., 2011) x (post) Health and well-being physical health...authorities. We will not be asking questions about sexual or physical | | | | | | | | | abuse of a child, but you should know that, if this information is

The Dilemma for USSOCOM: Transitioning SOF-Peculiar to Service-Common

DTIC Science & Technology

2012-02-15

suggests a lack of “ advertising ”, i.e. the need for a clearing house of ideas. General Haase’s brief suggested the DoD did not have a defined...of debate. Still another avenue is the Capability Portfolio Management ( CPM ) system which seeks to optimize capability investments across the...defense enterprise.59 Though CPMs are charged to identify issues, priorities, and capability and resources mismatches, they have no independent decision

The Role of the Global SOF Network in a Resource Constrained Environment

DTIC Science & Technology

2013-11-01

backed by actions. Step Two: Matching Skill Sets with Individuals: Who Needs to Know What? This step sounds simple enough in theory . You need to...Training Finally, step five is the recognition that, like physical training and condition- ing, cognitive skills need to be continuously refreshed. These...and maintaining the data needed , and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other

A Graphics Editor for Structured Analysis with a Data Dictionary.

DTIC Science & Technology

1987-12-01

4-3 Human/Computer Interface Considerations 4-3 Screen Layout .... ............. 4-4 Menu System ..... .............. 4-6 Voice Feedback...central computer system . This project is a direct follow on to the 1986 thesis by James W. Urscheler. lie created an initial version of a tool (nicknamed...graphics information. Background r SADT. SADT is the name of SofTech’s methodology for doing requirement analysis and system design. It was first published

University of Kansas Research and Educational Support for U.S. Army Programs and Initiatives at Fort Leavenworth, Kansas

DTIC Science & Technology

2013-09-03

the flanking ranges are Cretaceous and Triassic igneous and metamorphic rocks . (O’Leary & Whitney, USGS Geologic Map of the Kandahar Region, 2005...focusing on interagency collaboration for US SOF officers who attend the Army’s Command and General Staff College; (2) a graduate business program...46. Holt, Christina; Fawcett, Stephen. “Supporting Transformative Community Change Efforts Using Online Technology.” 47. Holt, Christina; Fawcett

Analysis of Rotary Aircraft Alternatives for NATO SOF Organic Air Wing

DTIC Science & Technology

2012-06-01

analysis with an assumed program start in 2013 and an end in 2019 to determine the impact of short program duration on platform selection. D...FY12 GO\\ LR,~itl\\ l Sli LABOR H13 (J()VI R\\\\iFI\\TSE I AROR FY14 GOVLR\\\\iLI\\ I Sl:. LABOR H15 SI:.PO CSS FY II SII’O CSS FY 12 SEI’() CSS fY 13

Enhanced Army Airborne Forces: A New Joint Operational Capability

DTIC Science & Technology

2014-01-01

that are trained to carry out airborne operations, including the 75th Ranger Regiment and Army special forces. Today’s airborne forces lack protected...Operation Just Cause Airborne units were used extensively in Panama, and the 82nd Air- borne’s 1st Brigade and the 75th Ranger Regiment were both...carry out airborne operations, including the 75th Ranger Regiment and Army special forces. The changes made to transition the Army into a force

Granulocyte-macrophage colony stimulating factor (GM-CSF) enhances cumulus cell expansion in bovine oocytes

PubMed Central

2013-01-01

Background The objectives of the study were to characterize the expression of the α- and β-subunits of granulocyte-macrophage colony stimulating factor (GM-CSF) receptor in bovine cumulus cells and oocytes and to determine the effect of exogenous GM-CSF on cumulus cells expansion, oocyte maturation, IGF-2 transcript expression and subsequent competence for embryonic development. Methods Cumulus-oocyte complexes (COC) were obtained by aspirating follicles 3- to 8-mm in diameter with an 18 G needle connected to a vacuum pump at −50 mmHg. Samples of cumulus cells and oocytes were used to detect GM- CSF receptor by immunofluorescence. A dose–response experiment was performed to estimate the effect of GM-CSF on cumulus cell expansion and nuclear/cytoplasmic maturation. Also, the effect of GM-CSF on IGF-2 expression was evaluated in oocytes and cumulus cells after in vitro maturation by Q-PCR. Finally, a batch of COC was randomly assigned to in vitro maturation media consisting of: 1) synthetic oviductal fluid (SOF, n = 212); 2) synthetic oviductal fluid supplemented with 100 ng/ml of GM-CSF (SOF + GM-CSF, n = 224) or 3) tissue culture medium (TCM 199, n = 216) and then subsequently in vitro fertilized and cultured for 9 days. Results Immunoreactivity for both α and β GM-CSF receptors was localized in the cytoplasm of both cumulus cells and oocytes. Oocytes in vitro matured either with 10 or 100 ng/ml of GM-CSF presented a higher (P < 0.05) cumulus cells expansion than that of the control group (0 ng/ml of GM-CSF). GM-CSF did not affect the proportion of oocytes in metaphase II, cortical granules dispersion and IGF-2 expression. COC exposed to 100 ng/ml of GM-CSF during maturation did not display significant differences in terms of embryo cleavage rate (50.4% vs. 57.5%), blastocyst development at day 7 (31.9% vs. 28.7%) and at day 9 (17.4% vs. 17.9%) compared to untreated control (SOF alone, P = 0.2). Conclusions GM-CSF enhanced cumulus cell expansion of in vitro matured bovine COC. However, GM-CSF did not increase oocyte nuclear or cytoplasmic maturation rates, IGF-2 expression or subsequent embryonic development. PMID:23799974

[The first national program of pediatric lung transplantation: the experience in pediatric intensive care].

PubMed

Frías Pérez, M; Montero Schiemann, C; Ibarra de la Rosa, I; Ulloa Santamaría, E; Muñoz Bonet, J; Velasco Jabalquinto, M; Pérez Navero, J; Lama Martínez, R; Santos Luna, F; Salvatierra Velázquez, A; López Pujol, J

1999-06-01

The aim of this study was to analyze the postoperative progress and medical management in the Pediatric Intensive Care Unit (PICU) of patients that underwent bilateral lung transplant. From April 1997 to June 1998, 10 pediatric lung transplants were performed at the Hospital Reina Sofía (Córdoba, Spain). There were 4 males and 6 females (mean age 11.5 years, range 5 to 15 years). Indications for transplantation were cystic fibrosis (n = 9) and one pulmonary fibrosis secondary to viral infection. Before the transplant, two patients required mechanical ventilation for acute respiratory decompensation and one patient was ventilator-dependent. Immunosuppression consisted of corticosteroids, azathioprine and cyclosporine or tacrolimus. Post-transplantation management included early extubation, when possible, optimal fluid balance to prevent lung edema, low aggressive mechanical ventilation and adequate treatment of complications, such as rejection and infection. There were no peri-operative mortalities. The mean stay in the PICU was 28 days (median: 17 days) and the mean time on mechanical ventilation was 19 days (median: 5.5 days). The most frequent complications were rejection (n = 8), hyperglycemia (n = 6), renal failure (n = 4), arterial hypertension (n = 4) and respiratory infections (n = 3). There were no airway complications. Even if the post-operative period in pediatric lung transplant patients is difficult, the results have been good with an important improvement in the quality of life of these patients has been achieved.

Mental health status of Sri Lanka Navy personnel three years after end of combat operations: a follow up study.

PubMed

Hanwella, Raveen; Jayasekera, Nicholas E L W; de Silva, Varuni A

2014-01-01

The main aim of this study was to assess the mental health status of the Navy Special Forces and regular forces three and a half years after the end of combat operations in mid 2009, and compare it with the findings in 2009. This cross sectional study was carried out in the Sri Lanka Navy (SLN), three and a half years after the end of combat operations. Representative samples of SLN Special Forces and regular forces deployed in combat areas were selected using simple random sampling. Only personnel who had served continuously in combat areas during the one year period prior to the end of combat operations were included in the study. The sample consisted of 220 Special Forces and 275 regular forces personnel. Compared to regular forces a significantly higher number of Special Forces personnel had experienced potentially traumatic events. Compared to the period immediately after end of combat operations, in the Special Forces, prevalence of psychological distress and fatigue showed a marginal increase while hazardous drinking and multiple physical symptoms showed a marginal decrease. In the regular forces, the prevalence of psychological distress, fatigue and multiple somatic symptoms declined and prevalence of hazardous drinking increased from 16.5% to 25.7%. During the same period prevalence of smoking doubled in both Special Forces and regular forces. Prevalence of PTSD reduced from 1.9% in Special Forces to 0.9% and in the regular forces from 2.07% to 1.1%. Three and a half years after the end of combat operations mental health problems have declined among SLN regular forces while there was no significant change among Special Forces. Hazardous drinking among regular forces and smoking among both Special Forces and regular forces have increased.

Can SOF Assist USPACOM in Building a Stronger Link to China’s PLA?

