SSTAC/ARTS review of the draft Integrated Technology Plan (ITP). Volume 8: Aerothermodynamics Automation and Robotics (A/R) systems sensors, high-temperature superconductivity

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

Not Available

Viewgraphs of briefings presented at the SSTAC/ARTS review of the draft Integrated Technology Plan (ITP) on aerothermodynamics, automation and robotics systems, sensors, and high-temperature superconductivity are included. Topics covered include: aerothermodynamics; aerobraking; aeroassist flight experiment; entry technology for probes and penetrators; automation and robotics; artificial intelligence; NASA telerobotics program; planetary rover program; science sensor technology; direct detector; submillimeter sensors; laser sensors; passive microwave sensing; active microwave sensing; sensor electronics; sensor optics; coolers and cryogenics; and high temperature superconductivity.

IMPACTS Results Summary for CY 2010

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

Weakley, Steven A.

Working in partnership with industry, the U.S. Department of Energy’s (DOE’s) Advanced Manufacturing Office (AMO) is helping reduce industrial energy use, carbon emissions, and waste while boosting productivity and economic competitiveness. Operating within the Office of Energy Efficiency and Renewable Energy (EERE), ITP conducts research, development, and demonstration (RD&D) projects and technology transfer activities that are producing substantial benefits to industry and helping the nation to address some of its biggest challenges in the areas of energy security and environmental performance. This document summarizes some of the impacts of ITP’s programs through 2010. The selection of 2010 as the timeframemore » for this report recognizes the fact that it takes at least two years to gain a full perspective on program performance and to assess the results of commercialization efforts for the technologies and practices at issue.« less

Pregnancy and Birth Outcomes among Women with Idiopathic Thrombocytopenic Purpura

PubMed Central

Wyszynski, Diego F.; Carman, Wendy J.; Cantor, Alan B.; Graham, John M.; Kunz, Liza H.; Slavotinek, Anne M.; Kirby, Russell S.; Seeger, John

2016-01-01

Objective. To examine pregnancy and birth outcomes among women with idiopathic thrombocytopenic purpura (ITP) or chronic ITP (cITP) diagnosed before or during pregnancy. Methods. A linkage of mothers and babies within a large US health insurance database that combines enrollment data, pharmacy claims, and medical claims was carried out to identify pregnancies in women with ITP or cITP. Outcomes included preterm birth, elective and spontaneous loss, and major congenital anomalies. Results. Results suggest that women diagnosed with ITP or cITP prior to their estimated date of conception may be at higher risk for stillbirth, fetal loss, and premature delivery. Among 446 pregnancies in women with ITP, 346 resulted in live births. Women with cITP experienced more adverse outcomes than those with a pregnancy-related diagnosis of ITP. Although 7.8% of all live births had major congenital anomalies, the majority were isolated heart defects. Among deliveries in women with cITP, 15.2% of live births were preterm. Conclusions. The results of this study provide further evidence that cause and duration of maternal ITP are important determinants of the outcomes of pregnancy. PMID:27092275

The Types and Nature of Questions vis-à-vis Students' Test-Taking Skills as Significant Indicators of Second Language Examinees? Performance on the TOEFL-ITP Reading Comprehension Sub-Test

ERIC Educational Resources Information Center

Perez-Amurao, Analiza

2011-01-01

This study examines the reading performance of selected students at the Pre-College program of the Mahidol University International College (PC-MUIC) as they are required to attain a score of 520 in the TOEFL-ITP (or equivalent performance in IELTS) to enter MUIC. Specifically, this research aims to evaluate whether the reading skills that…

Integrated Technology Plan for the Civil Space Program, 1991

NASA Technical Reports Server (NTRS)

1991-01-01

The purpose of the Integrated Technology Plan (ITP) is to serve as a strategic plan for the OAST space research and technology (R&T) program, and as a strategic planning framework for other NASA and national participants in advocating and conducting technology developments that support future U.S. civil space missions. The ITP begins with a discussion of the national policy and NASA organization which establishes the overall framework for civil space R&T planning. The second chapter provides a top-level review of the potential users of civil space R&T, their strategic mission plans, and the technologies they have identified as needed to achieve those plans. The overall methodology used to develop a civil space technology strategy is discussed. The technical details of the 1991 strategic plan are described, ending with a review of civil space R&T priorities. The fourth chapter describes how the strategic plan is annually translated into the OAST Space R&T Program, with a summary of the fiscal year 1992 program. The ITP concludes with a discussion of requirements for technology development coordination and strategies for facilitating the transfer of civil space technology to the private sector. Several appendices also are attached that provide further information regarding budget implications of the strategic plan, organizational roles, and other topics.

Health-related quality of life of immune thrombocytopenic purpura patients: results from a web-based survey.

PubMed

Snyder, Claire F; Mathias, Susan D; Cella, David; Isitt, John J; Wu, Albert W; Young, Joan

2008-10-01

To assess the health-related quality of life (HRQOL) of immune thrombocytopenic purpura (ITP) patients. This was a cross-sectional, descriptive study comparing ITP patients' HRQOL to age and gender matched controls. ITP patients from the Platelet Disorder Support Association were recruited until 1000 surveys had been completed. Controls were randomly sampled from the Harris Interactive Online Panel. ITP patients and controls completed a one-time web-based survey, including a comprehensive HRQOL assessment. ITP patients completed the SF-36, the EQ-5D, and the ITP-Patient Assessment Questionnaire (ITP-PAQ). Controls completed the SF-36 and EQ-5D only. ITP patients' SF-36 and EQ-5D scores were compared to controls in unadjusted and adjusted analyses. Associations between splenectomy status, duration of illness, and platelet count with ITP patients' HRQOL scores were also examined. This analysis included 1002 ITP patients and 1031 controls. ITP patients scored worse on seven of eight SF-36 domains and the Physical and Mental Summary scores (all p < 0.05) and on the EQ-5D visual analog scale (65.5 vs. 82.3; p = 0.002). ITP patients who had undergone splenectomy had similar SF-36 and EQ-5D scores to non-splenectomy patients but scored significantly worse on 5 of 10 ITP-PAQ scales: Bother, Psychological, Fear, Social Activity, and Work (all p < 0.05). ITP patients diagnosed within the past 5 years had worse Bother and Overall Quality of Life scores than less recently diagnosed patients but were similar on other ITP-PAQ scales. Lower platelet count was consistently associated with worse ITP-PAQ scores and had weaker associations with SF-36 and EQ-5D scores. ITP was associated with consistent and statistically significant deficits on generic HRQOL measures. The ITP-PAQ demonstrated differences based on disease severity and treatments. The self-selection bias in the two samples limits the generalizability of the results to all patients with ITP. Further research is needed in more generalizable samples.

Internationally trained pharmacists' perception of their communication proficiency and their views on the impact on patient safety.

PubMed

Ziaei, Zainab; Hassell, Karen; Schafheutle, Ellen I

2015-01-01

According to Great Britain (GB)'s pharmacy regulator's standards of conduct, ethics and performance, pharmacists have a responsibility to ensure that they have sufficient linguistic skills to communicate and perform their job safely. Yet, very little is known about internationally trained pharmacists' (ITPs) linguistic proficiency. The purpose of this study was to investigate ITPs' perceptions of their communication proficiency and the resultant impact on patient safety. Eight focus groups were conducted between May and July 2010, with 31 European Economic Area (EEA) and 11 non-EEA pharmacists who, at the time of the study, practiced in community pharmacy (n = 29) or hospital (n = 13), in London, Manchester, Liverpool and Glasgow. The framework method was used to analyze qualitative data, and the Model of Communicative Proficiency (MCP) served as a framework to handle and explain the data obtained. ITPs experienced communication difficulties through new dialects, use of idioms and colloquial language in their workplace. The differences between the "BBC English" they learned formally and the "Street English" used in GB also led to difficulties. Culture was also recognized as an important aspect of communication. ITPs in this study were adamant that communication difficulty did not compromise patient safety. Communicative deficiency of ITPs arose primarily from two sources: linguistic competence and socio-cultural competence. These deficiencies could have negative implications for patient safety. The findings of this study should be taken into account when designing adaptation programs for ITPs. Copyright © 2015 Elsevier Inc. All rights reserved.

Operational Improvements From the Automatic Dependant Surveillance Broadcast In-Trail Procedure in the Pacific Organized Track System

NASA Technical Reports Server (NTRS)

Chartrand, Ryan C.; Jones, Kenneth M.; Allen, Bonnie D.

2012-01-01

The Federal Aviation Administration's Surveillance and Broadcast Services Program has supported implementation of the Automatic Dependant Surveillance Broadcast (ADS-B) In-Trail Procedure (ITP) on commercial revenue flights. ADS-B ITP is intended to be used in non-radar airspace that is employing procedural separation. Through the use of onboard tools, pilots are able to make a new type of altitude change request to an Air Traffic Service Provider (ATSP). The FAA, in partnership with United Airlines, is conducting flight trials of the ITP in revenue service in the Pacific. To support the expansion of flight trials to the rest of the US managed Pacific Airspace Region, a computerized batch study was conducted to investigate the operational impacts and potential benefits that can be gained through the use of the ITP in the Pacific Organized Track System (PACOTS). This study, which simulated the Oakland managed portion of the PACOTS, suggests that potential benefits in the PACOTS are significant with a considerable increase in time spent at optimum altitude and associated fuel savings.

SSTAC/ARTS review of the draft Integrated Technology Plan (ITP). Volume 6: Controls and guidance

NASA Technical Reports Server (NTRS)

1991-01-01

Viewgraphs of briefings from the Space Systems and Technology Advisory Committee (SSTAC)/ARTS review of the draft Integrated Technology Plan (ITP) on controls and guidance are included. Topics covered include: strategic avionics technology planning and bridging programs; avionics technology plan; vehicle health management; spacecraft guidance research; autonomous rendezvous and docking; autonomous landing; computational control; fiberoptic rotation sensors; precision instrument and telescope pointing; microsensors and microinstruments; micro guidance and control initiative; and earth-orbiting platforms controls-structures interaction.

A disease-specific measure of health-related quality of life for use in adults with immune thrombocytopenic purpura: its development and validation.

PubMed

Mathias, Susan D; Bussel, James B; George, James N; McMillan, Robert; Okano, Gary J; Nichol, Janet L

2007-02-22

No validated disease-specific measures are available to assess health-related quality of life (HRQoL) in adult subjects with immune thrombocytopenic purpura (ITP). Therefore, we sought to develop and validate the ITP-Patient Assessment Questionnaire (ITP-PAQ) for adult subjects with ITP. Information from literature reviews, focus groups with subjects, and clinicians were used to develop 50 ITP-PAQ items. Factor analyses were conducted to develop the scale structure and reduce the number of items. The final 44-item ITP-PAQ, which includes ten scales [Symptoms (S), Bother-Physical Health (B), Fatigue/Sleep (FT), Activity (A), Fear (FR), Psychological Health (PH), Work (W), Social Activity (SA), Women's Reproductive Health (RH), and Overall (QoL)], was self-administered to adult ITP subjects at baseline and 7-10 days later. Test-retest reliability, internal consistency reliability, construct and known groups validity of the final ITP-PAQ were evaluated. Seventy-three subjects with ITP completed the questionnaire twice. Test-retest reliability, as measured by the intra-class correlation, ranged from 0.52-0.90. Internal consistency reliability was demonstrated with Cronbach's alpha for all scales above the acceptable level of 0.70 (range: 0.71-0.92), except for RH (0.66). Construct validity, assessed by correlating ITP-PAQ scales with established measures (Short Form-36 v.1, SF-36 and Center for Epidemiologic Studies Depression Scale, CES-D), was demonstrated through moderate correlations between the ITP-PAQ SA and SF-36 Social Function scales (r = 0.67), and between ITP-PAQ PH and SF-36 Mental Health Scales (r = 0.63). Moderate to strong inter-scale correlations were reported between ITP-PAQ scales and the CES-D, except for the RH scale. Known groups validity was evaluated by comparing mean scores for groups that differed clinically. Statistically significant differences (p < 0.01) were observed when subjects were categorized by treatment status [S, FT, B, A, PH, and QoL, perceived effectiveness of ITP treatment [S], and time elapsed since ITP diagnosis [PH]. Results provide preliminary evidence of the reliability and validity of the ITP-PAQ in adult subjects with ITP. Further work should be conducted to assess the responsiveness and to estimate the minimal clinical important difference of the ITP-PAQ to more fully understand the impact of ITP and its treatments on HRQoL.

Impact of ITP on physician visits and workplace productivity.

PubMed

Tarantino, Michael D; Mathias, Susan D; Snyder, Claire F; Isitt, John J; Gernsheimer, Terry; Young, Joan

2010-02-01

To assess the impact of immune thrombocytopenic purpura (ITP) on primary care and specialist visits and workplace productivity. This was a cross-sectional, descriptive study comparing ITP patients to age- and gender-matched controls. Subjects completed a one-time web-based survey, which included questions on work loss, work productivity, and physician visits. ITP patients and controls were compared on these outcomes. For ITP patients, the relationship between work-related issues and physician visits with clinical characteristics (time since diagnosis, platelet count, number of treatments received, and an ITP-specific health-related quality of life measure, the ITP-PAQ) was explored. A total of 1002 ITP patients and 1031 controls completed the survey. On average, ITP patients were 46 years old, diagnosed 9 years ago, and had platelet counts of 148 x 10(9)/L; 37% had undergone splenectomy. More ITP patients had primary care (20% vs. 11%) and specialist (28% vs. 11%) visits in the past month versus controls (p < or = 0.001). Higher proportions of ITP patients have ever taken sick leave (56% vs. 30%), and missed chore hours in the past week (18% vs. 13%) (p < or = 0.003). ITP patients scored significantly worse than controls on all six work productivity items. Patients diagnosed within the past year were more likely to have specialist visits and to miss chore hours versus those diagnosed less recently. Worse ITP-PAQ scores and more ITP-related treatments were related to more physician visits and worse work-related and productivity outcomes. Platelet count is not associated with these outcomes. The study is limited by the potential for biased samples due to recruitment approaches, the inherent issues of a cross-sectional study design and recall bias in questionnaire responses. ITP was consistently associated with more physician visits and worse work and productivity outcomes. Future research should build on these findings by calculating a comprehensive cost-of-illness of ITP including both direct and indirect costs.

Aircraft Hydraulic Systems Dynamic Analysis. Volume 8. Transient Thermal Analysis (HYTTHA). Computer Program Technical Description

DTIC Science & Technology

1977-02-01

8217P(V, .’f\\,, OCA A, 4 6), V"D(S4, 3LL) X , )lq , 5)\\8, 1( 5) , + ITP ,V0L.L,ACVI;’ D ’k-11AY VA[.IL11:3 + , ’AV./24,/, PLAC/25/,r~ f/26/ ,’A/27/, ITP /28...8217) DT(TFA2)=D( ITF) DT( rPN) =D( irF) DT(’TVF1)=D( ITF) iT(TrVF2) =D( I’rF) L1=L( 1) L2=L( 2) TF( Ll)D( ITP ) TF( L,2)=D( IT F) TC ( L1) =D( ITC) TC( L2)=D...34Gas Dynamics", McGraw Hill, 1958 7. Report GH20-0205-4 "System/360 Scientific Subroutine Package - Version III, Programmer’s Manual," IBM Corp., August

The Relationship between Self-esteem and Quality of Life of Patients with Idiopathic Thrombocytopenic Purpura at Isfahan's Sayed Al-Shohada Hospital, Iran, in 2013.

PubMed

Hemati, Zeinab; Kiani, Davood

2016-04-01

Idiopathic thrombocytopenic purpura (ITP) is a chronic disease which is accompanied with hopelessness and loss of the sense of well-being due to its symptoms and treatment. It also affects patients' sense of social and spiritual well-being. This disorder decreases patients' self-esteem and their quality of life by changing their mental image and self-confidence. This study was performed to find the relationship between self-esteem and quality of life of patients with ITP. This was a descriptive-analytical study on 64 patients with ITP who referred to Isfahan's Sayed Al-Shohada Hospital, Iran. In this study, patients with ITP were selected randomly using a random number chart. The data collection tools consisted of the World Health Organization Quality of Life (WHOQOL)-BREF and Coopersmith Self-esteem Inventory (CSEI). Data were analyzed using SPSS and chi-square and Mann-Whitney tests and the Pearson and Spearman's rank correlation coefficients. In total, 64 patients completed the questionnaires. RESULTS showed that 32% of subjects were over 36 years of age and 59% were women. In addition, 29.7% of ITP patients had low self-esteem and quality of life. Chi-square test showed a significant relationship between self-esteem and quality of life of patients with ITP. The results of the present study showed that considerable attention must be paid to self-esteem, as one of the most important factors influencing the promotion of quality of life. Therefore, it is suggested that patient's self-esteem be improved by the implementation of educational and psychological programs in order to decrease the consequences of poor quality of life.

Enhanced Oceanic Operations Human-In-The-Loop In-Trail Procedure Validation Simulation Study

NASA Technical Reports Server (NTRS)

Murdoch, Jennifer L.; Bussink, Frank J. L.; Chamberlain, James P.; Chartrand, Ryan C.; Palmer, Michael T.; Palmer, Susan O.

2008-01-01

The Enhanced Oceanic Operations Human-In-The-Loop In-Trail Procedure (ITP) Validation Simulation Study investigated the viability of an ITP designed to enable oceanic flight level changes that would not otherwise be possible. Twelve commercial airline pilots with current oceanic experience flew a series of simulated scenarios involving either standard or ITP flight level change maneuvers and provided subjective workload ratings, assessments of ITP validity and acceptability, and objective performance measures associated with the appropriate selection, request, and execution of ITP flight level change maneuvers. In the majority of scenarios, subject pilots correctly assessed the traffic situation, selected an appropriate response (i.e., either a standard flight level change request, an ITP request, or no request), and executed their selected flight level change procedure, if any, without error. Workload ratings for ITP maneuvers were acceptable and not substantially higher than for standard flight level change maneuvers, and, for the majority of scenarios and subject pilots, subjective acceptability ratings and comments for ITP were generally high and positive. Qualitatively, the ITP was found to be valid and acceptable. However, the error rates for ITP maneuvers were higher than for standard flight level changes, and these errors may have design implications for both the ITP and the study's prototype traffic display. These errors and their implications are discussed.

Platelet-Derived Growth Factor-BB Protects Mesenchymal Stem Cells (MSCs) Derived From Immune Thrombocytopenia Patients Against Apoptosis and Senescence and Maintains MSC-Mediated Immunosuppression

PubMed Central

Zhang, Jia-min; Feng, Fei-er; Wang, Qian-ming; Zhu, Xiao-lu; Fu, Hai-xia; Xu, Lan-ping; Liu, Kai-yan

2016-01-01

Immune thrombocytopenia (ITP) is characterized by platelet destruction and megakaryocyte dysfunction. Mesenchymal stem cells (MSCs) from ITP patients (MSC-ITP) do not exhibit conventional proliferative abilities and thus exhibit defects in immunoregulation, suggesting that MSC impairment might be a mechanism involved in ITP. Platelet-derived growth factor (PDGF) improves growth and survival in various cell types. Moreover, PDGF promotes MSC proliferation. The aim of the present study was to analyze the effects of PDGF-BB on MSC-ITP. We showed that MSC-ITP expanded more slowly and appeared flattened and larger. MSC-ITP exhibited increased apoptosis and senescence compared with controls. Both the intrinsic and extrinsic pathways account for the enhanced apoptosis. P53 and p21 expression were upregulated in MSC-ITP, but inhibition of p53 with pifithrin-α markedly inhibited apoptosis and senescence. Furthermore, MSCs from ITP patients showed a lower capacity for inhibiting the proliferation of activated T cells inducing regulatory T cells (Tregs) and suppressing the synthesis of anti-glycoprotein (GP)IIb-IIIa antibodies. PDGF-BB treatment significantly decreased the expression of p53 and p21 and increased survivin expression in MSC-ITP. In addition, the apoptotic rate and number of senescent cells in ITP MSCs were reduced. Their impaired ability for inhibiting activated T cells, inducing Tregs, and suppressing the synthesis of anti-GPIIb-IIIa antibodies was restored after PDGF-BB treatment. In conclusion, we have demonstrated that PDGF-BB protects MSCs derived from ITP patients against apoptosis, senescence, and immunomodulatory defects. This protective effect of PDGF-BB is likely mediated via the p53/p21 pathway, thus potentially providing a new therapeutic approach for ITP. Significance Immune thrombocytopenia (ITP) is characterized by platelet destruction and megakaryocyte dysfunction. Platelet-derived growth factor (PDGF) improves growth and survival in various cell types and promotes mesenchymal stem cell (MSC) proliferation. PDGF-BB protects MSCs derived from ITP patients against apoptosis, senescence, and immunomodulatory defects. This protective effect of PDGF-BB is likely mediated via the p53/p21 pathway, thus potentially providing a new therapeutic approach for ITP. PMID:27471307

Chronic adult primary immune thrombocytopenia (ITP) in the Asia-Pacific region.

PubMed

Heng, Lee Lai; Caguioa, Priscilla; Chin, Ng Soo; Chiou, Tzeon-Jye; Lee, Jong Wook; Miyakawa, Yoshitaka; Tambunan, Karmel L; Chong, Beng H

2011-08-01

Patients with primary immune thrombocytopenia (ITP) from the Asia-Pacific region often exhibit characteristics distinct from those of patients from the West. Moreover, as the region itself is heterogeneous, the ITP landscape among individual Asia-Pacific countries can be diverse. The recently released international consensus report on ITP places new emphasis on ITP, but does not address the unique ITP landscape in the Asia-Pacific region, which is home to 60% of the world's population. In an attempt to characterize how the ITP landscape differs between the West and the Asia-Pacific region, an expert panel with representatives from Northeast Asia, Southeast Asia, and Australia was convened. Important differences were identified between the guidance provided in the international consensus report and experience in the Asia-Pacific region, namely diagnostic practices, incidence and approach to ITP secondary to H. pylori infection, systemic lupus erythematosus-related ITP, the use of bone marrow examination, initial treatment strategies, and the role of splenectomy, rituximab, and thrombopoietin receptor agonists.

Idiopathic thrombocytopenic purpura diagnosed during the second decade of life.

PubMed

Lowe, Eric J; Buchanan, George R

2002-08-01

To retrospectively review our institutional experience of adolescents with idiopathic thrombocytopenic purpura (ITP). Medical record review of all patients diagnosed with ITP between the ages of 10 and 18 years seen at our center from January 1976 to March 2000. Data were collected from 126 patients. Of the evaluable 110 cases, 63 (57%) satisfied the criteria for chronic ITP, 30 (27%) for acute ITP, and 17 (15%) were uncertain. Sex distribution and mean ages were similar in all 3 groups. Platelet count at presentation was higher in patients with chronic ITP. Splenectomy was performed in 24 patients, with 17 (77%) of 22 having normal platelet counts at last follow-up. Outcome for the nonsplenectomized patients with chronic ITP included normalization of platelet count (n = 4), minimal or no bleeding without treatment (n = 29), treatment for ongoing symptoms (n = 5), and unknown (n = 1). Two patients died, 1 from intracranial hemorrhage and 1 from Escherichia coli sepsis and pulmonary hemorrhage. Patients 10 to 18 years of age with ITP are more likely than younger children to have chronic disease. Many patients with ITP recover without drug therapy or need for splenectomy. ITP in adolescents shares features of both childhood and adult ITP.

Influence of coil current modulation on polycrystalline diamond film deposition by irradiation of Ar/CH4/H2 inductively coupled thermal plasmas

NASA Astrophysics Data System (ADS)

Betsuin, Toshiki; Tanaka, Yasunori; Arai, T.; Uesugi, Y.; Ishijima, T.

2018-03-01

This paper describes the application of an Ar/CH4/H2 inductively coupled thermal plasma with and without coil current modulation to synthesise diamond films. Induction thermal plasma with coil current modulation is referred to as modulated induction thermal plasma (M-ITP), while that without modulation is referred to as non-modulated ITP (NM-ITP). First, spectroscopic observations of NM-ITP and M-ITP with different modulation waveforms were made to estimate the composition in flux from the thermal plasma by measuring the time evolution in the spectral intensity from the species. Secondly, we studied polycrystalline diamond film deposition tests on a Si substrate, and we studied monocrystalline diamond film growth tests using the irradiation of NM-ITP and M-ITP. From these tests, diamond nucleation effects by M-ITP were found. Finally, following the irradiation results, we attempted to use a time-series irradiation of M-ITP and NM-ITP for polycrystalline diamond film deposition on a Si substrate. The results indicated that numerous larger diamond particles were deposited with a high population density on the Si substrate by time-series irradiation.

Identification and Characterization of Receptors for Ion Transport Peptide (ITP) and ITP-like (ITPL) in the Silkworm Bombyx mori*

PubMed Central

Nagai, Chiaki; Mabashi-Asazuma, Hideaki; Nagasawa, Hiromichi; Nagata, Shinji

2014-01-01

Ion transport peptide (ITP) and its alternatively spliced variant, ITP-like (ITPL), are insect peptides that belong to the crustacean hyperglycemic hormone family. These peptides modulate the homeostatic mechanisms for regulating energy metabolism, molting, and reproduction and are specifically conserved in ecdysozoans. Many of the details of the molecular mechanisms by which crustacean hyperglycemic hormone family peptides exert pleiotropy remain to be elucidated, including characterization of their receptors. Here we identified three Bombyx mori orphan neuropeptide G protein-coupled receptors (BNGRs), BNGR-A2, -A24, and -A34, as receptors for ITP and ITPL (collectively referred to as ITPs). BNGR-A2 and -A34 and BNGR-A24 respond to recombinant ITPs, respectively, with EC50 values of 1.1–2.6 × 10−8 m, when expressed in a heterologous expression system. These three candidate BNGRs are expressed at larval B. mori tissues targeted by ITPs, with cGMP elevation observed after exposure to recombinant ITPs. ITPs also increased the cGMP level in B. mori ovary-derived BmN cells via membrane-bound and soluble guanylyl cyclases. The simultaneous knockdown of bngr-A2 and -A34 significantly decreased the response of BmN cells to ITP, whereas knockdown of bngr-A24 led to decreased responses to ITPL. Conversely, transient expression of bngr-A24 potentiated the response of BmN cells to ITPL. An in vitro binding assay showed direct interaction between ITPs and heterologously expressed BNGRs in a ligand-receptor-specific manner. Taken together, these data demonstrate that BNGR-A2 and -A34 are ITP receptors and that BNGR-A24 is an ITPL receptor in B. mori. PMID:25278025

Clinical Features, Treatment, and Outcome of HIV-Associated Immune Thrombocytopenia in the HAART Era

PubMed Central

Ambler, Kimberley L. S.; Vickars, Linda M.; Leger, Chantal S.; Foltz, Lynda M.; Montaner, Julio S. G.; Harris, Marianne; Dias Lima, Viviane; Leitch, Heather A.

2012-01-01

The characteristics of HIV-associated ITP were documented prior to the HAART era, and the optimal treatment beyond HAART is unknown. We performed a review of patients with HIV-associated ITP and at least one platelet count <20 × 109/L since January 1996. Of 5290 patients in the BC Centre for Excellence in HIV/AIDS database, 31 (0.6%) had an ITP diagnosis and platelet count <20 × 109/L. Initial ITP treatment included IVIG, n = 12; steroids, n = 10; anti-RhD, n = 8; HAART, n = 3. Sixteen patients achieved response and nine patients achieved complete response according to the International Working Group criteria. Median time to response was 14 days. Platelet response was not significantly associated with treatment received, but complete response was lower in patients with a history of injection drug use. Complications of ITP treatment occurred in two patients and there were four unrelated deaths. At a median followup of 48 months, 22 patients (71%) required secondary ITP treatment. This is to our knowledge the largest series of severe HIV-associated ITP reported in the HAART era. Although most patients achieved a safe platelet count with primary ITP treatment, nearly all required retreatment for ITP recurrence. New approaches to the treatment of severe ITP in this population are needed. PMID:22693513

Clinical Features, Treatment, and Outcome of HIV-Associated Immune Thrombocytopenia in the HAART Era.

PubMed

Ambler, Kimberley L S; Vickars, Linda M; Leger, Chantal S; Foltz, Lynda M; Montaner, Julio S G; Harris, Marianne; Dias Lima, Viviane; Leitch, Heather A

2012-01-01

The characteristics of HIV-associated ITP were documented prior to the HAART era, and the optimal treatment beyond HAART is unknown. We performed a review of patients with HIV-associated ITP and at least one platelet count <20 × 10(9)/L since January 1996. Of 5290 patients in the BC Centre for Excellence in HIV/AIDS database, 31 (0.6%) had an ITP diagnosis and platelet count <20 × 10(9)/L. Initial ITP treatment included IVIG, n = 12; steroids, n = 10; anti-RhD, n = 8; HAART, n = 3. Sixteen patients achieved response and nine patients achieved complete response according to the International Working Group criteria. Median time to response was 14 days. Platelet response was not significantly associated with treatment received, but complete response was lower in patients with a history of injection drug use. Complications of ITP treatment occurred in two patients and there were four unrelated deaths. At a median followup of 48 months, 22 patients (71%) required secondary ITP treatment. This is to our knowledge the largest series of severe HIV-associated ITP reported in the HAART era. Although most patients achieved a safe platelet count with primary ITP treatment, nearly all required retreatment for ITP recurrence. New approaches to the treatment of severe ITP in this population are needed.

Applicability of 2009 international consensus terminology and criteria for immune thrombocytopenia to a clinical pediatric population.

PubMed

Grace, Rachael F; Long, Michelle; Kalish, Leslie A; Neufeld, Ellis J

2012-02-01

Since pediatric immune thrombocytopenia (ITP) is relatively infrequent, comparisons among clinical studies are critical but have previously been limited by differences in terminology. In 2009, an international working group (IWG) developed consensus criteria to enhance comparability in future studies in adults and children. We performed a retrospective medical record review of all pediatric ITP patients seen at a single children's hospital with a first visit between 2003 and 2010 and applied both historical (criteria(Hist) ) and IWG (criteria(IWG) ) ITP criteria to available clinical data. Among the 505 patients seen for ITP over 7 years, 98% could be classified as "acute" or "chronic" ITP using the criteria(Hist) , while only 90.7% could be classified as "newly diagnosed," "persistent," or "chronic" ITP using the criteria(IWG) (P < 0.01). Only 33.7% met criteria(IWG) for severe ITP, whereas 77.4% met criteria(Hist) for severe ITP. A striking difference was that overall response to therapies was lower if the criteria(IWG) were used rather than the criteria(Hist) , particularly for IVIG (55.4% vs. 70%, P = 0.02) and rituximab (35.3% vs. 83.3% P = 0.05). Only 2 subjects (0.4%) met the criteria(IWG) for refractory ITP. Most ITP patients could easily be classified using the 2009 criteria(IWG) . Limitations to applying the criteria(IWG) included absence of treatment response durations, incomplete definition of pediatric "refractory ITP," and exclusion of secondary ITP. Nevertheless, the criteria(IWG) were more clinically relevant given the reliance on definitions based on bleeding and their ability to be applied prospectively. The utility of using the criteria(IWG) within prospective trials remains to be determined. Copyright © 2011 Wiley Periodicals, Inc.

Field efficacy of pyrethroid treated plastic sheeting (durable lining) in combination with long lasting insecticidal nets against malaria vectors

PubMed Central

2010-01-01

Background Insecticide treated plastic sheeting (ITPS), sometimes known as durable lining, has potential as a long-lasting insecticidal surface for malaria vector control when used as lining for interior walls and ceilings inside the home. Against a backdrop of increasing long lasting net (LN) coverage, we examined the effect of combining permethrin-treated plastic sheeting (ITPS) with LNs in Burkina Faso. Methods A verandah trap experimental hut trial of ITPS with or without Olyset LN was conducted in the Vallée du Kou near Bobo-Dioulasso, where the two molecular forms of Anopheles gambiae s.s., S (frequency 65%) and M (frequency 35%), occur. The S form is mostly pyrethroid resistant (Fkdr = 92%) owing to the kdr mechanism, and the M form is mostly kdr susceptible (Fkdr = 7%). The treatment arms included ITPS, Olyset, ITPS plus Olyset, ITPS plus untreated net (with or without holes), and untreated control. Results ITPS was significantly inferior to Olyset LN in terms of mortality (37% vs 63%), blood feeding inhibition (20% vs 81%) and deterrence (0 vs 42%) effects, and hence altogether inferior as a means of personal protection (16% vs 89%). The addition of ITPS to Olyset did not improve mortality (62%), blood feeding inhibition (75%), deterrence (50%) or personal protection (88%) over that of Olyset used alone. Use of untreated nets - both holed and intact - with ITPS provided greater protection from blood-feeding. The intact net/ITPS combination killed more mosquitoes than ITPS on its own. Conclusions Although ITPS has a potential role for community control of malaria, at low coverage it is unlikely to be as good as Olyset LNs for household protection. The combination of pyrethroid IRS and pyrethroid LN - as practiced in some countries - is unlikely to be additive except, perhaps, at high levels of IRS coverage. A combination of LN and ITPS treated with an alternative insecticide is likely to be more effective, particularly in areas of pyrethroid resistance. PMID:20682050

Field efficacy of pyrethroid treated plastic sheeting (durable lining) in combination with long lasting insecticidal nets against malaria vectors.

PubMed

Chandre, Fabrice; Dabire, Roch K; Hougard, Jean-Marc; Djogbenou, Luc S; Irish, Seth R; Rowland, Mark; N'guessan, Raphael

2010-08-03

Insecticide treated plastic sheeting (ITPS), sometimes known as durable lining, has potential as a long-lasting insecticidal surface for malaria vector control when used as lining for interior walls and ceilings inside the home. Against a backdrop of increasing long lasting net (LN) coverage, we examined the effect of combining permethrin-treated plastic sheeting (ITPS) with LNs in Burkina Faso. A verandah trap experimental hut trial of ITPS with or without Olyset LN was conducted in the Vallée du Kou near Bobo-Dioulasso, where the two molecular forms of Anopheles gambiae s.s., S (frequency 65%) and M (frequency 35%), occur. The S form is mostly pyrethroid resistant (Fkdr = 92%) owing to the kdr mechanism, and the M form is mostly kdr susceptible (Fkdr = 7%). The treatment arms included ITPS, Olyset, ITPS plus Olyset, ITPS plus untreated net (with or without holes), and untreated control. ITPS was significantly inferior to Olyset LN in terms of mortality (37% vs 63%), blood feeding inhibition (20% vs 81%) and deterrence (0 vs 42%) effects, and hence altogether inferior as a means of personal protection (16% vs 89%). The addition of ITPS to Olyset did not improve mortality (62%), blood feeding inhibition (75%), deterrence (50%) or personal protection (88%) over that of Olyset used alone. Use of untreated nets - both holed and intact - with ITPS provided greater protection from blood-feeding. The intact net/ITPS combination killed more mosquitoes than ITPS on its own. Although ITPS has a potential role for community control of malaria, at low coverage it is unlikely to be as good as Olyset LNs for household protection. The combination of pyrethroid IRS and pyrethroid LN - as practiced in some countries - is unlikely to be additive except, perhaps, at high levels of IRS coverage. A combination of LN and ITPS treated with an alternative insecticide is likely to be more effective, particularly in areas of pyrethroid resistance.

RESULTS FROM THE U.S. DOE 2006 SAVE ENERGY NOW ASSESSMENT INITIATIVE: DOE's Partnership with U.S. Industry to Reduce Energy Consumption, Energy Costs, and Carbon Dioxide Emissions

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

Wright, Anthony L; Martin, Michaela A; Gemmer, Bob

In the wake of Hurricane Katrina and other severe storms in 2005, natural gas supplies were restricted, prices rose, and industry sought ways to reduce its natural gas use and costs. In October 2005, U.S. Department of Energy (DOE) Energy Secretary Bodman launched his Easy Ways to Save Energy campaign with a promise to provide energy assessments to 200 of the largest U.S. manufacturing plants. A major thrust of the campaign was to ensure that the nation's natural gas supplies would be adequate for all Americans, especially during home heating seasons. In a presentation to the National Press Club onmore » October 3, 2005, Secretary Bodman said: 'America's businesses, factories, and manufacturing facilities use massive amounts of energy. To help them during this period of tightening supply and rising costs, our Department is sending teams of qualified efficiency experts to 200 of the nation's most energy-intensive factories. Our Energy Saving Teams will work with on-site managers on ways to conserve energy and use it more efficiently.' DOE's Industrial Technologies Program (ITP) responded to the Secretary's campaign with its Save Energy Now initiative, featuring a new and highly cost-effective form of energy assessments. The approach for these assessments drew heavily on the existing resources of ITP's Technology Delivery component. Over the years, ITP-Technology Delivery had worked with industry partners to assemble a suite of respected software decision tools, proven assessment protocols, training curricula, certified experts, and strong partnerships for deployment. Because of the program's earlier activities and the resources that had been developed, ITP was prepared to respond swiftly and effectively to the sudden need to promote improved industrial energy efficiency. Because of anticipated supply issues in the natural gas sector, the Save Energy Now initiative strategically focused on natural gas savings and targeted the nation's largest manufacturing plants--those that consume a total of 1 trillion British thermal units (Btu) or more annually. The approximately 6800 U.S. facilities that fall into this category collectively account for about 53% of all energy consumed by industry in the United States. The 2006 Save Energy Now energy assessments departed from earlier DOE plant assessments by concentrating solely on steam and process heating systems, which are estimated to account for approximately 74% of all natural gas use for manufacturing. The assessments also integrated a strong training component designed to teach industrial plant personnel how to use DOE's steam or process heating opportunity assessment software tools. This approach had the advantages of promoting strong buy-in of plant personnel for the assessment and its outcomes and preparing them better to independently replicate the assessment process at the company's other facilities. The Save Energy Now initiative also included provisions to help plants that applied for but did not qualify for assessments (based on the 1 trillion Btu criterion). Services offered to these plants included (1) an assessment by one of DOE's 26 university-based Industrial Assessment Centers (IACs), (2) a telephone consultation with a systems expert at the DOE's Energy Efficiency and Renewable Energy Information Center, or (3) other technical materials and services available through ITP (e.g., the Save Energy Now CD). By the end of 2006, DOE had completed all 200 of the promised assessments, identifying potential natural gas savings of more than 50 trillion Btu and energy cost savings of about $500 million. These savings, if fully implemented, could reduce CO2 emissions by 4.04 million metric tons annually. These results, along with the fact that a large percentage of U.S. energy is used by a relatively small number of very large plants, clearly suggest that assessments are an expedient and cost-effective way to significantly affect large amounts of energy use. Building on the success of the 2006 initiative, ITP has expanded the effort in 2007 with the goal of conducting 250 more assessments in large U.S. industrial plants. The 2007 assessments are addressing not only steam and process heating, but also pumping, compressed air, and fan systems. The full report reviews the tools and resources developed by the DOE ITP program before 2006, which are the foundation and catalyst for the Save Energy Now assessment efforts. The report describes the process by which industrial plants applied to obtain assessments in 2006 and the overall process and philosophy of conducting assessments. A comprehensive review of the results from the 2006 assessments is presented, along with a summary of key accomplishments and findings.« less

Genetic studies in pediatric ITP: outlook, feasibility and requirements

PubMed Central

Bergmann, Anke K.; Grace, Rachael F.; Neufeld, Ellis J.

2010-01-01

The genomic revolution in medicine has not escaped attention of clinicians and scientists involved in medical management and research studies of immune thrombocytopenic purpura (ITP). In principle, ITP biology and care will benefit greatly from modern methods to understand the patterns of gene expression and genetic markers associated with fundamental parameters of the disease including predictors of remission; risk factors for severity; determinants of response to various therapies; and possibly biological sub-types. However, applying modern genetics to ITP carries severe challenges: (i) achieving adequate sample sizes is a fundamental problem because ITP is rare (and in pediatric ITP, chronic cases constitute only about 1/4 of the total); (ii) familial transmission of childhood ITP is so rare that a convincing pedigree requires consideration of other immunologic or hematologic disorders; (iii) ITP is probably biologically heterogeneous, based on clinical observations, immunological studies and animal models. Here we review the advantages and disadvantages of potential genetic approaches. Sufficient information is available to set reasonable bounds on which genetic analyses of ITP are feasible, and how they are most likely to be accomplished. The highest priority is for accurate phenotypes to compare to genetic analyses. Several registries worldwide hold promise for accomplishing this goal. PMID:20309691

Management of antithrombotic therapy in adults with immune thrombocytopenia (ITP): a survey of ITP specialists and general hematologist-oncologists.

PubMed

Pishko, Allyson M; Misgav, Mudi; Cuker, Adam; Cines, Douglas B; George, James N; Vesely, Sara K; Terrell, Deirdra R

2018-07-01

While patients with immune thrombocytopenia (ITP) and low platelet counts are at risk for bleeding, they are not protected against arterial and venous thrombotic events. Frequently, hematologists are asked to consult on a patient with ITP requiring an antiplatelet (AP) agent or anticoagulant (AC). No direct evidence exists to guide hematologists in weighing the risk of thrombosis against the risk of bleeding in patients with ITP. Therefore, we performed a survey to determine the preferred management of AP/AC therapy in ITP patients. The survey described hypothetical patient scenarios and asked respondents to recommend a minimum platelet count for initiation of AP/AC therapy. We surveyed both hematologists with an international reputation in treatment of ITP (n = 48) and also general hematologist-oncologists in Oklahoma (n = 97). Response rates were 38/48 (79%) for the ITP specialists and 46/97 (47%) for general hematologist-oncologists. Overall, recommended platelet thresholds for antithrombotic therapy were similar between ITP specialists and general hematologist-oncologists. Although both groups recommended a minimum platelet count of 50 × 10 9 /L for AP and AC therapy in most scenarios, there was great variability in individual practice patterns among respondents. This study highlights the need for studies of patients with ITP who require AP/AC therapy to provide high-quality evidence for establishing optimal management strategies.

Tumor necrosis factor-α -308G/A gene polymorphism in Egyptian children with immune thrombocytopenic purpura.

PubMed

El Sissy, Maha H; El Sissy, A H; Elanwary, Sherif

2014-07-01

Immune thrombocytopenic purpura (ITP) is an autoimmune disease characterized by increased platelet destruction. Although the cause of ITP remains unclear, it is accepted that both environmental and genetic factors play an important role in the development of the disease. Children with ITP have a T-helper 1-type cytokine pattern with elevated levels of tumor necrosis factor-alpha (TNF-α) as in most autoimmune diseases. Researchers have shown that polymorphism in the TNF-α gene at position -308 affects gene transcriptions with increased TNF-α production. The current case-control study aimed at detecting the frequency of TNF-α -308G/A gene polymorphism as genetic markers in Egyptian children with ITP, and to clear out their possible role in choosing the treatment protocols of therapy, using PCR restriction fragment length polymorphism assay. Ninety-two ITP patients and 100 age and sex-matched healthy controls were recruited in the study. The results obtained revealed that the frequency of TNF-α -308A/A homotype in ITP patients was significantly higher than that of the controls, and conferred almost six-fold increased risk of ITP acquisition. The polymorphic A allele frequency was significantly higher in ITP patients than in the controls, conferring almost two-fold increased ITP risk. In conclusion, our study suggests the possibility that TNF-α -308 gene polymorphism may contribute to the susceptibility of childhood ITP in Egyptian children.

Management of immune thrombocytopenia: Korean experts recommendation in 2017.

PubMed

Jang, Jun Ho; Kim, Ji Yoon; Mun, Yeung-Chul; Bang, Soo-Mee; Lim, Yeon Jung; Shin, Dong-Yeop; Choi, Young Bae; Yhim, Ho-Young; Lee, Jong Wook; Kook, Hoon

2017-12-01

Management options for patients with immune thrombocytopenia (ITP) have evolved substantially over the past decades. The American Society of Hematology published a treatment guideline for clinicians referring to the management of ITP in 2011. This evidence-based practice guideline for ITP enables the appropriate treatment of a larger proportion of patients and the maintenance of normal platelet counts. Korean authority operates a unified mandatory national health insurance system. Even though we have a uniform standard guideline enforced by insurance reimbursement, there are several unsolved issues in real practice in ITP treatment. To optimize the management of Korean ITP patients, the Korean Society of Hematology Aplastic Anemia Working Party (KSHAAWP) reviewed the consensus and the Korean data on the clinical practices of ITP therapy. Here, we report a Korean expert recommendation guide for the management of ITP.

Immune Thrombocytopenia

PubMed Central

Kistanguri, Gaurav; McCrae, Keith R.

2013-01-01

Immune thrombocytopenia (ITP) is a common hematologic disorder characterized by isolated thrombocytopenia. ITP presents as a primary form characterized by isolated thrombocytopenia (platelet count < 100 × 109/L) in the absence of other causes or disorders that may be associated with thrombocytopenia, or a secondary form in which immune thrombocytopenia develops in association with another disorder that is usually immune or infectious. ITP may affect individuals of all ages, with peaks during childhood and in the elderly, in whom the age specific incidence of ITP is greatest. Bleeding is the most common clinical manifestation of ITP, with the risk of bleeding and related morbidity increased in elderly patients. The pathogenesis of ITP is complex, involving alterations in humoral and cellular immunity. Thrombocytopenia is caused by antibodies that react with glycoproteins expressed on platelets and megakaryocytes (glycoprotein IIb/IIIa, Ib/IX and others), causing shortened survival of circulating platelets and impairing platelet production. Diminished numbers and function of regulatory T cells, as well as the effects of cytotoxic T cells also contribute to the pathogenesis of ITP. Corticosteroids remain the most common first line therapy for ITP, occasionally in conjunction with intravenous immunoglobulin (IVIg) and anti-Rh(D). However, these agents do not lead to durable remissions in the majority of adults with ITP, and considerable heterogeneity exists in the use of second line approaches, which may include splenectomy, Rituximab, or thrombopoietin receptor agonists (TRAs). This review summarizes the classification and diagnosis of primary and secondary ITP, as well as the pathogenesis and options for treatment. Remarkable advances in the understanding and management of ITP have been achieved over the last decade, though many questions remain. PMID:23714309

Quantitative aspects of microchip isotachophoresis for high precision determination of main components in pharmaceuticals.

PubMed

Hradski, Jasna; Chorváthová, Mária Drusková; Bodor, Róbert; Sabo, Martin; Matejčík, Štefan; Masár, Marián

2016-12-01

Although microchip electrophoresis (MCE) is intended to provide reliable quantitative data, so far there is only limited attention paid to these important aspects. This study gives a general overview of key aspects to be followed to reach high-precise determination using isotachophoresis (ITP) on the microchip with conductivity detection. From the application point of view, the procedure for the determination of acetate, a main component in the pharmaceutical preparation buserelin acetate, was developed. Our results document that run-to-run fluctuations in the sample injection volume limit the reproducibility of quantitation based on the external calibration. The use of a suitable internal standard (succinate in this study) improved the repeatability of the precision of acetate determination from six to eight times. The robustness of the procedure was studied in terms of impact of fluctuations in various experimental parameters (driving current, concentration of the leading ions, pH of the leading electrolyte and buffer impurities) on the precision of the ITP determination. The use of computer simulation programs provided means to assess the ITP experiments using well-defined theoretical models. A long-term validity of the calibration curves on two microchips and two MCE equipments was verified. This favors ITP over other microchip electrophoresis techniques, when chip-to-chip or equipment-to-equipment transfer of the analytical method is required. The recovery values in the range of 98-101 % indicate very accurate determination of acetate in buserelin acetate, which is used in the treatment of hormone-dependent tumors. This study showed that microchip ITP is suitable for reliable determination of main components in pharmaceutical preparations.

Synthesis of Individual Transition Plans: Format and Process.

ERIC Educational Resources Information Center

La Mar, Kathleen; Rosenberg, Bill

This document presents a prototype Individual Transition Plan (ITP) process and format for students receiving special education services. Following an overview of the role of transition, a section on the ITP process discusses pre-meeting activities, conducting an ITP meeting, monitoring and evaluating the ITP meeting, and a rationale for the…

Functions of Ion Transport Peptide and Ion Transport Peptide-Like in the Red Flour Beetle Tribolium castaneum

USDA-ARS?s Scientific Manuscript database

Ion transport peptide (ITP) and ITP-like (ITPL) are highly conserved neuropeptides in insects and crustaceans. We investigated the alternatively spliced variants of ITP/ITPL in Tribolium castaneum to understand their functions. We identified three alternatively spliced transcripts named itp, itpl-...

Impact of chronic Immune Thrombocytopenic Purpura (ITP) on health-related quality of life: a conceptual model starting with the patient perspective

PubMed Central

Mathias, Susan D; Gao, Sue K; Miller, Kimberly L; Cella, David; Snyder, Claire; Turner, Ralph; Wu, Albert; Bussel, James B; George, James N; McMillan, Robert; Wysocki, Diane Kholos; Nichol, Janet L

2008-01-01

Background Immune thrombocytopenic purpura (ITP), a condition characterized by autoimmune-mediated platelet destruction and suboptimal platelet production, is associated with symptoms such as bruising, epistaxis, menorrhagia, mucosal bleeding from the gastrointestinal and urinary tracts and, rarely central nervous system bleeding. The aim of this research is to develop a conceptual model to describe the impact of ITP and its treatment on patients' health-related quality of life (HRQoL). Methods A literature search and focus groups with adult ITP patients were conducted to identify areas of HRQoL affected by ITP. Published literature was reviewed to identify key HRQoL issues and existing questionnaires used to assess HRQoL. Focus group transcripts were reviewed, and common themes were extracted by grouping conceptual categories that described the impact on HRQoL. Results The literature synthesis and themes from the focus group data suggest that decreased platelet counts, disease symptoms, and treatment side effects influence multiple domains of HRQoL for ITP patients. Key areas affected by ITP and its treatments include emotional and functional health, work life, social and leisure activities, and reproductive health. Conclusion ITP affects various areas of HRQoL. This conceptual model will help inform the evaluation of therapeutic strategies for ITP. PMID:18261217

[Interdigital tinea pedis resulting from Fusarium spp. in Dakar, Senegal].

PubMed

Diongue, K; Diallo, M A; Ndiaye, M; Seck, M C; Badiane, A S; Ndiaye, D

2018-03-01

Fungal interdigital tinea pedis (ITP) is a common pathology mainly due to dermatophytes and yeasts. Fusarium sp. is rarely incriminated in the genesis of intertrigo. In Dakar, a recent study conducted in 2016 on fungal ITP showed that Fusarium were more involved in the etiology of ITP than dermatophytes, coming just after yeasts dominated by Candida. Following this, we wanted to draw attention to the increasing incidence of ITP resulting from Fusarium spp., in Dakar, Senegal, and to analyze the epidemiological and mycological particularities of these ITP due to Fusarium spp. A retrospective study including all patients received at the laboratory for suspicion of ITP between January 1st, 2014 and June 30th, 2017 was conducted. Diagnosis was based on mycological examination, including direct examination and culture. Mycological analysis was considered positive when direct examination and culture were positive after at least one repeat. Twenty-nine cases of Fusarium ITP accounting for 44.6% of all ITP in the study period were diagnosed in 15 men and 14 women. The mean age of the patients was 48.4 years. Fusarium ITP were diagnosed in immunocompetent patients except in two diabetics. The mean duration of the lesions was 6.83 years. The most frequent species isolated belonged to the Fusarium solani complex with 19 cases. Fusarium ITP in a healthy subject requires regular monitoring because any subsequent decrease in immune defenses could lead to fatal hematogenous spread. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Electrolyte system strategies for anionic ITP with ESI-MS detection. 3. The ITP spacer technique in moving-boundary systems and configurations with two self-maintained ITP subsystems.

PubMed

Gebauer, Petr; Malá, Zdena; Boček, Petr

2014-03-01

This contribution is the third part of the project on strategies used in the selection and tuning of electrolyte systems for anionic ITP with ESI-MS detection. The strategy presented here is based on the creation of self-maintained ITP subsystems in moving-boundary systems and describes two new principal approaches offering physical separation of analyte zones from their common ITP stack and/or simultaneous selective stacking of two different analyte groups. Both strategic directions are based on extending the number of components forming the electrolyte system by adding a third suitable anion. The first method is the application of the spacer technique to moving-boundary anionic ITP systems, the second method is a technique utilizing a moving-boundary ITP system in which two ITP subsystems exist and move with mutually different velocities. It is essential for ESI detection that both methods can be based on electrolyte systems containing only several simple chemicals, such as simple volatile organic acids (formic and acetic) and their ammonium salts. The properties of both techniques are defined theoretically and discussed from the viewpoint of their applicability to trace analysis by ITP-ESI-MS. Examples of system design for selected model separations of preservatives and pharmaceuticals illustrate the validity of the theoretical model and application potential of the proposed techniques by both computer simulations and experiments. Both new methods enhance the application range of ITP-MS and may be beneficial particularly for complex multicomponent samples or for analytes with identical molecular mass. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Feasibility and acceptability of insecticide-treated plastic sheeting (ITPS) for vector control in Papua New Guinea

PubMed Central

2012-01-01

Background This study assessed the feasibility and acceptability of utilizing insecticide-treated plastic sheeting (ITPS) as a malaria control intervention in Papua New Guinea (PNG). Methods ZeroVector® ITPS was installed in 40 homes across four study sites representing a cross section of malaria transmission risk and housing style. Structured questionnaires were completed at the time of ITPS installation (n=40) and at four weeks post installation (n=40) with the household head. Similarly, group interviews with the male and/or female household heads were completed at installation (n=5) and four-week follow-up (n=4). Results ZeroVector® ITPS was successfully installed in a range of homes employing traditional and/or modern building materials in PNG. The ITPS installations remained intact over the course of the four-week trial period and were highly acceptable to both male and female household heads. No dissatisfaction with the ITPS product was reported at four-week follow-up; however, the installation process was time consuming, participants reported a reduction in mosquito net use following ITPS installation and many participants expressed concern about the longevity of ITPS over the longer term. Conclusion ZeroVector® ITPS installation is feasible and highly acceptable in a diverse range of PNG contexts and is likely to be favourably received as a vector control intervention if accessible en masse. A longer-term evaluation is required before firm policy or public health decisions can be made regarding the potential application of ITPS in the national malaria control programme. The positive study findings suggest a longer-term evaluation of this promising malaria control intervention warrants consideration. PMID:23046535

Feasibility and acceptability of insecticide-treated plastic sheeting (ITPS) for vector control in Papua New Guinea.

PubMed

Pulford, Justin; Tandrapah, Anthony; Atkinson, Jo-An; Kaupa, Brown; Russell, Tanya; Hetzel, Manuel W

2012-10-09

This study assessed the feasibility and acceptability of utilizing insecticide-treated plastic sheeting (ITPS) as a malaria control intervention in Papua New Guinea (PNG). ZeroVector® ITPS was installed in 40 homes across four study sites representing a cross section of malaria transmission risk and housing style. Structured questionnaires were completed at the time of ITPS installation (n=40) and at four weeks post installation (n=40) with the household head. Similarly, group interviews with the male and/or female household heads were completed at installation (n=5) and four-week follow-up (n=4). ZeroVector® ITPS was successfully installed in a range of homes employing traditional and/or modern building materials in PNG. The ITPS installations remained intact over the course of the four-week trial period and were highly acceptable to both male and female household heads. No dissatisfaction with the ITPS product was reported at four-week follow-up; however, the installation process was time consuming, participants reported a reduction in mosquito net use following ITPS installation and many participants expressed concern about the longevity of ITPS over the longer term. ZeroVector® ITPS installation is feasible and highly acceptable in a diverse range of PNG contexts and is likely to be favourably received as a vector control intervention if accessible en masse. A longer-term evaluation is required before firm policy or public health decisions can be made regarding the potential application of ITPS in the national malaria control programme. The positive study findings suggest a longer-term evaluation of this promising malaria control intervention warrants consideration.

[Quantity and function of T follicular helper cells in the bone marrow of patients with immune thrombocytopenia].

PubMed

Zhang, Yang; Qu, Wen; Ruan, Er-Bao; Fu, Rong; Wang, Guo-Jin; Liu, Hong; Wang, Xiao-Ming; Wu, Yu-Hong; Song, Jia; Xing, Li-Min; Guan, Jing; Li, Li-Juan; Wang, Hua-Quan; Shao, Zong-Hong

2014-06-01

This study was purposed to detect the quantity and function of bone marrow (BM) T follicular helper (Tfh) cells of patients with immune thrombocytopenia, and to explore the role of Tfh cells in the pathogenesis of ITP. Twenty-one newly diagnosed ITP patients, twenty ITP patients in recovery stage and eighteen normal controls were enrolled in this study. The percentages of Tfh cells, Tfh-related molecules ICOS, CD40L, IL-21 in BM were detected by flow cytometry (FCM), and the mRNA expression of BCL-6 in BMMNC was determined by semi-quantitive RT-PCR. Correlation of Tfh cell level with the disease severity of ITP patients was analysed. The results showed that the ratio of CD4(+)CXCR5(+)/CD4(+) cells in newly diagnosed ITP patients [(5.532 ± 2.599)%] was significantly higher than that in ITP patients with recovery stage [(4.064 ± 2.026)%] and controls [(4.048 ± 1.413)%] (P < 0.05). The ratio of CD4(+)CXCR5(+)ICOS(+)/CD4(+) CXCR5(+) cells in newly diagnosed ITP patients [(14.586 ± 8.561)%] was higher than that in recovery stage ITP patients [(12.884 ± 10.161)%] and controls [(7.487 ± 5.176)%]. The differences be-tween newly diagnosed ITP patients and controls were statistically significant (P < 0.05). The ratio of CD4(+)CXCR5(+) CD40L(+)/CD4(+) CXCR5(+) cells in newly diagnosed ITP patients [(15.309 ± 10.756)%] and in ITP patients with recovery stage [(18.242 ± 12.243)%] were significantly higher than that in controls [(8.618 ± 5.719) %] (P < 0.05). The ratio of intracytoplasm CD4(+) CXCR5(+) IL-21(+)/CD4(+)CXCR5(+) cells in newly diagnosed ITP patients [(58.560 ± 26.285)%] and in ITP patients with recovery stage [(57.035 ± 30.936)%] were significantly higher than that in controls [(36.289 ± 24.868)%] (P < 0.05). The relative expression levels of BCL-6 mRNA in BMMNC of three groups were (1.407 ± 0.264), (1.149 ± 0.217) and (0.846 ± 0.157), respectively. The differences between 3 groups were significant(P < 0.05). It is concluded that the quantity and function of Tfh cells in ITP patients increase, which may play an important role in the pathogenesis of ITP.

Chinese guidelines for treatment of adult primary immune thrombocytopenia.

PubMed

Liu, Xin-Guang; Bai, Xiao-Chuan; Chen, Fang-Ping; Cheng, Yun-Feng; Dai, Ke-Sheng; Fang, Mei-Yun; Feng, Jian-Ming; Gong, Yu-Ping; Guo, Tao; Guo, Xin-Hong; Han, Yue; Hong, Luo-Jia; Hu, Yu; Hua, Bao-Lai; Huang, Rui-Bing; Li, Yan; Peng, Jun; Shu, Mi-Mi; Sun, Jing; Sun, Pei-Yan; Sun, Yu-Qian; Wang, Chun-Sen; Wang, Shu-Jie; Wang, Xiao-Min; Wu, Cong-Ming; Wu, Wen-Man; Yan, Zhen-Yu; Yang, Feng-E; Yang, Lin-Hua; Yang, Ren-Chi; Yang, Tong-Hua; Ye, Xu; Zhang, Guang-Sen; Zhang, Lei; Zheng, Chang-Cheng; Zhou, Hu; Zhou, Min; Zhou, Rong-Fu; Zhou, Ze-Ping; Zhu, Hong-Li; Zhu, Tie-Nan; Hou, Ming

2018-06-01

Primary immune thrombocytopenia (ITP) is a bleeding disorder commonly encountered in clinical practice. The International Working Group (IWG) on ITP has published several landmark papers on terminology, definitions, outcome criteria, bleeding assessment, diagnosis, and management of ITP. The Chinese consensus reports for diagnosis and management of adult ITP have been updated to the 4th edition. Based on current consensus positions and new emerging clinical evidence, the thrombosis and hemostasis group of the Chinese Society of Hematology issued Chinese guidelines for management of adult ITP, which aim to provide evidence-based recommendations for clinical decision making.

NASA space research and technology overview (ITP)

NASA Technical Reports Server (NTRS)

Reck, Gregory M.

1992-01-01

A series of viewgraphs summarizing NASA space research and technology is presented. Some of the specific topics covered include the organization and goals of the Office of Aeronautics and Space Technology, technology maturation strategy, integrated technology plan for the Civil Space Program, program selection and investment prioritization, and space technology benefits.

Evaluating clinically meaningful change on the ITP-PAQ: preliminary estimates of minimal important differences.

PubMed

Mathias, Susan D; Gao, Sue K; Rutstein, Mark; Snyder, Claire F; Wu, Albert W; Cella, David

2009-02-01

Interpretation of data from health-related quality of life (HRQoL) questionnaires can be enhanced with the availability of minimally important difference (MID) estimates. This information will aid clinicians in interpreting HRQoL differences within patients over time and between treatment groups. The Immune Thrombocytopenic Purpura (ITP)-Patient Assessment Questionnaire (PAQ) is the only comprehensive HRQoL questionnaire available for adults with ITP. Forty centers from within the US and Europe enrolled ITP patients into one of two multicenter, randomized, placebo-controlled, double-blind, 6-month, phase III clinical trials of romiplostim. Patients enrolled in these studies self-administered the ITP-PAQ and two items assessing global change (anchors) at baseline and weeks 4, 12, and 24. Using data from the ITP-PAQ and these two anchors, an anchor-based estimate was computed and combined with the standard error of measurement and standard deviation to compute a distribution-based estimate in order to provide an MID range for each of the 11 scales of the ITP-PAQ. A total of 125 patients participated in these clinical trials and provided data for use in these analyses. Combining results from anchor- and distribution-based approaches, MID values were computed for 9 of the 11 scales. MIDs ranged from 8 to 12 points for Symptoms, Bother, Psychological, Overall QOL, Social Activity, Menstrual Symptoms, and Fertility, while the range was 10 to 15 points for the Fatigue and Activity scales of the ITP-PAQ. These estimates, while slightly higher than other published MID estimates, were consistent with moderate effect sizes. These MID estimates will serve as a useful tool to researchers and clinicians using the ITP-PAQ, providing guidance for interpretation of baseline scores as well as changes in ITP-PAQ scores over time. Additional work should be done to finalize these initial estimates using more appropriate anchors that correlate more highly with the ITP-PAQ scales.

Flow cytometric immunobead assay for quantitative detection of platelet autoantibodies in immune thrombocytopenia patients.

PubMed

Zhai, Juping; Ding, Mengyuan; Yang, Tianjie; Zuo, Bin; Weng, Zhen; Zhao, Yunxiao; He, Jun; Wu, Qingyu; Ruan, Changgeng; He, Yang

2017-10-23

Platelet autoantibody detection is critical for immune thrombocytopenia (ITP) diagnosis and prognosis. Therefore, we aimed to establish a quantitative flow cytometric immunobead assay (FCIA) for ITP platelet autoantibodies evaluation. Capture microbeads coupled with anti-GPIX, -GPIb, -GPIIb, -GPIIIa and P-selectin antibodies were used to bind the platelet-bound autoantibodies complex generated from plasma samples of 250 ITP patients, 163 non-ITP patients and 243 healthy controls, a fluorescein isothiocyanate (FITC)-conjugated secondary antibody was the detector reagent and mean fluorescence intensity (MFI) signals were recorded by flow cytometry. Intra- and inter-assay variations of the quantitative FCIA assay were assessed. Comparisons of the specificity, sensitivity and accuracy between quantitative and qualitative FCIA or monoclonal antibody immobilization of platelet antigen (MAIPA) assay were performed. Finally, treatment process was monitored by our quantitative FCIA in 8 newly diagnosed ITPs. The coefficient of variations (CV) of the quantitative FCIA assay were respectively 9.4, 3.8, 5.4, 5.1 and 5.8% for anti-GPIX, -GPIb, -GPIIIa, -GPIIb and -P-selectin autoantibodies. Elevated levels of autoantibodies against platelet glycoproteins GPIX, GPIb, GPIIIa, GPIIb and P-selectin were detected by our quantitative FCIA in ITP patients compared to non-ITP patients or healthy controls. The sensitivity, specificity and accuracy of our quantitative assay were respectively 73.13, 81.98 and 78.65% when combining all 5 autoantibodies, while the sensitivity, specificity and accuracy of MAIPA assay were respectively 41.46, 90.41 and 72.81%. A quantitative FCIA assay was established. Reduced levels of platelet autoantibodies could be confirmed by our quantitative FCIA in ITP patients after corticosteroid treatment. Our quantitative assay is not only good for ITP diagnosis but also for ITP treatment monitoring.

A Brief History of the Institute of Theoretical Physics in the Chinese Academy of Sciences since 1978

NASA Astrophysics Data System (ADS)

Jinyan, Liu

2014-03-01

The Institute of Theoretical Physics (ITP), Chinese academy of Sciences (CAS), founded in June 1978, is a specialized institute studying major issues in the fundamental research of theoretical physics. ITP has played an important role in the development of theoretical physics in China, especially in organizing and undertaking major national projects, expanding international exchanges and cooperation, and nurturing advanced researchers. My presentation will examine the reasons why ITP was founded in 1978 and why Peng Huanwu and Zhou Guangzhao, two prominent Chinese theorists, were chosen as the first and second directors of ITP. Moreover, I will summarize ITP's scientific activities and achievements in the past 35 years. Last but not least, I will compare ITP with university physics departments and explore its unique characters (both strength and weakness).

Refractory Immune Thrombocytopenic Purpura and Cytomegalovirus Infection: A Call for a Change in the Current Guidelines.

PubMed

Shimanovsky, Alexei; Patel, Devbala; Wasser, Jeffrey

2016-01-01

Immune thrombocytopenic purpura (ITP) is characterized by a decreased platelet count caused by excess destruction of platelets and inadequate platelet production. In many cases, the etiology is not known, but the viral illness is thought to play a role in the development of some cases of ITP. The current (2011) American Society of Hematology ITP guidelines recommend initial diagnostic studies to include testing for HIV and Hepatitis C. The guidelines suggest that initial treatment consist of observation, therapy with corticosteroids, IVIG or anti D. Most cases respond to the standard therapy such that the steroids may be tapered and the platelet counts remain at a hemostatically safe level. Some patients with ITP are dependent on long-term steroid maintenance, and the thrombocytopenia persists with the tapering of the steroids. Recent case reports demonstrate that ITP related to cytomegalovirus (CMV) can persist in spite of standard therapy and that antiviral therapy may be indicated. Herein we report a case of a 26-year-old female with persistent ITP that resolved after the delivery of a CMV-infected infant and placenta. Furthermore, we review the current literature on CMV-associated ITP and propose that the current ITP guidelines be amended to include assessment for CMV, even in the absence of signs and symptoms, as part of the work-up for severe and refractory ITP, especially prior to undergoing an invasive procedure such as splenectomy.

Helicobacter pylori infection and chronic immune thrombocytopenic purpura: long-term results of bacterium eradication and association with bacterium virulence profiles.

PubMed

Emilia, Giovanni; Luppi, Mario; Zucchini, Patrizia; Morselli, Monica; Potenza, Leonardo; Forghieri, Fabio; Volzone, Francesco; Jovic, Gordana; Leonardi, Giovanna; Donelli, Amedea; Torelli, Giuseppe

2007-12-01

Eradication of Helicobacter pylori may lead to improvement of chronic immune thrombocytopenic purpura (ITP), although its efficacy over time is uncertain. We report the results of H pylori screening and eradication in 75 consecutive adult patients with ITP. We also used molecular methods to investigate lymphocyte clonality and H pylori genotypes in the gastric biopsies from 10 H pylori-positive patients with ITP and 19 H pylori-positive patients without ITP with chronic gastritis. Active H pylori infection was documented in 38 (51%) patients and successfully eradicated in 34 (89%) patients. After a median follow-up of 60 months, a persistent platelet response in 23 (68%) of patients with eradicated infection was observed; 1 relapse occurred. No differences in mucosal B- or T-cell clonalities were observed between patients with ITP and control participants. Of note, the frequency of the H pylori cagA gene (P = .02) and the frequency of concomitant H pylori cagA, vacAs1, and iceA genes (triple-positive strains; P = .015) resulted statistically higher in patients with ITP than in control participants. All asymptomatic H pylori-positive patients with ITP were suffering from chronic gastritis. Our data suggest a sustained platelet recovery in a proportion of patients with ITP by H pylori eradication alone. Overrepresentation of specific H pylori genotypes in ITP suggests a possible role for bacterium-related factors in the disease pathogenesis.

Refractory Immune Thrombocytopenic Purpura and Cytomegalovirus Infection: A Call for a Change in the Current Guidelines

PubMed Central

Shimanovsky, Alexei; Patel, Devbala; Wasser, Jeffrey

2016-01-01

Immune thrombocytopenic purpura (ITP) is characterized by a decreased platelet count caused by excess destruction of platelets and inadequate platelet production. In many cases, the etiology is not known, but the viral illness is thought to play a role in the development of some cases of ITP. The current (2011) American Society of Hematology ITP guidelines recommend initial diagnostic studies to include testing for HIV and Hepatitis C. The guidelines suggest that initial treatment consist of observation, therapy with corticosteroids, IVIG or anti D. Most cases respond to the standard therapy such that the steroids may be tapered and the platelet counts remain at a hemostatically safe level. Some patients with ITP are dependent on long-term steroid maintenance, and the thrombocytopenia persists with the tapering of the steroids. Recent case reports demonstrate that ITP related to cytomegalovirus (CMV) can persist in spite of standard therapy and that antiviral therapy may be indicated. Herein we report a case of a 26-year-old female with persistent ITP that resolved after the delivery of a CMV-infected infant and placenta. Furthermore, we review the current literature on CMV-associated ITP and propose that the current ITP guidelines be amended to include assessment for CMV, even in the absence of signs and symptoms, as part of the work-up for severe and refractory ITP, especially prior to undergoing an invasive procedure such as splenectomy. PMID:26740871

Effect of steroids on the activation status of platelets in patients with Immune thrombocytopenia (ITP).

PubMed

Bhoria, Preeti; Sharma, Saniya; Varma, Neelam; Malhotra, Pankaj; Varma, Subhash; Luthra-Guptasarma, Manni

2015-01-01

The activation status of platelets in Immune Thrombocytopenia (ITP) patients--which is still somewhat controversial--is of potential interest, because activated platelets tend to aggregate (leading to excessive clotting or thromboembolic events) but cannot do so when platelet numbers are low, as in ITP. Although corticosteroids are the first line of therapy in ITP, the effect of steroids on activation of platelets has not been evaluated so far. We examined the status of platelet activation (with and without stimulation with ADP) in ITP patients, at the start of therapy (pre-steroid treatment, naive) and post-steroid treatment (classified on the basis of steroid responsiveness). We used flow cytometry to evaluate the levels of expression of P-selectin, and PAC-1 binding to platelets of 55 ITP patients and a similar number of healthy controls, treated with and without ADP. We found that platelets in ITP patients exist in an activated state. In patients who are responsive to steroids, the treatment reverses this situation. Also, the fold activation of platelets upon treatment with ADP is more in healthy controls than in ITP patients; treatment with steroids causes platelets in steroid-responsive patients to become more responsive to ADP-activation, similar to healthy controls. Thus steroids may cause changes in the ability of platelets to get activated with an agonist like ADP. Our results provide new insights into how, and why, steroid therapy helps in the treatment of ITP.

Donors With Immune Thrombocytopenia: Do They Pose a Risk to Transplant Recipients?

PubMed

Trotter, P B; Robb, M; Summers, D; Watson, C J E; Clatworthy, M; Bradley, J A; Hill, Q A; Neuberger, J

2017-03-01

Transplant-mediated alloimmune thrombocytopenia (TMAT) from donors with immune thrombocytopenia (ITP) can result in significant bleeding complications in the recipient. The risk to a recipient of TMAT if they receive an organ from a donor with ITP is unknown. The outcomes of recipients of organs from deceased donors with ITP recorded in the UK Transplant Registry between 2000 and 2015 were reviewed. Twenty-one deceased organ donors had a predonation diagnosis of ITP. These donors were significantly more likely to have died from intracranial hemorrhage than were all other deceased organ donors (85% vs. 57%, p < 0.001). Organs from donors with ITP resulted in 49 organ transplants (31 kidney, 14 liver, four heart), with only one case of TMAT, which occurred in a liver transplant recipient and resulted in death from bleeding complications 18 days posttransplantation. The recipient of a kidney from the same organ donor was not affected. Unadjusted 5-year patient and graft survival was significantly worse for liver transplant recipients from donors with ITP compared with liver transplant recipients from donors without ITP (64% vs. 85%, p = 0.012). Organs from donors with ITP may be considered for transplantation, but livers should be used with caution. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

A novel canine model of immune thrombocytopenia: Has ITP gone to the dogs?

PubMed Central

LeVine, Dana N; Birkenheuer, Adam J; Brooks, Marjory B; Nordone, Shila K; Bellinger, Dwight A; Jones, Sam L; Fischer, Thomas H; Oglesbee, Stephen E; Frey, Kahlina; Brinson, Nicole S; Peters, Allison Pazandak; Marr, Henry S; Motsinger-Reif, Alison; Gudbrandsdottir, Sif; Bussel, James B; Key, Nigel S

2014-01-01

Summary Canine immune thrombocytopenia (ITP) is analogous to human ITP, with similar platelet counts and heterogeneity in bleeding phenotype among affected individuals. With a goal of ultimately investigating this bleeding heterogeneity, a canine model of antibody-mediated ITP was developed. Infusion of healthy dogs with 2F9, a murine IgG2a monoclonal antibody to the canine platelet glycoprotein GPIIb (a common target of autoantibodies in ITP) resulted in profound, dose-dependent thrombocytopenia. Model dogs developed variable bleeding phenotypes, e.g. petechiae and haematuria, despite similar degrees of thrombocytopenia. 2F9 infusion was not associated with systemic inflammation, consumptive coagulopathy, or impairment of platelet function. Unexpectedly however, evaluation of cytokine profiles led to the identification of platelets as a potential source of serum interleukin-8 (IL8) in dogs. This finding was confirmed in humans with ITP, suggesting that platelet IL8 may be a previously unrecognized modulator of platelet-neutrophil crosstalk. The utility of this model will allow future study of bleeding phenotypic heterogeneity including the role of neutrophils and endothelial cells in ITP. PMID:25039744

Clinical course and prognostic factors of childhood immune thrombocytopenia: single center experience of 10 years

PubMed Central

Jung, Jae Yeob; O, A Rum; Kim, Je Keong

2016-01-01

Purpose This study aimed to evaluate the clinical course of childhood immune thrombocytopenia (ITP) and to assess the risk factors for developing chronic ITP. Methods The records of 64 children diagnosed with ITP from November 2005 and December 2014 at single center were retrospectively analyzed. Results The median age at diagnosis and the median platelet count were 1 year (range, 1 month to 15 years) and 9×109/L (range, 0–84×109/L), respectively. No patient experienced severe bleeding. Nineteen children (29.7%) spontaneously recovered their platelet count to ≥100×109/L at a median of 10 days. In total 45 patients (70.3%) received intravenous immunoglobulin (IVIG) as first-line therapy, and showed platelet recovery at 1 week. The final diagnosis of 55 (85.9%) and 9 patients (14.1%) was acute and chronic ITP, respectively. Older age, absence of prior infection and insidious onset of symptoms were significantly associated with the development of chronic ITP. Among the patients who received IVIG, those with platelet count <45×109/L at 1 month after IVIG showed a significantly higher incidence of chronic ITP compared to those with platelet count ≥45×109/L (88.8% vs. 44.4%, P<0.01). Conclusion In most patients, ITP runs a benign course and approximately 86% of them recover within 1 year of their initial diagnosis. The potential impact of the risk factors of chronic ITP on clinical practice needs to be explored and further studies are warranted to determine whether IVIG influences the course of ITP. PMID:27610182

Utility of the immature platelet fraction in pediatric immune thrombocytopenia: Differentiating from bone marrow failure and predicting bleeding risk.

PubMed

McDonnell, Alicia; Bride, Karen L; Lim, Derick; Paessler, Michele; Witmer, Char M; Lambert, Michele P

2018-02-01

Differentiating childhood immune thrombocytopenia (ITP) from other cause of thrombocytopenia remains a diagnosis of exclusion. Additionally factors that predict bleeding risk for those patients with ITP are currently not well understood. Previous small studies have suggested that immature platelet fraction (IPF) may differentiate ITP from other causes of thrombocytopenia and in combination with other factors may predict bleeding risk. We performed a retrospective chart review of thrombocytopenic patients with an IPF measured between November 1, 2013 and July 1, 2015. Patients were between 2 months and 21 years of age with a platelet count <50 × 10 9 /l. Each patient chart was reviewed for final diagnosis and bleeding symptoms. A bleeding severity score was retrospectively assigned. Two hundred seventy two patients met inclusion criteria, 97 with ITP, 11 with bone marrow failure (BMF), 126 with malignancy, and 38 with other causes of thrombocytopenia. An IPF > 5.2% differentiated ITP from BMF with 93% sensitivity and 91% specificity. Absolute immature platelet number (AIPN) was significantly lower in ITP patients with severe to life-threatening hemorrhage than those without, despite similar platelet counts. On multivariate analysis, an IPF < 10.4% was confirmed as an independent predictor of bleeding risk at platelet counts <10 × 10 9 /l in patients with ITP. IPF measurement alone has utility in both the diagnosis of ITP and identifying patients at increased risk of hemorrhage. Further study is required to understand the pathophysiological differences of ITP patients with lower IPF/AIPN. © 2017 Wiley Periodicals, Inc.

Clinical Features and Treatment Outcomes of Primary Immune Thrombocytopenic Purpura in Hospitalized Children Under 2-Years Old

PubMed Central

Farhangi, H; Ghasemi, A; Banihashem, A; Badiei, Z; Jarahi, L; Eslami, G; Langaee, T

2016-01-01

Background Immune thrombocytopenic purpura (ITP) is the most prevalent cause of thrombocytopenia in children. Despite the importance of ITP in children under 2-years old, only a few publications are available in the literature.ITP usually presents itself as isolated thrombocytopenia and mucocutaneous bleeding. Materials and Methods This study was conducted on 187 under 2-year-old children diagnosed with ITP and treated at Dr. Sheikh Hospital from 2004 to 2011.In this retrospective study, clinical symptoms, laboratory findings, history of viral infections, vaccination history, and treatment efficacy in children under 2-years old with ITP were investigated.Patients were followed for one year after being discharged from the hospital. Results The risk of the disease developing into chronic form was higher in older children (0.001). ITP in children under 3-months old was significantly associated with vaccination (p=0.007). There was no significant differences between male and female patients in regards to newly diagnosed ITP, persistent, and chronic disease status (p = 0.21). No significant difference in bleeding symptoms was observed between patients under 3-months old and 3 to 24-months old (p=0.18). Conclusion Infantile ITP respond favorably to treatment. The risk of the disease developing into chronic form is higher in 3-to-24-month-old children compared to under-three-month olds. PMID:27222699

Making Shock Waves in Microfluidics: The Physics and Applications of Isotachophoresis

NASA Astrophysics Data System (ADS)

Santiago, Juan

2007-11-01

Microfluidics lies at the interfaces between engineering, chemistry, and biology, and aims to develop chemical laboratories on a chip. An important technique is on-chip capillary electrophoresis which has been applied to a wide range of chemical and biochemical assay applications over the last decade. Perhaps the best way of improving the sensitivity of on-chip electrophoresis is to integrate an online sample preconcentration method. At Stanford, we are developing methods to concentrate ions into small volumes using a method called isotachophoresis (ITP). In ITP, sample ions are injected between the high mobility co-ions of a leading electrolyte (LE) and the low mobility co-ions of a trailing electrolyte (TE). Upon application of an electric field, the disparate ion mobilities of the LE and TE cause sample species to segregate and focus into a series of narrow self-sharpening zones which migrate at equal velocity (hence ``isotacho''). ITP-type processes have been studied and used for more than 60 years, and yet there remain significant challenges in the robust modeling of these transport processes and the creation of widely applicable assays. We use ITP to create sample ion concentration ``shock waves'' in microchannels. These concentration waves can be integrated with on-chip electrophoresis for high sensitivity assays, and novel modes of operation. The talk will summarize the basic physics of ITP, experimental studies of ITP, models of ITP, and the development of novel ITP-assays with unprecedented sensitivity and new functionality. For example, using leading-to-sample ion concentration ratios of 10^15 and local electric fields of ˜4 kV/cm, we can achieve order one micron wide ITP zones. We can achieve million fold preconcentration in 120 s and can detect 100 attomolar sample concentrations (to our knowledge the highest demonstrated sensitivity for an electrophoresis-related assay). We have also developed a method that uses ITP to separate, indirectly detect, and identify the electrophoretic mobilities of unlabeled (non-fluorescent) analytes using surrogate fluorescent molecules. Our goal is the development of novel on-chip ITP assays which expand the design space of microfluidic devices.

Indigenous and traditional plants: South African parents’ knowledge, perceptions and uses and their children’s sensory acceptance

PubMed Central

2013-01-01

Background The dietary shift from indigenous and traditional plants (ITPs) to cash crops and exotic plant food sources increases the risk of malnutrition and other nutrition-related non-communicable diseases, especially in poor rural communities. Farm communities in South Africa have been associated with poor nutritional status and extreme poverty. ITPs have been found to be affordable sources of several micronutrients. However, knowledge of and the use of these plants are declining, and little is known about the child’s acceptance of dishes prepared with ITPs. This knowledge can be used to improve the general acceptance of ITPs. This study aimed to gain insight into parents’ knowledge and perceptions and their use of ITPs in a farming community in the North West Province and to assess children’s acceptance of and preference for dishes made with African leafy vegetables (ALVs) and Swiss chard. Methods Parents (n = 29) responsible for food preparation for children in grade 2 to 4 in two schools were purposively selected for four focus group discussions. A sensory evaluation assessed the children’s (n = 98) acceptance of, preference for and intended consumption of dishes made with leafy vegetables. The dishes were made of Amaranthus spp., Cleome gynandra, Cucurbita maxima, Vigna unguiculata and Beta vulgaris. Results Parents mentioned 30 edible ITPs during the focus group discussions. Parents had knowledge of available ITPs and their use as food. Location, seasonal variation and rainfall affected the availability of and access to ITPs. Sun-dried ITPs were stored in sacks for later use. ITPs were perceived as healthy, affordable and delicious, hence acceptable to the parents. The children also evaluated the dishes made with ALVs as acceptable in terms of colour, smell and taste. Swiss chard was preferred, most likely because of the children’s exposure to this vegetable. Children indicated that they would like to eat these leafy vegetables twice a week. Conclusion These results look promising for the promotion of ITPs as a strategy to reduce malnutrition in rural farm communities and for potential inclusion of these micronutrient-rich ALVs in school feeding programmes to improve the nutritional status of children. PMID:24274394

Intelligent Elements for the ISHM Testbed and Prototypes (ITP) Project

NASA Technical Reports Server (NTRS)

Maul, William A.; Park, Han; Schwabacher, Mark; Watson, Michael; Mackey, Ryan; Fijany, Amir; Trevino, Luis; Weir, John

2005-01-01

Deep-space manned missions will require advanced automated health assessment capabilities. Requirements such as in-space assembly, long dormant periods and limited accessibility during flight, present significant challenges that should be addressed through Integrated System Health Management (ISHM). The ISHM approach will provide safety and reliability coverage for a complete system over its entire life cycle by determining and integrating health status and performance information from the subsystem and component levels. This paper will focus on the potential advanced diagnostic elements that will provide intelligent assessment of the subsystem health and the planned implementation of these elements in the ISHM Testbed and Prototypes (ITP) Project under the NASA Exploration Systems Research and Technology program.

Helicobacter pylori Eradication in Patients with Immune Thrombocytopenic Purpura: A Review and the Role of Biogeography.

PubMed

Frydman, Galit H; Davis, Nick; Beck, Paul L; Fox, James G

2015-08-01

Idiopathic thrombocytopenic purpura (ITP) is typically a diagnosis of exclusion, assigned by clinicians after ruling out other identifiable etiologies. Since a report by Gasbarrini et al. in 1998, an accumulating body of evidence has proposed a pathophysiological link between ITP and chronic Helicobacter pylori (H. pylori) infection. Clinical reports have described a spontaneous resolution of ITP symptoms in about 50% of chronic ITP patients following empirical treatment of H. pylori infection, but response appears to be geography dependent. Studies have also documented that ITP patients in East Asian countries are more likely to express positive antibody titers against H. pylori-specific cytotoxic-associated gene A (CagA), a virulence factor that is associated with an increased risk for gastric diseases including carcinoma. While a definitive mechanism by which H. pylori may induce thrombocytopenia remains elusive, proposed pathways include molecular mimicry of CagA by host autoantibodies against platelet surface glycoproteins, as well as perturbations in the phagocytic activity of monocytes. Traditional treatments of ITP have been largely empirical, involving the use of immunosuppressive agents and immunoglobulin therapy. However, based on the findings of clinical reports emerging over the past 20 years, health organizations around the world increasingly suggest the detection and eradication of H. pylori as a treatment for ITP. Elucidating the exact molecular mechanisms of platelet activation in H. pylori-positive ITP patients, while considering biogeographical differences in response rates, could offer insight into how best to use clinical H. pylori eradication to treat ITP, but will require well-designed studies to confirm the suggested causative relationship between bacterial infection and an autoimmune disease state. © 2015 John Wiley & Sons Ltd.

Misdiagnosis of primary immune thrombocytopenia and frequency of bleeding: lessons from the McMaster ITP Registry

PubMed Central

Nazy, Ishac; Clare, Rumi; Jaffer, Anushka M.; Aubie, Brandon; Li, Na; Kelton, John G.

2017-01-01

Nonspecific diagnostic criteria and uncertain estimates of severe bleeding events are fundamental gaps in knowledge of primary immune thrombocytopenia (ITP). To address these issues, we created the McMaster ITP Registry. In this report, we describe the methodology of the registry, the process for arriving at the diagnosis, and the frequency of bleeding. Consecutive patients with platelets <150 × 109/L from a tertiary hematology clinic in Canada were eligible. Patients completed a panel of investigations and were managed per clinical need. Two hematologists initially determined the cause of the thrombocytopenia using standard criteria and reevaluated the diagnosis over time, which was adjudicated at regular team meetings. Bleeding was graded from 0 (none) to 2 (severe) prospectively using an ITP-specific tool. Data were validated by duplicate chart review and source verification. Between 2010 and 2016, 614 patients were enrolled. Median follow-up for patients with >1 visit was 1.7 years (interquartile range, 0.8-3.4). At registration, 295 patients were initially diagnosed with primary ITP; of those, 36 (12.2%) were reclassified as having a different diagnosis during follow-up. At registration, 319 patients were initially diagnosed with another thrombocytopenic condition; of those, 10 (3.1%) were ultimately reclassified as having primary ITP. Of 269 patients with a final diagnosis of primary ITP, 56.5% (95% confidence interval [CI], 50.4-62.5] experienced grade 2 bleeding at 1 or more anatomical site, and 2.2% (95% CI, 0.8-4.8) had intracranial hemorrhage. Nearly 1 in 7 patients with primary ITP were misdiagnosed. Grade 2 bleeding was common. Registry data can help improve the clinical and laboratory classification of patients with ITP. PMID:29296891

Comparative Toxicogenomic Responses to the Flame Retardant mITP in Developing Zebrafish.

PubMed

Haggard, Derik E; Das, Siba R; Tanguay, Robert L

2017-02-20

Monosubstituted isopropylated triaryl phosphate (mITP) is a major component of Firemaster 550, an additive flame retardant mixture commonly used in polyurethane foams. Developmental toxicity studies in zebrafish established mITP as the most toxic component of FM 550, which causes pericardial edema and heart looping failure. Mechanistic studies showed that mITP is an aryl hydrocarbon receptor (AhR) ligand; however, the cardiotoxic effects of mITP were independent of the AhR. We performed comparative whole genome transcriptomics in wild-type and ahr2 hu3335 zebrafish, which lack functional ahr2, to identify transcriptional signatures causally involved in the mechanism of mITP-induced cardiotoxicity. Regardless of ahr2 status, mITP exposure resulted in decreased expression of transcripts related to the synthesis of all-trans-retinoic acid and a host of Hox genes. Clustered gene ontology enrichment analysis showed unique enrichment in biological processes related to xenobiotic metabolism and response to external stimuli in wild-type samples. Transcript enrichments overlapping both genotypes involved the retinoid metabolic process and sensory/visual perception biological processes. Examination of the gene-gene interaction network of the differentially expressed transcripts in both genetic backgrounds demonstrated a strong AhR interaction network specific to wild-type samples, with overlapping genes regulated by retinoic acid receptors (RARs). A transcriptome analysis of control ahr2-null zebrafish identified potential cross-talk among AhR, Nrf2, and Hif1α. Collectively, we confirmed that mITP is an AhR ligand and present evidence in support of our hypothesis that mITP's developmental cardiotoxic effects are mediated by inhibition at the RAR level.

Antiphospholipid antibodies and antiphospholipid syndrome in patients presenting with immune thrombocytopenic purpura: a prospective cohort study.

PubMed

Diz-Küçükkaya, R; Hacihanefioğlu, A; Yenerel, M; Turgut, M; Keskin, H; Nalçaci, M; Inanç, M

2001-09-15

The pathogenetic role and the clinical importance of the presence of antiphospholipid antibodies (APAs) in patients with immune thrombocytopenic purpura (ITP) are not clear. In this study, the prevalence and clinical significance of APAs were investigated in patients with ITP. Eighty-two newly diagnosed ITP patients were prospectively studied. They were evaluated for the presence of lupus anticoagulant (LA) and immunoglobulin G/M anticardiolipin antibodies (ACAs). Thirty-one patients (37.8%) were APA positive at diagnosis. No statistically significant differences were found between the APA-positive and APA-negative groups regarding gender, initial platelet counts, or response to methylprednisolone therapy. After 5 years of follow-up, cumulative thrombosis-free survival of APA-positive (n = 31) and APA-negative (n = 51) ITP patients was 39% and 97.7%, respectively. A significant difference was found between these groups by log-rank test (P =.0004). In addition, LA was an important risk marker for the development of thrombosis in ITP patients. After a median follow-up of 38 months, 14 ITP patients (45%) who had APA positivity developed clinical features (thrombosis or fetal losses) of antiphospholipid syndrome (APS). There were no differences between the APA-positive patients with and without APS regarding the initial platelet counts, response to the therapy, or ACA positivity. The positivity rate for LA was significantly higher in those patients with ITP who developed APS (chi(2): P =.0036; relative risk 7.15; 95% confidence interval, 1.7-47). In conclusion, this study indicates that a significant proportion of patients initially presenting with ITP and APA positivity developed APS. In patients with ITP, the persistent presence of APAs is an important risk factor for the development of APS.

Helicobacter pylori Eradication in Patients with Immune Thrombocytopenic Purpura: A Review and the Role of Biogeography

PubMed Central

Frydman, Galit H.; Davis, Nick; Beck, Paul L.; Fox, James G.

2015-01-01

Idiopathic thrombocytopenic purpura (ITP) is typically a diagnosis of exclusion, assigned by clinicians after ruling out other identifiable etiologies. Since a report by Gasbarrini et al. in 1998, an accumulating body of evidence has proposed a pathophysiological link between ITP and chronic Helicobacter pylori (H. pylori) infection. Clinical reports have described a spontaneous resolution of ITP symptoms in about 50% of chronic ITP patients following empirical treatment of H. pylori infection, but response appears to be geography dependent. Studies have also documented that ITP patients in East Asian countries are more likely to express positive antibody titers against H. pylori-specific cytotoxic-associated gene A (CagA), a virulence factor that is associated with an increased risk for gastric diseases including carcinoma. While a definitive mechanism by which H. pylori may induce thrombocytopenia remains elusive, proposed pathways include molecular mimicry of CagA by host autoantibodies against platelet surface glycoproteins, as well as perturbations in the phagocytic activity of monocytes. Traditional treatments of ITP have been largely empirical, involving the use of immunosuppressive agents and immunoglobulin therapy. However, based on the findings of clinical reports emerging over the past 20 years, health organizations around the world increasingly suggest the detection and eradication of H. pylori as a treatment for ITP. Elucidating the exact molecular mechanisms of platelet activation in H. pylori-positive ITP patients, while considering biogeographical differences in response rates, could offer insight into how best to use clinical H. pylori eradication to treat ITP, but will require well-designed studies to confirm the suggested causative relationship between bacterial infection and an autoimmune disease state. PMID:25728540

Progression of Human Factors Considerations for the In-Trail Procedure

DOT National Transportation Integrated Search

2016-03-16

The In-Trail Procedure (ITP) is one of the Automatic Dependent Surveillance-Broadcast (ADS-B) applications in the NextGen program. The Federal Aviation Administration, in partnership with United Airlines, is conducting an operational evaluation of th...

Synthetic marijuana "K2" induced ITP.

PubMed

Öztürk, Erman; Oral, Alihan; Özdemir, Melek; Bambul, Nail

2015-01-01

Immune thrombocytopenia (ITP) is a heterogeneous disease which can be primary or secondary due to other conditions such as drugs. CB2 receptors (CB2R) also have a role in the ITP pathogenesis as CB2 receptor gene (CNR2) polymorphisms are associated with chronic immune thrombocytopenia and autoimmune diseases. K2 is synthetic marijuana which acts on cannabinoid receptors that are found on immune cells and thrombocytes. Here, we present a case who presented with ITP secondary to K2 usage and was successfully treated with 1 mg/kg prednisolone. This is the first ITP case in the literature due to K2. It is important in the era of the new drugs development of the CB2R mimetics.

The interval testing procedure: A general framework for inference in functional data analysis.

PubMed

Pini, Alessia; Vantini, Simone

2016-09-01

We introduce in this work the Interval Testing Procedure (ITP), a novel inferential technique for functional data. The procedure can be used to test different functional hypotheses, e.g., distributional equality between two or more functional populations, equality of mean function of a functional population to a reference. ITP involves three steps: (i) the representation of data on a (possibly high-dimensional) functional basis; (ii) the test of each possible set of consecutive basis coefficients; (iii) the computation of the adjusted p-values associated to each basis component, by means of a new strategy here proposed. We define a new type of error control, the interval-wise control of the family wise error rate, particularly suited for functional data. We show that ITP is provided with such a control. A simulation study comparing ITP with other testing procedures is reported. ITP is then applied to the analysis of hemodynamical features involved with cerebral aneurysm pathology. ITP is implemented in the fdatest R package. © 2016, The International Biometric Society.

Investigation of celiac disease followed by immune thrombocytopenic purpura diagnosis in patients and comparison with literature

PubMed Central

Sarbay, Hakan; Kocamaz, Halil; Akin, Mehmet; Ozhan, Bayram

2017-01-01

OBJECTIVE: Celiac disease (CD) and Immune thrombocytopenic purpura (ITP) may occur together as a result of similar autoimmune mechanisms. The aim of this study was to assess the frequency of CD in a group of ITP patients and in the literature. METHODS: A total of 29 patients in Pamukkale University Faculty of Medicine Hospital Pediatric Hematology and Oncology Department with ITP were included in the study. Test was performed for the antibodies related to CD. Positive result for celiac antibodies was confirmed with biopsy. The results were compared with the literature. RESULTS: Of the study group, 13 patients (44.8%) were female and 16 (55.2%) were male. The mean age was 7.2±4.7 years and mean platelet count at the time of admission was 13,440±11,110/mm3 (range: 2000-41,000/mm3). Twelve patients (41.4%) were diagnosed as acute ITP, 6 patients (20.7%) as persistent ITP, and 11 patients (37.9%) as chronic ITP, according to the duration of thrombocytopenia. Antibody positivity was detected in 1 patient. Histological evaluation was compatible with CD. Results were compared with studies regarding the prevalence of CD in the population. No significant difference was found. CONCLUSION: Although it is not necessary to perform CD test in every case of ITP, the presence of differential diagnosis of CD is important to prevent unnecessary treatment, especially in ITP patients with growth retardation or malabsorption findings. PMID:28971174

Thromboembolism in adults with primary immune thrombocytopenia: a systematic literature review and meta-analysis.

PubMed

Doobaree, Indraraj Umesh; Nandigam, Raghava; Bennett, Dimitri; Newland, Adrian; Provan, Drew

2016-10-01

Adults with primary immune thrombocytopenia (ITP) may be susceptible to thromboembolism (TE). The objective of this systematic review was to evaluate studies that reported the prevalence and risk of developing TE in the ITP population from ITP diagnosis and splenectomy. We searched several bibliographic databases and included 29 studies. Using meta-analytical techniques, the pooled prevalence of TE before ITP diagnosis was 7.84% (arterial 6.25%; venous 1.95%). The pooled 'annualised' cumulative incidence (without prior TE) and cumulative risk (irrespective of prior TE) were 1.29%/yr and 3.00%/yr, respectively. Splenectomised patients had pooled cumulative risk of arterial TE (ATE) and venous TE (VTE) of 0.19%/yr and 1.10%/yr, respectively. In cohorts, regardless of a history of TE, the pooled relative risk (RR) of any TE was 1.60 (1.34, 1.86) for ITP vs. ITP-free individuals [arterial: 1.52 (1.25, 1.80); venous: 1.70 (0.96, 2.43)]. Splenectomised patients were at higher risk of venous events, pooled RR 2.39 (1.61, 3.17). To conclude, we found an increased risk of TE (mainly ATE) among ITP individuals and a higher risk of VTEs after splenectomy. How intrinsic (ITP pathophysiology, age, gender) and extrinsic factors (treatment) contribute to this risk could not be investigated here but is a task for future studies. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Successful early romiplostim use in a case of severe immune thrombocytopenia with critical carotid arterial injury.

PubMed

Watanabe, Reiko; Tabayashi, Takayuki; Tomikawa, Tatsuki; Sagawa, Morihiko; Anan-Nemoto, Tomoe; Kimura, Yuta; Takahashi, Yasuyuki; Tokuhira, Michihide; Otaki, Satoshi; Oi, Hidenori; Sawano, Makoto; Sugiyama, Satoshi; Kizaki, Masahiro

2017-01-01

Thrombopoietin receptor (TPO-R) agonists have been shown to be effective in refractory chronic immune thrombocytopenia (ITP); however, their efficacy in patients under critical care is not known. We report the case of a female patient with a newly diagnosed ITP who experienced severe bleeding from an external wound. The patient was administered the standard treatments for ITP, which are high-dose intravenous immunoglobulin (IVIg) and corticosteroids. However, following failure of these treatments, we administered romiplostim on day 6 after the onset of ITP. On day 6 after the initiation of romiplostim, there was improvement in platelet count and bleeding tendency. We were subsequently able to perform a splenectomy successfully. The efficacy of TPO-R agonists in ITP has been reported in several situations, including before surgery in an ITP patient; however, the use of TPO-R for arterial bleeding with shock has not been reported. To our knowledge, the present article is a rare case report of the use of a TPO-R agonist in a patient with critical artery injury. Our data suggest that the early use of romiplostim is effective in emergency cases of newly diagnosed ITP with life-threatening bleeding, which is refractory to standard treatment.

Comparison of Antioxidative Effects of Insect Tea and Its Raw Tea (Kuding Tea) Polyphenols in Kunming Mice.

PubMed

Zhao, Xin; Song, Jia-Le; Yi, Ruokun; Li, Guijie; Sun, Peng; Park, Kun-Young; Suo, Huayi

2018-01-19

Kudingcha is a traditional Chinese tea, and insect tea is a special drink produced by the metabolism of insect larvae using the raw Kuding tea. Insect tea polyphenols (ITP) and its raw tea (Kuding tea) polyphenols (KTP) are high-purity polyphenols extracted by centrifuge precipitation. The present study was designed to compare the antioxidative effects of insect tea polyphenols (ITP) and its raw tea (Kuding tea) polyphenols (KTP) on d-galactose-induced oxidation in Kunming (KM) mice. KM mice were treated with ITP (200 mg/kg) and KTP (200 mg/kg) by gavage, and vitamin C (VC, 200 mg/kg) was also used as a positive control by gavage. After determination in serum, liver and spleen, ITP-treated mice showed higher superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and glutathione (GSH) activities and lower nitric oxide (NO), malonaldehyde (MDA) activities than VC-treated mice, KTP-treated mice and untreated oxidation mice (control group). By H&E section observation, the mice induced by d-galactose-induced oxidation showed more changes than normal mice, and oxidative damage appeared in liver and spleen tissues; ITP, VC and KTP improved oxidative damage of liver and spleen tissues, and the effects of ITP were better than VC and KTP. Using quantitative polymerase chain reaction (qPCR) and western blot experiments, it was observed that ITP could increase the mRNA and protein expression of neuronal nitric oxide synthase (nNOS), endothelial nitric oxide synthase (eNOS), manganese superoxide dismutase (Mn-SOD), cupro/zinc superoxide dismutase (Cu/Zn-SOD), catalase (CAT), heme oxygenase-1 (HO-1), nuclear factor erythroid 2 related factor 2 (Nrf2), gamma glutamylcysteine synthetase (γ-GCS), and NAD(P)H:quinone oxidoreductase 1 (NQO1) and reduce inducible nitric oxide synthase (iNOS) expression in liver and spleen tissues compared to the control group. These effects were stronger than for VC and KTP. Both ITP and KTP had good antioxidative effects, and after the transformation of insects, the effects of ITP were better than that of KTP and even better than VC. Thus, ITP can be used as an antioxidant and anti-ageing functional food.

Electrocortical and behavioral responses elicited by acute electrical stimulation of inferior thalamic peduncle and nucleus reticularis thalami in a patient with major depression disorder.

PubMed

Velasco, Marcos; Velasco, Francisco; Jiménez, Fiacro; Carrillo-Ruiz, José D; Velasco, Ana Luisa; Salín-Pascual, Rafael

2006-02-01

Our aim was to study electrocortical and behavioral responses elicited by 6, 60 and 3/s stimulation of the inferior thalamic peduncle (ITP) and nucleus reticularis thalami (Re) in a patient with of major depression disorder resistant to psychotherapy, pharmacotherapy and electroconvulsive therapy and candidate to be treated by electrical stimulation of the ITP. In this patient, two multicontact electrodes were implanted bilaterally through frontal coronal parasagittal burr-holes with oblique trajectories aiming ITP and Re. Stimulation was performed through externalized systems. Referential scalp electroencephalographic (EEG) recordings were performed and subjective sensations and clinical symptoms reported by patient and changes in responsiveness in single response tasks during stimulation trials were systematically recorded. Unilateral, low (6/s) and high (60/s) frequency stimulation of either ITP or Re produced identical recruiting-like responses or desynchronization-DC shift changes predominant at frontopolar region, bilaterally. Billateral, high intensity 3/s stimulation or either ITP or Re produced electrocortical responses that consisted in generalized 3/s spike-wave complexes predominant at frontopolar, frontocentral and frontotemporal regions. However, while ITP responses were accompanied by all symptoms described for a spontaneous absence attack, Re responses were behaviorly accompanied only by delayed reaction time. These data suggests that in humans as in cats, ITP and Re are both part of a non-specific thalamo-orbitofrontal system normally engaged in cortical synchronization, selective attention and sleep. Under abnormal conditions, ITP and RE may play a role in the physiopathology of typical absence attacks and depression disorders.

Non-aqueous electrolytes for isotachophoresis of weak bases and its application to the comprehensive preconcentration of the 20 proteinogenic amino acids in column-coupling ITP/CE-MS.

PubMed

Kler, Pablo A; Huhn, Carolin

2014-11-01

Isotachophoresis (ITP) has long been used alone but also as a preconcentration technique for capillary electrophoresis (CE). Unfortunately, up to now, its application is restricted to relatively strong acids and bases as either the degree of (de)protonation is too low or the water dissociation is too high, evoking zone electrophoresis. With the comprehensive ITP analysis of all 20 proteinogenic amino acids as model analytes, we, here, show that non-aqueous ITP using dimethylsulfoxide as a solvent solves this ITP shortcoming. Dimethylsulfoxide changes the pH regime of analytes and electrolytes but, more importantly, strongly reduces the proton mobility by prohibiting hydrogen bonds and thus, the so-called Zundel-Eigen-Zundel electrical conduction mechanism of flipping hydrogen bonds. The effects are demonstrated in an electrolyte system with taurine or H(+) as terminator, and imidazole as leader together with strong acids such as oxalic and even trifluoroacetic acid as counterions, both impossible to use in aqueous solution. Mass spectrometric as well as capacitively coupled contactless conductivity detection (C(4)D) are used to follow the ITP processes. To demonstrate the preconcentration capabilities of ITP in a two-dimensional set-up, we, here, also demonstrate that our non-aqueous ITP method can be combined with capillary electrophoresis-mass spectrometry in a column-coupling system using a hybrid approach of capillaries coupled to a microfluidic interface. For this, C(4)D was optimized for on-chip detection with the electrodes aligned on top of a thin glass lid of the microfluidic chip.

On-line coupling of capillary isotachophoresis and zone electrophoresis for the assay of phenolic compounds in plant extracts.

PubMed

Urbánek, Marek; Pospísilová, Marie; Polásek, Miroslav

2002-04-01

The combination of capillary isotachophoresis (ITP) and capillary zone electrophoresis (CZE) in the column coupling configuration was optimized in a mode where the electrolyte for the CZE step is different from the leading and terminating ITP electrolytes. Two colored markers, picric acid and 1-nitroso-2-naphthol, were used for exact timing of the transfer of isotachophoretically stacked analyte zones into the CZE column and for the control of the residual amount of the leading and terminating ITP electrolytes entering the CZE capillary together with the analytes, thus controlling the duration of transient ITP migration in the CZE capillary and ensuring good separation of the analytes and reproducibility of the migration times (relative standard deviations 1%). ITP-CZE was applied to the simultaneous assay of several cinnamic acid derivatives and flavonoids in methanolic extracts of Sambucus flowers and Crataegus leaves and flowers. The preconcentrating and cleansing effect of the ITP step allowed injection of relatively large sample volumes (30 microL). The limits of detection were approximately 20-50 ng x mL(-1) and 100 ng x mL(-1) for the acids and flavonoids, respectively ( thick similar 200-times lower compared to conventional CE) with spectrophotometric detection at 254 nm. The ITP-CZE exhibited satisfactory linearity and precision when using CZE buffer of pseudo "pH" 9.0; 1-nitroso-2-naphthol was employed as the internal standard. The separation took approximately 35 min. The ITP-CZE results for rutin, hyperoside, and vitexin-2-O"-rhamnoside were in good accordance with those obtained previously by high-performance liquid chromatography.

Automated designation of tie-points for image-to-image coregistration.

Treesearch

R.E. Kennedy; W.B. Cohen

2003-01-01

Image-to-image registration requires identification of common points in both images (image tie-points: ITPs). Here we describe software implementing an automated, area-based technique for identifying ITPs. The ITP software was designed to follow two strategies: ( I ) capitalize on human knowledge and pattern recognition strengths, and (2) favour robustness in many...

Who Withdraws from Initial Teacher Preparation Programmes and Why?

ERIC Educational Resources Information Center

Hobson, Andrew J.; Giannakaki, Marina-Stefania; Chambers, Gary N.

2009-01-01

Background: In recent years, withdrawal from initial teacher preparation (ITP) programmes, in England and elsewhere, has become a cause for concern amongst both ITP providers and policy-makers. Purpose: This paper seeks to enhance the presently underdeveloped evidence base on the causes of withdrawal from ITP and on the characteristics of student…

Isotachophoresis-Based Surface Immunoassay.

PubMed

Paratore, Federico; Zeidman Kalman, Tal; Rosenfeld, Tally; Kaigala, Govind V; Bercovici, Moran

2017-07-18

In the absence of amplification methods for proteins, the immune-detection of low-abundance proteins using antibodies is fundamentally limited by binding kinetic rates. Here, we present a new class of surface-based immunoassays in which protein-antibody reaction is accelerated by isotachophoresis (ITP). We demonstrate the use of ITP to preconcentrate and deliver target proteins to a surface decorated with specific antibodies, where effective utilization of the focused sample is achieved by modulating the driving electric field (stop-and-diffuse ITP mode) or applying a counter flow that opposes the ITP motion (counterflow ITP mode). Using enhanced green fluorescent protein (EGFP) as a model protein, we carry out an experimental optimization of the ITP-based immunoassay and demonstrate a 1300-fold improvement in limit of detection compared to a standard immunoassay, in a 6 min protein-antibody reaction. We discuss the design of buffer chemistries for other protein systems and, in concert with experiments, provide full analytical solutions for the two operation modes, elucidating the interplay between reaction, diffusion, and accumulation time scales and enabling the prediction and design of future immunoassays.

Nuclear criticality safety evaluation of the passage of decontaminated salt solution from the ITP filters into tank 50H for interim storage

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

Hobbs, D.T.; Davis, J.R.

This report assesses the nuclear criticality safety associated with the decontaminated salt solution after passing through the In-Tank Precipitation (ITP) filters, through the stripper columns and into Tank 50H for interim storage until transfer to the Saltstone facility. The criticality safety basis for the ITP process is documented. Criticality safety in the ITP filtrate has been analyzed under normal and process upset conditions. This report evaluates the potential for criticality due to the precipitation or crystallization of fissionable material from solution and an ITP process filter failure in which insoluble material carryover from salt dissolution is present. It is concludedmore » that no single inadvertent error will cause criticality and that the process will remain subcritical under normal and credible abnormal conditions.« less

Length of stay, hospitalization cost, and in-hospital mortality in US adult inpatients with immune thrombocytopenic purpura, 2006-2012.

PubMed

An, Ruopeng; Wang, Peizhong Peter

2017-01-01

In this study, we examined the length of stay, hospitalization cost, and risk of in-hospital mortality among US adult inpatients with immune thrombocytopenic purpura (ITP). We analyzed nationally representative data obtained from Nationwide/National Inpatient Sample database of discharges from 2006 to 2012. In the US, there were an estimated 296,870 (95% confidence interval [CI]: 284,831-308,909) patient discharges recorded for ITP from 2006 to 2012, during which ITP-related hospitalizations had increased steadily by nearly 30%. The average length of stay for an ITP-related hospitalization was found to be 6.02 days (95% CI: 5.93-6.10), which is 28% higher than that of the overall US discharge population (4.70 days, 95% CI: 4.66-4.74). The average cost of ITP-related hospitalizations was found to be US$16,594 (95% CI: US$16,257-US$16,931), which is 48% higher than that of the overall US discharge population (US$11,200; 95% CI: US$11,033-US$11,368). Gender- and age-adjusted mortality risk in inpatients with ITP was 22% (95% CI: 19%-24%) higher than that of the overall US discharge population. Across diagnosis related groups, length of stay for ITP-related hospitalizations was longest for septicemia (7.97 days, 95% CI: 7.55-8.39) and splenectomy (7.40 days, 95% CI: 6.94-7.86). Splenectomy (US$25,262; 95% CI: US$24,044-US$26,481) and septicemia (US$18,430; 95% CI: US$17,353-US$19,507) were associated with the highest cost of hospitalization. The prevalence of mortality in ITP-related hospitalizations was highest for septicemia (11.11%, 95% CI: 9.60%-12.63%) and intracranial hemorrhage (9.71%, 95% CI: 7.65%-11.77%). Inpatients with ITP had longer hospital stay, bore higher costs, and faced greater risk of mortality than the overall US discharge population.

Romiplostim for Immune Thrombocytopenia in Neuroblastoma Patients Receiving Chemotherapy.

PubMed

Fassel, Hannah; Bussel, James B; Roberts, Stephen S; Modak, Shakeel

2018-04-20

Thrombocytopenia, a serious complication of myelosuppressive chemotherapy in cancer patients, is managed with platelet transfusions until recovery of platelet counts. However, children receiving chemotherapy can rarely develop immune thrombocytopenia (ITP) that is refractory to transfused platelets. This limits the ability to achieve adequate platelet counts and administer further myelosuppressive chemotherapy safely, especially if first-line ITP therapy is ineffective. We report 2 cases of intravenous immunoglobulin refractory ITP in children receiving chemotherapy for high-risk neuroblastoma. ITP was successfully treated with the thrombopoietin-receptor-agonist romiplostim, allowing safe and timely continuation of antineuroblastoma therapies in these high-risk patients.

Evaluation of the Boussignac Cardiac arrest device (B-card) during cardiopulmonary resuscitation in an animal model.

PubMed

Moore, Johanna C; Lamhaut, Lionel; Hutin, Alice; Dodd, Kenneth W; Robinson, Aaron E; Lick, Michael C; Salverda, Bayert J; Hinke, Mason B; Labarere, José; Debaty, Guillaume; Segal, Nicolas

2017-10-01

The purpose of this study was to examine continuous oxygen insufflation (COI) in a swine model of cardiac arrest. The primary hypothesis was COI during standard CPR (S-CPR) should result in higher intrathoracic pressure (ITP) during chest compression and lower ITP during decompression versus S-CPR alone. These changes with COI were hypothesized to improve hemodynamics. The second hypothesis was that changes in ITP with S-CPR+COI would result in superior hemodynamics compared with active compression decompression (ACD) + impedance threshold device (ITD) CPR, as this method primarily lowers ITP during chest decompression. After 6min of untreated ventricular fibrillation, S-CPR was initiated in 8 female swine for 4min, then 3min of S-CPR+COI, then 3min of ACD+ITD CPR, then 3min of S-CPR+COI. ITP and hemodynamics were continuously monitored. During S-CPR+COI, ITP was always positive during the CPR compression and decompression phases. ITP compression values with S-CPR+COI versus S-CPR alone were 5.5±3 versus 0.2±2 (p<0.001) and decompression values were 2.8±2 versus -1.3±2 (p<0.001), respectively. With S-CPR+COI versus ACD+ITD the ITP compression values were 5.5±3 versus 1.5±2 (p<0.01) and decompression values were 2.8±2 versus -4.7±3 (p<0.001), respectively. COI during S-CPR created a continuous positive pressure in the airway during both the compression and decompression phase of CPR. At no point in time did COI generate a negative intrathoracic pressures during CPR in this swine model of cardiac arrest. Copyright © 2017 Elsevier B.V. All rights reserved.

Real-life management of primary immune thrombocytopenia (ITP) in adult patients and adherence to practice guidelines.

PubMed

Lozano, María Luisa; Revilla, N; Gonzalez-Lopez, T J; Novelli, S; González-Porras, J R; Sánchez-Gonzalez, B; Bermejo, N; Pérez, S; Lucas, F J; Álvarez, M T; Arilla, M J; Perera, M; do Nascimento, J; Campos, R M; Casado, L F; Vicente, V

2016-06-01

Very few data exist on the management of adult patients diagnosed with primary immune thrombocytopenia (ITP). The objectives of this study were to describe the diagnostic and treatment patterns for ITP and to compare the findings to recent ITP guidelines. We retrospectively analyzed the medical records of adult ITP patients diagnosed with primary ITP between January 2011 and June 2012 and examined whether management strategies were consistent or not with eight recent guideline-recommended practices. Overall, median age at the diagnosis of the disease (n = 101) was 58 years and median platelet count 12 × 10(9)/L with 75.2 % of patients having symptoms of ITP. The study perceived two major shortcomings in the diagnostic approach: (1) failure to perform peripheral blood film examination in 22.8 % of patients, a test that is mandatory by all guidelines, and (2) ordinary bone marrow assessment in more than half of the patients at diagnosis (50.5 %), a test not routinely recommended by guidelines. Low appropriateness in therapeutic management of patients included (1) unjustified use of intravenous immunoglobulin in the absence of bleeding in 54.8 % of patients and (2) splenectomy not being deferred until 6-12 months from diagnosis (median 161 days). Data also reflect a trend towards the early use of thrombopoietin receptor agonists in the treatment of patients who are refractory to any first-line therapy. We have recognized important areas of inapropriateness in the diagnostic and therapeutic management of adult ITP patients. Compliance with established guidelines should be encouraged in order to improve patient outcomes.

Rate of bleeding-related episodes in adult patients with primary immune thrombocytopenia: a retrospective cohort study using a large administrative medical claims database in the US.

PubMed

Altomare, Ivy; Cetin, Karynsa; Wetten, Sally; Wasser, Jeffrey S

2016-01-01

Immune thrombocytopenia (ITP) is a rare disorder characterized by low platelet counts and an increased tendency to bleed. The goal of ITP therapy is to treat or prevent bleeding. Actual rates of bleeding are unknown. Clinical trial data may not reflect real-world bleeding rates because of the inclusion of highly refractory patients and more frequent use of rescue therapy. We used administrative medical claims data in the US to examine the occurrence of bleeding-related episodes (BREs) - a composite end point including bleeding and/or rescue therapy use - in adults diagnosed with primary ITP (2008-2012). BRE rates were calculated overall and by ITP phase and splenectomy status. Patients were followed from ITP diagnosis until death, disenrollment from the health plan, or June 30, 2013, whichever came first. We identified 6,651 adults diagnosed with primary ITP over the study period (median age: 53 years; 59% female). During 13,064 patient-years of follow-up, 3,768 patients (57%) experienced ≥1 BRE (1.08 BREs per patient-year; 95% confidence interval: 1.06-1.10). The majority (58%) of BREs consisted of rescue therapy use only. Common bleeding types were gastrointestinal hemorrhage, hematuria, ecchymosis, and epistaxis. Intracranial hemorrhage was reported in 74 patients (1%). Just over 7% of patients underwent splenectomy. Newly diagnosed and splenectomized patients had elevated BRE rates. We provide current real-world estimates of BRE rates in adults with primary ITP. The majority of ITP patients experienced ≥1 BRE, and over half were defined by rescue therapy use alone. This demonstrates the importance of examining both bleeding and rescue therapy use to fully assess disease burden.

Childhood immune thrombocytopenia: Clinical presentation and management

PubMed Central

2012-01-01

Immune thrombocytopenia (ITP) is an acquired hematological disorder that is developed secondary to the production of auto-antibodies against platelets leading to isolated thrombocytopenia, in the absence of other causes of thrombocytopenia such as drugs, infections, malignancy, or other autoimmune diseases [1–6]. ITP commonly affects children between one and seven years of age. Severe life threatening bleeding is rare (0.2–0.9%) [7–12]. Childhood primary ITP usually runs a benign, self-limiting course, with or without treatment. Complete remission occurs within six months from diagnosis, commonly within 6–12 weeks, in the majority of children with the diagnosis of ITP. However, 20–30% of children will continue to have persistent low platelets count with bleeding symptoms beyond six months from diagnosis [4, 12–18]. The diagnosis of ITP in children is essentially one of exclusion. The child is usually one to seven years old, develops skin bruises, petechiae, or mucosal bleeding, who is otherwise healthy and having no lymphadenopathy or organomegally. Full blood count reveals isolated thrombocytopenia with normal hemoglobin (Hb) level, white blood count (WBC) and normal peripheral blood smear. Initial management options for newly diagnosed childhood ITP include; observation only, the use of intravenous immunoglobulin (IVIG), steroids, anti-D immunoglobulin, each alone or in combination [6, 19.] Children who develop chronic ITP may benefit from splenectomy [19, 20–24]. Rituximab, a chimeric monoclonal antibody (anti-CD20), may lead to complete remission, and defers the need for splenectomy [25–27]. Recently, the thrombopoietin (TPO) agonists (Romiplostim and Eltrombopag) produced very good response in adult and pediatric patients with severe chronic ITP [28–30]. PMID:27493327

Nuclear criticality safety bounding analysis for the in-tank-precipitation (ITP) process, impacted by fissile isotopic weight fractions

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

Bess, C.E.

The In-Tank Precipitation process (ITP) receives High Level Waste (HLW) supernatant liquid containing radionuclides in waste processing tank 48H. Sodium tetraphenylborate, NaTPB, and monosodium titanate (MST), NaTi{sub 2}O{sub 5}H, are added for removal of radioactive Cs and Sr, respectively. In addition to removal of radio-strontium, MST will also remove plutonium and uranium. The majority of the feed solutions to ITP will come from the dissolution of supernate that had been concentrated by evaporation to a crystallized salt form, commonly referred to as saltcake. The concern for criticality safety arises from the adsorption of U and Pt onto MST. If sufficientmore » mass and optimum conditions are achieved then criticality is credible. The concentration of u and Pt from solution into the smaller volume of precipitate represents a concern for criticality. This report supplements WSRC-TR-93-171, Nuclear Criticality Safety Bounding Analysis For The In-Tank-Precipitation (ITP) Process. Criticality safety in ITP can be analyzed by two bounding conditions: (1) the minimum safe ratio of MST to fissionable material and (2) the maximum fissionable material adsorption capacity of the MST. Calculations have provided the first bounding condition and experimental analysis has established the second. This report combines these conditions with canyon facility data to evaluate the potential for criticality in the ITP process due to the adsorption of the fissionable material from solution. In addition, this report analyzes the potential impact of increased U loading onto MST. Results of this analysis demonstrate a greater safety margin for ITP operations than the previous analysis. This report further demonstrates that the potential for criticality in the ITP process due to adsorption of fissionable material by MST is not credible.« less

Severe bleeding events in adults and children with primary immune thrombocytopenia: a systematic review.

PubMed

Neunert, C; Noroozi, N; Norman, G; Buchanan, G R; Goy, J; Nazi, I; Kelton, J G; Arnold, D M

2015-03-01

The burden of severe bleeding in adults and children with immune thrombocytopenia (ITP) has not been established. To describe the frequency and severity of bleeding events in patients with ITP, and the methods used to measure bleeding in ITP studies. We performed a systematic review of all prospective ITP studies that enrolled 20 or more patients. Two reviewers searched Medline, Embase, CINAHL and the Cochrane registry up to May 2014. Overall weighted proportions were estimated using a random effects model. Measurement properties of bleeding assessment tools were evaluated. We identified 118 studies that reported bleeding (n = 10 908 patients). Weighted proportions for intracerebral hemorrhage (ICH) were 1.4% for adults (95% confidence interval [CI], 0.9-2.1%) and 0.4% for children (95% CI, 0.2-0.7%; P < 0.01), most of whom had chronic ITP. The weighted proportion for severe (non-ICH) bleeding was 9.6% for adults (95% CI, 4.1-17.1%) and 20.2% for children (95% CI, 10.0-32.9%; P < 0.01) with newly-diagnosed or chronic ITP. Methods of reporting and definitions of severe bleeding were highly variable in primary studies. Two bleeding assessment tools (Buchanan 2002 for children; Page 2007 for adults) demonstrated adequate inter-rater reliability and validity in independent assessments. ICH was more common in adults and tended to occur during chronic ITP; other severe bleeds were more common in children and occurred at all stages of disease. Reporting of non-ICH bleeding was variable across studies. Further attention to ITP-specific bleeding measurement in clinical trials is needed to improve standardization of this important outcome for patients. © 2014 International Society on Thrombosis and Haemostasis.

Severe bleeding events in adults and children with primary immune thrombocytopenia: a systematic review

PubMed Central

NEUNERT, C.; NOROOZI, N.; NORMAN, G.; BUCHANAN, G. R.; GOY, J.; NAZI, I.; KELTON, J. G.; ARNOLD, D. M.

2016-01-01

Summary Background The burden of severe bleeding in adults and children with immune thrombocytopenia (ITP) has not been established. Objectives To describe the frequency and severity of bleeding events in patients with ITP, and the methods used to measure bleeding in ITP studies. Patients/Methods We performed a systematic review of all prospective ITP studies that enrolled 20 or more patients. Two reviewers searched Medline, Embase, CINAHL and the Cochrane registry up to May 2014. Overall weighted proportions were estimated using a random effects model. Measurement properties of bleeding assessment tools were evaluated. Results We identified 118 studies that reported bleeding (n = 10 908 patients). Weighted proportions for intracerebral hemorrhage (ICH) were 1.4% for adults (95% confidence interval [CI], 0.9–2.1%) and 0.4% for children (95% CI, 0.2–0.7%; P < 0.01), most of whom had chronic ITP. The weighted proportion for severe (non-ICH) bleeding was 9.6% for adults (95% CI, 4.1–17.1%) and 20.2% for children (95% CI, 10.0–32.9%; P < 0.01) with newly-diagnosed or chronic ITP. Methods of reporting and definitions of severe bleeding were highly variable in primary studies. Two bleeding assessment tools (Buchanan 2002 for children; Page 2007 for adults) demonstrated adequate interrater reliability and validity in independent assessments. Conclusions ICH was more common in adults and tended to occur during chronic ITP; other severe bleeds were more common in children and occurred at all stages of disease. Reporting of non-ICH bleeding was variable across studies. Further attention to ITP-specific bleeding measurement in clinical trials is needed to improve standardization of this important outcome for patients. PMID:25495497

Use of Recombinant Factor VIIa in a Pediatric Patient With Initial Presentation of Refractory Acute Immune Thrombocytopenic Purpura and Severe Bleeding

PubMed Central

Gurion, Reut; Siu, Anita; Weiss, Aaron R.; Masterson, Margaret

2012-01-01

Severe bleeding in acute immune thrombocytopenic purpura (ITP) is rare but can cause significant complications to the patient. Here we report the case of a pediatric patient with acute ITP and hematuria refractory to anti-D immune globulin, high dose intravenous immunoglobulin G, and high dose steroids. Her hematuria was successfully treated with recombinant factor VIIa (rFVIIa). While further investigation on the use of rFVIIa in ITP is warranted, this case report contributes to the pediatric literature for its use during the course of an initial presentation of ITP with hemorrhagic complications. PMID:23258971

Shared decision making in the management of children with newly diagnosed immune thrombocytopenia.

PubMed

Beck, Carolyn E; Boydell, Katherine M; Stasiulis, Elaine; Blanchette, Victor S; Llewellyn-Thomas, Hilary; Birken, Catherine S; Breakey, Vicky R; Parkin, Patricia C

2014-10-01

This study aimed to examine the treatment decision-making process for children hospitalized with newly diagnosed immune thrombocytopenia (ITP). Using focus groups, we studied children with ITP, parents of children with ITP, and health care professionals, inquiring about participants' experience with decision support and decision making in newly diagnosed ITP. Data were examined using thematic analysis. Themes that emerged from children were feelings of "anxiety, fear, and confusion"; the need to "understand information"; and "treatment choice," the experience of which was age dependent. For parents, "anxiety, fear, and confusion" was a dominant theme; "treatment choice" revealed that participants felt directed toward intravenous immune globulin (IVIG) for initial treatment. For health care professionals, "comfort level" highlighted factors contributing to professionals' comfort with offering options; "assumptions" were made about parental desire for participation in shared decision making (SDM) and parental acceptance of treatment options; "providing information" was informative regarding modes of facilitating SDM; and "treatment choice" revealed a discrepancy between current practice (directed toward IVIG) and the ideal of SDM. At our center, families of children with newly diagnosed ITP are not experiencing SDM. Our findings support the implementation of SDM to facilitate patient-centered care for the management of pediatric ITP.

Splenic TFH expansion participates in B-cell differentiation and antiplatelet-antibody production during immune thrombocytopenia.

PubMed

Audia, Sylvain; Rossato, Marzia; Santegoets, Kim; Spijkers, Sanne; Wichers, Catharina; Bekker, Cornelis; Bloem, Andries; Boon, Louis; Flinsenberg, Thijs; Compeer, Ewoud; van den Broek, Theo; Facy, Olivier; Ortega-Deballon, Pablo; Berthier, Sabine; Leguy-Seguin, Vanessa; Martin, Laurent; Ciudad, Marion; Samson, Maxime; Trad, Malika; Lorcerie, Bernard; Janikashvili, Nona; Saas, Philippe; Bonnotte, Bernard; Radstake, Timothy R D J

2014-10-30

Antiplatelet-antibody-producing B cells play a key role in immune thrombocytopenia (ITP) pathogenesis; however, little is known about T-cell dysregulations that support B-cell differentiation. During the past decade, T follicular helper cells (TFHs) have been characterized as the main T-cell subset within secondary lymphoid organs that promotes B-cell differentiation leading to antibody class-switch recombination and secretion. Herein, we characterized TFHs within the spleen of 8 controls and 13 ITP patients. We show that human splenic TFHs are the main producers of interleukin (IL)-21, express CD40 ligand (CD154), and are located within the germinal center of secondary follicles. Compared with controls, splenic TFH frequency is higher in ITP patients and correlates with germinal center and plasma cell percentages that are also increased. In vitro, IL-21 stimulation combined with an anti-CD40 agonist antibody led to the differentiation of splenic B cells into plasma cells and to the secretion of antiplatelet antibodies in ITP patients. Overall, these results point out the involvement of TFH in ITP pathophysiology and the potential interest of IL-21 and CD40 as therapeutic targets in ITP. © 2014 by The American Society of Hematology.

CD16+ monocytes control T-cell subset development in immune thrombocytopenia

PubMed Central

Zhong, Hui; Bao, Weili; Li, Xiaojuan; Miller, Allison; Seery, Caroline; Haq, Naznin; Bussel, James

2012-01-01

Immune thrombocytopenia (ITP) results from decreased platelet production and accelerated platelet destruction. Impaired CD4+ regulatory T-cell (Treg) compartment and skewed Th1 and possibly Th17 responses have been described in ITP patients. The trigger for aberrant T-cell polarization remains unknown. Because monocytes have a critical role in development and polarization of T-cell subsets, we explored the contribution of monocyte subsets in control of Treg and Th development in patients with ITP. Unlike circulating classic CD14hiCD16− subpopulation, the CD16+ monocyte subset was expanded in ITP patients with low platelet counts on thrombopoietic agents and positively correlated with T-cell CD4+IFN-γ+ levels, but negatively with circulating CD4+CD25hiFoxp3+ and IL-17+ Th cells. Using a coculture model, we found that CD16+ ITP monocytes promoted the expansion of IFN-γ+CD4+ cells and concomitantly inhibited the proliferation of Tregs and IL-17+ Th cells. Th-1–polarizing cytokine IL-12, secreted after direct contact of patient T-cell and CD16+ monocytes, was responsible for the inhibitory effect on Treg and IL-17+CD4+ cell proliferation. Our findings are consistent with ITP CD16+ monocytes promoting Th1 development, which in turn negatively regulates IL-17 and Treg induction. This underscores the critical role of CD16+ monocytes in the generation of potentially pathogenic Th responses in ITP. PMID:22915651

Platelet count recovery after intravenous immunoglobulin predicts a favorable outcome in children with immune thrombocytopenia

PubMed Central

Ji, Mi Hong; Kim, Sung Jin; Ahn, Hyo Seop

2016-01-01

Background Childhood immune thrombocytopenic purpura (ITP) is a common acquired bleeding disorder. Even though most children recover, either spontaneously or with therapy, 10-20% of newly diagnosed ITP cases have a chronic course beyond 12 months. This study evaluated whether clinical and laboratory findings can predict the response to intravenous immunoglobulin (IVIG) and progression to persistent or chronic ITP in children. Methods During the period between March 2003 and June 2015, we retrospectively analyzed 72 children, newly diagnosed with ITP, who received IVIG treatment. Peripheral blood counts were obtained at diagnosis and at 1, 3, 6, and 12 months after IVIG treatment. Results After 6 months of IVIG treatment, 14 of 72 patients (19.4%) had persistent ITP, and after 12 months, 7 of 40 patients (17.5%) had chronic ITP. Age at diagnosis, gender, history of viral infection, or vaccination before disease onset were not statistically correlated with platelet recovery at 6 and 12 months. However, a platelet count recovery of ≥100×103/µL at 1 and 3 months was significantly correlated with platelet recovery at 6 (P<0.001 and P<0.001, respectively) and 12 (P=0.007 and P=0.004, respectively) months. Conclusion This study demonstrated that early platelet count recovery, at 1 and 3 months after IVIG treatment, predicts a short disease duration and a favorable outcome in children with newly diagnosed ITP. Further investigation in a larger group of patients is warranted to validate these findings. PMID:27382553

Immunosuppressive function of mesenchymal stem cells from human umbilical cord matrix in immune thrombocytopenia patients.

PubMed

Ma, Li; Zhou, Zeping; Zhang, Donglei; Yang, Shaoguang; Wang, Jinhong; Xue, Feng; Yang, Yanhui; Yang, Renchi

2012-05-01

Human umbilical cord matrix/Wharton's jelly (hUC)-derived mesenchymal stem cells (MSC) have been shown to have marked therapeutic effects in a number of inflammatory diseases and autoimmune diseases in humans based on their potential for immunosuppression and their low immunogenicity. Currently, no data are available on the effectiveness of UC-MSC transplantation in immune thrombocytopenia (ITP) patients. It was the objective of this study to assess the effect of allogeneic UC-MSCs on ITP patients in vitro and in vivo. Peripheral blood mononuclear cells (PBMCs) and bone marrow mononuclear cells (BM-MNCs) from ITP patients and healthy controls were co-cultured with UC-MSCs for three days and seven days, respectively. Flow cytometry and ELISA were applied to assess the various parameters. In PBMCs from ITP patients, the proliferation of autoreactive T, B lymphocytes and destruction of autologous platelets were dramatically suppressed by UC-MSCs. UC-MSCs not only suppressed co-stimulatory molecules CD80, CD40L and FasL expression but also in shifting Th1/Th2/Treg cytokines profile in ITP patients. UC-MSCs obviously reversed the dysfunctions of megakaryocytes by promoting platelet production and decreasing the number of living megakaryocytes as well as early apoptosis. In addition, the level of thrombopoietin was increased significantly. Our clinical study showed that UC-MSCs play a role in alleviating refractory ITP by increasing platelet numbers. These findings suggested that UC-MSCs transplantation might be a potential therapy for ITP.

Intrathecal pressure monitoring and cerebrospinal fluid drainage in acute spinal cord injury: a prospective randomized trial.

PubMed

Kwon, Brian K; Curt, Armin; Belanger, Lise M; Bernardo, Arlene; Chan, Donna; Markez, John A; Gorelik, Stephen; Slobogean, Gerard P; Umedaly, Hamed; Giffin, Mitch; Nikolakis, Michael A; Street, John; Boyd, Michael C; Paquette, Scott; Fisher, Charles G; Dvorak, Marcel F

2009-03-01

Ischemia is an important factor in the pathophysiology of secondary damage after traumatic spinal cord injury (SCI) and, in the setting of thoracoabdominal aortic aneurysm repair, can be the primary cause of paralysis. Lowering the intrathecal pressure (ITP) by draining CSF is routinely done in thoracoabdominal aortic aneurysm surgery but has not been evaluated in the setting of acute traumatic SCI. Additionally, while much attention is directed toward maintaining an adequate mean arterial blood pressure (MABP) in the acute postinjury phase, little is known about what is happening to the ITP during this period when spinal cord perfusion pressure (MABP - ITP) is important. The objectives of this study were to: 1) evaluate the safety and feasibility of draining CSF to lower ITP after acute traumatic SCI; 2) evaluate changes in ITP before and after surgical decompression; and 3) measure neurological recovery in relation to the drainage of CSF. Twenty-two patients seen within 48 hours of injury were prospectively randomized to a drainage or no-drainage treatment group. In all cases a lumbar intrathecal catheter was inserted for 72 hours. Acute complications of headache/nausea/vomiting, meningitis, or neurological deterioration were carefully monitored. Acute Spinal Cord Injury motor scores were documented at baseline and at 6 months postinjury. On insertion of the catheter, mean ITP was 13.8 +/- 1.3 mm Hg (+/- SD), and it increased to a mean peak of 21.7 +/- 1.5 mm Hg intraoperatively. The difference between the starting ITP on catheter insertion and the observed peak intrathecal pressure after decompression was, on average, an increase of 7.9 +/- 1.6 mm Hg (p < 0.0001, paired t-test). During the postoperative period, the peak recorded ITP in the patients randomized to the no-drainage group was 30.6 +/- 2.3 mm Hg, which was significantly higher than the peak intraoperative ITP (p = 0.0098). During the same period, the peak recorded ITP in patients randomized to receive drainage was 28.1 +/- 2.8 mm Hg, which was not statistically higher than the peak intraoperative ITP (p = 0.15). The insertion of lumbar intrathecal catheters and the drainage of CSF were not associated with significant adverse events, although the cohort was small and only a limited amount of CSF was drained. Intraoperative decompression of the spinal cord results in an increase in the ITP measured caudal to the injury site. Increases in intrathecal pressure are additionally observed in the postoperative period. These increases in intrathecal pressure result in reduced spinal cord perfusion that will otherwise go undetected when measuring only the MABP. Characteristic changes in the observed intrathecal pressure waveform occur after surgical decompression, reflecting the restoration of CSF flow across the SCI site. As such, the waveform pattern may be used intraoperatively to determine if adequate decompression of the thecal sac has been accomplished.

Management of Immune Thrombocytopenic Purpura: An Update

PubMed Central

Warrier, Rajasekharan; Chauhan, Aman

2012-01-01

Rapid strides have been made in the field of hematology, and advances in immune thrombocytopenic purpura (ITP) management are no exception. From idiopathic to immune, the changed nomenclature is itself a testimonial to the growing awareness and improvements in the management of ITP. We discuss the pathophysiology, clinical presentation, and current management of this common pediatric disorder and summarize current guidelines for ITP treatment. PMID:23049459

Measurement of utility values in the UK for health states related to immune thrombocytopenic purpura.