DTIC Science & Technology

2014-05-15

April 27, 2014. 7 Leon E . Panetta, Sustaining U.S. Global Leadership: Priorities for 21 st Century Defense (Washington DC: Office of the Secretary...9 Leon E . Panetta, Sustaining U.S. Global Leadership: Priorities for 21 st Century Defense, p. 2. 10 Ibid, pp. 1-3. 11 Chuck Hagel...20 Leon E . Panetta, Military and Security Developments Involving the People’s Republic of China 2013 (Washington DC: Office of the Secretary

Study to Improve Airframe Turbine Engine Rotor Blade Containment

DTIC Science & Technology

1977-07-01

REPORT NO. FAA-RD-77-44 ( DOT-FA76WA-3843 JUNE 1976 STUDY TO IMPROVE AIRFRAME TURBINE ENGINE ROTOR BLADE CONTAINMENT C. 0. GUNDERSON SOF Tftj. -" So...both engines appeared to be able to marginally contain the 1 and 2 blade fragments in all compressor and turbine stages, but probably would rfiot have...adjacent blades including serrations from any stage. The investigation was made on high bypass ratio turbofan engines which power wide body transports

Rutting Performance of Cold-Applied Asphalt Repair Materials for Airfield Pavements

DTIC Science & Technology

2017-06-23

susceptibility of hot mix asphalt (HMA) using the asphalt pavement analyzer (APA). Designation T340- 10. Washington, DC: American Association of State...ER D C/ G SL T R- 17 -1 0 Rutting Performance of Cold-Applied Asphalt Repair Materials for Airfield Pavements G eo te ch ni ca l a nd S...of Cold-Applied Asphalt Repair Materials for Airfield Pavements Ben C. Cox, John F. Rushing, and Web Floyd Geotechnical and Structures Laboratory

Investment Strategy for DoD Automatic Test Systems. Volume 2. Supporting Data

DTIC Science & Technology

1994-01-01

DESCOM Col Steve Dasher PM, TMDE Col William Deegan SAALC/LDA Mr. Don Desilets NVWC NPT (8314) Mr. W. Devers IDA Lt Col Easley HQ USAF (SOF) Mr. Bit Frank...OOALCJFISEA Mr. Craig Wall ASC/SMG Mr. Frank Wiilis OOALCMTISADC LCDR Patrick Witt NAWCADLKE 0 F- F-4 S Industry Participants (Briefings and Interviews...Effectiveness Analysis) COEA) Update (MSIIIB Report). January 1992 VXI Consortion. VXI (VXE Bus Extensions for Instrumentation) Briefing. Wall, Craig . ASD/ENEM

Proceedings of the Irvine Workshop on Alternatives for the Environment, Certification, and Control of the DOD Common High Order Language, Held at California University, Irvine on 20-22 June 1978.

DTIC Science & Technology

1978-01-01

of the poet Lord Byron, and Babbage ’s "programmer." For reasons of historical accuracy, the use of the working title "DODi" has been retained in the...Surface Weapons Center Al Irvine, SofTech, Inc. Rob Kling, UC - Irvine John C. Knight, NASA Langley Research Center Charles L. Lawson, Jet Propulsion

2012 Workplace and Gender Relations Survey of Active Duty Members: Nonresponse Bias Analysis Report

DTIC Science & Technology

2014-01-01

Control and Prevention ), or command climate surveys (e.g., DEOCS). 6 Table 1. Comparison of Trends in WGRA and SOFS-A Response Rates (Shown in...DMDC draws optimized samples to reduce survey burden on members as well as produce high levels of precision for important domain estimates by using...statistical significance at α= .05 Because paygrade is a significant predictor of survey response, we next examined the odds ratio of each paygrade levels

Compaction Control of Earth-Rock Mixtures

DTIC Science & Technology

1991-08-01

specifications have avoided dealing with the full-scale materials. For example, the specified range for water contenz and the value of minimum de - sired percent...Record Samples taken from that embankment or concerning the satisfactory result sof tets perfornt d on t lous. s c p s relative to de ~sgn r, q:.irements...precision of the compaction test provided that the lines of optimums of the families of curves are neatly de - fined. That is to say that the

The Other Quiet Professionals: Lessons for Future Cyber Forces from the Evolution of Special Forces

DTIC Science & Technology

2014-01-01

Special Forces, Rangers, civil affairs, and psychological operations units—under the new command. Furthermore, the army provided Special Forces with...and 10th Special Forces (Airborne) groups; the 4th Psychological Operations Group, 96th Civil Affairs Battalion; the 75th Ranger Regiment; the 160th...and reserve psychological operations and civil affairs units. Similarly, the Navy sought to withhold U.S. Naval Special Warfare forces, arguing that

Combination of biodiesel-ethanol-diesel fuel blend and SCR catalyst assembly to reduce emissions from a heavy-duty diesel engine.

PubMed

Shi, Xiaoyan; Yu, Yunbo; He, Hong; Shuai, Shijin; Dong, Hongyi; Li, Rulong

2008-01-01

In this study, the efforts to reduce NOx and particulate matter (PM) emissions from a diesel engine using both ethanol-selective catalytic reduction (SCR) of NOx over an Ag/Al2O3 catalyst and a biodiesel-ethanol-diesel fuel blend (BE-diesel) on an engine bench test are discussed. Compared with diesel fuel, use of BE-diesel increased PM emissions by 14% due to the increase in the soluble organic fraction (SOF) of PM, but it greatly reduced the Bosch smoke number by 60%-80% according to the results from 13-mode test of European Stationary Cycle (ESC) test. The SCR catalyst was effective in NOx reduction by ethanol, and the NOx conversion was approximately 73%. Total hydrocarbons (THC) and CO emissions increased significantly during the SCR of NOx process. Two diesel oxidation catalyst (DOC) assemblies were used after Ag/Al2O3 converter to remove CO and HC. Different oxidation catalyst showed opposite effect on PM emission. The PM composition analysis revealed that the net effect of oxidation catalyst on total PM was an integrative effect on SOF reduction and sulfate formation of PM. The engine bench test results indicated that the combination of BE-diesel and a SCR catalyst assembly could provide benefits for NOx and PM emissions control even without using diesel particle filters (DPFs).

Hsp47 mediates Cx43-dependent skeletal growth and patterning in the regenerating fin.

PubMed

Bhadra, Joyita; Iovine, M Kathryn

2015-11-01

Skeletal morphogenesis describes how bones achieve their correct shape and size and appropriately position joints. We use the regenerating caudal fin of zebrafish to study this process. Our examination of the fin length mutant short fin (sof (b123)) has revealed that the gap junction protein Cx43 is involved in skeletal morphogenesis by promoting cell proliferation and inhibiting joint formation, thereby coordinating skeletal growth and patterning. Here we demonstrate that serpinh1b is molecularly and functionally downstream of cx43. The gene serpinh1b codes for a protein called Hsp47, a molecular chaperone responsible for proper folding of procollagen molecules. Knockdown of Hsp47 in regenerating fins recapitulates the sof (b123) phenotypes of reduced fin length, reduced segment length and reduced level of cell proliferation. Furthermore, Hsp47 knockdown affects the organization and localization of the collagen-based actinotrichia. Together, our findings reveal that serpinh1b acts in a cx43 dependent manner to regulate cell proliferation and joint formation. We conclude that disruption of the collagen-based extracellular matrix influences signaling events required for cell proliferation, as well as the patterning of skeletal precursor cells that influences segment length. Therefore, we suggest that Hsp47 function is necessary for skeletal growth and patterning during fin regeneration. Copyright © 2015 Elsevier B.V. All rights reserved.

Reheating of soy oil is detrimental to bone metabolism in oestrogen deficient rats.

PubMed

Ima-Nirwana, S; Ahmad, S Nazrun; Yee, L J; Loh, H C; Yew, S F; Norazlina, M; Abdul, M T Gapor; Kamsiah, J

2007-03-01

The short-term and long- term effects of heated soy oil on bone metabolism in ovariectomised Sprague-Dawley rats were studied. Three-month-old female rats, were divided into five groups: normal control (NC); ovariectomised control (OVXC); ovariectomised and fed rat chow with added fresh soybean oil (SOF) or once-heated soy oil (SO1) or five-times-heated soy oil (SO5). Short-term parameters measured after one month were serum interleukin-6 (IL-6) and osteocalcin. Long-term parameters measured after six months were the structural bone histomorphometrical parameters. Vitamin E content in the soy oil subjected to the different heating treatments were also measured. Rats in the SO5 group had higher levels of IL-6 after one month compared to the other four groups. Osteocalcin levels in the SO1 and SO5 groups remained high after treatment, while those in the NC and SOF groups declined. After six months, bone mass declined in the SO5 group. Vitamin E assay in the oils showed that levels of alpha-tocopherol decreased after heating the oil once and five times, while levels of gamma- and delta-tocopherols only declined after heating five times. Repeated heating of soy oil destroyed the tocopherols causing raised serum IL-6 and osteocalcin levels, leading to increased bone resorption and osteoporosis in the long term.

Ledipasvir/sofosbuvir is effective and well tolerated in postkidney transplant patients with chronic hepatitis C virus.

PubMed

Morales, Amilcar L; Liriano-Ward, Luz; Tierney, Amber; Sang, Michelle; Lalos, Alexander; Hassan, Mohamed; Nair, Vinay; Schiano, Thomas; Satoskar, Rohit; Smith, Coleman

2017-05-01

Patients with end-stage renal diseases on hemodialysis have a high prevalence of hepatitis C infection (HCV). In most patients, treatment for HCV is delayed until postrenal transplant. We assessed the effectiveness and tolerance of ledipasvir/sofosbuvir (LDV/SOF) in 32 postkidney transplant patients infected with HCV. The group was composed predominantly of treatment-naïve (75%) African American (68.75%) males (75%) infected with genotype 1a (62.5%). Most patients received a deceased donor kidney graft (78.1%). A 96% sustained viral response (SVR) was reported (27/28 patients). One patient relapsed. One patient with baseline graft dysfunction developed borderline rejection. No graft loss was reported. Six HIV-coinfected patients were included in our analysis. Five of these patients achieved SVR 12. There were four deaths, and one of the deaths was in the HIV group. None of the deaths were attributed to therapy. Coinfected patients tolerated therapy well with no serious adverse events. Serum creatinine remained stable at baseline, end of therapy, and last follow-up, (1.351±.50 mg/dL; 1.406±.63 mg/dL; 1.290±.39 mg/dL, respectively). In postkidney transplant patients with HCV infection with or without coinfection with HIV, a combination of LDV/SOF was well tolerated and effective. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of Optical Quality: Ocular Scattering and Aberrations in Eyes Implanted with Diffractive Multifocal or Monofocal Intraocular Lenses.