PubMed

Szende, Agota; Brazier, John; Schaefer, Caroline; Deuson, Robert; Isitt, John J; Vyas, Paresh

2010-08-01

To measure utility values associated with immune (idiopathic) thrombocytopenic purpura (ITP), as perceived by the United Kingdom (UK) general public. A multi-step process, including clinical trial data, literature review, and patient focus group, was used to develop ITP health states valued in a web survey. Six ITP health states were defined based on platelet levels, risk of bleeding and key adverse events/disease complications. Clinical trial data on bleeding and ITP-specific quality of life data were key sources for developing health-state descriptions. 359 respondents, randomly selected from a managed web panel in the UK, completed the web-based Time Trade-Off survey. Wilcoxon signed-rank test was used to compare differences between each pair of health states. Sample characteristics (mean age: 47.9 +/- 16.9 years; 54% female) were comparable to the UK general population. ITP health states were valued as significantly worse than perfect health. Experiencing bleeding episodes was a more important driver than low platelet levels in valuing a health state to be worse. Substantial disutilities were associated with surviving an intracranial haemorrhage. Mean (SD) utility values for each ITP health state are: HS1: platelets >or=50 x 10(9)/L, no outpatient bleed: 0.863 +/- 0.15; HS2: platelets >or=50 x 10(9)/L, outpatient bleed: 0.734 +/- 0.19; HS3: platelets <50 x 10(9)/L, no outpatient bleed: 0.841 +/- 0.19; HS4: platelets <50 x 10(9)/L, outpatient bleed: 0.732 +/- 0.19; HS5: intracranial haemorrhage (2-6 months): 0.038 +/- 0.46; HS6: steroid treatment adverse events: 0.758 +/- 0.20. Potential limitations relate to web user population characteristics and lack of comparative testing of web-based TTO methods. Results provide evidence that the UK general population associate substantial loss of value living with ITP, suggesting an important role for new ITP treatments. Utility values based on these health states may be useful in future cost-effectiveness studies of existing and/or new ITP treatments.

Deterministic and reliability based optimization of integrated thermal protection system composite panel using adaptive sampling techniques

NASA Astrophysics Data System (ADS)

Ravishankar, Bharani

Conventional space vehicles have thermal protection systems (TPS) that provide protection to an underlying structure that carries the flight loads. In an attempt to save weight, there is interest in an integrated TPS (ITPS) that combines the structural function and the TPS function. This has weight saving potential, but complicates the design of the ITPS that now has both thermal and structural failure modes. The main objectives of this dissertation was to optimally design the ITPS subjected to thermal and mechanical loads through deterministic and reliability based optimization. The optimization of the ITPS structure requires computationally expensive finite element analyses of 3D ITPS (solid) model. To reduce the computational expenses involved in the structural analysis, finite element based homogenization method was employed, homogenizing the 3D ITPS model to a 2D orthotropic plate. However it was found that homogenization was applicable only for panels that are much larger than the characteristic dimensions of the repeating unit cell in the ITPS panel. Hence a single unit cell was used for the optimization process to reduce the computational cost. Deterministic and probabilistic optimization of the ITPS panel required evaluation of failure constraints at various design points. This further demands computationally expensive finite element analyses which was replaced by efficient, low fidelity surrogate models. In an optimization process, it is important to represent the constraints accurately to find the optimum design. Instead of building global surrogate models using large number of designs, the computational resources were directed towards target regions near constraint boundaries for accurate representation of constraints using adaptive sampling strategies. Efficient Global Reliability Analyses (EGRA) facilitates sequentially sampling of design points around the region of interest in the design space. EGRA was applied to the response surface construction of the failure constraints in the deterministic and reliability based optimization of the ITPS panel. It was shown that using adaptive sampling, the number of designs required to find the optimum were reduced drastically, while improving the accuracy. System reliability of ITPS was estimated using Monte Carlo Simulation (MCS) based method. Separable Monte Carlo method was employed that allowed separable sampling of the random variables to predict the probability of failure accurately. The reliability analysis considered uncertainties in the geometry, material properties, loading conditions of the panel and error in finite element modeling. These uncertainties further increased the computational cost of MCS techniques which was also reduced by employing surrogate models. In order to estimate the error in the probability of failure estimate, bootstrapping method was applied. This research work thus demonstrates optimization of the ITPS composite panel with multiple failure modes and large number of uncertainties using adaptive sampling techniques.

Pilot In-Trail Procedure Validation Simulation Study

NASA Technical Reports Server (NTRS)

Bussink, Frank J. L.; Murdoch, Jennifer L.; Chamberlain, James P.; Chartrand, Ryan; Jones, Kenneth M.

2008-01-01

A Human-In-The-Loop experiment was conducted at the National Aeronautics and Space Administration (NASA) Langley Research Center (LaRC) to investigate the viability of the In-Trail Procedure (ITP) concept from a flight crew perspective, by placing participating airline pilots in a simulated oceanic flight environment. The test subject pilots used new onboard avionics equipment that provided improved information about nearby traffic and enabled them, when specific criteria were met, to request an ITP flight level change referencing one or two nearby aircraft that might otherwise block the flight level change. The subject pilots subjective assessments of ITP validity and acceptability were measured via questionnaires and discussions, and their objective performance in appropriately selecting, requesting, and performing ITP flight level changes was evaluated for each simulated flight scenario. Objective performance and subjective workload assessment data from the experiment s test conditions were analyzed for statistical and operational significance and are reported in the paper. Based on these results, suggestions are made to further improve the ITP.

Severe hemorrhage in children with newly diagnosed immune thrombocytopenic purpura

PubMed Central

Buchanan, George R.; Imbach, Paul; Bolton-Maggs, Paula H. B.; Bennett, Carolyn M.; Neufeld, Ellis J.; Vesely, Sara K.; Adix, Leah; Blanchette, Victor S.; Kühne, Thomas

2008-01-01

Controversy exists regarding management of children newly diagnosed with immune thrombocytopenic purpura (ITP). Drug treatment is usually administered to prevent severe hemorrhage, although the definition and frequency of severe bleeding are poorly characterized. Accordingly, the Intercontinental Childhood ITP Study Group (ICIS) conducted a prospective registry defining severe hemorrhage at diagnosis and during the following 28 days in children with ITP. Of 1106 ITP patients enrolled, 863 were eligible and evaluable for bleeding severity assessment at diagnosis and during the subsequent 4 weeks. Twenty-five children (2.9%) had severe bleeding at diagnosis. Among 505 patients with a platelet count less than or equal to 20 000/mm3 and no or mild bleeding at diagnosis, 3 (0.6%), had new severe hemorrhagic events during the ensuing 28 days. Subsequent development of severe hemorrhage was unrelated to initial management (P = .82). These results show that severe bleeding is uncommon at diagnosis in children with ITP and rare during the next 4 weeks irrespective of treatment given. We conclude that it would be difficult to design an adequately powered therapeutic trial aimed at demonstrating prevention of severe bleeding during the first 4 weeks after diagnosis. This finding suggests that future studies of ITP management should emphasize other outcomes. PMID:18698007

A simple technique to determine thrombopoiesis level using immature platelet fraction (IPF).

PubMed

Abe, Yasunori; Wada, Hideo; Tomatsu, Hiroaki; Sakaguchi, Akane; Nishioka, Junji; Yabu, Yasunori; Onishi, Katsuya; Nakatani, Kaname; Morishita, Yoshitaka; Oguni, Shinichiro; Nobori, Tsutomu

2006-01-01

Immature platelet fraction (IPF) has been measured by fully automated analyzer (XE-2100) as reticulated platelet (RP) which is reflected with thrombopoiesis in bone marrow. IPF value in the healthy volunteers was 3.3% (1.0-10.3) and upper 95% confidential interval (95% CI) of IPF was determined as 7.7%. IPF was significantly high in the patients with idiopathic thrombocytopenic purpura (ITP; 17.4%, 1.2-53.2%) and recovery phase of post-chemotherapy, and significantly low in nadir phase of post-chemotherapy, and within normal range in the patients with ITP in complete remission (CR) and with aplastic anemia (AA). Total count of IPF was significantly low in patients with ITP, AA or post-chemotherapy. Mean platelet volume (MPV) was significantly high in only patients with ITP. IPF 7.7% is best point for highest sensitivity (86.8%) and specificity (92.6%) in diagnosis of ITP and recovery phase of post-chemotherapy. In receiver operating characteristic curve for diagnosis of ITP and recovery phase of post-chemotherapy, IPF was significantly more useful than MPV. These results show that IPF reflects the pathology of thrombocytopenic disorders, and that measurement of IPF is useful for the differential diagnosis and analysis of platelet kinetics.

Assay for Listeria monocytogenes cells in whole blood using isotachophoresis and recombinase polymerase amplification.

PubMed

Eid, Charbel; Santiago, Juan G

2016-12-19

We present a new approach which enables lysis, extraction, and detection of inactivated Listeria monocytogenes cells from blood using isotachophoresis (ITP) and recombinase polymerase amplification (RPA). We use an ITP-compatible alkaline and proteinase K approach for rapid and effective lysis. We then perform ITP purification to separate bacterial DNA from whole blood contaminants using a microfluidic device that processes 25 μL sample volume. Lysis, mixing, dispensing, and on-chip ITP purification are completed in a total of less than 50 min. We transfer extracted DNA directly into RPA master mix for isothermal incubation and detection, an additional 25 min. We first validate our assay in the detection of purified genomic DNA spiked into whole blood, and demonstrate a limit of detection of 16.7 fg μL -1 genomic DNA, the equivalent of 5 × 10 3 cells per mL. We then show detection of chemically-inactivated L. monocytogenes cells spiked into whole blood, and demonstrate a limit of detection of 2 × 10 4 cells per mL. Lastly, we show preliminary experimental data demonstrating the feasibility of the integration of ITP purification with RPA detection on a microfluidic chip. Our results suggest that ITP purification is compatible with RPA detection, and has potential to extend the applicability of RPA to whole blood.

A new physiological model for studying the effect of chest compression and ventilation during cardiopulmonary resuscitation: The Thiel cadaver.

PubMed

Charbonney, Emmanuel; Delisle, Stéphane; Savary, Dominique; Bronchti, Gilles; Rigollot, Marceau; Drouet, Adrien; Badat, Bilal; Ouellet, Paul; Gosselin, Patrice; Mercat, Alain; Brochard, Laurent; Richard, Jean-Christophe M

2018-04-01

Studying ventilation and intrathoracic pressure (ITP) induced by chest compressions (CC) during Cardio Pulmonary Resuscitation is challenging and important aspects such as airway closure have been mostly ignored. We hypothesized that Thiel Embalmed Cadavers could constitute an appropriate model. We assessed respiratory mechanics and ITP during CC in 11 cadavers, and we compared it to measurements obtained in 9 out-of-hospital cardiac arrest patients and to predicted values from a bench model. An oesophageal catheter was inserted to assess chest wall compliance, and ITP variation (ΔITP). Airway pressure variation (ΔPaw) at airway opening and ΔITP generated by CC were measured at decremental positive end expiratory pressure (PEEP) to test its impact on flow and ΔPaw. The patient's data were derived from flow and airway pressure captured via the ventilator during resuscitation. Resistance and Compliance of the respiratory system were comparable to those of the out-of-hospital cardiac arrest patients (C RS TEC 42 ± 12 vs C RS PAT 37.3 ± 10.9 mL/cmH 2 O and Res TEC 17.5 ± 7.5 vs Res PAT 20.2 ± 5.3 cmH 2 O/L/sec), and remained stable over time. During CC, ΔITP varied from 32 ± 12 cmH 2 O to 69 ± 14 cmH 2 O with manual and automatic CC respectively. Transmission of ΔITP at the airway opening was significantly affected by PEEP, suggesting dynamic small airway closure at low lung volumes. This phenomenon was similarly observed in patients. Respiratory mechanics and dynamic pressures during CC of cadavers behave as predicted by a theoretical model and similarly to patients. The Thiel model is a suitable to assess ITP variations induced by ventilation during CC. Copyright © 2018 Elsevier B.V. All rights reserved.

Design of an integral thermal protection system for future space vehicles

NASA Astrophysics Data System (ADS)

Bapanapalli, Satish Kumar

Thermal protection systems (TPS) are the features incorporated into a spacecraft's design to protect it from severe aerodynamic heating during high-speed travel through planetary atmospheres. The ablative TPS on the space capsule Apollo and ceramic tiles and blankets on the Space Shuttle Orbiter were designed as add-ons to the main load-bearing structure of the vehicles. They are usually incompatible with the structure due to mismatch in coefficient of thermal expansion and as a result the robustness of the external surface of the spacecraft is compromised. This could potentially lead to catastrophic consequences because the TPS forms the external surface of the vehicle and is subjected to numerous other loads like aerodynamic pressure loads, small object high-speed impacts and handling damages during maintenance. In order to make the spacecraft external surface robust, an Integral Thermal Protection System (ITPS) concept has been proposed in this research in which the load-bearing structure and the TPS are combined into one single structure. The design of an ITPS is a formidable task because the requirement of a load-bearing structure and a TPS are often contradictory to one another. The design process has been formulated as an optimization problem with mass per unit area of the ITPS as the objective function and the various functions of the ITPS were formulated as constraints. This is a multidisciplinary design optimization problem involving heat transfer and structural analysis fields. The constraints were expressed as response surface approximations obtained from a large number of finite element analyses, which were carried out with combinations of design variables obtained from an optimized Latin-Hypercube sampling scheme. A MATLABRTM code has been developed to carry out these FE analyses automatically in conjunction with ABAQUSRTM . Corrugated-core structures were designed for ITPS applications with loads and boundary conditions similar to that of a Space Shuttle-like vehicle. Temperature, buckling, deflection and stress constraints were considered for the design process. An optimized mass ranging between 3.5--5 lb/ft2 was achieved by the design. This is considerably heavier when compared to conventional TPS designs. However, the ITPS can withstand substantially large mechanical loads when compared to the conventional TPS. Truss-core geometries used for ITPS design in this research were found to be unsuitable as they could not withstand large thermal gradients frequently encountered in ITPS applications. The corrugated-core design was used for further studying the influence of the various input parameters on the final design weight of the ITPS. It was observed that boundary conditions not only significantly influence the ITPS design but also have a major impact on the effect of various input parameters. It was found that even a small amount of heat loss from bottom face sheet leads to significant reduction in ITPS weight. Aluminum and Beryllium are the most suitable materials for bottom face sheet with Beryllium having considerable advantages in terms of heat capacity, stiffness and density. Although ceramic matrix composites have many superior properties when compared to metal alloys (Titanium alloys and Inconel), their low tensile strength presents difficulties in ITPS applications.

Concurrent Programming Using Actors: Exploiting Large-Scale Parallelism,

DTIC Science & Technology

1985-10-07

ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT. TASK* Artificial Inteligence Laboratory AREA Is WORK UNIT NUMBERS 545 Technology Square...D-R162 422 CONCURRENT PROGRMMIZNG USING f"OS XL?ITP TEH l’ LARGE-SCALE PARALLELISH(U) NASI AC E Al CAMBRIDGE ARTIFICIAL INTELLIGENCE L. G AGHA ET AL...RESOLUTION TEST CHART N~ATIONAL BUREAU OF STANDA.RDS - -96 A -E. __ _ __ __’ .,*- - -- •. - MASSACHUSETTS INSTITUTE OF TECHNOLOGY ARTIFICIAL

Multidrug resistance-1 in T lymphocytes and natural killer cells of adults with idiopathic thrombocytopenic purpura: effect of prednisone treatment.

PubMed

López-Karpovitch, Xavier; Graue, Gerardo; Crespo-Solís, Erick; Piedras, Josefa

2008-07-01

High P-glycoprotein-mediated multidrug resistance-1 (P-gp/MDR1) activity in lymphocytes from idiopathic thrombocytopenic purpura (ITP) patients may affect disease outcome. ITP treatment includes glucocorticoids that are substrates of P-gp; hence, P-gp functional activity and antigenic expression were assessed by flow cytometry in T and natural killer (NK) cells from ITP patients before and after prednisone therapy. Herein, patients' T and NK cells did not show increased MDR1 functional activity, whereas P-gp antigenic expression was significantly enhanced in both therapy-free and prednisone-treated patients. Prednisone treatment did not significantly modify the function and expression of MDR1 in T and NK cells of ITP patients.

High-dose dexamethasone or all-trans-retinoic acid restores the balance of macrophages towards M2 in immune thrombocytopenia.

PubMed

Feng, Q; Xu, M; Yu, Y Y; Hou, Y; Mi, X; Sun, Y X; Ma, S; Zuo, X Y; Shao, L L; Hou, M; Zhang, X H; Peng, J

2017-09-01

Essentials M1/M2 imbalance is involved in many autoimmune diseases, and could be restored. The expressions and functions of M1 and M2 were investigated in an in vitro culture system. A preferred M1 polarization is involved in the pathogenesis of immune thrombocytopenia (ITP). High-dose dexamethasone or all-trans-retinoic acid restores M1/M2 balance in ITP patients. Background Immune thrombocytopenia (ITP) is an autoimmune disorder. Deficiency of immune tolerance in antigen-presenting cells and cross-communication between antigen-presenting cells and T cells are involved in the pathogenesis of ITP. Macrophages can polarize into proinflammatory M1 or anti-inflammatory M2 phenotypes in response to different environmental stimuli, and have diverse immunologic functions. Objectives To investigate the M1/M2 imbalance in ITP and whether high-dose dexamethasone (HD-DXM) or all-trans-retinoic acid (ATRA) could restore this imbalance. Methods The numbers of M1 and M2 macrophages in the spleens of ITP patients and patients with traumatic spleen rupture were analyzed by immunofluorescence. Monocyte-derived macrophages were cultured and induced with cytokines and drugs. The expression of M1 and M2 markers and functions of M1 and M2 macrophages before and after modulation by HD-DXM or ATRA were evaluated with flow cytometry and ELISA. Results There was preferred M1 polarization in ITP spleens as compared with healthy controls. Monocyte-derived macrophages from ITP patients had increased expression of M1 markers and impaired immunosuppressive functions. Either HD-DXM or ATRA corrected this imbalance by decreasing the expression of M1 markers and increasing the expression of M2 markers. Moreover, HD-DXM-modulated or ATRA-modulated macrophages suppressed both CD4 + and CD8 + T-cell proliferation and expanded CD4 + CD49 + LAG3 + type 1 T-regulatory cells. HD-DXM or ATRA modulated macrophages to shift the T-cell cytokine profile towards Th2. Treating patients with HD-DXM or ATRA revealed that macrophages induced from responders showed a predominant M2-like phenotype and immunosuppressive function. Conclusions Aberrant macrophage polarization is involved in the pathogenesis of ITP. Either HD-DXM or ATRA is able to correct this imbalance. © 2017 International Society on Thrombosis and Haemostasis.

A lower starting dose of eltrombopag is efficacious in Japanese patients with previously treated chronic immune thrombocytopenia.

PubMed

Tomiyama, Y; Miyakawa, Y; Okamoto, S; Katsutani, S; Kimura, A; Okoshi, Y; Ninomiya, H; Kosugi, H; Nomura, S; Ozaki, K; Ikeda, Y; Hattori, T; Katsura, K; Kanakura, Y

2012-05-01

Eltrombopag is an oral, non-peptide thrombopoietin receptor agonist that has shown efficacy and safety in chronic immune thrombocytopenia (ITP). However, ethnic differences in eltrombopag exposure have been reported: area under the curve exposure to eltrombopag was 87% greater among ITP patients of East Asian descent than among ITP patients of non-East Asian ITP descent. To evaluate the efficacy and safety of eltrombopag by using, in Japanese ITP patients, lower starting (12.5 mg) and maximum (50 mg) doses of eltrombopag than the standard starting (50 mg) and maximum (75 mg) doses approved in the USA and Europe. We examined 23 Japanese patients with previously treated chronic ITP with a platelet count of < 30,000 μL(-1) in a multicenter study comprising a randomized, double-blind, placebo-controlled phase for 6-week evaluation (15 eltrombopag, and eight placebo) and an open-label phase for 6-month evaluation (23 eltrombopag). The response rate (platelet count of ≥ 50,000 μL(-1) ) at week 6 of the 6-week double-blind phase was 60% in eltrombopag-treated patients and 0% in placebo-treated patients. Ten of 23 patients (43.5%) responded for ≥ 75% of predefined assessment visits during the 6-month open-label phase. Notably, 22% (5/23) of patients responded to 12.5 mg of eltrombopag, which was administered within the first 3 weeks of eltrombopag treatment. Bleeding decreased with eltrombopag treatment as compared with baseline. Eltrombopag was generally well tolerated; one patient experienced a transient ischemic attack on day 9. Eltrombopag (12.5-50 mg) is effective for the management of Japanese patients with chronic ITP (NCT00540423). © 2012 International Society on Thrombosis and Haemostasis.

Effect of short-term, high-dose methylprednisolone on oxidative stress in children with acute immune thrombocytopenia.

PubMed

Cura, Musa; Koç, Ahmet; Aksoy, Nurten; Özdemir, Zeynep Canan

2016-12-01

Immune thrombocytopenia (ITP) is the most common cause of acquired childhood thrombocytopenia and is characterized by increased immune-mediated destruction of circulating thrombocytes. Oxidative damage may be involved in ITP pathogenesis; paraoxonase (PON) and arylesterase (ARE) enzymes are closely associated with the cellular antioxidant system. We investigated the effect of short-term high-dose methylprednisolone (HDMP) treatment on the total oxidant status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI), and PON and ARE enzymatic activity in children with acute ITP. Thirty children with acute ITP constituted the study group and 30 healthy children constituted the control group. Children with acute ITP were treated with HDMP: 30 mg/kg for 3 days, then 20 mg/kg for 4 days. The TOS, TAC, OSI, PON, and ARE levels were determined before and after 7 days of HDMP treatment. The TAC level ( P <0.001), and PON ( P <0.001) and ARE (P=0.001) activities were lower and the TOS ( P =0.003) and OSI ( P <0.001) levels were higher in children with acute ITP than those in healthy children in the control group. We also observed statistically significant increases in the TAC ( P <0.01), PON ( P <0.001) and ARE levels ( P =0.001) and decreases in the TOS ( P <0.05) and OSI levels ( P <0.05) with 7 days of HDMP treatment compared to their values before treatment. Our study demonstrated increased oxidative stress (OSI and TOC) and decreased antioxidant capacity (TAC), PON, and ARE in ITP patients and that steroid treatment could be effective in reducing the oxidative stress.

Evaluation of health related quality of life in children with immune thrombocytopenia with the PedsQL™ 4.0 Generic Core Scales: a study on behalf of the pays de Loire pediatric hematology network.

PubMed

Strullu, Marion; Rakotonjanahary, Josué; Tarral, Eliane; Savagner, Christophe; Thomas, Caroline; Méchinaud, Françoise; Reguerre, Yves; Poignant, Sylvaine; Boutet, Arnaud; Bassil, Joachim; Médinger, Dominique; Quemener, Emmanuel; Young, Nancy L; Rachieru, Petronela; Klaassen, Robert J; Pellier, Isabelle

2013-11-13

Immune thrombocytopenia (ITP) is a childhood disorder that is often life-altering for children and their parents. Health related quality of life (HRQL) has never been chronologically monitored in children with ITP. We initiated a prospective study to assess HRQL from diagnosis to six months and define factors that influence this outcome in children with ITP. 73 children with acute ITP aged from 2 to 18 years were prospectively enrolled in the study. According to the presence of bleeding, they were or were not given a 4-day course of corticosteroid treatment. The PedsQL™ 4.0 Generic Core Scale was completed by children and parents upon their inclusion in the study and 6 months after diagnosis. Over the six month period, quality of life improved in terms of their global, physical and psychosocial well-being for 54.5%, 35.6% and 36.2% of patients respectively. This improvement is clinically relevant compared to scores at diagnosis, corresponding at least to a minimal clinically important difference (MCID). Factors such as sex, age, platelet count, bleeding scores, bone marrow aspiration and persistence of ITP at 6 months were not significantly associated with HRQL scores. However, preceding viral infection was identified to have an impact on HRQL. This first longitudinal study assessing HRQL in children with ITP reveals a global improvement in PedSQL™ 4.0. However, these results should be considered with caution since our data also confirm that self-report HRQL scores are not influenced by any analyzed biologic or clinical parameters. Others tools, such as Kids' ITP Tools, would probably be required to assess the HRQL of this population. Trial registration clinical trials.gov Identifier: NCT00331357.

75 FR 23226 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-03

... Service (FAS), today accepted a petition, and began a review of a petition, for trade adjustment..., FAS, USDA, at (202) 720-0638, or by e-mail at: [email protected]fas.usda.gov . Additional program... is http://www.fas.usda.gov/itp/taa . Dated: April 27, 2010. John D. Brewer, Administrator, Foreign...

75 FR 23226 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-03

... Service (FAS), today accepted a petition, and began a review of a petition, for trade adjustment... Adjustment Assistance Staff, FAS, USDA, at (202) 720-0638, or by e-mail at: [email protected]fas.usda.gov... Farmers program. The URL is http://www.fas.usda.gov/itp/taa . Dated: April 27, 2010. John D. Brewer...

75 FR 23225 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-03

... Service (FAS), today accepted a petition, and began a review of a petition, for trade adjustment..., FAS, USDA, at (202) 720-0638, or by e-mail at: [email protected]fas.usda.gov . Additional program... is http://www.fas.usda.gov/itp/taa . Dated: April 27, 2010. John D. Brewer, Administrator, Foreign...

Acquisition of Ice-Tethered Profilers with Velocity (ITP-V) Instruments for Future Arctic Studies

DTIC Science & Technology

2016-11-15

instrument that measures sea water temperature and salinity versus depth, the ITP-V adds a multi-axis acoustic -travel-time current meter and...housing capped by an ultra-high-molecular-weight polyethylene dome. The electronics case sits within a foam body designed to provide buoyancy for...then transmits them by satellite to a logger computer at WHO I. The ITP-V instruments add a multi-axis acoustic -travel-time current meter and

Molecular mimicry by Helicobacter pylori CagA protein may be involved in the pathogenesis of H. pylori-associated chronic idiopathic thrombocytopenic purpura.

PubMed

Takahashi, Toru; Yujiri, Toshiaki; Shinohara, Kenji; Inoue, Yusuke; Sato, Yutaka; Fujii, Yasuhiko; Okubo, Masashi; Zaitsu, Yuzuru; Ariyoshi, Koichi; Nakamura, Yukinori; Nawata, Ryouhei; Oka, Yoshitomo; Shirai, Mutsunori; Tanizawa, Yukio

2004-01-01

The eradication of Helicobacter pylori often leads to platelet recovery in patients with chronic idiopathic thrombocytopenic purpura (cITP). Although this clinical observation suggests the involvement of H. pylori, little is known about the pathogenesis of cITP. We initially examined the effect of H. pylori eradication on platelet counts in 20 adult Japanese cITP patients. Then, using platelet eluates as the probe in immunoblot analyses, we examined the role of molecular mimicry in the pathogenesis of cITP. Helicobacter pylori infection was detected in 75% (15 of 20) of cITP patients. Eradication was achieved in 13 (87%) of the H. pylori-positive patients, seven (54%) of which showed increased platelet counts within the 4 months following treatment. Completely responsive patients also showed significant declines in platelet-associated immunoglobulin G (PAIgG) levels. Platelet eluates from 12 (nine H. pylori-positive and three H. pylori-negative) patients recognized H. pylori cytotoxin-associated gene A (CagA) protein, and in three completely responsive patients, levels of anti-CagA antibody in platelet eluates declined after eradication therapy. Cross-reactivity between PAIgG and H. pylori CagA protein suggests that molecular mimicry by CagA plays a key role in the pathogenesis of a subset of cITP patients.

Can neutral analytes be concentrated by transient isotachophoresis in micellar electrokinetic chromatography and how much?

PubMed

Matczuk, Magdalena; Foteeva, Lidia S; Jarosz, Maciej; Galanski, Markus; Keppler, Bernhard K; Hirokawa, Takeshi; Timerbaev, Andrei R

2014-06-06

Transient isotachophoresis (tITP) is a versatile sample preconcentration technique that uses ITP to focus electrically charged analytes at the initial stage of CE analysis. However, according to the ruling principle of tITP, uncharged analytes are beyond its capacity while being separated and detected by micellar electrokinetic chromatography (MEKC). On the other hand, when these are charged micelles that undergo the tITP focusing, one can anticipate the concentration effect, resulting from the formation of transient micellar stack at moving sample/background electrolyte (BGE) boundary, which increasingly accumulates the analytes. This work expands the enrichment potential of tITP for MEKC by demonstrating the quantitative analysis of uncharged metal-based drugs from highly saline samples and introducing to the BGE solution anionic surfactants and buffer (terminating) co-ions of different mobility and concentration to optimize performance. Metallodrugs of assorted lipophilicity were chosen so as to explore whether their varying affinity toward micelles plays the role. In addition to altering the sample and BGE composition, optimization of the detection capability was achieved due to fine-tuning operational variables such as sample volume, separation voltage and pressure, etc. The results of optimization trials shed light on the mechanism of micellar tITP and render effective determination of selected drugs in human urine, with practical limits of detection using conventional UV detector. Copyright © 2014 Elsevier B.V. All rights reserved.

Defective circulating CD25 regulatory T cells in patients with chronic immune thrombocytopenic purpura

PubMed Central

Yu, Jin; Heck, Susanne; Patel, Vivek; Levan, Jared; Yu, Yu; Bussel, James B.

2008-01-01

Immune thrombocytopenic purpura (ITP) is characterized by the presence of antiplatelet autoantibodies as a result of loss of tolerance. CD4+CD25+ regulatory T cells (Tregs) are important for maintenance of peripheral tolerance. Decreased levels of peripheral Tregs in patients with ITP have been reported. To test whether inefficient production or reduced immunosuppressive activity of Tregs contributes to loss of tolerance in patients with chronic ITP, we investigated the frequency and function of their circulating CD4+CD25hi Tregs. We found a com-parable frequency of circulating CD4+CD25hiFoxp3+ Tregs in patients and controls (n = 16, P > .05). However, sorted CD4+CD25hi cells from patients with chronic ITP (n = 13) had a 2-fold reduction of in vitro immunosuppressive activity compared with controls (n = 10, P < .05). The impaired suppression was specific to Tregs as shown by cross-mixing experiments with T cells from controls. These data suggest that functional defects in Tregs contribute to breakdown of self-tolerance in patients with chronic ITP. PMID:18420827

Long-term salvage therapy with cyclosporin A in refractory idiopathic thrombocytopenic purpura.

PubMed

Emilia, Giovanni; Morselli, Monica; Luppi, Mario; Longo, Giuseppe; Marasca, Roberto; Gandini, Giovanna; Ferrara, Leonardo; D'Apollo, Nicola; Potenza, Leonardo; Bertesi, Marcello; Torelli, Giuseppe

2002-02-15

Treatment of severe, chronic idiopathic thrombocytopenic purpura (ITP) refractory to most usual therapies is a difficult challenge. Little information exists on the clinical use of cyclosporin A (CyA) in the treatment of ITP. This report describes long-term treatment with CyA (median, 40 months) and follow-up (median, 36.8 months) in 12 adult patients with resistant ITP. CyA used in relatively low doses (2.5-3 mg/kg of body weight per day) led to a clinical improvement in 10 patients (83.3%). Five had a complete response (41.1%), 4 a complete response to maintenance therapy (33.3%), and one a partial response (8.3%). Two patients had no response. Most patients with a response (60%) had a long-term remission (mean, 28.6 months) after discontinuation of CyA. One patient had a relapse of ITP 4 years after CyA therapy was stopped. Side effects were moderate and transient, even in patients dependent on continued CyA treatment. CyA seems to represent reasonable salvage treatment in severe, potentially life-threatening, refractory ITP.

Low-level light treatment ameliorates immune thrombocytopenia

PubMed Central

Yang, Jingke; Zhang, Qi; Li, Peiyu; Dong, Tingting; Wu, Mei X.

2016-01-01

Immune thrombocytopenia (ITP) is an immune-mediated acquired bleeding disorder characterized by abnormally low platelet counts. We reported here the ability of low-level light treatment (LLLT) to alleviate ITP in mice. The treatment is based on noninvasive whole body illumination 30 min a day for a few consecutive days by near infrared light (830 nm) transmitted by an array of light-emitting diodes (LEDs). LLLT significantly lifted the nadir of platelet counts and restored tail bleeding time when applied to two passive ITP models induced by anti-CD41 antibody. The anti-platelet antibody hindered megakaryocyte differentiation from the progenitors, impaired proplatelet and platelet formation, and induced apoptosis of platelets. These adverse effects of anti-CD41 antibody were all mitigated by LLLT to varying degrees, owing to its ability to enhance mitochondrial biogenesis and activity in megakaryocytes and preserve mitochondrial functions in platelets in the presence of the antibody. The observations argue not only for contribution of mitochondrial stress to the pathology of ITP, but also clinical potentials of LLLT as a safe, simple, and cost-effective modality of ITP. PMID:27901126

Low-level light treatment ameliorates immune thrombocytopenia

NASA Astrophysics Data System (ADS)

Yang, Jingke; Zhang, Qi; Wu, Mei X.

2017-02-01

Immune thrombocytopenia (ITP) is an immune-mediated acquired bleeding disorder characterized by abnormally low platelet counts. We reported here the ability of low-level light treatment (LLLT) to alleviate ITP in mice. The treatment is based on noninvasive whole body illumination 30 min a day for a few consecutive days by near infrared light (830 nm) transmitted by an array of light-emitting diodes (LEDs). LLLT significantly lifted the nadir of platelet counts and restored tail bleeding time when applied to two passive ITP models induced by anti-CD41 antibody. The anti-platelet antibody hindered megakaryocyte differentiation from the progenitors, impaired proplatelet and platelet formation, and induced apoptosis of platelets. These adverse effects of anti-CD41 antibody were all mitigated by LLLT to varying degrees, owing to its ability to enhance mitochondrial biogenesis and activity in megakaryocytes and preserve mitochondrial functions in platelets in the presence of the antibody. The observations argue not only for contribution of mitochondrial stress to the pathology of ITP, but also clinical potentials of LLLT as a safe, simple, and cost-effective modality of ITP.

Simplified transient isotachophoresis/capillary gel electrophoresis method for highly sensitive analysis of polymerase chain reaction samples on a microchip with laser-induced fluorescence detection.

PubMed

Liu, Dayu; Ou, Ziyou; Xu, Mingfei; Wang, Lihui

2008-12-19

We present a sensitive, simple and robust on-chip transient isotachophoresis/capillary gel electrophoresis (tITP/CGE) method for the analysis of polymerase chain reaction (PCR) samples. Using chloride ions in the PCR buffer and N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid (HEPES) in the background electrolyte, respectively, as the leading and terminating electrolytes, the tITP preconcentration was coupled with CGE separation with double-T shaped channel network. The tITP/CGE separation was carried out with a single running buffer. The separation process involved only two steps that were performed continuously with the sequential switching of four voltage outputs. The tITP/CGE method showed an analysis time and a separation efficiency comparable to those of standard CGE, while the signal intensity was enhanced by factors of over 20. The limit of detection of the chip-based tITP/CGE method was estimated to be 1.1 ng/mL of DNA in 1x PCR buffer using confocal fluorescence detection following 473 nm laser excitation.

Subacute sclerosing panencephalitis and immune thrombocytopenia: More than a coincidence?

PubMed

Oncel, I; Saltik, S; Anlar, B

2018-02-01

Subacute sclerosing panencephalitis (SSPE) is a progressive disease caused by persistent measles virus (MV). It has an incidence of 0.4-2.0/million in Turkey. Immune thrombocytopenia (ITP) is a bleeding disorder whose estimated incidence is 4.2/100.000 person/years in the pediatric age group. We observed three cases with ITP in our cohort of 315 pediatric SSPE cases, an incidence higher than coincidentally expected in the general population. We hypothesize an association between SSPE and ITP. Our three cases had measles 1-2 years before the onset of ITP and 8-10 years before first symptoms of SSPE. A common immunogenetic background creating susceptibility to infection and autoimmunity might play a role. Alternatively, chronic antigenic stimulation by the MV leading to synthesis of cross-reacting antibodies against platelets, or treatment of ITP with immunoglobulins or steroids might affect or alter the development and manifestation of SSPE. The co-occurrence of these two disorders of viral and immune pathogenesis may draw attention to similar observations and provide clues for their mechanisms. Copyright © 2018 Elsevier Ltd. All rights reserved.

In-Trail Procedure Air Traffic Control Procedures Validation Simulation Study

NASA Technical Reports Server (NTRS)

Chartrand, Ryan C.; Hewitt, Katrin P.; Sweeney, Peter B.; Graff, Thomas J.; Jones, Kenneth M.

2012-01-01

In August 2007, Airservices Australia (Airservices) and the United States National Aeronautics and Space Administration (NASA) conducted a validation experiment of the air traffic control (ATC) procedures associated with the Automatic Dependant Surveillance-Broadcast (ADS-B) In-Trail Procedure (ITP). ITP is an Airborne Traffic Situation Awareness (ATSA) application designed for near-term use in procedural airspace in which ADS-B data are used to facilitate climb and descent maneuvers. NASA and Airservices conducted the experiment in Airservices simulator in Melbourne, Australia. Twelve current operational air traffic controllers participated in the experiment, which identified aspects of the ITP that could be improved (mainly in the communication and controller approval process). Results showed that controllers viewed the ITP as valid and acceptable. This paper describes the experiment design and results.

Programmatic Re-Evaluation of Ion Exchange as a 1st Generation ITP Replacement

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

Scott, A.B.

This re-evaluation differs from previous work in that (1) the Ion Exchange option was evaluated from a standpoint assuming that ITP would never start up, thus Ion Exchange was the only viable option, (2) the DOE prescribed balanced assumptions were quite different than the WSRC Assumptions used previously, and (3) other Site events and changes within HLWM have tended to reduce the disadvantages of Ion Exchange relative to ITP as the first generation salt decontamination process.

Micromechanical analysis and design of an integrated thermal protection system for future space vehicles

NASA Astrophysics Data System (ADS)

Martinez, Oscar

Thermal protection systems (TPS) are the key features incorporated into a spacecraft's design to protect it from severe aerodynamic heating during high-speed travel through planetary atmospheres. The thermal protection system is the key technology that enables a spacecraft to be lightweight, fully reusable, and easily maintainable. Add-on TPS concepts have been used since the beginning of the space race. The Apollo space capsule used ablative TPS and the Space Shuttle Orbiter TPS technology consisted of ceramic tiles and blankets. Many problems arose from the add-on concept such as incompatibility, high maintenance costs, non-load bearing, and not being robust and operable. To make the spacecraft's TPS more reliable, robust, and efficient, we investigated Integral Thermal Protection System (ITPS) concept in which the load-bearing structure and the TPS are combined into one single component. The design of an ITPS was a challenging task, because the requirement of a load-bearing structure and a TPS are often conflicting. Finite element (FE) analysis is often the preferred method of choice for a structural analysis problem. However, as the structure becomes complex, the computational time and effort for an FE analysis increases. New structural analytical tools were developed, or available ones were modified, to perform a full structural analysis of the ITPS. With analytical tools, the designer is capable of obtaining quick and accurate results and has a good idea of the response of the structure without having to go to an FE analysis. A MATLABRTM code was developed to analytically determine performance metrics of the ITPS such as stresses, buckling, deflection, and other failure modes. The analytical models provide fast and accurate results that were within 5% difference from the FEM results. The optimization procedure usually performs 100 function evaluations for every design variable. Using the analytical models in the optimization procedure was a time saver, because the optimization time to reach an optimum design was reached in less than an hour, where as an FE optimization study would take hours to reach an optimum design. Corrugated-core structures were designed for ITPS applications with loads and boundary conditions similar to that of a Space Shuttle-like vehicle. Temperature, buckling, deflection and stress constraints were considered for the design and optimization process. An optimized design was achieved with consideration of all the constraints. The ITPS design obtained from the analytical solutions was lighter (4.38 lb/ft2) when compared to the ITPS design obtained from a finite element analysis (4.85 lb/ft 2). The ITPS boundary effects added local stresses and compressive loads to the top facesheet that was not able to be captured by the 2D plate solutions. The inability to fully capture the boundary effects lead to a lighter ITPS when compared to the FE solution. However, the ITPS can withstand substantially large mechanical loads when compared to the previous designs. Truss-core structures were found to be unsuitable as they could not withstand the large thermal gradients frequently encountered in ITPS applications.

Clinical Aspects of Pregnancy and Delivery in Patients with Chronic Idiopathic Thrombocytopenic Purpura (ITP)

PubMed Central

Won, Young-Woong; Moon, Won; Yun, Yeong-Seop; Oh, Ho-Suk; Choi, Jung-Hye; Lee, Young-Yeul; Kim, In-Soon; Choi, Il-Young

2005-01-01

Background Idiopathic thrombocytopenic purpura (ITP) is a condition that often develops in young women and, consequently, physicians should frequently manage and monitor pregnant patients with this disorder. Methods We reviewed the charts of 30 women with chronic ITP delivered in 31 pregnancies from January 1995 to December 2003. Results Fifteen patients were diagnosed with ITP before pregnancy and sixteen patients were diagnosed during pregnancy. The mean platelet counts before pregnancy, during pregnancy, and at delivery were 70,040/mm3, 83,960/mm3, and 62,680/mm3, respectively. The symptoms of hemostatic impairment were not noted in most of the pregnancies (77%, 24/31). During pregnancy and at delivery, most of the women (61%, 19/31) received various kinds of treatment to raise platelet counts. At delivery, the most commonly used therapy was platelet transfusion (48.4%, 15/31). Seven pregnancies (22.6%) were treated with corticosteroids during pregnancy and at delivery. Five pregnancies (16.1%) were treated with IV IgG during pregnancy and at delivery. Fifteen deliveries (51.7%) were performed by cesarean section and fourteen (48.3%) with vaginal delivery. Bleeding was uncommon at delivery. There were no cases of infants with any clinical signs of hemorrhage. Conclusion Our current results suggest that ITP in pregnancy can proceed safely with low hemorrhagic risk in both infants and mothers, and that mothers with ITP can deliver healthy infants without serious hemorrhagic complications PMID:16134767

Fostering clinical engagement and medical leadership and aligning cultural values: an evaluation of a general practice specialty trainee integrated training placement in a primary care trust.

PubMed

Ruston, Annmarie; Tavabie, Abdol

2010-01-01

To report on the extent to which a general practice specialty trainee integrated training placement (ITP) developed the leadership skills and knowledge of general practice specialty trainees (GPSTRs) and on the potential of the ITP to improve clinical engagement. A case study method was used in a Kent primary care trust (PCT). Sources of data included face-to-face and telephone interviews (three GPSTRs, three PCT clinical supervisors, three general practitioner (GP) clinical supervisors and three Deanery/PCT managers), reflective diaries, documentary sources and observation. Interview data were transcribed and analysed using the constant comparative method. All respondents were positive about the value and success of the ITP in developing the leadership skills of the GPSTRs covering three dimensions: leadership of self, leadership of teams and leadership of organisations within systems. The ITP had enabled GP trainees to understand the context for change, to develop skills to set the direction for change and to collect and apply evidence to decision making. The ITP was described as an effective means of breaking down cultural barriers between general practice and the PCT and as having the potential for improving clinical engagement. The ITP provided a model to enable the effective exchange of knowledge and understanding of differing cultures between GPSTRs, general practice and the PCT. It provided a sound basis for effective, dispersed clinical engagement and leadership.

Software Independent Verification and Validation (SIV&V) Simplified

DTIC Science & Technology

2006-12-01

Configuration Item I/O Input/Output I2V2 Independent Integrated Verification and Validation IBM International Business Machines ICD Interface...IPT Integrated Product Team IRS Interface Requirements Specification ISD Integrated System Diagram ITD Integrated Test Description ITP ...programming languages such as COBOL (Common Business Oriented Language) (Codasyl committee 1960), and FORTRAN (FORmula TRANslator) ( IBM 1952) (Robat 11

Improving the U.S. Navy’s Execution of Technical Authority through a Common Risk Management and Technical Assessment Process

DTIC Science & Technology

2008-09-01

ITP . Assessment Indicators: • Has the risk management team (RMT) provided a risk management plan (RMP)? − Does the RMP provide an organized...processes. Diskettes, which contain the necessary programs for accessing BMP◊NET from IBM -compatible or Macintosh computers with a modem, and answers to

Integral Ramjet Booster Demonstration Program

DTIC Science & Technology

1975-02-01

Table 3-10 THREE-COMPONENT DECOMPOSITION MODEL Component r0 Ibm ;"-3 7ft Ibm ^ft A (Resin) 60.75 B (Resin) 20.24 C (Reinf.) 110.00...Cured Strands Burn rate 1000 psia/ + 70°F, in./sec Pressure exponent o. (-65 to +1600F), %/"F itP , (-65 to tUCF), ü/8» Ballistic Properties, 6

B cell depleting therapy regulates splenic and circulating T follicular helper cells in immune thrombocytopenia.

PubMed

Audia, Sylvain; Rossato, Marzia; Trad, Malika; Samson, Maxime; Santegoets, Kim; Gautheron, Alexandrine; Bekker, Cornelis; Facy, Olivier; Cheynel, Nicolas; Ortega-Deballon, Pablo; Boulin, Mathieu; Berthier, Sabine; Leguy-Seguin, Vanessa; Martin, Laurent; Ciudad, Marion; Janikashvili, Nona; Saas, Philippe; Radstake, Timothy; Bonnotte, Bernard

2017-02-01

B cells are involved in immune thrombocytopenia (ITP) pathophysiology by producing antiplatelet auto-antibodies. However more than a half of ITP patients do not respond to B cell depletion induced by rituximab (RTX). The persistence of splenic T follicular helper cells (TFH) that we demonstrated to be expanded during ITP and to support B cell differentiation and antiplatelet antibody-production may participate to RTX inefficiency. Whereas it is well established that the survival of TFH depends on B cells in animal models, nothing is known in humans yet. To determine the effect of B cell depletion on human TFH, we quantified B cells and TFH in the spleen and in the blood from ITP patients treated or not with RTX. We showed that B cell depletion led to a dramatic decrease in splenic TFH and in CXCL13 and IL-21, two cytokines predominantly produced by TFH. The absolute count of circulating TFH and serum CXCL13 also decreased after RTX treatment, whatever the therapeutic response. Therefore, we showed that the maintenance of TFH required B cells and that TFH are not involved in the inefficiency of RTX in ITP. Copyright © 2016 Elsevier Ltd. All rights reserved.

Work experiences of internationally trained pharmacists in Great Britain.

PubMed

Ziaei, Zainab; Hassell, Karen; Schafheutle, Ellen I

2015-04-01

Internationally trained health professionals are an important part of the domestic workforce, but little is known about the working experiences of internationally trained pharmacists (ITPs) in Great Britain (GB). The purpose of this study is to explore the work experiences of ITPs practising in the community or hospital sector in GB. Twenty-five semi-structured, face-to-face interviews were conducted with a sample of European Economic Area (EEA) and non-EEA pharmacists who, at the time of the study, practised in the community (n = 20) or hospital sector (n = 5) in the North West England from March to May 2009. In general, ITPs complained about their heavy workload, long working hours and lack of support from their employers. Specifically, EEA pharmacists in most cases felt excluded from the professional network and sensed colleagues saw them as 'foreigners' while some non-EEA pharmacists had to deal with a level of hostility from patients. This novel research provides a foundation for future work on ITPs in GB and could assist employers to better target their efforts in development of standards to support the working experiences of ITPs in GB. © 2014 Royal Pharmaceutical Society.

Integrated Aero-Servo-Thermo-Propulso-Elasticity (ASTPE) for Hypersonic Scramjet Vehicle Design/Analysis

DTIC Science & Technology

2009-12-04

heat flux q, see Figure 4.6 - Optimized Weights Winitia, = 0.777 Ibm /ft 2, Wfma! = 0.543 Ibm /ft 2 Shown in Table 4.1 are the optimization results...vehicle: no (0), yes (1), or optimize (2) ideriv - Calculate derivatives: no (0), yes (1) itps - If itps is 1, then prepare for tps and smb. ideriv and... itps cannot be 1 at one time ifeedback - If 1, then gets weight and Cg information from SMB and TPSOPT (1) = height set (1), matrix (2) OUTPUT FILE

[Correlation of Plasma Co-stimulatory Molecules B7-H2 and B7-H3 with Platelet Auto-antibodies in Patients with Immune Thrombocytopenic Purpura].

PubMed

Zuo, Bin; Zhao, Yun-Xiao; Yang, Jian-Feng; He, Yang

2015-08-01

To investigate whether the plasma level of platelet auto- antibodies in ITP patients is related to that of co-stimulatory molecules sB7-H2 and sB7-H3. A total of 61 ITP patients and 25 healthy controls from the First Affiliated Hospital of Soochow University from June 2012 to August 2013 were enrolled in this study. The expression levels of platelet auto-antibodies against 5 glycoproteins (GPIX, GP Ib, GP IIIa, GPIIb and P-selectin) in plasma were detected by flow cytometric immuno-beads array, and the expression of soluable co-stimulatory molecules sB7-H2 and sB7-H3 was measured by ELISA. The plasma levels of 5 auto-antibodies against platelet membrance glycoproteins significantly increased in ITP patiens (P < 0.01). Compared with healthy controls, sB7-H2 levels increased (P < 0.05), while the sB7-H3 level did not significantly change (r = 0.13, P > 0.05). However, the correlation analysis showed that sB7-H3 negatively correlated with platelet P-selectin auto-antibody (r = -0.46, P < 0.05), and sB7-H2 and sB7-H3 significantly reduced in ITP patients with positive P-selectin auto-antibody (P < 0.01). In ITP patients, platelet counts negatively correlated with sB7-H2 (r = -0.3907, P < 0.01), but did not correlate with sB7-H3. Soluble costimulatory molecule sB7-H2 elevates in ITP patients, and the level of sB7-H3 is associated with auto-antibodies against P-selectin, suggesting that costimulatory molecules B7-H2 and B7-H3 may be involved in the pathogenesis of immune regulation abnormality in ITP.

TRTH-20. TREATMENT OF OPTIC PATHWAY GLIOMA AND IMMUNE THROMBOCYTOPENIA (ITP) WITH EVEROLIMUS

PubMed Central

Singh, Rohini; Gardner, Sharon; Allen, Jeffrey

2017-01-01

Abstract BACKGROUND: ITP has been described in case reports and a few small series of patients with solid tumors. One possible mechanism of ITP associated with cancer is tumor- induced autoimmunity. CASE DESCRIPTION: A now 15 -year -old female with neurofibromatosis 1 (NF-1) was diagnosed at 6 years of age with an optic pathway glioma. She received treatment with carboplatin and vincristine, and had stable disease for 11 months, until she developed an allergic reaction to carboplatin. At 10 years of age, she exhibited progressive disease and received immunotherapy with three doses of an HLA-restricted peptide vaccine given over 6 weeks. At age 11, she was diagnosed with immune thrombocytopenia, which was controllable with WinRho, and her platelet count remained between 50,000–60,000. At age 14, despite stable MRI findings, she experienced a decrease in visual acuity necessitating further treatment, and Everolimus was instituted. After one year of treatment, her vision has remained stable, and she has a sustained improvement in her platelet count to above 200,000. DISCUSSION/CONCLUSION: There are a number of extenuating factors that may have possibly contributed to the occurrence of ITP, including the emergence of OPG, the allergic reaction to carboplatin, and the prior immunotherapy protocol. Our patient’s decline in visual acuity prompting treatment was closely related temporally to the development of chronic ITP, suggesting the possibility of immune cell dysregulation in both the immune cytopenia and tumor growth. Everolimus, an mTOR inhibitor, has been observed to cause regression of several types of tumors as well as alter immune function and, in a larger series of patients in China, suppress manifestations of ITP. However, this case is unusual in the quick and enduring response of the ITP to Everolimus. This case suggests the efficacy of both the anti-tumor and immunomodulatory effects in Everolimus treatment.

Analytical capillary isotachophoresis after 50 years of development: Recent progress 2014-2016.

PubMed

Malá, Zdena; Gebauer, Petr; Boček, Petr

2017-01-01

This review brings a survey of papers on analytical ITP published since 2014 until the first quarter of 2016. The 50th anniversary of ITP as a modern analytical method offers the opportunity to present a brief view on its beginnings and to discuss the present state of the art from the viewpoint of the history of its development. Reviewed papers from the field of theory and principles confirm the continuing importance of computer simulations in the discovery of new and unexpected phenomena. The strongly developing field of instrumentation and techniques shows novel channel methodologies including use of porous media and new on-chip assays, where ITP is often included in a preseparative or even preparative function. A number of new analytical applications are reported, with ITP appearing almost exclusively in combination with other principles and methods. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Postinfluenza Vaccination Idiopathic Thrombocytopenic Purpura in Three Elderly Patients

PubMed Central

Nagasaki, Joji; Manabe, Masahiro; Ido, Kentaro; Ichihara, Hiroyoshi; Aoyama, Yasutaka; Ohta, Tadanobu; Furukawa, Yoshio; Mugitani, Atsuko

2016-01-01

The etiologies of secondary idiopathic thrombocytopenic purpura (ITP) include infection, autoimmune disease, and immunodeficiency. We report the cases of three elderly patients who developed ITP after receiving influenza vaccinations. The platelet count of an 81-year-old woman fell to 27,000/μL after she received an influenza vaccination. A 75-year-old woman developed thrombocytopenia (5,000 platelets/μL) after receiving an influenza vaccination. An 87-year-old woman whose laboratory test values included a platelet count of 2,000/μL experienced genital bleeding after receiving an influenza vaccination. After Helicobacter pylori (HP) eradication or corticosteroid treatment, all of the patients' platelet counts increased. Influenza vaccination is an underlying etiology of ITP in elderly patients. HP eradication or corticosteroid treatment is effective for these patients. Clinicians should be aware of the association between ITP and influenza vaccinations. PMID:26998369

Regulatory T Cells in Patients with Idiopathic Thrombocytopenic Purpura.

PubMed

Akyol Erikçi, Alev; Karagöz, Bülent; Bilgi, Oğuz

2016-06-05

Immune thrombocytopenic purpura (ITP) is an immune-mediated bleeding disorder in which platelets are opsonized by autoantibodies and destroyed by an Fc receptor-mediated phagocytosis by the reticuloendothelial system within the spleen. Autoimmune processes are also considered in the pathogenesis of this disorder. CD4+CD25+FoxP3+ regulatory T (Treg) cells and CD8+CD28- Treg cells have roles in autoimmune diseases. We investigated these regulatory cells in ITP patients. We included 22 ITP patients and 16 age-matched healthy subjects. CD4+CD25+FoxP3+ Treg cells and CD8+CD28- cells were investigated by three-color flow cytometry. The ratios of these cell populations to total lymphocytes were calculated. Statistical analysis was carried out with the Mann-Whitney U test. CD4+CD25+ Treg cells were 9.69±3.70% and 12.99±5.58% in patients with ITP and controls, respectively. CD4+CD25highFoxP3+ cells were 27.72±19.74% and 27.55±23.98% in ITP patients and controls, respectively. The percentages of both of these cell types were not statistically significant when compared to the control group. We did not find any differences in ratios of CD4+CD25+FoxP3+ Treg cells or CD8+CD28- T cells in lymphocytes between patients and healthy subjects. We conclude that these circulatory cells are not different in ITP, but further studies are needed to explore the putative roles of these regulatory cells.

Can antibodies with specificity for soluble antigens mimic the therapeutic effects of intravenous IgG in the treatment of autoimmune disease?

PubMed Central

Siragam, Vinayakumar; Brinc, Davor; Crow, Andrew R.; Song, Seng; Freedman, John; Lazarus, Alan H.

2005-01-01

Intravenous Ig (IVIg) mediates protection from the effects of immune thrombocytopenic purpura (ITP) as well as numerous other autoimmune states; however, the active antibodies within IVIg are unknown. There is some evidence that antibodies specific for a cell-associated antigen on erythrocytes are responsible, at least in part, for the therapeutic effect of IVIg in ITP. Yet whether an IVIg directed to a soluble antigen can likewise be beneficial in ITP or other autoimmune diseases is also unknown. A murine model of ITP was used to determine the effectiveness of IgG specific to soluble antigens in treating immune thrombocytopenic purpura. Mice experimentally treated with soluble OVA + anti-OVA versus mice treated with OVA conjugated to rbcs (OVA-rbcs) + anti-OVA were compared. In both situations, mice were protected from ITP. Both these experimental therapeutic regimes acted in a complement-independent fashion and both also blocked reticuloendothelial function. In contrast to OVA-rbcs + anti-OVA, soluble OVA + anti-OVA (as well as IVIg) did not have any effect on thrombocytopenia in mice lacking the inhibitory receptor FcγRIIB (FcγRIIB–/– mice). Similarly, antibodies reactive with the endogenous soluble antigens albumin and transferrin also ameliorated ITP in an FcγRIIB-dependent manner. Finally, broadening the significance of these experiments was the finding that anti-albumin was protective in a K/BxN serum–induced arthritis model. We conclude that IgG antibodies directed to soluble antigens ameliorated 2 disparate IVIg-treatable autoimmune diseases. PMID:15630455

SSTAC/ARTS review of the draft Integrated Technology Plan (ITP). Volume 1: Plenary Session

NASA Technical Reports Server (NTRS)

1991-01-01

Briefings from the plenary session of the conference on SSTAC/ARTS Review of the Draft Integrated Technology Plan (ITP) held on 24-28 Jun. 1991 are included. Viewgraphs from the presentations are included.

75 FR 49458 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

... Service (FAS) today accepted and began a review of a petition for trade adjustment assistance filed under... Assistance for Farmers Program Staff, FAS, USDA by phone: (202) 720-0638 or (202) 690- 0633; or by e-mail at: [email protected]fas.usda.gov ; or visit the TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa . Dated...

Design and Operation of Automated Ice-Tethered Profilers for Real-Time Seawater Observations in the Polar Oceans

DTIC Science & Technology

2006-06-01

of the system (up to 3 years depending on the profiling schedule ). Shortly after deployment, each ITP begins profiling the water column at its...was programmed with accelerated sampling schedules of multiple one-way traverses per day between 10 and 750-760 m depth in order to quickly evaluate endurance and component fatigue.

Theoretical Studies of Materials for High-Power Infrared Coatings

DTIC Science & Technology

1975-12-31

occurs when T reaches a value Tf fc 1000 K, as a rough estimate. Setting T = Tf in (8.2) and (8.3) and solving for It gives Itp =- ♦aCjVtra2...r tp « TH (^ Itp = (4KHtpTf/a)(traVaab8) . ^r tp X> TH . 1^5) 2 For the moment it is assumed that o. = 0.1 ffa , and that all...VIII Next consider the ratio < ^ >! /( Itp ),0ns. From (8.4) and (8.5), (VlUs dtp) lOns 3KH(lMs) Cja2 - 7.5 (8.8) where the numerical value

Levofloxacin-Induced Acute Immune-Mediated Thrombocytopenia of Rapid-Onset.

PubMed

Shih, Andrew W; Lam, Andy S; Warkentin, Theodore E

2018-04-01

Drug-induced immune thrombocytopenia (D-ITP) typically occurs after the patient has been receiving the implicated drug for at least 1 week, due to newly forming drug-dependent antibodies ("typical-onset" D-ITP). A "rapid-onset" form of D-ITP can occur when previous sensitization has occurred, where antibodies have thus already been formed, and a precipitous platelet count fall occurs upon reexposure. Typical-onset D-ITP has been reported after levofloxacin, but the rapid-onset form with a well-documented previous exposure has not been described. We report a 76-year-old male treated with levofloxacin for acute exacerbation of chronic obstructive pulmonary disease. After a single 750 mg oral dose of levofloxacin, his platelet count fell from 187 to 5 × 10 9 /L (nadir) over 4 days. Other causes of thrombocytopenia were ruled out. He had received a previous course of levofloxacin 6 months earlier. Discontinuation of levofloxacin and treatment with intravenous immunoglobulin and dexamethasone resulted in platelet count recovery. Levofloxacin-dependent antibodies were not detectable, consistent with the known low sensitivity of laboratory tests for drug-dependent antibodies, presumably indicating antibodies against levofloxacin metabolites, as is indirectly supported by the abrupt but relatively slow platelet count decline observed. This case illustrates a rapid-onset presentation of levofloxacin-induced D-ITP in the setting of previous drug exposure.

Immune Thrombocytopenic Purpura Detected with Oral Hemorrhage: a Case Report

PubMed Central

Sugiura, Tsutomu; Yamamoto, Kazuhiko; Murakami, Kazuhiro; Horita, Satoshi; Matsusue, Yumiko; Nakashima, Chie; Kirita, Tadaaki

2018-01-01

Immune thrombocytopenic purpura (ITP) is an immune-mediated acquired disease found in both adults and children. It is characterized by transient or persistent decreases in the platelet count. We report a case of ITP detected based on oral hemorrhagic symptoms. The patient was a 79-year-old female with no significant past medical history. She presented with sudden onset of gingival bleeding and hemorrhagic bullae on the buccal mucosa. Gingival bleeding was difficult to control. Laboratory tests revealed severe thrombocytopenia with a platelet count as low as 2000/μL. Under a provisional diagnosis of a hematological disorder, she was referred to a hematologist. A peripheral smear showed normal-sized platelets. A bone marrow examination revealed increased numbers of megakaryocytes without morphologic abnormalities. The patient was diagnosed with ITP and treated with a combination of pulsed steroid therapy and high-dose immunoglobulin therapy. However, her severe thrombocytopenia was refractory to these treatments. Then, a thrombopoietin receptor agonist was begun as a second-line treatment. Her platelets rapidly increased, and no bleeding complications were reported. Because oral symptoms can be one of the initial manifestations of ITP, dentists should be familiar with the clinical appearance of ITP, and attention must be paid to detect and diagnose unidentified cases. PMID:29854891

Effect of lipophilicity on microneedle-mediated iontophoretic transdermal delivery across human skin in vitro.

PubMed

Pawar, Kasturi R; Smith, Forrest; Kolli, Chandra Sekhar; Babu, R Jayachandra

2013-10-01

The effect of lipophilicity of drug on the microneedle (MN)-mediated iontophoretic delivery across dermatomed human skin was studied. Beta blockers with similar pKa but varied log P values were selected as model drugs in this study. Iontophoresis (ITP) or MNs, when used independently, increased the transdermal flux of beta blockers as compared with passive delivery (PD). ITP across the MN-treated skin (MN + ITP) increased the permeation rate of all beta blockers as compared with PD (p < 0.001). The enhancement ratios (ER) for hydrophilic molecules (atenolol and sotalol) were 71- and 78-fold higher for ITP + MN as compared with PD. However, for lipophilic molecule such as propranolol, there was 10-fold increase in the ER as compared with PD. These observations were further substantiated by the skin retention data; an inverse relationship between the skin retention and the hydrophilicity of the drug was observed. The results in the present study point out that the lipophilicity of the molecule plays a significant role on the electrically assisted transdermal delivery of drugs across the microporated skin. Using the combination of ITP + MN, hydrophilic drugs (atenolol and sotalol) were delivered at a much higher rate as compared with lipophilic molecules (propranolol and acebutolol). © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association.

The influence of isolated thoracoplasty on the evolution of pulmonary function after treatment of severe thoracic scoliosis.

PubMed

Koller, Heiko; Schulte, Tobias L; Meier, Oliver; Koller, Juliane; Bullmann, Viola; Hitzl, Wolfgang; Mayer, Michael; Lange, Tobias; Schmücker, Jens

2017-06-01

Isolated thoracoplasty (iTP) on the convex side is performed long time after scoliosis surgery has been performed. ITP is thought to cause a further decline in pulmonary function (PF); however, the amount of decline is ill defined. The objectives of this study were to examine the influence of iTP on the postoperative evolution of PF and rib hump reduction in patients that previously undergone scoliosis surgery. Over an 11-year period, 75 patients underwent iTP. The authors performed a retrospective case series review. Patients with data from PF tests performed preoperatively and at the last follow-up were included. Minimum follow-up was 12 months. The PF value reported was predicted FVC (FVC%). According to the American Thoracic Society, pulmonary impairment was classified as no impairment (FVC: >80-100%), mild (FVC: >65 ≤80%), moderate (FVC: >50 ≤65), and severe (FVC ≤50%). The outcome was studied using validated measures (SRS-24 score, COMI, and the COPD Assessment Test (CAT)). The CAT is stratified into mild impairment (<10 pts), moderate impairment (10-20 pts), severe impairment (>20-30 pts), and disabled (>30 pts). Twenty-six patients fulfilled the inclusion criteria. The patients' average age was 28 years at surgery with iTP, and 22 were females; the average BMI was 23, and the average follow-up was 76 months. Twenty of the patients had AIS, and six had congenital scoliosis. The time between scoliosis correction and iTP averaged 39 months. The mean number of resected rib segments was 7, and the mean blood loss was 834 ml. FVC% was 66% preoperatively and 57% at follow-up, with a significant change of 9% (p < .02). Fourteen patients had a FVC% change between preoperation and follow-up that was ≥5%; this change was not dependent on the preoperative FVC%. PF showed a slight but non-significant improvement with longer follow-up. At the time of iTP, the thoracic curve averaged 67°, and thoracic kyphosis averaged 46°. Rib hump height was 34 mm before iTP and 15 mm at follow-up (p < .03). At follow-up, the SRS-24 score was 81, the COMI score was 4 points, and the CAT score was 8 points. Eight patients had a CAT >10. Two patients had a major complication. A comparison of patients with pulmonary impairment preoperation vs. follow-up found 4 vs. 1 patients had no PF impairment, 8 vs. 4 patients had mild impairment, 10 vs. 13 patients had moderate impairment, and 4 vs. 8 patients had severe impairment. Isolated TP was shown an effective technique for rib hump resection. Six years after iTP, the FVC% declined by an average of 9%. Several patients had long-lasting effects in terms of %FVC decline. iTP should be reserved for patients with significant rib hump deformity.

Hospitalizations in pediatric patients with immune thrombocytopenia in the United States

PubMed Central

Tarantino, Michael D.; Danese, Mark; Klaassen, Robert J.; Duryea, Jennifer; Eisen, Melissa; Bussel, James

2016-01-01

Abstract To examine utilization and outcomes in pediatric immune thrombocytopenia (ITP) hospitalizations, we used ICD-9 code 287.31 to identify hospitalizations in patients with ITP in the 2009 HCUP KID, an all-payer sample of pediatric hospitalizations from US community hospitals. Diagnosis and procedure codes were used to estimate rates of ITP-related procedures, comorbidity prevalence, costs, length of stay (LOS), and mortality. In 2009, there were an estimated 4499 hospitalizations in children aged 6 months–17 years with ITP; 43% in children aged 1–5 years; and 47% with emergency department encounters. The mean hospitalization cost was $5398, mean LOS 2.0 days, with 0.3% mortality (n = 13). With any bleeding (15.2%, including gastrointestinal 2.0%, hematuria 1.3%, intracranial hemorrhage [ICH] 0.6%), mean hospitalization cost was $7215, LOS 2.5 days, with 1.5% mortality. For ICH (0.6%, n = 27), mean cost was $40 209, LOS 8.5 days, with 21% mortality. With infections (14%, including upper respiratory 5.2%, viral 4.9%, bacterial 1.9%), the mean cost was $6928, LOS 2.9 days, with 0.9% mortality. Septic shock was reported in 0.3% of discharges. Utilization included immunoglobulin administration (37%) and splenectomies (2.3%). Factors associated with higher costs included age >6 years, ICH, hematuria, transfusion, splenectomy, and bone marrow diagnostics (p < 0.05). In conclusion, of the 4499 hospitalizations with ITP, mortality rates of 1.5%, 21%, and 0.9% were seen with any bleeding, ICH, and infection, respectively. Higher costs were associated with clinically significant bleeding and procedures. Future analyses may reveal effects of the implementation of more recent ITP guidelines and use of additional treatments. PMID:26941022

Roles of CDX2 and EOMES in human induced trophoblast progenitor cells

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

Chen, Ying, E-mail: ying.chen@hc.msu.edu; Wang, Kai; Gong, Yun Guo

Highlights: ► CDX2 and EOMES play critical roles in human induced trophoblast progenitors (iTP). ► iTP cells directly transformed from fibroblasts. ► Differentiation of iTP cells into extravillous trophoblasts and syncytiotrophoblasts. -- Abstract: Abnormal trophoblast lineage proliferation and differentiation in early pregnancy have been associated with the pathogenesis of placenta diseases of pregnancy. However, there is still a gap in understanding the molecular mechanisms of early placental development due to the limited primary trophoblast cultures and fidelity of immortalized trophoblast lines. Trophoblasts stem (TS) cells, an in vitro model of trophectoderm that can differentiate into syncytiotrophoblasts and extravillous trophoblasts, canmore » be an attractive tool for early pregnancy research. TS cells are well established in mouse but not in humans due to insufficient knowledge of which trophoblast lineage-specific transcription factors are involved in human trophectoderm (TE) proliferation and differentiation. Here, we applied induced pluripotent stem cell technique to investigate the human trophoblast lineage-specific transcription factors. We established human induced trophoblast progenitor (iTP) cells by direct reprogramming the fibroblasts with a pool of mouse trophoblast lineage-specific transcription factors consisting of CDX2, EOMES, and ELF5. The human iTP cells exhibit epithelial morphology and can be maintained in vitro for more than 2 months. Gene expression profile of these cells was tightly clustered with human trophectoderm but not with human neuron progenitor cells, mesenchymal stem cells, or endoderm cells. These cells are capable of differentiating into cells with an invasive capacity, suggesting extravillous trophoblasts. They also form multi-nucleated cells which secrete human chorionic gonadotropin and estradiol, consistent with a syncytiotrophoblast phenotype. Our results provide the evidence that transcription factors CDX2 and EOMES may play critical roles in human iTP cell generation.« less

Working alliance, interpersonal trust and perceived coercion in mental health review hearings

PubMed Central

2011-01-01

Background There is some evidence that when mental health commitment hearings are held in accordance with therapeutic jurisprudence principles they are perceived as less coercive, and more just in their procedures leading to improved treatment adherence and fewer hospital readmissions. This suggests an effect of the hearing on therapeutic relationships. We compared working alliance and interpersonal trust in clinicians and forensic patients, whose continued detentions were reviewed by two different legal review bodies according to their legal category. Methods The hearings were rated as positive or negative by patients and treating psychiatrists using the MacArthur scales for perceived coercion, perceived procedural justice (legal and medical) and for the impact of the hearing. We rated Global assessment of Function (GAF), Positive and Negative Symptom Scale (PANSS), Working Alliance Inventory (WAI) and Interpersonal Trust in Physician (ITP) scales six months before the hearing and repeated the WAI and ITP two weeks before and two weeks after the hearing, for 75 of 83 patients in a forensic medium and high secure hospital. Results Psychiatrists agreed with patients regarding the rating of hearings. Patients rated civil hearings (MHTs) more negatively than hearings under insanity legislation (MHRBs). Those reviewed by MHTs had lower scores for WAI and ITP. However, post-hearing WAI and ITP scores were not different from baseline and pre-hearing scores. Using the receiver operating characteristic, baseline WAI and ITP scores predicted how patients would rate the hearings, as did baseline GAF and PANSS scores. Conclusions There was no evidence that positively perceived hearings improved WAI or ITP, but some evidence showed that negatively perceived hearings worsened them. Concentrating on functional recovery and symptom remission remains the best strategy for improved therapeutic relationships. PMID:22074788

Band-broadening suppressed effect in long turned geometry channel and high-sensitive analysis of DNA sample by using floating electrokinetic supercharging on a microchip.

PubMed

Xu, Zhongqi; Murata, Kenji; Arai, Akihiro; Hirokawa, Takeshi

2010-03-12

A featured microchip owning three big reservoirs and long turned geometry channel was designed to improve the detection limit of DNA fragments by using floating electrokinetic supercharging (FEKS) method. The novel design matches the FEKS preconcentration needs of a large sample volume introduction with electrokinetic injection (EKI), as well as long duration of isotachophoresis (ITP) process to enrich low concentration sample. In the curved channel [ approximately 45.6 mm long between port 1 (P1) and the intersection point of two channels], EKI and ITP were performed while the side port 3 (P3) was electrically floated. The turn-induced band broadening with or without ITP process was investigated by a computer simulation (using CFD-ACE+ software) when the analytes traveling through the U-shaped geometry. It was found that the channel curvature determined the extent of band broadening, however, which could be effectively eliminated by the way of ITP. After the ITP-stacked zones passed the intersection point from P1, they were rapidly destacked for separation and detection from ITP to zone electrophoresis by using leading ions from P3. The FEKS carried on the novel chip successfully contributed to higher sensitivities of DNA fragments in comparison with our previous results realized on either a single channel or a cross microchip. The analysis of low concentration 50 bp DNA step ladders (0.23 mugml after 1500-fold diluted) was achieved with normal UV detection at 260 nm. The obtained limit of detections (LODs) were on average 100 times better than using conventional pinched injection, down to several ngml for individual DNA fragment.

FERMI/GLAST Integrated Trending and Plotting System Release 5.0

NASA Technical Reports Server (NTRS)

Ritter, Sheila; Brumer, Haim; Reitan, Denise

2012-01-01

An Integrated Trending and Plotting System (ITPS) is a trending, analysis, and plotting system used by space missions to determine performance and status of spacecraft and its instruments. ITPS supports several NASA mission operational control centers providing engineers, ground controllers, and scientists with access to the entire spacecraft telemetry data archive for the life of the mission, and includes a secure Web component for remote access. FERMI/GLAST ITPS Release 5.0 features include the option to display dates (yyyy/ddd) instead of orbit numbers along orbital Long-Term Trend (LTT) plot axis, the ability to save statistics from daily production plots as image files, and removal of redundant edit/create Input Definition File (IDF) screens. Other features are a fix to address invalid packet lengths, a change in naming convention of image files in order to use in script, the ability to save all ITPS plot images (from Windows or the Web) as GIF or PNG format, the ability to specify ymin and ymax on plots where previously only the desired range could be specified, Web interface capability to plot IDFs that contain out-oforder page and plot numbers, and a fix to change all default file names to show yyyydddhhmmss time stamps instead of hhmmssdddyyyy. A Web interface capability sorts files based on modification date (with newest one at top), and the statistics block can be displayed via a Web interface. Via the Web, users can graphically view the volume of telemetry data from each day contained in the ITPS archive in the Web digest. The ITPS could be also used in nonspace fields that need to plot data or trend data, including financial and banking systems, aviation and transportation systems, healthcare and educational systems, sales and marketing, and housing and construction.

Operational Improvements From the In-Trail Procedure in the North Atlantic Organized Track System

NASA Technical Reports Server (NTRS)

Chartrand, Ryan C.; Bussink, Frank J. L.; Graff, Thomas J.; Murdoch, Jennifer L.; Jones, Kenneth M.

2008-01-01

This paper explains the computerized batch processing experiment examining the operational impacts of the introduction of Automatic Dependent Surveillance-Broadcast (ADS-B) equipment and the In-Trail Procedure (ITP) to the North Atlantic Organized Track System (NATOTS). This experiment was conducted using the Traffic Manager (TMX), a desktop simulation capable of simulating airspace environments and aircraft operations. ADS-B equipment can enable the use of new ground and airborne procedures, such as the ITP. The ITP is among the first of these new procedures, which will make use of improved situation awareness in the local surrounding airspace of ADS-B equipped aircraft to enable more efficient oceanic flight level changes. The data collected were analyzed with respect to multiple operationally relevant parameters including fuel burn, request approval rates, and the distribution of fuel savings. This experiment showed that through the use of ADS-B or ADS-B and the ITP that operational improvements and benefits could be achieved.

Operational Improvements From Using the In-Trail Procedure in the North Atlantic Organized Track System

NASA Technical Reports Server (NTRS)

Chartrand, Ryan C.; Bussink, Frank J.; Graff, Thomas J.; Jones, Kenneth M.

2009-01-01

This paper explains the computerized batch processing experiment examining the operational impacts of the introduction of Automatic Dependent Surveillance-Broadcast (ADS-B) equipment and the In-Trail Procedure (ITP) to the North Atlantic Organized Track System. This experiment was conducted using the Traffic Manager (TMX), a desktop simulation capable of simulating airspace environments and aircraft operations. ADS-B equipment can enable the use of new ground and airborne procedures, such as the ITP. ITP is among the first of these new procedures, which will make use of improved situation awareness in the local surrounding airspace of ADS-B equipped aircraft to enable more efficient oceanic flight level changes. The collected data were analyzed with respect to multiple operationally relevant parameters including fuel burn, request approval rates, and the distribution of fuel savings. This experiment showed that through the use of ADS-B or ADS-B and the ITP that operational improvements and benefits could be achieved.

In-tank precipitation facility (ITP) and H-Tank Farm (HTF) geotechnical report, WSRC-TR-95-0057, Revision 0, Volume 5

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

NONE

A geotechnical study has been completed in H-Area for the In-Tank Precipitation Facility (ITP) and the balance of the H-Area Tank Farm (HTF) at the Savannah River Site (SRS) in South Carolina. The study consisted of subsurface field exploration, field and laboratory testing, and engineering analyses. The purpose of these investigations is to evaluate the overall stability of the H-Area tanks under static and dynamic conditions. The objectives of the study are to define the site-specific geological conditions at ITP and HTF, obtain engineering properties for the assessment of the stability of the native soils and embankment under static andmore » dynamic loads (i.e., slope stability, liquefaction potential, and potential settlements), and derive properties for soil-structure interaction studies. This document (Volume 5) contains the laboratory test results for the In-Tank Precipitation Facility (ITP) and H-Tank Farm (HTF) Geotechnical Report.« less

A-Scan Ultrasound Measurement of Ocular Changes during Accommodation.

DTIC Science & Technology

1987-04-01

r.I.FMt# I. F’riUECT TASK AREA & WORK UNIT NUMBERSAF [T S’LUt)I’ENT AT: Pacific University SI.- ITP )LtIG oF FICE NAME AND ADDRESS 12. REPORT DATE A1FIT...analysis of the distribution made. This involved writing a program on the IBM PCAT which would generate, and statistically analyze three findings grouped in

A Program for Storing Oceanographic Data on Magnetic Tape

DTIC Science & Technology

1975-03-31

PRCPeR (TMA.TNlt.TDX.X^A.YNA.x^B.YMB’.XDtVD) SCPUTES THE X-Y cesHri^ATts ra» PLSTTING BATHYMETRY PRSGBA^ER ■ LE8N LA LU- itPE - C9DE...R IBM 1130 INPUT, IDEP MT ■ OUTPUT, KCDF KCDM MTDC INTERNAL NUDF WUDF WUOM wCaR • UNCBRRECTtn nfePTH IN FATHfiMS MATTHEWS TABLE

Safety and Performance Analysis of the Non-Radar Oceanic/Remote Airspace In-Trail Procedure

NASA Technical Reports Server (NTRS)

Carreno, Victor A.; Munoz, Cesar A.

2007-01-01

This document presents a safety and performance analysis of the nominal case for the In-Trail Procedure (ITP) in a non-radar oceanic/remote airspace. The analysis estimates the risk of collision between the aircraft performing the ITP and a reference aircraft. The risk of collision is only estimated for the ITP maneuver and it is based on nominal operating conditions. The analysis does not consider human error, communication error conditions, or the normal risk of flight present in current operations. The hazards associated with human error and communication errors are evaluated in an Operational Hazards Analysis presented elsewhere.

U.S. Food and Drug Administration approval summary: Eltrombopag for the treatment of pediatric patients with chronic immune (idiopathic) thrombocytopenia.

PubMed

Ehrlich, Lori A; Kwitkowski, Virginia E; Reaman, Gregory; Ko, Chia-Wen; Nie, Lei; Pazdur, Richard; Farrell, Ann T

2017-12-01

The U.S. Food and Drug Administration (FDA) approved eltrombopag for pediatric patients with chronic immune (idiopathic) thrombocytopenia (ITP) ages ≥6 on June 11, 2015, and ages ≥1 on August 24, 2015. Approval was based on the FDA review of two randomized trials that included 159 pediatric patients with chronic ITP who had an insufficient response to corticosteroids, immunoglobulins, or splenectomy. This manuscript describes the basis for approval of these applications. The FDA concluded that eltrombopag has shown efficacy and a favorable benefit to risk profile for pediatric patients with chronic ITP. © 2017 Wiley Periodicals, Inc.

HLW system plan - revision 2

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

Not Available

1994-01-14

The projected ability of the Tank Farm to support DWPF startup and continued operation has diminished somewhat since revision 1 of this Plan. The 13 month delay in DWPF startup, which actually helps the Tank Farm condition in the near term, was more than offset by the 9 month delay in ITP startup, the delay in the Evaporator startups and the reduction to Waste Removal funding. This Plan does, however, describe a viable operating strategy for the success of the HLW System and Mission, albeit with less contingency and operating flexibility than in the past. HLWM has focused resources frommore » within the division on five near term programs: The three evaporator restarts, DWPF melter heatup and completion of the ITP outage. The 1H Evaporator was restarted 12/28/93 after a 9 month shutdown for an extensive Conduct of Operations upgrade. The 2F and 2H Evaporators are scheduled to restart 3/94 and 4/94, respectively. The RHLWE startup remains 11/17/97.« less

Evaluation of resveratrol, green tea extract, curcumin, oxaloacetic acid, and medium-chain triglyceride oil on life span of genetically heterogeneous mice.

PubMed

Strong, Randy; Miller, Richard A; Astle, Clinton M; Baur, Joseph A; de Cabo, Rafael; Fernandez, Elizabeth; Guo, Wen; Javors, Martin; Kirkland, James L; Nelson, James F; Sinclair, David A; Teter, Bruce; Williams, David; Zaveri, Nurulain; Nadon, Nancy L; Harrison, David E

2013-01-01

The National Institute on Aging Interventions Testing Program (ITP) was established to evaluate agents that are hypothesized to increase life span and/or health span in genetically heterogeneous mice. Each compound is tested in parallel at three test sites. It is the goal of the ITP to publish all results, negative or positive. We report here on the results of lifelong treatment of mice, beginning at 4 months of age, with each of five agents, that is, green tea extract (GTE), curcumin, oxaloacetic acid, medium-chain triglyceride oil, and resveratrol, on the life span of genetically heterogeneous mice. Each agent was administered beginning at 4 months of age. None of these five agents had a statistically significant effect on life span of male or female mice, by log-rank test, at the concentrations tested, although a secondary analysis suggested that GTE might diminish the risk of midlife deaths in females only.

Evaluation of Resveratrol, Green Tea Extract, Curcumin, Oxaloacetic Acid, and Medium-Chain Triglyceride Oil on Life Span of Genetically Heterogeneous Mice

PubMed Central

Miller, Richard A.; Astle, Clinton M.; Baur, Joseph A.; de Cabo, Rafael; Fernandez, Elizabeth; Guo, Wen; Javors, Martin; Kirkland, James L.; Nelson, James F.; Sinclair, David A.; Teter, Bruce; Williams, David; Zaveri, Nurulain; Nadon, Nancy L.; Harrison, David E.

2013-01-01

The National Institute on Aging Interventions Testing Program (ITP) was established to evaluate agents that are hypothesized to increase life span and/or health span in genetically heterogeneous mice. Each compound is tested in parallel at three test sites. It is the goal of the ITP to publish all results, negative or positive. We report here on the results of lifelong treatment of mice, beginning at 4 months of age, with each of five agents, that is, green tea extract (GTE), curcumin, oxaloacetic acid, medium-chain triglyceride oil, and resveratrol, on the life span of genetically heterogeneous mice. Each agent was administered beginning at 4 months of age. None of these five agents had a statistically significant effect on life span of male or female mice, by log-rank test, at the concentrations tested, although a secondary analysis suggested that GTE might diminish the risk of midlife deaths in females only. PMID:22451473

ITP: hematology's Cosette from Les Misérables.

PubMed

Rao, V Koneti

2013-03-14

In this issue of Blood, Gudbrandsdottir et al from Denmark report that in the largest multicenter cohort to date comprising newly diagnosed adults with primary immune thrombocytopenia (ITP), addition of rituximab (RTX) to high-dose dexamethasone (DEX) as first-line therapy yields higher sustained response rates.

Complement Activation on Platelets Correlates with a Decrease in Circulating Immature Platelets in Patients with Immune Thrombocytopenic Purpura

PubMed Central

Peerschke, Ellinor I.B.; Andemariam, Biree; Yin, Wei; Bussel, James B.

2010-01-01

The role of the complement system in immune thrombocytopenic purpura (ITP) is not well defined. We examined plasma from 79 patients with ITP, 50 healthy volunteers, and 25 patients with non-immune mediated thrombocytopenia, to investigate their complement activation/fixation capacity (CAC) on immobilized heterologous platelets. Enhanced CAC was found in 46 plasma samples (59%) from patients with ITP, but no samples from patients with non-immune mediated thrombocytopenia. Plasma from healthy volunteers was used for comparison. In patients with ITP, an enhanced plasma CAC was associated with a decreased circulating absolute immature platelet fraction (A-IPF) (<15 × 109/L) (p = 0.027) and thrombocytopenia (platelet count less than 100K/μl) (p= 0.024). The positive predictive value of an enhanced CAC for a low A-IPF was 93%, with a specificity of 77%. The specificity and positive predictive values increased to 100% when plasma CAC was defined strictly by enhanced C1q and/or C4d deposition on test platelets. Although no statistically significant correlation emerged between CAC and response to different pharmacologic therapies, an enhanced response to splenectomy was noted (p <0.063). Thus, complement fixation may contribute to the thrombocytopenia of ITP by enhancing clearance of opsonized platelets from the circulation, and/or directly damaging platelets and megakaryocytes. PMID:19925495

Is there any Role for Splenectomy in Adulthood Onset Chronic Immun e Thrombocytopenia in the Era of TPO Receptors Agonists? A Critic al Overview.

PubMed

Vibor, Milunovic; Rogulj, Inga Mandac; Ostojic, Slobodanka Kolonic

2017-07-04

Immune thrombocytopenia (ITP) in adulthood is characterized by chronic relapsing course. Despite the efficacious first line treatment (corticosteroid, intravenous immunoglobulin), majority of patients will enter the chronic phase warranting another treatment approach. Until recently, splenectomy performed in ITP chronic phase represented the standard of care with longterm remissions in more than 70% of patients, but it has never been tested in clinical trials. However, with the advances of our understanding of ITP pathophysiology and the shifting focus on megakaryocyte impairment, novel drugs were introduced in the treatment paradigm, mainly trombopoietin receptor agonists (TPO-RAs); romiplostim and eltrombopag. These TPO-RAs were tested in randomized controlled trials resulting in adequate platelet response with few side effects and less need for additional therapy leading to approval of corresponding regulatory agencies and wide acceptance by hematological community, but however TPO-RAs must be taken continuously to maintain the response. With their onset, the rate of splenectomy in chronic ITP has diminished in modern era. The main aim behind conducting this review is to evaluate the pros and cons of splenectomy compared to TPO-RAs treatment in order to provide the critical overview which may help the practicing clinician in managing often challenging cases of chronic ITP. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Cerebral Venous Thrombosis after Intravenous Immunoglobulin Therapy in Immune Thrombocytopenic Purpura

PubMed Central

James, Joe; Shiji, P. V.; Radhakrishnan, Chandni

2017-01-01

A common misconception is that immune thrombocytopenic purpura (ITP) causes only bleeding diathesis. From this case vignette of a young male with ITP who had cerebral venous thrombosis, we highlight the importance of considering venous thrombosis in such patients when they present with focal cerebral signs. PMID:29307971

Towards an Integrative Theory of Peace Education

ERIC Educational Resources Information Center

Danesh, H. B.

2006-01-01

This paper proposes the integrative theory of peace (ITP) and briefly outlines the education for peace curriculum (EFP) developed on the basis of this theory. ITP is based on the concept that peace is, at once, a psychological, social, political, ethical and spiritual state with its expressions in intrapersonal, interpersonal, intergroup,…

A disease-specific measure of health-related quality of life in adults with chronic immune thrombocytopenic purpura: psychometric testing in an open-label clinical trial.

PubMed

Mathias, Susan D; Bussel, James B; George, James N; McMillan, Robert; Okano, Gary J; Nichol, Janet L

2007-05-01

The Immune Thrombocytopenic Purpura Patient Assessment Questionnaire (ITP-PAQ) was developed to assess disease-specific quality of life (QoL) in adults with ITP. It is a 44-item questionnaire that includes scales for physical health (symptoms, fatigue/sleep, bother, and activity), emotional health (psychological and fear), overall QoL, social activity, women's reproductive health, and work. A previous study reported preliminary evidence of its reliability and validity. The present study was conducted to ascertain the responsiveness (ability to detect a clinically important treatment effect), reliability, and validity of the ITP-PAQ and to corroborate the earlier findings. The women's reproductive health scale was evaluated for psychometric evidence of the existence of separate menstrual symptoms and fertility subscales. The ITP-PAQ was evaluated in the context of an ongoing open-label extension study assessing the tolerability and durability of increases in the platelet count with AMG 531 (a thrombopoiesis peptibody that increases platelet production by targeting the thrombopoietin receptor) administered by subcutaneous injection once weekly in adult patients with ITP It was self-administered at baseline and at weeks 4, 12, and 24. The responsiveness of the questionnaire was evaluated by calculating and comparing the change scores of patients who showed clinical improvement-categorized as platelet responders (those with a platelet count > or =50 x 10(9) cells/L and a doubling of baseline values at week 24) and durable platelet responders (those with a platelet count > or =50 x 10(9) cells/L and a doubling of baseline values on > or =6 occasions during weeks 17-24)-with the change scores of patients wh did not show clinical improvement. The reliability (internal consistency and test-retest) and validity (convergent, discriminant, and known groups) of the questionnaire were also evaluated. Validity was examined in terms of correlations between the ITP-PAQ and the 36-item Short-Form Health Survey (SF-36), a generic measure of health-related QoL. Thirty-four patients completed the ITP-PAQ. Most of the scales were found capable of detecting clinically important treatment effects, with the scales for symptoms, fatigue/sleep, bother, and activity being particularly responsive. All scales were found to have internal consistency reliability (Cronbach's alpha, 0.700-0.950), with the exceptions of the menstrual symptoms subscale (0.988 and 0.959 at weeks 12 and 24, respectively) and the work scale (0.691 at week 24). Test-retest reliability was acceptable (intraclass correlation coefficient, 0.725-0.867), with the exceptions of the scales for symptoms (0.677) and women's reproductive health (0.592) and the fertility subscale (0.171). Construct validity was supported by correlations between specific ITP-PAQ and SF-36 scales, with the exceptions of the menstrual symptoms and fertility subscales. Discriminant validity was reported for the symptoms, fatigue/sleep, bother, and activity scales. Durable platelet responders had significantly better scores than nonresponders on the symptoms (P = 0.022), bother (P = 0.008), psychological (P = 0.033), and overall QoL scales (P = 0.032). Compared with those who had undergone splenectomy, patients without splenectomy had significantly higher scores on the women's reproductive health scale (P = 0.03). The results of this analysis indicate that the ITP-PAQ has acceptable responsiveness, reliability, and validity. Further study of the minimal clinically important difference in ITP-PAQ scale scores is needed.

Low-dose vincristine in the treatment of corticosteroid-refractory idiopathic thrombocytopenic purpura (ITP) in non-splenectomized patients.

PubMed Central

Cervantes, F.; Montserrat, E.; Rozman, C.; Diumenjo, C.; Feliu, E.; Grañena, A.

1980-01-01

Eight non-splenectomized patients with corticosteroid-refractory idiopathic thrombocytopenic purpura (ITP) were treated with low-dose vincristine (1 mg/week up to a total dose of 4 mg). Complete remission was achieved in 2 cases and partial remission in 3. Bleeding stopped in one patient who failed to remit. No statistical relationship was found between the response to vincristine and the duration of the disease or the corticosteroid-therapy. Side effects were only observed in one patient. By comparing these results with those reported in the literature, it can be inferred that low-dose vincristine may be useful in the management of corticosteroid-refractory ITP. PMID:7194478

Perspectives of New Trades Tutors: Boundary Crossing between Vocational Identities

ERIC Educational Resources Information Center

Chan, Selena

2012-01-01

This article reports on a study of the perspectives of new tutors teaching traditional vocational trades who recently commenced teaching in the Institutes of Technologies and Polytechnics (ITPs) sector in New Zealand. The perspectives are collated from questionnaires and interviews of 13 tutors, from five ITPs, who have been teaching full-time for…

Risk of thrombosis with anti-phospholipid syndrome in systemic lupus erythematosus treated with thrombopoietin-receptor agonists.

PubMed

Guitton, Zelie; Terriou, Louis; Lega, Jean-Christophe; Nove-Josserand, Raphaele; Hie, Miguel; Amoura, Zahir; Bussel, James B; Hamidou, Mohamed; Rosenthal, Eric; Lioger, Bertrand; Chauveau, Dominique; Chaminade, Axel; Magy-Bertrand, Nadine; Michel, Marc; Audia, Sylvain; Godeau, Bertrand; Mahevas, Matthieu

2018-05-10

The use of thrombopoietin-receptor agonists (TPO-RAs) has increased as a second-line therapy in ITP, but the efficacy and safety of such drugs has not been evaluated in SLE-associated ITP. This was a multicentre retrospective cohort study from 2009 to 2016. Participating centres (n = 11) were secondary- or tertiary-care hospitals belonging to the French national network for adult ITP. We included 18 patients with SLE-ITP treated with TPO-RAs; 10 (55%) had aPL, 5 (27%) showing definite APS. Except for one patient, all (94%) achieved response with TPO-RAs overall. After a median follow-up of 14.7 months with TPO-RAs, four arterial thrombosis events (including one catastrophic APS) occurred in four patients. Two venous thrombosis events occurred in a patient without APS or aPLs. Our results suggest that aPLs should be systematically screened before TPO-RA initiation in patients with SLE. With aPL positivity, alternative therapy should be discussed (if possible), especially in patients with definite APS or suboptimal adherence to anti-coagulation therapy.

Sensitive determination of anions in saliva using capillary electrophoresis after transient isotachophoretic preconcentration.

PubMed

Xu, Zhongqi; Doi, Takayuki; Timerbaev, Andrei R; Hirokawa, Takeshi

2008-10-19

A transient isotachophoresis-capillary electrophoresis (tITP-CE) system for the determination of minor inorganic anions in saliva is described. The complete separation and quantification of bromide, iodide, nitrate, nitrite, and thiocyanate has been achieved with only centrifugation and dilution of the saliva sample. In-line tITP preconcentration conditions, created by introduction of the plugs of 5 mM dithionic acid (leading electrolyte) and 10 mM formic acid (terminating electrolyte) before and after the sample zone, respectively, allowed the limits of direct UV absorption detection (at 200 nm) to be up to 50-fold improved as compared with CE without tITP. As a result, nitrate and thiocyanate were still detectable at 4.6 and 3.8 microgl(-1), respectively, in 1000 times diluted saliva. The daily variations of anionic concentrations in saliva samples taken from a smoking health volunteer were discussed based on the results of tITP-CE analysis. It was confirmed that the thiocyanate concentration in saliva noticeably increased after smoking. This is apparently the first report on simultaneous quantification of more than four anionic salivary constituents using CE.

Desialylation is a mechanism of Fc-independent platelet clearance and a therapeutic target in immune thrombocytopenia

PubMed Central

Li, June; van der Wal, Dianne E.; Zhu, Guangheng; Xu, Miao; Yougbare, Issaka; Ma, Li; Vadasz, Brian; Carrim, Naadiya; Grozovsky, Renata; Ruan, Min; Zhu, Lingyan; Zeng, Qingshu; Tao, Lili; Zhai, Zhi-min; Peng, Jun; Hou, Ming; Leytin, Valery; Freedman, John; Hoffmeister, Karin M.; Ni, Heyu

2015-01-01

Immune thrombocytopenia (ITP) is a common bleeding disorder caused primarily by autoantibodies against platelet GPIIbIIIa and/or the GPIb complex. Current theory suggests that antibody-mediated platelet destruction occurs in the spleen, via macrophages through Fc–FcγR interactions. However, we and others have demonstrated that anti-GPIbα (but not GPIIbIIIa)-mediated ITP is often refractory to therapies targeting FcγR pathways. Here, we generate mouse anti-mouse monoclonal antibodies (mAbs) that recognize GPIbα and GPIIbIIIa of different species. Utilizing these unique mAbs and human ITP plasma, we find that anti-GPIbα, but not anti-GPIIbIIIa antibodies, induces Fc-independent platelet activation, sialidase neuraminidase-1 translocation and desialylation. This leads to platelet clearance in the liver via hepatocyte Ashwell–Morell receptors, which is fundamentally different from the classical Fc–FcγR-dependent macrophage phagocytosis. Importantly, sialidase inhibitors ameliorate anti-GPIbα-mediated thrombocytopenia in mice. These findings shed light on Fc-independent cytopenias, designating desialylation as a potential diagnostic biomarker and therapeutic target in the treatment of refractory ITP. PMID:26185093

Efficacy and safety of a new intravenous immunoglobulin 10% formulation (octagam® 10%) in patients with immune thrombocytopenia.

PubMed

Robak, Tadeusz; Mainau, Claudia; Pyringer, Barbara; Chojnowski, Krzysztof; Warzocha, Krzysztof; Dmoszynska, Anna; Straub, Jan; Imbach, Paul

2010-10-01

Intravenous immunoglobulin (IVIg) has an established role in the treatment of immune thrombocytopenia (ITP). The safety and efficacy of a new ready-to-use IVIg 10% formulation (octagam(®) 10%) were investigated in a prospective phase III study in 116 adult patients with ITP (platelet count ≤20×10(9)/l). Sixty-six patients had chronic ITP and 49 were newly diagnosed. Patients received octagam 10% 1 g/kg/day on two consecutive days; infusion rate was adjusted according to tolerability to a maximum of 0·12 ml/kg/minute. Eighty per cent of patients attained the primary efficacy endpoint of clinical response (platelet count ≥50×10(9)/l within 6 days of dosing). The median time to response was 2 days and the median duration of response was 12 days; mean response duration was 24·1 days. octagam 10% was well tolerated and effective in this population representative of adult patients with ITP, even at the maximum infusion rate of 0·12 ml/kg/minute, without unexpected safety issues.

A sticky situation: myocardial infarction in a young woman with immune thrombocytopenia on eltrombopag and a history of mediastinal radiation.

PubMed

Teichman, Jennifer; Taher, Ahmed; Hashi, Abdulaziz; Bagai, Akshay; Sholzberg, Michelle

2018-01-01

More recent immune thrombocytopenia (ITP) treatment strategies enhance platelet production with the use of thrombopoietin receptor agonists (TPO-RA) such as eltrombopag. Patients receiving TPO-RA agents may be at an increased risk of thromboembolism, however the pathophysiology and common underlying risk factors are not well understood. We present the case of a young asplenic woman on eltrombopag for chronic ITP with acute myocardial infarction involving the right coronary artery. Past medical history was significant for remote mediastinal radiation for lymphoma and splenectomy for ITP. She had no other risk factors for coronary artery disease. She underwent coronary catheterization and balloon angioplasty to the culprit lesion, although stenting was deferred due to concerns with dual antiplatelet therapy. She was discharged from hospital on single antiplatelet therapy with acetylsalicylic acid. We believe that the patient's ITP, recent eltrombopag use, surgical asplenia and history of mediastinal radiation synergistically contributed to her myocardial infarction. The risks of bleeding and thromboembolism must be carefully weighed in patients receiving TPO-RA therapy.

[Primary immune thrombocytopenia in adults in Mexico: national characteristics and the relation to international literature].

PubMed

Meillón-García, Luis Antonio; García-Chávez, Jaime; Gómez-Almaguer, David; Gutiérrez-Espíndola, Guillermo R; Martínez-Murillo, Carlos

2014-01-01

In order to identify the clinical approach of a sample of Mexican hematologists for primary immune thrombocytopenia (ITP) in adults in Mexico, we applied an electronic survey via the internet to identify common practices for the diagnosis and treatment of ITP and draw a comparison between the information from these hematologists with international guidelines or the international literature. The results were analyzed using measures of central tendency. The sample was 21 medical hematologists, predominantly from Mexico City (average age: 51.4 years). A total of 66.7% of the surveyed physicians use international guidelines to make therapeutic decisions, and 43% defined ITP including the numerical concept (< 100 x 10(9)/l). We found some differences between requested clinical exams and tests indicated by the guidelines. In first-line treatment (except emergency), 91% of the participants start with prednisone and 24% use dexamethasone. Danazol is used in persistent ITP by most (41%) of the specialists. In second-line treatment, 67% would indicate splenectomy. Some differences were found between clinical practice of the hematologists in Mexico versus guidelines recommendations.

Occult hemorrhage in children with severe ITP.

PubMed

Flores, Adolfo; Buchanan, George R

2016-03-01

Little is known about the frequency and significance of clinically unapparent or occult hemorrhage in ITP. Therefore, we prospectively explored the sites and frequency of occult bleeding in children with severe ITP at diagnosis or upon symptomatic relapse in a prospective, single-institution cohort study of patients ≤ 18 years of age and a platelet count ≤ 10,000/mm(3) . Data collected included bleeding severity assessment, urinalysis, fecal occult blood testing, and non-contrast brain MRI. Stool and urine samples were tested within 7 days of diagnosis or symptomatic relapse. Three months after diagnosis or relapse a noncontrast brain MRI evaluated hemosiderin deposits resulting from prior localized hemorrhage. Fifty-two ITP patients were enrolled with a mean platelet count of 4,000/mm(3) . A significant occurrence of occult hemorrhage was identified in the urine (27%) compared with clinically overt hematuria (0.91%, P < 0.0005). CNS microbleeding in the superficial cortex of the left frontal lobe was identified in one child with occult bleeding in the urinary tract. There was no relationship between occult hemorrhage and bleeding manifestations on physical examination. Occult hemorrhage was not a harbinger of subsequent bleeding. Our findings suggest that occult hemorrhage occurs with greater frequency than overt bleeding in children with severe ITP. CNS microbleeding is a potential risk in this patient population. Assessment of brain microbleeds and microscopic hematuria in this patient population require additional study. © 2015 Wiley Periodicals, Inc.

Development of occupational exposure limits for the Hanford tank farms.

PubMed

Still, Kenneth R; Gardner, Donald E; Snyder, Robert; Anderson, Thomas J; Honeyman, James O; Timchalk, Charles

2010-04-01

Production of plutonium for the United States' nuclear weapons program from the 1940s to the 1980s generated 53 million gallons of radioactive chemical waste, which is stored in 177 underground tanks at the Hanford site in southeastern Washington State. Recent attempts to begin the retrieval and treatment of these wastes require moving the waste to more modern tanks and result in potential exposure of the workers to unfamiliar odors emanating from headspace in the tanks. Given the unknown risks involved, workers were placed on supplied air respiratory protection. CH2MHILL, the managers of the Hanford site tank farms, asked an Independent Toxicology Panel (ITP) to assist them in issues relating to an industrial hygiene and risk assessment problem. The ITP was called upon to help determine the risk of exposure to vapors from the tanks, and in general develop a strategy for solution of the problem. This paper presents the methods used to determine the chemicals of potential concern (COPCs) and the resultant development of screening values and Acceptable Occupational Exposure Limits (AOELs) for these COPCs. A total of 1826 chemicals were inventoried and evaluated. Over 1500 chemicals were identified in the waste tanks headspaces and more than 600 of these were assigned screening values; 72 of these compounds were recommended for AOEL development. Included in this list of 72 were 57 COPCs identified by the ITP and of these 47 were subsequently assigned AOELs. An exhaustive exposure assessment strategy was developed by the CH2MHILL industrial hygiene department to evaluate these COPCs.

Differential roles of fibrinogen and von Willebrand factor on clot formation and platelet adhesion in reconstituted and immune thrombocytopenia.

PubMed

Misgav, Mudi; Shenkman, Boris; Budnik, Ivan; Einav, Yulia; Martinowitz, Uri

2011-05-01

Bleeding tendencies in immune thrombocytopenia (ITP) do not always correlate with the number of platelets, suggesting platelet function variation. We used a model of normal whole blood thrombocytopenia to compare platelet function and other hemostatic variables with ITP patients. We further investigated the effect of in vitro spiking with von Willebrand factor (vWF) and fibrinogen on platelet function and hemostatic variables. The Cone and Plate(let) Analyzer was used to measure platelet adhesion (surface coverage [SC], %) and aggregation (average size, μm(2)) under defined shear rate (1200 s(-1)). Rotational thromboelastometry was used to determine variables of clot formation triggered by CaCl(2) and tissue factor. In both the model of thrombocytopenia as well as in ITP, the SC and to some extent the average size were correlated to the platelet number over a range of 5 to 80 × 10(6)/mL. The results obtained for most ITP samples were within the boundaries of the lower and upper limits set by the whole blood model of thrombocytopenia. The addition of 2 U/mL vWF (Haemate-P) to whole blood (calculated to plasma volume) results in an increase in the SC and average size without affecting clot formation. Spiking with fibrinogen (100 and 300 mg/dL) did not affect platelet deposition but improved clot formation. Using a model of whole blood thrombocytopenia enables us to establish reference variables for the Cone and Plate(let) Analyzer and rotational thromboelastometry and to assess platelet function and clot formation in the presence of severe thrombocytopenia. We demonstrated that in most cases of ITP, platelet function is comparable to normal platelets. This work also suggests that vWF and fibrinogen differentially affect primary and secondary hemostasis and therefore both may perform a function in the bleeding phenotype and possibly may be considered for treatment in patients with ITP. © 2011 International Anesthesia Research Society

Methodology of analysis of very weak acids by isotachophoresis with electrospray-ionization mass-spectrometric detection: Anionic electrolyte systems for the medium-alkaline pH range.

PubMed

Malá, Zdena; Gebauer, Petr

2018-01-15

This work describes for the first time a functional electrolyte system setup for anionic isotachophoresis (ITP) with electrospray-ionization mass-spectrometric (ESI-MS) detection in the neutral to medium-alkaline pH range. So far no application was published on the analysis of very weak acids by anionic ITP-MS although there is a broad spectrum of potential analytes with pK a values in the range 5-10, where application of this technique promises interesting gains in both sensitivity and specificity. The problem so far was the lack of anionic ESI-compatible ITP systems in the mentioned pH range as all typical volatile anionic system components are fully ionized at neutral and alkaline pH and thus too fast to suit as terminators. We propose an original solution of the problem based on the combination of two ITP methods: (i) use of the hydroxyl ion as a natural and ESI-compatible terminator, and (ii) use of configurations based on moving-boundary ITP. The former method ensures effective stacking of analytes by an alkaline terminator of sufficiently low mobility and the latter offers increased flexibility for tuning of the separation window and selectivity according to actual needs. A theoretical description of the proposed model is presented and applied to the design of very simple functional electrolyte configurations. The properties of example systems are demonstrated by both computer simulation and experiments with a group of model analytes. Potential effects of carbon dioxide present in the solutions are demonstrated for particular systems. Experimental results confirm that the proposed methodology is well capable of performing sensitive and selective ITP-MS analyses of very weak acidic analytes (e.g. sulfonamides or chlorophenols). Copyright © 2017 Elsevier B.V. All rights reserved.

Development and implementation of a novel immune thrombocytopenia bleeding score for dogs.

PubMed

Makielski, Kelly M; Brooks, Marjory B; Wang, Chong; Cullen, Jonah N; O'Connor, Annette M; LeVine, Dana N

2018-04-21

A method of quantifying clinical bleeding in dogs with immune thrombocytopenia (ITP) is needed because ITP patients have variable bleeding tendencies that inconsistently correlate with platelet count. A scoring system will facilitate patient comparisons and allow stratification based on bleeding severity in clinical trials. To develop and evaluate a bleeding assessment tool for dogs, and a training course for improving its consistent implementation. Client-owned dogs (n = 61) with platelet counts <50,000/μL; 34 classified as primary ITP, 17 as secondary ITP, and 10 as non-ITP. A novel bleeding assessment tool, DOGiBAT, comprising bleeding grades from 0 (none) to 2 (severe) at 9 anatomic sites, was developed. Clinicians and technicians completed a training course and quiz before scoring thrombocytopenic patients. The training course was assessed by randomizing student volunteers to take the quiz with or without prior training. A logistic regression model assessed the association between training and quiz performance. The correlation of DOGiBAT score with platelet count and outcome measures was assessed in the thrombocytopenic dogs. Clinicians and technicians consistently applied the DOGiBAT, correctly scoring all quiz cases. The odds of trained students answering correctly were higher than those of untrained students (P < .0001). In clinical cases, DOGiBAT score and platelet count were inversely correlated (r s  = -0.527, P < .0001), and DOGiBAT directly correlated with transfusion requirements (r s  = 0.512, P < .0001) and hospitalization duration (r s  = 0.35, P = .006). The DOGiBAT and assessment quiz are simple tools to standardize evaluation of bleeding severity. With further validation, the DOGiBAT may provide a clinically relevant metric to characterize ITP severity and monitor response in treatment trials. Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Flow cytometric analysis of platelet cyclooxygenase-1 and -2 and surface glycoproteins in patients with immune thrombocytopenia and healthy individuals.

PubMed

Rubak, Peter; Kristensen, Steen D; Hvas, Anne-Mette

2017-06-01

Immature platelets may contain more platelet enzymes such as cyclooxygenase (COX)-1 and COX-2 than mature platelets. Patients with immune thrombocytopenia (ITP) have a higher fraction of immature platelets and can therefore be utilized as a biological model for investigating COX-1 and COX-2 platelet expression. The aims were to develop flow cytometric assays for platelet COX-1 and COX-2 and to investigate the COX-1 and COX-2 platelet expression, platelet turnover, and platelet glycoproteins in ITP patients (n = 10) compared with healthy individuals (n = 30). Platelet count and platelet turnover parameters (mean platelet volume (MPV), immature platelet fraction (IPF), and immature platelet count (IPC)) were measured by flow cytometry (Sysmex XE-5000). Platelet COX-1, COX-2, and the glycoproteins (GP)IIb, IX, Ib, Ia, and IIIa were all analyzed by flow cytometry (Navios) and expressed as median fluorescence intensity. COX analyses were performed in both whole blood and platelet rich plasma (PRP), whereas platelet glycoproteins were analyzed in whole blood only. ITP patients had significantly lower platelet count (55 × 10 9 /L) than healthy individuals (240 × 10 9 /L, p < 0.01), but a higher MPV (p = 0.03) and IPF (p < 0.01). IPC was similar for the two groups (p = 0.74). PRP had significantly lower MPV (p < 0.01) and significantly higher platelet count and IPC (both p-values <0.03) when compared with whole blood. IPF was similar for PRP and whole blood (p = 0.18). COX-1 expression was 10 times higher and COX-2 expression was 50% higher in PRP than in whole blood (p COX-1 < 0.01, p COX-2 < 0.01). Platelet COX-1 expression was higher in ITP patients than healthy individuals using whole blood (p COX-1 < 0.01) and PRP, though this was nonsignificant in PRP (p COX-1 = 0.17). In ITP patients, positive correlations were found between platelet turnover and COX-1 expression (all p-values <0.01, rho = 0.80-0.94), whereas healthy individuals showed significant though weaker correlations between platelet turnover and COX-1 and COX-2 expressions (all p-values <0.03, rho = 0.44-0.71). GPIIb, IX, and Ib expression was increased in ITP patients compared with healthy individuals (all p-values < 0.03). GPIIb, IX, Ib, and IIIa showed positive correlations with platelet turnover in ITP patients (all p-values <0.02, rho = 0.71-0.94), but weak and nonsignificant correlations in healthy individuals (all p-values >0.14, rho = 0.11-0.28). In conclusion, ITP patients expressed higher COX-1 and platelet glycoprotein levels than healthy individuals. COX-1 and platelet glycoproteins demonstrated positive correlations with platelet turnover in ITP patients. In healthy individuals, COX-1 and COX-2 expression correlated positively with platelet turnover. PRP was more sensitive compared with whole blood as regards determination of COX. Therefore, PRP is the recommended matrix for investigating COX-1 and COX-2 in platelets.

The Basic Tenets of Invitational Theory and Practice: An Invitational Glossary

ERIC Educational Resources Information Center

Shaw, Daniel E.; Siegel, Betty L.; Schoenlein, Allyson

2013-01-01

A review of the literature which concentrates on Invitational Theory and Practice (ITP) has revealed an inconsistent and oft times confusing or contradictory use of named concepts, labels, phrases, wordings, definitions, and other such titles of major ITP principles (Shaw and Siegel, 2010). Presented in a glossary type format, the purpose of this…

Implementation of Metal Casting Best Practices

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

Eppich, Robert; Naranjo, Robert D.

2007-01-01

The project examined cases where metal casters had implemented ITP research results and the benefits they received due to that implementation. In cases where casters had not implemented those results, the project examined the factors responsible for that lack of implementation. The project also informed metal casters of the free tools and service offered by the ITP Technology Delivery subprogram.

78 FR 68465 - NiSource, Inc.; Record of Decision, Habitat Conservation Plan, Environmental Impact Statement...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-14

...-FF03E00000] NiSource, Inc.; Record of Decision, Habitat Conservation Plan, Environmental Impact Statement... to the Endangered Species Act of 1973, as amended (ESA). The ITP authorizes NiSource, Inc., to take... public of the availability of the ROD associated with an ITP application received from NiSource, Inc...

Upper-Ocean Variability in the Arctic’s Amundsen and Nansen Basins

DTIC Science & Technology

2017-05-01

collect vertical profiles of ocean temperature, salinity and horizontal velocity at few- hour interval as well as sample for specified time periods...deployed for the MIZ program - specifically, vertical temperature, salinity and velocity profiles were collected every 3 hours in the upper 250m of the...the system), this ITP-V returned 5+ months of upper ocean temperature, salinity , velocity and turbulence data from the Makarov Basin, a region of

Gender-related analysis of the clinical presentation, treatment response and outcome in patients with immune thrombocytopenia.

PubMed

Andrès, Emmanuel; Mecili, Mustapha; Fothergill, Helen; Zimmer, Jacques; Vogel, Thomas; Maloisel, Frédéric

2012-09-01

Immune thrombocytopenia (idiopathic thrombocytopenic purpura [ITP]) frequently occurs in young adults, particularly women in their third or fourth decade. The female predominance suggests that sex hormones may play a role in the different aspects of ITP. In this paper, we report a gender-related analysis of patients with ITP, specifically examining the clinical manifestations, responses to treatment and overall outcomes of the patients. We included patients with "ITP" attending the departments of onco-hematology or internal medicine B (university hospital of Strasbourg, France) between 1990 and December 2010 The gender-related analysis was retrospective. We studied in 225 consecutive cases of established ITP with a follow-up period of 1.7 to 112 months The mean age of the patients was 44 years; 156 patients were female. The analysis revealed no significant statistical differences regarding patient characteristics between the female and male groups, with the exception of the following characteristics: the bleeding score, which altered in the presence of meno- and/or metrorrhagia and hematuria in female patients (P=0.03); the presence of anemia (P=0.04); and the detection of antinuclear and/or antiphospholipid antibodies (P=0.02). During the follow-up, no statistically significant difference was found regarding outcome or treatment response in relation to gender among these 225 patients (all P>0.05). Gender does not appear to affect the manifestation of immune thrombocytopenia, the outcome or response to treatment. However, further large-scale randomized trials are needed to confirm these findings. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Immune thrombocytopenic purpura (ITP) associated with vaccinations: a review of reported cases.

PubMed

Perricone, Carlo; Ceccarelli, Fulvia; Nesher, Gideon; Borella, Elisabetta; Odeh, Qasim; Conti, Fabrizio; Shoenfeld, Yehuda; Valesini, Guido

2014-12-01

Immune thrombocytopenic purpura (ITP) is an autoimmune condition characterized by low platelet count with mucocutaneous and other bleedings. Clinical manifestations may range from spontaneous formation of purpura and petechiae, especially on the extremities, to epistaxis, bleeding at the gums or menorrhagia, any of which occur usually if the platelet count is below 20,000 per μl. A very low count may result in the spontaneous formation of hematomas in the mouth or on other mucous membranes. Fatal complications, including subarachnoid or intracerebral, lower gastrointestinal or other internal bleeding can arise due to an extremely low count. Vaccines may induce ITP by several mechanisms. Vaccine-associated autoimmunity may stem not only from the antigen-mediated responses but also from other constituents of the vaccine, such as yeast proteins, adjuvants, and preservatives diluents. The most likely is through virally induced molecular mimicry. The binding of pathogenic autoantibodies to platelet and megakaryocytes may cause thrombocytopenia by different mechanisms, such as opsonization, direct activation of complement, or apoptotic pathways. The autoantibodies hypothesis is not sufficient to explain all ITP cases: In the anti-platelet antibody-negative cases, a complementary mechanism based on T cell immune-mediated mechanism has been suggested. In particular, T cell subsets seem dysregulated with an increased production of pro-inflammatory cytokines, as IFN-γ and TNF, and chemokines, as CXCL10. Vaccines are one of the most striking discoveries in human history that changed dramatically life expectancy. Nonetheless, the occurrence of adverse events and autoimmune phenomena has been described following vaccination, and ITP may represent one of this.

The influence of clothing on human intrathoracic pressure during airblast.

PubMed

Young, A J; Jaeger, J J; Phillips, Y Y; Yelverton, J T; Richmond, D R

1985-01-01

Exposure to airblast can result in injury to the lungs and other gas-containing organs. The mechanism of lung injury is not clearly understood, but may be related to the rapid increase in intrathoracic pressure (ITP) which is produced when the blast wave strikes the chest wall. The purpose of this study was to determine if ITP during airblast would be influenced by several different types of protective clothing. Ten healthy young male volunteers were exposed to airblast while standing face-on and wearing 1) military fatigues (control condition); 2) fatigues with field jacket; 3) fatigues with ballistic armor vest; 4) fatigues with ceramic vest; 5) fatigues with ceramic vest over the ballistic vest. The incident blast waves simulated artillery muzzle blast. In each subject, an esophageal strain-gauge pressure transducer measured ITP during the blast. The pressure signal was analyzed for ITPmax, and maximum rate of rise of ITP (dP X dt max-1). In addition, the power density spectra of each ITP wave was computed and the peak frequency (fp) and centroid frequency (fc) were calculated. When the subjects wore the ballistic vest, the mean ITPmax was higher (p less than 0.05) than when they were exposed to airblast in fatigues alone. ITPmax was not influenced by the other clothing ensembles. The mean dP X dtmax-1 was not significantly different with any protective clothing ensemble. Clothing had no significant effect of fp, but with the ballistic vest, the mean calculated fc was higher (p less than 0.05) than that for the fatigues alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Patterns and influences in health-related quality of life in children with immune thrombocytopenia: A study from the Dallas ITP Cohort.

PubMed

Flores, Adolfo; Klaassen, Robert J; Buchanan, George R; Neunert, Cindy E

2017-08-01

Relationships between clinical/demographic factors and health-related quality of life (HRQoL) in childhood immune thrombocytopenia (ITP) remain poorly understood. Recent studies reveal conflicting information about factors that contribute to HRQoL. This was a prospective, single-institution, cohort study of newly diagnosed children with ITP. Serial evaluations of HRQoL were performed using the Kid's ITP Tools (KIT), scored from 0 (worst) to 100 (best), at enrollment and 1 week, 6 months, and 12 months following diagnosis. All visits included bleeding severity grading. Relationships between HRQoL and platelet count, treatment, bleeding severity, and course of disease were examined. A total of 99 children with newly diagnosed ITP were evaluable for analysis. KIT scores were low at diagnosis for parents (median 26, range 15-43) and children (median 65, range 55-81) and were not influenced by age or platelet count. At diagnosis, children who received treatment had lower platelet counts (P = 0.005), more severe hemorrhage (P < 0.0125), and lower HRQoL by parent, child, and proxy reporting (P < 0.05). Oral bleeding negatively impacted proxy-reported disease burden at diagnosis (P = 0.01). Persistence of disease and lower platelet counts at 6 and 12 month visits were the only factors noted to consistently impact quality of life beyond diagnosis for both parents and children. HRQoL is low at diagnosis but significantly improves over time. Patients with ongoing disease and lower platelet counts continue to have significant disease burden. © 2017 Wiley Periodicals, Inc.

Immune thrombocytopenia after bee venom therapy: a case report.

PubMed

Abdulsalam, Mohammad Adel; Ebrahim, Bader Esmael; Abdulsalam, Ahmad Jasem

2016-03-25

Immune thrombocytopenia (ITP) is a hematological disorder with an isolated decrease in number of circulating platelets. Bee venom therapy (BVT) is a form of alternative medicine. It is still being practiced in the Middle East and other parts of Asia. In BVT, acupuncture points are used to inject diluted bee venom into the body. The pharmacological basis behind BVT is not fully understood. However, it has been used to treat various medical conditions such as arthritis and low back pain. On the other hand there have been a number of reported complications of BVT use such as ITP. We present a case report on ITP after BVT. A 61 year old lady presented with gum bleeding and ecchymosis and found to have isolated thrombocytopenia (platelet count of 9 × 10(9)/L) after receiving four direct bee sting sessions. There was no evidence of any other risk factors of ITP. Bee venom components and toxicity may be associated with thrombocytopenia as a complication. Further research is needed to postulate guidelines and protocol for BVT. In the meantime, monitoring of the practice of BVT should be made, with an emphasis on patient education regarding the safety profile and associated risks compared to the gained benefits.

Bilateral large subconjunctival haemorrhages unmasking immune thrombocytopenic purpura during retinopathy of prematurity screening.

PubMed

Chandra, Parijat; Kumawat, Devesh; Kumar, Vinod; Tewari, Ruchir

2017-10-04

Although thrombocytopenia is known to be associated with pathogenesis of retinopathy of prematurity (ROP), immune thrombocytopenic purpura (ITP) is rare in infancy and not reported to occur with ROP. A preterm infant with aggressive posterior ROP developed bilateral massive subconjunctival haemorrhage after scleral indentation during screening. On evaluation, the infant was found to have severe ITP. Following intravenous transfusion of platelets and immunoglobulin, platelet counts improved and subconjunctival haemorrhage resolved over time. This case highlights the unusual presentation of ITP and also discusses the association of thrombocytopenia with ROP. Ophthalmologists should get prompt haematological work-up of such occurrences. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

United Kingdom immune thrombocytopenia registry: retrospective evaluation of bone marrow fibrosis in adult patients with primary immune thrombocytopenia and correlation with clinical findings.

PubMed

Rizvi, Hasan; Butler, Tom; Calaminici, Mariarita; Doobaree, Indraraj U; Nandigam, Raghava C; Bennett, Dimitri; Provan, Drew; Newland, Adrian C

2015-05-01

Fibrosis has been reported in some patients with immune thrombocytopenia (ITP) treated with thrombopoietin receptor agonists (TPO-RA). However, fibrosis has also been reported in patients with various stages of ITP, who were TPO-RA treatment-naïve. In our study, we looked for fibrosis in bone marrow trephine biopsies taken at initial diagnosis from 32 adult patients with ITP. Ten of the 32 evaluated samples (31·25%) showed increased reticulin (Grade 1-2 on Bauermeister scale and Grade 0-1 on the European Consensus scale), which showed a positive correlation with ethnicity (0·3%) but did not correlate with disease severity, any clinical features or co-morbidities. © 2015 John Wiley & Sons Ltd.

Percentage of Memory B Lymphocytes and Regulatory T Lymphocytes in Peripheral Blood are Low but Not Predictive of Therapy outcomes in Newly Diagnosed Adult Patients with Primary Immune Thrombocytopenia.

PubMed

Yilmaz, Mustafa; Ayhan, Semiha

2017-12-01

Although changes in the number and function of regulatory T lymphocytes have been reported in primary immune thrombocytopenia (ITP), no study has investigated whether quantification of these cell types in peripheral blood could be used as early predictive marker of treatment outcome. And, it is not clear whether any change occurs in peripheral blood memory B lymphocyte levels in ITP. Hence, the aim of this study was to investigate the percentage of regulatory T lymphocytes and memory B lymphocytes in peripheral blood of ITP patients compared to controls, and also examine whether these levels have any significant predictive value for therapy outcome. A total of 20 newly diagnosed, untreated patients with ITP and 20 healthy controls were included. Flow cytometric analyses of lymphocyte subtypes in the peripheral blood were performed in specimens obtained from patients at the time of diagnosis and one month after the therapy initiation. First line corticosteroid (1 mg/kg/day methylprednisolone) therapy or splenectomy as second line treatment was performed, and patients were followed up for 3 years. Percentage of regulatory T lymphocytes (0.25 ± 0.17% vs. 1.14 ± 0.77%, P  < 0.0001, n = 20) and percentage of memory B lymphocytes (1.57 ± 1.24% vs. 4.38 ± 2.41%, P  < 0.001, n = 20) was significantly lower in ITP patients than healthy controls, at baseline. After one month therapy, the percentage of memory B lymphocytes of ITP patients significantly increased (from 1.66 ± 1.31% to 3.0 ± 1.7%, P  < 0.009, n = 17). The initial value of regulatory T (0.33 ± 0.30%, n = 10 vs. 0.16 ± 0.05%, n = 7, P  > 0.05) and memory B lymphocytes percentages (2.1 ± 1.8%, n = 10 vs. 1.1 ± 0.75%, n = 7, P  > 0.05) were not significantly different for those who had complete response to first line therapy than those required splenectomy. These results indicate that regulatory T lymphocytes and memory B lymphocytes percentages are not useful for predicting treatment outcome in patients with newly diagnosed adult patients with ITP.

Development of Occupational Exposure Limits for the Hanford Tank Farms

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

Still, Kenneth; Gardner, Donald; Snyder, Robert

Production of plutonium for the United States’ nuclear weapons program from the 1940’s to the 1980’s generated 53 million gallons of radioactive chemical waste, which is storedin 177 underground tanks at the Hanford Site in southeastern W 18 ashington State. Recent 19 attempts to begin the retrieval and treatment of these wastes require moving the waste to 20 more modern tanks results in potential exposure of the workers to unfamiliar odors 21 emanating from headspace in the tanks. Given the unknown risks involved, workers 22 were placed on supplied air respiratory protection. CH2M HILL, the managers of the 23 Hanfordmore » Site Tank Farms, asked an Independent Toxicology Panel (ITP) to assist them in issues relating to an Industrial Hygiene and risk assessment problem. The ITP was called upon to help determine the risk of exposure to vapors from the tanks, and in general develop a strategy for solution of the problem. This paper presents the methods used to determine the chemicals of potential concern (COPC) and the resultant development of screening values and Acceptable Occupational Exposure Limits (AOELs) for these COPCs. A total of 1,826 chemicals were inventoried and evaluated. Over 1,500 chemicals were identified in the waste tanks headspaces and more than 600 of these were assigned screening values; 72 of these compounds were recommended for AOEL development. Included in this list of 72 were 57 COPCs identified by the ITP and of these 47 were subsequently assigned AOELs. An exhaustive exposure assessment strategy was developed by the CH2M HILL industrial hygiene department to evaluate these COPCs.« less

A Computer Aided Statistical Covariance Program for Missile System Analysis

DTIC Science & Technology

1974-04-01

the example (rl) on the IBM 360/65 at Oklahoma State University. REFERENCES Euler 40 (r=l) (1) James R. R^wland and Willard M. Holmes,"Stochastic...B21P 1PIt RK 1, PYAK ItP YBK1 PYIKI, 144 2W01 DQ1 ,PYLI MtRLI MtGBI AStQBIAS , RBIAS PB, QBt RBtUEvVEWEt 145 3THETAt PHI tPS I t X tY ,Z SD. XTCGt YTC3

Immune thrombocytopenia: No longer ‘idiopathic’

PubMed Central

McCRAE, KEITH

2012-01-01

Immune thrombocytopenia (ITP) is a common hematologic disorder. Its pathogenesis involves both accelerated platelet destruction and impaired platelet production. First-line agents are usually effective initially but do not provide long-term responses. Splenectomy remains an effective long-term therapy, as does rituximab (Rituxan) in a subset of patients. Thrombopoietic agents offer a new alternative, although their place in the overall management of ITP remains uncertain. PMID:21632906

Immune Thrombocytopenia as a Consequence of Rocky Mountain Spotted Fever.

PubMed

Baldeo, Cherisse; Seegobin, Karan; Zuberi, Lara

2017-01-01

Primary immune thrombocytopenia (ITP) - also called idiopathic thrombocytopenic purpura or immune thrombocytopenic purpura - is an acquired thrombocytopenia caused by autoantibodies against platelet antigens. It is one of the more common causes of thrombocytopenia in otherwise asymptomatic adults. Rocky Mountain spotted fever (RMSF) is a potentially lethal, but curable, tick-borne disease. We present a case of ITP that was triggered by RMSF.

Cytokine gene polymorphism [tumor necrosis factor-alpha (-308), IL-10 (-1082), IL-6 (-174), IL-17F, 1RaVNTR] in pediatric patients with primary immune thrombocytopenia and response to different treatment modalities.

PubMed

Mokhtar, Galila M; El-Beblawy, Nagham M S; Adly, Amira A; Elbarbary, Nancy S; Kamal, Tarek M; Hasan, Esraa M

2016-04-01

To evaluate the association between development, progression, and response to therapy among patients with immune thrombocytopenia (ITP) and different cytokine gene polymorphisms known to be related to autoimmunity [tumor necrosis factor (TNF)-alpha, interleukin (IL)-10, IL-6, IL-17, IL-1Ra]. A total of 50 pediatric patients with ITP (20 newly diagnosed, 30 chronic) and 50 healthy controls were investigated via PCR-restriction fragment length polymorphism analysis for cytokine gene polymorphism. Compared with controls, all patients showed a higher frequency of IL-6-174 CC [P = 0.0001, odds ratio (OR) = 7.048, 95% confidence interval (CI) = 2.18-22.7], higher GA genotype of TNF-α (-308) (P = 0.001, OR = 6.469, 95% CI = 2.0-20.9), higher CC genotype of IL-17F (P = 0.0001, OR = 55.545, 95% CI = 14.4-213.2), higher GG of IL-10-1082 (P = 0.029, OR = 3.6, 95% CI = 1.08-12.18), and A1A2 genotype of IL-1Ra (P = 0.039, OR = 2.374, 95% CI = 1.03-5.4). IL-10 GA and IL-1Ra A1A1 genotypes were higher among chronic patients (P = 0.042, P = 0.001 respectively) compared with newly diagnosed ones. Best platelet response to steroid treatment was found among GC genotype of IL-6 (-174) and GG genotype of IL-10 (-1082) in all patients with ITP. This suggests that previously mentioned cytokine gene polymorphisms possibly contribute to the susceptibility of acquisition of childhood ITP. Furthermore, GA genotype of IL-10 and A1A1 genotype of IL-1Ra polymorphisms are associated with increased risk of chronic ITP. IL-6 (-174) and IL-10 (-1082) genes might play a role in the effectiveness of steroid therapy among patients with ITP.

High dose Intravenous Anti-D Immune Globulin is More Effective and Safe in Indian Paediatric Patients of Immune Thrombocytopenic Purpura

PubMed Central

Jena, Rabindra Kumar; Swain, Kali Prasanna

2016-01-01

Introduction Immune Thrombocytopenia (ITP) is characterised by an autoimmune antibody-mediated destruction of platelets and impaired platelet production. Few controlled trials exist to guide management of patients with ITP in Indian scenario for which patients require an individualized approach. Anti-D (Rho (D) immune globulin) at a higher dose can prove to be a cost effective and safe alternative for Indian patients with ITP. Aim To compare the safety and efficacy of higher dose (75μg/kg) intravenous Anti-D immune globulin against the standard dose of 50μg/kg for the management of ITP in Indian patients. Materials and Methods One hundred and sixty four children with newly diagnosed ITP between 4-14 years were randomly selected for inclusion and were treated with 50μg/kg (standard dose) or 75μg /kg (higher dose) of Anti-D to compare the efficacy and safety of higher dose intravenous anti-D immune globulin. Efficacy of Anti-D was measured in terms of rate of response and median time to response for increase in platelet counts. Any adverse event was noted. A decrease in haemoglobin concentration suggested accompanying haemolysis. Results Seventy one out of 84 patients treated with Anti-D at 75μg/kg produced complete response (85%) with median time of response being 2.5 days. On the contrary, 45 patients (70%) patients treated with 50μg/kg had complete response. However, there was no significant increase in haemolysis with higher dose. A significant correlation was found between dose and peak increase in platelet count measured at 7th day following administration. However, there was no relationship between the decrease in haemoglobin and the dose given, or between the increase in platelet count and fall in haemoglobin. Conclusion A 75μg/kg dose of Anti-D is more effective with acceptable side effect in comparison to 50μg dose for treatment of newly diagnosed Indian patients of ITP. PMID:28208873

Electrophysiology of the mammillary complex in vitro. II. Medial mammillary neurons

NASA Technical Reports Server (NTRS)

Alonso, A.; Llinas, R. R.

1992-01-01

1. The electrophysiological properties of guinea pig medial mammillary body (MMB) neurons were studied using an in vitro slice preparation. 2. The neurons (n = 80) had an average resting potential of -57 +/- 5.5 (SD) mV, an input resistance of 176 +/- 83 M omega, and a spike amplitude of 58 +/- 15.7 mV. Most of the neurons were silent at rest (n = 52), but some fired spontaneous single spikes (n = 16) or spike bursts (n = 14). 3. The main electrophysiological characteristic of MMB neurons was the ability to generate Ca(2+)-dependent regenerative events, which resulted in very robust burst responses. However, this regenerative event was not the same for all neurons, ranging from typical low-threshold Ca2+ spikes (LTSs) to intermediate-threshold plateau potentials (ITPs). 4. The ITPs were distinct from the LTSs in that they lasted > or = 100 ms and were not inactivated at membrane potentials at or positive to -55 mV. 5. Some cells with a prominent ITP and no LTS (n = 36) displayed repetitive, usually rhythmic, bursting (n = 14). This ITP could be powerful enough to maintain rhythmic membrane potential oscillations after pharmacological block of Na+ conductances. 6. A group of 32 MMB neurons displayed complex bursting that was generated by activation of both LTSs and ITPs. This was established on the basis of their distinct time- and voltage-dependent characteristics. In a group of neurons (n = 14), the burst responses were exclusively generated by an LTS; however, a Ca(2+)-dependent plateau potential contributed to the generation of rebound-triggered oscillatory firing. 7. In addition to the Ca(2+)-dependent LTS and/or ITP, MMB neurons always displayed high-threshold Ca2+ spikes after reduction of K+ conductances with tetraethylammonium. 8. MMB neurons display one of the richer varieties of voltage-dependent Ca2+ conductances so far encountered in mammalian CNS. We propose that the very prominent endogenous bursting and oscillatory properties of MB neurons allow this nuclear complex to function as an oscillatory relay for the transmission of low-frequency rhythmic activities throughout the limbic circuit.

Role of Cannabinoid CB2 Receptor Gene (CNR2) Polymorphism in Children with Immune Thrombocytopenic Purpura in Beni-Suef Governorate in Egypt.

PubMed

Ezzat, Dina A; Hammam, Amira A; El-Malah, Waleed M; Khattab, Rasha A; Mangoud, Eman M

2017-01-01

The cannabinoid system is involved in the immune regulation by modulation of Th cells type 1 and 2. It is composed of the CB2 receptor which is expressed at 10 to 100 folds greater levels on immune cells than the CB1 receptors. The CB2 is encoded by the cannabinoid CB receptor gene (CNR2) gene. This study aims to investigate the polymorphism in CNR2 gene variation rs 35761398 (Q63R) in Egyptian children with immune thrombocytopenic purpura and to investigate the relation between this gene polymorphism and either the susceptibility to or the chronicity of the disease. Forty children diagnosed as ITP were included in this study and 20 healthy children as normal control. CNR2 gene was investigated in those children by PCR RFLP technique (restriction fragment length polymorphism). CNR2 genotyping revealed that 45% of ITP patients had the QR heterotype, 50% had the RR homotype and 5% had QQ, the wild type with significantly higher frequency of homomutant genotype in comparison to controls. The relative odds ratio suggested a double risk for developing ITP in RR homotype (OR 2.152). A significant overpresentation of the RR genotype and of R allele was observed in the chronic patients (P=0.002 and 0.003, respectively). The associated risk to develop chronic ITP increased more than two folds for the RR homotype (OR=2.854). In conclusion, this study confirms the role of CNR2 Q63R polymorphism in the susceptibility to ITP in children and chronicity of the disease. Copyright© by the Egyptian Association of Immunologists.