PubMed

Liao, Xuan; Lin, Jia; Tian, Jing; Wen, BaiWei; Tan, QingQing; Lan, ChangJun

2018-06-01

To compare objective optical quality, ocular scattering and aberrations of eyes implanted with an aspheric monofocal intraocular lens (IOL) or an aspheric apodized diffractive multifocal IOL three months after surgery. Prospective consecutive nonrandomized comparative cohort study. A total of 80 eyes from 57 cataract patients were bilaterally or unilaterally implanted with monofocal (AcrySof IQ SN60WF) or multifocal (AcrySof IQ ReSTOR SN6AD1) IOLs. Respectively, 40 eyes of 27 patients were implanted with monofocal IOLs, and 40 eyes of 30 patients were implanted with multifocal IOLs. Ocular high-order aberration (HOA) values were obtained using Hartmann-Shack aberrometer; objective scatter index (OSI), modulation transfer function (MTF) cutoff, Strehl ratio (SR), and contrast visual acuity OV at 100%, 20%, and 9% were measured using Objective Quality Analysis System II (OQAS II). Ocular aberrations performed similar in both groups (p > 0.05). However, significantly higher values of OSI and lower values of MTF cutoff, SR and OV were found in the SN6AD1 group (p < 0.05). Both ocular scattering and wave-front aberrations play essential role in retinal image quality, which may be overestimated when only aberrations were taken into account. Combining the effect of ocular scattering with HOA will result in a more accurate assessment of the visual and optical quality.

Water's Way at Sleepers River watershed – revisiting flow generation in a post-glacial landscape, Vermont USA

USGS Publications Warehouse

Shanley, James B.; Sebestyen, Stephen D.; McDonnell, Jeffrey J.; McGlynn, Brian L.; Dunne, Thomas

2015-01-01

The Sleepers River Research Watershed (SRRW) in Vermont, USA, has been the site of active hydrologic research since 1959 and was the setting where Dunne and Black demonstrated the importance and controls of saturation-excess overland flow (SOF) on streamflow generation. Here, we review the early studies from the SRRW and show how they guided our conceptual approach to hydrologic research at the SRRW during the most recent 25 years. In so doing, we chronicle a shift in the field from early studies that relied exclusively on hydrometric measurements to today's studies that include chemical and isotopic approaches to further elucidate streamflow generation mechanisms. Highlights of this evolution in hydrologic understanding include the following: (i) confirmation of the importance of SOF to streamflow generation, and at larger scales than first imagined; (ii) stored catchment water dominates stream response, except under unusual conditions such as deep frozen ground; (iii) hydrometric, chemical and isotopic approaches to hydrograph separation yield consistent and complementary results; (iv) nitrate and sulfate isotopic compositions specific to atmospheric inputs constrain new water contributions to streamflow; and (v) convergent areas, or ‘hillslope hollows’, contribute disproportionately to event hydrographs. We conclude by summarizing some remaining challenges that lead us to a vision for the future of research at the SRRW to address fundamental questions in the catchment sciences.

Stabilization Operations Through Military Capacity Building-Integration Between Danish Conventional Forces and Special Operations Forces

DTIC Science & Technology

2016-12-01

Svendsen 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Postgraduate School Monterey, CA 93943-5000 8. PERFORMING ORGANIZATION REPORT...operations forces should be fully integrated across doctrine, organization , and technology, and predominantly advise, mentor, and train local forces. With...stability operations. This capstone makes additional recommendations related to doctrine, organization , and technology, as well as education and

Interdependence and Conventional and Special Operations Forces: A Decade of Tactical, Operational, and Strategic Effects

DTIC Science & Technology

2014-05-14

INTERDEPENDENCE AND CONVENTIONAL AND SPECIAL OPERATIONS FORCES: A DECADE OF TACTICAL , OPERATIONAL, AND STRATEGIC EFFECTS A Monograph by LTC...5a. CONTRACT NUMBER Interdependence and Conventional and Special Operations Forces: 5b. GRANT NUMBER A Decade of Tactical , Operational, and...Staff College ATTN: ATZL-SWD-GD 100 Stimson Ave . Ft. Leavenworth, KS 66027-2301 9. SPONSORING

Monitoring of Emissions From a Refinery Tank Farm Using a Combination of Optical Remote Sensing Techniques

NASA Astrophysics Data System (ADS)

Polidori, A.; Tisopulos, L.; Pikelnaya, O.; Mellqvist, J.; Samuelsson, J.; Marianne, E.; Robinson, R. A.; Innocenti, F.; Finlayson, A.; Hashmonay, R.

2016-12-01

Despite great advances in reducing air pollution, the South Coast Air Basin (SCAB) still faces challenges to attain federal health standards for air quality. Refineries are large sources of ozone precursors and, hence contribute to the air quality problems of the region. Additionally, petrochemical facilities are also sources of other hazardous air pollutants (HAP) that adversely affect human health, for example aromatic hydrocarbons. In order to assure safe operation, decrease air pollution and minimize population exposure to HAP the South Coast Air Quality Management District (SCAQMD) has a number of regulations for petrochemical facilities. However, significant uncertainties still exist in emission estimates and traditional monitoring techniques often do not allow for real-time emission monitoring. In the fall of 2015 the SCAQMD, Fluxsense Inc., the National Physical Laboratory (NPL), and Atmosfir Optics Ltd. conducted a measurement study to characterize and quantify gaseous emissions from the tank farm of one of the largest oil refineries in the SCAB. Fluxsense used a vehicle equipped with Solar Occultation Flux (SOF), Differential Optical Absorption Spectroscopy (DOAS), and Extractive Fourier Transform Infrared (FTIR) spectroscopy instruments. Concurrently, NPL operated their Differential Absorption Lidar (DIAL) system. Both research groups quantified emissions from the entire tank farm and identified fugitive emission sources within the farm. At the same time, Atmosfir operated an Open Path FTIR (OP-FTIR) spectrometer along the fenceline of the tank farm. During this presentation we will discuss the results of the emission measurements from the tank farm of the petrochemical facility. Emission rates resulting from measurements by different ORS methods will be compared and discussed in detail.

Defense.gov - Dignity, Honor, Respect - For the Fallen

Science.gov Websites

combat operation passes through Dover Air Force Base, Del. The responsibility, and honor, of preparing Operations Center. Stories Dignified Transfer Pays Tribute to Fallen DOVER AIR FORCE BASE, Del., March 12 vehicle to the Air Force Mortuary Affairs Operations Center at Dover Air Force Base, Del. Story Center

Operating force information on-line acquisition of a novel slave manipulator for vascular interventional surgery.

PubMed

Zhao, Yan; Guo, Shuxiang; Xiao, Nan; Wang, Yuxin; Li, Youxiang; Jiang, Yuhua

2018-04-02

Vascular interventional surgery has its advantages compared to traditional operation. Master-slave robotic technology can further improve the operation accuracy, efficiency and safety of this complicated and high risk surgery. However, on-line acquisition of operating force information of catheter and guidewire remains to be a significant obstacle on the path to enhancing robotic surgery safety. Thus, a novel slave manipulator is proposed in this paper to realize on-line sensing of guidewire torsional operating torque and axial operation force during robotic assisted operations. A strain sensor is specially designed to detect the small scale torsional operation torque with low rotational frequency. Additionally, the axial operating force is detected via a load cell, which is incorporated into a sliding mechanism to eliminate the influence of friction. For validation, calibration and performance evaluation experiments are conducted. The results indicate that the proposed operation torque and force detection device is effective. Thus, it can provide the foundation for enabling accurate haptic feedback to the surgeon to improve surgical safety.

Diversity within the Joint Team: Understanding the Different Operational Perspectives of the Army and Air Force

DTIC Science & Technology

2012-12-06

potential of airpower. Mitchell carried the torch for these young airmen and had plans to develop a strategic bombing force, but the war ended...and ways they use to overcome the problems within their specific domains, the Army and Air Force have developed different operational perspectives...domains, the Army and Air Force have developed different operational perspectives. The differences would not matter if each conducted operations

Remotely adjustable fishing jar and method for using same

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

Wyatt, W.B.

1992-10-20

This patent describes a method for providing a jarring force to dislodge objects stuck in well bores, the method it comprises: connecting a jarring tool between an operating string and an object in a well bore; selecting a jarring force to be applied to the object; setting the selected reference jarring force into a mechanical memory mechanism by progressively engaging a first latch body and a second latch body; retaining the reference jarring force in the mechanical memory mechanism during diminution of tensional force applied by the operating string; and initiating an upwardly directed impact force within the jarring toolmore » by increasing tensional force on the operating string to a value greater than the tensional force corresponding with the selected jarring force. This patent also describes a remotely adjustable downhole fishing jar apparatus comprising: an operating mandrel; an impact release spring; a mechanical memory mechanism; and releasable latching means.« less

Acquisition of a Memory Skill.

DTIC Science & Technology

1980-05-01

MONICA, CA 90406 1 Dr. Robert Sternberg 1 Dr. Walt W . Tornow Dept. of Psychology Control Data Corporation Yale University Corporate Personnel Research...AD-AGBV 7514 CARNEGIE-MELLON UNIV PITTSBURGH PA DEPT OF PSYCHOLOGY F/G 5/10 ACQUISITION OF A MEMORY SKILL.(U) MAY 80 W 6 CHASE, K A ERICSSON, S...of Mental Health. We thank J.R. Anderson, M.T.H. Chi, W . Jones, M. W . Schustack, and H.A. Simon for their valuable comments. Avasa Bei On For specia

Nonlinear Modeling and Initial Condition Estimation for Identifying the Aerothermodynamic Environment of the Space Shuttle Orbiter.