Efficacy and tolerability of old and new drugs used in the treatment of immune thrombocytopenia: Results from a long-term observation in clinical practice

PubMed Central

Depré, Fabian; Aboud, Nasra; Mayer, Beate; Salama, Abdulgabar

2018-01-01

Background Many patients with immune thrombocytopenia (ITP) may require special attention and long-term treatment. Little is known on the efficacy and tolerability of the drugs used in practice. Material and methods We retrospectively reviewed the results of therapy of 400 patients with chronic ITP. All Patients were treated at our institution between 1996–2016 under consideration of guidelines, general recommendations, and individual aspects, including gender, age, weight, comorbidity, patient’s medical history and bleeding risk. Results Treatment was not required in 25% of patients (n = 100) during observation. In treated patients (n = 300), the rate of patients that responded and tolerated treatment with prednisolone was 59% (52/88), with azathioprine 32% (29/90), with eltrombopag 49% (31/63), with romiplostim 59% 27/45, with IVIG (intravenous immunoglobulines) 75% (94/126), with anti-D 37% (19/52) and with dexamethasone 60% (25/42) patients. Eighteen treated patients (6%) entered sustained remission after treatment with various drugs. Twenty-six patients underwent splenectomy (Splx) resulting in sustained remission in 15 cases (60%). Only two patients remained refractory to Splx and to all used drugs. Discussion None of the currently available drugs used in the treatment of ITP are invariably safe and effective. Responses, the duration of response, intolerability, and the course of disease are unpredictable. Although the treatment of ITP has considerably improved in the recent years, the currently available drugs may rarely cure affected patients. The need for safe and effective therapy in ITP is evident. Optimal treatment decisions for each patient remains a challenge in many cases. PMID:29856800

Telemetry packetization for improved mission operations. [instrument packages for Space Shuttle mission operations data management

NASA Technical Reports Server (NTRS)

Greene, E. P.

1976-01-01

The requirements for mission-operations data management will accelerate sharply when the Space Transportation System (i.e., Space Shuttle) becomes the primary vehicle for research from space. These demands can be satisfied most effectively by providing a higher-level source encoding function within the spaceborne vehicle. An Instrument Telemetry Packet (ITP) concept is described which represents an alternative to the conventional multiplexed telemetry frame approach for acquiring spaceborne instrument data. By providing excellent data-integrity protection at the source and a variable instrument bandwidth capability, this ITP concept represents a significant improvement over present data acquisition procedures. Realignments in the ground telemetry processing functions are described which are intended to take advantage of the ITP concept and to make the data management system more responsive to the scientific investigators.

Perioperative Care of a Patient with Refractory Idiopathic Thrombocytopenic Purpura Undergoing Total Knee Arthroplasty

PubMed Central

Gudimetla, Veera; Stewart, Andrew; Luscombe, Karen L; Charalambous, Charalambos P

2012-01-01

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder leading to low platelet count and an increased risk of bleeding. Major joint replacement surgery in a patient with ITP can be associated with severe postoperative bleeding. We present our experience of perioperative management in a patient with severe refractory chronic idiopathic thrombocytopenic purpura who successfully underwent a cemented total knee replacement. PMID:23269964

FcγRIII in ITP: it ain't over 'til it's over.

PubMed

McCrae, Keith R

2016-01-07

In this issue of Blood, Yu et al describe a novel anti–Fcγ receptor III (FcγRIII)-albumin fusion protein that inhibits the development of thrombocytopenia in a murine model of immune thrombocytopenia (ITP).1 The unique aspect of this protein is that it blocks FcγRIII-mediated uptake of antibody-coated platelets without activating FcγRIII and the associated inflammatory response.

Heart rate variability in prediction of individual adaptation to endurance training in recreational endurance runners.

PubMed

Vesterinen, V; Häkkinen, K; Hynynen, E; Mikkola, J; Hokka, L; Nummela, A

2013-03-01

The aim of this study was to investigate whether nocturnal heart rate variability (HRV) can be used to predict changes in endurance performance during 28 weeks of endurance training. The training was divided into 14 weeks of basic training (BTP) and 14 weeks of intensive training periods (ITP). Endurance performance characteristics, nocturnal HRV, and serum hormone concentrations were measured before and after both training periods in 28 recreational endurance runners. During the study peak treadmill running speed (Vpeak ) improved by 7.5 ± 4.5%. No changes were observed in HRV indices after BTP, but after ITP, these indices increased significantly (HFP: 1.9%, P=0.026; TP: 1.7%, P=0.007). Significant correlations were observed between the change of Vpeak and HRV indices (TP: r=0.75, P<0.001; HFP: r=0.71, P<0.001; LFP: r=0.69, P=0.01) at baseline during ITP. In order to lead to significant changes in HRV among recreational endurance runners, it seems that moderate- and high-intensity training are needed. This study showed that recreational endurance runners with a high HRV at baseline improved their endurance running performance after ITP more than runners with low baseline HRV. © 2011 John Wiley & Sons A/S.

A Computer Model Predicting the Thermal Response to Microwave Radiation

DTIC Science & Technology

1982-12-01

While each of these represents the result of a triple integration, the total running time is still only between 3 and 4 main on an IBM 360 for K...T/Tp]Tp + (i-1)T p (3.4.9) M(TN) min(([T-[T/Tp] iTp )/T ],Np) (3.4.10) t(TNTT)= MTN) +rTT 1T (3.4.11) t(,ppPT, ’(,p )T L"’PJ-’P x =x(NJ~1~T~ = 0 if...TRM - SRM1)/TRM 101 .: S . .-. . . . . . . . .. . . . . 4.6. Program Size and Running Time The program requires 252K on the ’GO’ step for an IBM 360

Acquisition of Ice-Tethered Profilers with Velocity (ITP-V) Instruments for Future Arctic Studies

DTIC Science & Technology

2015-09-30

jacketed wire rope tether and end weight should the ice fracture or melt , and to provide modest protection in the event of ice ridging. The profiler...1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Acquisition of Ice -Tethered Profilers with Velocity (ITP...evolving thermohaline stratification, the ocean currents and air- ice -sea interactions on time scales of minutes to seasonal and longer. OBJECTIVES

Computer Center CDC Libraries/NSRDC (Subprograms).

DTIC Science & Technology

1981-02-01

TRANSFORM." COMM, OF THE ACM, VOL, 10, NO. 10, OCTOBER 1967. 3. SYSTEM/360 SCIENTIFIC SUBROUTINE PACKAGE, IBM TECHNICAL PUBLICATONS DEPARTMENT, 1967...VARIABLE 3) UP TO 9 DEPENDENT VARIABLES PER PLOT. FUNCTIONAL CATEGORIES: J5 LANGUAGE: FORTRAN IV USAGE COMMON /PLO/ NRUN, NPLOT, ITP .6), ITY(6), ITX(61...PLO/ NRUN - NUMBER OF THIS RUN iDEFAULT: 1) NPLOT - NUMBER OF PLOT (DEFAULT: 1 ITP - PAGE TITLE (DEFAULT: BLANK) ITY - Y TITLE (DEFAULT: BLANK) ITX - X

Rapid hybridization of nucleic acids using isotachophoresis

PubMed Central

Bercovici, Moran; Han, Crystal M.; Liao, Joseph C.; Santiago, Juan G.

2012-01-01

We use isotachophoresis (ITP) to control and increase the rate of nucleic acid hybridization reactions in free solution. We present a new physical model, validation experiments, and demonstrations of this assay. We studied the coupled physicochemical processes of preconcentration, mixing, and chemical reaction kinetics under ITP. Our experimentally validated model enables a closed form solution for ITP-aided reaction kinetics, and reveals a new characteristic time scale which correctly predicts order 10,000-fold speed-up of chemical reaction rate for order 100 pM reactants, and greater enhancement at lower concentrations. At 500 pM concentration, we measured a reaction time which is 14,000-fold lower than that predicted for standard second-order hybridization. The model and method are generally applicable to acceleration of reactions involving nucleic acids, and may be applicable to a wide range of reactions involving ionic reactants. PMID:22733732

Safety and efficacy of a 10% intravenous immunoglobulin preparation in patients with immune thrombocytopenic purpura: results of two international, multicenter studies.

PubMed

Kovaleva, Lidia; Apte, Shashikant; Damodar, Sharat; Ramanan, Vijay; Loriya, Svetlana; Navarro-Puerto, Jordi; Khojasteh, Ali

2016-12-01

To assess safety and efficacy of a 10% intravenous immunoglobulin in patients with primary immune thrombocytopenic purpura (ITP). ITP patients in two multicenter studies (Trials A/B) were treated with 2 g/kg Flebogamma ® 10% DIF (over 2-5 days) and were followed up to 1-3 months. 18 patients in Trial A and 58 in Trial B were enrolled (12 children in Trial B). The response rate (platelet count ≥50 × 10 9 /l) was 72.2% (Trial A) and 76.1/100% (adults/children; Trial B). Most patients improved bleedings (83.3% Trial A; 88.9% Trial B). Potential treatment-related adverse events were reported by 38.9% (Trial A) and 30.4/83.3% (adults/children; Trial B) of patients. All serious adverse events (five patients) resolved without sequelae. Flebogamma 10% DIF was effective and safe in patients with primary ITP.

Autoimmune neutropenia preceding Helicobacter pylori-negative MALT lymphoma with nodal dissemination

PubMed Central

Harada, Saori; Yamazaki, Sho; Nakamura, Fumihiko; Morita, Ken; Yoshimi, Akihide; Shinozaki-Ushiku, Aya; Fukayama, Masashi; Kurokawa, Mineo

2014-01-01

Autoimmune neutropenia (AIN), resulting from granulocyte-specific autoantibodies, is much less frequent than other autoimmune hematologic disorders including autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). These autoimmune disorders may precede, synchronize, or follow collagen disorders, viral infections, and lymphoid neoplasms. Herein we present the first case of AIN in association with Helicobacter pylori-negative mucosa-associated lymphoid tissue (MALT) lymphoma with nodal dissemination. In our case, AIN, accompanied by ITP, occurred prior to the clinical manifestation of lymphoma. AIN and ITP were well managed afterwards, but they relapsed in accordance with the recurrence of lymphoma. The administration of prednisolone at 0.5 mg/kg daily alleviated the cytopenias within a week. In general, combination chemotherapy is performed for the treatment of lymphoma-associated autoimmune hematologic disorders and indeed seems to be effective. Our case indicates that corticosteroid monotherapy may be effective for lymphoma-associated AIN especially when AIN precedes the onset of lymphoma. PMID:25337296

Dissolving polymeric microneedle arrays for electrically assisted transdermal drug delivery.

PubMed

Garland, Martin J; Caffarel-Salvador, Ester; Migalska, Katarzyna; Woolfson, A David; Donnelly, Ryan F

2012-04-10

It has recently been proposed that the combination of skin barrier impairment using microneedles (MNs) coupled with iontophoresis (ITP) may broaden the range of drugs suitable for transdermal delivery, as well as enabling the rate of delivery to be achieved with precise electronic control. However, no reports exist on the combination of ITP with in situ drug loaded polymeric MN delivery systems. Furthermore, although a number of studies have highlighted the importance of MN design for transdermal drug delivery enhancement, to date, there has been no systematic investigation of the influence of MN geometry on the performance of polymeric MN arrays which are designed to remain in contact with the skin during the period of drug delivery. As such, for the first time, this study reports on the effect of MN heigth and MN density upon the transdermal delivery of small hydrophilic compounds (theophylline, methylene blue, and fluorescein sodium) across neonatal porcine skin in vitro, with the optimised MN array design evaluated for its potential in the electrically faciliatated delivery of peptide (bovine insulin) and protein (fluorescein isothiocyanate-labelled bovine serum albumin (FTIC-BSA)) macromolecules. The results of the in vitro drug release investigations revealed that the extent of transdermal delivery was dependent upon the design of the MN array employed, whereby an increase in MN height and an increase in MN density led to an increase in the extent of transdermal drug delivery achieved 6h after MN application. Overall, the in vitro permeation studies revealed that the MN design containing 361 MNs/cm(2) of 600 μm height resulted in the greatest extent of transdermal drug delivery. As such, this design was evaluated for its potential in the MN mediated iontophoretic transdermal delivery. Whilst the combination of MN and ITP did not further enhance the extent of small molecular weight solute delivery, the extent of peptide/protein release was significantly enhanced when ITP was used in combination of the soluble PMVE/MA MN arrays. For example, the cumulative amount of insulin permeated across neonatal porcine skin at 6h was found to be approximately 150 μg (3.25%), 227 μg (4.85%) and 462 μg (9.87%) for ITP, MN, and MN/ITP delivery strategies, respectively. Similarly, the cumulative amount of FTIC-BSA delivered across neonatal porcine skin after a 6h period was found to be approximately 110 μg (4.53%) for MN alone and 326 μg (13.40%) for MN in combination with anodal ITP (p<0.001). As such, drug loaded soluble PMVE/MA MN arrays show promise for the electrically controlled transdermal delivery of biomacromolecules in a simple, one-step approach. Copyright © 2012 Elsevier B.V. All rights reserved.

Platelet antibody in prolonged remission of childhood idiopathic thrombocytopenic purpura

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

Ware, R.; Kinney, T.R.; Rosse, W.

1985-11-01

Evaluations were performed in 20 patients with childhood idiopathic thrombocytopenic purpura (ITP) who remained in remission longer than 12 months. The mean duration of follow-up from diagnosis was 39 months (range 17 to 87 months). Eleven patients (four girls) in group 1 had an acute course of ITP, defined as platelet count greater than 150 X 10(9)/L within 6 months of diagnosis. Nine patients (five girls) in group 2 had a chronic course, defined as platelet count less than 150 X 10(9)/L for greater than or equal to 1 year or requiring splenectomy in an attempt to control hemorrhagic symptoms.more » Platelet count and serum (indirect) platelet-associated IgG (PAIgG) levels were normal in all 20 patients at follow-up. Both direct and indirect PAIgG levels were measured using a SVI-monoclonal anti-IgG antiglobulin assay. All had normal direct PAIgG levels, except for one patient in group 1 who had a borderline elevated value of 1209 molecules per platelet. These data suggest that the prevalence of elevated platelet antibodies is low during sustained remission without medication in patients with a history of childhood ITP. These data may be relevant for pregnant women with a history of childhood ITP, with regard to the risk of delivering an infant with thrombocytopenia secondary to transplacental passage of maternal platelet antibody.« less

Training Records And Information Network UNIX Version

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

Johnston, Michael

1996-12-01

TRAIN-UNIX is used to track training requirements, qualifications, training completion and schedule training, classrooms and instructors. TRAIN-UNIX is a requirements-based system. When the identified training requirements for specific jobs are entered into the system, the employees manager or responsible training person assigns jobs to an employee. TRAIN-UNIX will then assemble an Individual Training Plan (ITP) with all courses required. ITP''s can also be modified to add any special training directed or identified by management, best business practices, procedures, etc. TRAIN-UNIX also schedules and tracks conferences, seminars, and required reading. TRAIN-UNIX is a secure database system on a server accessible viamore » the network. Access to the user functions (scheduling, data entry, ITP modification etc.) within TRAIN-UNIX are granted by function, as needed, by the system administrator. An additional level of security allows those who access TRAIN-UNIX to only add, modify or view information for the organizations to which they belong. TRAIN-UNIX scheduling function allows network access to scheduling of students. As a function of the scheduling process, TRAIN-UNIX checks to insure that the student is a valid employee, not double booked, and the instructor and classroom are not double booked. TRAIN-UNIX will report pending lapse of courses or qualifications. This ability to know the lapse of training along with built in training requesting function allows the training deliverers to forecast training needs.« less

TRAIN-UNIX. Training Records And Information Network UNIX Version

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

Lawrence, M.E.; Crires, J.T.; Johnston, M.

1995-12-01

TRAIN-UNIX is used to track training requirements, qualifications, training completion and schedule training, classrooms and instructors. TRAIN-UNIX is a requirements-based system. When the identified training requirements for specific jobs are entered into the system, the employees manager or responsible training person assigns jobs to an employee. TRAIN-UNIX will then assemble an Individual Training Plan (ITP) with all courses required. ITP`s can also be modified to add any special training directed or identified by management, best business practices, procedures, etc. TRAIN-UNIX also schedules and tracks conferences, seminars, and required reading. TRAIN-UNIX is a secure database system on a server accessible viamore » the network. Access to the user functions (scheduling, data entry, ITP modification etc.) within TRAIN-UNIX are granted by function, as needed, by the system administrator. An additional level of security allows those who access TRAIN-UNIX to only add, modify or view information for the organizations to which they belong. TRAIN-UNIX scheduling function allows network access to scheduling of students. As a function of the scheduling process, TRAIN-UNIX checks to insure that the student is a valid employee, not double booked, and the instructor and classroom are not double booked. TRAIN-UNIX will report pending lapse of courses or qualifications. This ability to know the lapse of training along with built in training requesting function allows the training deliverers to forecast training needs.« less

Using a standardised protocol was effective in reducing hospitalisation and treatment use in children with newly diagnosed immune thrombocytopenia.

PubMed

Labrosse, R; Vincent, M; Nguyen, U-P; Chartrand, C; Di Liddo, L; Pastore, Y

2017-10-01

Childhood immune thrombocytopenia (ITP) has been associated with low bleeding rates and a high frequency of spontaneous remission. Although current guidelines suggest that most patients are just observed, children still receive platelet-enhancing therapies for fear of bleeding complications. We hypothesised that a standardised protocol with a step-down approach would reduce hospitalisation and treatment use. A retrospective chart review was performed on patients diagnosed with acute ITP between January 2010 and December 2014, before (n = 54) and after (n = 37) the standardised protocol, which was introduced in January 2013. Management and events during the first 3 months following diagnosis were recorded. The protocol resulted in a 34% decrease in the hospitalisation rate (p < 0.001) at diagnosis. Prednisone treatment duration at diagnosis was also significantly reduced (13.1 versus 5.8 days, p = 0.004). Children over 3 years of age were 3.8 times less likely to be hospitalised (95% CI 1.94-7.61) and 2.3 times less likely to receive treatment (95% CI 1.2-4.3). There was no difference in the rate of persistent ITP (38% versus 30%, p = 0.43) or serious bleeding complications (7% versus 5%, p = 0.70). Our ITP management protocol significantly reduced hospitalisation rates and length of prednisone treatment without any increase in disease complications. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Determination of ammonium in wastewaters by capillary electrophoresis on a column-coupling chip with conductivity detection.

PubMed

Luc, Milan; Kruk, Pavol; Masár, Marián

2011-07-01

Analytical potentialities of a chip-based CE in determination of ammonium in wastewaters were investigated. CZE with the electric field and/or ITP sample stacking was performed on a column-coupling (CC) chip with integrated conductivity detectors. Acetate background electrolytes (pH ∼3) including 18-crown-6-ether (18-crown-6) and tartaric acid were developed to reach rapid (in 7-8 min) CZE and ITP-CZE resolutions of ammonium from other cations (sodium, potassium, calcium and magnesium) present in wastewater samples. Under preferred working conditions (suppressed hydrodynamic flow (HDF) and EOF on the column-coupling chip), both the employed methods did provide very good repeatabilities of the migration (RSD of 0.2-0.8% for the migration time) and quantitative (RSD of 0.3-4.9% for the peak area) parameters in the model and wastewater samples. Using a 900-nL sample injection volume, LOD for ammonium were obtained at 20 and 40 μg/L concentrations in CZE and ITP-CZE separations, respectively. Very good agreements of the CZE and ITP-CZE determinations of ammonium in six untreated wastewater samples (only filtration and dilution) with the results obtained by a reference spectrometric method indicate a very good accuracy of both the CE methods presented. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Results from the electro-optic sensors domain of the materials and components for missiles innovation and technology partnership (phase 1)

NASA Astrophysics Data System (ADS)

Bray, Mark E.; Shears, Robert A.

2013-10-01

The Materials and Components for Missiles Innovation and Technology Partnership (ITP) is a research programme supporting research for guided weapons at Technology Readiness Levels 1 to 4. The Anglo-French initiative is supported by the DGA and the MoD, with matched funding from industry. A major objective is to foster projects which partner UK and French universities, SMEs and larger companies. The first projects started in January 2008 and the first phase completed in spring 2013. Providing funding is secured, the next phase of the programme is due to start later in 2013. Selex ES leads Domain 3 of the MCM-ITP which develops Electro-Optic sensor technology. In collaboration with DGA, MoD and MBDA, the prime contractor, we identified 4 key objectives for the first ITP phase and focussed resources on achieving these. The objectives were to enable better imagery, address operationally stressing scenarios, provide low overall through life cost and improve active and semi-active sensors Nine normal projects and one ITP innovation fund project have been supported within the domain. The technology providers have included 3 SMEs and 8 research centres from both the United Kingdom and France. Highlights of the projects are included. An outline of the priorities for the domain for the new phase ise provided and we encourage organisations with suitable technology to contact us to get involved.

Eltrombopag for the treatment of chronic idiopathic (immune) thrombocytopenic purpura (ITP).

PubMed

Boyers, D; Jia, X; Crowther, M; Jenkinson, D; Fraser, C; Mowatt, G

2011-05-01

This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of eltrombopag for the treatment of adults with chronic idiopathic (immune) thrombocytopenic purpura (ITP), based on a review of the manufacturer's submission (MS) to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal process. ITP is an autoimmune disorder by which antibodies are formed against platelets with annual incidence rates in the UK/USA ranging from 1.13 to 6.62 cases per 100,000 adults. Eltrombopag increases the production of platelets at a rate that outpaces their destruction by the immune system, and has a UK marketing authorisation both for the treatment of adult ITP in splenectomised patients who are refractory to other treatments and as a second-line treatment for adult non-splenectomised patients for whom surgery is contraindicated. Both splenectomised and non-splenectomised patient groups were considered in the analysis. Two economic models were presented, one for a watch-and-rescue treatment scenario and the second for the long-term treatment of patients with more severe ITP. The submission's evidence was sourced from the relatively high-quality RAISE [RAndomized placebo-controlled Idiopathic thrombocytopenic purpura (ITP) Study with Eltrombopag] randomised controlled trial. The study indicated a statistically significant difference in favour of eltrombopag compared with placebo in the odds of achieving the primary outcome of a platelet count of between 50 and 400 × 109/l during the 6-month treatment period (odds ratio 8.2, 99% confidence interval 3.6 to 18.7). In the eltrombopag group, 50/83 (60%) non-splenectomised patients and 18/49 (37%) splenectomised patients achieved this outcome. Median duration of response for all patients was 10.9 weeks (splenectomised patients 6 weeks and non-splenectomised patients 13.4 weeks). Patients treated with eltrombopag required less rescue medication and had lower odds of bleeding events than placebo-treated subjects in both patient groups. In the watch-and-rescue economic model, the ERG found that substantial reductions in the cost of eltrombopag are needed for the incremental cost-effectiveness ratio (ICER) to fall below £ 30,000. Further analyses found that the ICER varied from £33,561 to £ 103,500 per quality-adjusted life-year (QALY) (splenectomised) and from £ 39,657 to £ 150,245 per QALY (non-splenectomised). Other than bleeding, no adverse events were modelled. In relation to the long-term treatment model, the ERG found that using non-randomised non-comparative data may result in biased estimates of unknown magnitude and direction. None of the treatment sequences resulted in an ICER approaching the recommended threshold of £ 30,000. The base-case results, using a 2-year time horizon and prescribing eltrombopag as second-line treatment post rituximab, were found to be favourable towards eltrombopag. In conclusion, based on the MS and additional ERG work, eltrombopag appears to be a safe treatment for ITP (although long-term follow-up studies are awaited) and has short-term efficacy. However, there is no robust evidence on long-term efficacy or cost-effectiveness of eltrombopag, and there is a lack of robust direct evidence on the effectiveness and cost-effectiveness of eltrombopag compared with other relevant comparators. NICE did not recommend eltrombopag for the treatment of chronic ITP within its marketing authorisation for splenectomised or non-splenectomised patients.

Pulsed high-dose dexamethasone improves interleukin 10 secretion by CD5+ B cells in patients with primary immune thrombocytopenia.

PubMed

Hua, Fanli; Ji, Lili; Zhan, Yanxia; Li, Feng; Zou, Shanhua; Wang, Xiaoyun; Song, Dongli; Min, Zhihui; Gao, Song; Wu, Yangjiong; Chen, Hao; Cheng, Yunfeng

2012-12-01

B cells expressing CD5 are potentially capable of producing interleukin 10 (IL-10) which contributes to the regulatory function of B cells. This study was aimed at exploring the alteration of numbers of CD5(+) B cells and their ability of producing IL-10 in patients with immune thrombocytopenia (ITP), and the effects of pulsed high-dose dexamethasone (HD-DXM) therapy on CD5(+) B cells. Peripheral blood mononuclear cells from 25 adult ITP patients were stained with PE-CD5/FITC-CD19 antibodies for flow cytometry analyses before and after HD-DXM therapy. The expression of IL-10 mRNA was measured by RT-PCR. After 24 h culture with or without dexamethasone in the presence of PMA, ionomycin and Brefeldin A, cells were permeabilized and stained with APC-IL-10 antibody to investigate intracellular IL-10 expression. Supernatant IL-10 concentration was detected by ELISA. The number of CD5(+) B cells was elevated in patients with ITP. Expression of IL-10 mRNA, percentage of IL-10(+) cells and intracellular IL-10 in CD5(+) B cells from untreated patients were significantly higher than that in controls. In contrast, ITP patients showed lower IL-10 concentration in supernatants than controls. After HD-DXM therapy, the number of CD5(+) B cells decreased to normal level, while intracellular IL-10 expression in CD5(+) B cells was further enhanced and IL-10 concentration in supernatants was also increased. Similar results were observed when dexamethasone was administrated in vitro. Increased number of CD5(+) B cells in which IL-10 is accumulated with decreased IL-10 concentration in supernatants suggests that the ability of CD5(+) B cells to secret IL-10 is impaired in ITP patients. Both the aberrant number and ability of IL-10 secretion of CD5(+) B cells could be corrected by HD-DXM.

Changes in bone marrow morphology in adults receiving romiplostim for the treatment of thrombocytopenia associated with primary immune thrombocytopenia.

PubMed

Janssens, Ann; Rodeghiero, Francesco; Anderson, David; Chong, Beng H; Boda, Zoltán; Pabinger, Ingrid; Červinek, Libor; Terrell, Deirdra R; Wang, Xuena; Franklin, Janet

2016-06-01

The effects of romiplostim on bone marrow morphology were evaluated in adults with immune thrombocytopenia (ITP). Patients with platelet counts <50 × 10(9)/L, ≥1 prior ITP therapies, and no collagen at baseline received weekly subcutaneous romiplostim starting at 1 μg/kg, adjusted to maintain platelet counts between 50 and 200 × 10(9)/L. Biopsies were scheduled after 1, 2, or 3 years of romiplostim (cohorts 1, 2, and 3, respectively). Irrespective of scheduled time, biopsies were performed earlier if patients discontinued or failed to achieve/maintain a response to romiplostim. Reticulin (silver stain) and collagen (trichrome stain) were graded by two hematopathologists using the modified Bauermeister scale (0-4). Of 169 patients, 131 had evaluable biopsies; 9/131 (6.9 %) had increases of ≥2 grades on the modified Bauermeister scale (cohort 1: 0/34; cohort 2: 2/39; cohort 3: 7/58), including two with collagen. Three of the nine patients had follow-up biopsies, including one patient with collagen; changes were reversible after romiplostim discontinuation. Of the nine patients, one had neutropenia detected by laboratory test and two had adverse events of anemia, both non-serious and not treatment-related. By actual exposure (as some biopsies did not occur as scheduled), the number of patients with grade increases ≥2 were year 1: 3/41, year 2: 1/38, year 3: 5/52. Twenty-four patients sustained platelet counts ≥50 × 10(9)/L for ≥6 months with no ITP medications after discontinuing romiplostim, i.e., they entered clinical remission of their ITP. In conclusion, in patients with ITP receiving romiplostim, bone marrow changes were observed in a small proportion of patients.ClinicalTrials.gov identifier: NCT#00907478.

Deep brain stimulation for treatment-resistant major depressive disorder: a comparison of two targets and long-term follow-up

PubMed Central

Raymaekers, S; Luyten, L; Bervoets, C; Gabriëls, L; Nuttin, B

2017-01-01

We previously found that electrical stimulation in the anterior limb of the internal capsule/bed nucleus of the stria terminalis (IC/BST) alleviates depressive symptoms in severe treatment-resistant obsessive-compulsive disorder (OCD) patients. Here we tested the hypothesis that electrical stimulation in either IC/BST or in the inferior thalamic peduncle (ITP) effectively reduces depressive symptoms in treatment-resistant major depressive disorder (TRD). In a double-blind crossover design, the effects of electrical stimulation at both targets were compared in TRD patients. The 17-item Hamilton Depression Rating scale (HAM-D) was the primary outcome measure. During the first crossover, patients received IC/BST stimulation versus no stimulation in random order (2 × 1 weeks). During the second crossover (3 × 2 months), patients received IC/BST versus ITP versus no stimulation. Patients and evaluators were blinded for stimulation conditions. All patients (n=7) were followed up for at least 3 years (3–8 years) after implantation. Six patients completed the first crossover and five patients completed the second. During the first crossover, mean (s.d.) HAM-D scores were 21.5 (2.7) for no stimulation and 11.5 (8.8) for IC/BST stimulation. During the second crossover, HAM-D scores were 15.4 (7.5) for no stimulation, 7.6 (3.8) for IC/BST stimulation and 11.2 (7.5) for ITP stimulation. The final sample size was too small to statistically analyze this second crossover. At last follow-up, only one patient preferred ITP over IC/BST stimulation. Two patients, with a history of suicide attempts before implantation, committed suicide during the follow-up phases of this study. Our data indicate that, in the long term, both ITP and IC/BST stimulation may alleviate depressive symptoms in patients suffering from TRD. PMID:29087373

Inverse treatment planning for spinal robotic radiosurgery: an international multi-institutional benchmark trial.

PubMed

Blanck, Oliver; Wang, Lei; Baus, Wolfgang; Grimm, Jimm; Lacornerie, Thomas; Nilsson, Joakim; Luchkovskyi, Sergii; Cano, Isabel Palazon; Shou, Zhenyu; Ayadi, Myriam; Treuer, Harald; Viard, Romain; Siebert, Frank-Andre; Chan, Mark K H; Hildebrandt, Guido; Dunst, Jürgen; Imhoff, Detlef; Wurster, Stefan; Wolff, Robert; Romanelli, Pantaleo; Lartigau, Eric; Semrau, Robert; Soltys, Scott G; Schweikard, Achim

2016-05-08

Stereotactic radiosurgery (SRS) is the accurate, conformal delivery of high-dose radiation to well-defined targets while minimizing normal structure doses via steep dose gradients. While inverse treatment planning (ITP) with computerized optimization algorithms are routine, many aspects of the planning process remain user-dependent. We performed an international, multi-institutional benchmark trial to study planning variability and to analyze preferable ITP practice for spinal robotic radiosurgery. 10 SRS treatment plans were generated for a complex-shaped spinal metastasis with 21 Gy in 3 fractions and tight constraints for spinal cord (V14Gy < 2 cc, V18Gy < 0.1 cc) and target (coverage > 95%). The resulting plans were rated on a scale from 1 to 4 (excellent-poor) in five categories (constraint compliance, optimization goals, low-dose regions, ITP complexity, and clinical acceptability) by a blinded review panel. Additionally, the plans were mathemati-cally rated based on plan indices (critical structure and target doses, conformity, monitor units, normal tissue complication probability, and treatment time) and compared to the human rankings. The treatment plans and the reviewers' rankings varied substantially among the participating centers. The average mean overall rank was 2.4 (1.2-4.0) and 8/10 plans were rated excellent in at least one category by at least one reviewer. The mathematical rankings agreed with the mean overall human rankings in 9/10 cases pointing toward the possibility for sole mathematical plan quality comparison. The final rankings revealed that a plan with a well-balanced trade-off among all planning objectives was preferred for treatment by most par-ticipants, reviewers, and the mathematical ranking system. Furthermore, this plan was generated with simple planning techniques. Our multi-institutional planning study found wide variability in ITP approaches for spinal robotic radiosurgery. The participants', reviewers', and mathematical match on preferable treatment plans and ITP techniques indicate that agreement on treatment planning and plan quality can be reached for spinal robotic radiosurgery.

Deep brain stimulation for treatment-resistant major depressive disorder: a comparison of two targets and long-term follow-up.

PubMed

Raymaekers, S; Luyten, L; Bervoets, C; Gabriëls, L; Nuttin, B

2017-10-31

We previously found that electrical stimulation in the anterior limb of the internal capsule/bed nucleus of the stria terminalis (IC/BST) alleviates depressive symptoms in severe treatment-resistant obsessive-compulsive disorder (OCD) patients. Here we tested the hypothesis that electrical stimulation in either IC/BST or in the inferior thalamic peduncle (ITP) effectively reduces depressive symptoms in treatment-resistant major depressive disorder (TRD). In a double-blind crossover design, the effects of electrical stimulation at both targets were compared in TRD patients. The 17-item Hamilton Depression Rating scale (HAM-D) was the primary outcome measure. During the first crossover, patients received IC/BST stimulation versus no stimulation in random order (2 × 1 weeks). During the second crossover (3 × 2 months), patients received IC/BST versus ITP versus no stimulation. Patients and evaluators were blinded for stimulation conditions. All patients (n=7) were followed up for at least 3 years (3-8 years) after implantation. Six patients completed the first crossover and five patients completed the second. During the first crossover, mean (s.d.) HAM-D scores were 21.5 (2.7) for no stimulation and 11.5 (8.8) for IC/BST stimulation. During the second crossover, HAM-D scores were 15.4 (7.5) for no stimulation, 7.6 (3.8) for IC/BST stimulation and 11.2 (7.5) for ITP stimulation. The final sample size was too small to statistically analyze this second crossover. At last follow-up, only one patient preferred ITP over IC/BST stimulation. Two patients, with a history of suicide attempts before implantation, committed suicide during the follow-up phases of this study. Our data indicate that, in the long term, both ITP and IC/BST stimulation may alleviate depressive symptoms in patients suffering from TRD.

Comparison of hydrodynamically closed isotachophoresis-capillary zone electrophoresis with hydrodynamically open capillary zone electrophoresis hyphenated with tandem mass spectrometry in drug analysis: pheniramine, its metabolite and phenylephrine in human urine.

PubMed

Piešťanský, Juraj; Maráková, Katarína; Kovaľ, Marián; Mikuš, Peter

2014-09-05

The advanced two dimensional isotachophoresis (ITP)-capillary zone electrophoresis (CZE) hyphenated with tandem mass spectrometry (MS/MS, here triple quadrupole, QqQ) was developed in this work to demonstrate analytical potentialities of this approach in the analysis of drugs in multicomponent ionic matrices. Pheniramine (PHM), phenylephrine (PHE), paracetamol (PCM) and their potential metabolic products were taken for the analysis by the ITP-CZE-ESI-QqQ technique working in hydrodynamically closed CE separation system and then a comparison with the conventional (hydrodynamically open) CZE-ESI-QqQ technique was made. The ITP-CZE-ESI-QqQ method was favorable in terms of obtainable selectivity (due to highly effective heart-cut analysis), concentration limits of detection (LOD at pgmL(-1) levels due to enhanced sample load capacity and ITP preconcentration), sample handling (on-line sample pretreatment, i.e. clean-up, preconcentration, preseparation), and, by that, possibilities for future automation and miniaturization. On the other hand, this experimental arrangement, in contrast to the CZE-ESI-QqQ arrangement supported by an electroosmotic flow, is principally limited to the analysis of uniformly (i.e. positively or negatively) charged analytes in one run without any possibilities to analyze neutral compounds (here, PCM and neutral or acidic metabolites of the drugs had to be excluded from the analysis). Hence, these general characteristics should be considered when choosing a proper analytical CE-MS approach for a given biomedical application. Here, the analytical potential of the ITP-CZE-ESI-QqQ method was demonstrated showing the real time profiles of excreted targeted drugs and metabolite (PHM, PHE, M-PHM) in human urine after the administration of one dose of Theraflu(®) to the volunteers. Copyright © 2014 Elsevier B.V. All rights reserved.

Immune Thrombocytopenia in Pregnancy

PubMed Central

Stavrou, Evi; McCrae, Keith R.

2009-01-01

SYNOPSIS Management of ITP in pregnancy can be a complex and challenging task, and may be complicated by fetal/neonatal thrombocytopenia. Though fetal intracranial hemorrhage is a rare complication of ITP in pregnancy, invasive studies designed to determine the fetal platelet count before delivery are associated with greater risk than that of fetal intracranial hemorrhage, and therefore are discouraged. Moreover, the risk of neonatal bleeding complications does not correlate with the mode of delivery, and thus cesarean section should be reserved for obstetric indications only. PMID:19932435

Proceedings of the Seminar on the DoD Computer Security Initiative Program, National Bureau of Standards, Gaithersburg, Maryland, July 17-18, 1979.

DTIC Science & Technology

1979-01-01

specifications have been prepared for a DoD communications processor on an IBM minicomputer, a minicomputer time sharing system for the DEC PDP-11 and...the Honeywell Level 6. a virtual machine monitor for the IBM 370, and Multics [10] for the Honeywell Level 68. MECHANISMS FOR KERNEL IMPLEMENTATION...HOL INA ZJO : ANERIONS g PROCESSORn , c ...THEOREMS 1 ITP I-THEOREMS PROOF EVIDENCE - p II KV./370 FORMAL DESIGN PROCESS M4ODULAR DECOMPOSITION * NON

Low-Voltage Paper Isotachophoresis Device for DNA Focusing

PubMed Central

Li, Xiang; Luo, Long; Crooks, Richard M.

2015-01-01

We present a new paper-based isotachophoresis (ITP) device design for focusing DNA samples having lengths ranging from 23 to at least 1517 bp. DNA is concentrated by more than two orders of magnitude within 4 min. The key component of this device is a 2 mm-long, 2 mm-wide circular paper channel formed by concertina folding a paper strip and aligning the circular paper zones on each layer. Due to the short channel length, a high electric field of ~16 kV/m is easily generated in the paper channel using two 9 V batteries. The multilayer architecture also enables convenient reclamation and analysis of the sample after ITP focusing by simply opening the origami paper and cutting out the desired layers. We profiled the electric field in the origami paper channel during ITP experiments using a nonfocusing fluorescent tracer. The result showed that focusing relies on formation and subsequent movement of a sharp electric field boundary between the leading and trailing electrolyte. PMID:26338530

Dysplastic changes in idiopathic thrombocytopenic purpura and the effect of corticosteroids to increase dysplasia and cause hyperdiploid macropolycytes.

PubMed

Olcay, L; Yetgin, S; Okur, H; Erekul, S; Tuncer, M

2000-10-01

This study evaluates the dysplastic hematological changes in nine patients with idiopathic thrombocytopenic purpura (ITP) in 11 attacks, before and after corticosteroid treatment. The pretreatment blood smears of patients with ITP, displayed more neutrophils with bizarre nuclei (P < 0.001), Döhle or Döhle-like inclusions (P < 0. 01), irregular distribution of granules (P < 0.05), hypo-agranulation (P < 0.05), pseudo-Pelger-Huet-like cells (P < 0. 01), and nuclei with chromatine clumping (P < 0.01) than the normal children. The eosinophils of ITP patients were also dysplastic, before treatment. The pretreatment diameter of the neutrophils and the percentage of macropolycytes were greater than those of the patients with viral infections and normal group (P < 0.05 for all). The percentage of neutrophils with bizarre nuclei and nuclei with chromatine clumping and the diameter of neutrophils and macropolycyte percentage increased with corticosteroid therapy (P < 0.01, < 0.01, < 0.01, and < 0.05, respectively). The neutrophil diameter, percentage of macropolycytes, and number of neutrophils with bizarre nuclei decreased within 1-4 weeks after the therapy was stopped. In the neutrophils of two patients, diploidy and hyperdiploidy were established before and on the last day of therapy, respectively, and diploidy reversed after therapy was stopped. In conclusion, ITP patients display dysplastic findings in both neutrophils and eosinophils before treatment and corticosteroids cause transient significant increase in some of the dysplastic changes in neutrophils. Copyright 2000 Wiley-Liss, Inc.

Evaluation of 143 Cases of Immune Thrombocytopenic Purpura With Regards to Clinical Course and Response to Treatment

PubMed Central

Albayrak, Murat; Balcik, Ozlem Sahin; Aki, Sahika Zeynep; Gokmen, Ayla; Ceran, Funda; Yokus, Osman; Dagdas, Simten; Ayli, Meltem; Ozet, Gulsum

2010-01-01

Objective: Immune thrombocytopenic purpura (ITP) is also known as idiopathic thrombocytopenic purpura. Increased platelet destruction and insufficient platelet production are both responsible for its etiopathogenesis. ITP can be diagnosed after excluding other possible causes of thrombocytopenia. Materials and Methods: One hundred forty-three cases of chronic ITP that were monitored in a hematology clinic were retrospectively evaluated. All cases received first line treatment of 1 mg/kg/day prednisolone. Corticosteroid nonresponsive (CN) cases and corticosteroid-dependent (CD) cases underwent splenectomies. Results: The rate of CN/CD cases was found to be 53% (n=76). Sixty-six percent of these cases (n=50) underwent splenectomies. The ratio of non-responsive cases to relapse cases after splenectomy (SN/SR) was 30% (n=15). The total number of cases was 41, including those without splenectomy (n=26) and with SY/SR (n=15). Helicobacter pylori (Hp) eradication, immunosuppressive agents and danazol treatments were administered to patients (n=10, n=14 and n=4, respectively). Currently, 13 patients are being monitored without treatment. Fifteen patients who were non-responsive to Hp eradication treatment, immunosuppressive treatment or danazol treatment are still being monitored without any treatment. Conclusion: Optimal treatment is not available for splenectomy-resistant cases of ITP. The response rates for Hp eradication treatment, immunosuppressive treatments and anabolic agents are low. Therefore, larger studies with more patients are required using new agents, such as thrombopoietin (TPO) receptor agonists and anti-CD20 monoclonal antibodies. PMID:25610140

Trace analysis of glyphosate in water by capillary electrophoresis on a chip with high sample volume loadability.

PubMed

Horčičiak, Michal; Masár, Marián; Bodor, Róbert; Danč, Ladislav; Bel, Peter

2012-03-01

A new method for the determination of trace glyphosate (GLYP), non-selective pesticide, by CZE with online ITP pre-treatment of drinking waters on a column-coupling (CC) chip has been developed. CC chip was equipped with two injection channels of 0.9 and 9.9 μL volumes, two separation channels of 9.3 μL total volume and a pair of conductivity detectors. A very effective ITP sample clean-up performed in the first channel at low pH (3.2) was introduced for quick CZE resolution and detection of GLYP carried out at higher pH (6.1) in the second channel on the CC chip. The LOD for GLYP was estimated at 2.5 μg/L (15 nmol/L) using a 9.9 |mL volume of the injection channel. ITP-CZE analyses of model and real samples have provided very favorable intra-day (0.1-1.2% RSD) and inter-day (2.9% RSD) repeatabilities of the migration time for GLYP while 0.2-6.9% RSD values were typical for the peak area data. Recoveries of GLYP in spiked drinking water varied in the range of 99-109%. A minimum pre-treatment of drinking water (degassing and dilution) and a short analysis time (ca. 10 min) were distinctive features of ITP-CZE determinations of GLYP on the CC chip with high sample volume loaded, as well. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Structural and functional characterization of a noncanonical nucleoside triphosphate pyrophosphatase from Thermotoga maritima

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

Awwad, Khaldeyah; Desai, Anna; Smith, Clyde

A 2.15 Å resolution crystal structure of TM0159 with bound IMP and enzyme-kinetic data are presented. This noncanonical nucleoside triphosphatase from T. maritima helps to maintain a correct pool of DNA and RNA precursor molecules. The hyperthermophilic bacterium Thermotoga maritima has a noncanonical nucleoside triphosphatase that catalyzes the conversion of inosine triphosphate (ITP), deoxyinosine triphosphate (dITP) and xanthosine triphosphate (XTP) into inosine monophosphate (IMP), deoxyinosine monophosphate (IMP) and xanthosine monophosphate (XMP), respectively. The k{sub cat}/K{sub m} values determined at 323 and 353 K fall between 1.31 × 10{sup 4} and 7.80 × 10{sup 4} M{sup −1} s{sup −1}. ITP andmore » dITP are slightly preferred over XTP. Activity towards canonical nucleoside triphosphates (ATP and GTP) was not detected. The enzyme has an absolute requirement for Mg{sup 2+} as a cofactor and has a preference for alkaline conditions. A protein X-ray structure of the enzyme with bound IMP was obtained at 2.15 Å resolution. The active site houses a well conserved network of residues that are critical for substrate recognition and catalysis. The crystal structure shows a tetramer with two possible dimer interfaces. One of these interfaces strongly resembles the dimer interface that is found in the structures of other noncanonical nucleoside pyrophosphatases from human (human ITPase) and archaea (Mj0226 and PhNTPase)« less

Splenectomy and the incidence of venous thromboembolism and sepsis in patients with immune thrombocytopenia

PubMed Central

Boyle, Soames; White, Richard H.; Brunson, Ann

2013-01-01

Patients with immune thrombocytopenia (ITP) who relapse after an initial trial of corticosteroid treatment present a therapeutic challenge. Current guidelines recommend consideration of splenectomy, despite the known risks associated with surgery and the postsplenectomy state. To better define these risks, we identified a cohort of 9976 patients with ITP, 1762 of whom underwent splenectomy. The cumulative incidence of abdominal venous thromboembolism (AbVTE) was 1.6% compared with 1% in patients who did not undergo splenectomy; venous thromboembolism (VTE) (deep venous thrombosis and pulmonary embolus) after splenectomy was 4.3% compared with 1.7% in patients who did not undergo splenectomy. There was increased risk of AbVTE early (<90 days; hazard ratio [HR] 5.4 [confidence interval (CI), 2.3-12.5]), but not late (≥90 days; HR 1.5 [CI, 0.9-2.6]) after splenectomy. There was increased risk of VTE both early (HR 5.2 [CI, 3.2-8.5]) and late (HR 2.7 [CI, 1.9-3.8]) after splenectomy. The cumulative incidence of sepsis was 11.1% among the ITP patients who underwent splenectomy and 10.1% among the patients who did not. Splenectomy was associated with a higher adjusted risk of sepsis, both early (HR 3.3 [CI, 2.4-4.6]) and late (HR 1.6 or 3.1, depending on comorbidities). We conclude that ITP patients post splenectomy are at increased risk for AbVTE, VTE, and sepsis. PMID:23637127

Health-related quality of life in children with chronic immune thrombocytopenia in China.

PubMed

Zhang, Heng; Wang, Li; Quan, Meijie; Huang, Jie; Wu, Peng; Lu, Qin; Fang, Yongjun

2016-03-15

The concept of health-related quality of life (HRQoL) was brought up decades ago and has been well utilized in many different areas. Regarding immune thrombocytopenia (ITP) management, much work has been done to emphasize the necessity of taking HRQoL into consideration. However, data on HRQoL of children with chronic ITP remain rare. This is a cross-sectional study. Children with chronic ITP aged from 2 to 18 and their parents were recruited. Participants completed the Pediatric Quality of Life Inventory™ (PedsQL™) and Kids' ITP Tools (KIT) questionnaires at only one time. The Pearson's correlation was examined between these measures for the pooled samples. A total of 42 families participated. Mean child self-report scores of KIT and PedsQL™ were 78.60 (SD = 12.40) and 85.13 (SD = 14.12), respectively, corresponding to parent proxy report scores, which were 73.40 (SD = 19.96) and 85.10 (SD = 13.56), respectively. Mean score of KIT parent impact report was only 40.39 (SD = 19.96). Significantly higher KIT scores (self-report and parent proxy) were observed in children with PLT more than 30 × 10*9/L compared to others, and this difference was even more noticeable in the PedsQL™ parent proxy report group (p < 0.001). As with intravenous immunoglobulin, the statistics difference appeared only in KIT child self-report group (p = 0.03), while for bone marrow examination, the difference appeared only in PedsQL™ parent proxy report group (p = 0.01). A negative relationship was apparent between duration of disease and scores. Gender and use of corticosteroids had no impact on the KIT and PedsQL™ scores here. Internal consistency reliability was demonstrated with Cronbach's alpha for all scales above the acceptable level of 0.89 (range from 0.88 to 0.97). There was a substantial concordance (p < 0.001) between the child and parent proxy scores (ICC for KIT is 0.59, ICC for PedsQL™ is 0.85). Meanwhile, KIT scores are correlated with PedsQL™ (r = 0.75 for child self report, r = 0.61 for parent proxy report). ITP affects HRQoL of children and parents. Parents are much more concerned with the disease than their children, which seriously influence their HRQoL as a result. The cross-culture translated KIT is reliable and valid with acceptable correlation to the PedsQL™. KIT provides valuable information of childhood ITP and will be a reliable outcome measure for further clinical research on HRQoL.

My days as a student of Prof. Hao (1982-1986)

NASA Astrophysics Data System (ADS)

Ding, Mingzhou

In 1982 I graduated from Peking University with a bachelor's degree in astrophysics. Passing the entrance exam the same year I became a graduate student in the Institute of Theoretical Physics (ITP), Chinese Academy of Sciences, with Prof. Hao Bailin as my advisor. More than 30 years have gone by. I often recall the days I spent at the ITP with great fondness. Classmates have become life-long friends. The lessons we have learned from Prof. Hao about research, scholarship and life continue to influence us today...

Advanced Materials in Support of EERE Needs to Advance Clean Energy Technologies Program Implementation

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

Liby, Alan L; Rogers, Hiram

The goal of this activity was to carry out program implementation and technical projects in support of the ARRA-funded Advanced Materials in Support of EERE Needs to Advance Clean Energy Technologies Program of the DOE Advanced Manufacturing Office (AMO) (formerly the Industrial Technologies Program (ITP)). The work was organized into eight projects in four materials areas: strategic materials, structural materials, energy storage and production materials, and advanced/field/transient processing. Strategic materials included work on titanium, magnesium and carbon fiber. Structural materials included work on alumina forming austentic (AFA) and CF8C-Plus steels. The advanced batteries and production materials projects included work onmore » advanced batteries and photovoltaic devices. Advanced/field/transient processing included work on magnetic field processing. Details of the work in the eight projects are available in the project final reports which have been previously submitted.« less

Transient isotachophoresis-capillary zone electrophoresis with contactless conductivity and ultraviolet detection for the analysis of paralytic shellfish toxins in mussel samples.

PubMed

Abdul Keyon, Aemi S; Guijt, Rosanne M; Bolch, Christopher J S; Breadmore, Michael C

2014-10-17

The accumulation of paralytic shellfish toxins (PSTs) in contaminated shellfish is a serious health risk making early detection important to improve shellfish safety and biotoxin management. Capillary electrophoresis (CE) has been proven as a high resolution separation technique compatible with miniaturization, making it an attractive choice in the development of portable instrumentation for early, on-site detection of PSTs. In this work, capillary zone electrophoresis (CZE) with capacitively coupled contactless conductivity detector (C(4)D) and UV detection were examined with counter-flow transient isotachophoresis (tITP) to improve the sensitivity and deal with the high conductivity sample matrix. The high sodium concentration in the sample was used as the leading ion while l-alanine was used as the terminating electrolyte (TE) and background electrolyte (BGE) in which the toxins were separated. Careful optimization of the injected sample volume and duration of the counter-flow resulted in limit of detections (LODs) ranging from 74.2 to 1020 ng/mL for tITP-CZE-C(4)D and 141 to 461 ng/mL for tITP-CZE-UV, an 8-97 fold reduction compared to conventional CZE. The LODs were adequate for the analysis of PSTs in shellfish samples close to the regulatory limit. Intra-day and inter-day repeatability values (percentage relative standard deviation, n=3) of tITP-CZE-C(4)D and tITP-CZE-UV methods for both migration time and peak height were in the range of 0.82-11% and 0.76-10%, respectively. The developed method was applied to the analysis of a contaminated mussel sample and validated against an Association of Official Analytical Chemists (AOAC)-approved method for PSTs analysis by high performance liquid chromatography (HPLC) with fluorescence detection (FLD) after pre-column oxidation of the sample. The method presented has potential for incorporation in to field-deployable devices for the early detection of PSTs on-site. Copyright © 2014 Elsevier B.V. All rights reserved.

Inverse treatment planning for spinal robotic radiosurgery: an international multi‐institutional benchmark trial

PubMed Central

Wang, Lei; Baus, Wolfgang; Grimm, Jimm; Lacornerie, Thomas; Nilsson, Joakim; Luchkovskyi, Sergii; Cano, Isabel Palazon; Shou, Zhenyu; Ayadi, Myriam; Treuer, Harald; Viard, Romain; Siebert, Frank‐Andre; Chan, Mark K.H.; Hildebrandt, Guido; Dunst, Jürgen; Imhoff, Detlef; Wurster, Stefan; Wolff, Robert; Romanelli, Pantaleo; Lartigau, Eric; Semrau, Robert; Soltys, Scott G.; Schweikard, Achim

2016-01-01

Stereotactic radiosurgery (SRS) is the accurate, conformal delivery of high‐dose radiation to well‐defined targets while minimizing normal structure doses via steep dose gradients. While inverse treatment planning (ITP) with computerized optimization algorithms are routine, many aspects of the planning process remain user‐dependent. We performed an international, multi‐institutional benchmark trial to study planning variability and to analyze preferable ITP practice for spinal robotic radiosurgery. 10 SRS treatment plans were generated for a complex‐shaped spinal metastasis with 21 Gy in 3 fractions and tight constraints for spinal cord (V14Gy<2 cc, V18Gy<0.1 cc) and target (coverage >95%). The resulting plans were rated on a scale from 1 to 4 (excellent‐poor) in five categories (constraint compliance, optimization goals, low‐dose regions, ITP complexity, and clinical acceptability) by a blinded review panel. Additionally, the plans were mathematically rated based on plan indices (critical structure and target doses, conformity, monitor units, normal tissue complication probability, and treatment time) and compared to the human rankings. The treatment plans and the reviewers' rankings varied substantially among the participating centers. The average mean overall rank was 2.4 (1.2‐4.0) and 8/10 plans were rated excellent in at least one category by at least one reviewer. The mathematical rankings agreed with the mean overall human rankings in 9/10 cases pointing toward the possibility for sole mathematical plan quality comparison. The final rankings revealed that a plan with a well‐balanced trade‐off among all planning objectives was preferred for treatment by most participants, reviewers, and the mathematical ranking system. Furthermore, this plan was generated with simple planning techniques. Our multi‐institutional planning study found wide variability in ITP approaches for spinal robotic radiosurgery. The participants', reviewers', and mathematical match on preferable treatment plans and ITP techniques indicate that agreement on treatment planning and plan quality can be reached for spinal robotic radiosurgery. PACS number(s): 87.55.de PMID:27167291

Assessment Study on Sensors and Automation in the Industries of the Future. Reports on Industrial Controls, Information Processing, Automation, and Robotics

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

Bennett, Bonnie; Boddy, Mark; Doyle, Frank

This report presents the results of an expert study to identify research opportunities for Sensors & Automation, a sub-program of the U.S. Department of Energy (DOE) Industrial Technologies Program (ITP). The research opportunities are prioritized by realizable energy savings. The study encompasses the technology areas of industrial controls, information processing, automation, and robotics. These areas have been central areas of focus of many Industries of the Future (IOF) technology roadmaps. This report identifies opportunities for energy savings as a direct result of advances in these areas and also recognizes indirect means of achieving energy savings, such as product quality improvement,more » productivity improvement, and reduction of recycle.« less

Batch Tests with IONSIV IE-911 and a Simulant of the Savannah River Site ''Average'' Supernatant: Distribution Ratios vs Time

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

Anderson, K.K.; Collins, J.L.; Hunt, R.D.

1999-02-01

The Department of Energy (DOE) is required by law to treat and safely dispose of the radioactive wastes from its nuclear weapon production activities. The primary radionuclide in the DOE liquid wastes or supernatants is {sup 137}Cs. At the Savannah River Site (SRS), the In-Tank Precipitation (ITP) process was selected as the baseline technology to remove {sup 137}Cs from the supernatants, which are stored in underground storage tanks. In the ITP process, tetraphenylborate reacts with the water-soluble cesium to form a precipitant. The treated supernatant can then be immobilized in grout or saltstone and stored in vaults at the SRS.more » However, problems were encountered during the full-scale ITP processing. These difficulties have led to the evaluation of alternative technologies and/or concepts to the currently configured ITP process. The High-Level Waste Salt Disposition Team at the SRS is currently performing this assessment. After an initial screening of all potential alternatives, the Salt Disposition Team selected four primary options to evaluate further before the final down-selection. Crystalline silicotitanate (CST), an inorganic ion exchanger, was chosen as one of the leading alternatives. Since nearly all of the CST tests have been performed on supernatants from Hanford and Oak Ridge, the Salt Disposition Team has requested that personnel at the SRS and Oak Ridge National Laboratory (ORNL) determine the performance of the engineered form of CST, IONSIV{reg_sign} IE-911, with actual and simulated SRS supernatants.« less

Corticosteroids compared with intravenous immunoglobulin for the treatment of immune thrombocytopenia in pregnancy.

PubMed

Sun, Dongmei; Shehata, Nadine; Ye, Xiang Y; Gregorovich, Sandra; De France, Bryon; Arnold, Donald M; Shah, Prakesh S; Malinowski, Ann Kinga

2016-09-08

Treatment options for immune thrombocytopenia (ITP) in pregnancy are limited, and evidence to guide management decisions is lacking. This retrospective study of singleton pregnancies from 2 tertiary centers compared the effectiveness of intravenous immunoglobulin (IVIg) and corticosteroids in treatment of ITP. Data from 195 women who had 235 pregnancies were reviewed. Treatment was not required in 137 pregnancies (58%). Of the remaining 98 pregnancies in 91 women, 47 (48%) were treated with IVIg and 51 were treated with corticosteroids as the initial intervention. Mean maternal platelet count at birth did not differ between groups (IVIg 69 × 10(9)/L vs corticosteroids 77 × 10(9)/L; P = .71) nor did the proportion of mothers who achieved a platelet count response (IVIg 38% vs corticosteroids 39%; P = .85). There were no fatal or severe maternal, fetal, or neonatal hemorrhages. Of 203 neonates in whom platelet counts were available, 56 (28%) had a birth platelet count <150 × 10(9)/L and 18 (9%) had platelet counts <50 × 10(9)/L. Nadir platelet counts for most affected neonates occurred at birth, although for some neonates, nadir platelet counts occurred up to 6 days postnatally. Intracranial hemorrhage was noted in 2 neonates (nadir platelet counts were 135 and 18 × 10(9)/L). There were no neonatal deaths. The majority of pregnant women with a history of ITP did not require treatment, and neonatal outcomes were comparable for mothers who received IVIg or corticosteroids for treatment of maternal ITP. © 2016 by The American Society of Hematology.

Expression of CD markers' in immune thrombocytopenic purpura: prognostic approaches.

PubMed

Behzad, Masumeh Maleki; Asnafi, Ali Amin; Jaseb, Kaveh; Jalali Far, Mohammad Ali; Saki, Najmaldin

2017-12-01

Immune Thrombocytopenic Purpura (ITP) is a common autoimmune bleeding disorder characterized by a reduction in peripheral blood platelet counts. In this disease, autoantibodies (Auto-Abs) are produced against platelet GPIIb/GPIIIa by B cells, which require interaction with T cells. In this review, the importance of B and T lymphocytes in ITP prognosis has been studied. Relevant literature was identified by a PubMed search (1990-2016) of English-language papers using the terms B and T lymphocyte, platelet, CD markers and immune thrombocytopenic purpura. T and B lymphocytes are the main immune cells in the body. Defective function causes disrupted balance of different subgroups of lymphocytes, and abnormal expression of surface markers of these cells results in self-tolerance dysfunction, as well as induction of Auto-Abs against platelet glycoproteins (PG). Given the role of B and T cells in production of autoantibodies against PG, it can be stated that the detection of changes in CD markers' expression in these cells can be a good approach for assessing prognosis in ITP patients. © 2017 APMIS. Published by John Wiley & Sons Ltd.

Hemorrhagic Stroke in an Adolescent Female with HIV-Associated Thrombotic Thrombocytopenic Purpura

PubMed Central

Rakhmanina, Natella; Wong, Edward CC; Davis, Jeremiah C; Ray, Patricio E

2014-01-01

HIV-1 infection can trigger acute episodes of Idiopathic Thrombocytoponic Purpura (ITP), and Thrombotic Thrombocytopenic Purpura (TTP), particularly in populations with advanced disease and poor adherence to antiretroviral therapy (ART). These diseases should be distinguished because they respond to different treatments. Previous studies done in adults with HIV-TTP have recommended the prompt initiation or re-initiation of ART in parallel with plasma exchange therapy to improve the clinical outcome of these patients. Here, we describe a case of HIV-TTP resulting in an acute hemorrhagic stroke in a 16 year old female with perinatally acquired HIV infection and non-adherence to ART, who presented with severe thrombocytopenia, microangiopathic hemolytic anemia, and a past medical history of HIV-ITP. Both differential diagnosis and treatments for HIV-ITP and HIV-TTP were considered simultaneously. A decrease in plasma ADAMTS13 activity (<5%) without detectable inhibitory antibodies confirmed the diagnosis of HIV-TTP. Re-initiation of ART and plasma exchange resulted in a marked decrease in the HIV-RNA viral load, recovery of the platelet count, and complete recovery was achieved with sustained virologic suppression. PMID:25429351

Precision and Accuracy of Analysis for Boron in ITP Samples

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

Tovo, L.L.

'Inductively Coupled Plasma Emission Spectroscopy (ICPES) has been used by the Analytical Development Section (ADS) to measure boron in catalytic tetraphenylboron decomposition studies performed by the Waste Processing Technology (WPT) section. Analysis of these samples is complicated due to the presence of high concentrations of sodium and organic compounds. Previously, we found signal suppression in samples analyzed "as received". We suspected that the suppression was due to the high organic concentration (up to 0.01 molar organic decomposition products) in the samples. When the samples were acid digested prior to analysis, the suppression was eliminated. The precision of the reported boronmore » concentration was estimated as 10 percent based on the known precision of the inorganic boron standard used for calibration and quality control check of the ICPES analysis. However, a precision better than 10 percent was needed to evaluate ITP process operating parameters. Therefore, the purpose of this work was (1) to measure, instead of estimating, the precision of the boron measurement on ITP samples and (2) to determine the optimum precision attainable with current instrumentation.'« less

Application of Rotorcraft Flight Simulation Program (C81) to Predict Rotor Performance and Bending Moments for a Model Four-Bladed Articulated Rotor System

DTIC Science & Technology

1974-11-01

IBM System 360 Scientific Subroutine Package (GH2O-O205- 4), Version 3, page 36 (International Business Machines Corporation, New York), September...CO en c mm c \\A a C ITP u. r* O" ^ ’-4 ■O h- INI X a IX. 2 < tL. < h- -J r-i m fM •—• O h- rvj (/l c < u. c r -j O -J \\r A <*\\ r.. ir rH O o 0* a 2

Simulating pedestrian flow by an improved two-process cellular automaton model

NASA Astrophysics Data System (ADS)

Jin, Cheng-Jie; Wang, Wei; Jiang, Rui; Dong, Li-Yun

In this paper, we study the pedestrian flow with an Improved Two-Process (ITP) cellular automaton model, which is originally proposed by Blue and Adler. Simulations of pedestrian counterflow have been conducted, under both periodic and open boundary conditions. The lane formation phenomenon has been reproduced without using the place exchange rule. We also present and discuss the flow-density and velocity-density relationships of both uni-directional flow and counterflow. By the comparison with the Blue-Adler model, we find the ITP model has higher values of maximum flow, critical density and completely jammed density under different conditions.

Evaluation of an Impedance Threshold Device as a VIIP Countermeasure

NASA Technical Reports Server (NTRS)

Ebert, D.; Macias, B.; Garcia, K.; Stenger, M.; Hargens, A.; Johnston, S.

2016-01-01

Visual Impairment /Intracranial Pressure (VIIP) is a top human spaceflight risk for which NASA does not currently have a proven mitigation strategy. Thigh cuffs (Braslets) and lower body negative pressure (LBNP; Chibis) devices have been or are currently being evaluated as a means to reduce VIIP signs and symptoms, but these methods alone may not provide sufficient relief of cephalic venous congestion and VIIP symptoms. Additionally, current LBNP devices are too large and cumbersome for their systematic use as a countermeasure. Therefore, a novel approach is needed that is easy to implement and provides specific relief of symptoms. This investigation will evaluate an impedance threshold device (ITD) as a VIIP countermeasure. The ITD works by providing up to 7 cm H2O (approximately 5 mmHg) resistance to inspiratory air flow, effectively turning the thorax into a vacuum pump upon each inhalation which lowers the intrathoracic pressure (ITP) and facilitates venous return to the heart. The ITD is FDA-approved and was developed to augment venous return to the central circulation and increase cardiac output during cardiopulmonary resuscitation (CPR) and in patients with hypotension. While the effect of ITD on CPR survival outcomes is controversial, the ITD's ability to lower ITP with a concomitant decrease in intracranial pressure (ICP) is well documented. A similar concept that creates negative ITP during exhalation (intrathoracic pressure regulator; ITPR) decreased ICP in 16 of 20 patients with elevated ICP in a hospital pilot study. ITP and central venous pressure (CVP) have been shown to decrease in microgravity however ITP drops more than CVP, indicating an increased transmural CVP. This could explain the paradoxical distention of jugular veins (JV) in microgravity despite lower absolute CVP and also suggests that JV transmural pressure is not dramatically elevated. Use of an ITD may lower JV pressure enough to remove or relieve cephalic venous congestion. During spaceflight experiments with Braslet thigh cuffs and modified (open-glottis) Mueller maneuvers, Braslets alone reduced cardiac preload but only reduced the internal JV (IJV) cross sectional area by 23%. The addition of Mueller maneuvers resulted in an IJV area reduction of 48%. This project will test if ITD essentially applies a Mueller maneuver with added negative ITP in every respiratory cycle, acting to: 1) reduce venous congestion in the neck and 2) potentially lower ICP. The expected mechanism of action is that in microgravity (or an analog) blood is relocated toward the heart from vasculature in the head and neck. Once validated, the ITD would be an exceptionally easy countermeasure to deploy and test on the ISS. Dosage could be altered though 1) duration of application and 2) inspiratory resistance set point. Effects could be additionally enhanced through co-application with other countermeasures such as thigh cuffs or LBNP.

Evaluation of an Impedance Threshold Device as a VIIP Countermeasure

NASA Technical Reports Server (NTRS)

Ebert, Douglas; Macias, Brandon; Sargsyan, Ashot; Garcia, Kathleen; Stenger, Michael; Hargens, Alan; Johnston, Smith; Kemp, David; Danielson, Richard

2016-01-01

Visual Impairment/Intracranial Pressure (VIIP) is a top human spaceflight risk for which NASA does not currently have a proven mitigation strategy. Thigh cuffs (Braslets) and lower body negative pressure (LBNP; Chibis) devices have been or are currently being evaluated as a means to reduce VIIP signs and symptoms, but these methods alone may not provide sufficient relief of cephalic venous congestion and VIIP symptoms. Additionally, current LBNP devices are too large and cumbersome for their systematic use as a countermeasure. Therefore, a novel approach is needed that is easy to implement and provides specific relief of symptoms. This investigation will evaluate an impedance threshold device (ITD) as a VIIP countermeasure. The ITD works by providing up to 7 cm H2O (approximately 5 mmHg) resistance to inspiratory air flow, effectively turning the thorax into a vacuum pump upon each inhalation which lowers the intrathoracic pressure (ITP) and facilitates venous return to the heart. The ITD is FDA-approved and was developed to augment venous return to the central circulation and increase cardiac output during cardiopulmonary resuscitation (CPR) and in patients with hypotension. While the effect of ITD on CPR survival outcomes is controversial, the ITD's ability to lower ITP with a concomitant decrease in intracranial pressure (ICP) is well documented. A similar concept that creates negative ITP during exhalation (intrathoracic pressure regulator; ITPR) decreased ICP in 16 of 20 patients with elevated ICP in a hospital pilot study. ITP and central venous pressure (CVP) have been shown to decrease in microgravity however ITP drops more than CVP, indicating an increased transmural CVP. This could explain the paradoxical distention of jugular veins (JV) in microgravity despite lower absolute CVP and also suggests that JV transmural pressure is not dramatically elevated. Use of an ITD may lower JV pressure enough to remove or relieve cephalic venous congestion. During spaceflight experiments with Braslet thigh cuffs and modified (open-glottis) Mueller maneuvers, Braslets alone reduced cardiac preload but only reduced the internal JV (IJV) cross sectional area by 23%. The addition of Mueller maneuvers resulted in an IJV area reduction of 48%. This project will test if ITD essentially applies a Mueller maneuver with added negative ITP in every respiratory cycle, acting to: 1) reduce venous congestion in the neck and 2) potentially lower ICP. The expected mechanism of action is that in microgravity (or an analog) blood is relocated toward the heart from vasculature in the head and neck. Once validated, the ITD would be an exceptionally easy countermeasure to deploy and test on the ISS. Dosage could be altered though 1) duration of application and 2) inspiratory resistance set point. Effects could be additionally enhanced through co-application with other countermeasures such as thigh cuffs or LBNP.

Install Waste Heat Recovery Systems for Fuel-Fired Furnaces (English/Chinese) (Fact Sheet) (in Chinese; English)

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

Not Available

Chinese translation of ITP fact sheet about installing Waste Heat Recovery Systems for Fuel-Fired Furnaces. For most fuel-fired heating equipment, a large amount of the heat supplied is wasted as exhaust or flue gases. In furnaces, air and fuel are mixed and burned to generate heat, some of which is transferred to the heating device and its load. When the heat transfer reaches its practical limit, the spent combustion gases are removed from the furnace via a flue or stack. At this point, these gases still hold considerable thermal energy. In many systems, this is the greatest single heat loss.more » The energy efficiency can often be increased by using waste heat gas recovery systems to capture and use some of the energy in the flue gas. For natural gas-based systems, the amount of heat contained in the flue gases as a percentage of the heat input in a heating system can be estimated by using Figure 1. Exhaust gas loss or waste heat depends on flue gas temperature and its mass flow, or in practical terms, excess air resulting from combustion air supply and air leakage into the furnace. The excess air can be estimated by measuring oxygen percentage in the flue gases.« less

A prospective randomized clinical trial of vincristine versus human intravenous immunoglobulin for acute adjunctive management of presumptive primary immune-mediated thrombocytopenia in dogs.

PubMed

Balog, K; Huang, A A; Sum, S O; Moore, G E; Thompson, C; Scott-Moncrieff, J C

2013-01-01

Dogs with immune-mediated thrombocytopenia (ITP) are at risk of hemorrhage when platelet count is <50,000/μL. Treatment with vincristine (VINC) or human intravenous immunoglobulin (hIVIG) decreases platelet recovery time compared with treatment with corticosteroids alone. To compare the effect of hIVIG versus VINC on platelet recovery in dogs with ITP. Prospective, randomized study. Twenty dogs with idiopathic ITP (platelet count <16,000/μL) were enrolled. All dogs were treated with corticosteroids. Dogs were randomly assigned to receive a single dose of hIVIG (0.5 g/kg) or VINC (0.02 mg/kg). Outcome measures were platelet recovery time, duration of hospitalization, and survival to discharge. There was no significant difference in age, sex, weight, or initial platelet count between dogs treated with hIVIG (n = 10) and dogs treated with VINC (n = 10). Median platelet recovery time for both groups was 2.5 days (P = .51). Median hospitalization time for all dogs that survived to discharge was 4 days and not different between groups (P = .29). Seven of 10 dogs in the hIVIG group and 10 of 10 in the VINC group survived to discharge. Survival analysis did not identify any significant difference between the groups at discharge, 6 months, and 1 year after entry into the study. No adverse effects were reported in either group. Vincristine should be the first-line adjunctive treatment for the acute management of canine ITP because of lower cost and ease of administration compared with human intravenous immunoglobulin (hIVIG). Copyright © 2013 by the American College of Veterinary Internal Medicine.

Clinical feature and management of immune thrombocytopenic purpura in a tertiary hospital in Northwest Nigeria

PubMed Central

Hassan, Abdulaziz; Adebayo, Adeshola; Musa, Abubakar Umar; Suleiman, Aishatu Maude; Ibrahim, Ismaila Nda; Kusfa, Ibrahim Usman; Aminu, Mohammed Sirajo

2017-01-01

Background: Immune thrombocytopenic purpura (ITP) is a rare bleeding disorder that may remit spontaneously. Life-threatening bleeding may require transfusion support, steroids, and other immunosuppressive therapy or splenectomy. Objective: To review the clinical presentation and laboratory features of ITP at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria. Subjects and Methods: A retrospective analytic study of case notes and bone marrow (BM) records of patients diagnosed with ITP at Haematology Department, ABUTH, Zaria, from January 1, 2004, to December 31, 2012. Results: There were nine cases (six females, three males), aged 6–20 (mean 11.11) years. The presentations were epistaxis 8 (88.9%), purpura 4 (44.4%), gum bleeding 4 (44.4%), menorrhagia 2 (22.2%), and intracranial hemorrhage (ICH) 1 (11.1%). Only 1 (11.1%) had clinical splenomegaly. Platelet count of <20 × 109/L was found in 4 (44.4%) while 6 (66.7%) had packed cell volume of <25%. All the nine cases had BM megakaryocytic hyperplasia. Six patients had blood transfusion support while 7 (77.8%) patients received oral prednisolone therapy with time to cessation of bleeding of 12–16 (mean of 8) weeks. One case had spontaneous remission while another had anti-D due to relapse after steroid therapy; this resulted in transient rise in platelet counts. None had other immunosuppressive therapy or splenectomy. Six (66.7%) cases were lost to follow-up after achieving remission and one died of ICH. Conclusion: ITP is not common in our center though its clinical presentations are varied. However, prednisolone and blood transfusion therapy are central to the management of these patients with favorable outcome. PMID:29269984

Urban DEM generation, analysis and enhancements using TanDEM-X

NASA Astrophysics Data System (ADS)

Rossi, Cristian; Gernhardt, Stefan

2013-11-01

This paper analyzes the potential of the TanDEM-X mission for the generation of urban Digital Elevation Models (DEMs). The high resolution of the sensors and the absence of temporal decorrelation are exploited. The interferometric chain and the problems encountered for correct mapping of urban areas are analyzed first. The operational Integrated TanDEM-X Processor (ITP) algorithms are taken as reference. The ITP main product is called the raw DEM. Whereas the ITP coregistration stage is demonstrated to be robust enough, large improvements in the raw DEM such as fewer percentages of phase unwrapping errors, can be obtained by using adaptive fringe filters instead of the conventional ones in the interferogram generation stage. The shape of the raw DEM in the layover area is also shown and determined to be regular for buildings with vertical walls. Generally, in the presence of layover, the raw DEM exhibits a height ramp, resulting in a height underestimation for the affected structure. Examples provided confirm the theoretical background. The focus is centered on high resolution DEMs produced using spotlight acquisitions. In particular, a raw DEM over Berlin (Germany) with a 2.5 m raster is generated and validated. For this purpose, ITP is modified in its interferogram generation stage by adopting the Intensity Driven Adaptive Neighbourhood (IDAN) algorithm. The height Root Mean Square Error (RMSE) between the raw DEM and a reference is about 8 m for the two classes defining the urban DEM: structures and non-structures. The result can be further improved for the structure class using a DEM generated with Persistent Scatterer Interferometry. A DEM fusion is thus proposed and a drop of about 20% in the RMSE is reported.

PROCESSING ALTERNATIVES FOR DESTRUCTION OF TETRAPHENYLBORATE

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

Lambert, D; Thomas Peters, T; Samuel Fink, S

Two processes were chosen in the 1980's at the Savannah River Site (SRS) to decontaminate the soluble High Level Waste (HLW). The In Tank Precipitation (ITP) process (1,2) was developed at SRS for the removal of radioactive cesium and actinides from the soluble HLW. Sodium tetraphenylborate was added to the waste to precipitate cesium and monosodium titanate (MST) was added to adsorb actinides, primarily uranium and plutonium. Two products of this process were a low activity waste stream and a concentrated organic stream containing cesium tetraphenylborate and actinides adsorbed on monosodium titanate (MST). A copper catalyzed acid hydrolysis process wasmore » built to process (3, 4) the Tank 48H cesium tetraphenylborate waste in the SRS's Defense Waste Processing Facility (DWPF). Operation of the DWPF would have resulted in the production of benzene for incineration in SRS's Consolidated Incineration Facility. This process was abandoned together with the ITP process in 1998 due to high benzene in ITP caused by decomposition of excess sodium tetraphenylborate. Processing in ITP resulted in the production of approximately 1.0 million liters of HLW. SRS has chosen a solvent extraction process combined with adsorption of the actinides to decontaminate the soluble HLW stream (5). However, the waste in Tank 48H is incompatible with existing waste processing facilities. As a result, a processing facility is needed to disposition the HLW in Tank 48H. This paper will describe the process for searching for processing options by SRS task teams for the disposition of the waste in Tank 48H. In addition, attempts to develop a caustic hydrolysis process for in tank destruction of tetraphenylborate will be presented. Lastly, the development of both a caustic and acidic copper catalyzed peroxide oxidation process will be discussed.« less

Influence of unilateral maxillary first molar extraction treatment on second and third molar inclination in Class II subdivision patients.

PubMed

Livas, Christos; Pandis, Nikolaos; Booij, Johan Willem; Halazonetis, Demetrios J; Katsaros, Christos; Ren, Yijin

2016-01-01

To assess the maxillary second molar (M2) and third molar (M3) inclination following orthodontic treatment of Class II subdivision malocclusion with unilateral maxillary first molar (M1) extraction. Panoramic radiographs of 21 Class II subdivision adolescents (eight boys, 13 girls; mean age, 12.8 years; standard deviation, 1.7 years) before treatment, after treatment with extraction of one maxillary first molar and Begg appliances and after at least 1.8 years in retention were retrospectively collected from a private practice. M2 and M3 inclination angles (M2/ITP, M2/IOP, M3/ITP, M3/IOP), constructed by intertuberosity (ITP) and interorbital planes (IOP), were calculated for the extracted and nonextracted segments. Random effects regression analysis was performed to evaluate the effect on the molar angulation of extraction, time, and gender after adjusting for baseline measurements. Time and extraction status were significant predictors for M2 angulation. M2/ITP and M2/IOP decreased by 4.04 (95% confidence interval [CI]: -6.93, 1.16; P  =  .001) and 3.67 (95% CI: -6.76, -0.58; P  =  .020) in the extraction group compared to the nonextraction group after adjusting for time and gender. The adjusted analysis showed that extraction was the only predictor for M3 angulation that reached statistical significance. M3 mesial inclination increased by 7.38° (95% CI: -11.2, -3.54; P < .001) and 7.33° (95% CI: -11.48, -3.19; P  =  .001). M2 and M3 uprighting significantly improved in the extraction side after orthodontic treatment with unilateral maxillary M1 extraction. There was a significant increase in mesial tipping of maxillary second molar crowns over time.

Peak oxygen uptake in a sprint interval testing protocol vs. maximal oxygen uptake in an incremental testing protocol and their relationship with cross-country mountain biking performance.

PubMed

Hebisz, Rafał; Hebisz, Paulina; Zatoń, Marek; Michalik, Kamil

2017-04-01

In the literature, the exercise capacity of cyclists is typically assessed using incremental and endurance exercise tests. The aim of the present study was to confirm whether peak oxygen uptake (V̇O 2peak ) attained in a sprint interval testing protocol correlates with cycling performance, and whether it corresponds to maximal oxygen uptake (V̇O 2max ) determined by an incremental testing protocol. A sample of 28 trained mountain bike cyclists executed 3 performance tests: (i) incremental testing protocol (ITP) in which the participant cycled to volitional exhaustion, (ii) sprint interval testing protocol (SITP) composed of four 30 s maximal intensity cycling bouts interspersed with 90 s recovery periods, (iii) competition in a simulated mountain biking race. Oxygen uptake, pulmonary ventilation, work, and power output were measured during the ITP and SITP with postexercise blood lactate and hydrogen ion concentrations collected. Race times were recorded. No significant inter-individual differences were observed in regards to any of the ITP-associated variables. However, 9 individuals presented significantly increased oxygen uptake, pulmonary ventilation, and work output in the SITP compared with the remaining cyclists. In addition, in this group of 9 cyclists, oxygen uptake in SITP was significantly higher than in ITP. After the simulated race, this group of 9 cyclists achieved significantly better competition times (99.5 ± 5.2 min) than the other cyclists (110.5 ± 6.7 min). We conclude that mountain bike cyclists who demonstrate higher peak oxygen uptake in a sprint interval testing protocol than maximal oxygen uptake attained in an incremental testing protocol demonstrate superior competitive performance.

Chinese medicine syndrome distribution of chronic hepatitis B virus carriers in immunotolerant phase.

PubMed

Xie, He-ping; Yang, Hong-zhi; Wu, Wei-kang; Guan, Wei-bing; Ke, Qian-shan; Li, Yong-wei; Dai, Min; Xiao, Ge-min; Zhang, Jiong-shan; Li, Yang-mei

2014-02-01

To explore Chinese medicine (CM) syndrome distribution of chronic hepatitis B virus (HBV) carriers in immunotolerant phase (ITP). One hundred and eighty-five chronic HBV carriers in ITP, seen in the Third Affiliated Hospital of Sun Yat-sen University from May 2009 to December 2010, were admitted in an observational study under the guidance of CM. Patients' CM symptoms and signs, demographics, liver biochemistries, and qualitative HBV DNA were recorded in the questionnaires. CM syndromes were then differentiated to 15 detailed types and analyzed by generalization. Lastly, the location, pathogenic factors and nature of the disease were also assessed. When CM syndrome patterns were differentiated to 15 types, there were 27 (15%) no syndrome cases, 94 (50%) single syndrome cases and 64 (35%) compound syndromes cases. The main detailed syndromes included Liver (Gan)-qi depression (LQD), Kidney (Shen)-qi deficiency (KQD), Spleen (Pi)-qi deficiency (SQD) and Kidney-yang deficiency (KYAD). After CM syndromes generalized to five types, their frequency was Spleen-Kidney deficiency (SKD)>LQD>inner dampness-heat retention (IDHR)>Liver-Kidney deficiency (LKD)>blood stasis blocking collateral (BSBC). SKD and LQD occupied 64%. The disease location included Liver, Gallbladder (Dan), Spleen, Stomach (Wei) and Kidney. The pathogenic factors were mainly qi stagnation, qi deficiency, yang deficiency, concurrently dampness-heat and blood stasis. The deficiency syndrome was more than excess syndrome in its nature. Most of chronic HBV carriers in ITP have their CM syndrome, and the most common types are SKAD, LQD. This study suggests that the natural history may be improved through breaking the state of immune tolerance or shorten the time of ITP by strengthening Spleen-Kidney and reliving Liver qi.

Technology Transfer and the Civil Space Program. Volume 2: Workshop proceedings

NASA Technical Reports Server (NTRS)

1992-01-01

The objectives were to (1) provide a top-level review of the Integrated Technology Plan (ITP) and current civil space technology plans, including planning processes and technologies; (2) discuss and assess technology transfer (TT) experiences across a wide range of participants; (3) identify alternate categories/strategies for TT and define the objectives of transfer processes in each case; (4) identify the roles of various government 'stakeholders', aerospace industry, industries at large, and universities in civil space technology research, development, demonstration, and transfer; (5) identify potential barriers and/or opportunities to successful civil space TT; (6) identify specific needs for innovations in policy, programs, and/or procedures to facilitate TT; and (7) develop a plan of attack for the development of a workshop report. Papers from the workshop are presented.

Experimental models for aging and their potential for novel drug discovery.

PubMed

Folch, Jaume; Busquets, Oriol; Sánchez-López, Miren EttchetoElena; Pallàs, Mercè; Beas-Zarate, Carlos; Marin, Miguel; Casadesus, Gemma; Olloquequi, Jordi; Auladell, Carme; Camins, Antoni

2017-07-07

The development of antiaging drugs is an interesting area of scientific research. In order to evaluate the beneficial effects of new potential drugs, it is necessary to gather the specific knowledge on the adequate preclinical models that are available. This review focuses on invertebrate and vertebrate preclinical models used to evaluate the efficacy of antiaging compounds, with the objective to extend lifespan and health span. Dietary restriction (DR), a common experimental process to extend lifespan in all organisms, is also discussed. Besides, classical antiaging drugs such as resveratrol, rapamycin and metformin, denominated DR mimetics, are reviewed. The main therapeutic targets of these drugs include sirtuins, IGF-1, and mTOR, all of them being modulated by DR. The National Institute on Aging (NIA) developed the Interventions Testing Program (ITP). At the preclinical level, the ITP uses genetically heterogeneous mice model (HET), which is probably the most suitable rodent model to study potential drugs preventing aging-related diseases. The accelerated-senescence mouse P8 is also an interesting rodent model for the research in the field of aging. Notwithstanding, non-human primates are still necessary prior to clinical trials, since they allow an easier extrapolation to humans due to their anatomical and physiological similarities. In this review, the different models and approaches for antiaging studies were evaluated. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Successful Treatment of Aggressive Mature B-cell Lymphoma Mimicking Immune Thrombocytopenic Purpura.

PubMed

Ono, Koya; Onishi, Yasushi; Kobayashi, Masahiro; Ichikawa, Satoshi; Hatta, Shunsuke; Watanabe, Shotaro; Okitsu, Yoko; Fukuhara, Noriko; Ichinohasama, Ryo; Harigae, Hideo

2018-03-30

A 55-year-old woman suffered from hemorrhagic tendency. She had severe thrombocytopenia without any hematological or coagulatory abnormalities, and a bone marrow examination revealed an increased number of megakaryocytes without any abnormal cells or blasts. No lymphadenopathy or hepatosplenomegaly was observed on computed tomography. She was initially diagnosed with immune thrombocytopenic purpura (ITP). None of the treatments administered for ITP produced a response. However, abnormal cells were eventually found during the third bone marrow examination. The pathological diagnosis was mature B-cell lymphoma. Rituximab-containing chemotherapy produced a marked increase in the patient's platelet count, and her lymphoma went into complete remission.

Separation and analysis of trace degradants in a pharmaceutical formulation using on-line capillary isotachophoresis-NMR.

PubMed

Eldridge, Stacie L; Almeida, Valentino K; Korir, Albert K; Larive, Cynthia K

2007-11-15

NMR spectroscopy is widely used in the pharmaceutical industry for the structure elucidation of pharmaceutical impurities, especially when coupled to a separation method, such as HPLC. However, NMR has relatively poor sensitivity compared with other techniques such as mass spectrometry, limiting its applicability in impurity analyses. This limitation is addressed here through the on-line coupling of microcoil NMR with capillary isotachophoresis (cITP), a separation method that can concentrate dilute components by 2-3 orders of magnitude. With this approach, 1H NMR spectra can be acquired for microgram (nanomole) quantities of trace impurities in a complex sample matrix. cITP-NMR was used in this work to isolate and detect 4-aminophenol (PAP) in an acetaminophen sample spiked at the 0.1% level, with no interference from the parent compound. Analysis of an acetaminophen thermal degradation sample revealed resonances of several degradation products in addition to PAP, confirming the effectiveness of on-line cITP-NMR for trace analyses of pharmaceutical formulations. Subsequent LC-MS/MS analysis provided complementary information for the structure elucidation of the unknown degradation products, which were dimers formed during the degradation process.

Improvement in platelet count after 3rd-line and 4th-line eradication therapy for Helicobacter pylori in patients with immune thrombocytopenia.

PubMed

Jomen, Wataru; Sato, Takashi; Maesawa, Chihaya

2017-01-01

Case 1: A 78-year-old woman was diagnosed with H. pylori positive gastritis at a previous hospital in April 2012 and received 3rd-line H. pylori eradication therapy, which ended in failure. She was referred to our department due to oral hemorrhage, petechiae involving all four extremities, and thrombocytopenia in January 2016. She was hospitalized with a diagnosis of ITP and received inpatient treatment. While receiving outpatient prednisolone (PSL) treatment, we administered 4th-line eradication therapy in March. Her platelet levels have since returned to normal, and PSL treatment has been discontinued. She is currently followed without treatment. Case 2: A 65-year-old woman was diagnosed with ITP at a previous hospital in June 2013 and received 2nd-line eradication therapy, which ended in failure. Thereafter, PSL treatment was continued but she was later referred to our department in March 2016. Since 3rd-line eradication therapy was successful, her platelet count normalized and PSL treatment has been discontinued. She is currently followed without treatment. Based on our observations in these two cases, third-line H. pylori eradication therapy is potentially effective in ITP patients.

ESP`s Tank 42 washwater transfer to the 241-F/H tank farms

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

Aponte, C.I.; Lee, E.D.

1997-12-01

As a result of the separation of the High-Level Liquid Waste Department into three separate organizations (formerly there were two) (Concentration, Storage, and Transfer (CST), Waste Pre-Treatment (WPT) and Waste Disposition (WD)) process interface controls were required. One of these controls is implementing the Waste the waste between CST and WPT. At present, CST`s Waste Acceptance Criteria is undergoing revision and WPT has not prepared the required Waste Compliance Plan (WCP). The Waste Pre-Treatment organization is making preparations for transferring spent washwater in Tank 42 to Tank 43 and/or Tank 22. The washwater transfer is expected to complete the washingmore » steps for preparing ESP batch 1B sludge. This report is intended to perform the function of a Waste Compliance Plan for the proposed transfer. Previously, transfers between the Tank Farm and ITP/ESP were controlled by requirements outlined in the Tank Farm`s Technical Standards and ITP/ESP`s Process Requirements. Additionally, these controls are implemented primarily in operating procedure 241-FH-7TSQ and ITP Operations Manual SW16.1-SOP-WTS-1 which will be completed prior to performing the waste transfers.« less

Nucleotide and bivalent cation specificity of the insulin-granule proton translocase.

PubMed Central

Hutton, J C; Peshavaria, M

1983-01-01

1. The nucleotide and bivalent cation specificity of the proton translocase activity of insulin secretory granules was investigated by assessing the inhibitor-sensitive rates of nucleotide hydrolysis by these organelles in relation to their chemiosmotic properties. 2. The relative rates of nucleotide hydrolysis by freeze/thawed granule preparations were: Mg2+ATP (100%) greater than Mg2+GTP (55%) greater than Mg2+UTP (48%) greater than Mg2+ITP (44%) greater than Mg2+CTP (23%) greater than Mg2+TTP (20%), and by intact granules were: Mg2+ATP (100%) greater than Mg2+ITP (74%) greater than Mg2+GTP (60%) greater than Mg2+CTP (35%). Mg2+ATP, Mg2+GTP and Mg2+ITP hydrolyses were inhibited by tributyltin and stimulated, in intact granules, by the protonophore carbonyl cyanide p-trifluoromethoxyphenylhydrazone; Mg2+CTP hydrolysis was not markedly affected by these compounds. Correspondingly, only Mg2+ATP, Mg2+GTP and Mg2+ITP produced large changes in the delta psi and delta mu H+ across the granule membrane. 3. The relative rates of maximal ATPase activity stimulated by bivalent cations in freeze/thawed granule preparations were: Mg2+ (100%) greater than Mn2+ (82%) greater than Ca2+ (40%) greater than Co2+ (36%) greater than Zn2+ (0%), and in intact granules were: Mg2+ (100%) greater than Mn2+ (85%) greater than Co2+ (61%) greater than Ca2+ (42%). Tributyltin and carbonyl cyanide p-trifluoromethoxyphenylhydrazone affected Mg2+-, Mn2+- and Co2+-activated, but not Ca2+-activated, ATP hydrolysis. Correspondingly, only Mg2+, Mn2+ and Co2+ supported the generation of a delta psi and delta mu H+ across granule membranes in the presence of ATP. 4. The results were consistent with a single proton translocase that had its catalytic site exposed on the external face of the granule membrane. The indicated specificity (Mg2+ATP = Mn2+ATP greater than Co2+ATP greater than Mg2+GTP greater than Mg2+ITP) was similar to that of enzymes described in membrane fractions prepared from adenohypophyseal tissue, adrenal chromaffin granules and yeast vacuoles. The insulin-granule activity thus appears to be a type of proton translocase, which is characteristic of intracellular storage vesicles in eukaryotic cells. PMID:6303313

Prevalence and Pattern of Autoimmune Conditions in Patients with Marginal Zone Lymphoma: A Single Institution Experience.

PubMed

Dasanu, Constantin A; Bockorny, Bruno; Grabska, Joanna; Codreanu, Ion

2015-04-01

Increased risk of B-cell non-Hodgkin lymphoma (NHL) in patients with autoimmune diseases is a known fact. An association may exist between marginal zone lymphoma (MZL) and certain autoimmune conditions and vice-versa. Herein, we present the analysis of a series of consecutive patients (n = 24) diagnosed with MZL at our institution between 2008-2014. Our series, analyzed both retrospectively and prospectively, consisted of a blend of nodal, extranodal and splenic MZL. The median age was 71.8 years; M/F ratio was 2:1. The presence of autoimmune conditions was compared to their documented prevalence in the general population and tested for statistical significance using both chi-square test (χ2) and Fisher test for small number of observations (95% confidence). A P-value < 0.05 was considered significant. A total of 50% of MZL patients had documented autoimmune conditions. In addition, 3 of 24 patients presented with more than one autoimmune disease. Statistically significant differences in our MZL patients were recorded for immune thrombocytopenia [ITP] (P < 0.01), autoimmune hemolytic anemia [AIHA] (P < 0.01), Hashimoto thyroiditis (P = 0.037) and rheumatoid arthritis [RA] (P = 0.021). The difference did not reach statistical significance for systemic lupus erythematosus (SLE) and psoriasis. ITP and AIHA in our cohort were synchronous with MZL diagnosis in all patients, while all non-hematologic autoimmune conditions were metachronous and diagnosed prior to MZL. In the course of caring for patients with MZL, a number of associated autoimmune disorders are recognized. Knowing these entities is important not only for making a correct diagnosis, but also for being able to recognize certain clinical events occurring during the course of the disease. A catalogue of autoimmune disorders associated with this type of NHL is important as they can pose formidable clinical problems for the MZL patients and their physicians.

Advanced technology for America's future in space

NASA Technical Reports Server (NTRS)

1990-01-01

In response to Recommendation 8 of the Augustine Committee Report, NASA's Office of Aeronautics, Exploration and Technology (OAET) developed a proposed 'Integrated Technology Plan for the Civil Space Program' that entails substantial changes in the processes, structure and the content of NASA's space research and technology program. The Space Systems and Technology Advisory Committee (SSTAC, a subcommittee of the NASA Advisory Committee) and several other senior, expert, informed advisory groups conducted a review of NASA's proposed Integrated Technology Plan (ITP). This review was in response to the specific request in Recommendation 8 that 'NASA utilize an expert, outside review process, managed from headquarters, to assist in the allocation of technology funds'. This document, the final report from that review, addresses: (1) summary recommendations; (2) mission needs; (3) the integrated technology plan; (4) summary reports of the technical panels; and (5) conclusions and observations.

Immune Thrombocytopenia in Two Unrelated Fanconi Anemia Patients – A Mere Coincidence?

PubMed Central

Karastaneva, Anna; Lanz, Sofia; Wawer, Angela; Behrends, Uta; Schindler, Detlev; Dietrich, Ralf; Burdach, Stefan; Urban, Christian; Benesch, Martin; Seidel, Markus G.

2015-01-01

Thrombocytopenia and pancytopenia, occurring in patients with Fanconi anemia (FA), are interpreted either as progression to bone marrow failure or as developing myelodysplasia. On the other hand, immune thrombocytopenia (ITP) represents an acquired and often self-limiting benign hematologic disorder, associated with peripheral, immune-mediated, platelet destruction requiring different management modalities than those used in congenital bone marrow failure syndromes, including FA. Here, we describe the clinical course of two independent FA patients with atypical – namely immune – thrombocytopenia. While in one patient belonging to complementation group FA-A, the ITP started at 17 months of age and showed a chronically persisting course with severe purpura, responding well to intravenous immunoglobulins (IVIG) and later also danazol, a synthetic androgen, the other patient (of complementation group FA-D2) had a self-limiting course that resolved after one administration of IVIG. No cytogenetic aberrations or bone marrow abnormalities other than FA-typical mild dysplasia were detected. Our data show that acute and chronic ITP may occur in FA patients and impose individual diagnostic and therapeutic challenges in this rare congenital bone marrow failure/tumor predisposition syndrome. The management and a potential context of immune pathogenesis with the underlying marrow disorder are discussed. PMID:26106590

Prognostic Factors for Immune Thrombocytopenia Outcome in Greek Children: A Retrospective Single-Centered Analysis

PubMed Central

Gkoutsias, Athanasios; Palianopoulos, Theodoros; Pappa, Eleni; Papapetrou, Evangelia; Tsaousi, Christina; Chaliasos, Nikolaos

2017-01-01

Immune thrombocytopenia (ITP) in children has a varied course and according to duration is distinguished as newly diagnosed (<3 months), persistent (3–12), and chronic (>12) types. Several studies have evaluated the prognostic factors for the progression of the disease, but similar works have yet to be performed in Greece. We aimed to identify prognostic markers for the three forms of the disease in 57 Greek children during a 13-year period. Information regarding age, gender, preceding infection, bleeding type, duration of symptoms and platelets at diagnosis, treatment, disease course, and immunological markers was recorded. 39 children had newly diagnosed, 4 persistent, and 14 chronic disease. Chronic ITP children were more likely to be of age > 10 years (p = 0.015) and have gradual initiation of the disease (p = 0.001), platelets > 10 × 109/L (p = 0.01), and impaired immunological markers (p < 0.003) compared to newly diagnosed/persistent groups. Recent history of infection was found mainly in the newly diagnosed/persistent group (p = 0.013). None of the children exhibited severe spontaneous bleeding. Conclusion. Even though ITP in children usually has a self-limited course, with rare serious bleeding complications, the chronic form of the disease is characterized by different predictive parameters, which can be used in clinical practice. PMID:29362564

In-Tank Processing (ITP) Geotechnical Summary Report

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

Cumbest, R.J.

A geotechnical investigation has been completed for the In Tank Processing Facility (ITP) which consists of buildings 241-96H and 241-32H; and Tanks 241-948H, 241-949H, 241-950H, and 241-951H. The investigation consisted of a literature search for relevant technical data, field explorations, field and laboratory testing, and analyses. This document presents a summary of the scope and results to date of the investigations and engineering analyses for these facilities. A final geotechnical report, which will include a more detailed discussion and all associated boring logs, laboratory test results, and analyses will be issued in October 1994.The purpose of the investigation is tomore » obtain geotechnical information to evaluate the seismic performance of the foundation materials and embankme nts under and around the ITP. The geotechnical engineering objectives of the investigation are to: 1) define the subsurface stratigraphy, 2) obtain representative engineering properties of the subsurface materials, 3) assess the competence of the subsurface materials under static and dynamic loads, 4) derive properties for seismic soil-structure interaction analysis, 5) evaluate the areal and vertical extent of horizons that might cause dynamic settlement or instability, and 6) determine settlement at the foundation level of the tanks.« less

Effects of pyrimidines on the guinea-pig coronary vasculature.

PubMed Central

Vials, A. J.; Burnstock, G.

1993-01-01

1. The effects of the pyrimidines, uridine 5'-triphosphate (UTP), thymidine 5'-triphosphate (TTP) and cytidine 5'-triphosphate (CTP), were examined in the guinea-pig coronary bed, by use of a Langendorff technique. Comparisons were made with the actions of the purines adenosine 5'-triphosphate (ATP), inosine 5'-triphosphate (ITP) and guanosine 5'-triphosphate (GTP). The effect of, the nitric oxide synthase inhibitor, L-NG-nitroarginine methyl ester (L-NAME) and, the prostaglandin synthesis inhibitor, indomethacin on the vasodilator response to these purines and pyrimidines was examined. The effects of these inhibitors were assessed on their ability to inhibit both the amplitude and the area of the vasodilator response. 2. The relative order of potency of the purines and pyrimidines studied was ATP > UTP > ITP >> GTP, TTP, CTP. 3. The maximum amplitude and area of the vasodilator response to the pyrimidines, UTP (5 x 10(-10)-5 x 10(-7) mol), TTP (5 x 10(-8)-5 x 10(-7) mol) and CTP (5 x 10(-7) mol), and purines, ITP (5 x 10(-9)-5 x 10(-7) mol) and GTP (5 x 10(-8)-5 x 10(-7) mol), were significantly reduced by L-NAME (3 x 10(-5) and 10(-4) M).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8298797

Effect of eltrombopag on platelet counts and bleeding during treatment of chronic idiopathic thrombocytopenic purpura: a randomised, double-blind, placebo-controlled trial.

PubMed

Bussel, James B; Provan, Drew; Shamsi, Tahir; Cheng, Gregory; Psaila, Bethan; Kovaleva, Lidia; Salama, Abdulgabar; Jenkins, Julian M; Roychowdhury, Debasish; Mayer, Bhabita; Stone, Nicole; Arning, Michael

2009-02-21

Eltrombopag is an oral, non-peptide, thrombopoietin-receptor agonist that stimulates thrombopoiesis, leading to increased platelet production. This study assessed the efficacy, safety, and tolerability of once daily eltrombopag 50 mg, and explored the efficacy of a dose increase to 75 mg. In this phase III, randomised, double-blind, placebo-controlled study, adults from 63 sites in 23 countries with chronic idiopathic thrombocytopenic purpura (ITP), platelet counts less than 30 000 per muL of blood, and one or more previous ITP treatment received standard care plus once-daily eltrombopag 50 mg (n=76) or placebo (n=38) for up to 6 weeks. Patients were randomly assigned in a 2:1 ratio of eltrombopag:placebo by a validated randomisation system. After 3 weeks, patients with platelet counts less than 50 000 per microL could increase study drug to 75 mg. The primary endpoint was the proportion of patients achieving platelet counts 50 000 per microL or more at day 43. All participants who received at least one dose of their allocated treatment were included in the analysis. This study is registered with ClinicalTrials.gov, number NCT00102739. 73 patients in the eltrombopag group and 37 in the placebo group were included in the efficacy population and were evaluable for day-43 analyses. 43 (59%) eltrombopag patients and six (16%) placebo patients responded (ie, achieved platelet counts >/=50 000 per microL; odds ratio [OR] 9.61 [95% CI 3.31-27.86]; p<0.0001). Response to eltrombopag compared with placebo was not affected by predefined study stratification variables (baseline platelet counts, concomitant ITP drugs, and splenectomy status) or by the number of previous ITP treatments. Of the 34 patients in the efficacy analysis who increased their dose of eltrombopag, ten (29%) responded. Platelet counts generally returned to baseline values within 2 weeks after the end of treatment. Patients receiving eltrombopag had less bleeding at any time during the study than did those receiving placebo (OR 0.49 [95% CI 0.26-0.89]; p=0.021). The frequency of grade 3-4 adverse events during treatment (eltrombopag, two [3%]; placebo, one [3%]) and adverse events leading to study discontinuation (eltrombopag, three [4%]; placebo, two [5%]), were similar in both groups. Eltrombopag is an effective treatment for managment of thrombocytopenia in chronic ITP.

LYNX: A Linked Eulerian and Lagrangian Code. Volume II. LYNX Computer Listing

DTIC Science & Technology

1975-11-01

177« 178« 179» ISO* 18|» 182« 183» IBM * 185* 1B6« 187» 198« 189« 190« |f|i 192» 193« 194» 195» 196« 197» 198» 199* 200» 201...XPLC ID) ,Y(JD) ,TAUI ID) ,YB(IJD) .FBI IJD) ,T 1 3B ( ID ) • XCT I IJD) »VOBUjD» ,ZZ(NN0IM) ,VV(NND1M) »OBFUL •BETA tAP •OTCP iTP ...CELL CONTAINING PARTICLE NO I. •OB IOUFUL •BETA »AP •UTCP iTP •COMPEN ,SHEN •YP1 »YP2 •KMAX ,KBAR • 1JMA< ,IK»UX

The Effect of Rituximab on Vaccine Responses in Patients with Immune Thrombocytopenia

PubMed Central

Nazi, Ishac; Kelton, John G.; Larché, Mark; Snider, Denis P.; Heddle, Nancy M.; Crowther, Mark A.; Cook, Richard J.; Tinmouth, Alan T.; Mangel, Joy; Arnold, Donald M.

2013-01-01

B-cell depletion therapy may impair vaccine responses and increase infection risk in patients with immune thrombocytopenia (ITP). Capitalizing on a multicenter randomized placebo-controlled trial, we investigated the effects of rituximab on the antibody and cellular responses to Streptococcus pneumoniae polysaccharide vaccine and Haemophilus influenzae type b (Hib) conjugate vaccine in ITP patients. Of 60 patients in the main trial, 24 patients received both vaccines 6 months after rituximab (n=17) or placebo (n=7). Among 20 evaluable patients, 3/14 (21%) in the rituximab group and 4/6 (67%) in the placebo group achieved a 4-fold increase in anti-pneumococcal antibodies (p=0.12). For anti-Hib antibodies, 4/14 (29%) and 5/6 (83%), respectively, achieved a 4-fold increase (p<0.05). Fewer patients in the rituximab group demonstrated functional Hib killing (2/14 [14%] versus 5/6 [83%], p<0.05). Three of 14 rituximab-treated patients failed to respond to vaccines by any criteria. After vaccinations, pre-plasma cell blasts and interferon-γ secreting T-cells were reduced in rituximab-treated patients. We found that antibody responses were impaired for at least 6 months after rituximab. Cellular immunity was reduced in parallel with the depleted B-cell pool. These findings have implications for the timing of vaccinations and the mechanism of infection after rituximab in patients with ITP. PMID:23851398

Long-Term Outcomes of Laparoscopic Splenectomy Versus Open Splenectomy for Idiopathic Thrombocytopenic Purpura

PubMed Central

Qu, Yikun; Xu, Jian; Jiao, Chengbin; Cheng, Zhuoxin; Ren, Shiyan

2014-01-01

The long-term outcomes of laparoscopic splenectomy (LS) versus open splenectomy (OS) in patients with idiopathic thrombocytopenic purpura (ITP) are not known. A retrospective analysis of 73 patients who underwent splenectomy (32 LS and 41 OS) for refractory ITP between April 2003 and June 2012 was conducted. LS was associated with shorter hospital stay (P = 0.01), less blood loss and blood transfusion during surgery, quicker resumption of oral diet (P < 0.0001), and earlier drain removal (P < 0.01). Conversion to OS was required in 4 patients (12.5%). Operation time was significantly longer in LS (P < 0.0001). Deep venous thrombosis (DVT) was observed in 1 patient after LS and in 4 patients after OS (P = 0.52). One patient died from intraperitoneal bleeding after OS, another patient developed pulmonary embolism. Median follow-up of 36 months was performed in LS group (29 of 32, 91%) and of 46 months in OS group (35 of 41, 85%), 25 patients (86%) in LS group and 32 (91%) in OS group reached sustained complete response (P = 0.792). Kaplan-Meier analysis showed that there was no significant difference in the relapse-free survival rate between the groups (P = 0.777). In conclusion, the long-term outcome of laparoscopic splenectomy is not different from that of open splenectomy for patients with ITP. PMID:24833154

Novel Separation of Actinides

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

Mariella, R

The separation of actinides and other elements of interest for nuclear forensics and threat reduction is currently performed using decades-old chemistries and ion-exchange columns. We propose to determine the technical feasibility of a novel method for separating actinide ions in solution. This method is based upon isotachophoresis (ITP), which has been applied in the purification of pharmaceuticals and other biochemical applications. This technique has the potential to separate inorganic ions more effectively than existing methods, which is key to analyzing very small samples. We will perform a quantitative assessment of the effectiveness of specific isotachophoretic approaches including predicting the physicalmore » and chemical properties, such as ion mobility, of inorganic ions under specific solvent conditions using a combination of ab initio calculations and semi-empirical methods. We expect to obtain a thorough understanding of the analytical systems parameters under which ITP is most effective for the separation of inorganic samples, including the influence of the double layer surrounding actinide ions, the Debye length for different ions and ion complexes, and Debye-Hueckel limits. Inorganic separations are key to nuclear forensics for countering terrorism and nuclear proliferation. If found to be feasible and potentially superior to currently used separation approaches, ITP could provide the conceptual basis for an improved means to separate samples of nuclear explosion debris for nuclear forensic analysis, in support of the Laboratory's missions in homeland and national security.« less

Enantioselective column coupled electrophoresis employing large bore capillaries hyphenated with tandem mass spectrometry for ultra-trace determination of chiral compounds in complex real samples.

PubMed

Piešťanský, Juraj; Maráková, Katarína; Kovaľ, Marián; Havránek, Emil; Mikuš, Peter

2015-12-01

A new multidimensional analytical approach for the ultra-trace determination of target chiral compounds in unpretreated complex real samples was developed in this work. The proposed analytical system provided high orthogonality due to on-line combination of three different methods (separation mechanisms), i.e. (1) isotachophoresis (ITP), (2) chiral capillary zone electrophoresis (chiral CZE), and (3) triple quadrupole mass spectrometry (QqQ MS). The ITP step, performed in a large bore capillary (800 μm), was utilized for the effective sample pretreatment (preconcentration and matrix clean-up) in a large injection volume (1-10 μL) enabling to obtain as low as ca. 80 pg/mL limits of detection for the target enantiomers in urine matrices. In the chiral CZE step, the different chiral selectors (neutral, ionizable, and permanently charged cyclodextrins) and buffer systems were tested in terms of enantioselectivity and influence on the MS detection response. The performance parameters of the optimized ITP - chiral CZE-QqQ MS method were evaluated according to the FDA guidance for bioanalytical method validation. Successful validation and application (enantioselective monitoring of renally eliminated pheniramine and its metabolite in human urine) highlighted great potential of this chiral approach in advanced enantioselective biomedical applications. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A low birth weight infant with no malformations delivered by a primary immune thrombocytopenia patient treated with eltrombopag.

PubMed

Suzuki, Naruko; Hiraga, Junji; Hariyama, Yumi; Takagi, Yusuke; Ohashi, Haruhiko; Kishigami, Yasuyuki; Oguchi, Hidenori; Kagami, Yoshitoyo

2018-07-01

Primary immune thrombocytopenia (ITP) is defined by a low platelet count secondary to antibody-mediated platelet destruction or reductions in platelet production. Although eltrombopag is a thrombopoietin receptor agonist that increases platelet production in refractory or relapsed ITP, the influence on pregnancy is limited. We present the case of a pregnant 25-year-old ITP patient referred to our hospital with a history of two induced abortions. After eradication of Helicobacter pylori and with oral prednisolone at 8 mg/day, platelet count remained below 10,000/µl. Because she declined splenectomy, eltrombopag was initiated at 12.5 mg/day. Afterward, platelet count was maintained at over 50,000/µl. Twenty-one months later, pregnancy became apparent. She continued treatment, and cesarean section was performed at 37 weeks of gestation after administration of intravenous immunoglobulin, platelet transfusions, and steroids. The baby weighed only 1670 g but showed no malformations, and platelet count at birth was 416,000/µl. Studies of eltrombopag in pregnancy have not been reported. A case with administration of eltrombopag from the last trimester of pregnancy that resulted in low birth weight has been reported. Embryo lethality and reduced fetal weights have been reported from animal experiments. Further investigation about the relationship between low birth weight deliveries and eltrombopag is necessary.

The influence of early psychosocial intervention on the long-term clinical outcomes of people suffering from schizophrenia.

PubMed

Cechnicki, Andrzej; Bielańska, Anna

2017-02-26

To compare the treatment outcomes of DSM-IV-TR schizophrenia patients in either a Community Treatment Program or an Individual Treatment Program (CTP vs. ITP). The assessment was made after the first hospitalization, and then after three and twelve years. Participants were randomly assigned to CTP (experimental) and ITP (traditional) group, with 40 people in each group. 67 people (84%) participated in all three assessments. The socio-demographic and clinical indicators were the same for both groups. In the first three years only the CTP group participated in day-care treatment, patient and family psychoeducation and community treatment. Later, both groups received this treatment. The following tools were used: Anamnestic and Catamnestic Questionnaire, the GAF scale, the BPRS LA and Lehman's Quality of Life Interview. It was only after twelve years that there was a significant beneficial improvement in the mean GAF score in the CTP group (p = 0.036), which was comparable with the results obtained by Watt and Shepherd for the course of the illness in favorable remission cases (p = 0.038). The difference in the number of relapses was also significantly in favor of the CTP group only after 12 years (p = 0.045), as was the difference in the number of rehospitalizations (p = 0.013). The general severity of symptoms was found to be significantly lower for the CPT group after 3 (p = 0.008) and 12 years (p = 0.030), whereas it was significantly lower in the case of positive syndrome only after 3 years (p = 0.044). 1. A greater number of favorable differences were identified for the CTP group at the twelve-year point than at the conclusion of the experiment. 2. The three-year delay in introducing psycho-social treatment was associated with a poorer long-term outcome for the clinical course of schizophrenia.

T-Cell Lymphoma

MedlinePlus

... Cell Lymphoma (AITL) is a rare, aggressive type accounting for about seven percent of all patients with ... as autoimmune hemolytic anemia (AIHA; where the immune system attacks red blood cells) and immune thrombocytopenia (ITP; ...

Idiopathic Thrombocytopenic Purpura (ITP)

MedlinePlus

... disorder follows a viral illness, such as the mumps or the flu. It may be that the ... the disorder after a viral illness, such as mumps, measles or a respiratory infection. Complications A rare ...

Genetics Home Reference: immune thrombocytopenia

MedlinePlus

... spots of bleeding under the skin are called purpura and larger spots are called ecchymoses. People with ... links) Johns Hopkins Medicine MedlinePlus Encyclopedia: Idiopathic Thrombocytopenic Purpura (ITP) Seattle Children's Hospital General Information from MedlinePlus ( ...

Thrombocytopenia in pregnancy with different diagnoses

PubMed Central

Wang, Xiaoyue; Xu, Yan; Luo, Wenxiang; Feng, Hui; Luo, Yizhou; Wang, Yanli; Liao, Hui

2017-01-01

Abstract To investigate the clinical features and perinatal treatment of thrombocytopenia induced by different causes during pregnancy. Clinical data from 195 pregnant women with thrombocytopenia attending 2 tertiary hospitals from January 2014 to October 2016 were retrospectively studied. The obtained data were analyzed with SPSS 19.0 software. There were 117 (60.0%), 55 (28.2%), and 23 cases (11.8%) of pregnancy-associated thrombocytopenia (PAT), idiopathic thrombocytopenia (ITP), and hypertensive disorder in pregnancy (PIH), respectively. The percentage of nulliparous women, gestational age at delivery, date of diagnosis of thrombocytopenia, and delivery mode significantly differed between the patients in these 3 groups (P < .05). Patients with PIH had a higher percentage of premature delivery and of lower birth weight infants than patients in the other 2 groups. The 3 groups had similar incidences of postpartum hemorrhage, rates of stillbirth, and neonatal Apgar scores at 5 minutes. PAT and PIH patients had different platelet counts after delivery compared with at diagnosis, whereas the platelet counts of the ITP patients were similar at diagnosis and after delivery. ITP patients in the nontreatment group and the treatment group had significantly different platelet counts (P < .05), and in the treatment group, the maternal platelet count did not differ for treatment with intravenous immunoglobulin (IVIg) versus corticosteroids. The causes of thrombocytopenia in pregnancy are diverse, and the clinical features vary widely. Timely analysis is needed to determine the primary cause of thrombocytopenia, and appropriate therapy should then be selected to effectively improve the prognosis of pregnancies. PMID:28723784

Investigating Cell Surface Markers on Normal Hematopoietic Stem Cells in Three Different Niche Conditions

PubMed Central

Garg, Swati; Madkaikar, Manisha

2013-01-01

Hematopoietic stem cells are of therapeutic interest to the clinicians and researchers due to their promising assistance in management of malignant and inherited hematological conditions. Evaluation of cell surface markers using multiparametric flow cytometry is a well adapted qualitative measure of cells in question for many years. An artillery of these markers has been studied in hematological malignancies and related disorders. However, their role and differential expression on normal hematopoietic stem cells from clinically available sources is not always described carefully. In the present study, we attempted to evaluate expression of CD44, CD90, CD96 and CD123 in three clinically available sources of normal HSCs (Hematopoietic stem cells). Sources of HSCs in the present study involved umbilical cord blood (UCB), normal bone marrow (NBM) and bone marrow from idiopathic thrombocytopenic purpura (ITP) patients (IBM). CD44 is an important homing receptor while CD90 is involved in maintaining stem cell quiescent. CD96 is known to be leukemia specific marker and CD123 is involved in stem cell differentiation and survival. We observed a significant difference in expression CD44, CD90 and CD123 on normal HSCs derived from umbilical cord and ITP marrow. CD96 was highly expressed on HSCs obtained from ITP marrow. Investigating expression of these markers on normal HSCs in different niches will be helpful in correlating their function with niche condition and delineating their ‘abnormal’ expression from the normal. PMID:24386557

Investigating cell surface markers on normal hematopoietic stem cells in three different niche conditions.

PubMed

Garg, Swati; Madkaikar, Manisha; Ghosh, Kanjaksha

2013-11-01

Hematopoietic stem cells are of therapeutic interest to the clinicians and researchers due to their promising assistance in management of malignant and inherited hematological conditions. Evaluation of cell surface markers using multiparametric flow cytometry is a well adapted qualitative measure of cells in question for many years. An artillery of these markers has been studied in hematological malignancies and related disorders. However, their role and differential expression on normal hematopoietic stem cells from clinically available sources is not always described carefully. In the present study, we attempted to evaluate expression of CD44, CD90, CD96 and CD123 in three clinically available sources of normal HSCs (Hematopoietic stem cells). Sources of HSCs in the present study involved umbilical cord blood (UCB), normal bone marrow (NBM) and bone marrow from idiopathic thrombocytopenic purpura (ITP) patients (IBM). CD44 is an important homing receptor while CD90 is involved in maintaining stem cell quiescent. CD96 is known to be leukemia specific marker and CD123 is involved in stem cell differentiation and survival. We observed a significant difference in expression CD44, CD90 and CD123 on normal HSCs derived from umbilical cord and ITP marrow. CD96 was highly expressed on HSCs obtained from ITP marrow. Investigating expression of these markers on normal HSCs in different niches will be helpful in correlating their function with niche condition and delineating their 'abnormal' expression from the normal.

Factors associated with the effect of open splenectomy for immune thrombocytopenic purpura.

PubMed

Li, Ying; Zhang, Dawei; Hua, Fanli; Gao, Song; Wu, Yangjiong; Xu, Jianmin

2017-01-01

To assess the effect and complications of open splenectomy (OS) for immune thrombocytopenic purpura (ITP) and determine preoperative factors associated with surgical effect. This was a retrospective analysis of ITP patients who failed medical therapy and were treated with OS between 1997 and 2014 at the Jinshan Hospital, China. Follow-up was 60 months. Surgical effect was determined from platelet counts and bleeding episodes. Complications were assessed including bleeding episodes. Preoperative factors were identified by logistic regression analysis. Fifty-six patients (48.2 ± 16.2 yr old; 39 females) were included. Disease course was 31.2 ± 48.2 months; 91.1% patients had preoperative platelet count <20 × 10 9 /L. OS effect at 1 wk, 1 month, 1 yr, and 5 yrs was in 91.1%, 92.9%, 91.1%, and 89.3% patients, respectively. Pneumonia or lower extremity thrombosis occurred in 7.1% patients. Postoperative mild, moderate, and severe bleeding occurred in 33.9%, 50.0%, and 16.1% patients, respectively. No patients required blood transfusion. Mortality was zero. Larger spleen size associated with surgical effect at 1 wk, 1 month, and 1 yr, and lower preoperative minimum platelet count associated with effect at 5 yrs (P < 0.05). Open splenectomy is an effective treatment with less complications for the management of ITP. Lower preoperative minimum platelet count associated with successful OS at 5 yrs. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

75 FR 19994 - Green Diamond Resource Company, California Timberlands Division, Forest Management Habitat...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... comparison of actual and estimated levels of owl displacement, a comparison of estimated and actual... displacements. During the comprehensive review, Green Diamond requested an amendment to the 1992 ITP to allow...

Analysis of thickness dependent on crystallization kinetics in thin isotactic-polysterene films

NASA Astrophysics Data System (ADS)

Khairuddin

2016-11-01

Crystalliaztion kinetics of thin film of Isotactic Polysterene (it-PS) films has been studied. Thin PET films having thickness of 338, 533, 712, 1096, 1473, and 2185 A° were prepared by using spin-cast technique. The it-PS crystals were grown on Linkam-hostage in the temperature range 130-240°C with an interval of 10°C. The crystal growths are measured by optical microscopy in lateral direction. It was found that a substantial thickness dependence on crystallisation rate. The analysis using fitting technique based on theory crystal growth of Lauritzen-Hoffman showed that the fitting technique could not resolve to predict the mechanism controlling the thickness dependence on the rate of crystallisation. The possible reasons were due to the crystallisation rate varies with the type of crystals (smooth, rough, overgrowth terrace), and the crystallisation rate changes with the time of crystallisation.

The ANU WellBeing study: a protocol for a quasi-factorial randomised controlled trial of the effectiveness of an Internet support group and an automated Internet intervention for depression

PubMed Central

2010-01-01

Background Recent projections suggest that by the year 2030 depression will be the primary cause of disease burden among developed countries. Delivery of accessible consumer-focused evidenced-based services may be an important element in reducing this burden. Many consumers report a preference for self-help modes of delivery. The Internet offers a promising modality for delivering such services and there is now evidence that automated professionally developed self-help psychological interventions can be effective. By contrast, despite their popularity, there is little evidence as to the effectiveness of Internet support groups which provide peer-to-peer mutual support. Methods/Design Members of the community with elevated psychological distress were randomised to receive one of the following: (1) Internet Support Group (ISG) intervention, (2) a multi-module automated psychoeducational and skills Internet Training Program (ITP), (3) a combination of the ISG and ITP, or (4) an Internet Attention Control website (IAC) comprising health and wellbeing information and question and answer modules. Each intervention was 12 weeks long. Assessments were conducted at baseline, post-intervention, 6 and 12 months to examine depressive symptoms, social support, self-esteem, quality of life, depression literacy, stigma and help-seeking for depression. Participants were recruited through a screening postal survey sent to 70,000 Australians aged 18 to 65 years randomly selected from four rural and four metropolitan regions in Australia. Discussion To our knowledge this study is the first randomised controlled trial of the effectiveness of a depression ISG. Trial registration Current Controlled Trials ISRCTN65657330. PMID:20211025

The clinical impact of a false-positive urine cocaine screening result on a patient's pain management.

PubMed

Kim, James A; Ptolemy, Adam S; Melanson, Stacy E F; Janfaza, David R; Ross, Edgar L

2015-06-01

The urine of a patient admitted for chest and epigastric pain tested positive for cocaine using an immunoassay-based drug screening method (positive/negative cutoff concentration 150 ng/mL). Despite the patient's denial of recent cocaine use, this positive cocaine screening result in conjunction with a remote history of drug misuse impacted the patient's recommended pain therapy. Specifically, these factors prompted the clinical team to question the appropriateness of opioids and other potentially addictive therapeutics during the treatment of cancer pain from previously undetected advanced pancreatic carcinoma. After pain management and clinical pathology consultation, it was decided that the positive cocaine screening result should be confirmed by gas chromatography-mass spectrometry (GC-MS) testing. This more sensitive and specific analytical technique revealed that both cocaine and its primary metabolite benzoylecgonine were undetectable (i.e., less than the assay detection limit of 50 ng/mL), thus indicating that the positive urine screening result was falsely positive. With this confirmation, the pain management service team was reassured in offering intrathecal pump (ITP) therapy for pain control. ITP implantation was well tolerated, and the patient eventually achieved excellent pain relief. However, ITP therapy most likely would not have been utilized without the GC-MS confirmation testing unless alternative options failed and extensive vigilant monitoring was initiated. As exemplified in this case, confirmatory drug testing should be performed on specimens with unexpected immunoassay-based drug screening results. To our knowledge, this is the first report of a false-positive urine cocaine screening result and its impact on patient management. Wiley Periodicals, Inc.

Therapeutic Suggestions for Chronic Subdural Hematoma Associated with Idiopathic Thrombocytopenic Purpura: A Case Report and Literature Review

PubMed Central

Takase, Hajime; Tatezuki, Junya; Ikegaya, Naoki; Yamamoto, Daisuke; Hashimoto, Mizuki; Takagi, Makoto; Mochimatsu, Yasuhiko; Kawahara, Nobutaka

2015-01-01

A 66-year-old woman who was previously diagnosed with idiopathic thrombocytopenic purpura (ITP) presented with mild right-sided hemiparesis and drowsiness. Head computed tomography (CT) imaging demonstrated a massive left chronic subdural hematoma (CSDH) with a midline shift. Because initial laboratory data showed a significantly decreased blood platelet count (0.3 × 104/mm3), medical treatments such as platelet transfusion, intravenous immunoglobulin (IVIG), and high-dose corticosteroid therapy, were initiated. She clinically and radiologically responded well to these treatments without any surgical intervention. In addition to presenting our case, we searched the PubMed and Ichushi Web databases to comprehensively illustrate clinical characteristics and treatment outcomes of similar cases. Including the present case, we found 19 reports and 23 cases of CSDH associated with ITP in the literature, and assessed 17 reports and 21 cases that were written in English and Japanese. None or mild neurological symptom were seen in 13 cases, and severe, such as coma and hemiparesis, were described in the younger 8 cases with significant difference. All except one were first treated with medical therapies. Most cases of the former group responded well to conservative therapy. On the other hand, most in the latter eventually needed surgical treatment in addition except recent two cases including the present case. CSDH associated with ITP is rarely described, and its management remains controversial. However, this report highlights multiple continuous medical treatments under strict observation and general care might be a useful alternative to avoid surgery in cases presenting with severe neurological deficits and extremely low platelet counts. PMID:28663980

Health-related quality of life in children with newly diagnosed immune thrombocytopenia

PubMed Central

Heitink-Pollé, Katja M.J.; Haverman, Lotte; Annink, Kim V.; Schep, Sarah J.; de Haas, Masja; Bruin, Marrie C.A.

2014-01-01

Despite its generally transient and benign course, childhood immune thrombocytopenia has a large impact on health-related quality of life. Recently published guidelines state that quality of life should be taken into account while making decisions on management in childhood immune thrombocytopenia. We, therefore, assessed health-related quality of life in children with newly diagnosed immune thrombocytopenia in a prospective multicenter study. One hundred and seven children aged 6 months-16 years (mean age 5.57 years) were included. We used Pediatric Quality of Life Inventory™ and Kids’ ITP Tools questionnaires at diagnosis and during standardized follow-up. Scores on the Pediatric Quality of Life Inventory™ Core Scales were compared with those of healthy children. Relationships between health-related quality of life scores and treatment modality, bleeding tendency and course of the disease were examined. Kids’ ITP Tools proxy reports and parent self-reports showed significant higher health-related quality of life scores in children who recovered than in children with persistent immune thrombocytopenia (at 3 months: Kids’ ITP Tools parent self-report score 80.85 for recovered patients (n=69) versus 58.98 for patients with persistent disease (n=21), P<0.001). No significant differences in health-related quality of life were found between children with mild or moderate bleeding or between children who received intravenous immunoglobulin or children who were carefully observed. In conclusion, health-related quality of life of children with newly diagnosed immune thrombocytopenia is not influenced by treatment modality or bleeding severity, but only by clinical course of the disease. (Dutch Trial Register identifier: NTR TC1563) PMID:24951468

The development of insecticide-treated durable wall lining for malaria control: insights from rural and urban populations in Angola and Nigeria

PubMed Central

2012-01-01

Background Durable lining (DL) is a deltamethrin-impregnated polyethylene material, which is designed to cover domestic walls that would normally be sprayed with residual insecticide. The operational success of DL as a long-lasting insecticidal substrate will be dependent on a high level of user acceptability as households must maintain correctly installed linings on their walls for several years. Preliminary trials were undertaken to identify a material to develop into a marketable wall lining and to assess its level of acceptability among rural and urban populations. Methods In Angola (n=60), prototype DL and insecticide-treated plastic sheeting (ITPS) were installed on urban house walls and ceilings, respectively, and acceptability was compared to indoor residual spraying (IRS) (n=20) using a knowledge, attitude and practice (KAP) questionnaire. In Nigeria (n=178), three materials (prototype DL, ITPS and insecticide-treated wall netting) were distributed among rural and urban households. User opinions were gathered from focus group discussions, in-depth interviews and KAP questionnaires. Results In Angola, after two weeks, the majority of participants (98%) expressed satisfaction with the products and identified the killing of insects as the materials’ principal benefits (73%). After one year, despite a loss of almost 50% of households to refugee repatriation, all 32 remaining households still asserted that they had liked the DL/ITPS in their homes and given the choice of intervention preferred DL/ITPS to IRS (94%) or insecticide-treated nets (78%). In Nigeria, a dichotomy between rural and urban respondents emerged. Rural participants favoured wall adornments and accepted wall linings because of their perceived decorative value and entomological efficacy. By contrast, urban households preferred minimal wall decoration and rejected the materials based upon objections to their aesthetics and installation feasibility. Conclusions The high level of acceptability among rural inhabitants in Nigeria identifies these communities as the ideal target consumer group for durable wall linings. The poorer compliance among urban participants suggests that wall linings would not be readily adopted or sustained in these regions. If DL is as well received by other rural populations it could overcome some of the logistical constraints associated with spray campaigns and has the potential to become a long-lasting alternative to IRS in malaria endemic areas. PMID:22989007

Thrust Vectoring Nozzle for Modern Military Aircraft

DTIC Science & Technology

2000-05-11

Thrust Vectoring Nozzle for Modern Military Aircraft Daniel Ikaza Industria de Turbo Propulsores S.A. (ITP) Parque Tecnol6gico, edificio 300 48170...programme has only been possible with the contribution of partners and organizations, namely: Spanish Ministries of Industry and Defence, with

Human Factors of CC-130 Operations: Training Systems Knowledge

DTIC Science & Technology

1999-03-01

M Multimedia, Ltd. Describes their Integrated Training and Performance Support ( ITPS ) Design Methodology, which includes 5 types of goals... IBM , and American Airlines indicate that "computer-based multimedia produced a savings of 68% over conventional classroom training" (p. 4

Design and Real-Time Implementation of a Baseband LPC Coder for Speech Transmission over 9600 BPS Noisy Channels. Volume II. Programming Listings.

DTIC Science & Technology

1980-02-01

cwc N (w~ mm. IDmm m w. C. msite &C-ew %a~m MCI I Di . m1a.2 ,% v oa m.1] W.k1i . . 13.M mmm r, q.W.3.44. I&1242 %D2 1.J1 M.1. ItP a b nNM - f .M2 47 4...a a a a a.a a.a0 IBM a aa a11,11 a .0 a1 . U q M4 MS K IaI u C% A4 U u0 1. w4 . N MKV Ia IO1 U a,". 44 4 .4 N m N N N N N6 N N N (M M M M U M M M CD

Functional Study of the P32T ITPA Variant Associated with Drug Sensitivity in Humans

PubMed Central

Stepchenkova, Elena I.; Tarakhovskaya, Elena R.; Spitler, Kathryn; Frahm, Christin; Menezes, Miriam R.; Simone, Peter D.; Kolar, Carol; Marky, Luis A.; Borgstahl, Gloria E. O.; Pavlov, Youri I.

2009-01-01

Sanitization of the cellular nucleotide pools from mutagenic base analogs is necessary for the accuracy of transcription and replication of genetic material and plays a substantial role in cancer prevention. The undesirable mutagenic, recombinogenic and toxic incorporation of purine base analogs (i.e. ITP, dITP, XTP, dXTP or 6-hydroxyaminopurine (HAP) deoxynucleoside triphosphate) into nucleic acids is prevented by inosine triphosphate pyrophosphatase (ITPA). The ITPA gene is a highly conserved, moderately expressed gene. Defects in ITPA orthologs in model organisms cause severe sensitivity to HAP and chromosome fragmentation. A human polymorphic allele 94C->A encodes for the enzyme with a P32T amino acid change and leads to accumulation of non-hydrolyzed ITP. ITPase activity is not detected in erythrocytes of these patients. The P32T polymorphism has also been associated with adverse sensitivity to purine base analog drugs. We have found that the ITPA-P32T mutant is a dimer in solution, as is wild-type ITPA, and has normal ITPA activity in vitro, but the melting point of ITPA-P32T is 5 degrees C lower than that of wild-type. ITPA-P32T is also fully functional in vivo in model organisms as determined by a HAP mutagenesis assay and its complementation of a bacterial ITPA defect. The amount of ITPA protein detected by western blot is severely diminished in a human fibroblast cell line with the 94C->A change. We propose that the P32T mutation exerts its effect in certain human tissues by cumulative effects of destabilization of transcripts, protein stability and availability. PMID:19631656

Helicobacter pylori eradication in patients with chronic immune thrombocytopenic purpura

PubMed Central

Noonavath, Ravinder Naik; Lakshmi, Chandrasekharan Padma; Dutta, Tarun Kumar; Kate, Vikram

2014-01-01

AIM: To assess the effect of Helicobacter pylori (H. pylori) eradication on platelet counts in patients with chronic immune thrombocytopenic purpura (cITP). METHODS: A total of 36 cITP patients were included in the study. The diagnosis of H. pylori was done by rapid urease test and Giemsa staining of the gastric biopsy specimen. All H. pylori positive patients received standard triple therapy for 14 d and were subjected for repeat endoscopy at 6 wk. Patients who continued to be positive for H. pylori on second endoscopy received second line salvage therapy. All the patients were assessed for platelet response at 6 wk, 3rd and 6th months. RESULTS: Of the 36 patients, 17 were positive for H. pylori infection and eradication was achieved in 16 patients. The mean baseline platelet count in the eradicated patients was 88615.38 ± 30117.93/mm3 and platelet count after eradication at 6 wk, 3 mo and 6 mo was 143230.77 ± 52437.51/mm3 (P = 0.003), 152562.50 ± 52892.3/mm3 (P = 0.0001), 150187.50 ± 41796.68/mm3 (P = 0.0001) respectively and in the negative patients, the mean baseline count was 71000.00 ± 33216.46/mm3 and at 6 wk, 3rd and 6th month follow up was 137631.58 ± 74364.13/mm3 (P = 0.001), 125578.95 ± 71472.1/mm3 (P = 0.005), 77210.53 ± 56892.28/mm3 (P = 0.684) respectively. CONCLUSION: Eradication of H. pylori leads to increase in platelet counts in patients with cITP and can be recommended as a complementary treatment with conventional therapy. PMID:24944483

Measurement of immature platelets with Abbott CD-Sapphire and Sysmex XE-5000 in haematology and oncology patients.

PubMed

Meintker, Lisa; Haimerl, Maria; Ringwald, Jürgen; Krause, Stefan W

2013-11-01

Measurement of immature platelets was introduced into routine diagnostics by Sysmex as immature platelet fraction (IPF) some years ago and recently by Abbott as reticulated platelet fraction (rPT). Here, we compare both methods. We evaluated the precision and agreement of these parameters between Sysmex XE-5000 and Abbott CD-Sapphire in three distinct thrombocytopaenic cohorts: 30 patients with beginning thrombocytopaenia and 64 patients with recovering platelets (PLT) after chemotherapy, 16 patients with immune thrombocytopaenia (ITP) or heparin-induced thrombocytopaenia type 2 (HIT) and 110 additional normal controls. Furthermore, we analysed, how IPF/rPT differed between these thrombocytopaenic cohorts and controls. Both analysers demonstrated acceptable overall precision (repeatability) of IPF/rPT with lower precision at low PLT counts. IPF/rPT artificially increased during storage of blood samples overnight. Inter-instrument comparison showed a moderate correlation (Pearson r²=0.38) and a systematic bias of 1.04 towards higher IPF-values with the XE-5000. IPF/rPT was highest in recovering thrombopoesis after chemotherapy and moderately increased in ITP/HIT. The normal range deduced from control samples was much narrower with CD-Sapphire (1.0%-3.8%, established here for the first time) in comparison to XE-5000 (0.8%-7.9%) leading to a smaller overlap of samples with increased PLT turnover and normal controls. IPF and rPT both give useful information on PLT turnover, although the two analysers only show a moderate inter-instrument correlation and have different reference ranges. A better separation of patient groups with high PLT turnover like ITP/HIT from normal controls is obtained by CD-Sapphire.

Final results of sequential doxorubicin plus gemcitabine and ifosfamide, paclitaxel, and cisplatin chemotherapy in patients with metastatic or locally advanced transitional cell carcinoma of the urothelium.

PubMed

Milowsky, Matthew I; Nanus, David M; Maluf, Fernando C; Mironov, Svetlana; Shi, Weiji; Iasonos, Alexia; Riches, Jamie; Regazzi, Ashley; Bajorin, Dean F

2009-09-01

Sequential chemotherapy with doxorubicin and gemcitabine (AG) followed by ifosfamide, paclitaxel, and cisplatin (ITP) was previously demonstrated to be well tolerated in patients with advanced transitional cell carcinoma (TCC). This study sought to evaluate the efficacy and to additionally define toxicity. Sixty patients with advanced TCC received AG every 2 weeks for five or six cycles followed by ITP every 21 days for four cycles. Granulocyte colony-stimulating factor was given between cycles. Myelosuppression was seen with 68% of patients who experienced grades 3 to 4 neutropenia and with 25% who experienced febrile neutropenia. Grade 3 or greater nonhematologic toxicities were infrequent. Forty (73%) of 55 evaluable patients (95% CI, 59% to 84%) demonstrated a major response (complete, n = 19; partial, n = 21) and had a median response duration of 11.3 months (range, 1.7 to >or= 105.6 months). Twenty-seven (79%) of 34 patients with locally advanced disease (ie, T4, N0, M0) or with regional lymph node involvement (ie, T3-4, N1, M0) and 10 (56%) of 18 patients with distant metastases achieved a major response. The median progression-free survival was 12.1 months (95% CI, 9.0 to 14.8 months), and the median overall survival was 16.4 months (95% CI, 14.0 to 22.5 months). At a median follow-up of 76.4 months, seven (11.7%) patients remain alive, and all were disease free. AG plus ITP is an active regimen in previously untreated patients with advanced TCC; however, it is associated with toxicity and does not clearly offer a benefit compared with other nonsequential, cisplatin-based regimens.