DTIC Science & Technology

1983-12-01

8217°%. .. o..’% - * 2’ . *. -o- . *o.oo o ,o ;j ’:-’ List of Figures Figure Page 1. System Identification of the Aerothermodynamic Environment of... System (STS) has of fered the engineering community a unique opportunity to flight test a reentry, hypersonic vehicle. The key 4 to the Shuttle’s...of the system (Refs. 7,8,9,10). Although the initial test flights have now been completed, data analysis and expansion of the existing data base

Financial Planning and Control for the Military Officer.

DTIC Science & Technology

1984-06-01

to take control and tV 00 W 43 60,1081 op I5.OET 1Vo sof~’ UNCLASSIFIED 5/N 0102- LPL 014- 6601 SE9CUIT CI.AS&IFICATIOPI OF THIS PAGE (menm bloo ...LL. June 1984 Thesis Advisor: John W . Creighton Approved for public release; distribution unlimited. Prepared for: SD A0 United States Naval Academy...By Annapolis, MD United States Marine Corps NAVAL POSTGRADUATE SCHOOL Monterey, California Commodore R. H. Shumaker David A. Schrady Superintendent

Signal Classification in Fading Channels Using Cyclic Spectral Analysis

DTIC Science & Technology

2009-07-01

Classifier Design The proposed classifier is designed to classify AM, BFSK, OFDM, DS - CDMA , 4-ASK, 8-ASK, BPSK, QPSK, 8-PSK, 16-PSK, 16-QAM, and 64-QAM...five independent neural networks, each trained to classify a signal as either AM, BFSK, DS - CDMA , or a linear modulation scheme with a real-valued...in an SOF image that resembles those of QAM and PSK signals. Additionally, the DS - CDMA scheme can be thought to look like a BPSK signal. However, due

Designing Collaboration: How to Prepare SOF Augmentation Teams for Assignment to a U.S. Embassy Country Team

DTIC Science & Technology

2014-06-01

allegiance will remain to their parent organization. Country team members must accept their role as part of an organization, willing to put the country...country team may be tempted to hold onto and treat certain types of information as special to their parent organization and keep it “stove piped...prepare personnel to master their assigned specialty within their parent organization, but do not emphasize preparing these same personnel for their

U.S. Army Biomedical Research and Development Laboratory Bibliography FY91-FY80 (Reverse Order). Appendix

DTIC Science & Technology

1991-01-01

G.E. Toms. 1991. SOF sterilizer, 1st article test. Memorandum Report No. 1 -91. Hodge, J.W., and G.E. Toms. 1991. Sterilizer, surgical instruments and...for the performance of FETAX, Stillwater, OK: Oklahoma State University Press. 3 Burrows, E.P. 1991. Mass spectral fragmentation pathways of 1 ...potential of LP1846 liquid gun propellant to induce unscheduled DNA synthesis in the in vitro hepatocyte DNA repair assay. Final report, Project Order

Kernel Ada Programming Support Environment (KAPSE) Interface Team. Volume I. Public Report.

DTIC Science & Technology

1982-04-01

productivity. Unfortunately, * command procedures often are needed to insulate the users from a poorly engineered human interface. Bot ~h command...0-MMa CAf- ON OPERaTnS Figu; a~ 0AS.Hs SItraei nemerc ~ nertEvrnet 0 1.--x In the SofTech ALS the user comunicates with the KAPSE rather than with VMS...a close relationship requires the host vendor to disclose all of his plans to the APSE CCB and maintenance comunity . In the commercial world, secrecy

A test of the Forest Inventory and Analysis Program’s down woody material indicator for regional fuel estimation in the Southern Appalachian Mountains (PROJECT SO-F-06-01)

Treesearch

G. Geof Wang; Zhi-Ping Wang; Aaron D. Stottlemyer; Thomas A. Waldrop

2013-01-01

Both the National Fire Plan (http://199.134.225.50/nwcc/t2_wa4/ pdf/RuralAssistance.pdf) and the Healthy Forest Initiative (http://www.fs.fed.us/projects/ hfi/2003/august/documents/hfi-fact-sheet. pdf) call for reduction of hazardous fuels. Consequently, estimations of forest fuel loading at various scales become necessary. The Forest Inventory and Analysis (FIA)...

A new scheme of force reflecting control

NASA Technical Reports Server (NTRS)

Kim, Won S.

1992-01-01

A new scheme of force reflecting control has been developed that incorporates position-error-based force reflection and robot compliance control. The operator is provided with a kinesthetic force feedback which is proportional to the position error between the operator-commanded and the actual position of the robot arm. Robot compliance control, which increases the effective compliance of the robot, is implemented by low pass filtering the outputs of the force/torque sensor mounted on the base of robot hand and using these signals to alter the operator's position command. This position-error-based force reflection scheme combined with shared compliance control has been implemented successfully to the Advanced Teleoperation system consisting of dissimilar master-slave arms. Stability measurements have demonstrated unprecedentedly high force reflection gains of up to 2 or 3, even though the slave arm is much stiffer than operator's hand holding the force reflecting hand controller. Peg-in-hole experiments were performed with eight different operating modes to evaluate the new force-reflecting control scheme. Best task performance resulted with this new control scheme.

Apparatus for providing vibrotactile sensory substitution of force feedback

NASA Technical Reports Server (NTRS)

Massimino, Michael J. (Inventor); Sheridan, Thomas B. (Inventor); Patrick, Nicholas J. M. (Inventor)

1997-01-01

A feedback apparatus for an operator to control an effector that is remote from the operator to interact with a remote environment has a local input device to be manipulated by the operator. Sensors in the effector's environment are capable of sensing the amplitude of forces arising between the effector and its environment, the direction of application of such forces, or both amplitude and direction. A feedback signal corresponding to such a component of the force, is generated and transmitted to the environment of the operator. The signal is transduced into a vibrotactile sensory substitution signal to which the operator is sensitive. Vibration producing apparatus present the vibrotactile signal to the operator. The full range of the force amplitude may be represented by a single, mechanical vibrator. Vibrotactile display elements can be located on the operator's limbs, such as on the hand, fingers, arms, legs, feet, etc. The location of the application of the force may also be specified by the location of a vibrotactile display on the operator's body. Alternatively, the location may be specified by the frequency of a vibrotactile signal.

What It Takes. Air Force Command of Joint Operations

DTIC Science & Technology

2009-01-01

Iraq Assistance Group IDE intermediate developmental education IO international organization ISAF International Security and Assistance Force ISR...Operations Table A.1—Continued Joint Task Force Mission/Operation Start End Service Command Rank JTF–Joint Area Support Group (JASG) Iraqi Freedom...be of interest to a wide group of Air Force personnel involved in the development and func- tion of the service’s command organizations, including

Army Special Operations Forces (ARSOF): How Can ARSOF Redirect Efforts in Colombia from Tactical to Operational Level Support Due to the Recent Transition of the Fuerzas Armadas Revolucionarias Colombianas (FARC)

DTIC Science & Technology

The remodeling of Army Special Operations Forces (ARSOF) support to Colombian Security Forces during the transition phase of the Revolutionary Armed ...Forces of Colombia needs to be revised at to retain stability in the country. The Fuerzas Armadas Revolucionarias Colombianas (Revolutionary Armed

Adsorption performance of Rh decorated SWCNT upon SF6 decomposed components based on DFT method

NASA Astrophysics Data System (ADS)

Zhang, Xiaoxing; Cui, Hao; Dong, Xingchen; Chen, Dachang; Tang, Ju

2017-10-01

Transition metal decorated carbon nanotubes (CNTs) applied in the field of gas adsorption and storage have in recent years accepted considerable attentions because of their superior adsorbing performance. In electrical engineering, they are employed as adsorbents to remove the decomposed products of SF6 caused by partial discharge, for guaranteeing the insulation status of gas insulation switchgear (GIS). In this paper, Rh doped SWCNT is introduced to investigate its adsorption properties towards typical gases of SF6 based on density functional theory (DFT) method. Both single and double molecules adsorbing systems were performed to investigate the adsorption ability of proposed material. Results indicate that Rh-CNT, which has strong interaction with defined gas molecules, is a promising material for SF6 decompositions adsorption especially SO2 and SOF2 that exhibit topmost sensitivity to the modified surface. Therefore, we suggest the Rh-CNT to be an adsorbent to be applied in GIS for guaranteeing the operation state of such devices and even to be exploited as gas sensor to evaluate the insulation state of the power system. Our calculations would provide experimentalist with a first insight into physicochemical properties of this material.

Adsorption mechanism of SF6 decomposed species on pyridine-like PtN3 embedded CNT: A DFT study

NASA Astrophysics Data System (ADS)

Cui, Hao; Zhang, Xiaoxing; Chen, Dachang; Tang, Ju

2018-07-01

Metal-Nx embedded CNT have aroused considerable attention in the field of gas interaction due to their strong catalytic behavior, which provides prospective scopes for gas adsorption and sensing. Detecting SF6 decomposed species in certain devices is essential to guarantee their safe operation. In this work, we performed DFT method and simulated the adsorption of three SF6 decomposed gases (SO2, SOF2 and SO2F2) onto the PtN3 embedded CNT surface, in order to shed light on its adsorption ability and sensing mechanism. Results suggest that the CNT embedded with PtN3 center has strong interaction with these gas molecules, leading to high hybridization between Pt dopant and active atoms inner gas molecules. These interactions are assumed to be chemisorption due to the remarkable Ead and QT, thus resulting in dramatic deformations in electronic structure of PtN3-CNT near the Fermi level. Furthermore, the electronic redistribution cause the conductivity increase of proposed material in three systems, based on frontier molecular orbital theory. Our calculations attempt to suggest novel sensing material that are potentially employed in detection of SF6 decomposed components.

Pathological evaluation of postmortem human eyes implanted with a new single-piece hydrophobic acrylic lens.