Sample distribution in peak mode isotachophoresis

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

Rubin, Shimon; Schwartz, Ortal; Bercovici, Moran, E-mail: mberco@technion.ac.il

We present an analytical study of peak mode isotachophoresis (ITP), and provide closed form solutions for sample distribution and electric field, as well as for leading-, trailing-, and counter-ion concentration profiles. Importantly, the solution we present is valid not only for the case of fully ionized species, but also for systems of weak electrolytes which better represent real buffer systems and for multivalent analytes such as proteins and DNA. The model reveals two major scales which govern the electric field and buffer distributions, and an additional length scale governing analyte distribution. Using well-controlled experiments, and numerical simulations, we verify andmore » validate the model and highlight its key merits as well as its limitations. We demonstrate the use of the model for determining the peak concentration of focused sample based on known buffer and analyte properties, and show it differs significantly from commonly used approximations based on the interface width alone. We further apply our model for studying reactions between multiple species having different effective mobilities yet co-focused at a single ITP interface. We find a closed form expression for an effective-on rate which depends on reactants distributions, and derive the conditions for optimizing such reactions. Interestingly, the model reveals that maximum reaction rate is not necessarily obtained when the concentration profiles of the reacting species perfectly overlap. In addition to the exact solutions, we derive throughout several closed form engineering approximations which are based on elementary functions and are simple to implement, yet maintain the interplay between the important scales. Both the exact and approximate solutions provide insight into sample focusing and can be used to design and optimize ITP-based assays.« less

Endogenous Opioid Antagonism in Physiological Experimental Pain Models: A Systematic Review

PubMed Central

Werner, Mads U.; Pereira, Manuel P.; Andersen, Lars Peter H.; Dahl, Jørgen B.

2015-01-01

Opioid antagonists are pharmacological tools applied as an indirect measure to detect activation of the endogenous opioid system (EOS) in experimental pain models. The objective of this systematic review was to examine the effect of mu-opioid-receptor (MOR) antagonists in placebo-controlled, double-blind studies using ʻinhibitoryʼ or ʻsensitizingʼ, physiological test paradigms in healthy human subjects. The databases PubMed and Embase were searched according to predefined criteria. Out of a total of 2,142 records, 63 studies (1,477 subjects [male/female ratio = 1.5]) were considered relevant. Twenty-five studies utilized ʻinhibitoryʼ test paradigms (ITP) and 38 studies utilized ʻsensitizingʼ test paradigms (STP). The ITP-studies were characterized as conditioning modulation models (22 studies) and repetitive transcranial magnetic stimulation models (rTMS; 3 studies), and, the STP-studies as secondary hyperalgesia models (6 studies), ʻpainʼ models (25 studies), summation models (2 studies), nociceptive reflex models (3 studies) and miscellaneous models (2 studies). A consistent reversal of analgesia by a MOR-antagonist was demonstrated in 10 of the 25 ITP-studies, including stress-induced analgesia and rTMS. In the remaining 14 conditioning modulation studies either absence of effects or ambiguous effects by MOR-antagonists, were observed. In the STP-studies, no effect of the opioid-blockade could be demonstrated in 5 out of 6 secondary hyperalgesia studies. The direction of MOR-antagonist dependent effects upon pain ratings, threshold assessments and somatosensory evoked potentials (SSEP), did not appear consistent in 28 out of 32 ʻpainʼ model studies. In conclusion, only in 2 experimental human pain models, i.e., stress-induced analgesia and rTMS, administration of MOR-antagonist demonstrated a consistent effect, presumably mediated by an EOS-dependent mechanisms of analgesia and hyperalgesia. PMID:26029906

Immune thrombocytopenia and autoimmune thyroid disease: a controversial overlap.

PubMed

Marta, Guilherme Nader; de Campos, Fernando Peixoto Ferraz

2015-01-01

Immune thrombocytopenia (ITP) is an entity characterized by a platelet count of less than 100 × 10(9)/L in the absence of other causes of thrombocytopenia, such as viral infections, rheumatic diseases, or drugs. Grave's disease is also an autoimmune condition in which thrombocytopenia is often observed. Moreover, in the literature, many reports show a marked interference of the thyroid dysfunction (mainly hyperthyroidism) in the control of thrombocytopenia. Although this issue still remains debatable, the authors report the case of a young woman with a previous diagnosis of ITP with a brilliant initial response to corticotherapy. Some years after this diagnosis, the patient presented thyrotoxicosis due to Grave's disease and the thrombocytopenia relapsed, but this time there was no response to the glucocorticoids. Only after the radioiodine I-131 thyroid ablation the control of thrombocytopenia was achieved. The authors call attention to this overlap and for testing thyroid function in every patient with an unexpected negative response to corticotherapy.

Immune thrombocytopenia and autoimmune thyroid disease: a controversial overlap

PubMed Central

de Campos, Fernando Peixoto Ferraz

2015-01-01

Immune thrombocytopenia (ITP) is an entity characterized by a platelet count of less than 100 × 109/L in the absence of other causes of thrombocytopenia, such as viral infections, rheumatic diseases, or drugs. Grave’s disease is also an autoimmune condition in which thrombocytopenia is often observed. Moreover, in the literature, many reports show a marked interference of the thyroid dysfunction (mainly hyperthyroidism) in the control of thrombocytopenia. Although this issue still remains debatable, the authors report the case of a young woman with a previous diagnosis of ITP with a brilliant initial response to corticotherapy. Some years after this diagnosis, the patient presented thyrotoxicosis due to Grave’s disease and the thrombocytopenia relapsed, but this time there was no response to the glucocorticoids. Only after the radioiodine I-131 thyroid ablation the control of thrombocytopenia was achieved. The authors call attention to this overlap and for testing thyroid function in every patient with an unexpected negative response to corticotherapy. PMID:26484334

TRPM8 and RAAS-mediated hypertension is critical for cold-induced immunosuppression in mice.

PubMed

Chan, Hao; Huang, Hsuan-Shun; Sun, Der-Shan; Lee, Chung-Jen; Lien, Te-Sheng; Chang, Hsin-Hou

2018-02-27

Mechanisms underlying cold-induced immunosuppression remain unclear. Here we found that cold exposure leads to transient receptor potential melastatin 8 (TRPM8)-dependent, renin-angiotensin-aldosterone system (RAAS)-mediated hypertension, which subsequently induces small molecule and fluid extravasation, increases plasma Ig levels, and elicits immunosuppression. An effect is similar to the clinically-used immunosuppressive treatments of intravenous immunoglobulin (IVIg) against various inflammatory diseases, such as immune thrombocytopenia (ITP). Essential roles of TRPM8 and Ig in cold-induced immunosuppression are supported by the cold-mediated amelioration of ITP and the cold-mediated suppression of bacterial clearance, which were observed in wild-type mice but not in Ig- and TRPM8-deficient mutants. Treatment with antihypertensive drugs aliskiren and losartan drastically reversed high plasma Ig levels and ameliorated cold-induced immunosuppression, indicating the involvement of the RAAS and hypertension. These results indicated that the natively increased plasma Ig level is associated with immunosuppression during periods of cold exposure, and antihypertensive drugs can be useful to manage cold-induced immunosuppression.

IT Assessment: Floyd College.

ERIC Educational Resources Information Center

Lord, Joan; Bishop, Jack

2001-01-01

Discusses Floyd College's (Georgia) Information Technology Project (ITP), which began in 1997. Reports that every student and faculty member at the college is given a laptop, network connections have been implemented all over campus, and a help desk service provides technical support. The project has been successful, but student headcount fell…

75 FR 31463 - Comal County Regional Habitat Conservation Plan, Comal County, TX

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-03

... as school development, road construction and maintenance, and parkland. The ITP will cover Comal... activities including, but not limited to: Public or private construction and development, utility... Wildlife Service, 10711 Burnet Road, Suite 200, Austin, TX 78758 or 512-490-0057. SUPPLEMENTARY INFORMATION...

Mid Course Space Experiment (MSX) Environmental Assessment

DTIC Science & Technology

1992-03-06

8217____ a ~~ACTrv=T _ _ _ _ _ _I wTLL USU/SDL =H/APL OSFC VAPE ITP Fabrication -SBV -SPIRIT ft1 -Satellites -Reference -UVISI ___________ Objects...Vandenberg Air Force Base ( VAPE ) Jobit Hopkins University/Applied Physics Laboratoty MM/UAPL) Kausi Tea Facility (KIT 3 Satellite trussn assucttue, OSDP

LED Lighting Facts® Program Supports Accuracy in SSL Product Information

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

None

Fact sheet that provides a summary of LED Lighting Facts, a program to assure that LED lighting is accurately represented in the marketplace, illustrated by the LED Lighting Facts label to disclose product performance data.

76 FR 65744 - Draft Environmental Assessment and Draft Habitat Conservation Plan for Lower Colorado River...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-24

...] Draft Environmental Assessment and Draft Habitat Conservation Plan for Lower Colorado River Authority... of availability of documents and announcement of public hearings. SUMMARY: The Lower Colorado River... issuance of an incidental take permit (ITP) to Lower Colorado River Authority Transmission Services...

Technology in the Freshman Biology Classroom: Breaking the Dual Learning Curve.

ERIC Educational Resources Information Center

Windelspecht, Michael

2001-01-01

Introduces the Instructional Technology Project (ITP) which provides universal, 24 hours/7 days a week Internet access to both students and faculty and incorporates technology into the curriculum. Uses five different modules involving technology that include e-mail, electronic discussion board, CD-ROM and multimedia, internet browsers, and…

Investigation on the Capability of a Non Linear CFD Code to Simulate Wave Propagation

DTIC Science & Technology

2003-02-01

Linear CFD Code to Simulate Wave Propagation Pedro de la Calzada Pablo Quintana Manuel Antonio Burgos ITP, S.A. Parque Empresarial Fernando avenida...mechanisms above presented, simulation of unsteady aerodynamics with linear and nonlinear CFD codes is an ongoing activity within the turbomachinery industry

Final Report on Contract N00014-92-C-0173 (Office of Naval Research)

DTIC Science & Technology

2001-01-10

PHILPOTTI* t Lawrence Livermore National Laboratory, University of California, Livermore, CA 94550, USA SIBM Research Division, Almaden Research Center...defines the ITP on one electrode and adsorbed hydrated lithium ion defines the OlIP on the second electrode. Ions have been classified according to

VLSI Design Techniques for Floating-Point Computation

DTIC Science & Technology

1988-11-18

J. C. Gibson, The Gibson Mix, IBM Systems Development Division Tech. Report(June 1970). [Heni83] A. Heninger, The Zilog Z8070 Floating-Point...Broadcast Oock Gen. ’ itp Divide Module Module byN Module Oock Communication l I T Oock Communication Bus Figure 7.2. Clock Distribution between

Rapid Feature Extraction via the Radon Transform.

DTIC Science & Technology

1988-02-01

preprint NSF- ITP -86- 138, submitted to Biological Cybernetics.(1986) [14] G.R. Gindi, A.F. Gmitro. and K. Parthasarathy, "\\Vinner-Take- All Net- works and...34Associative Holographic Memories," IBM J. Res. Development 13, 156 (1969). [46] A. F. Gmitro, and G. R. Gindi, "Computed Tomography Videography: An

A Survey of Parallel Sorting Algorithms.

DTIC Science & Technology

1981-12-01

see that, in this algorithm, each Processor i, for 1 itp -2, interacts directly only with Processors i+l and i-l. Processor j 0 only interacts with...Chan76] Chandra, A.K., "Maximal Parallelism in Matrix Multiplication," IBM Report RC. 6193, Watson Research Center, Yorktown Heights, N.Y., October 1976

77 FR 37656 - Multi-Species Habitat Conservation Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-22

... the survival and recovery of the species in the wild; and (5) the applicant will meet other measures... phlox (Phlox hirsuta), and from NMFS for the Southern Oregon/Northern California Coast coho salmon... the ITP for the unlisted Klamath and Trinity Rivers Chinook salmon (O. tshawytscha) ESU and the...

Quarterly Report: Microchannel-Assisted Nanomaterial Deposition Technology for Photovoltaic Material Production

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

Palo, Daniel R.

2011-04-26

Quarterly report to ITP for Nanomanufacturing program. Report covers FY11 Q2. The primary objective of this project is to develop a nanomanufacturing process which will reduce the manufacturing energy, environmental discharge, and production cost associated with current nano-scale thin-film photovoltaic (PV) manufacturing approaches. The secondary objective is to use a derivative of this nanomanufacturing process to enable greener, more efficient manufacturing of higher efficiency quantum dot-based photovoltaic cells now under development. The work is to develop and demonstrate a scalable (pilot) microreactor-assisted nanomaterial processing platform for the production, purification, functionalization, and solution deposition of nanomaterials for photovoltaic applications. The highmore » level task duration is shown. Phase I consists of a pilot platform for Gen II PV films along with parallel efforts aimed at Gen III PV quantum dot materials. Status of each task is described.« less

Systems Integration: RNAV and the Upgraded Third Generation System.

DTIC Science & Technology

1976-12-01

ra ted . ibm ’ rm ’su it i s a need I or the M I ‘~. program , whose obj em I t vi’s were t’ctahl 1 shed as follows : • t)eve 1 - i new pu’ i ’~ 1’ . j...pec: ted of’ oth er- lOORI r I e~ I a n’ m.’s . Tnt.’sc itp rc Vt ’;”C’fl t a a re’ in thetc low in~ areas: dont rol icr ~~ir ’k 1 o,u d — - The dr...0 ’ 1 As ‘.UIilF) 1. ion $ /6M $11 2M $ ~ I ( IbM $ /OM $ .1 / 1 M H i gh Lost Assum p t t o r i I t4M ‘HiM 1 :‘M - t 6 /M 108M h?7M - - I nroute

Autonomous Observations of the Upper Ocean Stratification and Velocity Fields About the Seasonally-Retreating Marginal Ice Zone

DTIC Science & Technology

2015-09-30

ITP data is underway on multiple fronts. A few scientific highlights follow: An undergraduate student from VIT University in India, Ratnaksha...Yale University PO Box 208109 New Haven, CT 06520-8109 phone: (203) 432-3167 fax: (203) 432 3134 email: mary-louise.timmermans@yale.edu

77 FR 46511 - Endangered and Threatened Wildlife and Plants; Receipt of Application for Incidental Take Permit...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-03

...: Written comments on the ITP application and HCP should be sent to the South Florida Ecological Services.... mail: Trish Adams, HCP Coordinator, South Florida Ecological Services Field Office, Attn: Permit number... INFORMATION CONTACT: Ms. Trish Adams, HCP Coordinator, South Florida Ecological Services Office, Vero Beach...

75 FR 35504 - San Rafael Cattle Company; Habitat Conservation Plan; Santa Cruz County, AZ

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-22

... introduction of covered species or other species and removal of aquatic invasive species. The covered area.... Fish and Wildlife Service (Service) for an incidental take permit (ITP) under the Endangered Species... species currently listed under the Endangered Species Act (Act), and two species that may become listed...

78 FR 34402 - Final Environmental Impact Statement, Habitat Conservation Plan, and Implementing Agreement...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-07

...-FF03E15000] Final Environmental Impact Statement, Habitat Conservation Plan, and Implementing Agreement, Ni... Environmental Impact Statement (FEIS) associated with an application received from NiSource Inc. (hereafter ``Ni... Endangered Species Act of 1973, as amended (ESA). If issued, the ITP would authorize NiSource to take 10...

78 FR 66377 - Notice of Intent To Prepare a Draft Environmental Impact Statement on a Proposed Incidental Take...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

... the proposed Project may include access roads, wind turbine assembly lay down areas, overhead and... to an incidental take permit (ITP) application that Champlin Hawaii Wind Holdings, LLC (Champlin...) near Kahuku, Hawaii, for production of wind-generated electrical energy on the island of Oahu. In...

78 FR 14816 - Endangered and Threatened Wildlife and Plants; Receipt of Application for Incidental Take Permit...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-07

...; Availability of Proposed Low- Effect Habitat Conservation Plan; Volusia County Council--Engineering, Volusia... County Council--Engineering (applicant), for a 2-year incidental take permit (ITP; TE98767A-0) under the... plan qualifies as low-effect under the National Environmental Policy Act (NEPA). To make this...

Wide Bandgap Superlattice Power Devices for Army Hybrid Electric Power Systems

DTIC Science & Technology

2006-11-01

years, with many rounds of SBIR Phase I and Phase II, plus several subcontracts for ITP (integrated product teams) supported by DMEA and TARDEC of...higher, and upon which IBM recently announced that a world record of MOSFET speed at over 300GHz has been realized. 11. HIGH TEMPERATURE

Application of Virtual World Technologies to Undersea Warfare Learning

DTIC Science & Technology

2009-08-20

Prescribed by ANSI Std Z39-18 Virtual World Technologies (VWTs) “Using Virtual Worlds To Shape the Future” by Dr. Susan U. Stucky, IBM Almaden Research...JUAN HSI US MIL ANDS AIR FORCE USS SKIPJACK11 Beavertail Lighthouse iTP TP ObsF ObsE Coordinated Military Presence NAVY AIR FORCE ARMYMARINES & OTHER

75 FR 41433 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-16

... Service (FAS) has denied a petition (No. 2010011) for trade adjustment assistance (TAA) for cranberries..., FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by e-mail: [email protected]fas.usda.gov ; or visit the TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa . [[Page 41434

75 FR 34476 - Draft Supplemental Environmental Impact Statement for Incidental Take and Wetland Fill Permits...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

... that would take the Alabama beach mouse (Peromyscus polionotus ammobates) and place fill in wetlands on... endangered Alabama beach mouse and fill in wetlands incidental to construction and occupation of adjacent... 48.1 acres of Alabama beach mouse habitat. Next Steps We will evaluate these ITP applications...

Transpersonal Graduate Education in Psychology: Alumni Self-Identified Thematic Patterns of Development

ERIC Educational Resources Information Center

Campbell, Colleen J.

2010-01-01

In a world that changes every day, individuals who assist others with change, support change, and create strategies for change, herein referred to as "change agents", play an important role in society. The California Institute of Integral Studies (CIIS), The Institute of Transpersonal Psychology (ITP), and Saybrook Graduate School and…

Evidence-Based Transition Planning Practices for Secondary Students with Disabilities: What Has Australia Signed Up For?

ERIC Educational Resources Information Center

O'Neill, Sue C.; Strnadová, Iva; Cumming, Therese M.

2016-01-01

There are no Commonwealth or state laws in Australia that require educational authorities to provide individualised transition plans (ITPs) to secondary students with disabilities. It is argued that, in lieu of legislation, Australia's signed commitment to international treaties and national policies obliges educational jurisdictions to provide…

Deoxyinosine triphosphate induces MLH1/PMS2- and p53-dependent cell growth arrest and DNA instability in mammalian cells

PubMed Central

Yoneshima, Yasuto; Abolhassani, Nona; Iyama, Teruaki; Sakumi, Kunihiko; Shiomi, Naoko; Mori, Masahiko; Shiomi, Tadahiro; Noda, Tetsuo; Tsuchimoto, Daisuke; Nakabeppu, Yusaku

2016-01-01

Deoxyinosine (dI) occurs in DNA either by oxidative deamination of a previously incorporated deoxyadenosine residue or by misincorporation of deoxyinosine triphosphate (dITP) from the nucleotide pool during replication. To exclude dITP from the pool, mammals possess specific hydrolysing enzymes, such as inosine triphosphatase (ITPA). Previous studies have shown that deficiency in ITPA results in cell growth suppression and DNA instability. To explore the mechanisms of these phenotypes, we analysed ITPA-deficient human and mouse cells. We found that both growth suppression and accumulation of single-strand breaks in nuclear DNA of ITPA-deficient cells depended on MLH1/PMS2. The cell growth suppression of ITPA-deficient cells also depended on p53, but not on MPG, ENDOV or MSH2. ITPA deficiency significantly increased the levels of p53 protein and p21 mRNA/protein, a well-known target of p53, in an MLH1-dependent manner. Furthermore, MLH1 may also contribute to cell growth arrest by increasing the basal level of p53 activity. PMID:27618981

TRPM8 and RAAS-mediated hypertension is critical for cold-induced immunosuppression in mice

PubMed Central

Lien, Te-Sheng; Chang, Hsin-Hou

2018-01-01

Mechanisms underlying cold-induced immunosuppression remain unclear. Here we found that cold exposure leads to transient receptor potential melastatin 8 (TRPM8)-dependent, renin–angiotensin–aldosterone system (RAAS)-mediated hypertension, which subsequently induces small molecule and fluid extravasation, increases plasma Ig levels, and elicits immunosuppression. An effect is similar to the clinically-used immunosuppressive treatments of intravenous immunoglobulin (IVIg) against various inflammatory diseases, such as immune thrombocytopenia (ITP). Essential roles of TRPM8 and Ig in cold-induced immunosuppression are supported by the cold-mediated amelioration of ITP and the cold-mediated suppression of bacterial clearance, which were observed in wild-type mice but not in Ig- and TRPM8-deficient mutants. Treatment with antihypertensive drugs aliskiren and losartan drastically reversed high plasma Ig levels and ameliorated cold-induced immunosuppression, indicating the involvement of the RAAS and hypertension. These results indicated that the natively increased plasma Ig level is associated with immunosuppression during periods of cold exposure, and antihypertensive drugs can be useful to manage cold-induced immunosuppression. PMID:29560109

On Chip Protein Pre-Concentration for Enhancing the Sensitivity of Porous Silicon Biosensors.

PubMed

Arshavsky-Graham, Sofia; Massad-Ivanir, Naama; Paratore, Federico; Scheper, Thomas; Bercovici, Moran; Segal, Ester

2017-12-22

Porous silicon (PSi) nanomaterials have been widely studied as label-free optical biosensors for protein detection. However, these biosensors' performance, specifically in terms of their sensitivity (which is typically in the micromolar range), is insufficient for many applications. Herein, we present a proof-of-concept application of the electrokinetic isotachophoresis (ITP) technique for real-time preconcentration of a target protein on a PSi biosensor. With ITP, a highly concentrated target zone is delivered to the sensing area, where the protein target is captured by immobilized aptamers. The detection of the binding events is conducted in a label-free manner by reflective interferometric Fourier transformation spectroscopy (RIFTS). Up to 1000-fold enhancement in local concentration of the protein target and the biosensor's sensitivity are achieved, with a measured limit of detection of 7.5 nM. Furthermore, the assay is successfully performed in complex media, such as bacteria lysate samples, while the selectivity of the biosensor is retained. The presented assay could be further utilized for other protein targets, and to promote the development of clinically useful PSi biosensors.

On-chip isothermal, chemical cycling polymerase chain reaction (ccPCR)

NASA Astrophysics Data System (ADS)

Persat, Alexandre; Santiago, Juan

2008-11-01

We demonstrate a novel ccPCR technique for microfluidic DNA amplification where temperature is held constant in space and time. The polymerase chain reaction is a platform of choice for biological assays and typically based on a three-step thermal cycling: DNA denaturation, primers annealing and extension by an enzyme. We here demonstrate a novel technique where high concentration chemical denaturants (solvents) denature DNA. We leverage the high electrophoretic mobility of DNA and the electrical neutrality of denaturants to achieve chemical cycling. We focus DNA with isotachophoresis (ITP); a robust electrophoretic preconcentration technique which generates strong electric field gradients and protects the sample from dispersion. We apply a pressure-driven flow to balance electromigration velocity and keep the DNA sample stationary in a microchannel. We drive the DNA through a series of high denaturant concentration zones. DNA denatures at high denaturant concentration. At low denaturant concentration, the enzyme creates complementary strands. DNA reaction kinetics are slower than buffer reactions involved in ITP. We demonstrate successful ccPCR amplification for detection of E. Coli. The ccPCR has the potential for simpler chemistry than traditional PCR.

Impact of advanced onboard processing concepts on end-to-end data system

NASA Technical Reports Server (NTRS)

Sos, J. Y.

1978-01-01

An investigation is conducted of the impact of advanced onboard data handling concepts on the total system in general and on ground processing operations, such as those being performed in the central data processing facility of the NASA Goddard Space Flight Center. In one of these concepts, known as the instrument telemetry packet (ITP) system, telemetry data from a single instrument is encoded into a packet, along with other ancillary data, and transmitted in this form to the ground. Another concept deals with onboard temporal registration of image data from such sensors as the thematic mapper, to be carried onboard the Landsat-D spacecraft in 1981. It is found that the implementation of the considered concepts will result in substantial simplification of the ground processing element of the system. With the projected tenfold increase in the data volume expected in the next decade, the introduction of ITP should keep the cost of the ground data processing function within reasonable bounds and significantly contribute to a more timely delivery of data/information to the end user.

Tolerability and safety of the intravenous immunoglobulin octagam® 10% in patients with immune thrombocytopenia: a post-authorisation safety analysis of two non-interventional phase IV trials.

PubMed

Wietek, Stefan; Svorc, Daniel; Debes, Anette; Svae, Tor-Einar

2018-05-01

To provide detailed data on the tolerability and safety of octagam ® 10%, a ready-to-use intravenous immunoglobulin, in a subgroup of patients with immune thrombocytopenia (ITP) involved in an integrated analysis of post-authorisation safety surveillance (PASS) studies. A subgroup analysis was conducted using data collected from two non-interventional studies that included patients with ITP treated with octagam ® 10%. Patients were observed and monitored for possible adverse drug reactions (ADRs) during or after administration of octagam ® 10%, with a particular focus on thromboembolic events (TEEs). ADRs were analysed at the case and event level. In this analysis of 112 patients receiving octagam ® 10% (mean dose 0.4 g/kg/infusion), there were five cases with at least one adverse drug reaction (ADR) associated with 626 infusions of octagam ® 10% (case incidence of 0.8% per infusion). ADRs were of mild or moderate severity. There were a total of 10 events, most commonly back pain (n = 3) and headache (n = 2). Nausea, dizziness and a sensation of heaviness were also reported. The remaining two events involved drug exposure during pregnancy. There were no TEEs or other serious ADRs. In this subgroup analysis of patients who received octagam ® 10% (manufactured using an amended process) in two PASS studies, the overall ADR rate was low, with ADRs occurring in only 0.8% of all infusions. No TEEs or other serious ADRs were reported. Routine clinical use of octagam ® 10% was safe and well tolerated, with no unexpected safety issues, in patients with ITP. The two studies from which data were taken are registered with the International Standard Randomised Controlled Trial Number Registry, numbers ISRCTN58800347 and ISRCTN02245668.

WE-DE-201-01: BEST IN PHYSICS (THERAPY): A Fast Multi-Target Inverse Treatment Planning Strategy Optimizing Dosimetric Measures for High-Dose-Rate (HDR) Brachytherapy

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

Guthier, C; University Medical Center Mannheim, Mannheim; Harvard Medical School, Boston, MA

Purpose: Inverse treatment planning (ITP) for interstitial HDR brachytherapy of gynecologic cancers seeks to maximize coverage of the clinical target volumes (tumor and vagina) while respecting dose-volume-histogram related dosimetric measures (DMs) for organs at risk (OARs). Commercially available ITP tools do not support DM-based planning because it is computationally too expensive to solve. In this study we present a novel approach that allows fast ITP for gynecologic cancers based on DMs for the first time. Methods: This novel strategy is an optimization model based on a smooth DM-based objective function. The smooth approximation is achieved by utilizing a logistic functionmore » for the evaluation of DMs. The resulting nonconvex and constrained optimization problem is then optimized with a BFGS algorithm. The model was evaluated using the implant geometry extracted from 20 patient treatment plans under an IRB-approved retrospective study. For each plan, the final DMs were evaluated and compared to the original clinical plans. The CTVs were the contoured tumor volume and the contoured surface of the vagina. Statistical significance was evaluated with a one-sided paired Wilcoxon signed-rank test. Results: As did the clinical plans, all generated plans fulfilled the defined DMs for OARs. The proposed strategy showed a statistically significant improvement (p<0.001) in coverage of the tumor and vagina, with absolute improvements of related DMs of (6.9 +/− 7.9)% and (28.2 +/− 12.0)%, respectively. This was achieved with a statistically significant (p<0.01) decrease of the high-dose-related DM for the tumor. The runtime of the optimization was (2.3 +/− 2.0) seconds. Conclusion: We demonstrated using clinical data that our novel approach allows rapid DM-based optimization with improved coverage of CTVs with fewer hot spots. Being up to three orders of magnitude faster than the current clinical practice, the method dramatically shortens planning time.« less

Aberrant EPHB4 gene methylation and childhood acute lymphoblastic leukemia

PubMed Central

Li, Yuhua; Wang, Huihui; Chen, Xiaowen; Mai, Huirong; Li, Changgang; Wen, Feiqiu

2017-01-01

The present study aimed to investigate the association between aberrant DNA methylation of the promoter region of the ephrin type-B receptor 4 (EPHB4) gene and the development of childhood acute lymphoblastic leukemia (ALL). Bisulfite sequencing polymerase chain reaction (BSP) was performed to determine the methylation density of cytosine-guanine pair islands in the promoter region of EPHB4, in bone marrow samples from 40 children with ALL. The mRNA and protein expression levels of EPHB4 were detected using reverse transcription-quantitative polymerase chain reaction and western blot analysis. A total of 10 children with idiopathic thrombocytopenic purpura (ITP) were recruited as controls. The results revealed that the average methylation density of the bone marrow samples from the patients with ALL was significantly higher, compared with the patients with ITP (P=0.046). The relative mRNA expression levels of EPHB4 in the patients with ITP (25.08±4.03) and the patients with ALL without methylation (12.33±2.16) were significantly higher, compared with that observed in the patients with ALL with methylation (6.48±2.73; P<0.01). Pearson analysis revealed a significant negative linear correlation between EPHB4 gene methylation and its expression levels (r=−0.957; P<0.01). Western blot analysis indicated that EPHB4 protein expression levels were low in the methylated ALL samples. An evaluation of the two-year disease-free survival (DFS) of the patients with ALL was performed, which revealed that the patients with unmethylated ALL exhibited a significantly higher two-year DFS rate, as compared with patients with methylated ALL (P=0.036). These results suggest that the methylation of the EPHB4 gene is prevalent in childhood ALL and may result in expressional inactivation, which consequently promotes ALL pathogenesis and is associated with an unfavorable prognosis. Therefore, the EPHB4 gene may function as a potential tumor suppressor in childhood ALL. PMID:29085439

Environmental Technology Verification Program Fact Sheet

EPA Science Inventory

This is a Fact Sheet for the ETV Program. The EPA Environmental Technology Verification Program (ETV) develops test protocols and verifies the performance of innovative technologies that have the potential to improve protection of human health and the environment. The program ...

Alternative, Renewable and Novel Feedstocks for Producing Chemicals

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

none,

2007-07-01

Vision2020 and ITP directed the Alternative, Renewable and Novel Feedstocks project to identify industrial options and to determine the work required to make alternative, renewable and novel feedstock options attractive to the U.S. chemicals industry. This report presents the Alternative, Renewable and Novel Feedstocks project findings which were based on a technology review and industry workshop.

76 FR 41288 - Draft Environmental Impact Statement and Multi-Species Habitat Conservation Plan; Receipt of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-13

... for Incidental Take Permit; NiSource, Inc. AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice... NiSource, Inc. (Applicant), for an incidental take permit under the Endangered Species Act of 1973... have received an application from NiSource, Inc., for an incidental take permit (ITP) (TE02636A) under...

77 FR 51554 - Draft Environmental Impact Statement and Habitat Conservation Plan; Receipt of Application for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-24

... from Beech Ridge Energy for an ITP for the operation, and maintenance of 67 existing turbines in the project area; the construction, operation and maintenance of up to 33 additional turbines and associated... low wind speeds by raising turbine cut-in speeds (the wind speed at which turbines begin generating...

Operation SANDSTONE Nuclear Explosions. Atomic Weapons Tests. Operation Sandstone. Annex 1, Part 3. Volume 1. Report to Joint Chiefs of Staff

DTIC Science & Technology

1948-03-16

necessary directives $ - for the conversion of an IBM . Shortl y thereafter the Office Lieutenent General Hull was informed that the U.8.8. LSM-250 had been...terrain be determined and that deve1o~~ent be started immediately. Itp I

75 FR 41434 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-16

... Service (FAS) has denied a petition (No. 2010008) for trade adjustment assistance (TAA) for crawfish that... Assistance for Farmers Staff, FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by e-mail: [email protected]fas.usda.gov ; or visit the TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa . Dated...

75 FR 42376 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... Service (FAS) today accepted and began a review of a petition for trade adjustment assistance filed under... Farmers Staff, FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by e-mail: [email protected]fas.usda.gov ; or visit the TAA for Farmers' Web site: http:// www.fas.usda.gov/itp/taa . Dated: July 14...

75 FR 41434 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-16

... Service (FAS) has denied a petition (No. 2010016) for trade adjustment assistance (TAA) for cranberries... Assistance for Farmers Staff, FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by e-mail: [email protected]fas.usda.gov ; or visit the TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa . Dated...

75 FR 43140 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

... Service (FAS) today accepted and began a review of a petition for trade adjustment assistance [[Page 43141... Assistance for Farmers Staff, FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by e-mail: [email protected]fas.usda.gov ; or visit the TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa . Dated...

75 FR 41434 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-16

... Service (FAS) has denied a petition (No. 2010004) for trade adjustment assistance (TAA) for cut lilies..., FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by e-mail: [email protected]fas.usda.gov ; or visit the TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa . Dated: July 8, 2010. John D...

Student Vocational Teachers: The Significance of Individual Positions in Workplace Learning

ERIC Educational Resources Information Center

Goh, Adeline Yuen Sze; Zukas, Miriam

2016-01-01

In most initial teacher preparation (ITP) programmes, learning in teaching placements is considered to be an important component for providing workplace learning experiences to develop the skills of being a teacher. This paper is based on a bigger qualitative study which explored the learning experiences of a group of in-service student vocational…

Family Support Programs and Incarcerated Parents: Overview of Family Support Programs.

ERIC Educational Resources Information Center

Family Resource Coalition, Chicago, IL.

This fact sheet begins with an overview of family support programs, which includes a discussion of the premises of family support programs and a list of typical program components. The remainder of the fact sheet focuses on support programs for incarcerated parents. The children of incarcerated parents, though innocent of any crime, are often…

A Matter of Facts: The North Carolina Community College System Fact Book, 2003.

ERIC Educational Resources Information Center

North Carolina Community Coll. System, Raleigh.

This 2003 fact book for the North Carolina Community College System (NCCCS) is divided into the following sections: (1) Introduction, which covers mission, history, programs, governance, funding and other areas. (2) Program Briefs, which covers basic skills, distance learning, community service, occupational continuing education, workforce…

Save Energy Now Assessments Results 2008 Summary Report

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

Wright, Anthony L; Martin, Michaela A; Nimbalkar, Sachin U

In October 2005, U.S. Department of Energy Secretary Bodman launched his Easy Ways to Save Energy campaign with a promise to provide energy assessments to 200 of the largest U.S. manufacturing plants. DOE's Industrial Technologies Program (ITP) responded to the Secretary's campaign with its Save Energy Now initiative, featuring a new and highly cost-effective form of energy savings assessment. The approach for these assessments drew heavily on the existing resources of ITP's technology delivery component. Over the years, ITP Technology Delivery has worked with industry partners to assemble a suite of respected software tools, proven assessment protocols, training curricula, certified energy experts, and strong partnerships for deployment. The Save Energy Now assessments conducted in calendar year 2006 focused on natural gas savings and targeted many of the nation's largest manufacturing plants - those that consume at least 1 TBtu of energy annually. The 2006 Save Energy Now assessments focused primarily on assessments of steam and process heating systems, which account for an estimated 74% of all natural gas use by U.S. manufacturing plants. Because of the success of the Save Energy Now assessments conducted in 2006 and 2007, the program was expanded and enhanced in two major ways in 2008: (1) a new goal was set to perform at least 260 assessments; and (2) the assessment focus was expanded to include pumping, compressed air, and fan systems in addition to steam and process heating. DOE ITP also has developed software tools to assess energy efficiency improvement opportunities in pumping, compressed air, and fan systems. The Save Energy Now assessments integrate a strong training component designed to teach industrial plant personnel how to use DOE's opportunity assessment software tools. This approach has the advantages of promoting strong buy-in of plant personnel for the assessment and its outcomes and preparing them better to independently replicate the assessment process at the company's other facilities. Another important element of the Save Energy Now assessment process is the follow-up process used to identify how many of the recommended savings opportunities from individual assessments have been implemented in the industrial plants. Plant personnel involved with the Save Energy Now assessments are contacted 6 months, 12 months, and 24 months after individual assessments are completed to determine implementation results. A total of 260 Save Energy Now assessments were successfully completed in calendar year 2008. This means that a total of 718 assessments were completed in 2006, 2007, and 2008. As of July 2009, we have received a total of 239 summary reports from the ESAs that were conducted in year 2008. Hence, at the time that this report was prepared, 680 final assessment reports were completed (200 from year 2006, 241 from year 2007, and 239 from year 2008). The total identified potential cost savings from these 680 assessments ismore » $$1.1 billion per year, including natural gas savings of about 98 TBtu per year. These results, if fully implemented, could reduce CO{sub 2} emissions by about 8.9 million metric tons annually. When this report was prepared, data on implementation of recommended energy and cost savings measures from 488 Save Energy Now assessments were available. For these 488 plants, measures saving a total of $$147 million per year have been implemented, measures that will save $169 million per year are in the process of being implemented, and plants are planning implementation of measures that will save another $239 million per year. The implemented recommendations are already achieving total CO{sub 2} reductions of about 1.8 million metric tons per year. This report provides a summary of the key results for the Save Energy Now assessments completed in 2008; details of the 6-month, 12-month, and 24-month implementation results obtained to date; and an evaluation of these implementation results. This report also summarizes key accomplishments, findings, and lessons learned from all the Save Energy Now assessments completed to date. A separate report (Wright et al. 2010) provides more detailed information on key results for all of the 2008 assessments of steam, process heating, pumping, compressed air, and fan systems. Two prior reports (Wright et al. 2007 and Wright et al. 2009) detail the results from the 2006 and 2007 assessments and discuss the major components of the assessment process and improvements in the process made in 2007.« less

Save Energy Now Assessments Results 2008 Detailed Report

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

Wright, Anthony L; Martin, Michaela A; Nimbalkar, Sachin U

In October 2005, U.S. Department of Energy Secretary Bodman launched his Easy Ways to Save Energy campaign with a promise to provide energy assessments to 200 of the largest U.S. manufacturing plants. DOE's Industrial Technologies Program (ITP) responded to the Secretary's campaign with its Save Energy Now initiative, featuring a new and highly cost-effective form of energy savings assessment. The approach for these assessments drew heavily on the existing resources of ITP's technology delivery component. Over the years, ITP Technology Delivery has worked with industry partners to assemble a suite of respected software tools, proven assessment protocols, training curricula, certified energy experts, and strong partnerships for deployment. The Save Energy Now assessments conducted in calendar year 2006 focused on natural gas savings and targeted many of the nation's largest manufacturing plants - those that consume at least 1 TBtu of energy annually. The 2006 Save Energy Now assessments focused primarily on assessments of steam and process heating systems, which account for an estimated 74% of all natural gas use by U.S. manufacturing plants. Because of the success of the Save Energy Now assessments conducted in 2006 and 2007, the program was expanded and enhanced in two major ways in 2008: (1) a new goal was set to perform at least 260 assessments; and (2) the assessment focus was expanded to include pumping, compressed air, and fan systems in addition to steam and process heating. DOE ITP also has developed software tools to assess energy efficiency improvement opportunities in pumping, compressed air, and fan systems. The Save Energy Now assessments integrate a strong training component designed to teach industrial plant personnel how to use DOE's opportunity assessment software tools. This approach has the advantages of promoting strong buy-in of plant personnel for the assessment and its outcomes and preparing them better to independently replicate the assessment process at the company's other facilities. Another important element of the Save Energy Now assessment process is the follow-up process used to identify how many of the recommended savings opportunities from individual assessments have been implemented in the industrial plants. Plant personnel involved with the Save Energy Now assessments are contacted 6 months, 12 months, and 24 months after individual assessments are completed to determine implementation results. A total of 260 Save Energy Now assessments were successfully completed in calendar year 2008. This means that a total of 718 assessments were completed in 2006, 2007, and 2008. As of July 2009, we have received a total of 239 summary reports from the ESAs that were conducted in year 2008. Hence, at the time that this report was prepared, 680 final assessment reports were completed (200 from year 2006, 241 from year 2007, and 239 from year 2008). The total identified potential cost savings from these 680 assessments ismore » $$1.1 billion per year, including natural gas savings of about 98 TBtu per year. These results, if fully implemented, could reduce CO{sub 2} emissions by about 8.9 million metric tons annually. When this report was prepared, data on implementation of recommended energy and cost savings measures from 488 Save Energy Now assessments were available. For these 488 plants, measures saving a total of $$147 million per year have been implemented, measures that will save $169 million per year are in the process of being implemented, and plants are planning implementation of measures that will save another $239 million per year. The implemented recommendations are already achieving total CO{sub 2} reductions of about 1.8 million metric tons per year. This report provides a summary of the key results for the Save Energy Now assessments completed in 2008; details of the 6-month, 12-month, and 24-month implementation results obtained to date; and an evaluation of these implementation results. This report also summarizes key accomplishments, findings, and lessons learned from all the Save Energy Now assessments completed to date. A separate report (Wright et al. 2010) provides more detailed information on key results for all of the 2008 assessments of steam, process heating, pumping, compressed air, and fan systems. Two prior reports (Wright et al. 2007 and Wright et al. 2009) detail the results from the 2006 and 2007 assessments and discuss the major components of the assessment process and improvements in the process made in 2007.« less

Autonomous Observations of the Upper Ocean Stratification and Velocity Fields About the Seasonally-Retreating Marginal Ice Zone

DTIC Science & Technology

2013-09-30

Unit and Attitude Heading Reference System (IMU/ AHRS ). The former was motivated by analysis of prototype data that suggested that vortex shedding from...relative orientation of the coordinate system of the VN-100 IMU/ AHRS (mounted on a board inside the ITP-V pressure case) relative to that of the ACM

Autonomous Observations of the Upper Ocean Stratification and Velocity Field about the Seasonally-Retreating Marginal Ice Zone

DTIC Science & Technology

2016-12-30

of Oceanography . Also, ITP-V investigators have collaborated with aNa a! Postgraduate School 3 student (Gallaher) whose dissertation is based on...under Arctic sea-ice. Journal of Physical Oceanography , doi: http://dx.doi.org/l 0.1175/JPO-D-12-0191.1 Cole, S.T. , F.T. Thwaites, R.A. Krishfield

75 FR 48359 - Endangered and Threatened Wildlife and Plants; Indiana Bat; Notice of Intent To Prepare an...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-10

... megawatts (MW) of renewable energy from as many as 200 1.5-MW wind energy turbines and the related facilities (access roads, collection lines, operation and maintenance facilities (O&M), substations, and a... Conservation Plan (HCP) and Incidental Take Permit (ITP) for the Indiana Bat (Myotis sodalis) at a wind power...

75 FR 4840 - Endangered and Threatened Wildlife and Plants; Indiana Bat; 30-Day Scoping Period for a National...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-29

... project would include installation of up to 100 wind turbines and associated collection lines, access... areas and concrete batch plants. The wind turbine hub height would be approximately 100 meters (m), and... conservation plan (HCP) and incidental take permit (ITP) for the Indiana bat (Myotis sodalis) at a wind power...

Atmospheric Electricity Hazards Analytical Model Development and Application. Volume I. Lightning Environment Modeling.

DTIC Science & Technology

1981-08-01

generates essentially all of the spectral content that was measured. 120 Itp ’ IRIESTIA 0 AVE AAGE LE VE. L OF SPE’CTRAL AMAPLI TUOL I 20 9633 931’ S9...MHz, Report No. 63-538-89, IBM Federal Systems Division, 1963. Hewitt, F.J., Radar echoes from interstroke process in lightning, Proc. Phys. Soc

Moment Method Solutions for Radiation and Scattering from Arbitrarily Shaped Surfaces.

DTIC Science & Technology

1981-02-01

IBM -370/168. A. Monopole Antenna on a Disk The study of the monopole antenna on a circular disk is of inter- est since it leads to the understanding...34 . . ._"-", - CHAPTER V ANALYSIS OF MICRUSI- itP ANTL-NNAS This chapter will present an analysis of the microstrip antenna. Surface-patch dipole modes are used to

Vulnerability Model. A Simulation System for Assessing Damage Resulting from Marine Spills

DTIC Science & Technology

1975-06-01

used and the scenario simulated. The test runs were made on an IBM 360/65 computer. Running times were generally between 15 and 35 CPU seconds...fect filrthcr north. A petroleum tank-truck operation was located within 600 feet Of L𔃻:- stock pond on which the crude oil had dammred itp . At 5 A-M

Study on a Cavitating Hydrofoil having a Practical Blade Profile Shape.

DTIC Science & Technology

1980-10-31

and punched on regular IBM cards. These cards were conveniently used as input data for data reduction. The data acquisition system also has an...FIGURE 3.4 FLOW CONFIGURATION OF DOUBLE WAKE MODEL FOR PARTIALLY CAVITATING FOIL W =+ itp B C F T w St (pI FIGURE 3.5 POTENTIAL PLANE ia W T B C F W

Assessment to Guide Individualized Transition Plans from School to Post-School for Children Ages 14+ with Moderate Disabilities

ERIC Educational Resources Information Center

Skidmore, Kevin

2014-01-01

As a part of the Individualized Education Plan (IEP), special education teachers work along with their student with special needs and their parent(s)/guardian(s) to create and implement Individualized Transition Plans (ITP) to assist the student with their transition to the post-school environment. As mandated by Individuals with Disabilities…

77 FR 49824 - Draft Environmental Assessment and Draft Habitat Conservation Plan for TransCanada Keystone...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-17

... (DHCP) should be submitted in writing, by one of the following methods: Email: [email protected] comments. Please specify if comments are in reference to the DEA, DHCP, or both. FOR FURTHER INFORMATION... 2. The applicant has developed a DHCP as part of the application for an ITP (TE80492A-0), which...

78 FR 42508 - Notice of Availability of Draft Environmental Assessment on the Effects of Issuing an Incidental...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

... application for an ITP to address sea turtle interactions with set gillnets in NC internal coastal waters... part of the public scoping process. The EA analyzes the effects to the human and natural environment... inshore waters; and, therefore, there may be some impact to sea birds from all of the alternatives. Social...

[The endoscopic and clinical features of Indigo Naturalis-associated ischemic lesions of colonic mucosa].

PubMed

Suo, Bao-jun; Zhou, Li-ya; Ding, Shi-gang; Lü, Yu-min; Gu, Fang; Lin, San-ren; Zheng, Ya-an

2011-08-01

By analysing the clinical features of Indigo Naturalis-associated ischemic lesion of colon mucosa to improve the precautionary and therapeutic level of the disease. Thirteen patients diagnosed as Indigo Naturalis-associated ischemic lesion of colon mucosa in Peking University Third Hospital from 2005 to 2010 were reviewed. The endoscopic and clinical features were analysed. The 13 patients with an average age of (60.6 ± 14.1) years old were prescribed Chinese traditional medicine containing Indigo Naturalis for psoriasis or idiopathic thrombocytopenic purpura (ITP). The ratio of males to females was 1:1.6. The typical manifestations were abdominal pain and bloody stool with watering diarrhea before bloody stool in 61.5% patients. Endoscopic and pathological characteristics were coincident with ischemic lesion and more like a chronic index. Vasodilatic medicine was effective and the average hemostatic time was (1.7 ± 0.8) days. The prognosis was well and no recurrence was found during 3 months follow-up. Patients having psoriasis or ITP treated with Chinese traditional medicine containing Indigo Naturalis have an inclination to colon mucosa lesions, even ischemic lesion. Careful assessment and observation before prescribing are necessary in these patients.

Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group.

PubMed

Rodeghiero, Francesco; Stasi, Roberto; Gernsheimer, Terry; Michel, Marc; Provan, Drew; Arnold, Donald M; Bussel, James B; Cines, Douglas B; Chong, Beng H; Cooper, Nichola; Godeau, Bertrand; Lechner, Klaus; Mazzucconi, Maria Gabriella; McMillan, Robert; Sanz, Miguel A; Imbach, Paul; Blanchette, Victor; Kühne, Thomas; Ruggeri, Marco; George, James N

2009-03-12

Diagnosis and management of immune thrombocytopenic purpura (ITP) remain largely dependent on clinical expertise and observations more than on evidence derived from clinical trials of high scientific quality. One major obstacle to the implementation of such studies and in producing reliable meta-analyses of existing data is a lack of consensus on standardized critical definitions, outcome criteria, and terminology. Moreover, the demand for comparative clinical trials has dramatically increased since the introduction of new classes of therapeutic agents, such as thrombopoietin receptor agonists, and innovative treatment modalities, such as anti-CD 20 antibodies. To overcome the present heterogeneity, an International Working Group of recognized expert clinicians convened a 2-day structured meeting (the Vicenza Consensus Conference) to define standard terminology and definitions for primary ITP and its different phases and criteria for the grading of severity, and clinically meaningful outcomes and response. These consensus criteria and definitions could be used by investigational clinical trials or cohort studies. Adoption of these recommendations would serve to improve communication among investigators, to enhance comparability among clinical trials, to facilitate meta-analyses and development of therapeutic guidelines, and to provide a standardized framework for regulatory agencies.

RhIG for the treatment of immune thrombocytopenia: consensus and controversy

PubMed Central

Despotovic, Jenny M.; Lambert, Michele P.; Herman, Jay H.; Gernsheimer, Terry B.; McCrae, Keith R.; Tarantino, Michael D.; Bussel, James B.

2012-01-01

Anti-D immune globulin (RhIG) is a front-line option in North America for the treatment of immune thrombocytopenia (ITP) in children and adults. Recently, addition of a Food and Drug Administration-mandated black box warning highlighted the risks of intravascular hemolysis, renal failure, and disseminated intravascular coagulation after anti-D infusion, prompting concern within the medical community regarding its use. A working group convened in response to this warning to prepare a consensus document regarding the safety of RhIG because there has been no increased incidence of adverse events since the initial discovery of these reactions many years ago. The efficacy of anti-D is well documented and only briefly reviewed. The estimated incidence and proposed mechanisms for the rare, major treatment-related complications are discussed, and signal detection data associated with heightened risk of acute hemolytic reactions are presented. The importance of considering host factors, given the rarity of severe reactions, is emphasized. Safety profiles of parallel treatment options are reviewed. The working group consensus is that RhIG has comparable safety and efficacy to other front-line agents for the treatment of children and adults with ITP. Safety may be further improved by careful patient selection. PMID:21981825

Thrombopoietin-receptor agonists for children with immune thrombocytopenia: a systematic review.

PubMed

Zhang, Jiaxing; Liang, Yi; Ai, Yuan; Xie, Juan; Li, Youping; Zheng, Wenyi

2017-10-01

We conducted a systematic review to assess the efficacy and safety of Thrombopoietin-receptor agonists (TPOras) for pediatric immune thrombocytopenia (ITP). We searched PubMed, Embase and Cochrane Library from their earliest records to January 2017. Randomized controlled trials (RCTs) were included. Primary outcomes were durable response and clinically significant bleeding. Secondary outcomes were overall response, overall bleeding events, the use of rescue medication and adverse events (AEs). Five randomized RCTs (261participants) were included. Compared with placebo group, the proportion of patients achieving durable platelet response was significantly higher in Eltrombopag (P = 0.0004) or Romiplostim (P = 0.002) group, so was the overall response in Eltrombopag [RR = 2.64, 95% CI (1.58, 4.44)] or Romiplostim [RR = 5.05, 95% CI (2.21, 11.53)] group. Both clinically significant bleeding (P = 0.04) and total bleeding (P = 0.01) in Eltrombopag group were significantly less frequent than those in placebo group, while no significant difference between Romiplostim and placebo group. The proportion of patients receiving rescue medication, the incidence of overall AEs and serious AEs between TPO-receptor agonists and placebo group were not significantly different. TPOras might improve both durable and overall platelet response in pediatric ITP, compared with placebo.

The acid-base buffer capacity of podzolic soils and its changes under the impact of treatment with the Mehra-Jackson and Tamm reagents

NASA Astrophysics Data System (ADS)

Maksimova, Yu. G.; Maryakhina, N. N.; Tolpeshta, I. I.; Sokolova, T. A.

2010-10-01

The acid-base buffer capacity before and after the treatment with the Mehra-Jackson and Tamm reagents was assessed by continuous potentiometric titration for the main genetic horizons of two profiles of podzolic soils in the Central Forest State Reserve. The total buffer capacity was calculated in the pH range from the initial titration point (ITP) to 3 for the acid titration and from the ITP to 10 for the base titration, as well as the buffer capacities in the pH intervals of 0.25. It was found that both treatments abruptly decreased the base buffer capacity, which reached 70-90% in the E horizons. The high direct linear correlation of the difference between the total base buffer capacities before and after each treatment with the content of Fe in the Tamm extract was revealed. From the results obtained, a conclusion was drawn that finely dispersed Fe hydroxides were the main solid-phase constituents ensuring the base buffer capacity, and the deprotonation of hydroxyl groups on the surface of Fe hydroxides was the essential buffer reaction during the base titration.

Focusing analytes from 50 μL into 500 pL: On-chip focusing from large sample volumes using isotachophoresis.

PubMed

van Kooten, Xander F; Truman-Rosentsvit, Marianna; Kaigala, Govind V; Bercovici, Moran

2017-09-05

The use of on-chip isotachophoresis assays for diagnostic applications is often limited by the small volumes of standard microfluidic channels. Overcoming this limitation is particularly important for detection of 'discrete' biological targets (such as bacteria) at low concentrations, where the volume of processed liquid in a standard microchannel might not contain any targets. We present a novel microfluidic chip that enables ITP focusing of target analytes from initial sample volumes of 50 μL into a concentrated zone with a volume of 500 pL, corresponding to a 100,000-fold increase in mean concentration, and a 300,000-fold increase in peak concentration. We present design considerations for limiting sample dispersion in such large-volume focusing (LVF) chips and discuss the trade-off between assay time and Joule heating, which ultimately governs the scalability of LVF designs. Finally, we demonstrate a 100-fold improvement of ITP focusing performance in the LVF chip as compared to conventional microchannels, and apply this enhancement to achieve highly sensitive detection of both molecular targets (DNA, down to 10 fM) and whole bacteria (down to 100 cfu/mL).

The Shifting Sands of Counseling Psychology Programs' Institutional Contexts: An Environmental Scan and Revitalizing Strategies

ERIC Educational Resources Information Center

Blustein, David L.; Goodyear, Rodney K.; Perry, Justin C.; Cypers, Scott

2005-01-01

Despite strong indicators of the robustness of counseling psychology, the specialty seems somewhat vulnerable, as evidenced by the fact that several solid programs have been forced to phase out or to convert to combined-integrated programs. In fact, analyzing the trends among counseling psychology programs reveals that 30% of programs that have…

Methamphetamine

MedlinePlus

... OPERATIONS Diversion Control Programs Most Wanted Fugitives Training Intelligence Submit a Tip DRUG INFO Drug Fact Sheets ... Operations Diversion Control Programs Most Wanted Fugitives Training Intelligence Submit a Tip Drug Info Drug Fact Sheets ...

Narcotics

MedlinePlus

... OPERATIONS Diversion Control Programs Most Wanted Fugitives Training Intelligence Submit a Tip DRUG INFO Drug Fact Sheets ... Operations Diversion Control Programs Most Wanted Fugitives Training Intelligence Submit a Tip Drug Info Drug Fact Sheets ...

Hydrocodone

MedlinePlus

... OPERATIONS Diversion Control Programs Most Wanted Fugitives Training Intelligence Submit a Tip DRUG INFO Drug Fact Sheets ... Operations Diversion Control Programs Most Wanted Fugitives Training Intelligence Submit a Tip Drug Info Drug Fact Sheets ...

Heroin Photos

MedlinePlus

... OPERATIONS Diversion Control Programs Most Wanted Fugitives Training Intelligence Submit a Tip DRUG INFO Drug Fact Sheets ... Operations Diversion Control Programs Most Wanted Fugitives Training Intelligence Submit a Tip Drug Info Drug Fact Sheets ...

Childhood Obesity Facts

MedlinePlus

... and Local Programs Related Topics Diabetes Nutrition Childhood Obesity Facts Recommend on Facebook Tweet Share Compartir On ... Children (WIC) Program, 2000-2014 Prevalence of Childhood Obesity in the United States Childhood obesity is a ...

Autonomous Observations of the Upper Ocean Stratification and Velocity Field about the Seasonality Retreating Marginal Ice Zone

DTIC Science & Technology

2016-12-30

graduate school at the Scripps institution of Oceanography . Also, ITP-Y investigators have collaborated with a Naval Postgraduate School 3 student...Physical Oceanography , doi: http://dx.doi.org/10. l J 75/JPO-D-1 2-0 19 l. l Cole, S.T., F.T. Thwaites, R.A. Kri shfield, and J.M. Toole, 2015

Facilitating the Interpretation of English Language Proficiency Scores: Combining Scale Anchoring and Test Score Mapping Methodologies

ERIC Educational Resources Information Center

Powers, Donald; Schedl, Mary; Papageorgiou, Spiros

2017-01-01

The aim of this study was to develop, for the benefit of both test takers and test score users, enhanced "TOEFL ITP"® test score reports that go beyond the simple numerical scores that are currently reported. To do so, we applied traditional scale anchoring (proficiency scaling) to item difficulty data in order to develop performance…

Numerical Modeling of the Vertical Heat Transport Through the Diffusive Layer of the Arctic Ocean

DTIC Science & Technology

2013-03-01

vertical heat transport through Arctic thermohaline staircases over time . Re-engaging in the inverse modeling technique that was started by Chaplin ...reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instruction, searching...function. ........................................42 Figure 23. Temperature—Salinity plots for ITPs 1-6 (After Chaplin 2009

Effects of Norfolk Harbor Deepening on Management of Craney Island Disposal Area.

DTIC Science & Technology

1983-04-01

VICKSBURG MS ENVIRONMENTAL LAB UNCLASSIFIED D F HAVES 01 APR 03 F/G 13/2 N smmmhhhhhhhhh smhmhhhhhomhl Ehhhhhhmhrnmm .4’ -Te SIBM 11-25 -A MIROOP RU4TT-oif...CLASSIFICATION OUNCLASSIFIEUNUMTED 1l SAMEAS ItP . C0 W USERS Unclasslfteg 22a. NAME OF RESPONSIBLE INDIVIDUAL 22b. TtLE VOtElA. Ale Code) U&, OfFICE

AIDA: An Airbase Damage Assessment Model

DTIC Science & Technology

1976-09-01

Command and Control System (WWMCCS); subsequently, it has been run on the IBM 360/370 series. AIDA is easily transferable to other computers because...9NAPNDtNTM ,K T EST 10’CR , ýCW,MCL 9 MODEoNPR INTPNAM, NST,𔃾TT 1138. COMMZ0N/STATS/N’TRI AL,# ITP IALP NSTAT, STAT (2509 8) tST AT2( 20#5) , STAT( 8) 41139

FEASIL Implementation under VAX VMS with Design Information.

DTIC Science & Technology

1986-11-01

desirable to eventually port FEASIL to the HP 9000, the IBM PC, and several other com- puters. However, the flowcharting and VAX conversion efforts have...v W l EU l l~rl EDIIkEL (pg 12) DEL El’F TJ-’LE C rr~PACE 13 HPvrwrH IIUpdate the I Itpe DescrL c ðere tau,1es remaining nthe relatioil ? ye

"Teaching Could Be a Fantastic Job "but"...": Three Stories of Student Teacher Withdrawal from Initial Teacher Preparation Programmes in England

ERIC Educational Resources Information Center

Chambers, Gary N.; Hobson, Andrew J.; Tracey, Louise

2010-01-01

Retention in initial teacher preparation (ITP) and the teaching profession, in England and elsewhere, has been the subject of numerous articles in academic and professional journals. Whilst a number of common findings are beginning to emerge from research on this subject, notably on the causes of student teacher withdrawal, studies have tended to…

Enhancing global vaccine pharmacovigilance: Proof-of-concept study on aseptic meningitis and immune thrombocytopenic purpura following measles-mumps containing vaccination

PubMed Central

Perez-Vilar, Silvia; Weibel, Daniel; Sturkenboom, Miriam; Black, Steven; Maure, Christine; Castro, Jose Luis; Bravo-Alcántara, Pamela; Dodd, Caitlin N.; Romio, Silvana A.; de Ridder, Maria; Nakato, Swabra; Molina-León, Helvert Felipe; Elango, Varalakshmi; Zuber, Patrick L.F.

2017-01-01

New vaccines designed to prevent diseases endemic in low and middle-income countries (LMICs) are now being introduced without prior record of utilization in countries with robust pharmacovigilance systems. To address this deficit, our objective was to demonstrate feasibility of an international hospital-based network for the assessment of potential epidemiological associations between serious and rare adverse events and vaccines in any setting. This was done through a proof-of-concept evaluation of the risk of immune thrombocytopenic purpura (ITP) and aseptic meningitis (AM) following administration of the first dose of measles-mumps-containing vaccines using the self-controlled risk interval method in the primary analysis. The World Health Organization (WHO) selected 26 sentinel sites (49 hospitals) distributed in 16 countries of the six WHO regions. Incidence rate ratios (IRR) of 5.0 (95% CI: 2.5-9.7) for ITP following first dose of measles-containing vaccinations, and of 10.9 (95% CI: 4.2-27.8) for AM following mumps-containing vaccinations were found. The strain-specific analyses showed significantly elevated ITP risk for measles vaccines containing Schwarz (IRR: 20.7; 95% CI: 2.7-157.6), Edmonston-Zagreb (IRR: 11.1; 95% CI: 1.4-90.3), and Enders´Edmonston (IRR: 8.5; 95% CI: 1.9-38.1) strains. A significantly elevated AM risk for vaccines containing the Leningrad-Zagreb mumps strain (IRR: 10.8; 95% CI: 1.3-87.4) was also found. This proof-of-concept study has shown, for the first time, that an international hospital-based network for the investigation of rare vaccine adverse events, using common standardized procedures and with high participation of LMICs, is feasible, can produce reliable results, and has the potential to characterize differences in risk between vaccine strains. The completion of this network by adding large reference hospitals, particularly from tropical countries, and the systematic WHO-led implementation of this approach, should permit the rapid post-marketing evaluation of safety signals for serious and rare adverse events for new and existing vaccines in all settings, including LMICs. PMID:28558983

Immunohistochemical study of Ulex europaeus agglutinin 1 (UEA-1) binding of megakaryocytes in bone marrow biopsy specimens: demonstration of heterogeneity in staining pattern reflecting the stages of differentiation.

PubMed

Liu, S M; Li, C Y

1996-01-01

During differentiation, megakaryocytes undergo nuclear endoreplication, an increase in cell size, cytoplasmic granulation, and release of platelets. The changes in highly lobulated nuclei with varying degree of polyploidy and increasing cell size are easily recognized morphologically. However, the actual cytoplasmic changes are more difficult to perceive morphologically. With the peroxidase-antiperoxidase (PAP) method using UEA-1 as the binding protein to the alpha-L-fucose of glycoprotein synthesized by megakaryocytes, we observed significant variation in cytoplasmic staining of megakaryocytes in routinely processed bone marrow biopsy sections. A total of 3344 megakaryocytes in bone marrow sections from 10 patients with nonhematologic diseases and from 10 patients with idiopathic thrombocytopenic purpura (ITP) was studied. According to the intensity and pattern of cytoplasmic staining, we divided megakaryocytes into at least six groups: (1) low granular (LG), (2) diffuse granular (DG), (3) diffuse dense granular (DDG), (4) marginal granular (MG), (5) denuded (DMK), and (6) endomitotic (EndoM). Most of the megakaryocytes were DG (mean, 42.75% +/- 19.21%) and DDG (mean, 50.25% +/- 21.23%). In correlation with nuclear morphology and cell size, it appears that substances binding to UEA-1 are located in the paranuclear region in early megakaryocytes and produce a low granular focal staining pattern (LG cells). Next, the granules spread throughout the cytoplasm (DG cells) and increase in quantity (DDG). This is followed by migration of granules to the periphery of the cytoplasm (MG cells) and is associated with the liberation of platelets and eventual formation of DMK megakaryocytes. Endomitosis, regulated by unknown factors, occurred in the MG stage. In comparing the group with nonhematologic disease (mean DG, 35.4% +/- 18.48%; DDG, 58.4% +/- 21.8%) and the group with ITP (mean DG, 50.1% +/- 17.82%; DDG, 42.1% +/- 18.12%), we found an increasing proportion of DG megakaryocytes in ITP, which suggests a left-shifted maturation of megakaryocytes. By understanding the staining pattern seen in the different stages of megakaryocytic differentiation, UEA-1 staining may be a practical method for studying megakaryocytopoiesis in routinely processed paraffin sections of bone marrow biopsy samples.

Enhancing global vaccine pharmacovigilance: Proof-of-concept study on aseptic meningitis and immune thrombocytopenic purpura following measles-mumps containing vaccination.

PubMed

Perez-Vilar, Silvia; Weibel, Daniel; Sturkenboom, Miriam; Black, Steven; Maure, Christine; Castro, Jose Luis; Bravo-Alcántara, Pamela; Dodd, Caitlin N; Romio, Silvana A; de Ridder, Maria; Nakato, Swabra; Molina-León, Helvert Felipe; Elango, Varalakshmi; Zuber, Patrick L F

2018-01-08

New vaccines designed to prevent diseases endemic in low and middle-income countries (LMICs) are now being introduced without prior record of utilization in countries with robust pharmacovigilance systems. To address this deficit, our objective was to demonstrate feasibility of an international hospital-based network for the assessment of potential epidemiological associations between serious and rare adverse events and vaccines in any setting. This was done through a proof-of-concept evaluation of the risk of immune thrombocytopenic purpura (ITP) and aseptic meningitis (AM) following administration of the first dose of measles-mumps-containing vaccines using the self-controlled risk interval method in the primary analysis. The World Health Organization (WHO) selected 26 sentinel sites (49 hospitals) distributed in 16 countries of the six WHO regions. Incidence rate ratios (IRR) of 5.0 (95% CI: 2.5-9.7) for ITP following first dose of measles-containing vaccinations, and of 10.9 (95% CI: 4.2-27.8) for AM following mumps-containing vaccinations were found. The strain-specific analyses showed significantly elevated ITP risk for measles vaccines containing Schwarz (IRR: 20.7; 95% CI: 2.7-157.6), Edmonston-Zagreb (IRR: 11.1; 95% CI: 1.4-90.3), and Enders'Edmonston (IRR: 8.5; 95% CI: 1.9-38.1) strains. A significantly elevated AM risk for vaccines containing the Leningrad-Zagreb mumps strain (IRR: 10.8; 95% CI: 1.3-87.4) was also found. This proof-of-concept study has shown, for the first time, that an international hospital-based network for the investigation of rare vaccine adverse events, using common standardized procedures and with high participation of LMICs, is feasible, can produce reliable results, and has the potential to characterize differences in risk between vaccine strains. The completion of this network by adding large reference hospitals, particularly from tropical countries, and the systematic WHO-led implementation of this approach, should permit the rapid post-marketing evaluation of safety signals for serious and rare adverse events for new and existing vaccines in all settings, including LMICs. Copyright © 2017 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

Facts about Physical Activity

MedlinePlus

... Physical Activity Overweight & Obesity Healthy Weight Breastfeeding Micronutrient Malnutrition State and Local Programs Facts about Physical Activity ... Physical Activity Overweight & Obesity Healthy Weight Breastfeeding Micronutrient Malnutrition State and Local Programs File Formats Help: How ...

Fact Sheet on the History of the Resource Conservation and Recovery Act (RCRA) Corrective Action Program

EPA Pesticide Factsheets

This fact sheet provides an overview of the main events that have shaped the current RCRA Corrective Action Program. It also provides a brief history of the statutory authorities, regulations, and policy that form the framework for the program.

Methamphetamine Lab Incidents, 2004-2014

MedlinePlus

... OPERATIONS Diversion Control Programs Most Wanted Fugitives Training Intelligence Submit a Tip DRUG INFO Drug Fact Sheets ... Operations Diversion Control Programs Most Wanted Fugitives Training Intelligence Submit a Tip Drug Info Drug Fact Sheets ...

Advanced Technological Education Program Fact Sheet, June 2007

ERIC Educational Resources Information Center

Ritchie, Liesel A.; Gullickson, Arlen R.; Wygant, Barbara

2007-01-01

This fact sheet summarizes data gathered in the 2007 annual survey for the National Science Foundation's (NSF) Advanced Technological Education (ATE) program. This was the eighth annual survey of ATE projects and centers conducted by The Evaluation Center at Western Michigan University. Included here are statistics about the program's grantees and…

Facts on Employee Assistance Programs. Clearinghouse Fact Sheet.

ERIC Educational Resources Information Center

Desmond, Thomas C.

Employee Assistance Programs (EAPs) offer employees confidential, professional assistance for the kinds of personal problems that adversely affect their lives and their jobs. These programs started when acute worker shortages during World War II, coupled with the successes of Alcoholic Anonymous, prompted some companies in the 1940s to develop…

Development of an Ion Mass Spectrometer and Sounding Rocket System for D-Region Cluster-Ion Measurements.

DTIC Science & Technology

1982-01-27

IbM . DI NbOl Preface The preparation of this report was possible only because of the manifold extra contributions of the following: R. Sukys...8217 T T T-T- ITP - Tf ’rr so ൦* ------- 267EUAY17 Pos-ton~~~~ Flgt aa sAliue CLISE-9/260 ELIPS-DesceOTLIt 58 1 S Table 7. Positive Ion Performance

Instrument Landing System Critical Area Studies.

DTIC Science & Technology

1983-11-01

0) 0 ) 6IJU: -OJ **D2! -6. .9.. 09 CL 4- L 0l ’-90 CC C~%01 I-IJ4u: WO N 0142b. -72- L. w- ~ Z2 ’*?-.r X -." 7, ’ Itp - - .- - - -~~2 IV - - dii z...Next there is Ms. Rachel Pollard who ran the model extensively on the IBM 370/44 and produced the calculational results basic to the study. Mr. Mark

Two-phase adiabatic pressure drop experiments and modeling under micro-gravity conditions

NASA Astrophysics Data System (ADS)

Longeot, Matthieu J.; Best, Frederick R.

1995-01-01

Thermal systems for space applications based on two phase flow have several advantages over single phase systems. Two phase thermal energy management and dynamic power conversion systems have the capability of achieving high specific power levels. However, before two phase systems for space applications can be designed effectively, knowledge of the flow behavior in a ``0-g'' acceleration environment is necessary. To meet this need, two phase flow experiments were conducted by the Interphase Transport Phenomena Laboratory Group (ITP) aboard the National Aeronautics and Space Administration's (NASA) KC-135, using R12 as the working fluid. The present work is concerned with modeling of two-phase pressure drop under 0-g conditions, for bubbly and slug flow regimes. The set of data from the ITP group includes 3 bubbly points, 9 bubbly/slug points and 6 slug points. These two phase pressure drop data were collected in 1991 and 1992. A methodology to correct and validate the data was developed to achieve high levels of confidence. A homogeneous model was developed to predict the pressure drop for particular flow conditions. This model, which uses the Blasius Correlation, was found to be accurate for bubbly and bubbly/slug flows, with errors not larger than 28%. For slug flows, however, the errors are greater, attaining values up to 66%.

Capillary zone electrophoresis determination of aniline and pyridine in sewage samples using transient isotachophoresis with a system-induced terminator.

PubMed

Hattori, Takanari; Okamura, Hideo; Asaoka, Satoshi; Fukushi, Keiichi

2017-08-18

Transient isotachophoresis (tITP) with a system-induced terminator (SIT) was developed for capillary zone electrophoresis (CZE) determination of aniline (An + ) and pyridine (Py + ) in sewage samples. After sample injection, a water vial was set at the sample-inlet side. Then voltage was applied to generate a system-induced terminator (H + ). Experiments and simulations revealed a concentration effect by tITP with an SIT: background electrolyte (BGE) - 100mM acetic acid (AcOH) and 50mM NaOH (pH 4.6); detection wavelength - 200nm for An + and 254nm for Py + ; vacuum injection period - 15s (190nL); SIT generation - 10kV applied for 80s with the sample inlet side anode; separation voltage - 20kV with the sample inlet side anode. The limits of detection (LODs, S/N=3) of An + and Py + respectively reached 10 and 42μg/L, with good repeatability (peak area RSDs≤6.9%) and calibration graph linearity (R 2 =0.9997). The proposed method was applied for determination of An + and Py + in sewage samples. Recoveries of An + (0.50mg/L) and Py + (2.0mg/L) in spiked sewage samples were 94-104%. Copyright © 2017 Elsevier B.V. All rights reserved.

Platelet Kinetics in Idiopathic Thrombocytopenic Purpura Patients Treated with Thrombopoietin Receptor Agonists

PubMed Central

Meyer, Oliver; Herzig, Eric; Salama, Abdulgabar

2012-01-01

Aim Thrombopoietin receptor agonists (Tpo RA) increase platelet counts in the majority of chronic autoimmune thrombocytopenia (idiopathic thrombocytopenic purpura; ITP) patients. It is unknown whether this treatment may also improve platelet survival (PS) in these patients. Methods In order to determine platelet survival (PS), autologous platelets were labeled with 111In oxine and retransfused in six patients under treatment with Tpo RA (romiplostim n = 3; eltrombopag n = 3). Results Stable platelet counts of greater than 100 × 103/μl were observed in all 6 patients. Platelet survival was decreased in all cases (mean 2.10 days; range 0.13–3.73 days). No correlation was found between platelet count and PS. Similarly, there was no significant relationship between platelet turnover and platelet count. However, a high platelet turnover, exceeding 25 or three times the norm was observed in 2 patients who presented the lowest PS (0.13 or 0.83 days). Two patients had a moderately shortened PS (1.91 or 2.42 days), and, correspondingly, a moderately increased platelet turnover rate (63,072 or 72,872 platelets/μl/day). Conclusion These results indicate that Tpo RA may not only overcompensate platelet destruction in ITP, but may interfere with other mechanisms, which, in some cases, results in a reduced platelet destruction rate. PMID:22896760

Semiquantitative Nucleic Acid Test with Simultaneous Isotachophoretic Extraction and Amplification.

PubMed

Bender, Andrew T; Borysiak, Mark D; Levenson, Amanda M; Lillis, Lorraine; Boyle, David S; Posner, Jonathan D

2018-06-19

Nucleic acid amplification tests (NAATs) provide high diagnostic accuracy for infectious diseases and quantitative results for monitoring viral infections. The majority of NAATs require complex equipment, cold chain dependent reagents, and skilled technicians to perform the tests. This largely confines NAATs to centralized laboratories and can significantly delay appropriate patient care. Low-cost, point-of-care (POC) NAATs are especially needed in low-resource settings to provide patients with diagnosis and treatment planning in a single visit to improve patient care. In this work, we present a rapid POC NAAT with integrated sample preparation and amplification using electrokinetics and paper substrates. We use simultaneous isotachophoresis (ITP) and recombinase polymerase amplification (RPA) to rapidly extract, amplify, and detect target nucleic acids from serum and whole blood in a paper-based format. We demonstrate simultaneous ITP and RPA can consistently detect 5 copies per reaction in buffer and 10 000 copies per milliliter of human serum with no intermediate user steps. We also show preliminary extraction and amplification of DNA from whole blood samples. Our test is rapid (results in less than 20 min) and made from low-cost materials, indicating its potential for detecting infectious diseases and monitoring viral infections at the POC in low resource settings.

Evidence-Based Programs. Technical Assistance Fact Sheets. Fact Sheet 1

ERIC Educational Resources Information Center

Kyler, Sandee J.; Bumbarger, Brian K.; Greenberg, Mark T.

2005-01-01

The term "evidence-based programs" is becoming quite common in prevention and human service work. However, many still struggle to recognize the importance of evidence-based programs and to understand what qualifies as "evidence-based." The language used may even seem to confound the issue further. The terms evidence-based,…

Criminal investigations and the Superfund program. Fact sheet (Final)

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

Not Available

1990-09-01

The fact sheet, directed toward any one who witnesses fraudulent activity in EPA programs, discusses areas in which fraud and abuse can occur and provides an understanding of the criminal investigation process that results from reports of suspicious activity.

Delta's Key to the Next Generation TOEFL[R] Test: Six Practice Tests for the iBT

ERIC Educational Resources Information Center

Gallagher, Nancy

2012-01-01

Six Practice Tests for the iBT gives students plenty of practice as they prepare for the Internet-based TOEFL (iBT) or the new form of the institutional TOEFL (ITP). This new book/audio set contains a concise description of the TOEFL and the types of questions in each section, as well as six full-length tests that have not been published before.…

The Physical Oceanography of the Northern Baffin Bay-Nares Strait Region.

DTIC Science & Technology

1987-12-01

completion of the cruise, the data were transferred to mass storage cartridges for further processing with the NPS IBM 3033 computer. Editing of spurious and...2()0(;at a depth ot /1’) in o I. it ruonttas t Witt) a ma:-imiitn t itp . t t i( of I 1 0 ,- itlcd of04 l S~to ht TSF o ,o ti is i m n fi, ’I or , o

Food Stamp and School Lunch Programs Alleviate Food Insecurity in Rural America. Fact Sheet

ERIC Educational Resources Information Center

Smith, Kristin; Savage, Sarah

2007-01-01

The Food Stamp and the National School Lunch Programs play a vital role in helping poor, rural Americans obtain a more nutritious diet and alleviate food insecurity and hunger. This fact sheet looks at the extent to which rural America depends on these programs and describes characteristics of beneficiaries of these federal nutrition assistance…

Lunar Reconnaissance Orbiter (LRO) Rapid Thermal Design Development

NASA Technical Reports Server (NTRS)

Baker, Charles; Cottingham, Christine; Garrison, Matthew; Melak, Tony; Peabody, Sharon; Powers, Dan

2009-01-01

The Lunar Reconnaissance Orbiter (LRO) project had a rapid development schedule starting with project conception in spring of 2004, instrument and launch vehicle selection late in 2005 and then launch in early 2009. The lunar thermal environment is one of the harshest in our solar system with the heavy infrared loading of the moon due to low albedo, lack of lunar atmosphere, and low effective regolith conduction. This set of constraints required a thermal design which maximized performance (minimized radiator area and cold control heater power) and minimized thermal hardware build at the orbiter level (blanketing, and heater service). The orbiter design located most of the avionics on an isothermalized heat pipe panel called the IsoThermal Panel (ITP). The ITP was coupled by dual bore heat pipes to an Optical Solar Reflector (OSR) covered heat pipe radiator. By coupling all of the avionics to one system, the hardware was simplified. The seven instruments were mainly heritage instruments which resulted in their desired radiators being located by their heritage design. This minimized instrument redesigns and therefore allowed them to be delivered earlier, though it resulted in a more complex orbiter level blanket and heater service design. Three of the instruments were mounted on a tight pointing M55J optical bench that needed to be covered in heaters to maintain pointing. Two were mounted to spacecraft controlled radiators. One was mounted to the ITP Dual Bores. The last was mounted directly to the bus structure on the moon facing panel. The propulsion system utilized four-20 pound insertion thrusters and eight-5 pound attitude control thrusters (ACS) in addition to 1000 kg of fuel in two large tanks. The propulsion system had a heater cylinder and a heated mounting deck for the insertion thrusters which coupled most of the propulsion design together simplifying the heater design. The High Gain Antenna System (HGAS) and Solar Array System (SAS) used dual axis actuator gimbal systems. HGAS required additional boom heaters to cool the approximately 10 W of RF losses thru the rotary joints and wave guides from the 40 W Ka system. By design this module needed a fair amount of heater, blanketing, and radiator complexity. The SAS system required a separate cable wrap radiator to help cool the Solar Array harness which dissipated 30 W thru the actuators and cable wraps. This module also was complex.

Tobacco industry's elaborate attempts to control a global track and trace system and fundamentally undermine the Illicit Trade Protocol.

PubMed

Gilmore, Anna B; Gallagher, Allen W A; Rowell, Andy

2018-06-13

The Illicit Trade Protocol (ITP) requires a global track and trace (T&T) system to reduce tobacco smuggling. Given the tobacco industry's (TI) historical involvement in tobacco smuggling, it stipulates that T&T 'shall not be performed by or delegated to the tobacco industry'. This paper explores the rationale for & nature of the TI's effors to influence the ITP & its T&T system. Analysis of leaked TI documents and publicly available data; ,investigation of front groups, trademark and patent ownership. Growing & diverse sources of evidence indicate that the TI remains involved in tobacco smuggling and that TI cigarettes account for around two-thirds of the illicit cigarette market. The TI therefore has a vested interest in controlling the global T&T system aimed to curtail this behaviour. To this end, Philip Morris International (PMI) adapted its pack marker system, Codentify, to meet T&T requirements, licensed it for free to its three major competitors who then collectively promoted it to governments using front groups and third parties including companies claiming to be independent despite clear TI links. PMI also sought to suggest Codentify was independent by selling some parts of its intellectual property on Codentify while retaining others, leaving a complex web of shared interests. In Africa, British American Tobacco used payments to obtain data suggesting its smaller competitor companies were evading taxes and secure influence with tax authorities. Regulatory capture has been enhanced by a public relations effort involving TI funding for conferences, training, research, and international police and anti-corruption organisations. Collectively this has created public messaging and a powerful network of organisations supportive of the TI's misleading postion on illicit. Governments should assume the TI seeks to control T&T systems in order to avoid scrutiny and minimise excise tax payments and that any T&T system based on Codentify, on intellectual property currently or previously owned by the TI, or being promoted or implemented by companies with TI links, is incompatible with the ITP and would not serve to reduce illicit trade. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Assessing Coverage of Population-Based and Targeted Fortification Programs with the Use of the Fortification Assessment Coverage Toolkit (FACT): Background, Toolkit Development, and Supplement Overview.

PubMed

Friesen, Valerie M; Aaron, Grant J; Myatt, Mark; Neufeld, Lynnette M

2017-05-01

Food fortification is a widely used approach to increase micronutrient intake in the diet. High coverage is essential for achieving impact. Data on coverage is limited in many countries, and tools to assess coverage of fortification programs have not been standardized. In 2013, the Global Alliance for Improved Nutrition developed the Fortification Assessment Coverage Toolkit (FACT) to carry out coverage assessments in both population-based (i.e., staple foods and/or condiments) and targeted (e.g., infant and young child) fortification programs. The toolkit was designed to generate evidence on program coverage and the use of fortified foods to provide timely and programmatically relevant information for decision making. This supplement presents results from FACT surveys that assessed the coverage of population-based and targeted food fortification programs across 14 countries. It then discusses the policy and program implications of the findings for the potential for impact and program improvement.

Advancing Next-Generation Energy in Indian Country (Fact Sheet)

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

Not Available

This fact provides information on the Strategic Technical Assistance Response Team (START) Program, a U.S. Department of Energy Office of Indian Energy Policy and Programs (DOE-IE) initiative to provide technical expertise to support the development of next-generation energy projects in Indian Country.

Advancing Energy Development in Indian Country (Fact Sheet)

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

Not Available

This fact sheet provides information on the Strategic Technical Assistance Response Team (START) Program, a U.S. Department of Energy Office of Indian Energy Policy and Programs (DOE-IE) initiative to provide technical expertise to support the development of next-generation energy projects in Indian Country.

Enhancing Tribal Energy Security and Clean Energy (Fact Sheet)

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

Not Available

This fact provides information on the Strategic Technical Assistance Response Team (START) Program, a U.S. Department of Energy Office of Indian Energy Policy and Programs (DOE-IE) initiative to provide technical expertise to support the development of next-generation energy projects in Indian Country.

International nuclear fuel cycle fact book. Revision 6

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

Harmon, K.M.; Lakey, L.T.; Leigh, I.W.

1986-01-01

The International Fuel Cycle Fact Book has been compiled in an effort to provide (1) an overview of worldwide nuclear power and fuel cycle programs and (2) current data concerning fuel cycle and waste management facilities, R and D programs and key personnel. Additional information on each country's program is available in the International Source Book: Nuclear Fuel Cycle Research and Development, PNL-2478, Rev. 2.

Fuels planning: science synthesis and integration; social issues fact sheet 01: Developing personal responsibility for fuels reduction: Building a successful program to engage property owners

Treesearch

Rocky Mountain Research Station USDA Forest Service

2004-01-01

In the course of work as a land manager, you will no doubt be involved in developing programs to achieve various objectives, including the improvement of fuels management on private lands. This fact sheet describes six steps that will help you plan and conduct a successful program.

VAKT for Basic Subtraction Facts.

ERIC Educational Resources Information Center

Thornton, Carol A.; Toohey, Margaret A.

Guidelines are presented for modifying basic instruction of subtraction facts for elementary level learning disabled students. A detailed case study is used to illustrate a five-step structured program: (1) find a way to work it out; (2) add to check; (3) learn the partner facts; (4) study families of facts; (5) review and practice. The selection…

SSTAC/ARTS review of the draft Integrated Technology Plan (ITP). Volume 3: Space power and thermal management

NASA Technical Reports Server (NTRS)

1991-01-01

Viewgraphs of briefings from the SSTAC/ARTS review of the draft integrated technology plan on thermal power and thermal management are presented. Topics covered include: space energy conversion research and technology; space photovoltaic energy conversion; chemical energy conversion and storage; thermal energy conversion; power management; thermal management; space nuclear power; high capacity power; surface power and thermal management; space platforms power and thermal management; and project SELENE.

Interprocess Communication Protocols for Computer Networks

DTIC Science & Technology

1975-12-01

this value without maintaining any state information about itp partner CCP. The receiving CCP returns a SYN giving its own ISN, or can reject...34Packet Arrival and Buffer Statistics in a Packet Switching Node," IBM Research Report RZ 594 {.s;Zni02),. September 1973. [Cochi73] B. J. Cochi...rwid 0. P. Karp, "Protocol for a Computer Netuork," IBM Sustem Journa! 12. 1, 1973, pp. 94-105. [ricKen2ie741 A. fl. McKenzie

Intra-Abdominal and Intra-Thoracic Pressures during Lifting and Jumping,

DTIC Science & Technology

1987-03-01

12,15,16,20). The oblique and transverse abdominal muscles, but not the rectus abdominus, have been shown via electromyography (EM0) to be primary...RECIPIENT’S CATALOG NUMBER 4. TITLE (and Subtitle) S. TYPE OF REPORT & PERIOD COVERED Intra- abdominal and intra-thoracic pressures during lifting and...pressure (ITP) and intra- abdominal pressure (lAP) during lifting and jumping, 11 males were monitored as they performed the dead lift (DL), slide row

SSTAC/ARTS review of the draft Integrated Technology Plan (ITP). Volume 3: Space power and thermal management

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

Not Available

Viewgraphs of briefings from the SSTAC/ARTS review of the draft integrated technology plan on thermal power and thermal management are presented. Topics covered include: space energy conversion research and technology; space photovoltaic energy conversion; chemical energy conversion and storage; thermal energy conversion; power management; thermal management; space nuclear power; high capacity power; surface power and thermal management; space platforms power and thermal management; and project SELENE.

Buffer salt effects in off-line coupling of capillary electrophoresis and mass spectrometry.

PubMed

Marák, Jozef; Stanová, Andrea

2014-05-01

In this work, the impact of buffer salts/matrix effects on the signal in direct injection MS with an electrospray interface (DI-ESI-MS) following pITP fractionation of the sample was studied. A range of buffers frequently used in CE analyses (pH 3-10) was prepared containing 10, 50, and 90% v/v of ACN, respectively. The sets of calibration solutions of cetirizine (an antihistaminic drug with an amphiprotic character) within a 0.05-2.0 mg/L concentration range were prepared in different buffers. The greatest enhancements in the MS signal (in terms of change in the slope of the calibration line) were obtained for the beta-alanine buffer (pH 3.5) in positive ionization and for the borate buffer (pH 9.2) in negative ionization, respectively. The procedure was successfully applied to the analysis of buserelin (a peptidic drug). The slope of the calibration line for solutions containing the beta-alanine buffer with 50% of ACN was 4 times higher than for water or urine, respectively. This study clearly demonstrates that the buffer salt/matrix effects in an offline combination of pITP and DI-ESI-MS can also play a positive role, as they can enhance the signal in MS. A similar influence of the above effects can also be presumed in the CE techniques combined on-line with ESI-MS.

Crystallographic and computational study of a network composed of [ZnCl4]2- anions and triply protonated 4'-functionalized terpyridine cations.

PubMed

Granifo, Juan; Suárez, Sebastián; Boubeta, Fernando; Baggio, Ricardo

2017-12-01

We report herein the synthesis, crystallographic analysis and a study of the noncovalent interactions observed in the new 4'-substituted terpyridine-based derivative bis[4'-(isoquinolin-2-ium-4-yl)-2,2':6',2''-terpyridine-1,1''-diium] tris[tetrachloridozincate(II)] monohydrate, (C 24 H 19 N 4 ) 2 [ZnCl 4 ] 3 ·H 2 O or (ITPH 3 ) 2 [ZnCl 4 ] 3 ·H 2 O, where (ITPH 3 ) 3+ is the triply protonated cation derived from 4'-(isoquinolin-4-yl)-2,2':6',2''-terpyridine (ITP) [Granifo et al. (2016). Acta Cryst. C72, 932-938]. The (ITPH 3 ) 3+ cation presents a number of interesting similarities and differences compared with its neutral ITP relative, mainly in the role fulfilled in the packing arrangement by the profuse set of D-H...A [D (donor) = C, N or O; A (acceptor) = O or Cl], π-π and anion...π noncovalent interactions present. We discuss these interactions in two different complementary ways, viz. using a point-to-point approach in the light of Bader's theory of Atoms In Molecules (AIM), analyzing the individual significance of each interaction, and in a more `global' analysis, making use of the Hirshfeld surfaces and the associated enrichment ratio (ER) approach, evaluating the surprisingly large co-operative effect of the superabundant weaker contacts.

Efficacy of combined intravenous immunoglobulins and steroids in children with primary immune thrombocytopenia and persistent bleeding symptoms.

PubMed

Parodi, Emilia; Giordano, Paola; Rivetti, Elisa; Giraudo, Maria Teresa; Ansaldi, Giulia; Davitto, Mirella; Mondino, Anna; Farruggia, Piero; Amendola, Giovanni; Matarese, Sofia M R; Rossi, Francesca; Russo, Giovanna; Ramenghi, Ugo

2014-07-01

The aim of this study was to investigate the effect of the combined administration of intravenous immunoglobulins and steroids as a second-line therapy in 34 children with primary immune thrombocytopenia and persistent, symptomatic bleeding. Combined therapy (intravenous immunoglobulins 0.4 g/kg daily on days 1 and 2, and methylprednisolone 20 mg/kg daily on days 1-3) was administered to 12 patients with newly diagnosed ITP who did not respond to the administration of a single therapy (either intravenous immunoglobulins or steroids) and to 22 children with persistent and chronic disease who required frequent administrations (i.e. more frequently than every 30 days) of either immunoglobulins or steroids (at the same standard dosages) in order to control active bleeding. A response (i.e. platelet count >50×10(9)/L and remission of active bleeding) was observed in 8/12 (67%) patients with newly diagnosed ITP. The clinical presentation of responders and non-responders did not differ apparently. Patients in the chronic/persistent phase of disease had a significantly longer median period of remission from symptoms compared with the previous longest period of remission (p=0.016). The treatment was well tolerated. Our data suggest that the combined approach described is a well-tolerated therapeutic option for children with primary immune thrombocytopenia and persistent bleeding symptoms that can be used in both emergency and/or maintenance settings.

African American Women's Perceptions and Attitudes Regarding Participation in Medical Research: The Mayo Clinic/The Links, Incorporated Partnership

PubMed Central

Brewer, LaPrincess C.; Parker, Monica W.; Balls-Berry, Joyce E.; Halyard, Michele Y.; Pinn, Vivian W.; Radecki Breitkopf, Carmen

2014-01-01

Abstract Objective: To examine perceptions and attitudes toward health-related research participation among professional African American women. Methods: Participants were members of an African American women's service organization, The Links, Incorporated. Data were collected via self-administered questionnaires at The Links, Incorporated 2012 National Assembly. Sociodemographics, prior research experience, intention to participate (ITP), willingness to participate (WTP) in a variety of research studies and attitudes about research participation were measured. Results: A total of 381 surveys were analyzed. A majority of respondents were married (66%), employed (69%), and college educated (96%). Median age was 59; 38% reported prior research participation. Overall, 78% agreed with the statement, “Participation in research will mean better care,” 24% agreed “Participation in research is risky” and 3% agreed “Scientists cannot be trusted.” Fifty-two percent agreed with the statement, “Research conducted in the U.S. is ethical.” Mean ITP in research was 4.9±1.7 on a rating scale of 1 (“definitely no”) to 7 (“definitely yes”). WTP was highest for an interview study and providing a blood sample, and lowest for clinical trial and medical record review. Conclusion: Attitudes toward research participation were generally favorable among professional African American women; many expressed WTP in a variety of research study types. PMID:25046058

The Fact Book: Report for the Florida College System, 2014

ERIC Educational Resources Information Center

Florida Department of Education, 2014

2014-01-01

This 2014 fact book for the Florida College System is divided into the following categories: (1) Student Information, which includes fall, annual, FTE, and program enrollment statistics, as well as credit program completion statistics; (2) Employee Information, which includes statistics regarding employee headcount by occupational activity, and…

The Fact Book: Report for the Florida College System, 2015

ERIC Educational Resources Information Center

Florida Department of Education, 2015

2015-01-01

This 2015 fact book for the Florida College System is divided into the following categories: (1) Student Information, which includes fall, annual, FTE, and program enrollment statistics, as well as credit program completion statistics; (2) Employee Information, which includes statistics regarding employee headcount by occupational activity, and…

The Fact Book: Report for the Florida College System, 2016

ERIC Educational Resources Information Center

Florida Department of Education, 2016

2016-01-01

This 2016 fact book for the Florida College System is divided into the following categories: (1) Student Information, which includes fall, annual, FTE, and program enrollment statistics, as well as credit program completion statistics; (2) Employee Information, which includes statistics regarding employee headcount by occupational activity and…

Advanced Technological Education Program 2008 Survey Fact Sheet

ERIC Educational Resources Information Center

Gullickson, Arlen R.; Wingate, Lori A.

2008-01-01

This fact sheet summarizes data gathered in the 2008 survey of National Science Foundation (NSF) Advanced Technological Education (ATE) grant recipients. Conducted by The Evaluation Center at Western Michigan University, this was the ninth annual survey of ATE projects and centers. Included here are statistics about the program's grantees and…

Spina Bifida: General Information. Fact Sheet Number 12 = La Espina Bifida: Informacion General. Fact Sheet Number 12.

ERIC Educational Resources Information Center

National Information Center for Children and Youth with Disabilities, Washington, DC.

This fact sheet offers definitions of the three types of spina bifida, outlines their incidence, describes characteristics of individuals with spina bifida, and reviews educational implications. The fact sheet emphasizes that school programs should be flexible to accommodate these students' special needs and frequent absences, that children with…

Synthesis of chemically-modified single-walled carbon nanotubes by counter-current ammonia gas injection into the induction thermal plasma process

NASA Astrophysics Data System (ADS)

Shahverdi, Ali

Pristine single-walled carbon nanotubes (SWCNTs) are poorly dispersible and insoluble in many solvents and need to be chemically modified prior to their use in many applications. This work is focused on the investigation of the synthesis of chemically modified SWCNTs material through an in situ approach. The main objectives of the presented research are: 1) to explore the in situ chemical process during the synthesis of SWCNT and 2) to closely examine the effect of a reactive environment on SWCNTs. Effects of the catalyst type and content on the SWCNTs final product, synthesized by induction thermal plasma (ITP), were studied to replace toxic cobalt (Co) in the feedstock. In this regard, three different catalyst mixtures (i.e. Ni-Y2O3, Ni-Co-Y2O3, and Ni-Mo-Y2O3) were used. Experimental results showed that the catalyst type affects the quality of the SWCNT final product. Similar quality SWCNTs can be produced when the same amount of Co was replaced by Ni. Moreover, the results observed in this experimental work were further explained by thermodynamic calculation results. Thermogravimetry (TG) was used throughout the work to characterize the SWCNTs product. TG was firstly standardized by studying the effects of three main instrumental parameters (temperature ramp, TR, initial mass of the sample, IM, and gas flow rate, FR) on the Tonset and full-width half maximum (FWHM) obtained from TG and derivative TG graphs of carbon black, respectively. Therefore, a two-level factorial statistical design was performed. The statistical analysis showed that the effect of TR, IM, and to a lower extent, FR, is significant on FWHM and insignificant on Tonset. A methodology was then developed based upon the SWCNTs synthesis using the ITP system, through an in situ chemistry approach. Ammonia (NH3) was selected and counter-currently injected into the ITP reactor at three different flow rates and by four different nozzle designs. Numerical simulation indicated a better mixing of NH3 in the ITP reactor when a certain nozzle was used. The experimental results showed the increase of D-band intensity in the Raman spectra of SWCNT samples upon the NH3 injection. NH3 could increase the nitrogen content of the SWCNTs final product up to 10 times. The SWCNTs sample treated with 15 vol% NH3 showed an enhanced dispersibility in Dimethylformamide and Isopropanol. Onion-like and planar carbon nanostructures were also observed. Complementary characterization on the SWCNT samples treated by 15 vol% NH3 indicated the surface modification of nanotubes. Metallic tubes showed a higher reactivity with NH3 than semiconducting ones. The model including the reactor thermo-flow field and NH3 thermal decomposition kinetics suggested a two-step SWCNT surface modification in which nanotubes firstly react with H and NH2 intermediates and later, NH3 chemisorbs on the nanotubes. The model also suggested that the intermediate species, like NNH and N2H2, play a role primarily in driving the NH3 decomposition rather than the chemical modification of SWCNTs. Keywords: Single-walled carbon nanotube, Induction thermal plasma, Thermogravimetry, Kinetic, Computational fluid dynamic, Thermodynamic, modification, Functionalization

Final Technical Report

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

Miller, Robert A.

2007-04-18

From September 1, 2002, to November 30, 2006, the Industrial Assessment Center (IAC) at the University of Illinois at Chicago (UIC) conducted over 120 industrial assessments across 19 different industry types in five different states. In the 1,000+ assessment recommendations written during the award, the UIC-IAC has written recommendations that, if implemented will save several millions of kilowatt-hours of electricity and several million British thermal units of natural gas annually. Additionally, the UIC-IAC has achieved an overall implementation rate in excess of 50%. During the overall span of the award period, the UIC-IAC has trained over 50 students, nearly 25%more » of which have remained in the energy field in some way after graduating from the IAC program. UIC-IAC students have received over $23,000 in scholarships in the last two years alone. During the course of the award, the UIC-IAC has made it a priority to incorporate ITP tools and technologies whenever possible. The ITP Best Practices tools have been used on several assessments and introduced to clients. DOE technologies are constantly compared against assessment clients to determine what technologies have reached the stage where they can effectively be introduced into industrial operations. The UIC-IAC has been involved in several projects for the Department of Energy (DOE), including energy assessments of Department of Defense bases and industrial facilities, the Plant Energy Profiler (PEP) tool assessment, and expanding the range of assessments to include large- energy users. Additionally, the UIC-IAC has forged a close relationship with the Midwest CHP Application Center, working to incorporate combined heat and power (CHP) and distributed generation (DG) technologies into industrial plants. The most recent project is the Save Energy Now (SEN) six- and 12-month follow-up surveys being conducted by UIC-IAC students. The SEN surveys are an effort for the DOE to determine the implementation rate of energy efficiency measures identified by Qualified System (QS) specialists throughout the nation. The UIC-IAC has also written several papers highlighting its work in the arena of energy efficiency. Currently, several UIC-IAC students have submitted a paper to the American Council for an Energy-Efficient Economy (ACEEE). This paper has been accepted by ACEEE and will be presented later in 2007.« less

An analysis of successful commercialization of federally funded R&D energy technologies

NASA Astrophysics Data System (ADS)

Asuquo, Gibson Esang

Several studies indicate that commercialization of federally funded R&D technologies to private sector remains low. In an extension of research demonstrating relative effectiveness of various technology-transfer mechanisms used by the Department of Energy (DOE) in transferring federally funded R&D technologies, this study quantitatively analyzed 52 Industrial Technology Program (ITP) funded R&D technologies, from 1993 through 2006, to understand commercialization success of DOE's funded R&D technologies, based on the correlative significance between independent variables (R&D durations and levels of funding) and dependent variable (technology commercialization output). No statistically significant linear relationship was found between the studied variables. The R2 (the coefficient of multiple determination) value indicates that only three percent (0.03) of the change in the output of commercialized technologies can be explained by the change in the two independent variables. The results of this study have led to an important conclusion that the research, development, and deployment (RD&D) of federally funded energy technologies is complex and a non-linear process. The problem requires a consideration of other factors and a research design that can accommodate the complexity involved. However, as determined by this study, the ITP technology commercialization output (success rate) of 22% is nearly two times as high as the 14% Booz-Allen estimate for the rest of U.S. industry. A quantitative research (such as this study) that attempts to understand the relative significance of correlational relationship between R&D variables appears to offer insufficient explanations as to why the federal government is not getting high technology commercialization output from its dollar investments in R&D. Some qualitative research approaches could move this important research to the next level in the future. Further research in this area should focus on causal effects between R&D variables. The study should attempt to identify the effect that could be caused by an early involvement of angel investors, venture capitalists, and end-users of technologies during RD&D. Successful commercialization of energy technologies requires targeting the most promising innovations that may be jointly supported by public and private sector. A few suggestions on how to improve commercialization of federally funded R&D are outlined in Section 10.3 of this study.

Training Extract AFSC 51XX Computer Systems Officer AFPT 90-51X-468.

DTIC Science & Technology

1983-06-01

AUTHOIZATICN TABLES .5! S.S 9.9 2.9 .0 iBM CONDUCT MOBILITY TRAINING ,4 T.$ .0 5.? 10.0 O 20V EVALUATE STUDENT PROUPEGS .5 .7 6.1 5.7 20.0 223 SELECT... ITP TEST PUOCEOURS. PLA&S OR CRITERIA .65 5.1 7.1 1.1 5. 8.8 7.1 13.2 7.7 P 869 APR o1T OP DISAPPROVE CONFIURBTION MANAGEMENT PLANS ICMP) .6s 5.6 9.6

Six Month Oral Toxicity Study of WR238605 Succinate in Rats. Volume 1

DTIC Science & Technology

1996-02-02

expressed on the basis of mg base/kg/day. Statistical analyses was performed on an IBM • compatible computer using the commercially available LabCat... iTP (F) tA/G *BUN tTBA(M/F?) Hematology1 NE *RBC(F) iHCT(F) *HGB(F) tMETHGB *PLT(M) i RBC...1 A-2 Part 1: Identity, Purity and Stability of Neat WR238605 Succinate 0bjttaTO IBM ! The objective of this study was to confirm the identity and

Operations Research Techniques for Human Factors Engineers

DTIC Science & Technology

1985-06-01

mathematical than Raiffa’s explanations. b) Raiffa, Howard. Decision Analisis : Introductory Lectutres on Choiceg~~a hdY9ETny a--s- s- se ia fly, 1968. A...response criterion (8)- d) Pastore , R.E., and Scheirer, C.J. "Signal Detection Theory: Considerations for General Application " itPs Nholo_ cal Bulletin...Relatioship: . N9--1: Joi Vonn rey and Sons, Tr-rppnT35 p -TT. 26. Rouse, William B. System Enin eerin? Models of Human-Machine Interaction. New Y E

Advancing Next-Generation Energy in Indian Country (Fact Sheet)

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

Not Available

2012-08-01

This fact sheet provides information on Tribes in the lower 48 states selected to receive assistance from the Strategic Technical Assistance Response Team (START) Program, a U.S. Department of Energy Office of Indian Energy Policy and Programs (DOE-IE) initiative to provide technical expertise to support the development of next-generation energy projects in Indian Country.

Advancing Next-Generation Energy in Indian Country (Fact Sheet)

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

Not Available

2012-08-01

This fact sheet provides information on the Alaska Native governments selected to receive assistance from the Strategic Technical Assistance Response Team (START) Program, a U.S. Department of Energy Office of Indian Energy Policy and Programs (DOE-IE) initiative to provide technical expertise to support the development of next-generation energy projects in Indian Country.

VTAE Facts, February 1994. Wisconsin Board of Vocational, Technical, and Adult Education.

ERIC Educational Resources Information Center

Wisconsin State Board of Vocational, Technical, and Adult Education, Madison.

Compiled by the Wisconsin Board of Vocational, Technical, and Adult Education (VTAE), this fact book presents information on enrollments, financing, programs, and staffing in the state's VTAE programs from 1983 to 1993. Enrollment data is presented in three tables: 1983-93 VTAE headcount enrollment by aid category; 1983-93 full-time equivalent…

Asheville, North Carolina: Reducing Electricity Demand through Building Programs & Policies (City Energy: From Data to Decisions)

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

Office of Strategic Programs, Strategic Priorities and Impact Analysis Team

This fact sheet "Asheville, North Carolina: Reducing Electricity Demand through Building Programs & Policies" explains how the City of Asheville used data from the U.S. Department of Energy's Cities Leading through Energy Analysis and Planning (Cities-LEAP) and the State and Local Energy Data (SLED) programs to inform its city energy planning. It is one of ten fact sheets in the "City Energy: From Data to Decisions" series.

Fertility preservation treatment for young women with autoimmune diseases facing treatment with gonadotoxic agents.

PubMed

Elizur, S E; Chian, R C; Pineau, C A; Son, W Y; Holzer, H E G; Huang, J Y J; Gidoni, Y; Levin, D; Demirtas, E; Tan, S L

2008-10-01

To describe a case series of seven women with SLE and other systemic autoimmune rheumatic diseases (SARDs) who required cyclophosphamide therapy and underwent fertility preservation treatments. Of the seven patients reported here, five women had SLE with nephritis, the sixth had immune thrombocytopenia purpura (ITP) and the seventh had microscopic polyangiitis (MPA) with renal involvement. All women were nulliparous and younger than 35 yrs. Patients with SLE underwent in vitro maturation (IVM) of immature oocytes aspirated during a natural menstrual cycle followed by vitrification of the matured oocytes if a male partner was not available, or vitrification of embryos if one was available. The patient with ITP and the patient with MPA underwent gonadotropin ovarian stimulation followed by oocyte or embryo vitrification. All women completed fertility preservation treatment successfully and mature oocytes or embryos (36 and 13, respectively) were vitrified. No complications were associated with this treatment and cytotoxic therapy was initiated as scheduled in all cases. Oocyte or embryo cryopreservation should be considered for fertility preservation in young women with SARDs who face imminent gonadotoxic treatment. In patients, where gonadotropin ovarian stimulation is deemed unsafe, IVM of immature oocytes, aspirated during a natural menstrual cycle, followed by vitrification or fertilization of the mature oocytes, seems to be safe and feasible. For patients in whom hormonal ovarian stimulation is not contraindicated, this method may be considered depending on the urgency to start cytotoxic therapy.

Efficacy of combined intravenous immunoglobulins and steroids in children with primary immune thrombocytopenia and persistent bleeding symptoms

PubMed Central

Parodi, Emilia; Giordano, Paola; Rivetti, Elisa; Giraudo, Maria Teresa; Ansaldi, Giulia; Davitto, Mirella; Mondino, Anna; Farruggia, Piero; Amendola, Giovanni; Matarese, Sofia M.R.; Rossi, Francesca; Russo, Giovanna; Ramenghi, Ugo

2014-01-01

Background The aim of this study was to investigate the effect of the combined administration of intravenous immunoglobulins and steroids as a second-line therapy in 34 children with primary immune thrombocytopenia and persistent, symptomatic bleeding. Materials and methods Combined therapy (intravenous immunoglobulins 0.4 g/kg daily on days 1 and 2, and methylprednisolone 20 mg/kg daily on days 1–3) was administered to 12 patients with newly diagnosed ITP who did not respond to the administration of a single therapy (either intravenous immunoglobulins or steroids) and to 22 children with persistent and chronic disease who required frequent administrations (i.e. more frequently than every 30 days) of either immunoglobulins or steroids (at the same standard dosages) in order to control active bleeding. Results A response (i.e. platelet count >50×109/L and remission of active bleeding) was observed in 8/12 (67%) patients with newly diagnosed ITP. The clinical presentation of responders and non-responders did not differ apparently. Patients in the chronic/persistent phase of disease had a significantly longer median period of remission from symptoms compared with the previous longest period of remission (p=0.016). The treatment was well tolerated. Discussion Our data suggest that the combined approach described is a well-tolerated therapeutic option for children with primary immune thrombocytopenia and persistent bleeding symptoms that can be used in both emergency and/or maintenance settings. PMID:24887226

Fourth-derivative synchronous spectrofluorimetry and HPLC with fluorescence detection as two analytical techniques for the simultaneous determination of itopride and domperidone.

PubMed

Ibrahim, Fawzia; Nasr, Jenny Jeehan

2016-02-01

Two simple, rapid and sensitive methods, namely, fourth-derivative synchronous spectrofluorimetry (method I) and HPLC with fluorescence detection (method II) were developed for the simultaneous analysis of a binary mixture of itopride HCl (ITP) and domperidone (DOM) without prior separation. The first method was based on measuring the fourth derivative of the synchronous fluorescence spectra of the two drugs at Δλ = 40 nm in methanol. The different experimental parameters affecting the synchronous fluorescence of the studied drugs were carefully optimized. Chromatographic separation was performed in < 6.0 min using a RP C18 column (250 mm × 4.6 mm i.d., 5 µm particle size) with fluorescence detection at 344 nm after excitation at 285 nm. A mobile phase composed of a mixture of 0.02 M phosphate buffer with acetonitrile in a ratio of 55 : 45, pH 4.5, was used at a flow rate of 1 mL/min. Linearity ranges were found to be 0.1-2 µg/mL for ITP in both methods, whereas those for DOM were found to be 0.08-2 and 0.05-1.5 µg/mL in methods I and II, respectively. The proposed methods were successfully applied for the determination of the studied drugs in synthetic mixtures and laboratory-prepared tablets. Copyright © 2015 John Wiley & Sons, Ltd.

School to Work Fact Sheets: Making School to Work Opportunities Happen for Youth with Disabilities.

ERIC Educational Resources Information Center

Horne, Richard L.; Thuli, Kelli J.

These six fact sheets are designed to communicate strategies for serving all youth, especially youth with disabilities, in school to work programs: (1) "Overview of the School-to-Work Opportunities Act" briefly describes this 1994 federal law and the three components of school-to-work programs: school-based learning, work-based learning,…

Improving Mastery of Basic Mathematics Facts in Elementary School through Various Learning Strategies.

ERIC Educational Resources Information Center

Haught, Laurie; Kunce, Christine; Pratt, Phyllis; Werneske, Roberta; Zemel, Susan

This report describes the intervention programs used to improve student proficiency in learning, recalling, and retaining basic mathematics facts. The targeted population consisted of first, second, third, and fifth grades in four suburban midwestern schools. The problems of recalling basic mathematics facts is documented through teacher surveys,…

Financing Home Energy and Renewable Energy Improvements with FHA PowerSaver Loans (Fact Sheet)

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

Not Available

2014-07-01

This fact sheet is a revision to the PowerSaver Loan Benefits fact sheet from April 2014. It describes how the U.S. Department of Housing and Urban Development (HUD) PowerSaver Loan Program offers borrowers low-cost FHA-insured loans to make energy-saving improvements to their homes.

5 CFR 890.1039 - Cases where additional fact-finding is required.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Suspension § 890.1039 Cases where additional fact-finding is...

04/02/2013 Fact Sheet

EPA Pesticide Factsheets

Fact sheet describing a proposal to amend the Greenhouse Gas Reporting Program (GHGRP), including technical amendments, amendments related to global warming potentials (GWPs), and confidentiality determinations for new or revised data elements.

Litter Control Achievement - Ohio 4-H Club Score Sheet [and] Activity Guides 1 through 7. 4-H Pilot Program 918.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Cooperative Extension Service.

Seven activity guides, evaluation sheet, and club scoresheet have been prepared for Ohio 4-H clubs' litter education program. Topics of the seven activity guides include: (1) general guidelines and types of activities; (2) little known facts about waste/litter; (3) guidelines for a walking tour; (4) fact sheet (questionnaire) related to garbage;…

What Works for Early Language and Literacy Development: Lessons from Experimental Evaluations of Programs and Intervention Strategies. Fact Sheet. Publication #2011-18

ERIC Educational Resources Information Center

Chrisler, Alison; Ling, Thomson

2011-01-01

Given the importance of the early childhood period as a time when the foundation is laid for later language and literacy, it is important to determine what activities and experiences lead to positive language and literacy outcomes in early childhood. This Fact Sheet reviews fifteen experimentally-evaluated programs and intervention strategies that…

Nairobi Forward-looking Strategies for the Advancement of Women: Issues and the Canadian Situation. Fact Sheets--1992 Update.

ERIC Educational Resources Information Center

Status of Women Canada, Ottawa (Ontario).

The 1992 edition of the fact sheets provides information on new and revised Canadian government programs and policies about the implementation of the Nairobi Forward-looking Strategies for the Advancement of Women program that were adopted at the United Nations World Conference on Women in Kenya in 1985. This edition continues to address the…

Interferometric Determinations of Asteroid Diameters

DTIC Science & Technology

1979-01-01

shapes. In pi ifleiple. leICccol)Cs of 4-. meter diaritter nott limited by seeing could obtain amigimlar tesi )IutiOn of 0.02 aicsec. tran~slatinig into...ran 12S. 11. WORI) EN pi’.~ ~ct htsfonIK1itP&. isae n a t buarcscc in V~c~tciL (A) ( Oritini. a rtzmilvett -cupcfgiat slt. (It) y oii- a puinl-3oIrcc...designed by ILynds flynds ai ai IN.6 llrcckintigel -TELE59M GUIDE EAOJCVOCe DETECTO *-gZ 3 iranr iri\\.nltd iifeOWMAtOR. AM" __ -=---- ----- -- ~ MAU

Dredging and Water Quality Problems in the Great Lakes. Volume 2. Appendices A1 to A19. Sampling Surveys with Separate Reports

DTIC Science & Technology

1969-01-01

Ii necessary and Identity by block number) Dredging Water Quality Water Pollution M0 AUOTR ACT e-ausamtoj m wesem. et itp omea d Identtfy by block...nmuibeA) The present report presents the results of a study conducted by the Corps Engineers with cooperation of the Federal Water Pollution Control...areas of the Great Lakes, as well as to develop the most practical methods for management of pollution problems that may be identified as resulting

A Compilation of the Pressures Measured on a Wing and Aileron with Various Amounts of Sweep in the Langley 8-Foot High-Speed Tunnel

DTIC Science & Technology

1948-04-13

jn .»47 in 3.J -. ITP -.•ŝ -,6V -.’#1 -.i*"" 4S 6.0 .140 .192 .147 .190 .1*9 1.3 10.0 -.W*1 -.49 -,«1 -.691 ..• 48 :••. .000 .001 -.007 -.009 —001...Committee for Aeronautics, Washington, D. TRANSLATION: COUNTRY U.S. LANGUAGE |TOSG’N.CUS: Eng. SJOASS. Confd’l DATE Apr𔃻)8 PAGES | IBM . 87

Naval Research Logistics Quarterly. Volume 28. Number 2,

DTIC Science & Technology

1981-06-01

Milwaukee Arnoldo Hax, Massachusetts Institute of Technology James G. Taylor, Naval Postgraduate School Alan J. Hoffman, IBM Corporation Harvey M. Wagner...geieral distributiiins /t). If /-I itself i,, if’ phase Itpe with representation (Pr .R f then f14) .1 = exp Ux )4r cxp IRA ) R (A it X ’rI exp l/t) c...23. n = 2 and m = I1, n = 4 in respective CPI times of 23.26 sec and 10.28 sec on IBM 360/65. Kuenne and Soland’s 191 largest reported problem was

Calculation of Multiple Burst Interactions for Six Simultaneous Explosions of 120 Ton ANFO Charges

DTIC Science & Technology

1979-12-15

aWh (poll kilo PAR41 (kPA) f6.N9 7%7 pound-muAls ( ibm avoitdlupoit) lilngrom (hIt) 6I35 924 X K2 -1 pound-mnuq.(onil (moment ul Inertia) ltill’ m...0.13 TIr1I FROM Der -~ i.41 fOLL from array contter.I 26 5 CHARES - t0 rnjS CqCH ILcao ~HZ L0 s "ൌ. 36 120 REIAXILC- 3 itP WAVE~ 4 8-j - i0jAU 0 M

5 CFR 890.1026 - Procedures if a fact-finding proceeding is not required.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1026 Procedures if a fact...

5 CFR 890.1037 - Cases where additional fact-finding is not required.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Suspension § 890.1037 Cases where additional fact-finding is...

Energy-Saving Opportunities for Manufacturing Companies, International Fact Sheet (Spanish)

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

Not Available

This English/Spanish fact sheet describes the Industrial Technologies Program Save Energy Now model and provides information on tools and resources to help manufacturing facilities reduce industrial energy intensity.

The NASA Scientific and Technical Information Program: Prologue to the Future

NASA Technical Reports Server (NTRS)

1991-01-01

The NASA STI Program offers researchers an infrastructure of people and systems that facilitates access to STI; worldwide. The Program is also NASA's institutional mechanism for disseminating the results of its research and developing activities. Through discussions in 1991, the STI Program formulated its Strategic Plan. The plan gives the Program a renewed sense of direction by focusing on future opportunities, customer requirements and Program goals, along with the changes needed to achieve those goals. The Program provides users access to a massive flow of STI which, in fact, represents the largest collection of aeronautical and space science information in the world. The STI Program products and services are outlined, along with the NASA centers, international operations, and the fact that total quality management drives NASA wide program developments. As is detailed, the NASA STI Program is using its resources as effectively as possible to meet the missing needs of NASA.

Massive neutron stars and Λ-hypernuclei in relativistic mean field models

NASA Astrophysics Data System (ADS)

Sun, Ting-Ting; Xia, Cheng-Jun; Zhang, Shi-Sheng; Smith, M. S.

2018-02-01

Based on relativistic mean field (RMF) models, we study finite Λ-hypernuclei and massive neutron stars. The effective N-N interactions PK1 and TM1 are adopted, while the N-Λ interactions are constrained by reproducing the binding energy of Λ-hyperon at 1s orbit of {}{{Λ }}{}40{Ca}. It is found that the Λ-meson couplings follow a simple relation, indicating a fixed Λ potential well for symmetric nuclear matter at saturation densities, i.e., around {V}{{Λ }}=-29.786 {MeV}. With those interactions, a large mass range of Λ-hypernuclei can be described well. Furthermore, the masses of PSR J1614-2230 and PSR J0348+0432 can be attained adopting the Λ-meson couplings {g}{{σ }{{Λ }}}/{g}{{σ }N}≳ 0.73, {g}{{ω }{{Λ }}}/{g}{{ω }N}≳ 0.80 for PK1 and {g}{{σ }{{Λ }}}/{g}{{σ }N}≳ 0.81, {g}{{ω }{{Λ }}}/{g}{{ω }N}≳ 0.90 for TM1, respectively. This resolves the hyperon puzzle without introducing any additional degrees of freedom. Supported by National Natural Science Foundation of China (11525524, 11505157, 11375022, 11705163, 11621131001), National Key Basic Research Program of China (2013CB834400), the Physics Research and Development Program of Zhengzhou University (32410017) and the Office of Nuclear Physics in the U.S. Dept. of Energy. The computation for this work was supported by the HPC Cluster of SKLTP/ITP-CAS and the Supercomputing Center, CNIC, of the CAS

Questions and Answers about AFTERSCHOOL CARE: A Sloan Work and Family Research Network Fact Sheet

ERIC Educational Resources Information Center

Sloan Work and Family Research Network, 2008

2008-01-01

The Sloan Work and Family Research Network has prepared Fact Sheets that provide statistical answers to some important questions about work-family and work-life issues. This Fact Sheet includes statistics about Afterschool Care, and answers the following questions about afterschool programs: (1) How does afterschool care help children?; (2) How…

Holiday Suicides: Fact or Myth?

MedlinePlus

... Press Room Social Media Publications Injury Center Holiday Suicides: Fact or Myth? Recommend on Facebook Tweet Share ... Developing and evaluating prevention programs. Learn More About Suicide CDC’s Overview of Suicide CDC’s Strategic Direction for ...

7 CFR 97.2 - Meaning of words.

Code of Federal Regulations, 2014 CFR

2014-01-01

... fact; conclusions with respect to all material issues of fact and law, as well as the reasons or basis... Protection Office. The Plant Variety Protection Office, Science and Technology Programs, AMS, USDA. Official...

7 CFR 97.2 - Meaning of words.

Code of Federal Regulations, 2010 CFR

2010-01-01

... fact; conclusions with respect to all material issues of fact and law, as well as the reasons or basis... Protection Office. The Plant Variety Protection Office, Science and Technology Programs, AMS, USDA. Official...

7 CFR 97.2 - Meaning of words.

Code of Federal Regulations, 2012 CFR

2012-01-01

... fact; conclusions with respect to all material issues of fact and law, as well as the reasons or basis... Protection Office. The Plant Variety Protection Office, Science and Technology Programs, AMS, USDA. Official...

7 CFR 97.2 - Meaning of words.

Code of Federal Regulations, 2011 CFR

2011-01-01

... fact; conclusions with respect to all material issues of fact and law, as well as the reasons or basis... Protection Office. The Plant Variety Protection Office, Science and Technology Programs, AMS, USDA. Official...

7 CFR 97.2 - Meaning of words.

Code of Federal Regulations, 2013 CFR

2013-01-01

... fact; conclusions with respect to all material issues of fact and law, as well as the reasons or basis... Protection Office. The Plant Variety Protection Office, Science and Technology Programs, AMS, USDA. Official...

Advancing a New Era of Energy Delivery in the West (Fact Sheet)

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

Not Available

2014-11-01

This 2-page fact sheet provides a high-level overview of the Western Area Power Administration's Transmission Infrastructure Program, including background, purpose, goals, eligibility criteria, and current projects.

Fact Sheets about the Fourth Unregulated Contaminant Monitoring Rule (UCMR 4)

EPA Pesticide Factsheets

Fact Sheets explaining the program, contaminants for monitoring, water systems applicable, timeframe & monitoring frequency, monitoring locations, critical requirements, data elements and where to find additional information on monitoring data.

Clean Air Markets - Quick Facts and Trends

EPA Pesticide Factsheets

The Quick Facts and Trends module is part of a suite of Clean Air Markets-related tools that are accessible at http://camddataandmaps.epa.gov/gdm/index.cfm. The Quick Facts and Trends module provides charts and graphs depicting national trends in emissions and heat input. The user can view, for example, data pertaining to the top annual and ozone season emitters of a selected pollutant, the number of units and facilities in a particular state, and trends in sulfur dioxide, nitrogen oxide and carbon dioxide emissions.EPA's Clean Air Markets Division (CAMD) includes several market-based regulatory programs designed to improve air quality and ecosystems. The most well-known of these programs are EPA's Acid Rain Program and the NOx Programs, which reduce emissions of sulfur dioxide (SO2) and nitrogen oxides (NOx)-compounds that adversely affect air quality, the environment, and public health. CAMD also plays an integral role in the development and implementation of the Clean Air Interstate Rule (CAIR).

Department of Energy Support of Energy Intensive Manufacturing Related to Refractory Research

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

Hemrick, James Gordon

For many years, the United States Department of Energy (DOE) richly supported refractory related research to enable greater energy efficiency processes in energy intensive manufacturing industries such as iron and steel, glass, aluminum and other non-ferrous metal production, petrochemical, and pulp and paper. Much of this support came through research projects funded by the former DOE Energy Efficiency and Renewable Energy (EERE) Office of Industrial Technologies (OIT) under programs such as Advanced Industrial Materials (AIM), Industrial Materials of the Future (IMF), and the Industrial Technologies Program (ITP). Under such initiatives, work was funded at government national laboratories such as Oakmore » Ridge National Laboratory (ORNL), at universities such as West Virginia University (WVU) and the Missouri University of Science and Technology (MS&T) which was formerly the University of Missouri Rolla, and at private companies engaged in these manufacturing areas once labeled industries of the future by DOE due to their strategic and economic importance to American industry. Examples of such projects are summarized below with information on the scope, funding level, duration, and impact. This is only a sampling of representative efforts funded by the DOE in which ORNL was involved over the period extending from 1996 to 2011. Other efforts were also funded during this time at various other national laboratories, universities and private companies under the various programs mentioned above. Discussion of the projects below was chosen because I was an active participant in them and it is meant to give a sampling of the magnitude and scope of investments made by DOE in refractory related research over this time period.« less

Treating for Two: Medicine and Pregnancy

MedlinePlus

... health condition. Multimedia and Tools Podcasts, videos, infographics, posters, and fact sheets. CDC’s Work CDC’s research program. ... Basics Research Findings by Health Condition Multimedia & Tools Posters and Fact Sheets 3 Things to Discuss with ...

Capillary moving-boundary isotachophoresis with electrospray ionization mass-spectrometric detection and hydrogen ion used as essential terminator: Methodology for sensitive analysis of hydroxyderivatives of s-triazine herbicides in waters.

PubMed

Malá, Zdena; Gebauer, Petr

2017-10-06

Capillary isotachophoresis (ITP) is an electrophoretic technique offering high sensitivity due to permanent stacking of the migrating analytes. Its combination with electrospray-ionization mass-spectrometric (ESI-MS) detection is limited by the narrow spectrum of ESI-compatible components but can be compensated by experienced system architecture. This work describes a methodology for sensitive analysis of hydroxyderivatives of s-triazine herbicides, based on implementation of the concepts of moving-boundary isotachophoresis and of H + as essential terminating component into cationic ITP with ESI-MS detection. Theoretical description of such kind of system is given and equations for zone-related boundary mobilities are derived, resulting in a much more general definition of the effective mobility of the terminating H + zone than used so far. Explicit equations allowing direct calculation for selected simple systems are derived. The presented theory allows prediction of stacking properties of particular systems and easy selection of suitable electrolyte setups. A simple ESI-compatible system composed of acetic acid and ammonium with H + and ammonium as a mixed terminator was selected for the analysis of 2-hydroxyatrazine and 2-hydroxyterbutylazine, degradation products of s-triazine herbicides. The proposed method was tested with direct injection without any sample pretreatment and provided excellent linearity and high sensitivity with limits of detection below 100ng/L (0.5nM). Example analyses of unspiked and spiked drinking and river water are shown. Copyright © 2017 Elsevier B.V. All rights reserved.

What do employers think their role is in ensuring language proficiency of internationally trained pharmacists.

PubMed

Ziaei, Zainab; Hassell, Karen; Schafheutle, Ellen I

2018-04-01

Until 2016, internationally trained pharmacists (ITPs) from the European Economic Area (EEA) did not need to prove sufficient language proficiency to the pharmacy regulator upon registration. Pharmacists themselves have a professional responsibility to ensure they can communicate and work effectively, but some responsibility also rests with employers, yet very little research has explored this. The aim of this study was to explore employer views of the communicative proficiency of ITPs whose first language was not English, their role as employers and potential implications for patient safety. Semi-structured, telephone interviews were conducted with seven community and two hospital employers with experience of employing EEA pharmacists, between May and July 2010. Verbatim interview transcripts were coded and analysed in NVivo using the framework approach. All participants mentioned the importance of having processes in place to assure EEA pharmacists' linguistic competency in the workplace. During recruitment, different strategies were used to assure language competency. Some employers only conducted interviews while others required candidates to pass English language assessments. Participants were most familiar with the International English Language Testing System, which was described as too general and not unique to pharmacy. Other pharmacy-specific tests such as the University of Bath English Language Test and Linguarama English Assessment Test for Pharmacists were alternatives. Currently, there is no one standard procedure in place to check the communicative competency of EEA pharmacists. The findings from this study suggest that there is need to establish a uniform assessment system so all the EEA pharmacists could be tested justly and consistently. © 2017 Royal Pharmaceutical Society.

Koi herpesvirus encodes and expresses a functional interleukin-10.

PubMed

Sunarto, Agus; Liongue, Clifford; McColl, Kenneth A; Adams, Mathew M; Bulach, Dieter; Crane, Mark St J; Schat, Karel A; Slobedman, Barry; Barnes, Andrew C; Ward, Alister C; Walker, Peter J

2012-11-01

Koi herpesvirus (KHV) (species Cyprinid herpesvirus 3) ORF134 was shown to transcribe a spliced transcript encoding a 179-amino-acid (aa) interleukin-10 (IL-10) homolog (khvIL-10) in koi fin (KF-1) cells. Pairwise sequence alignment indicated that the expressed product shares 25% identity with carp IL-10, 22 to 24% identity with mammalian (including primate) IL-10s, and 19.1% identity with European eel herpesvirus IL-10 (ahvIL-10). In phylogenetic analyses, khvIL-10 fell in a divergent position from all host IL-10 sequences, indicating extensive structural divergence following capture from the host. In KHV-infected fish, khvIL-10 transcripts were observed to be highly expressed during the acute and reactivation phases but to be expressed at very low levels during low-temperature-induced persistence. Similarly, KHV early (helicase [Hel] and DNA polymerase [DNAP]) and late (intercapsomeric triplex protein [ITP] and major capsid protein [MCP]) genes were also expressed at high levels during the acute and reactivation phases, but only low-level expression of the ITP gene was detected during the persistent phase. Injection of khvIL-10 mRNA into zebrafish (Danio rerio) embryos increased the number of lysozyme-positive cells to a similar degree as zebrafish IL-10. Downregulation of the IL-10 receptor long chain (IL-10R1) using a specific morpholino abrogated the response to both khvIL-10 and zebrafish IL-10 transcripts, indicating that, despite the structural divergence, khvIL-10 functions via this receptor. This is the first report describing the characteristics of a functional viral IL-10 gene in the Alloherpesviridae.

Energy-Saving Opportunities for Manufacturing Enterprises (International English Fact Sheet)

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

Not Available

This fact sheet provides information about the Industrial Technologies Program Save Energy Now energy audit process, software tools, training, energy management standards, and energy efficient technologies to help U.S. companies identify energy cost savings.

Space and nuclear research and technology

NASA Technical Reports Server (NTRS)

1975-01-01

A fact sheet is presented on the space and nuclear research and technology program consisting of a research and technology base, system studies, system technology programs, entry systems technology, and experimental programs.

Hardware independence checkout software

NASA Technical Reports Server (NTRS)

Cameron, Barry W.; Helbig, H. R.

1990-01-01

ACSI has developed a program utilizing CLIPS to assess compliance with various programming standards. Essentially the program parses C code to extract the names of all function calls. These are asserted as CLIPS facts which also include information about line numbers, source file names, and called functions. Rules have been devised to establish functions called that have not been defined in any of the source parsed. These are compared against lists of standards (represented as facts) using rules that check intersections and/or unions of these. By piping the output into other processes the source is appropriately commented by generating and executing parsed scripts.

Fact Sheet: Risk Management Plan (RMP) Audit Program

EPA Pesticide Factsheets

Risk management programs, which consist of a hazard assessment, a prevention program, and an emergency response program; must be periodically audited to assess whether the plans are adequate or need to be revised to comply with the regulation.

[Development of advanced educational programs, including research programs, for undergraduate students in National Universities: the facts in 2010].

PubMed

Kurosaki, Yuji; Tomioka, Yoshihisa; Santa, Tomofumi; Kitamura, Yoshihisa

2012-01-01

This article summarizes detailed facts obtained from the questionnaire conducted in 2010 at about 14 National Universities on the topic of "Research programs and advanced educational programs for undergraduate students". The contents of the questionnaire included: (1) Research programs based on the coalition of university and hospital and/or community pharmacy, other Graduate Schools, such as School of Medicine etc., and the University Hospital, (2) Educational systems for the achievement of research programs and their research outcomes, (3) Research programs based on pharmacist practices, (4) Ongoing advanced educational programs for undergraduate students, taking advantage of the coalition with Graduate School, School of Medicine (and Dentistry), and University Hospital. Some of the advanced educational programs outlined in this questionnaire will be carried out by our group in the coming years and the educational benefits together with associated problems shall as well be clarified. This approach will be informative for the development of the leader-oriented pharmacist programs for the college of Pharmacy.

International waste management fact book

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

Amaya, J P; LaMarche, M N; Upton, J F

1997-10-01

Many countries around the world are faced with nuclear and environmental management problems similar to those being addressed by the US Department of Energy. The purpose of this Fact Book is to provide the latest information on US and international organizations, programs, activities and key personnel to promote mutual cooperation to solve these problems. Areas addressed include all aspects of closing the commercial and nuclear fuel cycle and managing the wastes and sites from defense-related, nuclear materials production programs.

5 CFR 890.1028 - Conducting a fact-finding proceeding.

Code of Federal Regulations, 2013 CFR

2013-01-01

....1028 Section 890.1028 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1028 Conducting a fact-finding proceeding. (a) Informal...

Fact Sheet: Alternative Low-Sulfur Diesel Fuel Transition Program for Alaska

EPA Pesticide Factsheets

This fact sheet summarizes EPA's final rule modifying the diesel fuel regulations to apply an effective date of 6-1-2010 for 15 ppm sulfur requirements for highway, nonroad, locomotive and marine diesel fuel produced/imported for, distributed

Self Cooling/Heating Devices

NASA Technical Reports Server (NTRS)

1992-01-01

A NASA RTTC assisted International Thermal Packaging (ITP) in the identification of a NASA-developed synthetic polymer that can absorb 1,000 times its weight in water. The desiccant was used in the manufacture of a self-chilling can, a major innovation for packaging food and beverages. The refrigeration device is a small cylinder, fully incorporated into the can. When used in beverage containers, the top of the can is popped, the internal carbonization pressure is relieved, and the self-chilling reaction is induced. Company product line has been expanded to include two related products, and several licensing agreements have been signed.

Naval Outgoing Message Processing, A Study of Message Generation and Message Preparation for Transmission and the Impact of Automation.

DTIC Science & Technology

1979-12-01

AM AM .m Itp 3MM"fvob 3MMopo" INA 7M 3M. St Z is pu~ e posep 3MM 3MMoar INA 3M 3MM St. 3M. Y" M3L-SINA1I 334IopAsoe * w*; INAt e M IM0NA .6.6.36...C or 20 ma current loop Current loop (60V. 60 ma) High level (±80V, 20 ma) INA Yes Yes Yes Same sIBM SELECTRIC Yes INA INA INA INA INA INA INA INA

Space-Variant Processing Using Phase Codes and Fourier-Plane Sampling Techniques,

DTIC Science & Technology

1980-06-01

hologram of Fig. 4-19 is played back. 93 III. I iil|r I Hal l II El l.,flI] I.A l filul Ili tI I1 a111 11 11 IBM ), i I I I ’ion’I I " ol F 110 1i a a0an U...t1vqljI"’i r r r r I PItl; itP r r rl rpp’n Id’Pma 4 t 1- -p Figure 4-28. Computer simulated output when all the impulse responses of Fig. 4-26 are played

The Spatial and Temporal Variability of the Arctic Atmospheric Boundary Layer and Its Effect on Electromagnetic (EM) Propagation.

DTIC Science & Technology

1987-12-01

could be run on the IBM 3033 mainframe at the Naval Postgraduate School. I would also like to thank Lt. Mike Dotson whose thesis provided the...29 pressure levels by using an interactive graphing package, Grafstat, available on the IBM 3033 mainframe at the Naval Postgraduate School. Profiles...Polarstern should probably have been 65 . ¢,- .. ... .. .. -- --- P4. itp so’ W. . Fi.3 5. Cae1 p sbr,1 u,10UC n hpslctosa anh20UC (1) S, 40 m ito ce 2) P, MZ

Facts controllers and HVDC enhance power transmission (A manufacturer`s perspective)

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

Juette, G.; Renz, K.

1995-12-31

Various types of FACTS as well as HVDC have been available for some time. New ones have been developed recently. Their respective benefits are well proven and have been made known. System studies have to be done to make full use of FACTS and HVDC problem solving capabilities. Siemens is offering digital models for correct representation of several FACTS devices and HVDC in widely used time-based simulation study programs. The manufacturers are doing their homework. It is up to the utility industry to make use of it now!