PubMed

Izak, Andrea M; Werner, Liliana; Pandey, Suresh K; Apple, David J

2004-07-01

To report the pathological findings in 14 human cadaver eyes implanted with a single-piece AcrySof(Alcon Laboratories) posterior chamber intraocular lens (IOL). David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Fourteen human autopsy eyes implanted with a single-piece AcrySof (SA30AL) IOL were evaluated. The eyes were sectioned at the equatorial plane, and the anterior segment containing the IOL in the capsular bag was evaluated from a posterior perspective (Miyake-Apple view) and from an anterior perspective (surgeon's view) after removal of cornea and iris. They were then processed through paraffin, sectioned, and stained with hematoxylin-eosin, periodic acid-Schiff, and Masson's trichrome and examined under light microscopy. All IOLs had symmetric in-the-bag fixation. Slight decentration was measured in 1 eye, which also had an anterior capsule tear. Grade 1 anterior capsule opacification was present in 9 eyes. No central posterior capsule opacification or posterior capsule folds were observed in any eye. Soemmering's ring formation was observed in 5 eyes. Zonular stretch caused by different degrees of capsular bag contraction was present in 4 eyes without decentration of the IOL. Analyses of pseudophakic cadaver eyes from the posterior (Miyake-Apple) view, complemented by microscopic analyses, proved useful in the evaluation of IOL-capsular bag interaction. These studies are more important in cases of newly introduced lens designs.

Beyond Line-of-Sight Information Dissemination for Force Protection

DTIC Science & Technology

2012-11-01

utilize ad hoc, mesh networks to support data-in-motion and remote data storage and access. These types of sensors are common among Force Protection...Operations and Forward Operating Base security . Current Force Protection Kits include a rich set of sensors that can be monitored from a core operator...and tactical war fighters in tactical network environments . Marti has the potential to improve situation awareness and Force Protection for

Searching for Partners: Regional Organizations and Peace Operations

DTIC Science & Technology

1998-06-01

directed force, the U.N. Protection Force (UNPROFOR), performed abysmally in Bosnia and had to be replaced by a combination of NATO and other forces...African regional organization. Other examplars were the operational support provided by NATO during the U.N. Protection Force (UNPROFOR) phase of...body capable of organizing or directing field operations. 34 Lewis a n d Marks Even in the realm of protecting human rights, OSCE has lost

20 CFR 10.905 - If an employee incurs a covered injury in connection with his or her service with an Armed Force...

Code of Federal Regulations, 2010 CFR

2010-04-01

... connection with his or her service with an Armed Force in a contingency operation but does not die of the... Armed Force in a contingency operation but does not die of the injury until years later, does the death... incurred in connection with the employee's service with an Armed Force in a contingency operation, the...

Change in corneal aberrations after cataract surgery with 2 types of aspherical intraocular lenses.

PubMed

Marcos, Susana; Rosales, Patricia; Llorente, Lourdes; Jiménez-Alfaro, Ignacio

2007-02-01

To study the effect of cataract surgery through 3.2 mm superior incisions on corneal aberrations with 2 types of monofocal intraocular lenses (IOLs) with an aspherical design. Instituto de Optica, Consejo Superior de Investigaciones Científicas, and Fundación Jiménez Díaz, Madrid, Spain. Corneal topography of 43 eyes was obtained before and after small corneal incision cataract surgery. Twenty-two eyes had implantation of a Tecnis Z9000 silicone IOL (Advanced Medical Optics) and 21 had implantation of an AcrySof IQ SN60WF acrylic IOL (Alcon Research Labs) using the recommended injector for each IOL type. The intended incision size (3.2 mm) was similar in the 2 groups. Corneal aberrations were estimated using custom-developed algorithms (based on ray tracing) for 10.0 mm and 5.0 mm pupils. Comparisons between preoperative and postoperative measurements and across the groups were made for individual Zernike terms and root-mean-square (RMS) wavefront error. The RMS (excluding tilt and defocus) did not change in the AcrySof IQ group and increased significantly in the Tecnis group with the 10.0 mm and 5.0 mm pupil diameters. Spherical aberration and coma-like terms did not change significantly; however, vertical astigmatism, vertical trefoil, and vertical tetrafoil changed significantly with surgery with the 10.0 mm and 5.0 mm pupil diameters (P<.0005). The induced wave aberration pattern for 3rd- and higher-order aberrations consistently showed a superior lobe, resulting from a combination of positive vertical trefoil (Z(3)(-3)) and negative tetrafoil (Z(4)(4)). The mean vertical astigmatism increased by 2.47 microm +/- 1.49 (SD) and 1.74 +/- 1.44 microm, vertical trefoil increased by 1.81 +/- 1.19 microm and 1.20 +/- 1.34 microm, and tetrafoil increased by -1.10 +/- 0.78 microm and -0.89 +/- 0.68 microm in the Tecnis group and AcrySof IQ group, respectively. There were no significant differences between the corneal aberrations in the 2 postoperative groups, although there was a tendency toward more terms or orders changing statistically significantly in the Tecnis group, which had slightly higher amounts of induced aberrations. Cataract surgery with a small superior incision induced consistent and significant changes in several corneal Zernike terms (vertical astigmatism, trefoil, and tetrafoil), resulting in a significantly increased overall corneal RMS wavefront error. These results can be used to improve predictions of optical performance with new IOL designs using computer eye models and identify the potentially different impact of incision strategies on cataract surgery.

Silicon on ferroelectic insulator field effect transistor (SOF-FET) a new device for the next generation ultra low power circuits

NASA Astrophysics Data System (ADS)

Es-Sakhi, Azzedin D.

Field effect transistors (FETs) are the foundation for all electronic circuits and processors. These devices have progressed massively to touch its final steps in sub-nanometer level. Left and right proposals are coming to rescue this progress. Emerging nano-electronic devices (resonant tunneling devices, single-atom transistors, spin devices, Heterojunction Transistors rapid flux quantum devices, carbon nanotubes, and nanowire devices) took a vast share of current scientific research. Non-Si electronic materials like III-V heterostructure, ferroelectric, carbon nanotubes (CNTs), and other nanowire based designs are in developing stage to become the core technology of non-classical CMOS structures. FinFET present the current feasible commercial nanotechnology. The scalability and low power dissipation of this device allowed for an extension of silicon based devices. High short channel effect (SCE) immunity presents its major advantage. Multi-gate structure comes to light to improve the gate electrostatic over the channel. The new structure shows a higher performance that made it the first candidate to substitute the conventional MOSFET. The device also shows a future scalability to continue Moor's Law. Furthermore, the device is compatible with silicon fabrication process. Moreover, the ultra-low-power (ULP) design required a subthreshold slope lower than the thermionic-emission limit of 60mV/ decade (KT/q). This value was unbreakable by the new structure (SOI-FinFET). On the other hand most of the previews proposals show the ability to go beyond this limit. However, those pre-mentioned schemes have publicized a very complicated physics, design difficulties, and process non-compatibility. The objective of this research is to discuss various emerging nano-devices proposed for ultra-low-power designs and their possibilities to replace the silicon devices as the core technology in the future integrated circuit. This thesis proposes a novel design that exploits the concept of negative capacitance. The new field effect transistor (FET) based on ferroelectric insulator named Silicon-On-Ferroelectric Insulator Field Effect Transistor (SOF-FET). This proposal is a promising methodology for future ultra-low-power applications, because it demonstrates the ability to replace the silicon-bulk based MOSFET, and offers subthreshold swing significantly lower than 60mV/decade and reduced threshold voltage to form a conducting channel. The SOF-FET can also solve the issue of junction leakage (due to the presence of unipolar junction between the top plate of the negative capacitance and the diffused areas that form the transistor source and drain). In this device the charge hungry ferroelectric film already limits the leakage.

Invited review: A commentary on predictive cheese yield formulas.

PubMed

Emmons, D B; Modler, H W

2010-12-01

Predictive cheese yield formulas have evolved from one based only on casein and fat in 1895. Refinements have included moisture and salt in cheese and whey solids as separate factors, paracasein instead of casein, and exclusion of whey solids from moisture associated with cheese protein. The General, Barbano, and Van Slyke formulas were tested critically using yield and composition of milk, whey, and cheese from 22 vats of Cheddar cheese. The General formula is based on the sum of cheese components: fat, protein, moisture, salt, whey solids free of fat and protein, as well as milk salts associated with paracasein. The testing yielded unexpected revelations. It was startling that the sum of components in cheese was <100%; the mean was 99.51% (N × 6.31). The mean predicted yield was only 99.17% as a percentage of actual yields (PY%AY); PY%AY is a useful term for comparisons of yields among vats. The PY%AY correlated positively with the sum of components (SofC) in cheese. The apparent low estimation of SofC led to the idea of adjusting upwards, for each vat, the 5 measured components in the formula by the observed SofC, as a fraction. The mean of the adjusted predicted yields as percentages of actual yields was 99.99%. The adjusted forms of the General, Barbano, and Van Slyke formulas gave predicted yields equal to the actual yields. It was apparent that unadjusted yield formulas did not accurately predict yield; however, unadjusted PY%AY can be useful as a control tool for analyses of cheese and milk. It was unexpected that total milk protein in the adjusted General formula gave the same predicted yields as casein and paracasein, indicating that casein or paracasein may not always be necessary for successful yield prediction. The use of constants for recovery of fat and protein in the adjusted General formula gave adjusted predicted yields equal to actual yields, indicating that analyses of cheese for protein and fat may not always be necessary for yield prediction. Composition of cheese was estimated using a predictive formula; actual yield was needed for estimation of composition. Adjusted formulas are recommended for estimating target yields and cheese yield efficiency. Constants for solute exclusion, protein-associated milk salts, and whey solids could be used and reduced the complexity of the General formula. Normalization of fat recovery increased variability of predicted yields. Copyright © 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Best Practices in User Needs/Requirements Generation

DTIC Science & Technology

2000-06-15

to the US Air Force, the framework was tested . All of the organizations demonstrated the existence of the four fundamental activities contained in...SP Air Force Deputy Chief of Staff for Security Police AF/TE Air Force Deputy Chief of Staff for Test and Evaluations AF/XO Air Force Deputy Chief of...Operational Test and Evaluation Center AFPD Air Force Policy Directive AFROC Air Force Requirements Oversight Council AFSOC Air Force Special Operations

Control of a Glove-Based Grasp Assist Device

NASA Technical Reports Server (NTRS)

Bergelin, Bryan J (Inventor); Ihrke, Chris A. (Inventor); Davis, Donald R. (Inventor); Linn, Douglas Martin (Inventor); Sanders, Adam M (Inventor); Askew, R. Scott (Inventor); Laske, Evan (Inventor); Ensley, Kody (Inventor)

2015-01-01

A grasp assist system includes a glove and sleeve. The glove includes a digit, i.e., a finger or thumb, and a force sensor. The sensor measures a grasping force applied to an object by an operator wearing the glove. The glove contains a tendon connected at a first end to the digit. The sleeve has an actuator assembly connected to a second end of the tendon and a controller in communication with the sensor. The controller includes a configuration module having selectable operating modes and a processor that calculates a tensile force to apply to the tendon for each of the selectable operating modes to assist the grasping force in a manner that differs for each of the operating modes. A method includes measuring the grasping force, selecting the mode, calculating the tensile force, and applying the tensile force to the tendon using the actuator assembly.

Air Force FY 2000 Financial Reporting of Operating Materials and Supplies

DTIC Science & Technology

2001-07-05

AIR FORCE FY 2000 FINANCIAL REPORTING OF OPERATING MATERIALS AND SUPPLIES Report No. D-2001-156 July 5...Covered (from... to) ("DD MON YYYY") Title and Subtitle Air Force FY 2000 Financial Reporting of Operating Materials and Supplies Contract or Grant...munitions assets. Objectives. The overall audit objective was to obtain information on the financial reporting of operating materials and supplies

Apparatus for providing sensory substitution of force feedback

NASA Technical Reports Server (NTRS)

Massimino, Michael J. (Inventor); Sheridan, Thomas B. (Inventor)

1995-01-01

A feedback apparatus for an operator to control an effector that is remote from the operator to interact with a remote environment has a local input device to be manipulated by the operator. Sensors in the effector's environment are capable of sensing the amplitude of forces arising between the effector and its environment, the direction of application of such forces, or both amplitude and direction. A feedback signal corresponding to such a component of the force, is generated and transmitted to the environment of the operator. The signal is transduced into an auditory sensory substitution signal to which the operator is sensitive. Sound production apparatus present the auditory signal to the operator. The full range of the force amplitude may be represented by a single, audio speaker. Auditory display elements may be stereo headphones or free standing audio speakers, numbering from one to many more than two. The location of the application of the force may also be specified by the location of audio speakers that generate signals corresponding to specific forces. Alternatively, the location may be specified by the frequency of an audio signal, or by the apparent location of an audio signal, as simulated by a combination of signals originating at different locations.

Coaxial needle insertion assistant with enhanced force feedback.

PubMed

De Lorenzo, Danilo; Koseki, Yoshihiko; De Momi, Elena; Chinzei, Kiyoyuki; Okamura, Allison M

2013-02-01

Many medical procedures involving needle insertion into soft tissues, such as anesthesia, biopsy, brachytherapy, and placement of electrodes, are performed without image guidance. In such procedures, haptic detection of changing tissue properties at different depths during needle insertion is important for needle localization and detection of subsurface structures. However, changes in tissue mechanical properties deep inside the tissue are difficult for human operators to sense, because the relatively large friction force between the needle shaft and the surrounding tissue masks the smaller tip forces. A novel robotic coaxial needle insertion assistant, which enhances operator force perception, is presented. This one-degree-of-freedom cable-driven robot provides to the operator a scaled version of the force applied by the needle tip to the tissue, using a novel design and sensors that separate the needle tip force from the shaft friction force. The ability of human operators to use the robot to detect membranes embedded in artificial soft tissue was tested under the conditions of 1) tip force and shaft force feedback, and 2) tip force only feedback. The ratio of successful to unsuccessful membrane detections was significantly higher (up to 50%) when only the needle tip force was provided to the user.

Evaluation of recovery in lip closing pressure and occlusal force and contact area after orthognathic surgery.

PubMed

Ueki, Koichiro; Moroi, Akinori; Sotobori, Megumi; Ishihara, Yuri; Marukawa, Kohei; Iguchi, Ran; Kosaka, Akihiko; Ikawa, Hiroumi; Nakazawa, Ryuichi; Higuchi, Masatoshi

2014-10-01

The purpose of this study was to evaluate the relationship between lip closing force, occlusal contact area and occlusal force after orthognathic surgery in skeletal Class III patients. The subjects consisted of 54 patients (28 female and 26 male) diagnosed with mandibular prognathism who underwent sagittal split ramus osteotomy with and without Le Fort I osteotomy. Maximum and minimum lip closing forces, occlusal contact area and occlusal force were measured pre-operatively, 6 months and 1 year post-operative. Maximum and minimum lip closing forces, occlusal contact area and occlusal force increased with time after surgery, however a significant increase was not found in the occlusal contact area in women. In increased ratio (6 months/pre-operative and 1 year/pre-operative), the maximum lip closing force was significantly correlated with the occlusal contact area (P < 0.0001). This study suggested that orthognathic surgery could improve the occlusal force, contact area and lip closing force, and an increase ratio in maximum lip closing force was associated with an increased ratio in occlusal contact area. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Aviation at the Operational Level of War: What Air Force Functions Properly Fall Under Army Aviation?

DTIC Science & Technology

1987-04-28

operations, and tactics. "Military strategy is the art and science of employing the armed forces of a nation or alliance to secure policy objectives...NTRODUCT ION Operational art and the operational level of war have returned to the vocabulary of the professional soldier. As the intermediate level of...conflict, operational art provides the linkage between what nations desire as strategic goals and how forces are tactically employed on a battlefield

Effects of Forced Air Warming on Airflow around the Operating Table.

PubMed

Shirozu, Kazuhiro; Kai, Tetsuya; Setoguchi, Hidekazu; Ayagaki, Nobuyasu; Hoka, Sumio

2018-01-01

Forced air warming systems are used to maintain body temperature during surgery. Benefits of forced air warming have been established, but the possibility that it may disturb the operating room environment and contribute to surgical site contamination is debated. The direction and speed of forced air warming airflow and the influence of laminar airflow in the operating room have not been reported. In one institutional operating room, we examined changes in airflow speed and direction from a lower-body forced air warming device with sterile drapes mimicking abdominal surgery or total knee arthroplasty, and effects of laminar airflow, using a three-dimensional ultrasonic anemometer. Airflow from forced air warming and effects of laminar airflow were visualized using special smoke and laser light. Forced air warming caused upward airflow (39 cm/s) in the patient head area and a unidirectional convection flow (9 to 14 cm/s) along the ceiling from head to foot. No convection flows were observed around the sides of the operating table. Downward laminar airflow of approximately 40 cm/s counteracted the upward airflow caused by forced air warming and formed downward airflow at 36 to 45 cm/s. Downward airflows (34 to 56 cm/s) flowing diagonally away from the operating table were detected at operating table height in both sides. Airflow caused by forced air warming is well counteracted by downward laminar airflow from the ceiling. Thus it would be less likely to cause surgical field contamination in the presence of sufficient laminar airflow.

Dynamic Runner Forces and Pressure Fluctuations on the Draft Tube Wall of a Model Pump-Turbine

NASA Astrophysics Data System (ADS)

Kirschner, O.; Ruprecht, A.; Göde, E.; Riedelbauch, S.

2016-11-01

When Francis-turbines and pump-turbines operate at off-design conditions, typically a vortex rope develops. The vortex rope causes pressure oscillations leading to fluctuations of the forces affecting the runner. The presence of dynamic runner forces over a long period of time might damage the bearings and possibly the runner. In this experimental investigation, the fluctuating part of the runner forces and the pressure oscillations on the draft tube wall were measured on a model pump-turbine with a simplified straight cone draft tube in different operating conditions. The investigation focuses on the correlation of the pressure fluctuations frequency measured at the draft tube wall with the frequency of the fluctuating forces on the runner. The comparison between pressure fluctuations and dynamic forces shows a significant correlation in all operating points. For the comparison of different components in the spatial directions of the forces, the pressure fluctuations were separated in a synchronous part and a rotating part for operating points with higher amplitudes. The rotating pressure fluctuations correlate with the radial forces especially in the operating points with a rotating vortex rope. At frequencies with higher amplitudes in the pressure fluctuations caused by the vortex rope movement, there are also higher amplitudes in the radial forces at the same frequencies.

32 CFR 631.15 - Air Force policy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Air Force policy. 631.15 Section 631.15 National... INVESTIGATIONS ARMED FORCES DISCIPLINARY CONTROL BOARDS AND OFF-INSTALLATION LIAISON AND OPERATIONS Off-Installation Operations (Military Patrols and Investigative Activities) and Policy § 631.15 Air Force policy...

Space station operations task force summary report

NASA Technical Reports Server (NTRS)

1987-01-01

A companion to the Space Stations Operation Task Force Panels' Reports, this document summarizes all space station program goals, operations, and the characteristics of the expected user community. Strategies for operation and recommendations for implementation are included.

Intra-operative measurement of applied forces during anterior scoliosis correction.

PubMed

Fairhurst, H; Little, J P; Adam, C J

2016-12-01

Spinal instrumentation and fusion for the treatment of scoliosis is primarily a mechanical intervention to correct the deformity and halt further progression. While implant-related complications remain a concern, little is known about the magnitudes of the forces applied to the spine during surgery, which may affect post-surgical outcomes. In this study, the compressive forces applied to each spinal segment during anterior instrumentation were measured in a series of patients with Adolescent Idiopathic Scoliosis. A force transducer was designed and retrofit to a routinely used surgical tool, and compressive forces applied to each segment during surgery were measured for 15 scoliosis patients. Cobb angle correction achieved by each force was measured on intra-operative fluoroscope images. Relative changes in orientation of the screw within the vertebra were also measured to detect intra-operative screw plough. Intra-operative forces were measured for a total of 95 spinal segments. The mean applied compressive force was 540N (SD 230N, range 88N-1019N). There was a clear trend for higher forces to be applied at segments toward the apex of the scoliosis. Fluoroscopic evidence of screw plough was detected at 10 segments (10.5%). The magnitude of forces applied during anterior scoliosis correction vary over a broad range. These forces do reach magnitudes capable of causing intra-operative vertebral body screw plough. Surgeons should be aware there is a risk for tissue overload during correction, however the clinical implications of intra-operative screw plough remain unclear. The dataset presented here is valuable for providing realistic input parameters for in silico surgical simulations. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Numerical Model Study of the Effect of Channel Deepening on Shoaling and Salinity Intrusion in the Savannah Estuary

DTIC Science & Technology

1989-12-01

H tY) T , iv OFTECHNICAL REPORT HL-89-26 A NUMERICAL MODEL STUDY OF THE EFFECT SOF CHANNEL DEEPENING ON SHOALING AND SALINITY INTRUSION IN THE... Study of the Effect of Channel Deepening on Shoaling and Salinity Intrusion in the Savannah Estuary 12. PERSONAL AUTHOR(S) Johnson, B. H.; Trawle, M. J...a multiple-connected system of channels. Results from a study in the Savannah Estuary show good agreement with 1985 field data on tides, velocities

The Influence of Acidity on Microbial Fuel Cells Containing Shewanella Oneidensis (PREPRINT)

DTIC Science & Technology

2008-09-01

d a fi b i s a h t s p t o m d C H p F 8 ig. 4. Cyclic voltammetry of filter sterilized media after 4 days of growth of S. neidensis MR-1 or S...of autologous mediators in the rowthmedium changeswith pH.We analyzed filter sterilized cul- ure supernatants by cyclic voltammetry (Fig. 4), and HPLC...Marsili et al., 2008). Cyclic voltammetrywas used to detect redox-active compounds n growthmedia supernatants fromMR-1 andDSP10 cultures. Fig. 4 hows

Stereoscopic, Force-Feedback Trainer For Telerobot Operators

NASA Technical Reports Server (NTRS)

Kim, Won S.; Schenker, Paul S.; Bejczy, Antal K.

1994-01-01

Computer-controlled simulator for training technicians to operate remote robots provides both visual and kinesthetic virtual reality. Used during initial stage of training; saves time and expense, increases operational safety, and prevents damage to robots by inexperienced operators. Computes virtual contact forces and torques of compliant robot in real time, providing operator with feel of forces experienced by manipulator as well as view in any of three modes: single view, two split views, or stereoscopic view. From keyboard, user specifies force-reflection gain and stiffness of manipulator hand for three translational and three rotational axes. System offers two simulated telerobotic tasks: insertion of peg in hole in three dimensions, and removal and insertion of drawer.

Time Critical Targeting Concept of Operations (CONOPS) Interactions

DTIC Science & Technology

2011-05-01

range of topics in force development and employment. Carl has participated in projects examining the interdiction of armoured ground forces , long...Critical Targeting Concept of Operations (CONOPS) Interactions Executive Summary In 2003, RAND Project Air Force examined the...Attack. ____________________ ________________________________________________ Carl Rhodes Project Air Force , RAND Corporation Carl Rhodes is the

Spin force and torque in non-relativistic Dirac oscillator on a sphere

NASA Astrophysics Data System (ADS)

Shikakhwa, M. S.

2018-03-01

The spin force operator on a non-relativistic Dirac oscillator (in the non-relativistic limit the Dirac oscillator is a spin one-half 3D harmonic oscillator with strong spin-orbit interaction) is derived using the Heisenberg equations of motion and is seen to be formally similar to the force by the electromagnetic field on a moving charged particle. When confined to a sphere of radius R, it is shown that the Hamiltonian of this non-relativistic oscillator can be expressed as a mere kinetic energy operator with an anomalous part. As a result, the power by the spin force and torque operators in this case are seen to vanish. The spin force operator on the sphere is calculated explicitly and its torque is shown to be equal to the rate of change of the kinetic orbital angular momentum operator, again with an anomalous part. This, along with the conservation of the total angular momentum, suggests that the spin force exerts a spin-dependent torque on the kinetic orbital angular momentum operator in order to conserve total angular momentum. The presence of an anomalous spin part in the kinetic orbital angular momentum operator gives rise to an oscillatory behavior similar to the Zitterbewegung. It is suggested that the underlying physics that gives rise to the spin force and the Zitterbewegung is one and the same in NRDO and in systems that manifest spin Hall effect.

The Limits of Special Operations Forces

DTIC Science & Technology

2016-12-07

counterin- surgency operations as well as the projection of discrete and discriminate force.2 Yet, despite the current enthusiasm, special operations...terms of signaling commitment and capa- bility through discrete operations. But absent other supporting elements—whether military, diplomatic, or

Air Force Military Personnel Entitlement Pay in Support of Contingency Operations

DTIC Science & Technology

2010-08-23

Report No. A-2006-0067- FFM , “Military Pay for Operation Enduring Freedom/Operation Iraqi Freedom Active Components,” April 5, 2006 U.S. Army Audit...Agency Report No. A-2006-0079- FFM , “Material Weakness Closeout on Line of Duty and Incapacitation Pay,” March 8, 2006 22B22BAir Force Air Force

Operational Art in I Field Force, 1965 to 1967

DTIC Science & Technology

2012-10-17

Approved for Public Release; Distribution is Unlimited Operational Art in I Field Force, 1965 to 1967 A Monograph by MAJ John E. Turner...Monograph 3. DATES COVERED (From - To) JAN 2012 – DEC 2012 4. TITLE AND SUBTITLE Operational Art in I Field Force, 1965-1967 5a. CONTRACT NUMBER...operational art from 1965 through 1967 under the leadership of LTG Stanley Larsen in the II Corps Tactical Zone (II CORPS). This accomplishment is

Peace Operations: Is There a Need for Wheeled Armored Vehicles?

DTIC Science & Technology

1996-12-20

stability and order.2 The United States’ view on peace operations is that U.N. peacekeeping contributes to the national security strategy . For the United...from those found in conventional operations because they demand a higher level of flexibility from the peacekeeping force. The organizational...structure, level of training, and type of equipment must allow the force to conduct operations in an environment that eschews the use of force. U.S. Army

Overseas Contingency Operations: Observations on the Use of Force Management Levels in Afghanistan, Iraq, and Syria

DTIC Science & Technology

2016-12-01

relating to security force assistance activities and readiness of U.S. Special Operations Forces. • Increased Use of Contractors and Personnel on...Temporary Duty. DOD relies on contractors to support a wide range of military operations and free up uniformed personnel to directly support mission...needs. During operations in Afghanistan and Iraq contractor personnel played a critical role in supporting U.S. troops and sometimes exceeded the

Employing U.S. Army Special Forces to Defeat America’s Emerging Threats

DTIC Science & Technology

2013-04-01

GPF operation which is primarily focused on improving allied and host nation security force capacity.36 In 2004, the El Salvadorian Ambassador to...forces to Haiti to conduct Stability Operations following their devastating earthquakes . Operation Unified Quest, led by LTG Ken Keen included personnel...U.S. Border Patrol (point of entry and border security operations), 95th Civil Affairs Brigade (Civil Affairs related activities), El Paso and Austin

Analysis of operational comfort in manual tasks using human force manipulability measure.

PubMed

Tanaka, Yoshiyuki; Nishikawa, Kazuo; Yamada, Naoki; Tsuji, Toshio

2015-01-01

This paper proposes a scheme for human force manipulability (HFM) based on the use of isometric joint torque properties to simulate the spatial characteristics of human operation forces at an end-point of a limb with feasible magnitudes for a specified limb posture. This is also applied to the evaluation/prediction of operational comfort (OC) when manually operating a human-machine interface. The effectiveness of HFM is investigated through two experiments and computer simulations of humans generating forces by using their upper extremities. Operation force generation with maximum isometric effort can be roughly estimated with an HFM measure computed from information on the arm posture during a maintained posture. The layout of a human-machine interface is then discussed based on the results of operational experiments using an electric gear-shifting system originally developed for robotic devices. The results indicate a strong relationship between the spatial characteristics of the HFM and OC levels when shifting, and the OC is predicted by using a multiple regression model with HFM measures.

Collaborative engagement experiment

NASA Astrophysics Data System (ADS)

Mullens, Katherine; Troyer, Bradley; Wade, Robert; Skibba, Brian; Dunn, Michael

2006-05-01

Unmanned ground and air systems operating in collaboration have the potential to provide future Joint Forces a significant capability for operations in complex terrain. Collaborative Engagement Experiment (CEE) is a consolidation of separate Air Force, Army and Navy collaborative efforts within the Joint Robotics Program (JRP) to provide a picture of the future of unmanned warfare. The Air Force Research Laboratory (AFRL), Material and Manufacturing Directorate, Aerospace Expeditionary Force Division, Force Protection Branch (AFRL/MLQF), The Army Aviation and Missile Research, Development and Engineering Center (AMRDEC) Joint Technology Center (JTC)/Systems Integration Laboratory (SIL), and the Space and Naval Warfare Systems Center - San Diego (SSC San Diego) are conducting technical research and proof of principle experiments for an envisioned operational concept for extended range, three dimensional, collaborative operations between unmanned systems, with enhanced situational awareness for lethal operations in complex terrain. This paper describes the work by these organizations to date and outlines some of the plans for future work.

Sensing And Force-Reflecting Exoskeleton

NASA Technical Reports Server (NTRS)

Eberman, Brian; Fontana, Richard; Marcus, Beth

1993-01-01

Sensing and force-reflecting exoskeleton (SAFiRE) provides control signals to robot hand and force feedback from robot hand to human operator. Operator makes robot hand touch objects gently and manipulates them finely without exerting excessive forces. Device attaches to operator's hand; comfortable and lightweight. Includes finger exoskeleton, cable mechanical transmission, two dc servomotors, partial thumb exoskeleton, harness, amplifier box, two computer circuit boards, and software. Transduces motion of index finger and thumb. Video monitor of associated computer displays image corresponding to motion.

An Examination of the Relationship between Usage and Operating and Support Costs for Air Force Aircraft

DTIC Science & Technology

2007-09-01

usage and O&S costs hours will inform Air Force leadership on how to better allocate its budget resources. We provide an overview of issues related...the Relationship Between Usage and Operating and Support Costs for Air Force Aircraft 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT...An Examination of the Relationship Between Usage and Operating and Support Costs for Air Force Aircraft Eric J. Unger This document was submitted as

Maximizing the Potential of the Special Operations Forces and General Purpose Forces

DTIC Science & Technology

2014-05-22

States (Washington, DC: Government Printing Office, 2013), I-15). 8David Tucker and Christopher J. Lamb , United States Special Operations Forces...functionally it was a messy misapplication of forces, that got the job done in a highly inefficient manner. 59Mets, 114. 60Chris Lamb , “Belief Systems and...Taking out the planes was a standoff operation, a job for a three-man team equipped with AT-4s ( shoulder -fired rockets) and machine guns,’ he

Measuring Combat Logistics Force (CLF) Adequacy in Supporting Naval Operations

DTIC Science & Technology

2012-03-01

existing fuel consumption rates and the hotel services load. Because logistics planning factors for foreign carriers were not available, existing... LOGISTICS FORCE (CLF) ADEQUACY IN SUPPORTING NAVAL OPERATIONS by Philip J. Mock March 2012 Thesis Advisor: Wayne Hughes Second Reader...DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE Measuring Combat Logistics Force (CLF) Adequacy in Supporting Naval Operations 5. FUNDING

Building the Future Air Force: Analysis of Platform versus Weapon Development

DTIC Science & Technology

2016-05-26

Operation Desert Storm, GulfWar. 16. SECURITY CLASSIFICATION OF: a. REPORT b. ABSTRACT c. THIS PAGE u u u 17. LIMITATION OF 18. NUMBER...More Surprises: The Vietnam War ...................................................................... 20 The Right Tools for the Job: Operation Desert...require flexibility amongst military forces. The more flexible the force, the more effective at fulfilling policy requirements. “ Operational mission

Teleoperator comfort and psychometric stability: Criteria for limiting master-controller forces of operation and feedback during telemanipulation

NASA Technical Reports Server (NTRS)

Wiker, Steven F.; Hershkowitz, Elaine; Zik, John

1989-01-01

The following question is addressed: How much force should operators exert, or experience, when operating a telemanipulator master-controller for sustained periods without encountering significant fatigue and discomfort, and without loss of stability in psychometric perception of force. The need to minimize exertion demands to avoid fatigue is diametrically opposed by the need to present a wide range of force stimuli to enhance perception of applied or reflected forces. For 104 minutes subjects repetitiously performed a series of 15 s isometric pinch grasps; controlled at 5, 15, and 25 percent of their maximum voluntary strength. Cyclic pinch grasps were separated by rest intervals of 7.5 and 15 s. Upon completion of every 10 minute period, subjects interrupted grasping activities to gage the intensity of fatigue and discomfort in the hand and forearm using a cross-modal matching technique. A series of psychometric tests were then conducted to determine accuracy and stability in the subject's perception of force experienced. Results showed that onset of sensations of discomfort and fatigue were dependent upon the magnitude of grasp force, work/rest ratio, and progression of task. Declines in force magnitude estimation slopes, indicating a reduction in force perception sensitivity, occurred with increased grasp force when work/rest ratios were greater than 1.0. Specific recommendations for avoiding discomfort and shifts in force perception, by limiting pinch grasp force required for master-controller operation and range of force reflection or work/rest ratios, are provided.

Surface geometry of three packable and one hybrid composite after polishing.

PubMed

Jung, Martin; Bruegger, Hilka; Klimek, Joachim

2003-01-01

This study evaluated the surface quality of four composite materials after polishing with six different polishing techniques. Eighty specimens were made using three packable composites (Definite/Degussa, SureFil/ Dentsply and Solitaire/Heraeus-Kulzer) and one hybrid composite (Herculite XRV/Kerr). Five specimens of each material were polished using flexible Sof-Lex discs. The remaining 75 specimens of each composite were prepared using three finishing protocols: a single 30 microm diamond (n = 25), two finishing diamonds (30/20 microm; n = 25) and a 30 microm diamond followed by a tungsten carbide finishing bur (n = 25). Final polishing of each of the three finishing groups was accomplished with SuperBuff, Diafix-oral, OneGloss, Astropol and HaWe Composite Polishers (n = 5, each). Surface roughness was evaluated quantitatively by laser-stylus profilometry. Average roughness (R(a)) was calculated; statistical analysis of the data was performed with two-way ANOVA and Scheffé post-hoc tests. The polished surfaces were examined qualitatively by SEM. The results showed significant effects on surface roughness from the different composites (p = 0.011) and polishing systems (p < 0.001). After polishing, the Solitaire surfaces (R(a) = 0.72 microm) were smoother than Definite (R(a) = 0.87 microm) and SureFil (R(a) = 0.89 microm) and significantly smoother than Herculite (R(a) = 0.92 microm; p = 0.011). Three of the polishing methods (SuperBuff, Diafix-oral and Astropol) achieved lower R(a)-values than Sof-Lex discs. The polishing quality of the one-step systems SuperBuff and Diafix-oral was strongly affected by the initial finishing protocol.

Effect of Various Finishing Procedures on the Reflectivity (Shine) of Tooth Enamel - An In-vitro Study.

PubMed

Patil, Harshal Ashok; Chitko, Shrikant Shrinivas; Kerudi, Veerendra Virupaxappa; Maheshwari, Amit Ratanlal; Patil, Neeraj Suresh; Tekale, Pawankumar Dnyandeo; Gore, Ketan Ashorao; Zope, Amit Ashok

2016-08-01

Reflectivity of an object is a good parameter for surface finish. As the patient evaluates finishing as a function of gloss/reflectivity/shine an attempt is made here to evaluate changes in surface finish with custom made reflectometer. The aim of the present study was to study the effect of various procedures during orthodontic treatment on the shine of enamel, using a custom made reflectometer. Sixty one extracted premolars were collected and each tooth was mounted on acrylic block. Reflectivity of the teeth was measured as compared to standard before any procedure. One tooth was kept as standard throughout the study. Sixty teeth were acid etched. Reflectivity was measured on custom made reflectometer and readings recorded. Same procedure was repeated after debonding. Then 60 samples were divided into three groups: Group 1 - Tungsten Carbide, Group 2 - Astropol, Group 3- Sof-Lex disc depending upon the finishing method after debonding and reflectivity was measured. The mean percentage of reflectivity after acid etching was 31.4%, debonding 45.5%, Tungsten carbide bur finishing (Group 1) was 58.3%, Astropol (Group 2) 72.8%, and Sof-Lex disc (Group 3) 84.4% as that to the standard. There was statistically very highly significant (p<0.001) difference in reflectivity restored by the three finishing materials in the study. Thus, the light reflection was better in Group 3> Group 2> Group 1. The primary goal was to restore the enamel to its original state after orthodontic treatment. The methods tested in this study could not restore the original enamel reflectivity.

Sulcus implantation of a 3-piece, 6.0 mm optic, hydrophobic foldable acrylic intraocular lens in phacoemulsification complicated by posterior capsule rupture.

PubMed

Brazitikos, Periklis D; Balidis, Miltiadis O; Tranos, Paris; Androudi, Sofia; Papadopoulos, Nick T; Tsinopoulos, Ioannis T; Karabatakis, Vasilios; Stangos, Nikolaos T

2002-09-01

To evaluate the safety of implanting a 3-piece, 6.0 mm optic, foldable acrylic intraocular lens (IOL) in cases of posterior capsule rupture during phacoemulsification. Department of Ophthalmology, Ahepa Hospital, Aristotle University Medical School, and Interbalkan Medical Center, Thessaloniki, Greece. This prospective noncomparative case series included 28 eyes (28 patients) having phacoemulsification complicated by extensive posterior capsule rupture with or without vitreous loss. In all eyes, a 3-piece, 6.0 mm optic, foldable acrylic IOL (AcrySof MA60BM, Alcon) was implanted in the sulcus. Postoperative examination included best corrected visual acuity (BCVA), anterior segment biomicroscopy, IOL centralization and position, intraocular pressure (IOP), and fundus biomicroscopy. The follow-up was 6 months. The most common postoperative complications were transient corneal edema in 12 eyes and increased IOP in 11 eyes. Slight asymptomatic decentralization from the center of the pupil (1.0 to 2.0 mm) and pseudophacodonesis were observed in 5 eyes each. Friction of the IOL with the iris occurred in 1 eye. Clinically significant cystoid macular edema occurred in 3 eyes. The final BCVA was between 20/15 and 20/25 in 18 patients, 20/30 in 2, between 20/40 and 20/50 in 4, and between 20/60 and 20/200 in 4. AcrySof IOL implantation in the sulcus during phacoemulsification complicated by posterior capsule rupture preserved the advantages of small-incision surgery. The postoperative behavior and centralization of the IOLs resembled those of poly(methyl methacrylate) lenses.